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المحاضرة الخامسة — Transcript · YTtoTranscript

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المحاضرة الخامسة

Lubna Shallah · 6,127 words · 31 min read · EN

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Below is the complete, readable transcript of المحاضرة الخامسة by Lubna Shallah on YouTube. Read the full text, copy any part you need, or generate a transcript for any video with our free tool.

Okay, in the name of God, we pray and send peace upon the Messenger of God, and we say, may God grant us and you a share of answered prayers during these days. Of course, we will start a new chapter lecture, but before I start the new chapter on antimicrobial agents, your colleague says there is a part, meaning by the way, it

might be missed, meaning no one is complete. Also, there is a part related to the topic of the factor affecting absorption, the factors that affect the rate of drug absorption. We talked about the surface area, the nature of the surface on which the drug is absorbed. Of course, when I talk about the surface area, I am talking about the surface area. If there are

layers of tissue, the surface area is larger, so the absorption is greater. When I talk about the blood, the more blood reaches the area, the higher the absorption rate. The relationship is direct. We talked about the solitude of the drug. The faster the drug is absorbed, the higher its absorption rate. By the way, does

this drug affect the stomach lining or not?

This is what I said. I'm only talking about the specifics of medications taken orally. Does the acidity of the stomach affect HCl or not? Some medications are alkaline. What does "alkaline" mean? It means not acidic, but alkaline, like the blood thinners. So, the acidity of

the stomach speeds up absorption because the composition of this medication, aspirin, is an astrobic acid. When it enters the stomach, which has an acidic environment, it's easily absorbed faster. But there are medications like Retin-A. Retin-A is actually prescribed for stomach acidity. For those with stomach ulcers, they are prescribed Rendin, Omeprazole, or Fumiodine. These

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medications are acidic, meaning they are not affected. On the contrary, they reduce stomach acidity, so their absorption will be weaker and slower because of the acidity. The stomach doesn't speed it up, it slows it down, because these medications are also prescribed to reduce the acidity of the substance. We have acetylated diuretics and basic diuretics. Acetylated diuretics are

insoluble and don't dissolve; they are inactive and unaffected by acidic environments. Basic diuretics, on the other hand, don't dissolve at all. So, acetylated diuretics, like aspirin, dissolves in the stomach and in acidic environments, while basic diuretics don't. Therefore, what dissolves in the stomach and in acidic environment has a higher absorption rate, but what doesn't dissolve in stomach acid

has a lower absorption rate. Yes, non-

specific medications that dissolve in fats and penetrate the cell membrane also have high absorption rates. Meanwhile, ionized ions (lipids and non-lipids) don't

penetrate the cell membrane, so their absorption will be lower than that of acetylated diuretics. The concentration of the medication... the higher the concentration, the higher the absorption. Okay, there's something else, ma'am. The higher the concentration, the higher the absorption rate. Okay, yes, go ahead. There's a point, not that in general I want you to know

which medication to take. Yes, so the exam space increased. Right, yes, okay. But you also said the amount doesn't stay in the stomach for long periods. It depends on the medication and what I want. I mean, sometimes we give medications in capsules, meaning they have a wall around them, like these gelatin capsules, and it takes

time for them to dissolve and be absorbed and distributed. I mean, I don't want the effect to be immediate, just an hour or two. I want the effect to last all day. It starts depending. Okay, I'm clear now. So, a lot or not? Yes, no, I want... what do I want in the end? Do I want the effect to be quick or

long-lasting? Okay, so now it's my turn. With ionized or not, it's not put in now. Now, ionized, non-ionized, which is not ionized, this is what diffuses, it's what is very specific to the cell and therefore easily absorbed. But ionized, ionized, it's not easy for it to penetrate the cell membrane, so its absorption and

penetration into cells is fine. Start with the new chapter. As I told you, you'll take the math material, it covers it, and I expect a question about it to come up in the exams. Normally, the question is, is the midterm exam after Eid? The midterm exams are in the middle of June, but after Eid, I'll

start quizzes. I'm with you, God willing. Hey guys, specify the classroom for you. No, the quizzes are in the classroom. Let's finish with all these questions of yours and let's start studying. Please, please. Okay, today the new chapter talked about antimicrobials. Antimicrobial drugs, meaning these drugs work on what? Antimicrobials, antimicrobials, antimicrobials for what? On microbes.

So, a literal translation of antimicrobial drugs is the drugs we give are antimicrobials. For germs in general, whether it's Pseudomonas spp. bacteria, everything you learned in microbiology, bacteria— I started explaining in the introduction—every year we find new types of bacteria that doctors and scientists discover. Scientists and

researchers face a great challenge in finding antibiotics and drugs to treat these new threats. Every day you hear about a new disease in the world, a new virus, a new bacterium. Yes, not the same old bacteria that have been around for ages, no, every day, every year we discover new bacteria, new viruses, and

many germs. Therefore, we as scientists and people in the health sector face a great challenge in finding the appropriate antibiotic for these bacteria that we discover.

When I discover new drugs, our bodies' ability to resist these infections and inflammations increases.

Although we have progress in science, we are in 2026, meaning we are approaching 2030, which the whole world expects to become virtual, where everything will stop seeing each other, everything will become electronic, a virtual world. So, God willing, it will happen. It contains everything, everything is good, God willing. So when I say that the more antibiotics we discover, the more the

body's ability to resist diseases and bacteria increases, but we still need to develop ourselves further because we live in a society in Gaza that is full of epidemics, both recent and severe.

It is known that there are still some medicines and antibiotics whose response is weak and does not respond adequately. On the

other hand, we have medicines that are effective and strong, but their uses are limited. Why? Because if we overuse them, it can lead to poisoning. We face a number of challenges. Either there are no medications suitable for the bacteria and microbes we discover every day, or we have medications and antibiotics, but their use can lead to even more

dangerous situations. Sometimes, many

microbes are resistant to antibiotics. We often

discover antibiotics available at home, but then someone tests a patient's culture and finds an antibiotic that costs $100 per ampoule. Unfortunately for this patient, the bacteria turned out to be resistant to that antibiotic. See how far resistance can go? Because bacteria aren't all the same. There are aerobic bacteria and non-aerobic bacteria. You've already covered that. And the biological and

microbial aspects— all of this shows how much we face challenges with antibiotics. Every year, you hear about conferences held at universities and health ministries just on the topic of antibiotics. Because every time we find a new antibiotic, a new generation of bacteria emerges that resists it. So, if it resists, does that mean the drug... Safia, look for a

medicine that doesn't fight bacteria. This one doesn't resist it. It's much more effective. Okay, so the

development we've seen in modern medicine and pharmaceuticals was dependent on two things or reasons. The first is the

achievement and discovery that the world discovered that many diseases are caused by microorganisms, bacteria and viruses. This is what Pasteur, you learned about him in biology. The second thing that led to development and progress in medicine and pharmaceuticals was the discovery of antibiotics. The first two antibiotics were discovered by Penicillin, who discovered Biflammen in

1929, and the sulfa drugs, a group of sulfa drugs, in 1938. So, these two reasons are why we have seen development in medicine and development in pharmaceuticals. Before that, there weren't these treatments and this level of effectiveness in pharmaceuticals. This is what Domick discovered, and this is what Louis Pasteur, whom you heard about in microbiology.

Okay, now let's get to the topic. Antibacterials, or antimicrobials, we need to talk about our classification. What does classification mean? Classification classifications. Okay, what do you want with that? (I'm done, I sneezed, may God have mercy on you, my daughter.) We have a classification of antibiotics according to the microorganism. We classify them

based on which microorganisms they affect: Gram-positive or Gram-negative. So, I give them to diseases caused by Gram- positive or Gram-negative bacteria. Okay? First, we have two things we need to know: bacteristatic or bacteriostatic. When I say classifying an antibacterial drug or antimicrobial, there are more than one way to classify it. The first way is based on the effect of this antibiotic

on the microorganism. Is the effect bacteriostatic or bacteriostatic? Is there a difference? Yes, there is. When I say bacteriostatic, it means it stops the microbial growth. An organosystem means it prevents the bacteria from multiplying and mutating. It doesn't prevent bacterial multiplication; this is called bacteriostatic. But a bactericidal antimicrobial kills and eliminates the entire organism. That's why

I say no one should study pharmacology without first studying organic chemistry, biology, and microbiology. So, the classification of antibacterial drugs, or antibiotics, or antimicrobials is based on their effect on the microorganism. We call them one of two things: either bacteriostatic or bacteriostatic. A bacteriostatic drug inhibits the growth, multiplication, and development of bacteria; it stops them from multiplying. This is called

bacteriostatic. A bactericidal drug doesn't just prevent multiplication; it completely eliminates the bacteria, killing them entirely. The second classification is based on the prevalence of the microorganism, meaning how widespread the antibiotic is. Some drugs are called broad- spectrum drugs, meaning they have a high prevalence or end the microorganism. An antibiotic eliminates, reduces, or kills many

microorganisms, both Gram-negative and Gram-positive. This is called a broad-spectrum antibiotic, meaning its use is not limited to Gram- negative or Gram-positive bacteria; it works on both. A narrow-spectrum antibiotic has a limited use. What does limited use mean? It means it's a microorganism that can work on a limited or narrow range of bacteria. So, this is the

second classification: based on what? Based on its spectrum, how many bacteria does it eliminate? Does it eliminate only Gram-positive bacteria, Gram-negative bacteria, or both? If it eliminates both, it's a broad- spectrum antibiotic. If it eliminates only one type of bacteria, it's called a narrow-spectrum antibiotic. Okay, so how does this antibiotic penetrate these

bacteria and stop their growth or kill them completely? Some antibiotics, or cell wall inhibitors, completely prevent the formation of the cell wall membrane. This is one type of antibiotic. There's another type that works on... The problem isn't just that it affects its formation and structure, but that it disrupts it. It can penetrate it and start to destroy it. There are some

types of antibiotics that inhibit proteins. These proteins are essential in the cell nucleus, right? Some drugs are antimetabolic agents. I heard, "Souad, where are you?" I don't know what. I don't know where Souad is. Where's Saad, your brother? You started like that. Go ahead, Saad. Antimetabolic agents mean these drugs work on the waste products of the cell resulting

from metabolism or from the breakdown and destruction of the microorganism. Okay, let's go back to this point I explained. Some antibiotics work as antimetabolic agents. What does antimetabolic mean? It means they break down the waste products resulting from the destruction of the microorganism. They break them down and work on them. Some drugs work on

viral replication. Yes.

Okay, go back to your places. Let the professor continue. Okay, so the qualification methods depend on... The second type of affinity is based

on how it works together, either positively or negatively. The third type of affinity is based on which part of the cell it works on. It affects the cell membrane, it works on the cell protein, it works on the cell's metabolism, and finally, it prevents viral replication or reproduction. Let's move to another point:

antimicrobial, anti-infective, or antibiotic. These three terms are distinct.

If I told you in the exam, "This one blocks that one, and this one

blocks that one," it would mean two things.

If you look up the terms in a dictionary and find the technical definitions for antimicrobial, anti-infective, and antibiotic, you'll find they aren't the same, not typical. But I can say this one and that one. Yes, antimicrobial is an antibiotic, an antimicrobial agent. Is it an anti-infective, right or wrong? Yes, what do you want? May

God give it to her. Look at it in the third one because I do n't have it. By God, the third one is in Zag, Zag area, okay, sweeties. Strictly speaking, antibiotic. Now we want to define our words in detail, especially when I say

who understood the sentence. Now, an antibiotic, we actually know what it is: a drug made from a microbe and working on a specific microbe. Now, penicillin, isn't it a fungus? And what is it given for? As an antibiotic for many diseases. Well, the basic principle is that an antibiotic is actually made from a

microbe in pharmaceuticals. Pharmaceutical companies, okay, and it works against a specific microbe. This is regarding antibiotics. Visit the S, okay, and like penicillin, stick to penicillin. I

mean, if we want to adopt this definition, I want to say that the components that actually contain microorganisms or microbes are considered, yes, they are, I mean, sufficient, I mean, sufficient antibiotics, sufficient, which are made from microorganisms of organisms, like the predecessor that discovered them. Dom, these are made in laboratories.

Antibiotics, the precursor group, are not antibiotics, be careful, they are not antibiotics. They are not like penicillin, they are not like gentamicin, they are completely different. The precursor group, meaning on the opposite side, or on the other side,

if we want to look at the definitions, what are they? Agent means any compound, any agent, whether natural or synthetic, that has the ability to kill. So, the talk has become, Doctor, there is a difference in the technical definition between antimicrobial and anti-infective

[laughs] and anti- infective, right? What is the difference? It is made from a microbe, yes, its source is a microbe, a microbe, and it works on the specific microorganism. This is the antibiotic. That's why I did n't consider precursors among the antibiotics. But the antimicrobial and anti-infective are any agent, any compound that

can be natural or synthetic, natural or binary. This compound is like alcohol, like polydine. These are all compounds that have the ability to kill or neutralize. Yes, these are what I call antimicrobials, anti-infections. This is an antibiotic, is that clear or not? Antibiotics like Valicin, Gentamicin, and Lamictal are made primarily from specific microorganisms.

They work on specific microorganisms. But antimicrobials and antiinfectives are agents, meaning compounds. This compound, whether natural or synthetic, has the ability to kill or destroy microorganisms. Clear? Ah, is that clear? Yes, okay. No, it's not considered an antibiotic, but it falls under the category of antiinfectives. Okay, there's a term you'll hear a lot and have come up with in microbiology and sensory analysis: culture. Do you remember? And if it's a culture, it's the

most common type of analysis.

What's it for? Please open the door. Open it, please, sir. Come on, if you want to leave, Mr. Ali. May

God give you strength. May God give you strength, Mr. Alaa. Hello. Who's choking? Come here. Come here. There's a fan here. Come here. Get your mask and come here quickly. Come here. I'm telling you, the fan is not needed. We sit and help, we drink, yes, this culture immunity is more widespread than the

test, meaning it is the most common type of test we do to determine sustainability. What does sustainability mean? I want to see if this medicine is effective against these bacteria or not? We go and do a culture: a blood culture, a culture from the ear, a culture from the affected surgical site. This culture result determines the type of

microorganism, what medications are effective against it, which medications work, which are resistant, which are intermediate, which are reversible, which are active, and which are ineffective. So when the doctor tells you, "I'm on antibiotics," or "I'm a patient on antibiotics. I've had a UTI for a month and I'm taking these antibiotics," well, that

's wrong. The proper thing is to do a culture. This culture will determine exactly what the microorganism is and what it's for. Which microorganism is active, resistant, or intermediate? Does this bacteria need amikacin or rocephin? Based on the results, it's clear. Now, for the sample of the oxytocin, we take a sample of bodily fluids or

serum to the lab. We take a serum sample in a tube. Chemistry, or we take a sample, like a swab, from the auditory canal, or from urine, or from cerebrospinal fluid, and send it to the lab so they can determine exactly what kind of bacteria it is, what it responds to, and what it

resists. This isn't covered in your lectures, but it's mentioned in the lecture. I'll point it out to you. Understand what I'm about to tell you because this is important. This culture we do determines the type of microbe, whether it's Gram-positive or Gram-negative. If it's Gram-positive, which drug will produce a result? I want to see which antibiotic is the culture

result. You're not the one to judge the culture result; the doctor reads it and finds that this patient has been taking Rosofen for a week, but this bacteria is resistant. That's why the patient tells you, " I'm taking the antibiotic for a week for nothing because this bacteria is resistant to the antibiotic." So

what should the doctor do? Stop the Rosofen and give him a sensitive drug. The drug that is sensitive to this bacteria means it will eliminate it.

When the patient says... This bacteria is sensitive to amikacin, meaning it gives me an effect, meaning the patient responds. So if they take amikacin, they will actually improve. But if they take another drug, it is not sensitive, it is resistant to it. I know this is new to you, but you will see this in reality when you look at

the patient's record and read it, or when you are at home with a woman who has a urinary tract infection or a blood infection. See if you have done a culture for her. In the culture, you will find a table, and in the table, you will find the names of antibiotics. Here is a diagram like Table Plus 1, 2, 3,

4. Here is Sensitive, here is Intermediate, and here is Restent. Sensitive means that this drug is effective, that this bacteria can be affected by this drug. Resistant means that this drug reduces the bacteria. Do you understand or not? Thank God, the treatment eats away at the root cause. Every drug is given based on the culture result.

How do we do the culture? We get this disc you saw in the microbiology slides, Dr. Farid's or Dr. Iyad's, the one that looks like a jelly dish. This red jelly dish is the culture where I put a drop—a drop from the ear, or a drop of blood, or urine, or from the wound.

Okay? And we culture it. No, it's not for diabetic patients. Everything depends on the case. We can do it according to the case. It's not necessarily for diabetic patients. I'll tell you

the benefit of the culture in half an hour. It calculates exactly what this microorganism is sensitive to, what drugs it responds to, and what it doesn't respond to. Okay, and what do I gain from this? Yes, we give this drug. Yes, because the bacteria respond. They give me the effect of this drug. If I give it, the bacteria resist.

Okay, and this is what we talked about a little while ago. The quickest thing is that I heard that when a sheikh is taking certain medications, for example, the culture tells us that the person has a certain disease. No, it doesn't tell us that there's something else we call a culture, or rather, a blood

level test. We draw He takes a sample and checks the blood level, the drug level in the blood. Based on the level, he says, "Has it reached toxicity? Has it reached infection? Has it reached tolerance? Do we need to lower the dose or increase the dose?" But the culture I'm talking about, the culture, I need to

take a sample from the human body. I need to take a sample from the wax swabs, or a sample from the throat, or a blood sample, or a sample from infected wounds, or a urine sample, and see what bacteria are in it so I can determine which antibiotics these bacteria are sensitive to and

which antibiotics they are resistant to. That's the whole story. I choose three words [clears throat]. Okay, I'll give them to you. I'll upload the slides for you. Don't worry. Is there a term you have or not? Superinfection.

Yes, infectious disease. Okay, so what does that mean, Doctor? We're facing a challenge, a challenge, because the abundance of antibiotics affects the normal flora. Okay, what is this normal flora? It's a type of bacteria. The beneficial bacteria that are in the intestines, yes, and when I go, I keep giving antibiotics, antibiotics. I mean, I want to say that the side effects of this

thing are that it causes a breakdown of the normal flora. Okay, and when it causes a breakdown of the normal flora, what happens? This patient becomes susceptible to infections and illnesses because the normal flora is part of his immune system in the digestive tract. We do

n't want to translate this literally; we want to say this is the situation: this patient had stomach infections, he had Helicobacter pylori, and we gave him antibiotics for a long time. He took a lot of antibiotics. Now, the excessive antibiotics caused a problem with his normal flora, reducing it. When the normal flora is reduced, he becomes susceptible to

new infections. So, the antibiotics have become a double-edged sword. I give him the antibiotics to eliminate the bacteria and germs in the stomach, but I face the challenge that the longer we give them, the more the normal flora is killed. And when the normal flora is killed, he becomes susceptible and prone to new infections,

especially in the digestive tract. Now that it's clear, it's clear. So, what is the use of antibiotics? Dr., and remember that there's a difference between an anti-infective and an antimicrobial. An antibiotic is a compound agent, a natural or organic compound, or a manufactured one, that works on, kills, eliminates, or breaks down microorganisms. Now I want to talk about the uses of

anti-infectives, but also remember that sometimes the three terms are interchangeable. The antibiotic I'm giving works on microorganisms, right? So, can I say that an antibiotic is antimicrobial? Right? Right? Right? But not every antimicrobial is an antibiotic. Let me repeat: every antibiotic is antimicrobial, yes, but not every antimicrobial is an antibiotic. A third time: every antibiotic is antimicrobial, but

not every antimicrobial is antimicrobial. Thank God. Okay, let's talk about the uses of anti-infectives, antibiotics, or antimicrobials. First use: Prophylactic As a precaution, I'm not sure the patient has any problems yet, but I want to give him a preventative dose of Protect Person Expose Non-Specific Organism. I want to give him this antibiotic because I

expect him to encounter or be exposed to a certain type of organism. So, I want to give him something like what patients do when they go into the operating room. For example, someone who has appendicitis (sorry, appendicitis) – he has appendicitis in his appendix. They took him in for an appendectomy. As a precaution, I

want to give him a dose of antibiotic because they're going to open his abdomen, and the environment isn't sterile. So, I expect him to get an infection. To prevent this infection, I want to give him an antibiotic like Topervent, which is for bacteria. What does this mean?

This patient has the flu; he has a runny nose. What's causing it? What organism is causing it? Is the antibiotic I give to someone with a runny nose for the flu virus? No, no, this isn't an antiviral; this is an antibiotic. Okay, so why do I give it to patients with a cold?

To prevent any secondary bacterial infection that might occur if this patient, who is already sick, is already sick again. The patient in front of us is sick, but this illness isn't caused by bacteria; it could be fungal, or viral. I give him the antibiotic as a preventative measure because this condition weakens his immunity, making it an

easy environment for any new secondary microbe, and he might develop a bacterial infection. So, I'm covering the patient from the beginning. I've explained that. Okay, thank God. Risk of infection in chronic patients, meaning someone with high blood pressure or chronic diabetes. This disease is chronic for them. So, these people are expected to develop infections due to the nature of

the disease itself, and because their immunity will be affected. So, to prevent them from developing infections, I give antibiotics as a preventative measure. A diabetic patient, because of their high blood sugar, is expected to develop many things and many infections. And when we get a small cut, it takes a lot of time. His wound, after a long period,

becomes infected, so I have to cover it with antibiotics as a precaution. So, what we've

been saying is, this patient entered the operating room or was involved in a car accident and came to the intensive care unit, and there was an infection in his wound or something similar. During the invasive procedure, it's expected that there will be microorganisms. So, I want to prevent him from developing a post-operative infection, so we have to cover it

with antibiotics.

Sometimes, we also need to ensure that the intestines are clean and sterile before the operation. I don't want any perforation or rupture to occur during the operation, and I don't want any inflammation in any part of the intestine that could spread throughout the patient's intestines and lead to gangrene. So, from the beginning, I

cover the patient with antibiotics before major surgical procedures. Before the operation, all five of these points apply, even if the patient hasn't yet developed an infection. This is a precautionary measure for diabetic patients. Prophylactic acid is used for procedures, not for those who have a viral infection. The second use is for patients who

already have an infection, an acute infection. For example, someone comes in with tonsillitis, someone with epididymis, someone with a bacterial infection. They already have the infection, they already have the infection, they already

have the microorganism. So here we give them the antibiotic to treat the acute infection. Now, no, no, that's prophylactic acid. I'm talking about an acute infection now. The patient comes in with the infection, so I want to treat the infection, not prevent it. Pay attention to the difference, please. Okay, there are contraindications here, right?

Or are there other ones? There are precautions, there are procedures, right? I've reached this point with you, and this isn't there either. This isn't there for you before the contraindications. I'm going to give you this lecture, don't worry, so listen to what I'm saying. Antibiotic selection involves safety and prevention procedures that must be considered

when choosing an antibiotic. As we mentioned in the lectures in the first chapter, there's something called the drug of choice, which is an alternative medication, and then there's the best choice, right? So, it's the same when I'm choosing an antibiotic for a patient with encephalitis. I tell the doctor, "What's the best thing to take?" Now, you're considering

methazine, but there's no methazine, no Augmentin, no Zineth. There are alternatives. Each category has several medications. The best medication is the drug of choice, which the doctor starts with. If it's unavailable due to the blockade or the war, there are other alternatives. You need to consider these. Will the effect be good, but not the same as the last? It will

give me the desired effect in the end.

What factors should I be aware of when I choose? This patient needs to be given a drug by a doctor. He doesn't want to give him Sofosbuvir, he wants to give him Amikacin. He told me it depends on the identification of the pathogen. What does identification mean? The identity of the pathogen. Okay, how do I know the identity of the

pathogen? May God bless you, bravo to you! From the culture, this needs to determine exactly. Okay, tell me, what is this microorganism? What is it? Is it sensitive or resistant? That's the first point. The second point is, does this drug have the ability to be sensitive or resistant to the pathogen? The third point is, what does spectrum mean? How

widespread is this drug? So that I can say this is the best drug to give for this case, is it scientifically proven that it eliminates pro-spectrum bacteria, or is it, excuse me, pro- spectrum bacteria that eliminates gram-positive and gram- negative bacteria, or is it limited? Of course, if it's pro- spectrum bacteria, then it will be the drug of choice, the

best drug. The sixth point, the fourth point, excuse me, is the dose. The dose is what will determine Is this the best drug, or is the second alternative, Timectogen, better? How long does it take for this drug to have an effect? Does the patient see improvement immediately after the first dose, or does it need a longer period? Of

course, if the effect is better and faster, then it's the one with the shorter duration of action that's best. The advantage comes from the dilution of the bowl. How did they take the medication intravenously? Oh, that's another point. What is the site of infection? Where is the infection located, and how did we administer it to

the patient? If this patient we gave this drug to has spinal cord infections, how will the antibiotic reach the spinal cord? That's a sad story. We need to find a very, very strong antibiotic and give it not just intravenously, but intrathecally, depending on the location of the infection. These factors greatly influence who is the best choice, which

drug is best, and which alternative we can use if this one isn't available. Okay, the second part you have is the contraindications. Anti-info: Contraindications of antibiotics. In cases where we shouldn't use antibiotics, people with allergies or hypersensitivity are the same as those with allergies.

What does this mean? When we give any antibiotic to a patient, the first question is, "Are you allergic to this drug?" There are cases where they don't have an allergy, and cases where they do. Not everyone has an allergy. We said this in one chapter. It's essential that they have an allergy to penicillin. It's like no one has ever taken

penicillin in their life, right? So we need to work on individualization. You have a rectangle in the book labeled "Antibiotics that are contraindicated in pregnancy." These antibiotics are strictly prohibited for pregnant women. Yes, the first one is metronidazole. Flagyl is prohibited for pregnant women, whether it's the first trimester, second trimester, or third trimester,

no matter how far along the pregnancy. I know you're pregnant. What? Yes, Acamol is safe, right? We talked about this in the lecture. Now, Flagyl, which is an intestinal antiseptic, metronidazole, okay, but it's a contraindication. Indications in the pregnancies, especially in the first trimester, look, I'll tell you, in the first trimester, the first three months of pregnancy,

all medications are stopped except for what will pass through this group. The second medication, I'm talking here about the part about antibiotics, I'm talking about all medications. We give her tonics, we give her Vicks, we give her iron, and antibiotics, but in large quantities. But I'm talking about antibiotics that are prohibited for

pregnant women, especially in the first trimester. Flagyl is prohibited, as is chlorphenicol, which is also an antibiotic. Aminoglycosides, which are examples of which are amikacin, gentamicin, sulfonamides, streptomycin, and neomycin, this whole group is prohibited for pregnant women. Tetracyclines are prohibited for pregnant women. Why are they prohibited for pregnant women? Because it's affected

because it affects the fetus inside her, in short. And when I get to each medication at its appropriate time, I'll tell you what this does to the fetus if a pregnant woman takes it. Okay, girls, what lecture do you have? Who's here? When they come, you'll let me out. We have five minutes. Antibiotics. I wrote down

the attendance, right? Yes, I wrote it down. I wrote the date and the name of the track. Antibiotics. No, this is the antibiotics course. It's made up of groups, not one group or one drug. I mean, maybe about seven groups. The first group is the aminoglycoside group, which we'll start with in the

next lecture. Under it will come gentamicin, amikacin, tepromycin, streptomycin, neomycin, and kanamicin. These are all aminoglycosides. Each one differs in uses, contraindications, and side effects, but they all have the same action and mechanism of action. There's another group, the cephalosporins group. Cephalosporins are a group, but there are different generations of them: granulation, sucrase, thrush, and fortification.

Greshen and every generation has its own types, oh wise ones, and they're not scary at all. The third group, which you're pictured, is the penicillin group. Yes, there's natural penicillin, amine penicillin, penicillin-resistant, anti- Pseudomonas, and beta-lactamase. The fourth group is tetracyclines, which have four cyclin rings, and there are three. The fifth group is

chlorphenicol, which pregnant women shouldn't take. The sixth group is macrodil, which includes erythromycin, chlormethin, and azithromycin. The seventh group is carbinem, which is metronidazole. The eighth group is metronidazole (Flagyl), which is also prohibited for pregnant women. The ninth group is sulfa, but we didn't say antibiotic, we said what it is. And the

last group is candamycin or delsin. There are two groups, sorry, 11 and 1. Quininol and glucopeptide. The glucopeptide is vancomycin, and this is a very strong and very expensive antibiotic. Quininol is Cipro and Nagram. They give it in cases of UT, eladexacid. These 17 groups are all 12. Sorry, I got to 17 plus the 12 groups.

All of these are anti-infectives. Yes, some of them are antibiotics, some are antimicrobials, and some are anti-infectives like sulfonamides. Now, we will go through all of these in this chapter, but not in one lecture, long lectures, so it will take a long time. Of course, we will start next time, God willing, with the first group,

aminoglycosides. No, that's not right. I'm a teacher. Happy New Year. Yes, it's a holiday. Regarding the face-to-face meeting, we will talk about it now, but now because I need to turn off the recording of the lecture. Now, the part that we explained today, I hope you will go and listen to it. I will upload it to the class during the day.

I am recording it on Zoom. The girls who attended or who are not at home or who are in Khan Younis, and I will go to them after the holiday, God willing, will listen to the lecture and understand it well. And please prepare any questions for future sessions; we'll discuss them either in person or via

Zoom. That's a separate matter. We'll continue with future lectures, God willing, after Eid. We hope you benefit and contribute, and that we haven't fallen short in any way. We wish you all the best.