Amoxycillin is an extended spectrum aminopenicillin. But it is not active against penicillinase producing organism. Clavulanic acid is a penicillinase inhibitor which initially reversibly and then irreversibly inhibits penicillinase 2-5 except cephalosporinase. So this drug combination has a synergistic action.

Sulphonyl ureas – first generation (tolbutamide, chlorpropamide); second generation – (glibenglamide, glipizide, gliclazide, glimiperide)
Biguanides – metformin
Meglitinides – repaglinide, nateglinide
Thiazolidine diones – rosiglitazone, pioglitazone
Alpha glucosidase inhibitors – acarbose, miglitol
Dipeptidyl peptidase-4 (DPP-4) inhibitors – sitagliptin
Glucagon like peptide (GLP-1) analogue – exenatide

Glibenclamide is an oral hypoglycemic drug belonging to the group sulphonyl ureas. It is a second generation sulphonyl urea. Other sulphonyl ureas include – glipizide, gliclazide and glimiperide.
Mechanism of action
It acts by increasing the release of insulin from the pancreatic beta cells. Glibenclamide acts by binding to sulphonyl urea receptor of the ATP sensitive potassium channel in the pancreatic beta cells. This reduces conductivity of the channel, which causes depolarisation of the pancreatic beta cells, resulting in the opening of voltage sensitive calcium channels. Opening of the channels cause calcium …

It is an antihelminthic drug, a newer congener of mebendazole.  Mechanism of action is same as that of mebendazole. It inhibits glucose uptake into the helminth’s cells and depletes the glycogen storage. This is by binding to the beta-tubulin and preventing its polymerisation. Microtubules within the cells of the helminths disappear. The drugs inconsistently absorbed from the intestine. Absorption can increased by giving along with a fatty meal.
Adverse effects
Mostly GI symptoms, alopecia
Uses
Single dose 400 mg albenazole is given for hook worm, ascarias, enterobius. 400 mg daily for 3 days is …

Metronidazole is a nitro-imidazole drug which has antiprotozoal and anti-anaerobe activity.
Spectrum
Protozoans - Entamoeba histolytic, Giardia lamblia, Trichomonas vaginalis
Bacteria – Camphylobacter jejuni, Helicobacter pylori, Fusobacterium, Bacteriodes fragilis, Spirochaetes, Clostridium perfringens, Clostridium difficile
Mechanism of action
Metronidazole has a nitro group which is converted into nitro radicle by the redox proteins of anaerobes. This acts as an electron acceptor and the availability of electrons to the electron transport chain is reduced. Certain organizms develop resistance to metronidazole by preventing the generation of nitro radicle.
Pharmacokinetics
Metronidazole is completely absorbed from the intestine and very little reaches the …

Methylergometrine produces non-physiological spasmodic contraction of the uterus in moderate to high doses and the uterus does’nt fully relax between the contractions. It also causes contraction of the lower segment of uterus. So the delivery of the fetus can be affected.
It is used after the delivery of the shoulder of the infant to reduce post partum hemorrhage. But it is indicated only in cases which have a higher risk of post partum hemorrhage.

Produces Cushing’s habitus – moon face, supraclavicular hump, trunkal obesity and relatively thin limbs, hirsuitim.
It causes proximal myopathy – shoulder, arms, hip, thigh
Fragility and thinning of skin – causes purple striae, especially on lower abdomen and thigh, easy bruisability and telangectasias
Decreased wound healing
Increased susceptibility to infections – flaring of tuberulosis can occur, predispose to oppurtunistic infections like candidiasis
Can cause posterior subcapsular cataract
Can cause peptic ulcer and silent perforation (two fold increase in risk)
Can cause hyperglycemia and may precipitate diabetes mellitus.
In pregnant females, steroids can cause gestational diabetes mellitus, hypertension and …

Lactulose is a semi-synthetic disaccharide composed of fructose and galactose. It is not absorbed in the intestine. It is broken down into osmotically more active products by the intestinal flora. This causes osmotic diarrhoea.
Hence it is used in the treatment of constipation. 10 gm twice daily is the dosage. It softens stools in one to three days.
Use in hepatic precoma
The products of lactulose degradation decreases the pH of the intestine. This converts the ammonia produced by the intestinal flora into NH4+ ions, thus decreasing the absorption. Hence it is used …

Aminoglycosides are highly ionised molecules and hence they are not absorbed orally.

High potency
Completely absorbed from the intestine with no interference by food
Long plasma half life (T 1/2) of 18 to 24 hours
Least effect on the normal flora of the intestine
Less propensity to cause diarrhoea