Metronidazole + Ciprofloxacin Pharmacology
Metronidazole + Ciprofloxacin
Metronidazole
Metabolism: Metabolized in liver by oxidation & glucuronide conjugation, Excretion: Excreted in urine.
2.Metallic taste
3.Nausea
4.Vomiting
5.Diarrhoea
6.Headache
7.Looseness of stool.
8.Peripheral neuropathy &CNS effects.
9.Mutagenesis.
10.Radiosensitisation.
11.Transient leucopenia
12.Dry mouth
13.Abdominal distress
14.Dizziness
15.Vertigo
16.Thrombophlebitis at site of injection
17.Ototoxicity
2.Blood dyscrasias
3.CNS disorders
2.Hepatic impairment
3.Alcoholic cirrhosis
4.Use cautiously along with other hepatotoxic drugs & In visual field changes
First trimester:contra indicated
Neonates: Contraindicated
2.Giardiasis
3.Trichomonas vaginitis
4.Pseudo membranous enterocolitis
5.Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis
6.Helicobacter pylori infections
7.Ulcerative gingivitis
Alcohol: A disulfiram-like reaction. Abdominal cramps, nausea, vomiting, headache & flushing.
Disulfiram: Acute psychotic reaction or confusional state.
Phenobarbital & Phenytoin: Increased metabolism of metronidazole resulting in decreased efficacy.
Lithium: Increased lithium levels and toxicity.
Flurouracil: Increased toxicity of flurouracil.
Lab tests: May interfere with chemical analysis for AST,SGOT, ALT, SGPT, LDH, triglycerides and hexokinase glucose. Zero values may occur.
Amoebiasis:400 to 800 mg 8hourly for 5 to 10days depending up on the severity of infection
In severe infections and liver abscess: 1gm as slow I.V. infusion followed by 0.5 gm twice daily till oral therapy is started
Giardiasis:200mg 8hourly for 1week or 2gm/day for 3days or I.V.500mg thrice daily
Trichomonas vaginitis: 400mg 8 hourly for a week or 2gm once daily for a week.
Male partner should be concurrently treated with the drug
Pseudo membranous enterocolitis:800 mg 8hourly
Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis:400 to 800 mg 8hourly
In severe cases: 15mg/kg I.V. infusion for 1hour followed by 7.5mg/kg 4 times daily till oral therapy is substituted
Helicobacter pylori infections:400mg 8hourly along with amoxicillin/clarithromycin and a proton pump inhibitor
Ulcerative gingivitis:200 to 800mg 8hourly
Children
Amoebiasis: 30 to 50mg/kg/day for 5to10 days.
Giardiasis:10 to 15mg/kg/day thrice daily
Children (below 12years): 7.5mg/kg I.V.
Ciprofloxacin
EYE DROPS: It is a fluroquinolone antibacterial having broad spectrum of activity.
2.Vomiting
3.Diarrhoea
4.Abdominal discomfort
5.Restlessness
6.Dizziness
7.Drowsiness
8.Arthralgia
9.Rash
10.Confusion
11.Insomnia
12.Anorexia
13.Bad taste
14.Headache
15.Photosensitivity
2.Renal impairment
3.Epilepsy
4.Dehydration
5.Caution while driving the vehicle or operating machine or involved in any hazardous activities.
NEONATES: contraindicated
2.Respiratory tract infection
3.Bone and joint infections,
4.Infectious diarrhoea
5.Gonorrhoea
6.ENT infections
7.Skin and soft tissue infections
8.Typhoid fever
9.Intra-abdominal infections
10.Prostatitis
11. Sinusitis
12.Chancroid
13.Gynaecological infections
14.Tularemia
Antineoplastic drugs: Decrease serum levels of ciprofloxacin.
Caffeine: Enhanced efficacy of caffeine.
Oral anti-coagulants: Enhanced efficacy of anti-coagulants.
Cyclosporine: Nephrotoxicity increased by ciprofloxacin.
Theophylline: Increased plasma levels of theophylline resulting in toxicity.
NSAIDs: CNS excitation may occur.
Rifampicin: Decreases serum concenteration of ciprofloxacin.
Chloramphenicol: Antagonises effects of ciprofloxacin.
Dose is determined on the basis of severity of the infection, type of infecting organism, age, weight and renal function of the patient.
UTI: 0.5 - 1 g / day in 2 divided doses.
Respiratory tract infection, Bone and joint infections, Infectious diarrhoea, ENT infections, .Skin and soft tissue infections, Enteric fever: 1 - 1.5 g / day in 2 divided doses
Typhoid fever, Intra-abdominal infections, Gynaecological infection: 1 g / day in 2 divided doses
Uncomplicated gonorrhea: 250 mg / day
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