Metronidazole + Spiramycin Pharmacology

Metronidazole + Spiramycin

About Metronidazole + Spiramycin
N/A
Mechanism of Action of Metronidazole + Spiramycin
N/A
Pharmacokinets of Metronidazole + Spiramycin
N/A
Onset of Action for Metronidazole + Spiramycin
N/A
Duration of Action for Metronidazole + Spiramycin
N/A
Half Life of Metronidazole + Spiramycin
N/A
Side Effects of Metronidazole + Spiramycin
N/A
Contra-indications of Metronidazole + Spiramycin
N/A
Special Precautions while taking Metronidazole + Spiramycin
N/A
Pregnancy Related Information
Use with caution.
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated
Children Related Information
N/A
Indications for Metronidazole + Spiramycin
1.Dental abscess
2.Cellulites of the jaw
3.Pericoronitis
4.Gingivitis
5.Stomatitis
6.Parotitis
7.Submaxillaritis
8.Prevention of local, post-op infectious complications following dental & oral surgery


Interactions for Metronidazole + Spiramycin
N/A
Typical Dosage for Metronidazole + Spiramycin
Adult: 4-6 tab daily in 2-3 divided doses (Spiramycin 3-4.5 MIU and Metronidazole 500-750 mg)
Children 10 to 15 yrs: 3 tab daily (Spiramycin 2.25 MIU and Metronidazole 375 mg)
Children 6 to 10 yrs: 2 tab daily (Spiramycin 1.5 MIU and Metronidazole 250 mg)
Schedule of Metronidazole + Spiramycin
N/A
Storage Requirements for Metronidazole + Spiramycin
Do not store above 25?C. Keep out of the reach of children.
Effects of Missed Dosage of Metronidazole + Spiramycin
N/A
Effects of Overdose of Metronidazole + Spiramycin
N/A

Metronidazole

About Metronidazole
A nitroimidazole antibiotic, Anti-infective, Antiprotozoal,amebicide.
Mechanism of Action of Metronidazole
Metronidazole is nitro imidazoles which have broad spectrum cidal activity against Protozoa and some anaerobic bacteria. Its selective toxicity to anaerobic microbes involves 1. Drug enters the cell by diffusion, 2. Nitro group of drug is reduced by redox proteins present only in anaerobic organisms to reactive nitro radical which exerts cytotoxic action by damaging DNA and other critical biomolecules. 3. DNA helix destabilization & strand breakage has been observed.
Pharmacokinets of Metronidazole
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver by oxidation & glucuronide conjugation, Excretion: Excreted in urine.
Onset of Action for Metronidazole
1 to 2 days
Duration of Action for Metronidazole
8hours.
Half Life of Metronidazole
8 hours.
Side Effects of Metronidazole
1.Anorexia.
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
Contra-indications of Metronidazole
1.Hypersensitivity to the drug
2.Blood dyscrasias
3.CNS disorders
Special Precautions while taking Metronidazole
1.Renal impairment
2.Hepatic impairment
3.Alcoholic cirrhosis
4.Use cautiously along with other hepatotoxic drugs & In visual field changes
Pregnancy Related Information
Use with caution
First trimester:contra indicated
Old Age Related Information
May be used.
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Neonates: Contraindicated
Indications for Metronidazole
1.Amoebiasis
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
Interactions for Metronidazole
Warfarin & other coumarin anticoagulants: Potentiates the anticoagulant effect resulting in increased prothrombin time.
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.
Typical Dosage for Metronidazole
Adult
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.
Schedule of Metronidazole
H
Storage Requirements for Metronidazole
Store in a well closed container in a cool dark place. Keep out of the reach of children.
Effects of Missed Dosage of Metronidazole
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Metronidazole
Treatment is supportive & symptomatic. Drug is removed by induced emesis, gastric lavage, and administration of activated charcoal & use of cathartics. For controlling seizures diazepam & phenytoin may be used.

Spiramycin

About Spiramycin
Macrolide Antibiotic, Antibacterial (systemic,antiprotozoal,In toxoplasmosis, cryptosporidiosis.
Mechanism of Action of Spiramycin
Spiramycin is a member of macrolide antibiotic. It binds to the 50S sub unit of bacterial ribosome and inhibits translocation.ie: they: interfere with the transfer of the newly formed peptide chain from the A site to the P site and fails to expose the A site .So that A site is unable to bind with the next aminoacyl t RNA complex. This leads to premature termination of amino acid chain and there by inhibits protein synthesis.
Pharmacokinets of Spiramycin
Absorption: Spiramycin is completely absorbed after oral administration.
Distribution: It is widely distributed in the body.
Metabolism: It undergoes insignificant metabolism.
Excretion: It is excreted through bile
Onset of Action for Spiramycin
1.5 - 3 hours
Duration of Action for Spiramycin
N/A
Half Life of Spiramycin
8 hours
Side Effects of Spiramycin
1. Nausea
2. Vomiting
3. Diarrhoea
4. Epigastric pain
5. Urticaria
6. Skin rash
7. Pruritis
Contra-indications of Spiramycin
1. Hypersensitivity to Spiramycin and other macrolide
Special Precautions while taking Spiramycin
1. Hepatic dysfunction
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
N/A
Indications for Spiramycin
1. Tonsilitis
2. Pharyngitis
3. Prostatitis
4. Toxoplasmosis
5. Urethritis
6. Skin and soft tissue infections
7. Amebiasis
8. Cryptosporidiosis
Interactions for Spiramycin
Carbamazepine: Plasma levels of carbamazepine increased.
Terfenadine and astemizole: Risk of cardiac arrhythmias.
Digoxin: May lead to digoxin toxicity.
Theophylline: Increased adverse efects of this drug.
Oral anticoagulants: Risk of bleeding.
Typical Dosage for Spiramycin
Adult: 3 - 6 million IU two times daily
Toxoplasmosis in pregnancy: 6000000 - 9000000 IU /day in divided dose for 3 weeks; Repeat the dose after 2 weeks interval till delivery
Child: 75000 - 150000 IU units/kg body weight two times daily
Schedule of Spiramycin
H
Storage Requirements for Spiramycin
Store in a cool dark place. Keep away from heat and moisture.
Effects of Missed Dosage of Spiramycin
Take the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose.
Effects of Overdose of Spiramycin
Give supportive measures and treatment.

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