Paracetamol + Ibuprofen + Codeine Pharmacology

Paracetamol + Ibuprofen + Codeine

About Paracetamol + Ibuprofen + Codeine
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Mechanism of Action of Paracetamol + Ibuprofen + Codeine
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Pharmacokinets of Paracetamol + Ibuprofen + Codeine
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Onset of Action for Paracetamol + Ibuprofen + Codeine
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Duration of Action for Paracetamol + Ibuprofen + Codeine
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Half Life of Paracetamol + Ibuprofen + Codeine
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Side Effects of Paracetamol + Ibuprofen + Codeine
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Contra-indications of Paracetamol + Ibuprofen + Codeine
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Special Precautions while taking Paracetamol + Ibuprofen + Codeine
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Paracetamol + Ibuprofen + Codeine
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Interactions for Paracetamol + Ibuprofen + Codeine
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Typical Dosage for Paracetamol + Ibuprofen + Codeine
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Schedule of Paracetamol + Ibuprofen + Codeine
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Storage Requirements for Paracetamol + Ibuprofen + Codeine
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Effects of Missed Dosage of Paracetamol + Ibuprofen + Codeine
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Effects of Overdose of Paracetamol + Ibuprofen + Codeine
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Paracetamol

About Paracetamol
Acetanilide derivative, Non narcotic Analgesic,Antipyretic.
Mechanism of Action of Paracetamol
Paracetamol has analgesic and antipyretic action.
It is more active on cyclo-oxygenase enzyme in brain. Peripherally it is a poor inhibitor of prostaglandin synthesis.
Analgesic action: Paracetamol raises the pain threshold and produces analgesic effect.
Antipyretic action: Paracetamol lowers fever by direct action on the thermoregulatory centre in the Hypothalamus and block the effects of endogenous pyrogen.
Pharmacokinets of Paracetamol
Absorption: Paracetamol is rapidly and completely absorbed after oral administration.
Distribution: It is distributed mostly in the body in unbound form.
Metabolism: It is extensively metabolised in the liver.
Excretion: Excreted in the urine.
Onset of Action for Paracetamol
30 - 60 minutes
Duration of Action for Paracetamol
6 hours
Half Life of Paracetamol
1-4 hours
Side Effects of Paracetamol
1. Nausea
2. Abdominal distress
3. Allergic reactions
4. Rash
Contra-indications of Paracetamol
1. Hypersensitivity to Paracetamol
Special Precautions while taking Paracetamol
1. Hepatic impairment
2. Renal impairment
3. Hypertension
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES : Contraindicated
Indications for Paracetamol
1. To relieve pain and fever
2. Acute gout
3. Migraine
Interactions for Paracetamol
Cholestyramine: Reduces absorption of paracetamol.
Charcoal: Activated, administered immediately reduces absorption of paracetamol.
Domperidone and metochlopramide: Enhance absorption of paracetamol.
Alcohol: Chronic excessive ingestion of alcohol potentiates hepatotoxicity of paracetamol.
Zidovudine: Effects zidovudine may be decreased.
Typical Dosage for Paracetamol
Adult:
500 - 1000 mg in 3 times daily
Maximum dose: 4 g / day
For migraine: 500 mg to be taken at the first sign of migraine attack and repeated 4 - 6 hourly until suppress mild attacks.
Children:
60 mg / kg body weight /day in 4 divided doses.
Schedule of Paracetamol
H
Storage Requirements for Paracetamol
Store at 15-30 degree C in a tightly closed container. Protect from heat and moisture. Keep out of the reach of children.
Effects of Missed Dosage of Paracetamol
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 Paracetamol
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal. N-acetylcysteine is the specific antidote for Paracetamol poisoning. Dose: 150 mg /kg body weight as IV infusion over 15 minutes followed by same dose over 20 hours.
Maintenance dose: 75 mg / kg orally every 4 - 6 hours for 2 - 3 days. Haemodialysis can be done in emergency conditions.

Ibuprofen

About Ibuprofen
NSAID, a propionic acid derivative, Analgesic and anti-inflammatory.
Mechanism of Action of Ibuprofen
Ibuprofen has analgesic, anti-inflammatory and antipyretic action. It acts by inhibiting Prostaglandin (PGs) synthesis and their release at the site of injury. Prostaglandins cause tenderness and amplify the action of other algesics. Ibuprofen inhibits cyclo-oxygenase enzyme and antagonizes prostaglandin actions. It also inhibits platelet aggregation and prolongs bleeding time.
Pharmacokinets of Ibuprofen
Absorption: Ibuprofen is rapidly absorbed after oral administration. Distribution: It is distributed in the body in protein bound form. Metabolism: It is metabolised in the liver. Excretion: Ibuprofen and its metabolites are excreted mainly in the urine and some amount in bile.
Onset of Action for Ibuprofen
? hours
Duration of Action for Ibuprofen
4-6 hours.
Half Life of Ibuprofen
2 hours
Side Effects of Ibuprofen
1.Nausea
2.Vomiting
3.Diarrhoea
4.Gastrointestinal bleeding
5.Abdominal distress
6.Constipation
7.Peptic ulcer
8.Dyspepsia
9.Headache
10.Drowsiness
11.Blurring of vision
12.Tinnitus
13.Depression
14.Thrombocytopenia
15.Rash
16.Pruritis

Contra-indications of Ibuprofen
1.Hypersensitivity to Ibuprofen and other NSAIDs
2.Peptic ulcer
Special Precautions while taking Ibuprofen
1.Hepatic impairment
2.Renal impairment
3.Hypertension
4.Gastrointestinal diseases
5.Pre existing asthma
6.Bleeding disorders
7.Phenylketonuria
8.Oedema
9.Heart failure
10.Myocardial infarction
11.Stroke
Pregnancy Related Information
Use with caution
PREGNANCY in third trimester: contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
CHILDREN below 6 months: contraindicated
Indications for Ibuprofen
1.Rheumatoid arthritis
2.Ankylosing spondylitis
3.Acute gout
4.Joint disorders e.g. inflammatory disease in joints, crystal deposition in the joints
5.Osteoarthritis
6.For the relief of fever, pain and inflammation in dental, minor surgery and orthopedic
7.Dysmenorrhoea
8.Juvenile arthritis
9.Migraine
10.Patent ductus arteriosus(IV)
Interactions for Ibuprofen
N/A
Typical Dosage for Ibuprofen
Adult: 1.2 g / day in3 divided doses
Arthritis, gout and dental pain: 300 - 800 mg 3 times daily dose can be increased if needed.
Maximum dose: 3200 mg / day
Pain, Dysmenorrhoea: 1600 - 2400 mg / day in 4 - 6 divided doses
Fever: 600 mg / day in 3 divided doses.
Maximum dose: 1200 mg / day
For migraine: 400 -800 mg 3 times daily
Children: 15- 20 mg / kg body weight / day in 3 - 4 divided doses
Maximum dose: 40 mg / kg body weight / day

Schedule of Ibuprofen
H
Storage Requirements for Ibuprofen
Store Ibuprofen at 15-30 degree C in a tightly closed light resistant container.
Effects of Missed Dosage of Ibuprofen
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 Ibuprofen
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal. Excretion of the drug can be enhanced by administration of alkaline diuretics.

Codeine

About Codeine
An opiate, methylmorphine , Narcotic analgesic, antitussive, and antidiarrheal.
Mechanism of Action of Codeine
Codeine exerts it`s action through opioid receptors and posses antitussive properties. It selectively and directly acts on cough centre and suppresses cough. It also posses analgesic action due to it`s agonistic action on opioid receptors.
Pharmacokinets of Codeine
Absorption: Well absorbed after oral and parenteral administration. Distribution: Widely distributed in the body; it crosses placenta and also enters in to the breast milk. Metabolism: Metabolized in the liver by demethylation and glucuronide conjugation, Excretion: Excreted mainly in the urine as nor codeine and free and conjugated morphine.
Onset of Action for Codeine
Oral: 30 to 45 minutes
I.V.: Rapid
I.M.: 10 to 30 minutes
S.C.: 10 to 30 minutes
Duration of Action for Codeine
Oral: 4 to 6 hours
I.V.: 4 to 6 hours
I.M.: 4 to 6 hours
S.C.: 4 to 6 hours
Half Life of Codeine
N/A
Side Effects of Codeine
1. Constipation
2. Nausea
3. Vomiting
4. Drymouth
5. Respiratory depression
6. Hypotension
7. Bradycardia
8. Dizziness
9. Sedation
10. Euphoria
11. Urine retention
12. Flushing
13. Pruritus
14. Diaphoresis
15. Physical dependence.
Contra-indications of Codeine
1. Hypersensitivity to the drug
2. Bronchial asthma
3. Increased intracranial pressure
4. Respiratory depression
5. Paralytic ileus
6. Head injury
7. Alcoholism
8. Diverticulitis
9. Following bowel surgery.
Special Precautions while taking Codeine
1. Renal impairment
2. Hepatic impairment
3. Increased CSF pressure
4. Hypothyroidism
5. Addison`s disease
6. COPD
7. In deliberate individuals
8. Prostatic hypertrophy
9. Epilepsy
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Codeine
1. Nonproductive cough
2. Mild to moderate pain.
Interactions for Codeine
N/A
Typical Dosage for Codeine
Adults:
Oral:
Nonproductive cough:10 to 20mg 4 times daily;Maximum dose: 120mg/day
Oral, S.C., I.M.:
Mild to moderate pain:15 to 60mg Orally, S.C., or I.M.;4 to 6 times daily as required by the patient.

Children:
Oral:
Nonproductive cough:
Over 12 years: 10 to 20mg 4 times daily
Age 6 to 12: 5 to 10mg 4 times daily;Maximum dose: 60mg/day
Age 2 to 6: 1mg/kg/day as four equally divided doses and do not exceed 30mg in 24 hours.
Oral, S.C., I.M.:
Mild to moderate pain:0.5mg/kg orally every 4 to 6 hours or 0.5mg/kg S.C. or I.M.
Schedule of Codeine
H
Storage Requirements for Codeine
Store at controlled room temperature at a range of 15 to 30 degree C and protects from light.
Effects of Missed Dosage of Codeine
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 Codeine
Establish adequate respiratory exchange via a patent airway and ventilation as needed. Administer opioid antagonist Naloxone to reverse respiratory depression use repeatedly as required. (Naloxone shouldn`t be administered unless patient has clinically significant respiratory or cardiovascular depression.). If patient shows signs and symptoms within 2 hours of ingestion empty the stomach by gastric lavage and induced emesis. Reduce absorption by administration of activated charcoal. Closely monitor vital parameters and correct fluid and electrolyte balance. Provide symptomatic and supportive treatment.

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Paracetamol + Ibuprofen + Codeine is a generic medicine name and there are several brands available for it. Some of the brands for paracetamol + ibuprofen + codeine might be better known than paracetamol + ibuprofen + codeine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have paracetamol + ibuprofen + codeine in stock, you can ask for one of the branded alternatives for paracetamol + ibuprofen + codeine.