Ranitidine +Cisapride Pharmacology
Ranitidine +Cisapride
Ranitidine
Anaesthetic adjuncts: It is used in patients undergoing prolonged operations, caesarian section,obese patients those are at increased risk of gastric regurgitation and aspiration pneumonia. It raises pH of gastric juice and also reduces its volume and thus chances of regurgitation. It is now routinely used before prolonged surgery.
2. Dizziness
3. Constipation
4. Vertigo
5. Confusion
6. Rash
7. Blurred vision
8. Thrombocytopenia
9. Leukopenia
2. Renal impairment
3. Acute Porphyria
NEONATES: Contraindicated
2. Benign gastric ulcer
3. Zollinger- Ellison syndrome
4. Gastroesophageal reflux
5. Acid indigestion
6. Heart burn
7. Sour stomach
8. Stress ulcers
9. Oesophagitis
10.Preanaesthetic medication
Diazepam: Efficacy of diazepam decreased.
Procainamide: Renal clearance of procainamide decreased.
Sulfonylureas: Hypoglycemic effects of glipizide enhanced.
Theophyllines: Increased efficacy of theophyllines with possible toxicity.
Warfarin: Increased hypoprothrombinemic effects.
Lab tests: False positive tests for urine proteins with multistix may occur.
Duodenal ulcer, benign gastric ulcer: 300 mg /day as single dose at bed time or in 2 divided dose (morning and bed time) for minimum of 4 weeks.
Maintenance dose: 150 mg / day at bed time.
Zollinger- Ellison syndrome: 300 - 450 mg / day in 2 - 3 divided doses; dose can be increased if necessary to a maximum up to 6g / day .
Gastroesophageal reflux: 300 mg / day as single dose at bed time or in 2 divided doses (morning and bed time) for maximum 2 months. In severe conditions dose can be increased to 600 mg / day in 4 divided doses for 3 months
Acid indigestion, Heart burn, Sour stomach: Dose: 75 mg once daily to a maximum up to 150 mg / day.
Oesophagitis: 150 mg/ day.
Dyspepsia: 75 - 300 mg / day depending on the severity of disease.
PAM: 150mg given night and in the morning before surgical procedures.
Children:
Duodenal ulcer, benign gastric ulcer: 4 - 8 mg / kg body weight / day in 2 divided doses.
Maximum dose: 300 mg / day
Cisapride
Distribution: It is very rapidly distributed in the body mainly to tissues in protein bound forms.
Metabolism: Cisapride is extensively metabolised in the liver.
Excretion: It is excreted mainly in urine and faeces.
2.Abdominal cramps
3.Headache
4.Constipation
5.Nausea
6.Urinary frequency
7.Rhinitis
8.Cough
2.Ventricular tachycardia
3.Ventricular fibrillation
4.Ventricular arrhythmia
5.Torsades de pointes
6.Ischaemic heart diseases
7.Congestive heart failure
8.Hypokalaemia
9.Respiratory failure
10.Hypokalaemia
11.Hypomagnesaemia
12.Respiratory failure
13.Renal failure
14.Gastrointestinal haemorrhag
2.Renal impairment
NEONATES: use with caution
2.Gastroparesis
3.Non ulcer dyspepsia
4.Disorders associated with decreased gastric motility
5.Chronic constipation
6.Nausea
Alcohol: Sedative effect augmented.
Anti-convulsants: Plasma levels of anticonvulsants must be carefully montiored.
Anti-coagulants: Prothrombin time increased.
Anti-cholinergics: Antagonize the effects of cisapride.
Oral: 40 mg / day in 4 divided doses 15 minutes before each meal and at bed time. Dose can be increased if needed to 80 mg / day.
Non ulcer dyspepsia: 30 mg / day in 3 divided doses for 1 month.
Gastroesophageal reflux diseases: 30 mg / day in 3 divided doses for 3 months and if needed additional 10 mg can be given at bed time.
Disorders associated with decreased gastric motility: 30 - 40 mg / day in 3 - 4 divided doses for 1 ? months.
Chronic constipation: 15 mg / day in 3 divided doses; dose can be increased to 30 mg / day if necessary.
Children (suspension only): 0.2 mg 3 times daily, maximum daily dose is 0.8 mg / kg / day.
Drug can be removed from the body by gastric lavage. Absorption of the drug can be reduced by administration of activated charcoal.
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