Amoxycillin + Clarithromycin + Tinidazole Pharmacology

Amoxycillin + Clarithromycin + Tinidazole

About Amoxycillin + Clarithromycin + Tinidazole
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Mechanism of Action of Amoxycillin + Clarithromycin + Tinidazole
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Pharmacokinets of Amoxycillin + Clarithromycin + Tinidazole
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Onset of Action for Amoxycillin + Clarithromycin + Tinidazole
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Duration of Action for Amoxycillin + Clarithromycin + Tinidazole
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Half Life of Amoxycillin + Clarithromycin + Tinidazole
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Side Effects of Amoxycillin + Clarithromycin + Tinidazole
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Contra-indications of Amoxycillin + Clarithromycin + Tinidazole
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Special Precautions while taking Amoxycillin + Clarithromycin + Tinidazole
N/A
Pregnancy Related Information
Contraindicated; Clarithromycin and Tinidazole are contraindicated in pregnancy so the combination generic cannot be used in pregnancy.
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated; Clarithromycin and Tinidazole are contraindicated in breast feeding so the combination generic cannot be used in lactating mother.
Children Related Information
N/A
Indications for Amoxycillin + Clarithromycin + Tinidazole
H. pylori infection
The combination of these three drugs works better to kill the bacteria than the antibiotics alone. It is a very effective combination to eradicate H. pylori infection in ulcer patients.
Interactions for Amoxycillin + Clarithromycin + Tinidazole
N/A
Typical Dosage for Amoxycillin + Clarithromycin + Tinidazole
Adult: 1 kit 2 times daily for 1 week
Schedule of Amoxycillin + Clarithromycin + Tinidazole
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Storage Requirements for Amoxycillin + Clarithromycin + Tinidazole
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Effects of Missed Dosage of Amoxycillin + Clarithromycin + Tinidazole
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Effects of Overdose of Amoxycillin + Clarithromycin + Tinidazole
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Amoxycillin

About Amoxycillin
Semisynthetic Broad spectrum beta-lactam antibiotic, An aminopenicillin Derivative.
Mechanism of Action of Amoxycillin
Amoxycillin is a bactericidal drug. It is a Beta lactum antibiotic. It binds to the Penicillin binding protein in the cell wall of bacteria and inhibits the enzyme transpeptidase which is responsible for the transpeptidation reaction in peptidoglycan synthesis. It also activates the endogenous enzyme which degrades the peptidoglycan.These results in inhibition of protein synthesis and there by cell wall synthesis. Amoxycillin is active against gram positive and gram negative bacteria except penicillinase producing once.
Pharmacokinets of Amoxycillin
Absorption .It is well absorbed after oral administration. Distribution: It is very widely distributed in the body .Metabolism: In significant metabolism. Excretion: It is excreted mainly through urine and small amount excreted
in breast milk
Onset of Action for Amoxycillin
60 -120 minutes
Duration of Action for Amoxycillin
6-8 hours
Half Life of Amoxycillin
60 minutes
Side Effects of Amoxycillin
1.Aaphylaxis
2. Vomiting
3.Diarrhoea
4 Nausea
5.Rash
6.Urticaria
7.Thrombocytopenia
8.Nephritis
9.Seizure
10.Super infections.
Contra-indications of Amoxycillin
Hypersensitivity to Amoxicillin and other Penicillins.
Special Precautions while taking Amoxycillin
1.Mononucleosis
2.Lymphatic leukaemia
3.HIV infections
4.Hepatic impairment
5.Renal impairment
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
Indications for Amoxycillin
1Urinary tract infections
2.Gonorrhoea
3 Meningitis
4.SABE
5.Respiratory tract infections
6.Septicemia
7.Soft tissue infections
8.Otitis media
9.Sinusitis
10.Tetanus
11.Biliarytract infections
12.Bronchitis
13.Salmonellosis
14.Typhoid
15.Gastroenteritis
16.Chlamydia infection
17.Paratyphoid fever
18.Dental infections
Interactions for Amoxycillin
Oral contraceptives: Efficacy reduced, may cause breakthrough bleeding or pregnancy.
Erythromycin, Tetracycline: Reduce efficacy.
Typical Dosage for Amoxycillin
ADULT: 250 - 500 mg three to four times daily.
In severe infections dose can be increased to 3 - 6 g daily depending on the severity of infection.
CHILDREN:125 - 250 mg three to four times a day depending on the severity of infection.
Schedule of Amoxycillin
H
Storage Requirements for Amoxycillin
It should store at temperature below 25 degree C. Keep away from moisture and heat. Keep out of the reach of children.
Effects of Missed Dosage of Amoxycillin
Take the dose as soon as noticed and if it is the time to the next dose then skip the missed dose
Effects of Overdose of Amoxycillin
Give supportive measures and symptomatic treatment. If the patient is conscious induce emesis or gastric lavage followed by charcoal administration. Haemodialysis can be done if needed.

Clarithromycin

About Clarithromycin
It is a new macrolide antimicrobial drug.It is the most effective macrolide against Haemophilus influenzae, chlamydia trachomaitis and chlamydia pneumoniae.
Mechanism of Action of Clarithromycin
Clarithromycin 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 tRNA complex. This leads to premature termination of amino acid chain and there by inhibits protein synthesis.
Pharmacokinets of Clarithromycin
Absorption: Clarithromycin is completely absorbed after oral administration. Distribution: It is widely distributed in the body .Metabolism: It is metabolized in to active and inactive compound .Excretion: It is excreted through urine.
Onset of Action for Clarithromycin
0.5 - 1 hour
Duration of Action for Clarithromycin
8 - 12 hour
Half Life of Clarithromycin
N/A
Side Effects of Clarithromycin
1.Nausea
2.Vomiting
3.Diarrhoea
4.Epigastric pain
5.Abnormal taste
6.Headache
7.Dizziness
8.Elevated hepatic enzyme
9.Pseudomembranous colitis
Contra-indications of Clarithromycin
1.Hypersensitivity to clarithromycin and other macrolide
2.Liver disease
Special Precautions while taking Clarithromycin
1.Renal impairment
2.Hepatic dysfunction
3.cardiac abnormalities
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
N/A
Indications for Clarithromycin
1.Tonsilitis
2.Pharyngitis
3.Pneumonia
4.Skin and soft tissue infections
5.Bronchitis
6.Otitis media
7.Prophylaxis of MAC
8.Leprosy
9.Acne
10.Nocardiosis
Interactions for Clarithromycin
Terfenadine: Concomitant use may cause cardiac arrhythmia.
Carbamazepine & Theophylline: Concurrent use causes increase in serum levels of these drugs.
Zidovudine: In HIV infected patients steady state Zidovudine levels decreased.
Increased efficacy of the following drugs which are metabolised by the cytochrome P450 system: Digoxin, Warfarin, Ergot alkaloids, Triazolam, Midazolam and Cyclosporine.
Typical Dosage for Clarithromycin
Adult: 250 - 500 mg twice daily for 1 - 2 week
Children: 7.5 mg/kg body weight two times daily for 1 - 2 week
Schedule of Clarithromycin
H
Storage Requirements for Clarithromycin
Store in a cool dark place. Keep away from heat and moisture.
Effects of Missed Dosage of Clarithromycin
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 Clarithromycin
Give supportive measures and treatment

Tinidazole

About Tinidazole
Nitroimidazole antibiotic, Antibacterial, antiprotozoal.
Mechanism of Action of Tinidazole
Tinidazole is nitro imidazole which has 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 excerts cytotoxic action by damaging DNA and other critical biomolecules. 3. .DNA helix destabilization &strand breakage has been observed.
Pharmacokinets of Tinidazole
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver by oxidation &glucuronide conjugation, Excretion: Excreted in urine.
Onset of Action for Tinidazole
Within few hours
Duration of Action for Tinidazole
16 hours
Half Life of Tinidazole
12 hours
Side Effects of Tinidazole
1.Anorexia
2.Bitter taste
3.Nausea
4.Vomiting
5.Diarrhoea
6.Fatigue
7.Dry mouth
8.Abdominal distress
9.Headache
10.Dizziness
11.Vertigo
12.Rash
13.Urticaria
14.Angioedema
15.Peripheral neuropathy & CNS effects,
Contra-indications of Tinidazole
1.Hypersensitivity to the drug
2.Blood dyscrasias
3.CNS disorders
Special Precautions while taking Tinidazole
1.Hepatic impairment
2.Alcoholic cirrhosis
3.Obstructive liver diseases
4. Use cautiously along with other hepatotoxic drugs & In visual field changes
5. Avoid alcohol use during therapy
Pregnancy Related Information
Use with caution, but contra indicated in first trimester
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated
Children Related Information
N/A
Indications for Tinidazole
1.Amoebiasis
2.Giardiasis
3.Trichomonas vaginitis
4.Anaerobic bacterial infections
5.Prophylactic agent after colorectal surgery
6.H. pylori infections
Interactions for Tinidazole
Alcohol: Disulfiram like reaction.
Ampicillin, Doxycycline and Cotrimoxaole: Synergism with these agents.
Typical Dosage for Tinidazole
Amoebiasis:
Adults: 2gm once daily for 3 days
Children: 30 to 50mg/kg/day or 600mg 12hourly for 5 to 10 days
Trichomoniasis & Giardiasis:
600mg once daily for a week or 2gm single dose
Anaerobic bacterial infections:
2 gm followed by 500mg 12 hourly for 5 days
Prophylaxis after colorectal surgery:
2gm single dose before surgery
H. pylori infections:
0.5gm 12hourly for 7 to14 days in triple combination
Schedule of Tinidazole
H
Storage Requirements for Tinidazole
Store at room temperature at a range of 15 to 30 degree C. Protect from excess heat and moisture.
Effects of Missed Dosage of Tinidazole
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 Tinidazole
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

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