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- Pharmacology For Amoxycillin + Clarithromycin + Lansoprazole
Amoxycillin + Clarithromycin + Lansoprazole Pharmacology
Amoxycillin + Clarithromycin + Lansoprazole
About Amoxycillin + Clarithromycin + LansoprazoleN/AMechanism of Action of Amoxycillin + Clarithromycin + LansoprazoleN/APharmacokinets of Amoxycillin + Clarithromycin + LansoprazoleN/AOnset of Action for Amoxycillin + Clarithromycin + LansoprazoleN/ADuration of Action for Amoxycillin + Clarithromycin + LansoprazoleN/AHalf Life of Amoxycillin + Clarithromycin + LansoprazoleN/ASide Effects of Amoxycillin + Clarithromycin + LansoprazoleN/AContra-indications of Amoxycillin + Clarithromycin + LansoprazoleN/ASpecial Precautions while taking Amoxycillin + Clarithromycin + LansoprazoleN/APregnancy Related InformationContraindicated; Clarithromycin is contraindicated in pregnancy so the combination generic cannot be used in pregnancy.Old Age Related InformationN/ABreast Feeding Related InformationContraindicated; Clarithromycin is contraindicated in breast feeding so the combination generic cannot be used in lactating mother.Children Related InformationN/AIndications for Amoxycillin + Clarithromycin + LansoprazoleH. 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 + LansoprazoleN/ATypical Dosage for Amoxycillin + Clarithromycin + LansoprazoleAdult: 1 kit 2 times daily for 1 weekSchedule of Amoxycillin + Clarithromycin + LansoprazoleN/AStorage Requirements for Amoxycillin + Clarithromycin + LansoprazoleN/AEffects of Missed Dosage of Amoxycillin + Clarithromycin + LansoprazoleN/AEffects of Overdose of Amoxycillin + Clarithromycin + LansoprazoleN/AAmoxycillin
About AmoxycillinSemisynthetic Broad spectrum beta-lactam antibiotic, An aminopenicillin Derivative.Mechanism of Action of AmoxycillinAmoxycillin 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 AmoxycillinAbsorption .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 Amoxycillin60 -120 minutesDuration of Action for Amoxycillin6-8 hoursHalf Life of Amoxycillin60 minutesSide Effects of Amoxycillin1.Aaphylaxis
2. Vomiting
3.Diarrhoea
4 Nausea
5.Rash
6.Urticaria
7.Thrombocytopenia
8.Nephritis
9.Seizure
10.Super infections.
Contra-indications of AmoxycillinHypersensitivity to Amoxicillin and other Penicillins.Special Precautions while taking Amoxycillin1.Mononucleosis
2.Lymphatic leukaemia
3.HIV infections
4.Hepatic impairment
5.Renal impairment
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Amoxycillin1Urinary 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 AmoxycillinOral contraceptives: Efficacy reduced, may cause breakthrough bleeding or pregnancy.
Erythromycin, Tetracycline: Reduce efficacy.Typical Dosage for AmoxycillinADULT: 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 AmoxycillinHStorage Requirements for AmoxycillinIt 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 AmoxycillinTake the dose as soon as noticed and if it is the time to the next dose then skip the missed doseEffects of Overdose of AmoxycillinGive 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 ClarithromycinIt is a new macrolide antimicrobial drug.It is the most effective macrolide against Haemophilus influenzae, chlamydia trachomaitis and chlamydia pneumoniae.Mechanism of Action of ClarithromycinClarithromycin 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 ClarithromycinAbsorption: 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 Clarithromycin0.5 - 1 hourDuration of Action for Clarithromycin8 - 12 hourHalf Life of ClarithromycinN/ASide Effects of Clarithromycin1.Nausea
2.Vomiting
3.Diarrhoea
4.Epigastric pain
5.Abnormal taste
6.Headache
7.Dizziness
8.Elevated hepatic enzyme
9.Pseudomembranous colitisContra-indications of Clarithromycin1.Hypersensitivity to clarithromycin and other macrolide
2.Liver diseaseSpecial Precautions while taking Clarithromycin1.Renal impairment
2.Hepatic dysfunction
3.cardiac abnormalitiesPregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationN/AIndications for Clarithromycin1.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.NocardiosisInteractions for ClarithromycinTerfenadine: 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 ClarithromycinAdult: 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 ClarithromycinHStorage Requirements for ClarithromycinStore in a cool dark place. Keep away from heat and moisture.Effects of Missed Dosage of ClarithromycinTake 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 ClarithromycinGive supportive measures and treatmentLansoprazole
About LansoprazoleA proton pump inhibitor, Benzimidazole derivative, Anti ulcer.Mechanism of Action of LansoprazoleLansoprazole is a proton pump inhibitor. It is a prodrug. After administration it diffuses in to the parietal cell of the stomach and accumulates in the secretory canaliculi. In the acidic medium Lansoprazole is converted to sulfenamide. This sulfenamide covalently interacts with sulfhydryl (SH) group in the proton pump
(H+ K+ATPase) and inhibits the exchange of extracellular K+ for intracellular H+ ion. Lansoprazole irreversibly inhibits proton pumps activity and decreases gastric acid secretion.
Pharmacokinets of LansoprazoleAbsorption: Lansoprazole is well absorbed after oral administration.Distribution: It is widely distributed in the body in protein bound form.Metabolism: Lansoprazole is extensively metabolised in the liver.Excretion: It is excreted mainly in the faeces and small amount in urine.
Onset of Action for Lansoprazole1- 2 hoursDuration of Action for Lansoprazole
1 day
Half Life of Lansoprazole30- 90 minutes
Side Effects of Lansoprazole1.Diarrhoea
2.Nausea
3.Vomiting
4.Abdominal pain
5.Constipation
6.Stomatitis
7.Agitation
8.Dizziness
9.Myalgia
10. Rash
Contra-indications of LansoprazoleHypersensitivity to Lansoprazole
Special Precautions while taking Lansoprazole1.Hepatic impairment
2.Monitor gastric malignancy
3.Avoid prolonged use
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with caution.Breast Feeding Related InformationUse with cautionChildren Related InformationContraindicated
NEONATES: Contraindicated
Indications for Lansoprazole1. Duodenal ulcer
2. Gastric ulcer
3. Zollinger- Ellison syndrome
4. Gastroesophageal reflux disease
5. Oesophagitis
6. Acid related dyspepsia
7. NSAID associated ulceration
Interactions for LansoprazoleAntacids: Bio-availability of lansoprazole reduced.
Oral contraceptives, Phenytoin, Theophylline and Warfarin: Caution should be exercised while using these drugs which are metabolised by the liver since lansoprazole is a weak inducer of P450 cytochrome.Typical Dosage for LansoprazoleAdult: 15 - 30 mg / day to be taken before meals.
Duodenal ulcer: 15 mg / day before meals for 1 month.
Gastric ulcer: 30 mg / day for 2 months.
Zollinger- Ellison syndrome: 60 mg / day increase the dose to 180 mg/ day in 2 divided doses if needed.
Gastroesophageal reflux disease: 15 mg / day for 2 months.
Oesophagitis: 30 mg / day before meals for 2 months continue the treatment for 2 more months if needed.
Acid related dyspepsia: 15 - 30 mg / day before breakfast for 1 month.
NSAID associated ulceration: 15 - 30 mg / day for 1 - 2 months.
Children: not recommended
Schedule of LansoprazoleHStorage Requirements for LansoprazoleStore at 15 - 30 degree C in a tightly closed container. Protect from light.Effects of Missed Dosage of LansoprazoleTake 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 LansoprazoleGive supportive measures and symptomatic treatment.
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