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- Pharmacology For Clarithromycin + Tinidazole + Lansoprazole
Clarithromycin + Tinidazole + Lansoprazole Pharmacology
Clarithromycin + Tinidazole + Lansoprazole
About Clarithromycin + Tinidazole + LansoprazoleN/AMechanism of Action of Clarithromycin + Tinidazole + LansoprazoleN/APharmacokinets of Clarithromycin + Tinidazole + LansoprazoleN/AOnset of Action for Clarithromycin + Tinidazole + LansoprazoleN/ADuration of Action for Clarithromycin + Tinidazole + LansoprazoleN/AHalf Life of Clarithromycin + Tinidazole + LansoprazoleN/ASide Effects of Clarithromycin + Tinidazole + LansoprazoleN/AContra-indications of Clarithromycin + Tinidazole + LansoprazoleN/ASpecial Precautions while taking Clarithromycin + Tinidazole + LansoprazoleN/APregnancy Related InformationContraindicated;since Clarithromycin and Tinidazole are contraindicated in pregnancy, the combination generic cannot be used in pregnancy.Old Age Related InformationN/ABreast Feeding Related InformationContraindicated, since Clarithromycin and Tinidazole are contraindicated in breast feeding , the combination generic cannot be used in breast feeding mother..Children Related InformationN/AIndications for Clarithromycin + Tinidazole + LansoprazoleIt is a combination of proton pump inhibitor Lansoprazole, antimicrobial agent Tinidazole and Clarithromycin.
1.Helicobacter pylori
Interactions for Clarithromycin + Tinidazole + LansoprazoleN/ATypical Dosage for Clarithromycin + Tinidazole + LansoprazoleTake 1 tablet of Clarithromycin,Tinidazole and Lansoprazole in the morning and evening for 1 week.Schedule of Clarithromycin + Tinidazole + LansoprazoleN/AStorage Requirements for Clarithromycin + Tinidazole + LansoprazoleN/AEffects of Missed Dosage of Clarithromycin + Tinidazole + LansoprazoleN/AEffects of Overdose of Clarithromycin + Tinidazole + LansoprazoleN/AClarithromycin
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 treatmentTinidazole
About TinidazoleNitroimidazole antibiotic, Antibacterial, antiprotozoal.Mechanism of Action of TinidazoleTinidazole 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 TinidazoleAbsorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver by oxidation &glucuronide conjugation, Excretion: Excreted in urine.
Onset of Action for TinidazoleWithin few hoursDuration of Action for Tinidazole16 hoursHalf Life of Tinidazole12 hoursSide Effects of Tinidazole1.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 Tinidazole1.Hypersensitivity to the drug
2.Blood dyscrasias
3.CNS disorders
Special Precautions while taking Tinidazole1.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 InformationUse with caution, but contra indicated in first trimesterOld Age Related InformationN/ABreast Feeding Related InformationContraindicatedChildren Related InformationN/AIndications for Tinidazole1.Amoebiasis
2.Giardiasis
3.Trichomonas vaginitis
4.Anaerobic bacterial infections
5.Prophylactic agent after colorectal surgery
6.H. pylori infections
Interactions for TinidazoleAlcohol: Disulfiram like reaction.
Ampicillin, Doxycycline and Cotrimoxaole: Synergism with these agents.Typical Dosage for TinidazoleAmoebiasis:
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 TinidazoleHStorage Requirements for TinidazoleStore at room temperature at a range of 15 to 30 degree C. Protect from excess heat and moisture.Effects of Missed Dosage of TinidazoleTake 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 TinidazoleTreatment 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 Lansoprazole
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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