Amoxycillin + Tinidazole + Pantoprazole Pharmacology

Amoxycillin + Tinidazole + Pantoprazole

About Amoxycillin + Tinidazole + Pantoprazole
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Mechanism of Action of Amoxycillin + Tinidazole + Pantoprazole
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Pharmacokinets of Amoxycillin + Tinidazole + Pantoprazole
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Onset of Action for Amoxycillin + Tinidazole + Pantoprazole
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Duration of Action for Amoxycillin + Tinidazole + Pantoprazole
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Half Life of Amoxycillin + Tinidazole + Pantoprazole
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Side Effects of Amoxycillin + Tinidazole + Pantoprazole
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Contra-indications of Amoxycillin + Tinidazole + Pantoprazole
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Special Precautions while taking Amoxycillin + Tinidazole + Pantoprazole
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Pregnancy Related Information
Contraindicated; Tinidazole and Pantoprazole are contraindicated in pregnancy so the combination generic cannot be used in pregnancy.
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated; Tinidazole and Pantoprazole are contraindicated in breast feeding so the combination generic cannot be used in lactating mother

Children Related Information
N/A
Indications for Amoxycillin + Tinidazole + Pantoprazole
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 + Tinidazole + Pantoprazole
N/A
Typical Dosage for Amoxycillin + Tinidazole + Pantoprazole
Adult: 1 kit 2 times daily for 1 week
Each kit contains Amoxycillin 750mg + Tinidazole 500mg + Lansoprazole 30mg
Schedule of Amoxycillin + Tinidazole + Pantoprazole
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Storage Requirements for Amoxycillin + Tinidazole + Pantoprazole
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Effects of Missed Dosage of Amoxycillin + Tinidazole + Pantoprazole
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Effects of Overdose of Amoxycillin + Tinidazole + Pantoprazole
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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.

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

Pantoprazole

About Pantoprazole
A proton pump inhibitor, Benzimidazole derivative, Anti ulcer.
Mechanism of Action of Pantoprazole
Pantoprazole 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 Pantoprazole 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. Pantoprazole irreversibly inhibits proton pumps activity and decreases gastric acid secretion. Pantoprazole is more acid stable and its activity is lowered in higher pH. It is the only proton pump inhibitor which is available as parenteral form.



Pharmacokinets of Pantoprazole
Absorption: Pantoprazole is well absorbed after oral administration. Its bioavailability is about 77% since it`s undergoes first pass metabolism.
Distribution: It is widely distributed in the body in protein bound form.
Metabolism: Pantoprazole is extensively metabolised in the liver.
Excretion: It is excreted mainly in the urine and small amount in faeces.
Onset of Action for Pantoprazole
2-4 hours
Duration of Action for Pantoprazole
1 day
Half Life of Pantoprazole
60 minutes
Side Effects of Pantoprazole
1. Diarrhoea
2. Nausea
3. Vomiting
4. Headache
5. Flatulence
6. Abdominal pain
7. Pruritis
8. Dizziness
9. Rash

Contra-indications of Pantoprazole
1. Hypersensitivity to Pantoprazole
Special Precautions while taking Pantoprazole
1. Hepatic impairment
2. Monitor liver function
3. Avoid prolonged use
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated.
Children Related Information
Use with caution
Below 12 years : Contraindicated
Indications for Pantoprazole
1. Duodenal ulcer
2. Benign Gastric ulcer
3. Zollinger- Ellison syndrome
4. Gastroesophageal reflux disease
Interactions for Pantoprazole
Phenazone (antipyrine), diazepam, digoxin, theophylline, carbamazepine, diclofenac, phenprocoumon, phenytoin, warfarin, nifedipine, caffeine, metoprolol or ethanol : No clinically relevant interaction at therapeutic doses.
Oral contraceptives : Does not appear to compromise hormonal contraceptive efficacy as no interaction with a low dose combined oral contraceptive has been seen.
Typical Dosage for Pantoprazole
Oral :
Adult: 20-40mg / day before breakfast.
Duodenal ulcer: 40mg / day to be taken before breakfast for 2 - 4 weeks.
Benign Gastric ulcer: 40mg / day to be taken before breakfast for 1 - 2months.
Zollinger- Ellison syndrome: 80 mg / day in 2 divided doses increase the dose to 240 mg/ day if needed.
Gastroesophageal reflux disease: 20 - 40 mg / day to be taken before breakfast for 1 month and continue the treatment for 1 more month if needed.
Parenteral: 40 mg once daily as IV injection over 15 minutes.
Children below 12 years : Not recommended
Schedule of Pantoprazole
H
Storage Requirements for Pantoprazole
Store at 15 - 30 degree C in a tightly closed container. Protect from light.
Effects of Missed Dosage of Pantoprazole
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 Pantoprazole
Give supportive measures and symptomatic treatment.

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