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- Pharmacology For Diclofenac Sodium + Paracetamol + Dextropropoxyphene
Diclofenac Sodium + Paracetamol + Dextropropoxyphene Pharmacology
Diclofenac Sodium + Paracetamol + Dextropropoxyphene
About Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AMechanism of Action of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/APharmacokinets of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AOnset of Action for Diclofenac Sodium + Paracetamol + DextropropoxypheneN/ADuration of Action for Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AHalf Life of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/ASide Effects of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AContra-indications of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/ASpecial Precautions while taking Diclofenac Sodium + Paracetamol + DextropropoxypheneN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AInteractions for Diclofenac Sodium + Paracetamol + DextropropoxypheneN/ATypical Dosage for Diclofenac Sodium + Paracetamol + DextropropoxypheneN/ASchedule of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AStorage Requirements for Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AEffects of Missed Dosage of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/AEffects of Overdose of Diclofenac Sodium + Paracetamol + DextropropoxypheneN/ADiclofenac Sodium
About Diclofenac SodiumN/AMechanism of Action of Diclofenac SodiumDiclofenac possess analgesic, anti-inflammatory and antipyretic action. It inhibits the enzyme cyclo-oxygenase and there by inhibits the synthesis of Prostaglandins (PGs). It is more potent against cyclo-oxygenase-2 enzyme as compared to other NSAIDs like Indomethacin, Naproxen etc. It reduces intracellular concentrations of free arachidonic acid in leukocyte by altering its release or uptake. .Pharmacokinets of Diclofenac SodiumAbsorption: Diclofenac sodium is rapidly absorbed after oral administration. It undergoes first pass metabolism and its bioavailability is 50 % only. Distribution: It is distributed in highly protein bound form. Metabolism: Diclofenac sodium is metabolised in the liver. Excretion: Drug and metabolites are primarily excreted in urine and some amount in the bile.Onset of Action for Diclofenac Sodium1- 4.5 hoursDuration of Action for Diclofenac SodiumHoursHalf Life of Diclofenac Sodium2 hoursSide Effects of Diclofenac Sodium1.Nausea
2.Vomiting
3.Anorexia
4.Diarrhoea
5.Gastrointestinal bleeding
6.Abdominal distress
7.Constipation
8.Flatulence
9.Ulceration of the stomach or intestine
10.Dyspepsia
11.Headache
12.Dizziness
13. Rash
Contra-indications of Diclofenac Sodium1.Hypersensitivity to Indomethacin and other Non steroidal anti inflammatory drugs(NSAID)
2.Peptic ulcer
3.Asthma
Special Precautions while taking Diclofenac Sodium1.Hepatic impairment
2.Renal impairment
3.Hypertension
4.Blood clotting disorders
5.Gastrointestinal diseases
6.Proctitis
7.Asthma
8.Cautioned against driving, operating or activities requiring concentration
9.Avoid alcohol
10.Heart failure
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with caution
CHILDREN below 14: contraindicatedIndications for Diclofenac Sodium1.Ankylosing spondylitis
2.Acute gout
3.Joint disorders e.g. inflammatory disease in joints, crystal deposition in the joints
4.Osteoarthritis
5.For the relief of pain and inflammation in dental minor surgery and orthopedic
6.Dysmenorrhoea
7.Juvenile chronic arthritis
8.Migraine
Interactions for Diclofenac SodiumLithium & Digoxin : Blood levels of lithium and digoxin increased leading to enhanced efficacy and posible toxicity.
Diuretics : Inhibits diuretics but efficacy of potassium sparing diuretics enhanced.
Methotrexate : Toxicity enhanced.
Salicylates : Efficacy of salicylates reduced.
Cyclosporine : Increases nephrotoxicity of both agents.
Hydantoins : Increases serum levels resulting in toxicity.
Typical Dosage for Diclofenac SodiumAdult: 100 - 150 mg / day in 2 - 3 divided doses.
For the relief of pain, Migraine, Dysmenorrhoea: 150 mg / day in 3 divided doses.
Osteoarthritis: 50 mg 2 - 3 times daily
Rheumatoid arthritis: 150 - 200 mg / day in 3 - 4 divided doses.
Ankylosing spondylitis: 25 mg 4 times daily give an extra dose of 25 mg at bed time if necessary.
Children Juvenile rheumatoid arthritis: 0.5 - 2 mg / kg body weight / day in divided doses.
Maximum dose: 3 mg / kg body weight / day in divided doses
Schedule of Diclofenac SodiumHStorage Requirements for Diclofenac SodiumStore Diclofenac sodium at room temperature in a tightly closed light resistant container.Effects of Missed Dosage of Diclofenac SodiumTake 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 Diclofenac SodiumGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal.Paracetamol
About ParacetamolAcetanilide derivative, Non narcotic Analgesic,Antipyretic.Mechanism of Action of ParacetamolParacetamol has analgesic and antipyretic action.
It is more active on cyclo-oxygenase enzyme in brain. Peripherally it is a poor inhibitor of prostaglandin synthesis.
Analgesic action: Paracetamol raises the pain threshold and produces analgesic effect.
Antipyretic action: Paracetamol lowers fever by direct action on the thermoregulatory centre in the Hypothalamus and block the effects of endogenous pyrogen.
Pharmacokinets of ParacetamolAbsorption: Paracetamol is rapidly and completely absorbed after oral administration.
Distribution: It is distributed mostly in the body in unbound form.
Metabolism: It is extensively metabolised in the liver.
Excretion: Excreted in the urine.
Onset of Action for Paracetamol30 - 60 minutesDuration of Action for Paracetamol6 hoursHalf Life of Paracetamol1-4 hoursSide Effects of Paracetamol1. Nausea
2. Abdominal distress
3. Allergic reactions
4. Rash
Contra-indications of Paracetamol1. Hypersensitivity to ParacetamolSpecial Precautions while taking Paracetamol1. Hepatic impairment
2. Renal impairment
3. Hypertension
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
NEONATES : Contraindicated
Indications for Paracetamol1. To relieve pain and fever
2. Acute gout
3. Migraine
Interactions for ParacetamolCholestyramine: Reduces absorption of paracetamol.
Charcoal: Activated, administered immediately reduces absorption of paracetamol.
Domperidone and metochlopramide: Enhance absorption of paracetamol.
Alcohol: Chronic excessive ingestion of alcohol potentiates hepatotoxicity of paracetamol.
Zidovudine: Effects zidovudine may be decreased.Typical Dosage for ParacetamolAdult:
500 - 1000 mg in 3 times daily
Maximum dose: 4 g / day
For migraine: 500 mg to be taken at the first sign of migraine attack and repeated 4 - 6 hourly until suppress mild attacks.
Children:
60 mg / kg body weight /day in 4 divided doses.
Schedule of ParacetamolHStorage Requirements for ParacetamolStore at 15-30 degree C in a tightly closed container. Protect from heat and moisture. Keep out of the reach of children.Effects of Missed Dosage of ParacetamolTake 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 ParacetamolGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal. N-acetylcysteine is the specific antidote for Paracetamol poisoning. Dose: 150 mg /kg body weight as IV infusion over 15 minutes followed by same dose over 20 hours.
Maintenance dose: 75 mg / kg orally every 4 - 6 hours for 2 - 3 days. Haemodialysis can be done in emergency conditions.
Dextropropoxyphene
About DextropropoxypheneA synthetic morphine derivative,Opioid-like agonist,optical isomer of Levopropoxyphene, Narcotic Analgesic, anti-tussive and local anesthetic.Mechanism of Action of DextropropoxypheneIt acts on the CNS Opioid receptors. It has agonist action on mu Opioid receptors. It primarily binds to the mu Opioid receptors and produce analgesia. Its CNS effects are same as morphine. It gives in combination with other Non Steroidal Anti Inflammatory Drugs or other analgesics usually.
Pharmacokinets of DextropropoxypheneAbsorption-Orally absorbed; primarily to the upper small intestine.
Distribution-Widely distributed in the body. Enters the cerebrospinal fluid and cross the placenta.
Metabolism-In liver it is metabolized by N-demethylation. Norpropoxyphene is its active metabolite. It has more half life than parent drug. It causes toxicity at sometime due to its metabolites accumulation in the body.
Excretion-It is excreted through urine.
Onset of Action for Dextropropoxyphene30 to 60 min. after oral administrationDuration of Action for Dextropropoxyphene4 to 6 hrsHalf Life of DextropropoxyphenePlasma half life is 6 to 12 hrsSide Effects of Dextropropoxyphene1. Nausea
2. Vomiting
3. Epigastric distress
4. Sedation
5. Dizziness
6. Urticaria
7. Visual disturbances
8. Physiological dependence
Contra-indications of Dextropropoxyphene1. Hypersensitivity to this drug
2. Respiratory depression
3. Children below 12 years
Special Precautions while taking Dextropropoxyphene1. In patients with hepatic failure or renal failure used cautiously
2. Patient can not drive or operate machinery after the drug administration. So the care should be taken
3. Use cautiously in patients with suicidal mentality
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationN/AIndications for Dextropropoxyphene1. Relieve moderate to severe pain in various conditions
2. Opioid withdrawal
Interactions for DextropropoxypheneBarbiturate anaesthetics: May increase respiratory and CNS depressive effects of propoxyphene.
Warfarin: Potentiation of hypoprothrombinemic effect.
Carbamazipine: May increase serum carbamzipine levels with resultant toxicity.Typical Dosage for DextropropoxypheneOral-
Adults - 65mg 3 to 4 times daily.
Schedule of DextropropoxypheneHStorage Requirements for DextropropoxypheneStore controlled room temperature i.e. between 15 and 30 degree CelsiusEffects of Missed Dosage of DextropropoxypheneTake 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 DextropropoxypheneProvide supportive and symptomatic treatment. Establish artificial respiratory exchange. In the case of respiratory or cardiovascular depression administer a narcotic antagonist i.e. naloxone.Induce emesis or gastric lavage if the patient shows symptoms within 2hrs after drug administration. Avoid the risk of aspiration. For the further removal of drug, administer activated charcoal via nasogastric tube. Continue the supportive treatment and closely monitor the laboratory parameters, vital signs, neurological status closely. In some cases dialysis may be helpful for the treatment.Home Delivery for Diclofenac Sodium + Paracetamol + Dextropropoxyphene in Your City
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