Dicyclomine + Paracetamol + Mefenamic acid Pharmacology

Dicyclomine + Paracetamol + Mefenamic acid

About Dicyclomine + Paracetamol + Mefenamic acid
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Mechanism of Action of Dicyclomine + Paracetamol + Mefenamic acid
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Pharmacokinets of Dicyclomine + Paracetamol + Mefenamic acid
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Onset of Action for Dicyclomine + Paracetamol + Mefenamic acid
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Duration of Action for Dicyclomine + Paracetamol + Mefenamic acid
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Half Life of Dicyclomine + Paracetamol + Mefenamic acid
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Side Effects of Dicyclomine + Paracetamol + Mefenamic acid
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Contra-indications of Dicyclomine + Paracetamol + Mefenamic acid
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Special Precautions while taking Dicyclomine + Paracetamol + Mefenamic acid
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Dicyclomine + Paracetamol + Mefenamic acid
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Interactions for Dicyclomine + Paracetamol + Mefenamic acid
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Typical Dosage for Dicyclomine + Paracetamol + Mefenamic acid
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Schedule of Dicyclomine + Paracetamol + Mefenamic acid
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Storage Requirements for Dicyclomine + Paracetamol + Mefenamic acid
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Effects of Missed Dosage of Dicyclomine + Paracetamol + Mefenamic acid
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Effects of Overdose of Dicyclomine + Paracetamol + Mefenamic acid
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Dicyclomine

About Dicyclomine
Anticholinergic ,Antimuscarinic, Antispasmodic and in urinary incontinence.
Mechanism of Action of Dicyclomine
Dicyclomine is an anticholinergic drug. It exerts its action by inhibiting muscarinic (((cholinergic))) receptors on smooth muscles and prevents the effect of Acetylcholine. Inhibition of Acetylcholine produces relaxation of smooth muscles of gastrointestinal tract and genitourinary tract and reduces the painful spasm and cramp. It inhibits gastrointestinal propulsive motility and reduces gastric acid secretion. It also has a direct relaxant effect on smooth muscle. It readily crosses the blood brain barrier and produces CNS effects.
Pharmacokinets of Dicyclomine
Absorption: About 70 % of the drug is absorbed after oral administration.
Distribution: It is extensively distributed in tissue mainly in protein bound (((99%))) form. It readily crosses blood brain barrier.
Metabolism: Dicyclomine undergoes hepatic metabolism
Excretion: It is excreted mainly in the urine and small amount in the faeces.
Onset of Action for Dicyclomine
1-2 hours.
Duration of Action for Dicyclomine
4-6 hours.
Half Life of Dicyclomine
1.8 hours (((initial phase))). 9 - 10 hours (((secondary phase)))
Side Effects of Dicyclomine
1.Constipation
2.Dry mouth
3.Nausea
4.Vomiting
5.Abdominal discomfort
6.Headache
7.Dizziness
8.Confusion
9.Palpitations
10.Tachycardia
11.Increased intraocular pressure
12.Mydriasis
13.Urine retention
14.Urinary hesitancy
15.Decreased sweating
Contra-indications of Dicyclomine
1.Hypersensitivity to Dicyclomine and other anticholinergic drugs
2.Narrow angle glaucoma
3.Obstructive gastro intestinal tract
4.Obstructive uropathy
5.Reflux oesophagitis
6.Severe ulcerative colitis
7.Myasthenia gravis
8.Unstable cardiovascular status in acute haemorrhage
Special Precautions while taking Dicyclomine
1.Renal impairment
2.Hepatic impairment
3.Heart failure
4.Prostatic hypertrophy
5.Hiatus hernia associated
6.Hyperthyroidism
7.Autonomic neuropathy
8.Ulcerative colitis
9.Arrhythmia
10.Hypertension
11.Coronary artery disease
Pregnancy Related Information
Use with caution.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution.
NEONATES: contraindicated
Indications for Dicyclomine
1. Irritable bowel syndrome
2.Colicky pain
Interactions for Dicyclomine
N/A
Typical Dosage for Dicyclomine
Adult:
Oral: 80 mg / day in 4 divided doses 30 - 60 minutes before meals. Depending on the patient`s response dose can be increased to 160 mg / day in 4 divided doses after 1 week.
Children:
Infant colic: 5 - 10 mg every 6 - 8 hours, 15 minutes before each feed; dose is depending on the patient`s response and age.
Schedule of Dicyclomine
H
Storage Requirements for Dicyclomine
Store at 15 - 30 degree C in a tightly closed container. Protect from light.Keep out of the reach of children
Effects of Missed Dosage of Dicyclomine
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 Dicyclomine
Give 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. Physostigmine is given to block the overdose symptoms of Dicyclomine.

Paracetamol

About Paracetamol
Acetanilide derivative, Non narcotic Analgesic,Antipyretic.
Mechanism of Action of Paracetamol
Paracetamol 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 Paracetamol
Absorption: 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 Paracetamol
30 - 60 minutes
Duration of Action for Paracetamol
6 hours
Half Life of Paracetamol
1-4 hours
Side Effects of Paracetamol
1. Nausea
2. Abdominal distress
3. Allergic reactions
4. Rash
Contra-indications of Paracetamol
1. Hypersensitivity to Paracetamol
Special Precautions while taking Paracetamol
1. Hepatic impairment
2. Renal impairment
3. Hypertension
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
NEONATES : Contraindicated
Indications for Paracetamol
1. To relieve pain and fever
2. Acute gout
3. Migraine
Interactions for Paracetamol
Cholestyramine: 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 Paracetamol
Adult:
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 Paracetamol
H
Storage Requirements for Paracetamol
Store 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 Paracetamol
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 Paracetamol
Give 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.

Mefenamic Acid

About Mefenamic Acid
NSAID, Analgesic,antiinflammatory.
Mechanism of Action of Mefenamic Acid
Mefenamic acid has analgesic, anti-inflammatory and antipyretic action. It acts by inhibiting Prostaglandin (PGs) synthesis and their release at the site of injury. Prostaglandins cause tenderness and amplify the action of other analgesics. Mefenamic acid inhibits cyclo-oxygenase enzyme and antagonizes prostaglandin actions.
Pharmacokinets of Mefenamic Acid
Absorption: Mefenamic acid is well absorbed after oral administration. Distribution: It is distributed in the body in protein bound form. Metabolism: It is metabolised in the liver. Excretion: Mefenamic acid and its metabolites are excreted mainly in the urine.
Onset of Action for Mefenamic Acid
1-2 hours.
Duration of Action for Mefenamic Acid
6 hours.
Half Life of Mefenamic Acid
2-4 hours.
Side Effects of Mefenamic Acid
1.Nausea
2.Vomiting
3.Anorexia
4.Diarrhoea
5.Gastrointestinal bleeding
6.Abdominal distress
7.Constipation
8.Peptic ulcer
9.Dyspepsia
10.Headache
11.Flatulence
12.Drowsiness
13.Insomnia
14.Agranulocytosis
15.Aplastic anaemia
16.Thrombocytopenia
17.Dizziness
18.Rash
Contra-indications of Mefenamic Acid
1.Hypersensitivity to Mefenamic acid and other NSAIDs
2.Inflammatory bowel disease
3.Peptic ulcer
Special Precautions while taking Mefenamic Acid
1.Hepatic impairment
2.Renal impairment
3.Hypertension
4.Gastrointestinal diseases
5.Pre existing asthma
6.Patient on anticoagulant therapy
7.Heart failure
8.Myocardial infarction
9.Stroke
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Below 14 years: contraindicated
NEONATES: used only to close the patent ductus arteriosus as IV form only
Indications for Mefenamic Acid
1.Muscular aches
2.Primary Dysmenorrhoea
3.Headaches
4.Acute gout
5.Dental pain
6.Patent ductus arteriosus
Interactions for Mefenamic Acid
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Typical Dosage for Mefenamic Acid
Adult: initial dose: 500 mg followed by 250 mg every 6 hours. Treatment is continued maximum up to 1 week.
Children above 14 years:
500 mg followed by 250 mg every 6 hours. Treatment is continued maximum up to 1 week.
Children below 14 years: not recommended.


Schedule of Mefenamic Acid
H
Storage Requirements for Mefenamic Acid
Store Mefenamic acid at room temperature in a tightly closed light resistant container.
Effects of Missed Dosage of Mefenamic Acid
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 Mefenamic Acid
Give 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.

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