Dicyclomine + Paracetamol + Tramadol Pharmacology

Dicyclomine + Paracetamol + Tramadol

About Dicyclomine + Paracetamol + Tramadol
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Mechanism of Action of Dicyclomine + Paracetamol + Tramadol
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Pharmacokinets of Dicyclomine + Paracetamol + Tramadol
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Onset of Action for Dicyclomine + Paracetamol + Tramadol
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Duration of Action for Dicyclomine + Paracetamol + Tramadol
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Half Life of Dicyclomine + Paracetamol + Tramadol
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Side Effects of Dicyclomine + Paracetamol + Tramadol
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Contra-indications of Dicyclomine + Paracetamol + Tramadol
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Special Precautions while taking Dicyclomine + Paracetamol + Tramadol
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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 + Tramadol
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Interactions for Dicyclomine + Paracetamol + Tramadol
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Typical Dosage for Dicyclomine + Paracetamol + Tramadol
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Schedule of Dicyclomine + Paracetamol + Tramadol
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Storage Requirements for Dicyclomine + Paracetamol + Tramadol
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Effects of Missed Dosage of Dicyclomine + Paracetamol + Tramadol
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Effects of Overdose of Dicyclomine + Paracetamol + Tramadol
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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.

Tramadol

About Tramadol
A synthetic analogue of codein, Centrally acting Narcotic Analgesic.
Mechanism of Action of Tramadol
It is centrally acting synthetic drug. Chemically it is not related to the opiates but it act on the Opioid receptors present in the CNS. It has weak agonistic action on mu Opioid receptors, it cause analgesia. Part of this analgesic effect is due to the inhibition of norepinephrine and serotonin reuptake inhibition. However it has agonistic action on mu receptors, respiratory depression and gastrointestinal effects are not prominent.
Pharmacokinets of Tramadol
Absorption-Absorbed well after oral, intravenous and other parenteral application.
Distribution-Widely distributed in the body, about 20% bound to the plasma protein. It may cross the placenta.
Metabolism-It is metabolized in the liver by O-demethylation; N-demethylation, glucoronidation or sulfation to its metabolites. Mono-O-desmethylate is its active metabolite.
Excretion - Excreted 30% as unchanged form and 60% as its metabolites via urine.
Onset of Action for Tramadol
30 to 60 hrs
Duration of Action for Tramadol
8 to 12 hrs
Half Life of Tramadol
N/A
Side Effects of Tramadol
1. Dizziness
2. Weakness
3. Headache
4. Anxiety
5. Agitation
6. Drowsiness
7. Blurred vision
8. Stomach upset
9. Vomiting
10. Diarrhea
11. Constipation
12. Itching
13. Sweating
14. Flushing
15. Dry mouth
Contra-indications of Tramadol
1. Hypersensitivity to this drug
2. Acute alcoholic intoxification
3. Hypnotics
4. With centrally acting analgesics
5. With psychotropic drug
6. With Opioid drug
Special Precautions while taking Tramadol
1. Head injury
2. Acute abdominal conditions
3. Seizures
4. Respiratory depression
5. Renal failure
6. Hepatic failure
7. Physical dependence on Opioids
Pregnancy Related Information
May be used
Old Age Related Information
Use with caution
Breast Feeding Related Information
May be used
Children Related Information
May be used
Indications for Tramadol
1. Post operative pain
2. Arthralgia
3. Musculoskeletal pain
4. Low back pain
5. Pain associated with other reasons
Interactions for Tramadol
Carbamazepine: A significant increase in Tramadol metabolism.
Hypnotics, Tranquilizers and other CNS depressants: Sedative effects potentiated.
MAOIs: Fatal interaction occurs.
Opioid analgesics like Buprenorphine, Butorphanol and Pentazocine: May precipitate withdrawl symptoms.
Tranquilizers: Analgesia potentiated.
Typical Dosage for Tramadol
Oral-
Adults - 50 to 100mg every 4 to 6 hrs or twice daily.
Intravenous-
50 to 100 mg given every 4 to 6 hrs.
Rectal-
100 mg suppository 4 times daily.
Schedule of Tramadol
N/A
Storage Requirements for Tramadol
Store at room temperature in a tightly closed container and away from heat & moisture. Keep out of reach of children.
Effects of Missed Dosage of Tramadol
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 Tramadol
Establish artificial respiratory exchange. Naloxone administration cannot relieve all the symptoms produced by tramadol. Haemodialysis can remove a small fraction of drug from the body. Provide symptomatic and supportive treatment.

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