Cefadroxil + Probenecid Pharmacology
Cefadroxil + Probenecid
Cefadroxil
2.Vomiting
3.Diarrhea
4.Gastritis
5.Super infection
6.Candidiasis
7.Rash
8.Hypersensitivity reactions
9.Angioedema
10.Vaginitis
11.Neutropenia
12.Thrombocytopenia
13.Headache
14.Dizziness
15.Hallucinations
16.Nephritis
17.Elevated liver enzymes.
2.Porphyria
3.Neuromuscular disorders.
2.Patient allergic to penicillins
3.Neuromuscular disorders
2. Tonsillitis & Pharyngitis
3. Skin &soft tissue infections
4. Otitis media.
Oral anticoagulants: Hypoprothrombinaemic effect potentiated, bleeding complications may occur.
Bacteriostatic Agents like Chloramphenicol: Decrease efficacy of Cefadroxil.
Probenecid: Slows tubular excretion and this enhances efficacy.
Frusemide & Ethacrynic Acid: Potentiate Nephrotoxicity of Cefadroxil.
Urine Glucose: False positive with Benedicts solution and Fehlings solution.
Direct Coomb?s Test: False positive.
Urinary 17-Ketosteroid values: Falsely elevated values.
Children:30mg/kg/day two times daily
Probenecid
Antibiotic therapy adjunct: Probenecid is a competitive inhibitor of the secretion of weak organic acids such as Penicillins and some of the cephalosporin antibiotics, at the proximal and distal renal tubules. It thereby increases blood concentrations of these antibiotics, increases their elimination half-life, and prolongs their duration of action
Distribution: Probenecid is widely distributed throughout the body
Metabolism: It is metabolised to active metabolite in the liver
Excretion: Probenecid and its active metabolites are excreted mainly in the urine. Probenecid is actively reabsorbed.
2. Vomiting
3. Headache
4. Dizziness
5. Anorexia
6. Sore gums
7. Urinary frequency
8. Renal colic
9. Nephrotic syndrome
10. Anaemia
11. Dermatitis
12. Pruritis
13. Flushing
14. Fever
2. Uric acid kidney stones
3. Blood dyscrasias
4. Acute gout
2. Peptic ulcer
Below 2 years: contraindicated
NEONATES: contraindicated
2. Gouty arthritis
3. Along with antibiotics (Stimulate the action of some antibiotics)
Allopurinol: Co-administration may increase uric acid lowering effect.
Barbiturate: Efficacy of thiopentone enhanced.
Benzodiazepines: More rapid or more prolonged benzodiazepine effect may occur.
Clofibrate: Increase in serum concentration of clofibric acid may occur.
Dapsone: Increased accumulation of dapsone may occur.
Methotrexate: Enhanced efficacy & toxicity of methotrexate.
NSAIDs: Increased plasma levels and toxicity of NSAID.
Penicillamine: Efficacy of penicillamine attenuated.
Sulfonylureas: Increased half-life of sulfonylureas.
Zidovudine: Bioavailability of zidovudine increased.
Salicylates: May result in inhibition of uricosuric effect.
Lab. Tests: False diagnosis of glycosuria. False high determination of theophylline by using Schack and Waxler technique. Probenecid may inhibit renal clearance of phenoelulonphtha-lein (PSP), 17 ketosteroids and sulfo-bromophthalein (BSP).
Gout: Initial dose: 500mg / day in 2 divided doses for 1 week followed by 1g /day if needed dosage can be increased by 500 mg/day every 1 month up to 2- 3 g/day.
Adjunct to penicillin or cephalosporin therapy: 2 g / day in 4 divided doses.
Gonorrhoea, uncomplicated: 1 g (as a single dose) 30 min before IM Penicillin and along with oral penicillin.
Neurosyphilis: 2g / day in 4 divided doses with penicillin G procaine aqueous
Pelvic inflammatory disease: 1 g (as a single dose) along with Cefoxitin,
Children:
Adjunct to penicillin or cephalosporin therapy: Pediatric, 2-14 years, initial: 25 mg/kg /day followed by 40mg/kg/day in 4 divided doses.
For children 50 kg or more: give adult dosage
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