Mupirocin + Metronidazole Pharmacology

Mupirocin + Metronidazole

About Mupirocin + Metronidazole
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Mechanism of Action of Mupirocin + Metronidazole
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Pharmacokinets of Mupirocin + Metronidazole
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Onset of Action for Mupirocin + Metronidazole
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Duration of Action for Mupirocin + Metronidazole
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Half Life of Mupirocin + Metronidazole
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Side Effects of Mupirocin + Metronidazole
N/A
Contra-indications of Mupirocin + Metronidazole
N/A
Special Precautions while taking Mupirocin + Metronidazole
N/A
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 Mupirocin + Metronidazole
Treatment of bacterial skin infection such as impetigo.
Interactions for Mupirocin + Metronidazole
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Typical Dosage for Mupirocin + Metronidazole
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Schedule of Mupirocin + Metronidazole
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Storage Requirements for Mupirocin + Metronidazole
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Effects of Missed Dosage of Mupirocin + Metronidazole
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Effects of Overdose of Mupirocin + Metronidazole
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Mupirocin

About Mupirocin
A naturally antibiotic isolated from Pseudomonas fluorescens, Antibiotic.
Mechanism of Action of Mupirocin
Mupirocin exerts its action by reversibly binding to isoleucyl transfer RNA synthetase and inhibits the enzyme activity. This enzyme is necessary for the synthesis of proteins in the bacteria. Inhibition of isoleucyl transfer RNA synthetase results in inhibition of protein synthesis and produce microbicidal action. It is more active against gram positive bacteria as compared to gram negative bacteria.
Pharmacokinets of Mupirocin
Absorption: Mupirocin is negligibly absorbed after topical administration.
Onset of Action for Mupirocin
N/A
Duration of Action for Mupirocin
N/A
Half Life of Mupirocin
N/A
Side Effects of Mupirocin
Topical use :
1. Irritation
2. Burning
3. Rashes
4. Pruritis
5. Stinging
6. Erythema
7. Dryness
8. Dermatitis
9. Pain
Nasal use:
1. Rhinitis
2. Cough
3. Headache
4. Pharyngitis
5. Change in taste
6. Chest congestion
Contra-indications of Mupirocin
1. Hypersensitivity to Mupirocin
Special Precautions while taking Mupirocin
1. If sensitivity occurs discard the use of the medicament
2. Renal impairment
3. Patient with burns
4. Avoid contact with eyes and mucous membrane
5. Avoid application in the large surface area(extensive wound)
6. Monitor for super infection
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 : Use with caution
Indications for Mupirocin
Bacterial skin infections:
1. Impetigo
2. Infected eczema
3. Folliculitis
4. Eradication of nasal colonization of Methicillin resistant S.aureus
Interactions for Mupirocin
N/A
Typical Dosage for Mupirocin
Adult:
Topical use: 2% cream, and ointment: Wash and dry the affected area thoroughly. Apply the medicament as a thin film over the affected part. Rub gently. Cover with a surgical gauze. Apply 3 times daily for 1 - 2 weeks.
Intranasal use: 2 % ointment: Apply the half of the content of a single use tube in to one nostril and other half in to other nostril. Press the sides of the nostrils together and release it. Repeat it for 1 minute. Apply it morning and evening.
Schedule of Mupirocin
N/A
Storage Requirements for Mupirocin
Store at room temperature in a tightly closed container. Keep away from moisture and heat. Keep out of the reach of children.
Effects of Missed Dosage of Mupirocin
Apply 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 Mupirocin
Give supportive measures and symptomatic treatment.

Metronidazole

About Metronidazole
A nitroimidazole antibiotic, Anti-infective, Antiprotozoal,amebicide.
Mechanism of Action of Metronidazole
Metronidazole is nitro imidazoles which have 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 exerts cytotoxic action by damaging DNA and other critical biomolecules. 3. DNA helix destabilization & strand breakage has been observed.
Pharmacokinets of Metronidazole
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver by oxidation & glucuronide conjugation, Excretion: Excreted in urine.
Onset of Action for Metronidazole
1 to 2 days
Duration of Action for Metronidazole
8hours.
Half Life of Metronidazole
8 hours.
Side Effects of Metronidazole
1.Anorexia.
2.Metallic taste
3.Nausea
4.Vomiting
5.Diarrhoea
6.Headache
7.Looseness of stool.
8.Peripheral neuropathy &CNS effects.
9.Mutagenesis.
10.Radiosensitisation.
11.Transient leucopenia
12.Dry mouth
13.Abdominal distress
14.Dizziness
15.Vertigo
16.Thrombophlebitis at site of injection
17.Ototoxicity
Contra-indications of Metronidazole
1.Hypersensitivity to the drug
2.Blood dyscrasias
3.CNS disorders
Special Precautions while taking Metronidazole
1.Renal impairment
2.Hepatic impairment
3.Alcoholic cirrhosis
4.Use cautiously along with other hepatotoxic drugs & In visual field changes
Pregnancy Related Information
Use with caution
First trimester:contra indicated
Old Age Related Information
May be used.
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Neonates: Contraindicated
Indications for Metronidazole
1.Amoebiasis
2.Giardiasis
3.Trichomonas vaginitis
4.Pseudo membranous enterocolitis
5.Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis
6.Helicobacter pylori infections
7.Ulcerative gingivitis
Interactions for Metronidazole
Warfarin & other coumarin anticoagulants: Potentiates the anticoagulant effect resulting in increased prothrombin time.
Alcohol: A disulfiram-like reaction. Abdominal cramps, nausea, vomiting, headache & flushing.
Disulfiram: Acute psychotic reaction or confusional state.
Phenobarbital & Phenytoin: Increased metabolism of metronidazole resulting in decreased efficacy.
Lithium: Increased lithium levels and toxicity.
Flurouracil: Increased toxicity of flurouracil.
Lab tests: May interfere with chemical analysis for AST,SGOT, ALT, SGPT, LDH, triglycerides and hexokinase glucose. Zero values may occur.
Typical Dosage for Metronidazole
Adult
Amoebiasis:400 to 800 mg 8hourly for 5 to 10days depending up on the severity of infection
In severe infections and liver abscess: 1gm as slow I.V. infusion followed by 0.5 gm twice daily till oral therapy is started
Giardiasis:200mg 8hourly for 1week or 2gm/day for 3days or I.V.500mg thrice daily
Trichomonas vaginitis: 400mg 8 hourly for a week or 2gm once daily for a week.
Male partner should be concurrently treated with the drug
Pseudo membranous enterocolitis:800 mg 8hourly
Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis:400 to 800 mg 8hourly
In severe cases: 15mg/kg I.V. infusion for 1hour followed by 7.5mg/kg 4 times daily till oral therapy is substituted
Helicobacter pylori infections:400mg 8hourly along with amoxicillin/clarithromycin and a proton pump inhibitor
Ulcerative gingivitis:200 to 800mg 8hourly
Children
Amoebiasis: 30 to 50mg/kg/day for 5to10 days.
Giardiasis:10 to 15mg/kg/day thrice daily
Children (below 12years): 7.5mg/kg I.V.
Schedule of Metronidazole
H
Storage Requirements for Metronidazole
Store in a well closed container in a cool dark place. Keep out of the reach of children.
Effects of Missed Dosage of Metronidazole
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 Metronidazole
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.

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