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- Pharmacology For Clidinium bromide + Chlordiazepoxide + Dicyclomine
Clidinium bromide + Chlordiazepoxide + Dicyclomine Pharmacology
Clidinium bromide + Chlordiazepoxide + DicyclomineAbout Clidinium bromide + Chlordiazepoxide + DicyclomineN/AMechanism of Action of Clidinium bromide + Chlordiazepoxide + DicyclomineN/APharmacokinets of Clidinium bromide + Chlordiazepoxide + DicyclomineN/AOnset of Action for Clidinium bromide + Chlordiazepoxide + DicyclomineN/ADuration of Action for Clidinium bromide + Chlordiazepoxide + DicyclomineN/AHalf Life of Clidinium bromide + Chlordiazepoxide + DicyclomineN/ASide Effects of Clidinium bromide + Chlordiazepoxide + DicyclomineN/AContra-indications of Clidinium bromide + Chlordiazepoxide + DicyclomineN/ASpecial Precautions while taking Clidinium bromide + Chlordiazepoxide + DicyclomineN/APregnancy Related InformationContraindicated; since Clidinium bromide and Chlordiazepoxide are contraindicated in pregnant woman.Old Age Related InformationN/ABreast Feeding Related InformationContraindicatedChildren Related InformationN/AIndications for Clidinium bromide + Chlordiazepoxide + DicyclomineIt is a combination of anti-anxiety Chlordiazepoxide and antspasmodic Clidinium bromide and Dicylomine. The combination is used to relax the digestive system and to reduce the acidity of stomach.
1.Peptic ulcer (Adjunctive therapy)
2.Irritable bowel syndrome
Interactions for Clidinium bromide + Chlordiazepoxide + DicyclomineN/ATypical Dosage for Clidinium bromide + Chlordiazepoxide + DicyclomineAdult: Maintenance dose is 1 - 2 tablets 3 or 4 times a day administered before meals and at bedtime.Schedule of Clidinium bromide + Chlordiazepoxide + DicyclomineN/AStorage Requirements for Clidinium bromide + Chlordiazepoxide + DicyclomineN/AEffects of Missed Dosage of Clidinium bromide + Chlordiazepoxide + DicyclomineN/AEffects of Overdose of Clidinium bromide + Chlordiazepoxide + DicyclomineN/A
Clidinium BromideAbout Clidinium BromideIt is a quaternary ammonium compound with anticholingeric properties, Antispasmodics (Systemic).Mechanism of Action of Clidinium BromideClidinium bromide is an anticholinergic drug. It exerts its action by inhibiting muscarinic cholinergic receptors on smooth muscles, cardiac muscles and prevents the effect of Acetylcholine. Inhibition of Acetylcholine produces relaxation of smooth muscles and prevents the muscle spasm in irritable bowel syndrome.Pharmacokinets of Clidinium BromideAbsorption: Clidinium bromide is poorly absorbed about (10 - 25 %) after oral administration.
Distribution:It does not penetrate CNS and eye.
Metabolism: It is extensively metabolised in the small intestine (by hydrolysis) and in the liver to inactive metabolites.
Excretion: Drug and its metabolites are excreted mainly in the urine.
Onset of Action for Clidinium Bromide60 minuteDuration of Action for Clidinium Bromide3 hoursHalf Life of Clidinium BromideN/ASide Effects of Clidinium Bromide1.Dry mouth
Contra-indications of Clidinium Bromide1.Hypersensitivity to Clidinium bromide and other anticholinergic drugs
2.Narrow angle glaucoma
3.Obstructive gastro intestinal tract
4.Bladder neck obstruction
Special Precautions while taking Clidinium Bromide1.Renal impairment
3.Cardiovascular diseases- Hypertension
4.Use caution while performing driving or performing other works requiring mental alertness
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with caution.Breast Feeding Related InformationContraindicatedChildren Related InformationContraindicated
Indications for Clidinium Bromide1.Peptic ulcer
3.Irritable bowel syndrome
Interactions for Clidinium BromideAmantadine : Increase in anticholingeric side effects.
Atenolol, Digoxin: Efficacy of atenolol and digoxin enhanced .
Phenothiazines : Decreases antipsychotic activity, and increases anticholingeric activity.
TCAs: Increased anticholinergic side effects ( Dry mouth, constipation, urinary retention)Typical Dosage for Clidinium BromideAdult: 2.5 - 5 mg 3 - 4 times daily before meals and at bed time.
Children: not recommended.
Schedule of Clidinium BromideHStorage Requirements for Clidinium BromideStore at below 30 degree C in a tightly closed container. Protect from moisture and sunlight.
Keep out of the reach of children
Effects of Missed Dosage of Clidinium BromideTake 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 Clidinium BromideGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal.
ChlordiazepoxideAbout ChlordiazepoxideBenzodiazepine derivative, Sedative /hypnotic, Antianxiety and skeletal muscle relaxant.Mechanism of Action of ChlordiazepoxideChlordiazepoxide mainly acts on Limbic system and ascending reticular formation in the CNS. It binds to the BZD receptor. The binding will facilitates GABA mediated chloride channel opening and produce hyperpolarisation. This will increase the concentration of inhibitory neurotransmitter GABA and chloride ions in the CNS and decreases firing rate of neurons. This in turn alters normal excitatory functions of the body.Pharmacokinets of ChlordiazepoxideAbsorption: It is absorbed after oral administration. Distribution: It is distributed widely in the body. Metabolism: It is metabolised to active metabolite in the liver. Excretion: Most metabolites are excreted through urineOnset of Action for Chlordiazepoxide1 - 2 hourDuration of Action for Chlordiazepoxide12 - 24 hourHalf Life of Chlordiazepoxide5 - 30 hourSide Effects of Chlordiazepoxide1.Ataxia
9.Pain at the site of injection
12.Mood changesContra-indications of ChlordiazepoxideHypersensitivity to BenzodiazepinesSpecial Precautions while taking Chlordiazepoxide1.Renal impairment
6.Use caution while driving vehicles, operating machines or other dangerous activitiesPregnancy Related InformationContraindicated.Old Age Related InformationUse with cautionBreast Feeding Related InformationContraindicated.Children Related InformationUse with caution
children < 6 years: contraindicated
NEONATES- contraindicatedIndications for Chlordiazepoxide1. Anxiety
2.Treatment of alcohol withdrawal symptom
4. Pre and post operative apprehensionInteractions for ChlordiazepoxideAlcohol & Other CNS Depressants: Enhanced CNS effects.
Aminophylline: Antagonizes the sedative effect.
Cimetidine, Oral contraceptives, Disulfiram, Fluoxetine, Isoniazid, Ketoconazole, Metoprolol, Propoxyphene, Propranolol.
Valproic acid: Elimination of chlordiazepoxide decreased due to inhibition of hepatic metabolism leading to enhanced activity.
Digoxin: Increase in serum concentration of Digoxin.
Imipramine & Desipramine: Enhanced activity of these drugs.
Levodopa : Decrease in antiparkinsonism efficacy.
Morphine, Pethidine, Atropine and Magnesium trisilicate: Absorption of chlordiazepoxide is impaired.
Probenecid: May cause rapid onset or prolonged effect.
Rifampicin: Decreases efficacy.
Typical Dosage for ChlordiazepoxideAdults: 5 - 10 mg 3 - 4 times daily
Severe anxiety: 20 - 25 mg 3 - 4 times daily
Treatment of alcohol withdrawal symptom: 25 - 100 mg daily; Depending on the patient`s condition dose can be reduced after 2 - 3 weeks
Pre and post operative apprehension: 5 - 10 mg 3 - 4 times daily; the drug should be given one day before surgery in pre operative apprehension
Children: 5mg 3 - 4 times daily.Schedule of ChlordiazepoxideHStorage Requirements for ChlordiazepoxideStore at temperature 15 - 30 degree C.Protect from light and moisture. Keep out of the reach of children.Effects of Missed Dosage of ChlordiazepoxideTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Effects of Overdose of ChlordiazepoxideGive support and symptomatic treatment. Induce emesis or gastric lavage has to be done followed by charcoal administration. Flumazenil can be given as antagonist.
DicyclomineAbout DicyclomineAnticholinergic ,Antimuscarinic, Antispasmodic and in urinary incontinence.Mechanism of Action of DicyclomineDicyclomine 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 DicyclomineAbsorption: 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 Dicyclomine1-2 hours.Duration of Action for Dicyclomine4-6 hours.Half Life of Dicyclomine1.8 hours (((initial phase))). 9 - 10 hours (((secondary phase)))Side Effects of Dicyclomine1.Constipation
11.Increased intraocular pressure
Contra-indications of Dicyclomine1.Hypersensitivity to Dicyclomine and other anticholinergic drugs
2.Narrow angle glaucoma
3.Obstructive gastro intestinal tract
6.Severe ulcerative colitis
8.Unstable cardiovascular status in acute haemorrhage
Special Precautions while taking Dicyclomine1.Renal impairment
5.Hiatus hernia associated
11.Coronary artery disease
Pregnancy Related InformationUse with caution.Old Age Related InformationUse with caution.Breast Feeding Related InformationContraindicatedChildren Related InformationUse with caution.
NEONATES: contraindicatedIndications for Dicyclomine1. Irritable bowel syndrome
Interactions for DicyclomineN/ATypical Dosage for DicyclomineAdult:
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.
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 DicyclomineHStorage Requirements for DicyclomineStore 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 DicyclomineTake 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 DicyclomineGive 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.
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