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- Pharmacology For Nimesulide + Paracetamol + Dextropropoxyphene
Nimesulide + Paracetamol + Dextropropoxyphene Pharmacology
Nimesulide + Paracetamol + Dextropropoxyphene
About Nimesulide + Paracetamol + DextropropoxypheneN/AMechanism of Action of Nimesulide + Paracetamol + DextropropoxypheneN/APharmacokinets of Nimesulide + Paracetamol + DextropropoxypheneN/AOnset of Action for Nimesulide + Paracetamol + DextropropoxypheneN/ADuration of Action for Nimesulide + Paracetamol + DextropropoxypheneN/AHalf Life of Nimesulide + Paracetamol + DextropropoxypheneN/ASide Effects of Nimesulide + Paracetamol + DextropropoxypheneN/AContra-indications of Nimesulide + Paracetamol + DextropropoxypheneN/ASpecial Precautions while taking Nimesulide + Paracetamol + DextropropoxypheneN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Nimesulide + Paracetamol + DextropropoxypheneN/AInteractions for Nimesulide + Paracetamol + DextropropoxypheneN/ATypical Dosage for Nimesulide + Paracetamol + DextropropoxypheneN/ASchedule of Nimesulide + Paracetamol + DextropropoxypheneN/AStorage Requirements for Nimesulide + Paracetamol + DextropropoxypheneN/AEffects of Missed Dosage of Nimesulide + Paracetamol + DextropropoxypheneN/AEffects of Overdose of Nimesulide + Paracetamol + DextropropoxypheneN/ANimesulide
About NimesulideCOX-2 selective NSAID, Analgesic,antipyretic.Mechanism of Action of NimesulideThis Non Steroidal Anti Inflammatory Drug reduces prostaglandin synthesis by the inhibition of cyclo oxygenase enzyme2 selectively. This is a weaker inhibition .So it produces weaker analgesic property. Its potent anti-inflammatory activity is due to its action on various stages of inflammation. This leads to the inhibition of super oxide anion formation invitro by activated neutrophil, inhibition of histamine release from tissue mast cells and basophiles. Additionally it also prevents platelet activating factor synthesis and metalloproteinase synthesis thus prevents the breakdown of osteoarthritic human cartilage. It also prevent tumor necrosis factor alpha and thus reduce the formation of cytokines. This drug can activate glucocorticoid receptors in the body.Pharmacokinets of NimesulideAbsorption-Completely absorbed after oral administration.
Distribution-Widely distributed in the body and extensively bind to the plasma proteins i.e.99%.
Metabolism-It is metabolized in liver to its metabolites.4-hydroxyl derivative is its one active metabolite.
Excretion - Excreted via urine and bile.
Onset of Action for Nimesulide30 to 60 minutesDuration of Action for Nimesulide8-10 hoursHalf Life of NimesulideIts plasma half life is long-nearly 2daysSide Effects of Nimesulide1. Nausea
2. Vomiting
3. Diarrhea
4. Heart burn
5. Epigastric pain
6. Pruritis
7. Skin rash
8. Headache
9. Dizziness
10.Somnolence
Contra-indications of Nimesulide1. Hypersensitivity to this drug
2. Active peptic ulcer
3. Hepatic impairment
Special Precautions while taking Nimesulide1. Renal impairment
2. Heart failure
3. Alcohol abuse
4. Colitis
5. Crohns disease
6. Diverticulitis
7. Gastric ulcer
8. Diabetis mellitus
9. Hemarrhoids
10. Hepatic failure
11. Rectal irritation or bleeding
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Nimesulide1. Painful inflammatory conditions associated with -
Musculoskeletal system, Dysmenorrhea, Thrombophlebitis, Gout
2. Dental pain
3. ENT infection
4. Osteoarthritis
5. Rheumatoid arthritis
6. Gynecological disorder
7. Low back pain
8. Post operative pain
9. Fever
Interactions for NimesulideFenofibrate, Salicyclic acid, Valproic acid and Tolbutamide: These drugs displace nimesulide from the plasma binding sites.
Methotrexate and Frusemide: These drugs may be displaced from plasma proteins by nimesulide.
Warfarin: Exercise caution since efficacy may be increased.
Theophylline: Efficacy of slow release theophylline preparations reduced. Typical Dosage for NimesulideOral-
Adults - 100 mg two times daily.
Children - 5mg/kg/day divided in 2 or 3 doses.
Schedule of NimesulideHStorage Requirements for NimesulideStore in cool, dark, dry placeEffects of Missed Dosage of NimesulideTake 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 NimesulideEmpty the stomach if necessary. Symptomatic treatment should be given
Paracetamol
About ParacetamolAcetanilide derivative, Non narcotic Analgesic,Antipyretic.Mechanism of Action of ParacetamolParacetamol 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 ParacetamolAbsorption: 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 Paracetamol30 - 60 minutesDuration of Action for Paracetamol6 hoursHalf Life of Paracetamol1-4 hoursSide Effects of Paracetamol1. Nausea
2. Abdominal distress
3. Allergic reactions
4. Rash
Contra-indications of Paracetamol1. Hypersensitivity to ParacetamolSpecial Precautions while taking Paracetamol1. Hepatic impairment
2. Renal impairment
3. Hypertension
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
NEONATES : Contraindicated
Indications for Paracetamol1. To relieve pain and fever
2. Acute gout
3. Migraine
Interactions for ParacetamolCholestyramine: 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 ParacetamolAdult:
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 ParacetamolHStorage Requirements for ParacetamolStore 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 ParacetamolTake 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 ParacetamolGive 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.
Dextropropoxyphene
About DextropropoxypheneA synthetic morphine derivative,Opioid-like agonist,optical isomer of Levopropoxyphene, Narcotic Analgesic, anti-tussive and local anesthetic.Mechanism of Action of DextropropoxypheneIt acts on the CNS Opioid receptors. It has agonist action on mu Opioid receptors. It primarily binds to the mu Opioid receptors and produce analgesia. Its CNS effects are same as morphine. It gives in combination with other Non Steroidal Anti Inflammatory Drugs or other analgesics usually.
Pharmacokinets of DextropropoxypheneAbsorption-Orally absorbed; primarily to the upper small intestine.
Distribution-Widely distributed in the body. Enters the cerebrospinal fluid and cross the placenta.
Metabolism-In liver it is metabolized by N-demethylation. Norpropoxyphene is its active metabolite. It has more half life than parent drug. It causes toxicity at sometime due to its metabolites accumulation in the body.
Excretion-It is excreted through urine.
Onset of Action for Dextropropoxyphene30 to 60 min. after oral administrationDuration of Action for Dextropropoxyphene4 to 6 hrsHalf Life of DextropropoxyphenePlasma half life is 6 to 12 hrsSide Effects of Dextropropoxyphene1. Nausea
2. Vomiting
3. Epigastric distress
4. Sedation
5. Dizziness
6. Urticaria
7. Visual disturbances
8. Physiological dependence
Contra-indications of Dextropropoxyphene1. Hypersensitivity to this drug
2. Respiratory depression
3. Children below 12 years
Special Precautions while taking Dextropropoxyphene1. In patients with hepatic failure or renal failure used cautiously
2. Patient can not drive or operate machinery after the drug administration. So the care should be taken
3. Use cautiously in patients with suicidal mentality
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationN/AIndications for Dextropropoxyphene1. Relieve moderate to severe pain in various conditions
2. Opioid withdrawal
Interactions for DextropropoxypheneBarbiturate anaesthetics: May increase respiratory and CNS depressive effects of propoxyphene.
Warfarin: Potentiation of hypoprothrombinemic effect.
Carbamazipine: May increase serum carbamzipine levels with resultant toxicity.Typical Dosage for DextropropoxypheneOral-
Adults - 65mg 3 to 4 times daily.
Schedule of DextropropoxypheneHStorage Requirements for DextropropoxypheneStore controlled room temperature i.e. between 15 and 30 degree CelsiusEffects of Missed Dosage of DextropropoxypheneTake 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 DextropropoxypheneProvide supportive and symptomatic treatment. Establish artificial respiratory exchange. In the case of respiratory or cardiovascular depression administer a narcotic antagonist i.e. naloxone.Induce emesis or gastric lavage if the patient shows symptoms within 2hrs after drug administration. Avoid the risk of aspiration. For the further removal of drug, administer activated charcoal via nasogastric tube. Continue the supportive treatment and closely monitor the laboratory parameters, vital signs, neurological status closely. In some cases dialysis may be helpful for the treatment.Home Delivery for Nimesulide + Paracetamol + Dextropropoxyphene in Your City
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Nimesulide + Paracetamol + Dextropropoxyphene is a generic medicine name and there are several brands available for it. Some of the brands for nimesulide + paracetamol + dextropropoxyphene might be better known than nimesulide + paracetamol + dextropropoxyphene itself. If the pharmacy that's willing to deliver medicines to your home doesn't have nimesulide + paracetamol + dextropropoxyphene in stock, you can ask for one of the branded alternatives for nimesulide + paracetamol + dextropropoxyphene.
