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- Pharmacology For Aceclofenac + Paracetamol + Serratiopeptidase
Aceclofenac + Paracetamol + Serratiopeptidase Pharmacology
Aceclofenac + Paracetamol + SerratiopeptidaseAbout Aceclofenac + Paracetamol + SerratiopeptidaseN/AMechanism of Action of Aceclofenac + Paracetamol + SerratiopeptidaseN/APharmacokinets of Aceclofenac + Paracetamol + SerratiopeptidaseN/AOnset of Action for Aceclofenac + Paracetamol + SerratiopeptidaseN/ADuration of Action for Aceclofenac + Paracetamol + SerratiopeptidaseN/AHalf Life of Aceclofenac + Paracetamol + SerratiopeptidaseN/ASide Effects of Aceclofenac + Paracetamol + SerratiopeptidaseN/AContra-indications of Aceclofenac + Paracetamol + SerratiopeptidaseN/ASpecial Precautions while taking Aceclofenac + Paracetamol + SerratiopeptidaseN/APregnancy Related InformationContraindicated. Aceclofenac and Serratiopeptidase are contraindicated in pregnancy, so the combination cannot be used in pregnancyOld Age Related InformationN/ABreast Feeding Related InformationLactation: Contraindicated. Since Aceclofenac and Serratiopeptidase contraindicated in lactation, the combination cannot be used in lactationChildren Related InformationN/AIndications for Aceclofenac + Paracetamol + Serratiopeptidase1.Pain and inflammation
Interactions for Aceclofenac + Paracetamol + SerratiopeptidaseN/ATypical Dosage for Aceclofenac + Paracetamol + SerratiopeptidaseAdults: 1 tablet / day should be taken 1- 2 hour after meals. Each tablet contains Aceclofenac 100 mg + Paracetamol 500 mg + Serratiopeptidase 15 mgSchedule of Aceclofenac + Paracetamol + SerratiopeptidaseN/AStorage Requirements for Aceclofenac + Paracetamol + SerratiopeptidaseN/AEffects of Missed Dosage of Aceclofenac + Paracetamol + SerratiopeptidaseN/AEffects of Overdose of Aceclofenac + Paracetamol + SerratiopeptidaseN/A
AceclofenacAbout AceclofenacNSAID, Analgesic, Antiinflammatory, Anti arthritic.Mechanism of Action of AceclofenacThis drug has several mechanism of action.
1. It inhibits cyclooxygenase (COX) activity and to suppress the PGE2 production by inflammatory cells, by inhibiting IL-Beta & TNF in the inflammatory cells (Intracellular Action).
2. It blocks degeneration and stimulates synthesis of extra cellular matrix of cartilages by inhibiting the action of different cytokines.
3. Drug and its metabolites inhibit IL-6 production by human chondrocytes. This leads to inhibition of increase of inflammatory cells in synovial tissue, inhibition of IL-1 amplification, inhibition of increased MMP synthesis and thus ensuring proteoglycan production.
4. It inhibits IL-1 and TNF production by human chondrocytes, inflammatory cells and synovial cells and therefore blocks suppression of GAG and collagen synthesis and stimulates growth factors mediated synthesis of GAG and collagen.
5. 4`-hydroxyaceclofenac a metabolite of aceclofenac inhibits pro MMP1 and pro MMP3 produced by synovial cells (Rheumatoid Synovial Cells) in serum and in synovial fluid and thus inhibits progressive joint destruction by MMPs.
6. Aceclofenac inhibits Neutrophil Adhesion & Accumulation at the inflammatory site in the early phase and thus blocks the pro-inflammatory actions of Neutrophils.
7. Aceclofenac is also an NSAID with greater COX-2 specificity
Pharmacokinets of AceclofenacAbsorption- It is rapidly and completely absorbed after oral administration
Distribution- Widely distributed in the body as protein-bound form. It is highly protein-bound (>99.7%). Aceclofenac penetrates into the synovial fluid, where the concentrations reach approximately 60% of those in plasma.
Metabolism- Metabolized into metabolites in the liver. Main metabolite is 4-hydroxyaceclofenac
Excretion- It is excreted through urine mainly as conjugated hydroxymetabolites
Onset of Action for AceclofenacN/ADuration of Action for AceclofenacN/AHalf Life of AceclofenacThe mean plasma elimination half-life is 4 - 4.3 hoursSide Effects of Aceclofenac1. Dyspepsia
2. Abdominal pain
14. Ulcerative stomatitis
15. Elevation of circulating levels of hepatic enzymes.
Contra-indications of Aceclofenac1. Hypersensitivity to the drug
2. Bleeding from the stomach or intestines
3. Moderate to severely decreased kidney function
4. Hypersensitivity to other NSAIDs
5. Active peptic ulcer
Special Precautions while taking Aceclofenac1. Hepatic porphyria
2. Bleeding tendencies
3. Blood disorders
4. Crohn`s disease
5. Decreased heart function
6. History of peptic ulcers
7. Inflammation of the bowel and back passage
8. Mildly decreased kidney function
9. Recent major surgery
10. Stomach disorders
11. Decreased liver function
12. Intestinal disorders
Pregnancy Related InformationContraindicated.Old Age Related InformationUse with caution.Breast Feeding Related InformationContraindicated.Children Related InformationUse with cautionIndications for Aceclofenac1. Ankylosing spondylitis
3. Symptomatic treatment of pain and inflammation in Post-Traumatic pain
4. Cervical pain
5. Low back pain
6. Acute gout
Interactions for AceclofenacLithium, digoxin and methotrexate: Aceclofenac may increase plasma concentrations of lithium, digoxin and methotrexate.
Anticoagulants: Activity of anticoagulants may be increased.
Diuretics : Aceclofenac inhibits the activity of diuretics. When concomitantly administrated with potassium sparing diuretics, serum potassium should be monitored.
Cyclosporin: Aceclofenac may enhance cyclosporin nephrotoxicity.
Quinolones : Aceclofenac may precipitate convulsions when coadministered with quinolone antibiotics.
Typical Dosage for AceclofenacOral-
Adult (general dose)-
100mg twice daily
Schedule of AceclofenacHStorage Requirements for AceclofenacStore below 25?CEffects of Missed Dosage of AceclofenacTake 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 AceclofenacGive symptomatic and supportive treatment. Induce gastric lavage and administer charcoal in repeated doses. Treated with antacid if necessary.
ParacetamolAbout 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
Contra-indications of Paracetamol1. Hypersensitivity to ParacetamolSpecial Precautions while taking Paracetamol1. Hepatic impairment
2. Renal impairment
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
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.
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.
SerratiopeptidaseAbout SerratiopeptidaseA proteolytic enzyme, A powerful anti-inflammatory, anti-edemic.Mechanism of Action of SerratiopeptidaseThis anti-inflammatory proteolytic enzyme bind to the alpha-2-macroglobulin in the blood, which helps to mask its antigenicity.Then it is slowly transferred to the site of inflammation. Serratiopeptidase hydrolyze bradykinin, histamine, serotoxin responsible for oedema.It reduces swelling improves microcirculation and expectoration of sputum. Due to this action Serratiopeptidase has anti-inflammatory, antioedemic and fibrinolytic activity and act rapidly on localized inflammation.Pharmacokinets of SerratiopeptidaseOrally absorbed. In the case of enteric coated tablet absorption take place in the intestine. After absorption it is directly enter in to the bloodstream. It is excreted via urine and bile.Onset of Action for SerratiopeptidaseN/ADuration of Action for Serratiopeptidase8 to 10 hrsHalf Life of SerratiopeptidaseN/ASide Effects of Serratiopeptidase1. Hypersensitivity
3. Gastric discomfort
8. Skin rash
Contra-indications of Serratiopeptidase1. Hypersensitivity to this drug
2. Blood coagulation disorder
Special Precautions while taking Serratiopeptidase1. In patients with renal failure or hepatic failurePregnancy Related InformationContraindicatedOld Age Related InformationN/ABreast Feeding Related InformationContraindicatedChildren Related InformationN/AIndications for Serratiopeptidase1. Antiinflammatory
3. Anti- rheumatoid
4. To promote transfer of antibiotics to the site of action
5. To promote lysis and discharge of sputum and pus
7. Fibrocystic breast swelling
Interactions for SerratiopeptidaseN/ATypical Dosage for SerratiopeptidaseOral-
Adults-5 to 10mg tab every 3 times daily.
10- 30 mg tab /day.
Schedule of SerratiopeptidaseN/AStorage Requirements for SerratiopeptidaseStore below 25 degree Celsius, protect from light and moisture.Effects of Missed Dosage of SerratiopeptidaseTake 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 SerratiopeptidaseGive supportive measures and symptomatic treatment.
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