Povidone Iodine + Metronidazole Pharmacology

Povidone Iodine + Metronidazole

About Povidone Iodine + Metronidazole
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Mechanism of Action of Povidone Iodine + Metronidazole
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Pharmacokinets of Povidone Iodine + Metronidazole
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Onset of Action for Povidone Iodine + Metronidazole
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Duration of Action for Povidone Iodine + Metronidazole
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Half Life of Povidone Iodine + Metronidazole
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Side Effects of Povidone Iodine + Metronidazole
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Contra-indications of Povidone Iodine + Metronidazole
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Special Precautions while taking Povidone Iodine + Metronidazole
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Povidone Iodine + Metronidazole
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Interactions for Povidone Iodine + Metronidazole
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Typical Dosage for Povidone Iodine + Metronidazole
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Schedule of Povidone Iodine + Metronidazole
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Storage Requirements for Povidone Iodine + Metronidazole
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Effects of Missed Dosage of Povidone Iodine + Metronidazole
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Effects of Overdose of Povidone Iodine + Metronidazole
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Povidone Iodine

About Povidone Iodine
Iodine preparation, External broad microbicidal spectrum antiseptic.
Mechanism of Action of Povidone Iodine
Povidone iodine is an iodophore antiseptic and is a microbicidal drug. It releases iodine from its complex and produces pharmacological actions. The released iodine produces antiseptic actions. Iodine is highly reactive with surrounding and has strong oxidizing effect on functional groups of amino acids (-NH 2, -SH etc.), Nucleotides, and fatty acids (double bond of unsaturated fatty acids). Interaction of Iodine with these groups in a cell results in disintegration of the cytoplasm, enzyme denaturation, loss of integrity in the bacterial cell membrane and fungal cell wall .These will leads to destruction of microbial protein and DNA and finally kills the microbes.
Pharmacokinets of Povidone Iodine
Absorption: It is poorly absorbed through intact skin but absorption is enhanced through denuded skin.
Onset of Action for Povidone Iodine
Immediate.
Duration of Action for Povidone Iodine
N/A
Half Life of Povidone Iodine
N/A
Side Effects of Povidone Iodine
1.Local irritation
2.Rashes
3.Itching
Contra-indications of Povidone Iodine
1. Hypersensitivity to Povidone iodine and other preparations containing iodine
2. Thyroid disorders - goiter, hypothyroidism
3. Application to large areas of skin
4. Patient on Lithium therapy
Special Precautions while taking Povidone Iodine
1. Hepatic impairment
2. If irritation or redness develops stop the drug use
3. Avoid contact with eyes
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.
Below 2 years: contraindicated
NEONATES: contraindicated
Indications for Povidone Iodine
As antiseptic in
1. Boils
2. Furunculosis
3. Burns
4. Ulcers
5. Otitis externa
6. Tinea infestations
7. Wound infections
8. Post surgical dressings
9. Cutaneous candidiasis
10. Trichomoniasis
11. Vaginal candidiasis
12. Oral candidiasis
13. Oral hygiene
Interactions for Povidone Iodine
Lab tests: May interfere with thyroid function tests.
Typical Dosage for Povidone Iodine
Topical
Adult:
Ointment (5% w/w Povidone iodine), Cream (5% w/w Povidone iodine). Spray(5 - 10 % w / v Povidone iodine solution), Solution (5 - 7.5 % w/ v Povidone iodine solution) and Powder( 5% w/w Povidone iodine)
Thoroughly clean and dry the area. Apply the drug. Cover with a bandage.
Gargle solution:
Oral candidiasis: 1% mouthwash solution rinse mouth with this solution
Oral hygiene: 0.1 % of 10 ml solution (undiluted or diluted with equal quantity of warm water solution) rinse mouth with this for 30 seconds 4 times daily for 2 weeks
Surgical scrub: 7.5 % w/v solution
Wet hands with water. Pour about 1 teaspoonful of Scrub on the palm of the hand and spread over both hands and
scrub thoroughly for about 5 minutes.
Use a brush if desired. Clean thoroughly under fingernails.
Add a little water and develop copious suds. Rinse thoroughly under running water.
Repeat the entire procedure.

Pessaries:
Vaginal candidiasis: 200 mg as pessaries. Insert 2 pessaries in vagina at night and continue for 2 weeks

Schedule of Povidone Iodine
N/A
Storage Requirements for Povidone Iodine
Store in a cool dry place. Protect from direct light and heat. Keep out of reach of children
Effects of Missed Dosage of Povidone Iodine
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 Povidone Iodine
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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