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- Pharmacology For Cyproheptadine + Vit B1+ Vit B2 + Vit B6
Cyproheptadine + Vit B1+ Vit B2 + Vit B6 Pharmacology
Cyproheptadine + Vit B1+ Vit B2 + Vit B6About Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/AMechanism of Action of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/APharmacokinets of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/AOnset of Action for Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/ADuration of Action for Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/AHalf Life of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/ASide Effects of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/AContra-indications of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/ASpecial Precautions while taking Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/APregnancy Related InformationUse with cautionOld Age Related InformationN/ABreast Feeding Related InformationContraindicated; since Cyproheptadine is contraindicated in breast feeding, so the combination cannot be used in breast feeding mother.Children Related InformationN/AIndications for Cyproheptadine + Vit B1+ Vit B2 + Vit B6Appetite stimulantInteractions for Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/ATypical Dosage for Cyproheptadine + Vit B1+ Vit B2 + Vit B61 teaspoonful to be taken 3 times daily.Schedule of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/AStorage Requirements for Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/AEffects of Missed Dosage of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/AEffects of Overdose of Cyproheptadine + Vit B1+ Vit B2 + Vit B6N/A
CyproheptadineAbout CyproheptadinePiperidine (nonselective) First Generation H1 Antagonist ,anticholinergic and antiserotonergic(5-HT2 receptor antagonist), antihistaminic,appetite stimulant.Mechanism of Action of CyproheptadineCyproheptadine is a sedative antihistamine with serotonin antagonist, and calcium-channel blocking actions. It competes with Histamine for H1 receptors present in the smooth muscle of gastrointestinal tract, bronchi, large blood vessels and uterus. Histamine cannot bind with H1 receptors and cannot produce histamine induced allergic symptoms. Cyproheptadine blocks serotonin receptors preferentially block 5HT2A receptor and are useful in migraine prophylaxis. It has weak anticholinergic activity and possesses mild CNS depressant properties. It also blocks voltage sensitive calcium channel in islet of pancreas and smooth muscle. Cyproheptadine increases appetite and cause weight gain.Pharmacokinets of CyproheptadineAbsorption: Cyproheptadine is well absorbed after oral administration. Distribution: It is distributed in the body in highly protein bound form. Metabolism: It is extensively metabolised in the liver. Excretion: Metabolites are excreted primarily in the urine; unchanged drug and small amount of metabolites are excreted through faeces.Onset of Action for Cyproheptadine15 - 60 minutesDuration of Action for CyproheptadineN/AHalf Life of Cyproheptadine1 - 4 hoursSide Effects of Cyproheptadine1.Dizziness
Contra-indications of Cyproheptadine1.Hypersensitivity to Cyproheptadine and other drugs of similar structure
2.Angle closure glaucoma
5.Bladder neck obstruction
9.Patient on monoamine oxidase inhibitory therapy.
Special Precautions while taking Cyproheptadine1.Hypertension
3.Increased intraocular pressure
5.Patient should be cautioned against activities requiring mental alertness such as driving, operating machine or involving in any hazardous activities 6.Avoid alcohol
Pregnancy Related InformationUse with cautionOld Age Related InformationContraindicated.Breast Feeding Related InformationContraindicated.Children Related InformationUse with caution
Indications for Cyproheptadine1.Antiallergic
Interactions for CyproheptadineAlcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, anti-anxiety drugs, narcotic analgesics): CNS depressant action potentiated.
MAOIs, tricylic antidepressants and atropine: Antimuscarinic action potentiated.
Aminoglycosides: Ototoxicity produced by aminoglycosides masked.
Typical Dosage for CyproheptadineAdult: 12 - 16 mg / day in 3 - 4 divided doses.
Maximum dose: 32 mg / day
Migraine prophylaxis and vascular headaches: Initial dose: 4 mg and may be repeated after 30 minutes; A maintenance dose of 4 mg may be given every 4 to 6 hours.
Children above 6 years: 8 - 12 mg / day in 2 - 3 divided doses
Maximum dose: 16 mg / day
Children 2 - 6: 4 - 6 mg / day in 2 - 3 divided doses
Maximum dose: 12 mg / day
Schedule of CyproheptadineGStorage Requirements for CyproheptadineStore at room temperature in a tightly closed container.Effects of Missed Dosage of CyproheptadineTake 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 CyproheptadineGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing vomiting. Absorption of the drug can be reduced by administration of activated charcoal. Hypotension can be treated by vasopressors and seizure with Diazepam or Phenytoin.
Vit B1About Vit B1
Physiological functions: Thiamine pyrophosphate is a coenzyme and the active form of vitamin B. It functions as coenzyme in decarboxylation of a-keto acid and in Hexose Monophosphate shunt.
Deficiency symptoms: In severe vitamin B1 deficiency beriberi develops. It is of two types:
a) Wet beriberi
b) Dry beriberi
Wet beriberi: In this the symptoms are related to the cardiovascular system and they are palpitations, tachycardia, dyspnoea, ECG changes, oedema, and high output cardiac failure.
Dry beriberi: The symptoms and signs are related to the Nervous system. The main features are peripheral neuritis, hyperaesthesia (localized areas) or anaesthesia, there is gradual loss in muscle strength, wrist drop, poor memory, depression, lack of initiative and anorexia.Mechanism of Action of Vit B1Thiamine exerts it`s action by influencing carbohydrate metabolism. It combines with ATP to form thiamine pyrophosphate in the body. Thiamine pyrophosphate acts as a coenzyme for carbohydrate metabolism, decarboxylation of ketoacids, and hexose monophosphate shunt. It also have plays some role in neuromuscular transmission.Pharmacokinets of Vit B1Absorption: Well absorbed orally.
Distribution: Widely distributed in the body. It is also distributed in to breast milk.
Metabolism: Metabolized in the liver.
Excretion: Excess thiamine is excreted through urine.
Onset of Action for Vit B1N/ADuration of Action for Vit B1N/AHalf Life of Vit B1N/ASide Effects of Vit B11. Angioedema
2. Cardiovascular collapse
8. Allergic reactions
9. Tightness of throat
10. Feeling of warmth
13. Tenderness and induration following I. M. administration
Contra-indications of Vit B11. Hypersensitivity to the drugSpecial Precautions while taking Vit B1N/APregnancy Related InformationUse with cautionOld Age Related InformationMay be usedBreast Feeding Related InformationUse with cautionChildren Related InformationMay be usedIndications for Vit B11. Thiamine deficiency
2. Dry beriberi
3. Wet beriberi
4. Wernicke`s encephalopathy
5. Hyperemesis gravidarum
6. Korsakoffs syndrome
7. Polyneuritis secondary to alcoholism
8. Multiple neurosis
9. Toxic and confusional states
10. Anorexia nervosa
Interactions for Vit B1N/ATypical Dosage for Vit B1Oral :
In mild deficiency: 10 to 25mg/day.
In severe deficiency: 200 to 300mg/day.
Adults: 10 to 20mg I.M. depending up on the severity of the condition (Up to 100mg I.M. or I.V. for severe cases); thrice daily for two weeks followed by dietary correction and multivitamin supplement containing 5 to 30mg Thiamine/day in single or divided doses for 1 month.
Wernicke`s encephalopathy: 100mg I.V. followed by 50 to 100mg IM. or I.V./day.
"Wet beriberi with heart failure": 10 to 30mg I.V. for emergency treatment.
Schedule of Vit B1C1 (Oral)Storage Requirements for Vit B1Store in a well closed container; in a cool place and protect from light.Effects of Missed Dosage of Vit B1Take 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 Vit B1Provide symptomatic treatment and supportive measures.
Vit B2About Vit B2N/AMechanism of Action of Vit B2Riboflavin exerts it`s action by influencing metabolic reactions. Riboflavin functions in the forms of flavin adenine dinucleotide (FAD), and flavin mononucleotide (FMN) which are coenzymes for flavoproteins involved in many oxidation-reduction reactions. Both FMN and FAD play a vital metabolic role in numerous tissue respiration systems. Riboflavin also directly involves in maintaining erythrocyte integrity.Pharmacokinets of Vit B2Absorption: Well absorbed orally; bioavailability increases when administer along with food.
Distribution: Widely distributed in the tissues and limited amount is stored in the liver, spleen, kidneys, and heart. It crosses the placenta and also secreted in to the breast milk.
Metabolism: Phosphorylated in the intestine, liver and other tissues to FMN and metabolized in to FAD the liver.
Excretion: Larger doses are excreted unchanged in urine.
Onset of Action for Vit B2N/ADuration of Action for Vit B2N/AHalf Life of Vit B266 to 84 minutesSide Effects of Vit B21. Bright yellow urine with higher dosesContra-indications of Vit B2No known contraindications.Special Precautions while taking Vit B2N/APregnancy Related InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationMay be usedChildren Related InformationMay be usedIndications for Vit B21. Ariboflavinosis
9. Dermatitis of trunk and extremities
10. Other riboflavin deficiency symptoms
Interactions for Vit B2Oral contraceptive:Dose of Riboflavin may need to be increased
Propantheline Bromide:Delays absorption rate of Riboflavin
Typical Dosage for Vit B2Oral:
Adults: 20 to 40mg three times daily or depending up on the severity.
Children: 20mg daily.
Adults and children over 12 years: 5 to 30mg/day depending up on the severity .
Children (below 12years): 3 to 10mg/day depending up on the severity.
Schedule of Vit B2C1Storage Requirements for Vit B2Store in a well closed container; in a cool place and protect from light.Effects of Missed Dosage of Vit B2Take 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 doseEffects of Overdose of Vit B2Provide symptomatic treatment and supportive measures.
Vit B6About Vit B6Physiological functions: It is involved as a coenzyme (Pyridoxal phosphate) in metabolism of tryptophan, in several metabolic transformations of amino acids including transamination, decarboxylation & racemization.
Deficiency symptoms: Peripheral neuritis, seizures, stomatitis, glossitis, anaemia, seborrhea like lesions.Mechanism of Action of Vit B6Vitamin B6 is a collective term for Pyridoxine, Pyridoxal, Pyridoxamine and their phosphorylated derivatives such as Pyridoxine phosphate, Pyridoxal phosphate and Pyridoxamine derivatives respectively. Vitamin B6 is essential for the metabolism of amino acid, glycogen and fatty acids, for nerve functions, for the formation of red blood cells and also helps the skin healthy. Vitamin B6 is also used for the synthesis of nucleic acid, Haemoglobin, Sphingomyelin, other Sphingolipids, Serotonin, Dopamine, Noradrenaline and GABA.Pharmacokinets of Vit B6Absorption: Vitamin B6 is readily absorbed after oral administration.
Distribution: It is mainly distributed in the body in protein bound form. It is stored primarily in the liver and to a lesser extent muscle and brain.
Metabolism: It is metabolised in the liver
Onset of Action for Vit B6N/ADuration of Action for Vit B6N/AHalf Life of Vit B615-20 daysSide Effects of Vit B61. Neuropathy
2. Unstable gait
4. Perioral numbness
6. Numbness of feet
8. Sensory neuropathy
Contra-indications of Vit B61. Hypersensitivity to Vitamin B6Special Precautions while taking Vit B6N/APregnancy Related InformationMay be usedOld Age Related InformationMay be usedBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
Indications for Vit B61. Vitamin B6 deficiency including inadequate diet and drug induced causes
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning
Interactions for Vit B6Cycloserine, Hydralazine, Isoniazide, Oral contraceptive, Penicillamine: Increase Pyridoxine requirement.
Levodopa: Pyridoxine reverses the therapeutic effect of Levodopa.
Phenobarbital, Phenytoin: Pyridoxine decreases serum level of these anticonvulsants.
Typical Dosage for Vit B6Adult: 10 - 20 mg / day
Dietary deficiency: 2.5 -10 mg / day for effective therapeutic response is obtained.
Maintenance dose: 2 - 5 mg / day for several weeks.
Drug induced deficiency: 100 - 200 mg / day for 3 weeks.
Maintenance dose: 25 - 100 mg / day
Neuropathy: 50 - 200 mg /day
Premenstrual syndrome: 40 - 500 mg / day
Hyperoxaluria type 1: 25 - 300 mg / day
Metabolic disorder: 100-500 mg /day.
Isoniazid poisoning: Initial dose: 1 - 4 g as IV administration, then 1 g IM every 30 minute until Pyridoxine dose is equal to the Isoniazid dose has been given.
Schedule of Vit B6N/AStorage Requirements for Vit B6Store it at 15 - 30 degree C. Protect from moisture and heat.Effects of Missed Dosage of Vit B6Take 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 Vit B6Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.
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