Cyproheptadine + Vit B1+ Vit B2 + Vit B6 Pharmacology

Cyproheptadine + Vit B1+ Vit B2 + Vit B6

About Cyproheptadine + Vit B1+ Vit B2 + Vit B6
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Mechanism of Action of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
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Pharmacokinets of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
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Onset of Action for Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Duration of Action for Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Half Life of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Side Effects of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Contra-indications of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Special Precautions while taking Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated; since Cyproheptadine is contraindicated in breast feeding, so the combination cannot be used in breast feeding mother.
Children Related Information
N/A
Indications for Cyproheptadine + Vit B1+ Vit B2 + Vit B6
Appetite stimulant
Interactions for Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Typical Dosage for Cyproheptadine + Vit B1+ Vit B2 + Vit B6
1 teaspoonful to be taken 3 times daily.
Schedule of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
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Storage Requirements for Cyproheptadine + Vit B1+ Vit B2 + Vit B6
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Effects of Missed Dosage of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A
Effects of Overdose of Cyproheptadine + Vit B1+ Vit B2 + Vit B6
N/A

Cyproheptadine

About Cyproheptadine
Piperidine (nonselective) First Generation H1 Antagonist ,anticholinergic and antiserotonergic(5-HT2 receptor antagonist), antihistaminic,appetite stimulant.
Mechanism of Action of Cyproheptadine
Cyproheptadine 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 Cyproheptadine
Absorption: 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 Cyproheptadine
15 - 60 minutes
Duration of Action for Cyproheptadine
N/A
Half Life of Cyproheptadine
1 - 4 hours
Side Effects of Cyproheptadine
1.Dizziness
2.Drowsiness
3.Fatigue
4.Nervousness
5.Sleepiness
6.Epigastric distress
7.Dry mouth
8.Nausea
9.Vomiting
10.Rash
11.Urine retention
12.Weight gain


Contra-indications of Cyproheptadine
1.Hypersensitivity to Cyproheptadine and other drugs of similar structure
2.Angle closure glaucoma
3.Acute asthma
4.Peptic ulcer
5.Bladder neck obstruction
6.Prostatic hyperplasia
7.Pyloroduodenal obstruction
8.Debilitated patients
9.Patient on monoamine oxidase inhibitory therapy.
Special Precautions while taking Cyproheptadine
1.Hypertension
2.Hyperthyroidism
3.Increased intraocular pressure
4.Bronchial asthma
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 Information
Use with caution
Old Age Related Information
Contraindicated.
Breast Feeding Related Information
Contraindicated.
Children Related Information
Use with caution
NEONATES: contraindicated
Indications for Cyproheptadine
1.Antiallergic
2.Appetite stimulant
3.Cluster headache
Interactions for Cyproheptadine
Alcohol 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 Cyproheptadine
Adult: 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 Cyproheptadine
G
Storage Requirements for Cyproheptadine
Store at room temperature in a tightly closed container.
Effects of Missed Dosage of Cyproheptadine
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 Cyproheptadine
Give 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 B1

About 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 B1
Thiamine 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 B1
Absorption: 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 B1
N/A
Duration of Action for Vit B1
N/A
Half Life of Vit B1
N/A
Side Effects of Vit B1
1. Angioedema
2. Cardiovascular collapse
3. Cyanosis
4. Restleessness
5. Nausea
6. Haemorrhage
7. Weakness
8. Allergic reactions
9. Tightness of throat
10. Feeling of warmth
11. Urticaria
12. Pruritus
13. Tenderness and induration following I. M. administration
Contra-indications of Vit B1
1. Hypersensitivity to the drug
Special Precautions while taking Vit B1
N/A
Pregnancy Related Information
Use with caution
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vit B1
1. 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
11. Delirium
Interactions for Vit B1
N/A
Typical Dosage for Vit B1
Oral :
In mild deficiency: 10 to 25mg/day.
In severe deficiency: 200 to 300mg/day.
I.M, I.V.:
Beriberi:
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 B1
C1 (Oral)
Storage Requirements for Vit B1
Store in a well closed container; in a cool place and protect from light.
Effects of Missed Dosage of Vit B1
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 Vit B1
Provide symptomatic treatment and supportive measures.

Vit B2

About Vit B2
N/A
Mechanism of Action of Vit B2
Riboflavin 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 B2
Absorption: 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 B2
N/A
Duration of Action for Vit B2
N/A
Half Life of Vit B2
66 to 84 minutes
Side Effects of Vit B2
1. Bright yellow urine with higher doses
Contra-indications of Vit B2
No known contraindications.
Special Precautions while taking Vit B2
N/A
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
May be used
Indications for Vit B2
1. Ariboflavinosis
2. Arteriosclerosis
3. Hypertension
4. Obesity
5. Diabetis
6. Cholepathy
7. Glossitis
8. Stomatitis
9. Dermatitis of trunk and extremities
10. Other riboflavin deficiency symptoms
Interactions for Vit B2
Oral contraceptive:Dose of Riboflavin may need to be increased
Propantheline Bromide:Delays absorption rate of Riboflavin
Typical Dosage for Vit B2
Oral:
Adults: 20 to 40mg three times daily or depending up on the severity.
Children: 20mg daily.
Riboflavin deficiency:
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 B2
C1
Storage Requirements for Vit B2
Store in a well closed container; in a cool place and protect from light.
Effects of Missed Dosage of Vit B2
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 Vit B2
Provide symptomatic treatment and supportive measures.

Vit B6

About Vit B6
Physiological 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 B6
Vitamin 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 B6
Absorption: 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 B6
N/A
Duration of Action for Vit B6
N/A
Half Life of Vit B6
15-20 days
Side Effects of Vit B6
1. Neuropathy
2. Unstable gait
3. Drowsiness
4. Perioral numbness
5. Paresthesia
6. Numbness of feet
7. Somnolence
8. Sensory neuropathy
9. Ataxia
Contra-indications of Vit B6
1. Hypersensitivity to Vitamin B6
Special Precautions while taking Vit B6
N/A
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES: Contraindicated
Indications for Vit B6
1. Vitamin B6 deficiency including inadequate diet and drug induced causes
2. Neuropathy
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning
Interactions for Vit B6
Cycloserine, 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 B6
Adult: 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 B6
N/A
Storage Requirements for Vit B6
Store it at 15 - 30 degree C. Protect from moisture and heat.
Effects of Missed Dosage of Vit B6
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 Vit B6
Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.

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