Dicyclomine + Nimesulide Pharmacology

Dicyclomine + Nimesulide

About Dicyclomine + Nimesulide
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Mechanism of Action of Dicyclomine + Nimesulide
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Pharmacokinets of Dicyclomine + Nimesulide
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Onset of Action for Dicyclomine + Nimesulide
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Duration of Action for Dicyclomine + Nimesulide
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Half Life of Dicyclomine + Nimesulide
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Side Effects of Dicyclomine + Nimesulide
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Contra-indications of Dicyclomine + Nimesulide
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Special Precautions while taking Dicyclomine + Nimesulide
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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 Dicyclomine + Nimesulide
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Interactions for Dicyclomine + Nimesulide
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Typical Dosage for Dicyclomine + Nimesulide
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Schedule of Dicyclomine + Nimesulide
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Storage Requirements for Dicyclomine + Nimesulide
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Effects of Missed Dosage of Dicyclomine + Nimesulide
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Effects of Overdose of Dicyclomine + Nimesulide
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Dicyclomine

About Dicyclomine
Anticholinergic ,Antimuscarinic, Antispasmodic and in urinary incontinence.
Mechanism of Action of Dicyclomine
Dicyclomine is an anticholinergic drug. It exerts its action by inhibiting muscarinic (((cholinergic))) receptors on smooth muscles and prevents the effect of Acetylcholine. Inhibition of Acetylcholine produces relaxation of smooth muscles of gastrointestinal tract and genitourinary tract and reduces the painful spasm and cramp. It inhibits gastrointestinal propulsive motility and reduces gastric acid secretion. It also has a direct relaxant effect on smooth muscle. It readily crosses the blood brain barrier and produces CNS effects.
Pharmacokinets of Dicyclomine
Absorption: About 70 % of the drug is absorbed after oral administration.
Distribution: It is extensively distributed in tissue mainly in protein bound (((99%))) form. It readily crosses blood brain barrier.
Metabolism: Dicyclomine undergoes hepatic metabolism
Excretion: It is excreted mainly in the urine and small amount in the faeces.
Onset of Action for Dicyclomine
1-2 hours.
Duration of Action for Dicyclomine
4-6 hours.
Half Life of Dicyclomine
1.8 hours (((initial phase))). 9 - 10 hours (((secondary phase)))
Side Effects of Dicyclomine
1.Constipation
2.Dry mouth
3.Nausea
4.Vomiting
5.Abdominal discomfort
6.Headache
7.Dizziness
8.Confusion
9.Palpitations
10.Tachycardia
11.Increased intraocular pressure
12.Mydriasis
13.Urine retention
14.Urinary hesitancy
15.Decreased sweating
Contra-indications of Dicyclomine
1.Hypersensitivity to Dicyclomine and other anticholinergic drugs
2.Narrow angle glaucoma
3.Obstructive gastro intestinal tract
4.Obstructive uropathy
5.Reflux oesophagitis
6.Severe ulcerative colitis
7.Myasthenia gravis
8.Unstable cardiovascular status in acute haemorrhage
Special Precautions while taking Dicyclomine
1.Renal impairment
2.Hepatic impairment
3.Heart failure
4.Prostatic hypertrophy
5.Hiatus hernia associated
6.Hyperthyroidism
7.Autonomic neuropathy
8.Ulcerative colitis
9.Arrhythmia
10.Hypertension
11.Coronary artery disease
Pregnancy Related Information
Use with caution.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution.
NEONATES: contraindicated
Indications for Dicyclomine
1. Irritable bowel syndrome
2.Colicky pain
Interactions for Dicyclomine
N/A
Typical Dosage for Dicyclomine
Adult:
Oral: 80 mg / day in 4 divided doses 30 - 60 minutes before meals. Depending on the patient`s response dose can be increased to 160 mg / day in 4 divided doses after 1 week.
Children:
Infant colic: 5 - 10 mg every 6 - 8 hours, 15 minutes before each feed; dose is depending on the patient`s response and age.
Schedule of Dicyclomine
H
Storage Requirements for Dicyclomine
Store at 15 - 30 degree C in a tightly closed container. Protect from light.Keep out of the reach of children
Effects of Missed Dosage of Dicyclomine
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 Dicyclomine
Give 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. Physostigmine is given to block the overdose symptoms of Dicyclomine.

Nimesulide

About Nimesulide
COX-2 selective NSAID, Analgesic,antipyretic.
Mechanism of Action of Nimesulide
This 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 Nimesulide
Absorption-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 Nimesulide
30 to 60 minutes
Duration of Action for Nimesulide
8-10 hours
Half Life of Nimesulide
Its plasma half life is long-nearly 2days
Side Effects of Nimesulide
1. 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 Nimesulide
1. Hypersensitivity to this drug
2. Active peptic ulcer
3. Hepatic impairment
Special Precautions while taking Nimesulide
1. 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 Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Nimesulide
1. 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 Nimesulide
Fenofibrate, 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 Nimesulide
Oral-
Adults - 100 mg two times daily.
Children - 5mg/kg/day divided in 2 or 3 doses.
Schedule of Nimesulide
H
Storage Requirements for Nimesulide
Store in cool, dark, dry place
Effects of Missed Dosage of Nimesulide
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 Nimesulide
Empty the stomach if necessary. Symptomatic treatment should be given

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