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- Pharmacology For Dicyclomine + Paracetamol + Domperidone
Dicyclomine + Paracetamol + Domperidone Pharmacology
Dicyclomine + Paracetamol + DomperidoneAbout Dicyclomine + Paracetamol + DomperidoneN/AMechanism of Action of Dicyclomine + Paracetamol + DomperidoneN/APharmacokinets of Dicyclomine + Paracetamol + DomperidoneN/AOnset of Action for Dicyclomine + Paracetamol + DomperidoneN/ADuration of Action for Dicyclomine + Paracetamol + DomperidoneN/AHalf Life of Dicyclomine + Paracetamol + DomperidoneN/ASide Effects of Dicyclomine + Paracetamol + DomperidoneN/AContra-indications of Dicyclomine + Paracetamol + DomperidoneN/ASpecial Precautions while taking Dicyclomine + Paracetamol + DomperidoneN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Dicyclomine + Paracetamol + DomperidoneN/AInteractions for Dicyclomine + Paracetamol + DomperidoneN/ATypical Dosage for Dicyclomine + Paracetamol + DomperidoneN/ASchedule of Dicyclomine + Paracetamol + DomperidoneN/AStorage Requirements for Dicyclomine + Paracetamol + DomperidoneN/AEffects of Missed Dosage of Dicyclomine + Paracetamol + DomperidoneN/AEffects of Overdose of Dicyclomine + Paracetamol + DomperidoneN/A
DicyclomineAbout DicyclomineAnticholinergic ,Antimuscarinic, Antispasmodic and in urinary incontinence.Mechanism of Action of DicyclomineDicyclomine 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 DicyclomineAbsorption: 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 Dicyclomine1-2 hours.Duration of Action for Dicyclomine4-6 hours.Half Life of Dicyclomine1.8 hours (((initial phase))). 9 - 10 hours (((secondary phase)))Side Effects of Dicyclomine1.Constipation
11.Increased intraocular pressure
Contra-indications of Dicyclomine1.Hypersensitivity to Dicyclomine and other anticholinergic drugs
2.Narrow angle glaucoma
3.Obstructive gastro intestinal tract
6.Severe ulcerative colitis
8.Unstable cardiovascular status in acute haemorrhage
Special Precautions while taking Dicyclomine1.Renal impairment
5.Hiatus hernia associated
11.Coronary artery disease
Pregnancy Related InformationUse with caution.Old Age Related InformationUse with caution.Breast Feeding Related InformationContraindicatedChildren Related InformationUse with caution.
NEONATES: contraindicatedIndications for Dicyclomine1. Irritable bowel syndrome
Interactions for DicyclomineN/ATypical Dosage for DicyclomineAdult:
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.
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 DicyclomineHStorage Requirements for DicyclomineStore 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 DicyclomineTake 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 DicyclomineGive 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.
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.
DomperidoneAbout DomperidoneAntidopaminergic, Motility stimulant,Piperidine derivative, Antiemetic, anti-vertigo.Mechanism of Action of DomperidoneDomperidone is a potent dopamine receptor antagonist. It acts centrally and blocks the Dopamine receptor in the Chemoreceptor trigger zone and produces Antiemetic effect.
Domperidone acts peripherally in the gastrointestinal system and increases oesophageal peristalsis, oesophageal sphincter pressure and gastric motility. These all facilitates gastric emptying. Domperidone is used in migraine to relieve nausea and vomiting.
Anaesthetic adjuncts: It is used preoperatively in order to reduce the post operative vomiting.
Pharmacokinets of DomperidoneAbsorption: Domperidone is rapidly absorbed after oral administration. Since it undergoes first pass metabolism oral bioavailability is only 15 %. Distribution: It is widely distributed in the body in protein bound form. Metabolism: Domperidone undergoes metabolism in the liver. Excretion: It is excreted mainly in the faeces and also in the urine.Onset of Action for Domperidone30 - 60 minutesDuration of Action for Domperidone6 - 8 hoursHalf Life of Domperidone7.5 hoursSide Effects of Domperidone1.Diarrhoea
Contra-indications of Domperidone1.Hypersensitivity to Domperidone
2.Prolactin releasing pituitary tumour(prolactinoma)
Special Precautions while taking Domperidone1.Hepatic impairment
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
NEONATES: contraindicatedIndications for Domperidone1.Nausea and vomiting associated with gastrointestinal disorder and migraine.
2.Delayed gastric emptying of functional origin
3.As an Antiemetic in patient receiving cytotoxic drugs
Interactions for DomperidoneDigoxin: Oral dose of digoxin needs to be reduced.
Aspirin, Paracetamol & Oral Diazepam: Increases absorption of these agents.
Anticholinergic agents: Antagonize the effects of domperidone.
Phenothiazines: CNS depression enhanced by domperidone.
Antimuscarinic agents and opioids: Antagonize GI effects of domperidone.
Suxamethonium: Neuromuscular blockade enhanced by domperidone.Typical Dosage for DomperidoneAdults: 30 - 40 mg / day in 3 - 4 divided doses 30 minutes before meals and at bed time if required. After 2 weeks dose can be increased to 60 - 80 mg / day if needed.
Migraine: 20 mg by mouth may be taken up to every 4 hours with Paracetamol, as required up to a maximum of 4 doses in 24 hours.
Children: 300 mcg / kg body weight 3 - 4 times daily 30 minutes before meals and at bed time if required
Schedule of DomperidoneHStorage Requirements for DomperidoneStore at room temperature (15 - 30 degree C). Protect from direct sun light and moistureEffects of Missed Dosage of DomperidoneTake 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 DomperidoneGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage and absorption of the drug can be reduced by administration of activated charcoal. To control Extrapyramidal reactions give antiparkinsonian or anticholinergic agents.
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