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- Pharmacology For Dicyclomine + Paracetamol + Tramadol
Dicyclomine + Paracetamol + Tramadol Pharmacology
Dicyclomine + Paracetamol + TramadolAbout Dicyclomine + Paracetamol + TramadolN/AMechanism of Action of Dicyclomine + Paracetamol + TramadolN/APharmacokinets of Dicyclomine + Paracetamol + TramadolN/AOnset of Action for Dicyclomine + Paracetamol + TramadolN/ADuration of Action for Dicyclomine + Paracetamol + TramadolN/AHalf Life of Dicyclomine + Paracetamol + TramadolN/ASide Effects of Dicyclomine + Paracetamol + TramadolN/AContra-indications of Dicyclomine + Paracetamol + TramadolN/ASpecial Precautions while taking Dicyclomine + Paracetamol + TramadolN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Dicyclomine + Paracetamol + TramadolN/AInteractions for Dicyclomine + Paracetamol + TramadolN/ATypical Dosage for Dicyclomine + Paracetamol + TramadolN/ASchedule of Dicyclomine + Paracetamol + TramadolN/AStorage Requirements for Dicyclomine + Paracetamol + TramadolN/AEffects of Missed Dosage of Dicyclomine + Paracetamol + TramadolN/AEffects of Overdose of Dicyclomine + Paracetamol + TramadolN/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.
TramadolAbout TramadolA synthetic analogue of codein, Centrally acting Narcotic Analgesic.Mechanism of Action of TramadolIt is centrally acting synthetic drug. Chemically it is not related to the opiates but it act on the Opioid receptors present in the CNS. It has weak agonistic action on mu Opioid receptors, it cause analgesia. Part of this analgesic effect is due to the inhibition of norepinephrine and serotonin reuptake inhibition. However it has agonistic action on mu receptors, respiratory depression and gastrointestinal effects are not prominent.Pharmacokinets of TramadolAbsorption-Absorbed well after oral, intravenous and other parenteral application.
Distribution-Widely distributed in the body, about 20% bound to the plasma protein. It may cross the placenta.
Metabolism-It is metabolized in the liver by O-demethylation; N-demethylation, glucoronidation or sulfation to its metabolites. Mono-O-desmethylate is its active metabolite.
Excretion - Excreted 30% as unchanged form and 60% as its metabolites via urine.
Onset of Action for Tramadol30 to 60 hrsDuration of Action for Tramadol8 to 12 hrsHalf Life of TramadolN/ASide Effects of Tramadol1. Dizziness
7. Blurred vision
8. Stomach upset
15. Dry mouth
Contra-indications of Tramadol1. Hypersensitivity to this drug
2. Acute alcoholic intoxification
4. With centrally acting analgesics
5. With psychotropic drug
6. With Opioid drug
Special Precautions while taking Tramadol1. Head injury
2. Acute abdominal conditions
4. Respiratory depression
5. Renal failure
6. Hepatic failure
7. Physical dependence on Opioids
Pregnancy Related InformationMay be usedOld Age Related InformationUse with cautionBreast Feeding Related InformationMay be usedChildren Related InformationMay be usedIndications for Tramadol1. Post operative pain
3. Musculoskeletal pain
4. Low back pain
5. Pain associated with other reasons
Interactions for TramadolCarbamazepine: A significant increase in Tramadol metabolism.
Hypnotics, Tranquilizers and other CNS depressants: Sedative effects potentiated.
MAOIs: Fatal interaction occurs.
Opioid analgesics like Buprenorphine, Butorphanol and Pentazocine: May precipitate withdrawl symptoms.
Tranquilizers: Analgesia potentiated.Typical Dosage for TramadolOral-
Adults - 50 to 100mg every 4 to 6 hrs or twice daily.
50 to 100 mg given every 4 to 6 hrs.
100 mg suppository 4 times daily.
Schedule of TramadolN/AStorage Requirements for TramadolStore at room temperature in a tightly closed container and away from heat & moisture. Keep out of reach of children.Effects of Missed Dosage of TramadolTake 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 TramadolEstablish artificial respiratory exchange. Naloxone administration cannot relieve all the symptoms produced by tramadol. Haemodialysis can remove a small fraction of drug from the body. Provide symptomatic and supportive treatment.
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