Cefuroxime + Probenecid Pharmacology
Cefuroxime + Probenecid
2.Rashes & allergic manifestations
5.Pseudo membranous colitis
11.Elevated liver enzymes
2.Along with other nephrotoxic drugs
3.Along with oral anticoagulants
4.Pseudo membranous colitis
2.Patients sensitive to Penicillin
3.Pneumonia & Pulmonary infections
4.Infections caused by ampicillin resistant H. influenzae
8.Urinary tract infections
Oral dose: 0.25 to 0.5gm two times daily
Parenteral dose: 0.75 to 1.5gm I.M or I.V. thrice daily for 5 to 10 days.
Severe infections: 1.5gm I.M. or I.V. four times daily
Meningitis: 3gm I.M.or I.V. thrice daily
Tonsillitis, Pharyngitis, Urinary tract infections etc.: 125 to 500mg orally twice daily up to 10 days
Children:30 to 100mg/kg/day I.M or I.V. three times daily or four times daily
Meningitis: Initially 200 to 240mg/kg/day I.V. three times daily or four times daily & continue the therapy with 100mg/kg/day.
Tonsillitis, Pharyngitis, Urinary tract infections etc.:
Above 1`2 years:same as adult dose
Below 12 years: 0.125gm to 0.25gm orally twice daily for 10 days or :20mg/kg/day oral suspension twice daily for 10 days
Otitismedia: 30mg/kg/day orally twice daily
Antibiotic therapy adjunct: Probenecid is a competitive inhibitor of the secretion of weak organic acids such as Penicillins and some of the cephalosporin antibiotics, at the proximal and distal renal tubules. It thereby increases blood concentrations of these antibiotics, increases their elimination half-life, and prolongs their duration of action
Distribution: Probenecid is widely distributed throughout the body
Metabolism: It is metabolised to active metabolite in the liver
Excretion: Probenecid and its active metabolites are excreted mainly in the urine. Probenecid is actively reabsorbed.
6. Sore gums
7. Urinary frequency
8. Renal colic
9. Nephrotic syndrome
2. Uric acid kidney stones
3. Blood dyscrasias
4. Acute gout
2. Peptic ulcer
Below 2 years: contraindicated
2. Gouty arthritis
3. Along with antibiotics (Stimulate the action of some antibiotics)
Allopurinol: Co-administration may increase uric acid lowering effect.
Barbiturate: Efficacy of thiopentone enhanced.
Benzodiazepines: More rapid or more prolonged benzodiazepine effect may occur.
Clofibrate: Increase in serum concentration of clofibric acid may occur.
Dapsone: Increased accumulation of dapsone may occur.
Methotrexate: Enhanced efficacy & toxicity of methotrexate.
NSAIDs: Increased plasma levels and toxicity of NSAID.
Penicillamine: Efficacy of penicillamine attenuated.
Sulfonylureas: Increased half-life of sulfonylureas.
Zidovudine: Bioavailability of zidovudine increased.
Salicylates: May result in inhibition of uricosuric effect.
Lab. Tests: False diagnosis of glycosuria. False high determination of theophylline by using Schack and Waxler technique. Probenecid may inhibit renal clearance of phenoelulonphtha-lein (PSP), 17 ketosteroids and sulfo-bromophthalein (BSP).
Gout: Initial dose: 500mg / day in 2 divided doses for 1 week followed by 1g /day if needed dosage can be increased by 500 mg/day every 1 month up to 2- 3 g/day.
Adjunct to penicillin or cephalosporin therapy: 2 g / day in 4 divided doses.
Gonorrhoea, uncomplicated: 1 g (as a single dose) 30 min before IM Penicillin and along with oral penicillin.
Neurosyphilis: 2g / day in 4 divided doses with penicillin G procaine aqueous
Pelvic inflammatory disease: 1 g (as a single dose) along with Cefoxitin,
Adjunct to penicillin or cephalosporin therapy: Pediatric, 2-14 years, initial: 25 mg/kg /day followed by 40mg/kg/day in 4 divided doses.
For children 50 kg or more: give adult dosage
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