Tinidazole + Diloxanide Furoate + Tetracycline Pharmacology

Tinidazole + Diloxanide Furoate + Tetracycline

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

About Tinidazole
Nitroimidazole antibiotic, Antibacterial, antiprotozoal.
Mechanism of Action of Tinidazole
Tinidazole is nitro imidazole which has broad spectrum cidal activity against Protozoa and some anaerobic bacteria. Its selective toxicity to anaerobic microbes involves 1. Drug enters the cell by diffusion, 2. Nitro group of drug is reduced by redox proteins present only in anaerobic organisms to reactive nitro radical which excerts cytotoxic action by damaging DNA and other critical biomolecules. 3. .DNA helix destabilization &strand breakage has been observed.
Pharmacokinets of Tinidazole
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver by oxidation &glucuronide conjugation, Excretion: Excreted in urine.
Onset of Action for Tinidazole
Within few hours
Duration of Action for Tinidazole
16 hours
Half Life of Tinidazole
12 hours
Side Effects of Tinidazole
1.Anorexia
2.Bitter taste
3.Nausea
4.Vomiting
5.Diarrhoea
6.Fatigue
7.Dry mouth
8.Abdominal distress
9.Headache
10.Dizziness
11.Vertigo
12.Rash
13.Urticaria
14.Angioedema
15.Peripheral neuropathy & CNS effects,
Contra-indications of Tinidazole
1.Hypersensitivity to the drug
2.Blood dyscrasias
3.CNS disorders
Special Precautions while taking Tinidazole
1.Hepatic impairment
2.Alcoholic cirrhosis
3.Obstructive liver diseases
4. Use cautiously along with other hepatotoxic drugs & In visual field changes
5. Avoid alcohol use during therapy
Pregnancy Related Information
Use with caution, but contra indicated in first trimester
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated
Children Related Information
N/A
Indications for Tinidazole
1.Amoebiasis
2.Giardiasis
3.Trichomonas vaginitis
4.Anaerobic bacterial infections
5.Prophylactic agent after colorectal surgery
6.H. pylori infections
Interactions for Tinidazole
Alcohol: Disulfiram like reaction.
Ampicillin, Doxycycline and Cotrimoxaole: Synergism with these agents.
Typical Dosage for Tinidazole
Amoebiasis:
Adults: 2gm once daily for 3 days
Children: 30 to 50mg/kg/day or 600mg 12hourly for 5 to 10 days
Trichomoniasis & Giardiasis:
600mg once daily for a week or 2gm single dose
Anaerobic bacterial infections:
2 gm followed by 500mg 12 hourly for 5 days
Prophylaxis after colorectal surgery:
2gm single dose before surgery
H. pylori infections:
0.5gm 12hourly for 7 to14 days in triple combination
Schedule of Tinidazole
H
Storage Requirements for Tinidazole
Store at room temperature at a range of 15 to 30 degree C. Protect from excess heat and moisture.
Effects of Missed Dosage of Tinidazole
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 Tinidazole
Treatment is supportive & symptomatic. Drug is removed by induced emesis, gastric lavage, and administration of activated charcoal &use of cathartics. For controlling seizures diazepam & phenytoin may be used

Diloxanide Furoate

About Diloxanide Furoate
Dichloroacetamide derivative, anti-protozoal, Luminal amebicides.
Mechanism of Action of Diloxanide Furoate
Diloxanide Furoate is a dicloroacetamide derivative which acts as a luminal amoebicide. It exerts its action by directly killing the trophozoites responsible for production of cysts.
Pharmacokinets of Diloxanide Furoate
Absorption: Orally well absorbed.
Metabolism: It is metabolized by glucuronide conjugation.
Excretion: Excreted through urine.
Onset of Action for Diloxanide Furoate
N/A
Duration of Action for Diloxanide Furoate
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Half Life of Diloxanide Furoate
N/A
Side Effects of Diloxanide Furoate
1. Flatulence
2. Nausea
3. Itching
4. Urticaria rashes
Contra-indications of Diloxanide Furoate
N/A
Special Precautions while taking Diloxanide Furoate
1. Hepatic impairment
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Below 2 years : Contraindicated
Indications for Diloxanide Furoate
1. Mild intestinal Amoebiasis,
2. Asymptomatic cyst passers of Entamoeba histolitica
Interactions for Diloxanide Furoate
No known interaction.
Typical Dosage for Diloxanide Furoate
Adults: 0.5gm 8hourly for 5 to 10days.
Children (above 2years): 20mg/kg/day in divided doses up to 10days.
Schedule of Diloxanide Furoate
H
Storage Requirements for Diloxanide Furoate
Store in a cool dry place.Protect from heat and light.Keep out of the reach of children.
Effects of Missed Dosage of Diloxanide Furoate
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 Diloxanide Furoate
Give supportive measures and symptomatic treatment.

Tetracycline

About Tetracycline
A broad-spectrum polyketide antibiotic,Tetracycline Derivative.
Mechanism of Action of Tetracycline
Tetracycline is a broad spectrum antibiotic which has more specific action against gram positive organisms than gram negative organisms. It exerts its bacteriostatic action by accumulating inside the bacteria through specific transporter protein & inhibits bacterial protein synthesis by attaching to 30 S subunit of bacterial ribosome (which are absent in mammals). It chelates cations like Ca &Mg and inhibits functioning of various enzymes & ribosome. It is used in some areas for the treatment of Chloroquine-resistant falciparum malaria
Pharmacokinets of Tetracycline
Absorption: Orally well absorbed, Distribution: widely distributed; shows protein- binding, Metabolism: metabolized by liver, Excretion: excreted through urine
Onset of Action for Tetracycline
3 hours
Duration of Action for Tetracycline
12 hours
Half Life of Tetracycline
8 hours
Side Effects of Tetracycline
1.Headache, dizziness, intracranial hypertension
2.Aggravates renal & hepatic impairment
3.Nausea
4.Vomiting
5.Epigastric distress
6.Super infection
7.Skin rashes
8.Arrhythmia, Cardiac arrest
9.Neutropenia, Thrombocytopenia
10.Elevated liver enzymes
11.Discoloration of teeth & Retardation of bone growth
12.Esophageal ulceration
Contra-indications of Tetracycline
Hypersensitive individuals
Special Precautions while taking Tetracycline
Renal impairment:
1.Tetracycline aggravates renal impairment & leads to negative nitrogen balance. So avoid use of drug in renal impairment.
Hepatic impairment:
High dose causes hepato toxicity, so dose adjustments is required & avoid
Other precautions:
1.Avoid use together with milk & milk products, Antacids, Cations, Vitamins, Products which contain divalent or trivalent cations
2.Potentiation of action of anticoagulants; so avoid use together
3.Diabetes mellitus, Hyperthyroidism, & Hypertensions
Pregnancy Related Information
Contraindicated
Old Age Related Information
May be used
Breast Feeding Related Information
Contraindicated
Children Related Information
Children: Contraindicated
Neonates: Contraindicated

Indications for Tetracycline
1. Pneumonia
2. Chlamydia infections
3. Rickettsial infections
4. Cholera
5. Brucellosis
6. Sexually transmitted diseases like syphilis, gonorrhea, Chancroid
7. Urinary tract infections
8. H-pylori infection
9. Acne
10. Lyme disease
11. Malaria
Interactions for Tetracycline
Antacids (aluminium, calcium, zinc, magnesium), Iron salts, Bismuth salts: Impair absorption of tetracyclines thus reducing its efficacy.
Anticoagulants: Increase the hypothrombinemic effects of anti-coagulants.
Cimetidine: Decreases GI absorption leading to decreased efficacy of tetracyclines.
Digoxin: Increased serum levels leading to digoxin toxicity.
Methoxyflurane: Nephrotoxic effects of both increased.
Oral contraceptives: Breakthrough bleeding, pregnancy due to decreased efficacy.
Penicillins: Efficacy reduced.
Food: Dairy products decrease efficacy of tetracyclines.
Lab tests: Bacterio-suppressive levels of Demeclocycline persist in both urine and blood for several days after cessation of therapy interfering with culture studies.
Typical Dosage for Tetracycline
Adults: Oral administration of 500mg tablets 6 hourly or 12 hourly as required.
Children: 15 to 25mg/kg bodyweight. Maximum dose 50mg/kg. Administer 6hourly or 12 hourly as required
Infections of cervix, urethra&rectum caused by Chlamydia trachomatis:2gm daily; orally; in four divided doses for a week.
Gonorrhea: Starts with 1.5gm oral administration & then administer 500mg tablets four times daily for four days
Syphilis: oral administration of 1-2 gm daily in four divided doses for two weeks
Brucellosis: 2gm daily in four divided doses for 28 days (along with streptomycin 1gm for first 21 days)
Ulcer caused by H-pylori infection: 2gm daily in four divided doses for 10 - 14 days.
Lyme disease: 0.25-0.5gm; orally four times daily for 10 days to One month.
Acne: Initial dose-0.5gm to 1gm orally four times daily; maintenance dose 0.12 to 0.5mg daily
Malaria: 1 g daily in 2 - 4 divided doses
Schedule of Tetracycline
H
Storage Requirements for Tetracycline
Store in a cool place
Effects of Missed Dosage of Tetracycline
Take the missed dose whenever remember. If it is the time of next dose avoid that dose; because over dosage leads to toxicity.
Effects of Overdose of Tetracycline
Treatment is supportive & symptomatic. Drug can be removed by gastric lavage

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