Consists of Chlorphenamine, Ibuprofen, Pseudoephedrine
|
||
Chlorphenamine/Ibuprofen/Pseudoephedrine Actions |
||
Consists of Chlorphenamine, Ibuprofen, Pseudoephedrine
Chlorphenamine Citadel Fine Pharmaceuticals is a broad-spectrum antimicrobial drug of fluoroquinolone group with bactericidal action. Inhibits DNA gyrase and inhibits the synthesis of bacterial DNA. Highly active against most gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.
Chlorphenamine Citadel Fine Pharmaceuticals is active against Staphylococcus spp. (including strains producing and not producing penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.
ciprofloxacin is active against bacteria producing beta-lactamases.
Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides resistant to ciprofloxacin. The effect on Treponema pallidum is studied not enough.
May be taken with or without food.
Alkylating agents work by three different mechanisms: 1) attachment of alkyl groups to DNA bases, resulting in the DNA being fragmented by repair enzymes in their attempts to replace the alkylated bases, preventing DNA synthesis and RNA transcription from the affected DNA, 2) DNA damage via the formation of cross-links (bonds between atoms in the DNA) which prevents DNA from being separated for synthesis or transcription, and 3) the induction of mispairing of the nucleotides leading to mutations. Chlorphenamine is cell cycle phase-nonspecific.
Ibuprofen is a nonsteroidal anti-inflammatory agent with analgesic and antipyretic action.
Pharmacology: While the precise mechanism of action is not known, it is thought that ibuprofen, like other nonsteroidal anti-inflammatory drugs, produces an anti-inflammatory effect at least in part by inhibiting prostaglandin synthetase. Ibuprofen also has been shown to have analgesic and antipyretic activity.
Pharmacodynamics: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) belonging to propionic acid derivative. In common with other NSAIDs, it possesses analgesic, antipyretic and anti-inflammatory activities. Ibuprofen exerts its effect mainly by inhibiting prostaglandin synthetase and thereby prevents the formation of prostaglandins, thromboxanes and other cyclooxygenase products. These properties provide symptomatic relief of inflammation and pain in rheumatoid arthritis and osteoarthritis. Ibuprofen does not possess glucocorticoid- or adrenocorticoid-stimulating properties and has no uricosuric action. Like other nonsteroidal anti-inflammatory agents, ibuprofen inhibits platelet aggregation and prolongs bleeding time (although within normal range) but does not affect prothrombin time or whole blood-clotting time.
Ibuprofen also inhibits the renal prostacycline synthesis and may cause risk of water retention by reducing the renal blood flow. This effect must be taken in account when using ibuprofen in patients with renal insufficiency, cardiac failure, liver impairment and conditions altering the plasma volume.
Pharmacokinetics: Ibuprofen is well absorbed after oral administration. Single dose of 200 mg taken on an empty stomach by volunteers produced peak serum levels after approximately 45 min. When taken after food, absorption was slower, peak levels appearing at 1.5-3 hrs. Ibuprofen is extensively bound to plasma proteins. About 95% of ibuprofen is metabolized to 2 major metabolites (A and B), both of which are devoid of anti-inflammatory and analgesic activity. Excretion is rapid, serum levels showing no evidence of accumulation. The excretion of ibuprofen is virtually complete 24 hrs after the last dose. The serum half-life of ibuprofen is approximately 2 hrs. Studies have shown that following ingestion of the drug, approximately 95% of the dose was recovered in the urine within 24 hrs as metabolites (A and B). The percentages of unchanged and conjugated ibuprofen were approximately 1% and 14%, respectively.
For safe and effective use of ibuprofen, do not take more of it, do not take it more often, and do not take it for a longer time than ordered by your doctor. Taking too much of ibuprofen may increase the chance of unwanted effects, especially in elderly patients.
When used for severe or continuing arthritis, ibuprofen must be taken regularly as ordered by your doctor in order for it to help you. ibuprofen usually begins to work within one week, but in severe cases up to two weeks or even longer may pass before you begin to feel better. Also, several weeks may pass before you feel the full effects of ibuprofen.
To lessen stomach upset, you may take ibuprofen with food or milk.
The dose of ibuprofen will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ibuprofen. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of ibuprofen, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Do not take more of this medication than is recommended. An overdose of ibuprofen can cause damage to your stomach or intestines. The maximum amount of ibuprofen for adults is 800 milligrams per dose or 3200 mg per day (4 maximum doses). Use only the smallest amount of ibuprofen needed to get relief from your pain, swelling, or fever.
Take ibuprofen with food or milk to lessen stomach upset.
Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
The ibuprofen chewable tablet must be chewed before you swallow it.
If you take ibuprofen for a long period of time, your doctor may want to check you on a regular basis to make sure this medication is not causing harmful effects. Do not miss any scheduled visits to your doctor.
Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.
Ibuprofen tablets contain Ibuprofen which possesses analgesic and antipyretic activities. Its mode of action, like that of other NSAIDs, is not completely understood, but may be related to prostaglandin synthetase inhibition.
In clinical studies in patients with rheumatoid arthritis and osteoarthritis, Ibuprofen tablets have been shown to be comparable to aspirin in controlling pain and inflammation and to be associated with a statistically significant reduction in the milder gastrointestinal side effects. Ibuprofen tablets may be well tolerated in some patients who have had gastrointestinal side effects with aspirin, but these patients when treated with Ibuprofen tablets should be carefully followed for signs and symptoms of gastrointestinal ulceration and bleeding. Although it is not definitely known whether Ibuprofen tablets causes less peptic ulceration than aspirin, in one study involving 885 patients with rheumatoid arthritis treated for up to one year, there were no reports of gastric ulceration with Ibuprofen tablets whereas frank ulceration was reported in 13 patients in the aspirin group (statistically significant p<.001).
Gastroscopic studies at varying doses show an increased tendency toward gastric irritation at higher doses. However, at comparable doses, gastric irritation is approximately half that seen with aspirin. Studies using 51Cr-tagged red cells indicate that fecal blood loss associated with Ibuprofen tablets in doses up to 2400 mg daily did not exceed the normal range, and was significantly less than that seen in aspirin-treated patients.
In clinical studies in patients with rheumatoid arthritis, Ibuprofen tablets have been shown to be comparable to indomethacin in controlling the signs and symptoms of disease activity and to be associated with a statistically significant reduction of the milder gastrointestinal and CNS side effects.
Ibuprofen tablets may be used in combination with gold salts and/or corticosteroids.
Controlled studies have demonstrated that Ibuprofen tablets are a more effective analgesic than propoxyphene for the relief of episiotomy pain, pain following dental extraction procedures, and for the relief of the symptoms of primary dysmenorrhea.
In patients with primary dysmenorrhea, Ibuprofen tablets have been shown to reduce elevated levels of prostaglandin activity in the menstrual fluid and to reduce resting and active intrauterine pressure, as well as the frequency of uterine contractions. The probable mechanism of action is to inhibit prostaglandin synthesis rather than simply to provide analgesia.
The Ibuprofen in Ibuprofen tablets is rapidly absorbed. Peak serum Ibuprofen levels are generally attained one to two hours after administration. With single doses up to 800 mg, a linear relationship exists between amount of drug administered and the integrated area under the serum drug concentration vs time curve. Above 800 mg, however, the area under the curve increases less than proportional to increases in dose. There is no evidence of drug accumulation or enzyme induction.
The administration of Ibuprofen tablets either under fasting conditions or immediately before meals yields quite similar serum Ibuprofen concentration-time profiles. When Ibuprofen tablets are administered immediately after a meal, there is a reduction in the rate of absorption but no appreciable decrease in the extent of absorption. The bioavailability of the drug is minimally altered by the presence of food.
A bioavailability study has shown that there was no interference with the absorption of Ibuprofen when Ibuprofen tablets were given in conjunction with an antacid containing both aluminum hydroxide and magnesium hydroxide.
Ibuprofen is rapidly metabolized and eliminated in the urine. The excretion of Ibuprofen is virtually complete 24 hours after the last dose. The serum half-life is 1.8 to 2.0 hours.
Studies have shown that following ingestion of the drug, 45% to 79% of the dose was recovered in the urine within 24 hours as metabolite A (25%), (+)-2-[p-(2hydroxymethyl-propyl) phenyl] propionic acid and metabolite B (37%), (+)-2-[p-(2carboxypropyl)phenyl] propionic acid; the percentages of free and conjugated Ibuprofen were approximately 1% and 14%, respectively.
Pseudoephedrine acts directly on both alpha- and, to a lesser degree, beta-adrenergic receptors. Through direct action on alpha-adrenergic receptors in the mucosa of the respiratory tract, pseudoephedrine produces vasoconstriction. Pseudoephedrine relaxes bronchial smooth muscle by stimulating beta2-adrenergic receptors. Like ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect. This is its main and direct mechanism of action. The displaced noradrenaline is released into the neuronal synapse where it is free to activate the postsynaptic adrenergic receptors.
For patients taking pseudoephedrine extended-release capsules:
For patients taking pseudoephedrine extended-release tablets:
To help prevent trouble in sleeping, take the last dose of pseudoephedrine for each day a few hours before bedtime. If you have any questions about this, check with your doctor.
Take pseudoephedrine only as directed. Do not take more of it, do not take it more often, and do not take it for a longer period of time than recommended on the label (usually 7 days), unless otherwise directed by your doctor. To do so may increase the chance of side effects.
The dose of pseudoephedrine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of pseudoephedrine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of pseudoephedrine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Do not crush ER drug product, swallow whole. May administer with or without food. Sudafed 24 Hour tablet may not completely dissolve and appear in stool.
Bariatric surgery: Tablet, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. ER tablets should be swallowed whole. Do not crush or chew. IR tablet, chewable tablet, capsule, oral solution, syrup, and suspension formulations are available. If safety and efficacy can be effectively monitored, no change in formulation or administration is required after bariatric surgery.
Pseudoephedrine is a sympathomimetic agent, structurally similar to ephedrine, used to relieve nasal and sinus congestion and reduce air-travel-related otalgia in adults. The salts pseudoephedrine hydrochloride and pseudoephedrine sulfate are found in many over-the-counter preparations either as single-ingredient preparations, or more commonly in combination with antihistamines and/or paracetamol/Pseudoephedrine. Unlike antihistamines, which modify the systemic histamine-mediated allergic response, pseudoephedrine only serves to relieve nasal congestion commonly associated with colds or allergies. The advantage of oral pseudoephedrine over topical nasal preparations, such as oxymetazoline, is that it does not cause rebound congestion (rhinitis medicamentosa).
There are no reviews yet. Be the first to write one! |
Information checked by Dr. Sachin Kumar, MD Pharmacology
|