Consists of Ethambutol HCl, INH, vit B6
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Pulna/Pulna Forte Actions |
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Consists of Ethambutol HCl, INH, vit B6
Description: Ethambutol HCl (Pulna/Pulna Forte) appears to inhibit the synthesis of 1 or more metabolites in susceptible bacteria resulting in impairment of cellular metabolism, arrest of multiplication, and cell death. It is active against susceptible bacteria only when they are undergoing cell division.
Pharmacokinetics:
Absorption: 80% is absorbed from the GI tract. Time to peak plasma concentration: W/in 4 hr.
Distribution: Distributed in most tissues, including lungs, kidneys, erythrocytes. Approx 10-50% may diffuse into CSF when meninges are inflamed. Crosses the placenta and enters breast milk.
Metabolism: Undergoes partial hepatic metabolism;, converted to the aldehyde and dicarboxylic acid derivatives (inactive).
Excretion: Via urine (as unchanged drug, 8-15% as metabolites) and faeces (20% as unchanged drug). Elimination half-life: Approx 3-4 hr.
Ethambutol HCl (Pulna/Pulna Forte) may be taken with food if Ethambutol HCl (Pulna/Pulna Forte) upsets your stomach.
To help clear up your tuberculosis (TB) completely, it is very important that you keep taking Ethambutol HCl (Pulna/Pulna Forte) for the full time of treatment, even if you begin to feel better after a few weeks. You may have to take it every day for as long as 1 to 2 years or more. It is important that you do not miss any doses.
The dose of Ethambutol HCl (Pulna/Pulna Forte) 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 Ethambutol HCl (Pulna/Pulna Forte). 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 Ethambutol HCl (Pulna/Pulna Forte), 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.
Take Ethambutol HCl (Pulna/Pulna Forte) exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Take each dose with a full glass (8 ounces) of water.
Ethambutol HCl (Pulna/Pulna Forte) can be taken with or without food. Taking Ethambutol HCl (Pulna/Pulna Forte) with food may decrease stomach upset.
Take all of the Ethambutol HCl (Pulna/Pulna Forte) that has been prescribed for you even if you begin to feel better. Your symptoms may begin to improve before the infection is completely treated.
Ethambutol HCl (Pulna/Pulna Forte) is usually combined with one or more other tuberculosis medicines.
Store this medication at room temperature away from moisture and heat.
Ethambutol HCl (Pulna/Pulna Forte) hydrochloride, following a single oral dose of 25 mg/kg of body weight, attains a peak of 2 to 5 mcg/mL in serum 2 to 4 hours after administration. When the drug is administered daily for longer periods of time at this dose, serum levels are similar. The serum level of Ethambutol HCl (Pulna/Pulna Forte) falls to undetectable levels by 24 hours after the last dose except in some patients with abnormal renal function. The intercellular concentrations of erythrocytes reach peak values approximately twice those of plasma and maintain this ratio throughout the 24 hours.
During the 24-hour period following oral administration of Ethambutol HCl (Pulna/Pulna Forte) approximately 50 percent of the initial dose is excreted unchanged in the urine, while an additional 8 to 15 percent appears in the form of metabolites. The main path of metabolism appears to be an initial oxidation of the alcohol to an aldehydic intermediate, followed by conversion to a dicarboxylic acid. From 20 to 22 percent of the initial dose is excreted in the feces as unchanged drug. No drug accumulation has been observed with consecutive single daily doses of 25 mg/kg in patients with normal kidney function, although marked accumulation has been demonstrated in patients with renal insufficiency.
Ethambutol HCl (Pulna/Pulna Forte) diffuses into actively growing mycobacterium cells such as tubercle bacilli. Ethambutol HCl (Pulna/Pulna Forte) appears to inhibit the synthesis of one or more metabolites, thus causing impairment of cell metabolism, arrest of multiplication, and cell death. No cross resistance with other available antimycobacterial agents has been demonstrated.
Ethambutol HCl (Pulna/Pulna Forte) has been shown to be effective against strains of Mycobacterium tuberculosis but does not seem to be active against fungi, viruses, or other bacteria. Mycobacterium tuberculosis strains previously unexposed to Ethambutol HCl (Pulna/Pulna Forte) have been uniformly sensitive to concentrations of 8 or less mcg/ mL, depending on the nature of the culture media. When Ethambutol HCl (Pulna/Pulna Forte) has been used alone for treatment of tuberculosis, tubercle bacilli from these patients have developed resistance to Ethambutol HCl (Pulna/Pulna Forte) hydrochloride by in-vitro susceptibility tests; the development of resistance has been unpredictable and appears to occur in a step-like manner. No cross resistance between Ethambutol HCl (Pulna/Pulna Forte) and other antituberculous drugs has been reported. Ethambutol HCl (Pulna/Pulna Forte) has reduced the incidence of the emergence of mycobacterial resistance to isoniazid when both drugs have been used concurrently. An agar diffusion microbiologic assay, based upon inhibition of Mycobacterium smegmatis (ATCC 607) may be used to determine concentrations of Ethambutol HCl (Pulna/Pulna Forte) in serum and urines.
Toxicological studies in dogs on high prolonged doses produced evidence of myocardial damage and failure, and depigmentation of the tapetum lucidum of the eyes, the significance of which is not known. Degenerative changes in the central nervous system, apparently not dose-related, have also been noted in dogs receiving Ethambutol HCl (Pulna/Pulna Forte) hydrochloride over a prolonged period. In the rhesus monkey, neurological signs appeared after treatment with high doses given daily over a period of several months. These were correlated with specific serum levels of Ethambutol HCl (Pulna/Pulna Forte) and with definite neuroanatomical changes in the central nervous system. Focal interstitial carditis was also noted in monkeys which received Ethambutol HCl (Pulna/Pulna Forte) hydrochloride in high doses for a prolonged period.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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