Metronidazole I V

Indication

Metronidazole  500 IV is indicated in the prophylaxis and treatment of infections in which anaerobic bacteria have been identified. It is indicated in:

1.The prevention of postoperative infections due to anaerobic bacteria

2.The treatment of septicemia, bacteraemia, peritonitis, brain abscess, necrotizing pneumonia, osteomyelitis, puerperal sepsis, pelvic abscess, pelvic cellulites, and post operative wound infections from which pathogenic anaerobes have been isolated.

Dosage & Administration

 Metronidazole  500 IV should be infused intravenously at an

approximate rate of 5 ml/min. Oral medication should be substituted as soon as feasible. Treatment for 7 days should be satisfactory for most patients, but the physician might decide to prolong treatment.

For bacterial infections:

Adults: 500 mg (100 ml) 8 hourly.

Children: 7.5 mg/kg (1.5 ml/kg) 8 hourly.

For treatment before and during surgery:

Adults: 500 mg (100 ml) shortly before operation, repeated 8 hourly

Children: 7.5 mg/kg (1.5 ml/kg) 8 hourly.

Side Effect

Pain, tenderness, redness or swelling over vein in which the medicine is

given. Other side Effects are unsteadiness, fever or chills, sore throat, headache, numbness, tingling pain or weakness in the hands or feet, pain, seizures, skin itching, unusual tiredness or weakness, vaginal irritation or discharge.

Drug Interaction

 Metronidazole shows drug interaction with the following:

alcohol or alcohol-containing beverages, barbiturates, carbamazepin, cimetidine, disulfiram, fluorouracil, lithium, methadone, phenytoin, warfarin etc.

Use in pregnancy & lactation

Studies have not been done in humans. Metronidazole has not been shown to cause birth defects in animal studies; however, use is not recommended during the first trimester of pregnancy. Use is not recommended in nursing mothers since metronidazole passes into the breast milk.

Precaution

Metronodazole should be given with caution in the following conditions- anemia or other blood disorders, liver disease, disease of nervous system, seizures etc.

Preparation

 100 ml solution of Metronidazole for intravenous infusion.

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Paracetamol & Caffeine.

Indication

 Fever, headache, migraine, muscle ache, backache, toothache &

menstrual pain.

Dosage & Administration

 Adults : 1-2 tablets every 4-6 hours. Maximum dose: 8 tablets daily. Not recommended for

children below 12 years.

Contraindication & Precaution

Hypersensitivity to Paracetamol, Caffeine or any other components of it.

Side Effect

This combination may cause skin rashes, neutropenia & gastrointestinal disturbances etc. High dose administration

may cause hepatotoxicity.

Uses in Pregnancy & Lactation

 Although there is epidemiological evidence of the safety of Paracetamol in pregnancy & lactation, medical advice should be sought before using this product.

Drug Interaction

 It increases the Effect of chloramphenicol and coumarin anticoagulant. Risk of hepatotoxicity of paracetamol may be increased in alcoholics or in patients taking other antiepileptic medications.

Precaution

 Should be given cautiously in the following cases: In patients with hepatic or renal failure, in patients taking other hepatotoxic medication. Prolonged use of the drug without consulting a physician should be avoided.

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Efavirenz

Indication

 In combination with other antiretroviral agents is indicated for the treatment of HIV infection.

Dosage and Administration

 Adults : 600 mg orally, once daily, in combination with a protease inhibitor and/or nucleoside analogue reverse transcriptase inhibitors (NRTIs).

Pediatric Patients  

 Weighing greater than 40 kg is 600 mg, once daily.

Body weight (kg) Adiva: Dose (mg)

10 to <15 200

15 to <20 250

20 to <25 300

25 to <32.5 350

32.5 to <40 400

>40 600

(2.5 ml of syrup) 3 to 4 times a day. In motion sickness: Adults : 25 to 50 mg 3 to 4 times a day. Children (above 9.1 kg): 12.5 to 25 mg 3 to 4 times a day (5mg/ kg/ 24 hours). In parkinsonism: Adults: 25 to 50 mg 3 to 4 times a day. Children (above 9.1 kg) : 12.5 to 25 mg 3 to 4 times a day (5mg/ kg/ 24 hours). In insomnia: Adults and children over 12 years of old : A dose of 20 to 50 mg is used as hypnotic in insomnia. In cough & cold: Adults: 25 mg every 4 hrs. Not to exceed 150 mg in 24 hours. Children (6 to 12 years) : 12.5 mg every 4 hours. Not to exceed 75 mg in 24 hours. Children (2 to 6 years): 6.25 mg every 4 hours.

Contraindication and Precaution

Contraindicated for the premature or newborn infants. Any patients in whom drowsiness is undesirable e.g. drivers,

machine operators. Patients with known hypersensitivity to Diphenhydramine or any components of the product. Patients should be cautioned not to operate vehicles or hazardous machinery until their response to the drug has been determined.

Drug Interaction

Antituberculous agent, para-aminosalicylic acid (PAS), alcohol, other CNS depressants (hypnotics, sedatives, tranquilizers, etc), MAO inhibitors.

Side Effect

Side Effects include drowsiness, dizziness, dryness of mouth, blurred vision, nausea and vomiting.

Uses in Pregnancy & Lactation

 Should be used in pregnancy only if clearly needed. Use in lactating mother is not recommended.

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Cetirizine

Indication:

Seasonal Allergic Rhinitis, Perennial Allergic Rhinitis, Chronic Idiopathic Urticaria, and Pruritus. It is also used in allergen induced asthma.

Dosage and Administration:

Administered with or without food. Adults and Children 6 years and older : Tablet: 1 tablet daily. Syrup: 2 teaspoonfuls once daily or 1 teaspoonful twice daily. In patients with decreased renal function (Creatinine clearance 11-31 ml/min), patients on emodialysis (Creatinine clearance less than 7 ml/min) and in hepatically impaired atients , a dose of 1/2 tablet or 1 teaspoonful once daily is recommended. Children 2-6 years : Syrup: 1 teaspoonful once daily or 1/2 teaspoonful twice daily. Children 6 months - <2 years : Syrup: 1/2 teaspoonful once daily. The mg once daily for three consecutive days.Giardiasis - 400 mg once daily for five days. Hydatid disease (Echinococcosis) - 400 mg twice daily for 28 days. For cystic echinococcosis the 28-days course may be repeated after 14 days without treatment to a total of three treatment cycles. For alveolar echinococcosis, 400 mg twice daily for 28 days followed by 14 days without treatment may need to continue for months or years.

Contraindication & Precaution:

Should only be used in the treatment of echinococcosis if there is constant medical supervision with regular monitoring of serum transaminase concentrations and of leucocyte and platelet counts.

Side Effect:

Epigastric pain, diarrhoea, headache, nausea, vomiting, dizziness, constipation, pruritis & dry mouth.

Use in Pregnancy & Lactation:

 Should not be administered during pregnancy & in women thought to be pregnant.

Pediatric Use:

For children of 12 months & above.

Preparation:

 400 mg Tablet & 200 mg / 5ml Suspension.

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