Pharmacology Made Simple : Polysaccharide Iron Complex

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Pharmacology Made Simple : Polysaccharide Iron Complex

Polysaccharide Iron Complex (PIC) is available in capsules of 150 mg.

They are excellent choice for treatment of iron deficiency anemia in pregnancy.

After treatment with PIC , clinical parameters such as red blood cell count,hemoglobin and haematocit improved significantly.

After 8 weeks of treatment with PIC 300 mg ,in a patient with Anemia ,the net increase in Hb of 9.5 mg/dl was by 2.6 mg / dl and haematocrit of 30.3 % was by 6.3 %.

Usual adult dose of Polysaccharide Iron complex is 150 mg capsule 1 to 2 daily and can be taken regardless of meal.

For patients having difficulty in swallowing of capsules,the PIC capsule can be opened and the powder can be diluted in liquid or sprinkled on food.

This medication is an iron supplement used to treat or prevent low blood levels of iron (e.g., for anemia or during pregnancy). Iron is an important mineral that the body needs to produce red blood cells and keep you in good health.

How to use Polysaccharide Iron 150

Iron is best absorbed on an empty stomach (usually if taken 1 hour before or 2 hours after meals). If stomach upset occurs, you may take this medication with food. Avoid taking antacids, dairy products, tea.

Side Effects

Constipation, diarrhea, stomach cramps, or upset stomach may occur. These effects are usually temporary and may disappear as your body adjusts to this medication.
Iron may cause your stools to turn black, an effect that is not harmful.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Precautions

This medication should not be used if you have certain medical conditions. Before taking this medication, consult your doctor or pharmacist if you have: iron overload disorder (e.g., hemochromatosis, hemosiderosis).

Before taking this medication, tell your doctor or pharmacist your medical history, especially of: use/abuse of alcohol, liver problems, stomach/intestinal problems (e.g., ulcer, colitis).

If your brand of iron supplement also contains folic acid, be sure to tell your doctor or pharmacist if you have vitamin B12 deficiency (pernicious anemia) before taking it.
Folic acid may falsely improve certain laboratory tests for vitamin B12 deficiency without actually treating this anemia. Untreated vitamin B12 deficiency may result in serious nerve problems (e.g., peripheral neuropathy symptoms such as numbness/pain/tingling sensations).

Chewable tablets of this medicine may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to restrict your intake of aspartame (or phenylalanine), consult your doctor or pharmacist about using this drug safely.

Liquid preparations of this product may contain sugar and/or alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease.
During pregnancy, this medication should be used only when clearly needed.
This medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Before taking this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially: certain antibiotics (e.g., penicillamine, chloramphenicol, quinolones such as ciprofloxacin/norfloxacin), bisphosphonates (e.g., alendronate), levodopa, methyldopa, thyroid replacement drugs (e.g., levothyroxine).

Avoid taking this medication at the same time as antacids or tetracycline antibiotics. Wait at least 2 hours between taking this medication and an antacid or tetracycline.

If your brand of iron also contains folic acid, be sure to tell your doctor or pharmacist if you take certain anti-seizure drugs (e.g., hydantoins such as phenytoin).

This medication may interfere with certain laboratory tests (e.g., fecal occult blood tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Pharmacology Made Simple : Erythromycin

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Pharmacology Made Simple : Erythromycin

Erythromycin is an antibiotic useful for the treatment of a number of bacterial infections.

This includes respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. 

It may also be used during pregnancy to prevent Group B streptococcal infection in the newborn.

Erythromycin may be used to improve delayed stomach emptying. It can be given intravenously and by mouth.

An eye ointment is routinely recommended after delivery to prevent eye infections in the newborn.

Mechanism of Action :

Erythromycin displays bacteriostatic activity or inhibits growth of bacteria, especially at higher concentrations .It binds to the 50s subunit of the bacterial rRNA complex, protein synthesis and subsequent structure and function processes critical for life or replication are inhibited.

Erythromycin interferes with aminoacyl translocation, preventing the transfer of the tRNA bound at the A site of the rRNA complex to the P site of the rRNA complex. Without this translocation, the A site remains occupied, thus the addition of an incoming tRNA and its attached amino acid to the nascent polypeptide chain is inhibited. 

This interferes with the production of functionally useful proteins, which is the basis of this antimicrobial action.

Side Effects:

It is generally safe in those who are allergic to penicillin.

Erythromycin also appears to be safe to use during pregnancy.While generally regarded as safe during breastfeeding its use by the mother during the first two weeks of life may increase the risk of pyloric stenosis in the baby.

Common side effects include abdominal cramps, vomiting, and diarrhea. More serious side effects may include Clostridium difficilecolitis, liver problems, prolonged QT, and allergic reactions.

This risk also applies if taken directly by the baby during this age.

It is in the macrolide family and works by decreasing bacterial protein production.

Interactions:

Erythromycin is metabolized by enzymes of the cytochrome P450 system, in particular, by isozymes of the CYP3A superfamily, CYP3A.

The activity of the CYP3A enzymes can be induced or inhibited by certain drugs (e.g. dexamethasone) which can cause it to affect the metabolism of many different drugs, e.g. erythromycin. If other CYP3A substrates — drugs that are broken down by CYP3A  such as simvastatin (Zocor), lovastatin (Mevacor), or atorvastatin (Lipitor)—are taken concomitantly with erythromycin, levels of the substrates increase, often causing adverse effects.

A noted drug interaction involves erythromycin and simvastatin, resulting in increased simvastatin levels and the potential for rhabdomyolysis. Another group of CYP3A4 substrates are drugs used for migraine such as ergotamine and dihydroergotamine; their adverse effects may be more pronounced if erythromycin is associated.

Earlier case reports on sudden death prompted a study on a large cohort that confirmed a link 

between erythromycin, ventricular tachycardia, and sudden cardiac death in patients also taking drugs that prolong the metabolism of erythromycin (like verapamil or diltiazem) by interfering with CYP3A4.

Hence, erythromycin should not be administered to people using these drugs, or drugs that also prolong the QT interval. Other examples include terfenadine (Seldane, Seldane-D), astemizole (Hismanal), cisapride (Propulsid, withdrawn in many countries for prolonging the QT time) and pimozide (Orap). Theophylline, which is used mostly in asthma, is also contraindicated.

Erythromycin and doxycycline can have a synergistic effect when combined and kill bacteria (E. coli) with a higher potency than the sum of the two drugs together.

This synergistic relationship is only temporary. After approximately 72 hours, the relationship shifts to become antagonistic, whereby a 50/50 combination of the two drugs kills less bacteria than if the two drugs were administered separately.