Generic name: cefadroxil Brand name: Drozid Dossage: 500 mg capsule 125 mg/5mL Powder for syrup Category:

antibacterial Formulaton: each capsule contains: Cefadroxil (monohydrate) 500mg Each 1 teaspoonful (5 mL) contains: Cefadroxil (monohydrate) 125 mg Indication: Respiratory tract infections: Tonsillitis, pharyngitis, pneumonia, bronchitis, bronchieactasis, lung abscesses, emphysema, pleuritis, sinusitis, laryngitis, otitis media. Urinary tract infections: Pyelonephritis, cystitis, adnexitis, endometritis Skin and soft tissues infections: Lymphangitis, abscesses, cellulitis, decubitus ulcers, mastitis, furunculosis, erysipelas Dosage and administration: Adults: -For treatment of uncomplicated urinary tract infections like cystitis 1-2 g daily, given as single dose or in 2 equally divided doses. For other urinary tract infections: 2 g daily or 2 equally divided doses. -Skin structure infections: 1 g daily given as a single dose or in 2 equally divided doses. -For the treatment of group A beta-hemolytic streptococcal pharyngitis and tonsillitis, the ususal dosage is 1 g daily, as a single dose or in 2 equally divided doses for at least 10 days. -For respiratory infections: usual dosge is 1 g/day in 2 divided doses (500 mg 2 times a day). For moderate to severe infections: the recommended dosage is 1-2 g daily in 2 divided doses (500mg -1000mg every 12 hours) Children: -urinary tract infections and skin infections: 30 mg/kg per day in divided doses every 12 hours -pharyngitis and tonsillitis: Chidlren dosage 30 mg/kg of body weight per day in single dose or in 2 divided doses. -the infection treatment caused by group A beta-hemolytic streptococcus is given at least for 10 days. For dry syrup: Prepare suspension at time of dispensing by adding 37 mL of water. Shake well before use. Contraindications: Patients with known hypersensitivity to cephalosporins.

Side effects: -Gastrointestinal: Nausea, vomiting and diarrhea -Hypersensitivity: Rash, urticaria, and angioedema -Other reactions: Pyrosis, anorexia, dyspepsia, abdominal pain, headache, dizziness, moniliasis, vaginitis, and pseudomembraneous colitis. Warnings and Precautions: -In penicillin-allergic patients due to the possibility of cross-allergy. If a hypersensitivity reaction occurs, the drug should be discontinued and the patient should be treated with usual agents (epinephrine or other pressor amines, antihistamines or corticosteroids). -Should be used with caution in the presence of impaired renal function (creatinine clearance rate <50 mL/min/1.73m2) and patients with colitis. -Reproduction study in mice and rats with doses up to 11 times the human dose have revealed no evidence of impaired fertility or harm the fetus due to Cefadroxil. However, there are no adequate and well controlled studies in pregnant women. -Positive use of Cefadroxil may result in overgrowth of nonsusceptible organisms. -Positive Benedit, Fehling or Clinitest tablets test in glycosuria reported during treatment with Cefadroxil. But not if using enzymatic reaction like Clinistix. Usage during pregnancy and lactation: -Although there have been no reports of adverse effects to the fetus to date, safe use of cephalosporins during pregnancy has not been definitely established. -The drugs should be used during pregnancy only when clearly needed. -Cephalosporins are secreted into the milk, so the drugs should be used with caution in nursing women. Pharmacology: Cefadroxil is rapidly and almost completely absorbed from the gastrointestinal trct. The rate of absorption is unaffected by food. Peak serum concentration +16 and 28 mg/mL are attained within 1-2 hours after single 500 mg and 1000 mg oral dose. The serum shelf-life of Cefadroxil is 12 hours in adults with normal renal function and prolonged patients with impaired renal function. Cefadroxil is excreted unchanged about 70-90% within 24 hours. Renal elimination of Cefadroxil is substantially reduced in patients with impaired renal function. In vitro test demonstrates that the cephalosporins are bactericidal because of their inhibition of cell wall synthesis. Sensitive gram-negative organisms are: E. coli, Klebsiella, pneumonia and some strains of P. mirabilis, Haemophylus influenza, Salmonella spp. and Shigella spp.

Drug interactions: -Concomitant administration of oral probenecid competitively inhibits tubular secretion resulting in higher and more prolonged serum concentrations of most cephalosporins. -Concurrent use of nephrotoxic agents such as aminoglycosides, colistin, polymyxin beta, or vancomycin may increase the risk of nephrotoxicity with some cephalosporins and probably should be avoided, if possible. -In vitro studies indicate that the antibacterial activity of cephalosporin may be additive or synergistic with aminoglycosides or penicillins against some organisms. Availability: Cefadroxil 500 mg Capsule, box contains 10 strips of 6 capsules Cefadroxil 125mg/5mL Powder for Syrup, bottle of 60 mL Storage: Store in a dry place, below 30 degrees Celsius Protect from light. Caution: foods, drugs, devices and cosmetics act prohibits dispensing without prescription. Dosage Cefadroxil is given by mouth, and doses are expressed in terms of the anhydrous substance; 1.04 g of cefadroxil monohydrate is equivalent to about 1 g of anhydrous cefadroxil. [edit]Side effects The most common side effects of Cefadroxil are diarrhoea (which, less commonly, may be bloody), nausea, upset stomach, and vomiting. Other side effects include[1]:

Rashes Hives Itching

Identification Name Cefadroxil

Accession Number DB01140 (APRD00196) Type small molecule

Groups Description

approved Long-acting, broad-spectrum, water-soluble, cephalexin derivative. [PubChem]

Structure Download: MOL | SDF | SMILES | InChI Display: 2D Structure | 3D Structure Synonyms

CDX Cefadroxil Monohydrate Cefradroxil Baxan Bidocef Cefa-Drops Cefamox Cephos Duracef Kefroxil Oracefal Sedral Sumacef Ultracef

Brand names

Brand name mixtures Categories

Not Available

Anti-Bacterial Agents Cephalosporins

CAS number Weight Chemical Formula

66592-87-8 Average: 363.388 Monoisotopic: 363.088891359 C16H17N3O5S

InChI Key InChI IUPAC Name SMILES Mass Spec Taxonomy Kingdom Classes

InChIKey=BOEGTKLJZSQCCD-UHFFFAOYSA-N

InChI=1S/C16H17N3O5S/c1-7-6-25-15-11(14(22)19(15)12(7)16(23)24)18-13(21) 9(20)5-3-8/h2-5,10-11,15,20H,6,17H2,1H3,(H,18,21)(H,23,24) Plain Text

7-[2-amino-2-(4-hydroxyphenyl)acetamido]-3-methyl-8-oxo-5-thia-1-azabicyclo[4.2 carboxylic acid CC1=C(N2C(SC1)C(NC(=O)C(N)C1=CC=C(O)C=C1)C2=O)C(O)=O Plain Text Not Available Organic

Phenols and Derivatives Phenethylamines Cephalosporins Hydroxy Compounds Acetates Phenols and Derivatives Amino Ketones Carboxylic Acids and Derivatives Aliphatic and Aryl Amines Benzene and Derivatives Beta Lactams Enamines Phenethylamines Heterocyclic compounds Aromatic compounds Carboxamides and Derivatives Cephalosporins Lactams Azetidines Phenyl Esters

Substructures

Pharmacology Indication Pharmacodynamics

For the treatment of the following infections (skin, UTI, ENT) caused by; S. pneum influenzae, staphylococci, S. pyogenes (group A beta-hemolytic streptococci), E. Klebsiella sp, coagulase-negative staphylococci andStreptococcus pyogenes

Cefadroxil, a first-generation cephalosporin antibiotic, is used to treat urinary tract and skin structure infections, pharyngitis, and tonsillitis.

Mechanism of action Absorption Volume of distribution Protein binding Metabolism Route of elimination Half life Clearance Toxicity Affected organisms Pathways

Like all beta-lactam antibiotics, cefadroxil binds to specific penicillin-binding prote located inside the bacterial cell wall, causing the inhibition of the third and last sta cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzym autolysins; it is possible that cefadroxil interferes with an autolysin inhibitor. Cefadroxil is well absorbed on oral administration; food does not interfere with its Not Available Binding rates of cefadroxil were 28.1% by U.F. method

Over 90% of the drug is excreted unchanged in the urine within 24 hours. It cross and appears in breast milk. 1.5 hours Not Available Nausea, vomiting, diarrhoea, allergic rashes may occur

Enteric bacteria and other eubacteria

Not Available

Pharmacoeconomics Aurobindo pharma ltd Hikma pharmaceuticals Ivax pharmaceuticals inc sub teva pharmaceuticals usa Lupin ltd Orchid healthcare Purepac pharmaceutical co Ranbaxy laboratories ltd Sandoz inc Teva pharmaceuticals usa inc Teva pharmaceuticals usa Warner chilcott inc Bristol laboratories inc div bristol myers co Apothecon inc div bristol myers squibb Ranbaxy pharmaceuticals inc

Manufacturers

Name

Diclofenac

Accession Number DB00586 (APRD00527)

Type Groups Description

small molecule approved

A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic ac available as the sodium salt. [PubChem]

Structure Download: MOL | SDF | SMILES | InChI Display: 2D Structure | 3D Structure

Synonyms

Diclofenac Acid Diclofenac Potassium Diclofenac Sodium ISV-205 Allvoran Apo-Diclo Assaren Benfofen Cataflam Delphimix Dichlofenac Dichronic Diclo-Phlogont Diclo-Puren Diclobenin Diclord Dicloreum Dolobasan Duravolten Dyloject Ecofenac Effekton Kriplex Neriodin Novapirina Novo-Difenac Novo-Difenac SR

Brand names

Nu-Diclo Pennsaid Primofenac Prophenatin ProSorb-D Rhumalgan Solaraze Solaraze T Tsudohmin Valetan Voldal Voltaren Voltaren Ophtha Voltaren Ophthalmic Voltaren Rapide Voltaren SR Voltaren-XR Voltarol Xenid

Brand name mixtures Categories

Not Available

Cyclooxygenase Inhibitors Nonsteroidal Anti-inflammatory Agents (NSAIAs)

CAS number Weight Chemical Formula InChI Key InChI IUPAC Name SMILES Mass Spec Taxonomy Kingdom

15307-86-5 Average: 296.149 Monoisotopic: 295.016684015 C14H11Cl2NO2 InChIKey=DCOPUUMXTXDBNB-UHFFFAOYSA-N

InChI=1S/C14H11Cl2NO2/c15-10-5-3-6-11(16)14(10)17-12-7-2-1-4-9(12)8-13(18 (H,18,19) Plain Text 2-{2-[(2,6-dichlorophenyl)amino]phenyl}acetic acid OC(=O)CC1=C(NC2=C(Cl)C=CC=C2Cl)C=CC=C1 Plain Text Not Available Organic

Aminobenzoates Phenylacetates Aminobenzoates Hydroxy Compounds Acetates Aliphatic and Aryl Amines Carboxylic Acids and Derivatives Phenylacetates Benzene and Derivatives Aryl Halides Halobenzenes Aromatic compounds Anilines

Classes

Substructures

Pharmacology Indication

For the acute and chronic treatment of signs and symptoms of osteoarthritis and r

Diclofenac is an acetic acid nonsteroidal antiinflammatory drug (NSAID) with anal Pharmacodynamics properties. Diclofenac is used to treat pain, dysmenorrhea, ocular inflammation, o rheumatoid arthritis, ankylosing spondylitis, and actinic keratosis

Mechanism of action

The antiinflammatory effects of diclofenac are believed to be due to inhibition of b migration and the enzyme cylooxygenase (COX-1 and COX-2), leading to the per prostaglandin synthesis. As prostaglandins sensitize pain receptors, inhibition of t responsible for the analgesic effects of diclofenac. Antipyretic effects may be due hypothalamus, resulting in peripheral dilation, increased cutaneous blood flow, an dissipation. Completely absorbed from the gastrointestinal tract.

Absorption Volume of distribution Protein binding

1.3 L/kg

More than 99% Hepatic Enzyme Prostaglandin G/H synthase 1 Metabolite 3'-Hydroxydiclofenac 5-Hydroxydiclofenac 4'-Hydroxydiclofenac Diclofenac acyl glucuronide Diclofenac acyl glucuronide Reaction

3'-hydrox

Metabolism

Cytochrome P450 3A4 Cytochrome P450 2C9 UDP-glucuronosyltransferase 1-1 UDP-glucuronosyltransferase 2B7

5-hydroxy

4'-hydrox

glucuroni

glucuroni

Route of

Diclofenac is eliminated through metabolism and subsequent urinary and biliary e

elimination Half life Clearance

glucuronide and the sulfate conjugates of the metabolites. Little or no free unchan excreted in the urine. Approximately 65% of the dose is excreted in the urine and the bile as conjugates of unchanged diclofenac plus metabolites. 2 hours

oral cl=622 mL/min [healthy] renal cl <1 mL/min [healthy]

Toxicity Affected organisms

Symptoms of overdose include loss of consciousness, increased intracranial pres pneumonitis. LD50=390mg/kg (orally in mice)

Humans and other mammals

diclofenac - oral, Cataflam, Zipsor GENERIC NAME: DICLOFENAC - ORAL (dye-KLOE-fen-ack) BRAND NAME(S): Cataflam, Zipsor rug Name Generic Name : diclofenac, diclofenac potassium, diclofenac sodium

Brand Name: Cataflam, Novo-Difenac-k (CAN), Voltaren Rapide (CAN), Novo-Difenac (CAN), Novo-Difenac SR (CAN), Nu-Diclo (CAN), Solaraze, Voltaren, Voltaren nu-Diclo SR (CAN), Ophtha (CAN), Voltaren-XR Classification: Anti-inflammatory, NSAID Pregnancy Category B Dosage & Route Dosages

ADULTS Oral

Pain, including dysmenorrhea: 50 mg tid PO; initial dose of 100 mg may help some patients (Cataflam). Osteoarthritis: 100150 mg/day PO in divided doses (Voltaren); 50 mg bidtid PO (Cataflam). Rheumatoid arthritis: 150200 mg/day PO in divided doses (Voltaren); 50 mg bidtid PO (Cataflam). Ankylosing spondylitis: 100125 mg/day PO. Give as 25 mg qid, with an extra 25-mg dose hs (Voltaren); 25 mg qid PO with an additional 25 mg at bedtime if needed (Cataflam).

Topical

Actinic keratosis: Cover lesion with gel and smooth into skin; do not cover with dressings or cosmetics (Solaraze).

Ophthalmic

1 drop to affected eye qid starting 24 hr after surgery for 2 wk.

PEDIATRIC PATIENTS Safety and efficacy not established. Therapeutic actions

Diclofenac has potent anti-inflammatory, analgesic and antipyretic actions. It inhibits the enzyme, cyclooxygenase, thus resulting in reduced synthesis of prostaglandin precursors.

Indications

Acute or long-term treatment of mild to moderate pain, including dysmenorrhea Rheumatoid arthritis Osteoarthritis Ankylosing spondylitis Treatment of actinic keratosis in conjunction with sun avoidance

Ophthalmic: Postoperative inflammation from cataract extraction

Adverse effects

GI disturbances; headache, dizziness, rash; GI bleeding, peptic ulceration; abnormalities of kidney function. Pain and tissue damage at Inj site (IM); local irritation (rectal); transient burning and stinging (ophthalmic). Potentially Fatal: Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis.

Contraindications

Active peptic ulcer; hypersensitivity to diclofenac or other NSAIDs. Treatment of perioperative pain in CABG surgery. 3rd trimester of pregnancy. Topical: Not to be applied onto damaged or nonintact skin.

Nursing considerations Assessment

History: Renal impairment; impaired hearing; allergies; hepatic, CV, and GI conditions; lactation, pregnancy Physical: Skin color and lesions; orientation, reflexes, ophthalmologic and audiometric evaluation, peripheral sensation; P, edema; R, adventitious sounds; liver evaluation; CBC, clotting times, renal function tests, LFTs, serum electrolytes, stool guaiac

Interventions

BLACK BOX WARNING: Be aware that patient may be at increased risk for CV events, GI bleed, renal insufficiency; monitor accordingly. Administer drug with food or after meals if GI upset occurs. Arrange for periodic ophthalmologic examination during long-term therapy. WARNING: Institute emergency procedures if overdose occurs (gastric lavage, induction of emesis, supportive therapy).

Teaching points

Take drug with food or meals if GI upset occurs. Take only the prescribed dosage. You may experience these side effects: Dizziness, drowsiness (avoid driving or using dangerous machinery while using this drug). Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers, changes in vision; black, tarry stools.

Nursing responsibilities Administer drug with foodor after mealsif GI upsetoccurs. Arrange for ophthalmologic exam duringlong-termtherapy. Instituteemergency procedure if overdoseuccurs. Side effects CNS: Headache,dizziness,somnolence,insomnia,fatigue,tiredness,dizziness,tinnitus, ophthalmiceffects. Dermatologic:Rash, pruritus,sweating, drymucousmembranes,stomatitis. GU: Dysuria,renalimpairment. GI: Nausea,dyspepsia, GI pain, diarrhea,vomiting,constipation,flatulence. Hematologic:Bleeding, plateletinhibition withhigher doses. Other:Peripheraledema,anaphylactoidreactions to fatalanaphylacticshock