From Inflammation To Infection To Infection Mefenamic Acid Clindamycin HCL Hussein H. Ahmad ® ®
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Transcript of From Inflammation To Infection To Infection Mefenamic Acid Clindamycin HCL Hussein H. Ahmad ® ®
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From Inflammation To Infection
Mefenamic Acid
Clindamycin HCL
Hussein H. Ahmad
® ®
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Mefenamic Acid
®
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Prostaglandins:
Hormone Like Substances which play a role in the Cell Metabolism.
Act as Chemical Mediators of the inflammatory response, increasing permeability (Vasodilatation) causing Inflammation.
Potentiate the effect of pain mediators (Histamine & Bradykinin) – They Sensitize the Pain Receptors.
They can cause PYREXIA by increasing their numbers due to an injection of a Pyrogen.
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Mechanism of Action
Inhibits prostaglandin biosynthesis (Like All Other NSAIDS)
Blocks Prostaglandin Action by Blocking PG Receptor Cells. (UNIQUE ACTION)
PONSTAN FORTE Exerts a DOUBLE
BLOCKADE Action on Prostaglandins.
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Pharmacokinetics and Metabolism
Well absorbed from the GIT.
Peak plasma concentrations 1 - 3 hours.
Rapid Onset of Action 30 min.
Pain Relief Maintained for 8 hours.
Extensively bounded to plasma proteins.
Metabolized by Gluco - conjugation in the liver.
> 50% is recovered in the urine as: unchanged drug or conjugated metabolites.
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Indications
For the relief of pain in acute andchronic conditions including painof traumatic, arthritic or muscularorigin; primary dysmenorrhoea,
headache and dental pain.
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In Dental pain…
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Effective analgesia
Extirpation of pulp
owe N.H.et al. Oral Surg. 1981;51(6):575.
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Analgesia in severe Dental Conditions
Rowe N.H.et al. Oral Surg. 1980; 50(3):257.
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1- Rees M. et al. The Lancet , Sep. 3, 1988.2- Smith R.P. et al. A J Gynecol. 1980;137(3):314-319
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500 mg 2-3 times daily
®
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Unique Original Mefenamic Acid With analgesic,
anti-inflammatory & antipyretic properties .
Unique double action
Effective in controlling pain following: Removal of an impacted molar Extirpation of pulp Dental surgery
Low side-effect profile
Dosage : 500 mg 2-3 times daily
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Clindamycin HCL
®
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> 50%Chronic sinusitis and otitis media
90-100%
Dental and oral infections
> 75% Pleurae-pulmonary infections
50-90%
Intra-abdominal infections
85-95%
Diabetic foot ulcersSydney M. Anaerobic Infections - A Clinical Overview. 2001 by Academic Press.
Prevalence of anaerobic bacteria in some common
infections
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Dalacin C®
In...
Dental Infections
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Gram Positive Aerobes: Staph Aureus. Staph Epidermidis. Streptococci except Strept Faecalis. Pneumococci.
Gram Positive Anaerobes: Propionibacterium species. Eubacterium species. Peptococcus species. Peptostreptococcus sp. Actinomyces species.
Other microbes: Chlamydia Trachomatis. Toxoplasma Gondii. Plasmodium Falciparum Malaria. Mycoplasma Hominis. Gardnerella Vaginalis.
Gram Negative Anaerobes: Bacteroides Fragilis. Bacteroides species Melaninogenicus. Fusobacterium species. Clostridium species.
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Targeted Spectrum
”Dalacin is one of the most active antibiotics against clinically significant anaerobic bacteria”
”Dalacin C is also effective against S. aureus, S. epidermidis and streptococcus species”
Vibhagool A.,et. Al, Therapy of bone and joints infections , Modern Medicine of the Middle East Vol.10/sept. 1993
Unique Benefit In Dental Infections
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Unique Benefit In Dental Infections
High Penetration into the
Site of Infection
“Dalacin C was found to have the greatest bone-to-serum ratio”
“Dalacin C penetrates well into abscesses”
Vibhagool A.,et. Al, Therapy of bone and joints infections , Modern Medicine of the Middle East
Vol.10/sept. 1993
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Unique Benefit In Dental Infections
High Clinical Efficacy
Refractory Periodontitis…
Scaling and Dalacin C 150 mg qid for 7 days decreased the incidence of active disease from an annual rate of 8% to 0.5% of sites per
patients.
1-Gordon J. et. Al, Efficacy of Clindamycin hydrochloride in refractory periodontitis, J Periodontol, 1990 Nov 61:686-91
2-Wilson DH, Br J Surg, 1980, 67:93.
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Unique Benefit In Dental Infections
1- Gordon J. et. Al, Efficacy of Clindamycin hydrochloride in refractory periodontitis, J Periodontol, 1990 Nov 61:686-912- Wilson DH, Br J Surg, 1980, 67:93.
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Soft Tissue Infection..
A Retrospective review of15,019 Patient treated withoral Dalacin C for soft
tissueinfections showed Excellentclinical results in 94.6% ofthe cases.
1-Gordon J. et. Al, Efficacy of Clindamycin hydrochloride in refractory periodontitis, J Periodontol, 1990 Nov 61:686-91
2-Wilson DH, Br J Surg, 1980, 67:93.
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Oral Dose :
600 - 1,800 mg / day
8 - 25 mg / Kg / day
( Adult )
( Pediatric )
®
Availability :
Caps 150 & 300 mg ( 16 caps/Box )
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High Penetration into the Site of Infection
Excellent Clinical Efficacy
Well Tolerated
1-Gordon J. et. Al, Efficacy of Clindamycin hydrochloride in refractory periodontitis, J Periodontal, 1990 Nov 61:686-912-Wilson DH, Br J Surg, 1980, 67:93.
Unique Benefit In Dental Infections
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THANK YOU
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Clindamycin, ampicillin, & cephalosporins were the 1st antibiotics associated
with CDAD ; the 2nd & 3rd generation cephalosp. , particularly cefotaxime,
ceftriaxone, cefuroxime & ceftazidime are now the agents most frequently
responsible for this condition … However all antibiotics , including
vancomycin & metronidazole (the agents most commonly used to treat
CDAD) have been found to carry a risk of subsequent CDAD ..
Pseudomembranous Colitis
Adapted from HARRISON’S Internal Medecine – 16th Edition
All 3 generations of cephalosporins, macrolides, clindamycin, & intravenous
β-lactam/β-lactamase inhibitors were intermediate-risk antibiotics with
similar AHRs …… Administration of Fluoroquinolones emerged as the most
important risk Factor for CDAD in Quebec during an epidemic …
Clinical Infectious Diseases 2005 ; 41: 1254-60
by 2005 Infectious Diseases Society of America
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We found that association between Fluoroquinolones and CDAD is stronger
than the association between clindamycin and CDAD … Thus, our study is
consistent with more recent reports that implicate Fluoroquinolone use as
risk factor for CDAD …Emerging Infectious Diseases, Vol 9, No 6, June 2003
Clindamycin was the highest-risk agent for CDAD in the 1970s … By the
late 1980s and through 1990s , cephalosporin antimicrobials… had become
the agents with the highest relative risk of CDAD …
Clinical Infectious Diseases 2004 ; 38: 646-8
Margaret E. McCusKer, Anthony Harris, Eli Perencevich, Marie-Claire Roghmann : Fluoroquinolone use & Clostridium difficile associated Diarrhea
Dale N. Gerding ; Clindamycin, cephalosporins, fluoroquinolones and clostridiumDifficile associated diarrhea : This is an antimicrobial resistance problem.
Pseudomembranous Colitis