Genital Organ Disease Case No.2 Trichomoniasis

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Genital Organ Disease Case No.2 Trichomoniasis

এই হলো আরেক সমস্যাঃঃ
রোগীর সাদাস্রাব আর আপনি রোগীর সাথে সাথে তার স্বামীকেও ট্রীটমেন্ট দিচ্ছেন। আর এইসময় যদি রোগীর স্বামী চেম্বারে না থাকেন তাহলে রোগী বাসায় যেয়ে কিছুতেই তার স্বামীকে এই ঔষধ খাওয়াতে পারেন না। কেন?
স্বামীঃ আমি কেন ঔষধ খাবো। তোমার সাদাস্রাবের সমস্যা তাহলে তুমিই খাও ঔষধ। আমাকে কেন ডাক্তার লিখেছেন ঔষধ??
আর এইজন্য চেম্বারে কাপল আসা জরুরী। বুঝাবেন।
দেখুন আপনার স্ত্রী এর যে সমস্যা এটা শুধু সাদাস্রাবই নয়, এখানে দুর্গন্ধ+চুলকানী+জ্বালাপোড়াও আছে, আর যখন সহবাস করা হয় তখন এর মাএা বাড়ে। সুতরাং এটা একটা প্যারাসাইটিক ইনফেকশন। এটা আপনার মধ্যেও থাকতে পারে অথবা সহবাসের ফলে স্ত্রী এর থেকে আপনার মধ্যেও যেতে পারে আর তাই আপনাকেও ট্রীটমেন্ট দেয়া হয়েছে।
ট্রাইকোমোনিয়াসিস কী? এই রোগের কারণ, লক্ষণ, চিকিৎসা ও সতর্কতা
ট্রাইকোমোনিয়াসিস কী? এই রোগের কারণ ও তার থেকে মুক্তি পাওয়ার উপায় কি তা নিম্নে আলোচনা করা হল।
যে সমস্ত রোগ জীবাণু থেকে আমরা নিজের অজান্তেই আক্রান্ত হয়ে পড়ি, তার মধ্যে অন্যতম হলো যৌনরোগ বা শারীরিক সংস্পর্শে বাহিত রোগ ৷ ডাক্তারি পরিভাষায় এই যৌন বাহিত রোগ গুলিকে বলে সেক্সুয়ালি ট্রান্সমিটেড ডিজিজ STD.
আমরা বুঝেও উঠতে পারিনা কিভাবে সম্পূর্ণ অজান্তে শারীরিক ঘনিষ্ঠতায় আমরা সংক্রমিত হই। এখনও এই ধরনের যৌন বাহিত রোগ নিয়ে মানুষের মধ্যে বহু ভুল ধারণা, অচলায়তন রয়েছে৷ সর্বোপরি রয়েছে সচেতনতার অভাব।
তেমনই একটি Jouno bahito rog বা সেক্সুয়ালি ট্রান্সমিটেড ডিজিজ হলো ট্রাইকোমোনিয়াসিস। এই রোগটি মূলত ছড়ায় ব্যাকটেরিয়ার মাধ্যমে। নারী-পুরুষ উভয়ের মধ্যেই এই রোগের প্রকোপ দেখা গেলেও মূলত নারীদের মধ্যে এর লক্ষণ বেশি প্রকট হয়ে থাকে। পুরুষদের মধ্যে এর প্রভাব সাধারণত কম হয়। এছাড়াও উপসর্গ কম হওয়ায় অনেক পুরুষেরাই রোগটিকে তেমন গুরুত্ব দেন না। তাই অনেক পুরুষই এভাবে নিজের অজান্তেই রোগ ছড়িয়ে দেন এক বা একাধিক সঙ্গীর শরীরে।

ট্রাইকোমোনিয়াসিস কী?

ট্রাইকোমোনিয়াসিস আসলে এক ধরণের যৌন বাহিত রোগ। এটি সাধারণত যৌন সংসর্গের সময় একপ্রকার ব্যাকটেরিয়ার সংক্রমণের কারণে ঘটে। এই রোগের উপসর্গ পুরুষের তুলনায় মহিলাদের মধ্যে বেশি দেখা যায়। পুরুষরা এই রোগে আক্রান্ত হয়, কিন্তু লক্ষণ দেখা না দেওয়ার কারণে রোগীর কাছে অজ্ঞাত থেকে যায়। কিন্তু তাতে তার দ্বারা অন্য কেউ সংক্রমিত হতে পারেন।

ট্রাইকোমোনিয়াসিস-এর লক্ষণ বা উপসর্গ গুলি কী কী?

মহিলাদের ক্ষেত্রে এই রোগের লক্ষণ গুলি হলো-

লক্ষণ এবং উপসর্গসমূহ

স্রাব সাদা রং-এর হতে পারে অথবা ফেনিল হলুদ রং –এ স্রাব দেখা যায় এবং স্রাবে দুর্গন্ধ থাকতে পারে।
সাধারণত যৌনাঙ্গের আশে পাশে চুলকানি থাকে।
মূত্র ত্যাগ এবং যৌনমিলনে ব্যথা বা জ্বালা এবং যোনির আশপাশে প্রদাহ হতে পারে।
অনেক সময় এটি কোন প্রকার উপসর্গ ছাড়াই হতে পারে।

• মূত্রত্যাগের সময়ে জ্বালাপোড়া হতে পারে।

• যোনি থেকে সবুজ-হলদেটে তরল নিঃসৃত হতে দেখা যায়।

• যোনিতে চুলকানি বা অস্বস্তি।

• যৌনমিলনের সময় অস্বস্তি বা জ্বালা যন্ত্রণা।

• যোনি থেকে দুর্গন্ধ।

• তলপেটে ব্যথা।

পুরুষদের ক্ষেত্রে বেশিরভাগই লক্ষণ গুলি তেমন প্রকট হয়না, তবে এই রোগের ক্ষেত্রে লক্ষণ গুলি হলো-

• মূত্রত্যাগ এবং বীর্যপাতের সময় যৌনাঙ্গে ব্যথা অনুভব হওয়া।

• লিঙ্গ থেকে তরল নিঃসরণ।

• যৌন মিলন বা মূত্রত্যাগের সময় জ্বালা অনুভব।

নারী এবং পুরুষ উভয়ের ক্ষেত্রেই এই উপসর্গগুলি সাধারণত সংক্রামিত হওয়ার ৫ থেকে ২৮ দিনের মধ্যে প্রকাশ পায়।

যদি সঠিক সময়ে চিকিৎসা না হয়, ট্রাইকোমোনিয়াসিস থেকে HIV সংক্রামিত হওয়ার ঝুঁকি তৈরি হয়, যা এইডস রোগের জন্ম দেয়৷

ট্রাইকোমোনিয়াসিস এর প্রধান কারণগুলি কী কী?

ট্রাইকোমোনিয়াসিস, Trichomonas Vaginalis নামক পরজীবীর সংক্রমণের ফলে ঘটে। এটি বীর্য (Semen) কিংবা যোনিরসের (Vaginae fluid) এর মধ্যে থাকে। এই সংক্রমণ যৌন সংসর্গের (যোনি, মলদ্বারে বা মৌখিক যৌনমিলন) মাধ্যমে এক জনের শরীর থেকে তার যৌনসঙ্গীর শরীরে ছড়িয়ে পড়ে। কারণসমূহ

মাসিকের সময় নোংরা কাপড় পরলে ।
অস্বাস্থ্যকর পরিবেশে সহবাস করলে।
এই জীবাণু পুরুষের মূত্রতন্ত্রে এবং যোনাঙ্গে থাকে তবে পুরুষের দেহের কোনো ক্ষতি সাধন করে না। কিন্তু যখন যৌনক্রিয়ার মাধ্যমে যোনিপথে এই জীবাণু আসে, তখন এই জীবাণু কার্যকর হয়ে ওঠে এবং আস্তে আস্তে মহিলাদের শরীরে এর লক্ষণ প্রকাশ পায় ।

ট্রাইকোমোনিয়াসিস কিভাবে নির্ণয় করা হয়?

ট্রাইকোমোনিয়াসিস নির্ণয় করার জন্য ডাক্তাররা সাধারণত যে পরীক্ষাগুলি করতে দেন, তা হলো-

• মহিলাদের ক্ষেত্রে যোনিরস বা ভ্যাজাইনাল ফ্লুইডের নমুনা পরীক্ষা করা হয়।

• পুরুষদের ক্ষেত্রে মূত্র বা বীর্যের (semen) নমুনা পরীক্ষা করা হয়।

• পরজীবী বা প্যারাসাইটের অস্তিত্ব পরীক্ষার জন্য অনেকসময় র‍্যাপিড অ্যান্টিজেন টেস্টও করা হয়৷

• নিউক্লিক অ্যাসিড অ্যাম্পলিফিকেশন টেস্ট।

ট্রাইকোমোনিয়াসিস থেকে কী কী জটিলতার সৃষ্টি হতে পারে?

সময় মতো চিকিৎসা না হলে অন্যান্য অনেক শারীরিক জটিলতার সৃষ্টি হতে পারে।

• কোনো গর্ভবতী নারী এই রোগে আক্রান্ত হলে গর্ভপাত হওয়ার সম্ভাবনা থাকে। এছাড়া নির্দিষ্ট সময়ের আগেই শরীর থেকে অ্যামনিওটিক ফ্লুইড বেরিয়ে যেতে পারে।

• এই রোগের চিকিৎসা সঠিক সময়ে না হলে একটি বড় আশঙ্কা থেকে যায় এইচআইভি আক্রান্ত হওয়ার।

ট্রাইকোমোনিয়াসিস রোগের চিকিৎসা

সঠিক সময়ে চিকিৎসা শুরু করলে ট্রাইকোমোনিয়াসিস রোগটি থেকে খুব সহজেই মুক্তি পাওয়া পাওয়া যায়। তাই নূন্যতম উপসর্গ দেখা দিলে অবশ্যই ডাক্তারের পরামর্শ নিতে হবে।

এই রোগটি যেহেতু ব্যাকটেরিয়া সংক্রমণের ফলে ঘটে তাই অ্যান্টিবায়োটিক প্রয়োগ করে এর চিকিৎসা করা হয়৷ একটি অ্যান্টিবায়োটিকের সম্পূর্ণ কোর্স এই রোগ থেকে মুক্তি দেয়। ডাক্তাররা সাধারণত মেট্রোনিডাজোল (Flagyl) এবং টিনিডাজোল (Tindamax) ওষুধ দুটি প্রয়োগ করেন ট্রাইকোমোনিয়াসিস এর চিকিৎসায়৷

তবে একটি বিষয় মাথায় রাখতেই হবে যে, অ্যান্টিবায়োটিকের কোর্স সম্পূর্ণ করার পর, এক সপ্তাহের আগে কোনো রকম যৌন সম্পর্ক স্থাপন করা উচিত নয়।

প্রতিরোধের পদ্ধতির মধ্যে রয়েছে সেক্স না করা , কনডম ব্যবহার না করা, ডাচিং না করা, এবং নতুন সঙ্গীর সাথে সেক্স করার আগে এসটিআই পরীক্ষা করা। যদিও ব্যাকটেরিয়া দ্বারা সৃষ্ট নয়, ট্রাইকোমোনিয়াসিস নির্দিষ্ট অ্যান্টিবায়োটিক ( মেট্রোনিডাজল , টিনিডাজল , সেকনিডাজল ) দিয়ে নিরাময় করা যায়। যৌন অংশীদারদেরও চিকিত্সা করা উচিত।

Treatment Management :- Tinidazole.

Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Indications of Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Trichomoniasis: Tinizol DS is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis. The organism should be identified by appropriate diagnostic procedures. Because trichomoniasis is a sexually transmitted disease with potentially serious sequelae, partners of infected patients should be treated simultaneously in order to prevent re-infection.

Giardiasis: Tinizol DS is indicated for the treatment of giardiasis caused by Giardia duodenalis in both adults and pediatric patients older than three years of age. Sections or subsections omitted from the full prescribing information are not listed.

Amebiasis: Tinizol DS is indicated for the treatment of intestinal amebiasis and amebic liver abscess caused by Entamoeba histolytica in both adults and pediatric patients older than three years of age. It is not indicated in the treatment of asymptomatic cystpassage.

Bacterial Vaginosis: Tinizol DS is indicated for the treatment of bacterial vaginosis (formerly referred to as Haemophilus vaginitis, Gardnerella vaginitis, nonspecific vaginitis, or anaerobic vaginosis) in non-pregnant women.

Other pathogens commonly associated with vulvovaginitis such as Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Candida albicans and Herpes simplex virus should be ruled out.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Tinizol DS and other antibacterialdrugs, Tinizol DS should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Pharmacology Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Tinidazole, a 5-nitroimidazole derivative with antimicrobial actions similar to metronidazole, is active against both protozoa (e.g. Trichomonas vaginalis, Entamoeba histolytica and Giardia lamblia) and obligate anaerobic bacteria. It damages DNA strands or inhibits DNA synthesis in microorganism.

Dosage Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Prevention of Postoperative Infections :

Adult: A single oral dose of 2g approximately 12 hours before surgery.
Children less than 12 years: Data are not available to allow dosage recommendations for children below the age of 12 years in the prophylaxis of anaerobic infections.

Trichomoniasis: a single 2 g oral dose taken with food. Treat sexual partners with the same dose and at the same time

Giardiasis:

Adults: a single 2 g dose taken with food.
Pediatric patients older than three years of age: a single dose of 50 mg/kg (up to 2 g) with food

Amebiasis, Intestinal:

Adults: 2 g per day for 3 days with food.
Pediatric patients older than three years of age: 50 mg/kg/day (up to 2 g per day) for 3 days with food

Amebic liver abscess:

Adults: 2 g per day for 3-5 days with food.
Pediatric patients older than three years of age: 50 mg/kg/day (up to 2 g per day) for 3-5 days with food

Bacterial vaginosis: Non-pregnant, adult women: 2 g once daily for 2 days taken with food, or 1 g once daily for 5 days taken with food.

Administration Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Should be taken with food. Take during or immediately after meals.

Interaction Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

The following interactions were reported with metronidazole, which is chemically-related to Tinizol DS.

Alcohol, disulfiram: Avoid during Tinizol DS use and for 3 days afterward because cramps, nausea, vomiting, headaches, and flushing may occur.

Anticoagulants, oral (eg, warfarin): Anticoagulant effects may be increased. Anticoagulant dose may need to be adjusted during coadministration and for up to 8 days after discontinuation. Cholestyramine: Bioavailability of Tinizol DS may be decreased.

Cyclosporine, lithium, tacrolimus: Levels may be elevated by Tinizol DS, increasing the risk of toxicity.

Drugs that induce CYP3A4 (eg, fosphenytoin, phenobarbital, phenytoin, rifampin): May increase metabolism of Tinizol DS, decreasing plasma levels and therapeutic effect.

Drugs that inhibit CYP3A4 (eg, cimetidine, ketoconazole): May prolong t½ and decrease Tinizol DS Cl, increasing plasma levels and risk of adverse reactions.

Fluorouracil: Cl may be decreased by Tinizol DS, increasing the risk of adverse reactions

Fosphenytoin, phenytoin: The t½ may be prolonged and Cl reduced by Tinizol DS, increasing the risk of adverse reactions.

Oxytetracycline: Therapeutic effect of Tinizol DS may be decreased.

Contraindications

As with other compounds of similar structure, tinidazole, is contraindicated in patients having, or with a history of, blood dyscrasias although no persistent haematological abnormalities have been noted in clinical or animal studies. Tinidazole should be avoided in patients with organic neurological disorders. Tinidazole should not be administered to patients with known hypersensitivity to the compound.

Side Effects Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Reported side effects have generally been infrequent, mild and self-limiting. Side effects from the gastrointestinal tract include nausea, vomiting, anorexia, diarrhoea and metallic taste. Hypersensitivity reactions, occasionally severe, may occur in rare cases in the form of skin rash, pruritis, urticaria and angioneurotic oedema. As with related compounds, Tinizol DS may produce transient leukopenia. Other rarely reported side-effects are headache, tiredness, furry tongue and dark urine.

Pregnancy & Lactation

Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Precautions & Warnings Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Compounds of similar chemical structure have produced various neurological disturbances such as dizziness, vertigo, uncoordination, and ataxia. If, during therapy with Tinizol DS, abnormal neurological signs develop, therapy should be discontinued. Use in Pregnancy & Lactation: Tinizol DS is contraindicated during the first trimester of pregnancy. While there is no evidence that Tinizol DS is harmful during the late stages of pregnancy, its use during the last two trimesters requires that the potential benefits outweigh the possible risk to mother and foetus. Tinizol DS is excreted in breast milk in concentrations similar to those seen in serum. Tinizol DS can be detected in breast milk for up to 72 hours following administration. Interruption of breast-feeding is recommended during Tinizol DS therapy and for 3 days following the last dose.

Use in Special Populations

Renal Impairment: Haemodialysis: Additional dose equal to half the usual dose at the end of haemodialysis.

Therapeutic Class Tablet 1.Tinizol Ds 1gm (AS A Tinidazole AS A Amoebicides).

Amoebicides

OR Tablet 2:- Secnidazole

Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Indications of Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Secnizol DS is indicated in-

Intestinal Amoebiasis
Hepatic Amoebiasis
Urethritis and vaginitis due to Trichomonas vaginalis
Giardiasis

Pharmacology of Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Secnidazole is rapidly absorbed following oral administration. The maximum serum level is obtained after 3 hours following oral administration of 2 gm Secnidazole. The plasma elimination half-life is about 20 hours. The majority of Secnidazole is eliminated via urine (50% of the ingested dose is excreted within 120 hours). The pharmacokinetic profile of Secnidazole gives it the longest half-life of second-generation nitroimidazoles, ensuring 72-hour therapeutic blood levels from a 2 gm single dose.

Dosage & Administration of Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Secnidazole tablet should be administered orally. The dosage schedule of is mentioned below:

Acute Intestinal Amoebiasis:

Adults: 2 gm single dose, taken preferably just before meal.
Children: 30 mg/kg single dose, taken preferably just before meal.

Asymptomatic Amoebiasis (minute& cystic form):

Adults: 2 gm once daily for only 3 days, taken preferably just before meal.
Children: 30 mg/kg once daily for only 3 days, taken preferably just before meal.

Hepatic Amoebiasis: Evacuation of pus must be performed simultaneously with Secnidazole treatment at the suppurative stage of hepatic amoebiasis.

Adults: 1.50 gm/day in a single or divided doses, just before meal, for 5 days.
Children: 30 mg/kg/day, in a single or divided dose, just before meal, for 5 days.

Giardiasis:

Adults: 2 gm single dose, taken preferably just before meal.
Children: 35-50 mg/kg single dose, taken preferably just before meal.

Trichomoniasis:

Adults: 2 gm single dose, taken preferably just before meal. The partner should also receive the same treatment concomitantly.

Interaction of Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Administration of Secnizol DS with disulfiram is not recommended: confusional state & paranoid reaction may occur.

Use of Secnizol DS simultaneously with warfarin requires close monitoring: increased effect or oral anticoagulants and of the hemormagic risk is likely.

Contraindications of Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Secnidazole is contra-indicated for those patients who are hypersensitive to imidazole derivatives.

Side Effects of Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

The clinical studies have shown that Secnizol DS is characterized by very good tolerance and no serious adverse reactions have been reported to date. The following side-effects may be observed with Secnizol DS as with all nitroimidazole derivatives & are rarely serious:

Most frequent side-effects: Gastrointestinal disturbances, nausea, epigastric pain, metallic taste, glossitis, stomatitis.
Occasional side effects: Urticaria, moderate leukopenia which is reversible on treatment discontinuation.
Rare side-effects: Vertigo, ataxia and motor incoordination, paresthesia, peripheral neuropathy. With Secnizol DS, gastrointestinal disorders e.g. nausea, vomiting, eoigastric pain, etc., have been reported in very rare cases.

Pregnancy & Lactation

Secnidazole may be prescribed in pregnancy after the first trimester. As with other similar drugs, Secnidazole should not be administered during the first trimester of pregnancy or during lactation because Secnidazoleis found in the placenta and breast milk.

Precautions & Warnings

Patients should be advised not to take alcohol during treatment with Secnizol DS (because of the possibility of antabuse effect). Administration of Secnizol DSshould be avoided to patients with a history of blood dyscrasia.

Therapeutic Class of Tablet 2 :-Secnizol DS 1000mg (AS A Secnidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Amoebicides, Anti-diarrhoeal Antiprotozoal

3.Metronidazole

Tablet 3:- Tablet 1:-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Indications of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Amodis is indicated in the treatment of following diseases:

The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci).
The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes.
In the treatment of urogenital trichomoniasis.
Bacterial vaginosis (also known as non-specific vaginitis).
All forms of amoebiasis (intestinal, extra-intestinal disease and that of symptomless cyst passers).
Giardiasis.
Acute ulcerative gingivitis.
Anaerobically infected leg ulcers and pressure sores.
Acute dental infections due to anaerobic organisms.
Antibiotic associated pseudomembranus colitis.

Pharmacology of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Metronidazole is a member of the imidazole class of antibacterial drug and is classified therapeutically as an antiprotozoal agent. The 5-nitro group of Metronidazole is reduced by anaerobes metabolically. Studies have demonstrated that the reduced form of this drug interacts with DNA and gives bactericidal action of Metronidazole.

Dosage & Administration of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Tablet and Suspension:

Trichomoniasis (Adults & Children over 10 yrs)-

200 mg tid or 400 mg bid for 7 days
800 mg in the morning and 1-2 gm at night for 2 days
2 gm as a single dose for 1 days

Trichomoniasis (Children)-

Children 7-10 yrs: 100 mg tid
Children 3-7 yrs: 100 mg bid
Children 1-3 yrs: 50 mg tid

Intestinal amoebiasis (Adults & Children over 10 yrs)-

800 mg tid for 5 days

Intestinal amoebiasis (Children)-

Children 7-10 yrs: 400 mg tid
Children 3-7 yrs: 200 mg qid
Children 1-3 yrs: 200 mg tid

Extra-intestinal & Asymptomatic amoebiasis (Adults & Children over 10 yrs)-

400-800 mg tid for 5-10 days

Extra-intestinal & Asymptomatic amoebiasis (Children)-

Children 7-10 yrs: 200-400 mg tid
Children 3-7 yrs: 100-200 mg qid
Children 1-3 yrs: 100-200 mg tid

Giardiasis (Adults & Children over 10 yrs)-

2 gm once daily for 3 days

Giardiasis (Children)-

Children 7-10 yrs: 1 gm once daily
Children 3-7 yrs: 600-800 mg once daily
Children 1-3 yrs: 500 mg once daily

Acute ulcerative gingivitis (Adults & Children over 10 yrs)-

200 mg tid for 3 days

Acute ulcerative gingivitis (Children)-

Children 7-10 yrs: 100 mg tid
Children 3-7 yrs: 100 mg bid
Children 1-3 yrs: 50 mg tid

Acute dental infections (Adults & Children over 10 yrs)-

200 mg tid for 3-7 days

Bacterial Vaginosis (Adults & Children over 10 yrs)-

400 mg bid for 7 days
2 gm as a single dose for 1 days

Leg ulcers and pressure sores (Adults & Children over 10 yrs)-

400 mg tid for 7 days

Anaerobic infections (Adults & Children over 10 yrs)-

800 mg initially and then 400 mg tid for 7 days

Anaerobic infections (Children)-

Children 1-10 yrs: 7.5 mg/kg tid

Surgical prophylaxis (Adults & Children over 10 yrs)-

400 mg tid started 24 hours before surgery for 1 days

Surgical prophylaxis (Children)-

Children 1-10 yrs: 7.5 mg/kg tid

Vaginal Gel:

The recommended dose is one applicator full of Metronidazole gel (approximately 5 grams containing approximately 37.5 mg of Metronidazole) intravaginally once or twice a day for 5 days. For once a day dosing, Metronidazole gel should be administered at bedtime.

Suppository:

Anaerobic Infections-

Adults: 1 g every 8 hours for 3 days, then 1 g every 12 hours.
Children: 5-10 years: 500 mg every 8 hours for 3 days, then every 12 hours, Over 10 years adult dose.

Surgical Prophylaxis-

Adults: 1 g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high risk procedures.
Children: 5-10 years: 500 mg 2 hours before surgery; up to 3 further doses of 500 mg may be given every 8 hours for high risk procedures.

IV Infusion:

Metronidazole intravenous infusion requires no dilution and should not be mixed with any other drugs prior to administration.

Adults and children over 12 years: Infuse 500 mg 8 hourly at a rate of 5 ml/minute and a maximum of 4 g should not be exceeded during a 24-hour period. Treatment for 7 days is sufficient for most patients, but treatment can be extended, especially for cases where reinfection is likely. For surgical prophylaxis, administration shortly before surgery should be followed by 8-hourly doses for the next 24 hours.
Children under 12 years: 7.5 mg/kg body weight/day every 8 hours at a rate of 5 ml/minute

Contraindications of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Metronidazole is contraindicated in patients with a history of hypersensitivity to Metronidazole or other Nitroimidazole derivatives.

Side Effects of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Metallic taste, nausea, vomiting, diarrhoea, drowsiness, rashes may be observed during treatment.

Pregnancy & Lactation of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

US FDA Pregnancy Category of Metronidazole is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Metronidazole have been shown to be excreted in human milk. So, caution should be exercised when Metronidazole is administered to a nursing woman.

Precautions & Warnings of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

If for compelling reasons, Amodis must be administered longer than the usually recommended duration, it is recommended that hematological tests, especially leucocyte count should be carried out regularly and that patients should be monitored for adverse reactions such as peripheral or central neuropathy (such as paresthesia, ataxia, dizziness, convulsive seizures).
Amodis should be administered with caution to patients with hepatic encephalopathy.
Patients should be warned that Amodis may darken urine.

Use in Special Populations of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Hepatic impairment: Amodis is mainly metabolised by hepatic oxidation. Substantial impairment of Amodis clearance may occur in the presence of advanced hepatic insufficiency. Significant cumulation may occur in patients with hepatic encephalopathy and the resulting high plasma concentrations of Amodis may contribute to the symptoms of the encephalopathy. Amodis should therefore, be administered with caution to patients with hepatic encephalopathy. The daily dosage should be reduced to one third and may be administered once daily. Patients should be warned that Amodis may darken urine.

Renal impairment: The elimination half-life of Amodis remains unchanged in the presence of renal failure. The dosage of Amodis therefore needs no reduction. Such patients however retain the metabolites of Amodis. The clinical significance of this is not known at present. In patients undergoing haemodialysis Amodis and metabolites are efficiently removed during an eight hour period of dialysis. Amodis should therefore be re-administered immediately after haemodialysis. No routine adjustment in the dosage of Amodis need be made in patients with renal failure undergoing intermittent peritoneal dialysis (IDP) or continuous ambulatory peritoneal dialysis (CAPD).

Overdose Effects of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Single oral doses of Amodis, up to 12 g have been reported in suicide attempts and accidental overdoses. Symptoms were limited to vomiting, ataxia and slight disorientation. There is no specific antidote for Amodis overdosages. In case of suspected massive overdosages, a symptomatic and supportive treatment should be instituted.

Therapeutic Class of Tablet :-Amodis 400 mg (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Amoebicides, Anti-diarrhoeal Antiprotozoal

Vaginal Gel 4:-Flamyd –V 1.3% 5gm tube (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Indications of Vaginal Gel :- Flamyd –V 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Amodis is indicated in the treatment of following diseases:

The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci).
The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes.
In the treatment of urogenital trichomoniasis.
Bacterial vaginosis (also known as non-specific vaginitis).
All forms of amoebiasis (intestinal, extra-intestinal disease and that of symptomless cyst passers).
Giardiasis.
Acute ulcerative gingivitis.
Anaerobically infected leg ulcers and pressure sores.
Acute dental infections due to anaerobic organisms.
Antibiotic associated pseudomembranus colitis.

Pharmacology of Vaginal gel Flamyd –V 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Dosage & Administration of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Tablet and Suspension:

Trichomoniasis (Adults & Children over 10 yrs)-

200 mg tid or 400 mg bid for 7 days
800 mg in the morning and 1-2 gm at night for 2 days
2 gm as a single dose for 1 days

Trichomoniasis (Children)-

Children 7-10 yrs: 100 mg tid
Children 3-7 yrs: 100 mg bid
Children 1-3 yrs: 50 mg tid

Intestinal amoebiasis (Adults & Children over 10 yrs)-

800 mg tid for 5 days

Intestinal amoebiasis (Children)-

Children 7-10 yrs: 400 mg tid
Children 3-7 yrs: 200 mg qid
Children 1-3 yrs: 200 mg tid

Extra-intestinal & Asymptomatic amoebiasis (Adults & Children over 10 yrs)-

400-800 mg tid for 5-10 days

Extra-intestinal & Asymptomatic amoebiasis (Children)-

Children 7-10 yrs: 200-400 mg tid
Children 3-7 yrs: 100-200 mg qid
Children 1-3 yrs: 100-200 mg tid

Giardiasis (Adults & Children over 10 yrs)-

2 gm once daily for 3 days

Giardiasis (Children)-

Children 7-10 yrs: 1 gm once daily
Children 3-7 yrs: 600-800 mg once daily
Children 1-3 yrs: 500 mg once daily

Acute ulcerative gingivitis (Adults & Children over 10 yrs)-

200 mg tid for 3 days

Acute ulcerative gingivitis (Children)-

Children 7-10 yrs: 100 mg tid
Children 3-7 yrs: 100 mg bid
Children 1-3 yrs: 50 mg tid

Acute dental infections (Adults & Children over 10 yrs)-

200 mg tid for 3-7 days

Bacterial Vaginosis (Adults & Children over 10 yrs)-

400 mg bid for 7 days
2 gm as a single dose for 1 days

Leg ulcers and pressure sores (Adults & Children over 10 yrs)-

400 mg tid for 7 days

Anaerobic infections (Adults & Children over 10 yrs)-

800 mg initially and then 400 mg tid for 7 days

Anaerobic infections (Children)-

Children 1-10 yrs: 7.5 mg/kg tid

Surgical prophylaxis (Adults & Children over 10 yrs)-

400 mg tid started 24 hours before surgery for 1 days

Surgical prophylaxis (Children)-

Children 1-10 yrs: 7.5 mg/kg tid

Vaginal Gel:

Suppository:

Anaerobic Infections-

Adults: 1 g every 8 hours for 3 days, then 1 g every 12 hours.
Children: 5-10 years: 500 mg every 8 hours for 3 days, then every 12 hours, Over 10 years adult dose.

Surgical Prophylaxis-

Adults: 1 g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high risk procedures.
Children: 5-10 years: 500 mg 2 hours before surgery; up to 3 further doses of 500 mg may be given every 8 hours for high risk procedures.

IV Infusion:

Metronidazole intravenous infusion requires no dilution and should not be mixed with any other drugs prior to administration.

Adults and children over 12 years: Infuse 500 mg 8 hourly at a rate of 5 ml/minute and a maximum of 4 g should not be exceeded during a 24-hour period. Treatment for 7 days is sufficient for most patients, but treatment can be extended, especially for cases where reinfection is likely. For surgical prophylaxis, administration shortly before surgery should be followed by 8-hourly doses for the next 24 hours.
Children under 12 years: 7.5 mg/kg body weight/day every 8 hours at a rate of 5 ml/minute

Contraindications of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Metronidazole is contraindicated in patients with a history of hypersensitivity to Metronidazole or other Nitroimidazole derivatives.

Side Effects of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Metallic taste, nausea, vomiting, diarrhoea, drowsiness, rashes may be observed during treatment.

Pregnancy & Lactation of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Precautions & Warnings of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

If for compelling reasons, Amodis must be administered longer than the usually recommended duration, it is recommended that hematological tests, especially leucocyte count should be carried out regularly and that patients should be monitored for adverse reactions such as peripheral or central neuropathy (such as paresthesia, ataxia, dizziness, convulsive seizures).
Amodis should be administered with caution to patients with hepatic encephalopathy.
Patients should be warned that Amodis may darken urine.

Use in Special Populations of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Overdose Effects of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Therapeutic Class of vaginal gel:-Flamyd v 1.3% (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal)

Vaginal Supposidory 4.Gynomix (AS A Metronidazole+Neomycin Sulphate+Polymyxin-B+Nystatin).(AS A Drugs used in Vaginal and Vulval condition).

Indications

Gynomix is indicated in-

Vaginal trichomoniasis
Vaginal leucorrhoeas
Mixed vaginal infections (Fungal or Bacterial).Composition
Each vaginal suppository contains-
Metronidazole BP 200 mg
Neomycin Sulphate BP 35000 IU
Polymyxin B Sulphate BP 35000 IU
Nystatin BP 100000 IU.
Pharmacology
Metronidazole, a nitroimidazole, is active against various anerobic bacteria and protozoa. Nystatin is a polyene antibiotic with antifungal activity. Neomycin is an aminoglycoside. It is bactericidal and active against some gram-positive and gram-negative organisms. Polymyxin is active against gram-negative organisms including Pseudomonas aeruginosa.Dosage & Administration
One suppository in the vagina at bedtime for 12 days or as directed by the physician.Contraindications
Contraindicated to the patients who are hypersensitive to Metronidazole, Neomycin Sulphate, Polymyxin B Sulphate and Nystatin.
Side Effects
Skin rash, urticaria may occur rarely.
Pregnancy & Lactation
Caution should be practiced in pregnancy and lactation.Therapeutic Class
Drugs used in Vaginal and Vulval condition

Note:::

In men Untreated Trichomoniasis—==>leads to prostatitis, epipidymitis, urethral stricture, infertility, decrease sperm motility and viability.

Raiyyan Tahsan Date:12-01-2025 time:06-55-35

Raiyyan Tahsan

Raiyyan Tahsan