CETECO CENFLU TW3 does not cause drowsiness, reduced pain due to sinusitis (10 blisters x 10 tablets)
Dosage form Film bag tablets
Specifications Box of 10 blisters x 10 tablets
Ingredient Paracetamol, caffeine, phenylephrine
Ingredient
| Composition information | Content |
| Paracetamol | 500mg |
| Caffeine | 25mg |
| Phenylephrine | 5mg |
Uses
indications
Cetecocenflu drugs help reduce sinusitis and symptoms of colds and flu, accompanied by fatigue and drowsiness.
Pharmacology
paracetamol: is a metabolic substance that has the activity of phenacetin, which has analgesic, fever -reducing effect. Paracetamol reduces body temperature in fever but rarely reduces body temperature in normal people. The drug acts on the hypothalamus, causing cooling off, increasing heat due to vasodilation and increased peripheral blood flow. With treatment dose, paracetamol has little impact on the cardiovascular and respiratory system, does not change acid -base balance, does not cause irritation or stomach bleeding. Paracetamol does not work on platelets or bleeding time.
caffeine: The Xanthin derivative is extracted from cafe, cocoa or synthesized from uric acid. Cafeine works clearly on the central nervous system.
Phenylephrin hydrochloride: is a drug-like sympathetic effect α1 (α1-adrenergic) has a direct effect on A, -adRenergic receptor that causes blood vessel contractions and increases blood pressure. Phenylephrin hydrochloride causes a bradycardia due to reflexes, reduces blood volume during circulation, reduces blood flow through the kidneys, as well as reduces blood into multiple tissues and organs of the body. The mechanism of α-adrenergic effect of phenylephrin is due to inhibition of loop production through adenyl cyclase inhibitor inhibitors, while β1-adrenergic effect is due to the activity of adenyl cyclase.
Dynamic pharmacokinetics
paracetamol: quickly absorbed and almost entirely through the digestive tract. The peak concentration of plasma is within 30 to 60 minutes after drinking with the dose of treatment. Paracetamol is quickly and evenly distributed in most body tissues. About 25% paracetamol in the blood combined with plasma proteins. The half -life of paracetamol plasma is 1.25 - 3 hours, which can last for toxic doses or in people with liver damage. Paracetamol is n-hydroxylation by cytochrom P450 to create n-acetyl-benzoquiniminimin. This metabolic substance normally reacts with sulfhydryl groups in glutathion and is dull.
However, if you take high doses of paracetamol, this metabolic is formed in sufficient amount to exhaust the glutathion of the liver.
In that situation, its reaction to the increasing sulfhydryl group of liver protein can lead to liver necrosis.
caffeine: fast oral absorption, oral bioavailability reaches over 90%. Cafein reaches maximum plasma concentrations after drinking about 1 hour. Cafeine is widely distributed in the body, through the placenta and breast milk. Distribution volume 0.4 - 0.6 liters/kg.
Cafein metabolizes in the liver by Demethyl reaction and oxidation. Elimination through urine is mainly in the form of metabolic. The sale time is about 3-7 hours, lasting longer in infants and premature babies.
Phenylephrin hydrochloride: Very erratic absorption through the gastrointestinal tract due to metabolic right on the digestive tract through the enzyme, so the bioavailability of the drug only reaches ≤ 38%. After drinking, the anti -congestion effect appears within 15-20 minutes, and lasts 2-4 hours. Phenylephrin in the circulation can be distributed into tissues with VD first phase: 26 - 61 liters and VD in a stable state: 340 liters. Phenylephrin is metabolized in the liver and intestines thanks to the enzyme monoaminoxidase (Mao) thanks to the amino redox reaction and the interconnected reaction with glucuronic acid. The drug is eliminated through the kidneys mainly in the form that has not been metabolized. Half life eliminates t/2 α for about 5 minutes and t/2 β about 2-3 hours.
Before taking CETECO CENFLU TW3 does not cause drowsiness, reduced pain due to sinusitis (10 blisters x 10 tablets)
How to use
cetecocenflu drug used oral. Do not use drugs continuously for more than 3 days without the guidance of a physician.
Dosage
Adults and children ≥ 16 years: 2 capsules/time x 4 times/day, 4 - 6 hours at a time. Take no more than 8 tablets/day.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?
paracetamol:
Expression:
The liver necrosis depends on the dose is the most serious toxic effect due to overdose and can cause death.
Nausea, vomiting, and abdominal pain usually occur within 2-3 hours after taking the poison of the drug. Blood methemoglobin, which leads to blue-purple, mucous and nail blue, is a specific sign of acute poisoning P-aminophenol; A small amount of sulfhemoglobin can also be produced.
When severe poisoning, it may initially stimulate the central nervous system, agitated and delirious. Next can be inhibiting the central nervous system: dumbfounded, lower body temperature, tired, fast breathing, shallow; Fast, weak, irregular, low blood pressure and circulatory failure. Shock may occur if a lot of vasodilation. The suffocating convulsions may occur. Often coma occurs before dying suddenly or after a few days of coma.
Clinical signs of liver injury becomes clearly within 2 to 4 days after taking toxic doses. Acute renal failure also occurs in some patients.
Management:
When severe poisoning, treatment is required to be active. Need to wash the stomach in any case, preferably within 4 hours after drinking.
The main detoxification is the use of sulfhydryl compounds. N-acetylcystein works when taken or intravenously. It must be used to detoxify immediately, as soon as possible if less than 36 hours after taking paracetamol. Treatment with n-acetylcysteine is more effective when giving the drug for less than 10 hours after taking paracetamol. Dilute N-acetylcystein solution with water or drink without alcohol to achieve a 5% solution and drink for 1 hour after mixing. Give N-acetylcystein oral at the first dose of 140 mg/kg, then give 17 more doses, each dose of 70 mg/kg 4 hours apart. Termination of treatment if the paracetamol test in plasma shows a low risk of liver toxicity. Without n-acetylcysteine, methionine may be used. If you have used activated carbon before using methionin, you must remove activated carbon from the stomach first. Also can use activated carbon and/or salt bleach because they have the ability to reduce the absorption of paracetamol.
phenylephrin hydrochloride:
Expression:
Hypertension, headache, convulsions, cerebral hemorrhage, chest drums, extra -syllable, paresthesia, slow heartbeat often occur early.
Management:
Hypertension can be overcome by taking A-adrenergic blockers such as phentolamine 5-10 mg, intravenous injection; If necessary, can be repeated. Hemorrhage is usually not helpful. Pay attention to symptomatic treatment and general support, medical care.
caffeine:
Expression:
caffeine when used in high doses causes the following effects: nervous tension, excitement, hypertension, waste expansion
Management, diuretic (from 300 mg/day or more), stimulating intestinal motility, insomnia.
Management:
Normally, patients will overcome the above symptoms after about 10 days of stopping caffeine, depending on the condition and some other factors.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.
Side Effects
When using the drug, there are common unwanted effects (ADR) such as:
paracetamol:
Serious skin reactions such as Stevens-Johnson syndrome, Lyell syndrome, poisoned epidermal necrosis, acne-based erythema acne, but rarely occur, but likely to cause death. If you see the appearance or other skin manifestations, you must stop taking the drug and examining a physician.
Skin rash and other allergic reactions occur. Usually erythema or urticaria, but sometimes worse and may be accompanied by fever due to drugs and mucosal lesions. If you see a fever, bullies around the natural cavities, you should think of Stevens-Johnson syndrome, to stop the drug immediately.
Paracetamol overdose can lead to severe liver damage and sometimes acute renal necrosis. People who are sensitive to salicylate rarely hypersensitive to paracetamol and related drugs. In a few individual cases, Paracetamol has caused neutropenia, thrombocytopenia and all bloody hematoma.
Uncommon, 1/1000 Common, ADR> 1/100: Cafe more can lead to psychological dependence. Cafe dependence can lead to manifestations such as headache, stress, tremor, nervousness, lack of concentration, angry. Notify the doctor with unwanted effects when using the drug.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Cetecocenflu drugs are contraindicated in the following cases:
Be cautious when using
need advice from physicians before use for patients in the following cases: prostate hypertrophy, blood vessel obstruction, cardiovascular disease.
paracetamol:
Overdose of paracetamol is the main cause of acute liver failure. Using many preparations containing paracetamol and can lead to harmful consequences such as paracetamol overdose.
Serious, fatal skin reactions include Stevens-Johnson syndrome, poisoned epidermal necrosis (Ten), all-body pustular syndrome (AGEP), lyell syndrome but rarely occurring with paracetamol, often regardless of the effect of other drugs. Patients need to stop using paracetamol and see a physician as soon as they see rash or other manifestations in the skin or sensitive reactions during treatment. Patients with a history of such reactions should not be used in preparations containing paracetamol.
Skin reactions include itchy and urticaria rash; Other sensitive reactions include larynx edema, angioedema, and anaphylactic reactions that may rarely occur.
Platelets, leukopenia, and all bloody hematuria have occurred with the use of p-aminophenol derivatives, especially when used for large doses. Neutral leukopenia and thrombocytopenic hemorrhage occur when using paracetamol. Rarely loss of granulocytes in patients using paracetamol.
People with phenylceton - urinary and people who have to limit the amount of phenylalanin put into the body must be warned that some paracetamol preparations contain aspartam, which will metabolize in the stomach - intestinal citadel phenylalanin after taken.
Be cautious when used for people with liver failure, kidney failure, alcoholic, chronic malnutrition or dehydration, patients with anemia before.
Should avoid or limit drinking alcohol because alcohol can be toxic to the liver of paracetamol.
phenylephrin hydrochloride:
In people with shock, using phenylephrin hydrochloride is not to replace the supplement of blood, plasma, fluid and electrolytes. Need to supplement the fluid before using phenylephrin.
Phenylephrin hydrochloride is not used as a single treatment in patients with hypoglycemia. Compensation therapy may need to be supplemented during or after drug use; Especially if the hypotension is re -recurred.
Monitoring central venous pressure or left ventricular blood pressure to detect and reduce blood volume; Track central venous pressure or artery pressure to avoid increasing burden on the circulatory system, which can cause congestive heart failure.
Hypoxemia and acid infection also reduce the effectiveness of phenylephrin; Therefore, it is necessary to identify and adjust before or at the same time as the drug.
caffeine:
To avoid too much caffeine tolerance, restricted caffeine drinks during the medication period.
The effect of the drug on the ability to drive and operate machinery
If there is a manifestation of dizziness during treatment, do not drive or operate machinery.
Using drugs for women during pregnancy and lactation
Pregnancy: Not for pregnant women.
Breastfeeding period: Excreted drugs on breast milk, so it should not be used for breastfeeding women.
Interactive drug
Interaction with other drugs and other types of interactions:
paracetamol:
Long -term drinking high -dose Paracetamol increases the anticoagulant effect of cooumarin and indoplasmic derivatives.
It is necessary to pay attention to the likelihood of causing serious hypothermia in patients with simultaneously phenothiazine and cooling therapy.
Out of alcohol too much and long may increase the risk of Paracetamol's liver toxicity.
Anti -convulsions (Phenytoin, Barbiturat, Carbamazepin) cause enzyme induction in the liver microsom, can increase the toxic liver toxic of paracetamol.
Simultaneous use of isoniazid with paracetamol can also lead to an increased risk of liver toxicity. The risk of paracetamol causes liver toxicity significantly increases in patients with paracetamol doses greater than the recommended dose while taking anti -convulsions or isoniazid. Patients must restrict self -use Paracetamol while taking anti -convulsions or isoniazid.
Probenecid can reduce paracetamol elimination and increase the half -life period in the plasma of paracetamol.
Isoniazid and tuberculosis drugs increase the toxicity of paracetamol for the liver.
phenylephrin hydrochloride:
The hypertension effect of phenylephrin will decrease, if before that, it has been used as a-adrenergic blockers like phentolamine mesylat.
Phentolamine can be used to treat hypertension due to overdose of phenylephrin.
Phenothiazin also has some A-adrenergic blockers; Therefore, using a phenothiazin before, can reduce the effect of hypertension and duration of effect of phenylephrin. When the blood pressure is lowered by an overdose of a phenothiazine or α-adrenergic blockers, the phenylephrin hydrochloride dose may be taken higher than the normal dose.
The heart stimulation effect of phenylephrin hydrochloride will be inhibited by using the β-adrenergic blockers like propranolol. Propranolol can be used to treat arrhythmia due to phenylephrin.
When combining phenylephrin hydrochloride with a birthout drug, hypertension effect will increase.
Phenylephrin hydrochloride is not used in combination with epinephrin or other sympathetic drugs, as tachycardia and perhance may occur.
Combining phenylephrin hydrochloride with anesthetics is Hydrocarbon Halogenation (eg cyclopropan) that increases heart irritation and can cause arrhythmia. With treatment, phenylephrin hydrochloride is much less arrhythmia than norepinephrin or metaraminol.
The heart stimulating effect and hypertension effect of phenylephrin hydrochloride are enhanced, if previously used the Mao inhibitors are due to the reduced phenylephrin metabolism.
Three -round antidepressants (such as imipramin) or guanethidin also increase the effect of hypertension of phenylephrin.
Atropin sulfate and other eyelashes when coordinated with phenylephrin will block the slow effect of reflective heart rate, increasing the effect of hypertension and dilated pupils of phenylephrin.
Alcaloid fungus spurs injected (like Ergonovin Maleat) when combined with phenylephrin will increase blood pressure very strongly.
Digitalis in combination with phenylephrin increases the sensitivity of the heart muscle due to phenylephrin.
Furosemid or other diuretics reduces hypertension due to phenylephrin.
Pilocarpin is a pupil, which is antagonistic with the dong -expanding effect of phenylephrin. After using phenylephrin to relax the pupil to complete the eye diagnosis, Pilocarpin can be used to recover faster.
Using phenylephrin for patients who have had a long time to take Guanethidin, the pupils of the pupils of phenylephrin increased much and the blood pressure also increased very strongly.
The pupil relaxation effect of phenylephrin is greatly reduced in patients using levodopa.
Not used with bromocriptin because of vasoconstrictor and hypertension.
caffeine:
antibiotic Ciprofloxacin, Norfloxacin increases the coffee storage time in the blood should increase the harmful effects of caffeine.
Use theophylline at the same time as caffeine increases theophylline concentration in the blood and cause nausea, vomiting, heart beating fast.
caffeine increases the risks that may occur when using Ephedra herbs.
Echinace is used to prevent colds or when infected, can increase the caffeine concentration in the blood and can increase the uncomfortable effect of caffeine.
Storage
Store at a temperature not exceeding 30 ° C in the original packaging, avoid moisture and avoid light.
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