Pabemin 325 Pharimexco nuggets treat mild to medium, cold, cough, runny nose (30 packs)

Dosage form Nuggets
Specifications 30 package box
Ingredient Paracetamol, chlorpheniramin maleat

Ingredient

Thành phần cho 1 gói

Composition information	Content
Paracetamol	325mg
Chlorpheniramin Maleat	2mg

Uses

indications

Pabemin® 325 drugs are indicated for treatment of mild to medium, cold, cough, runny nose.

Pharmacokology

paracetamol (acetaminophen or N - acetyl - P - Aminophenol)

is the active metabolite of phenacetin, an analgesic - antipyretic. 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.

paracetamol, with treatment dose, less impact on the cardiovascular and respiratory system, does not change acid -base balance, does not cause irritation, scratches or stomach bleeding as when using salicylate. The reason is because Paracetamol does not work on the whole body cyclooxygenase, which only affects the cyclooxygenase/prostaglandin of the central nervous system.

Paracetamol does not work on platelets or bleeding time.

With the dose of treatment, paracetamol metabolizes mainly through the Sulfate and Glucuronid complex reaction. A small amount usually turns into a toxic metabolite, N-acetyl-P-Benzoquinonimin (NAPQI). Napqi is detoxified by glutathion and eliminated into urine and/or bile. When metabolic is not connected to glutathion, it will be toxic to liver cells and cause cell necrosis.

Paracetamol is often safe when used for treatment, because the amount of Napqi is formed relatively low and glutathion formed in liver cells that are sufficiently associated with NAPQI. However, when overdose or sometimes with common doses in some sensitive people (such as malnutrition, or drug interactions, alcoholism, genetics), NAPQI concentration can accumulate toxic to the liver.

chlorpheniramin

A mixture of optical counter -anti -hype and antihistamine, which has very little sedative effects. Like most other histamine resistance, chlorpheniramine also has side effects against acetylcholin, but this effect is different between individuals. The antihistamine effect of chlorpheniramine through the closing body competes the H1 receptors of the acting cells.

Dynamic pharmacokinetics

paracetamol

fast and completely absorbing through the gastrointestinal tract. The distribution is evenly distributed in most body tissues, about 25% of the blood paracetamol in combination with plasma proteins.

Paracetamol is metabolized mainly in the liver and excreted through urine after the liver combination with glucuronic acid. The selling time varies from 1 to 3 hours. After the treatment dose, 90 - 100%of the urine can be found on the first day, mainly after the liver combination with glucuronic acid (about 60%), sulfuric acid (about 35%), or cysteine (about 3%); A small amount of hydroxyl metabolites - chemicals and reduction of acetyl.

Paracetamol is n-hydroxylation by cytochrom P450 to create N-acetyl-Benzoquinonimin, an intermediate reaction. This metabolic substance normally reacts with sulfhydryl groups in glutathion and is dimidated. If Paracetamol is taken high doses, this metabolite forms a sufficient amount to exhaust the glutathion of the liver.

chlorpheniramin maleat

Good absorption when taken and appear in plasma within 30-60 minutes. Chlorpheniramin Maleat metabolizes fast and high. Metabolic substances include desmethyl - Didesmethylclorpheniramine and some unknown substances, one or more substances among them are active. The concentration of chlorpheniramine in serum is not correlated in accordance with the antihistamine effect because there is an unknown metabolic substance that also works.

The drug is excreted mainly in urine in a constant or metabolic form, the excretion depends on the pH and the urine flow. Only a small amount is seen in the feces. Adults have the function of liver and kidney function normally selling time ranging from 12 to 43 hours and for children from 5.2 - 23.1 hours. In patients with chronic renal failure, lasting up to 280 - 330 hours.

Before taking Pabemin 325 Pharimexco nuggets treat mild to medium, cold, cough, runny nose (30 packs)

How to use

Take oral use.

Dissolve nuggets into water, stir before drinking.

Dosage

How to drink every 4-6 hours, no more than 5 times/day.

If the pain lasts more than 5 days, a high fever above 39.5 ° C, a fever lasts more than 3 days or a recurrent fever: Do not continue treatment without consulting your doctor.

Adults and children over 12 years: Take 1-2 packs/time.

Children from 6 to 12 years old: Take 1 pack/time.

Children under 6 years old: Must consult a doctor.

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?

Symptoms of overdose

paracetamol

Liver damage can occur in adults who have taken 10 g or more than 10 g paracetamol. Taking 5 g or more than 5 g of paracetamol can lead to liver damage if the patient has the following risk factors:

If the patient is long -term treatment with carbamazepin, phenobarbiton, phenytoin, primidon, rifampicin, or other drugs that cause liver enzyme.

or regularly drink alcohol beyond the recommended amount.

or patients are likely to lose glutathion, such as eating disorders, cystic fibrosis, HIV infection, malnutrition.

Paracetamol overdose symptoms for the first 24 hours are pale, nausea, vomiting, appetite and abdominal pain. Liver damage may become clear after drinking 12 - 48 hours. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, liver failure can progress into brain disease, hemorrhage, hypoglycemia, brain edema and death. Acute renal failure with acute renal necrosis, hematuria and proteinuria can grow even in the absence of serious liver damage. Arrhythmia and pancreatitis have been reported.

chlorpheniramin

Symptoms and overdose signs of chlorpheniramin maleat include sedation, naughty stimulation of the central nervous system, mental rebellion, seizure, apnea, convulsions, anti -secretion effects Acetylcholin, hypertonic reaction and cardiovascular collapse, arrhythmia.

Treatment

Early diagnosis is important in the treatment of paracetamol overdose. There are methods to quickly determine the concentration of drugs in plasma. However, do not delay treatment while waiting for the test results if the history is suggested to overdose. When severe poisoning, it is important to treat positive support. Gastric lavage is needed in any case, preferably within 4 hours after drinking.

The main detoxification is the use of sulfhydryl compounds, perhaps partly due to the addition of glutathion reserves in the liver.

n-acetylcysteine works when taken or intravenously. Must give the drug immediately if less than 36 hours after taking paracetamol. Treatment with N - Acetylcystein is more effective when giving the drug for less than 10 hours after taking paracetamol. When drinking, dilute N - Acetylcystein solution with water or drinks without alcohol to achieve a 5% solution and must be taken within 1 hour after mixing. Give N - Acetylcysteine 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.

The unwanted effect of N-acetylcystein includes skin rash (including urticaria, no need to stop the drug), nausea, vomiting, diarrhea, and anaphylactic reaction.

Without n-acetylcystein, methionine can be used (see specialized methionine). Also can use activated carbon and/or salt bleach, they have the ability to reduce the absorption of paracetamol. Treatment of symptoms and supporting life function, special attention should be paid to liver, kidney, respiratory, heart and water balance.

Stomach or vomiting with ipecacuanha syrup. Then, for active carbon and bleach to limit absorption.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Pabemin® 325, you may experience unwanted effects (ADR).

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 a ban or other skin manifestations, you must stop the medicine and see a doctor.

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 holes of self, should think of Stevens-Johnson syndrome, stop immediately.

Patients with susceptibility to rare salicylate sensitive to paracetamol and related drugs. In a few individual cases, paracetamol has caused neutropenia, thrombocytopenia and all bloody hemoglobin. The sedative effect is very different from sleeping lightly to deep sleep, dry mouth, dizziness and irritation occurs when interrupted treatment. However, most patients suffer from side effects when treating continuously, especially if increasing the dose slowly.

Common, ADR> 1/100

Central nervous system: Sleeping, sedation.

digestion: dry mouth ..

Uncommon, 1/1000

DA: Ban.

stomach - intestines: nausea, vomiting.

Hematology: Dehydration (neutropenia, all bloody hemolysis, leukopenia), anemia.

kidney: Kidney disease, kidney toxicity when abused for a long time.

Rare, ADR

Other: Hypersensitivity reaction.

Systemic: dizziness.

digestive: nausea.

Instructions on how to handle ADR

When experiencing the side effects of the drug, stop taking the drug when any allergic reaction occurs and notify the doctor or go to the nearest medical facility for timely treatment).

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Pabemin® 325 drug contraindicated in the following cases:

Hypersensitivity to the ingredients of the drug.

Patients with narrow -angle gloco, prostate hypertrophy, acute asthma attacks, bladder neck obstruction, duodenal gaster.

Lactions, newborns and children are lacking in months.

People who are taking Mao inhibitors within 14 days, up to the time of treatment with Pabemin 325.

Patients with glucose-6-phosphate dehydrogenase (G6PD).

Caution when using

Doctors need to warn patients on signs of serious skin reactions such as Stevenjohnson syndrome (SJS), toxic skin necrosis syndrome (name) or lyell syndrome, acute non -acne pustular syndrome (AGEP). Paracetamol is relatively non -toxic to the dose of treatment. Sometimes there are skin reactions including itchy and urticaria, other sensitive reactions including laryngeal edema, angioedema, and anti -segment reactions that can rarely occur.

Ophthalmology, leukopenia, and all bloody hemorrhage 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. Paracetamol must be used in patients with anemia before, because purple blue may not manifest clearly, although there are dangerous high concentrations of methemoglobin in the blood. Drinking plenty of alcohol can cause toxicity to the liver of paracetamol; Should avoid or limit drinking.

Clorpheniramine may increase the risk of urination due to the anti -acetylcholin secretion side effects, especially in people with prostate hypertrophy, urinary tract, pyloric garges, and worsen in patients with myasthenia gravis.

The sedative effect of dorpheniramine increases when drinking alcohol and when used simultaneously with other sedatives. There is a risk of respiratory complications, respiratory decline and apnea, which can cause very trouble in people with pulmonary obstruction or children. Must be cautious when chronic lung disease, shortness of breath or shortness of breath. There is a risk of tooth decay in patients treated for a long time, due to anti -secretion effect, causing dry mouth. Avoid use for patients with glaucoma like glaucoma.

The drug contains white sugar and therefore should not be used for patients with rare genetic problems such as: intolerance of fructose, deficiency of sucrase-isomaltase or glucose-galactose absorption.

Elderly: Use medication carefully with the elderly (> 60 years old) because these people often increase sensitivity to anti -secretion effects Acetylcholin.

The ability to drive and operate machinery

The drug can cause chicken sleep, dizziness, dizziness, blurred vision and mental impairment. Therefore, avoid being used for people operating machinery or driving train.

Pregnancy

only taking drugs during pregnancy when really necessary. Do not use for pregnant women in the last 3 months of pregnancy because it can cause epilepsy in newborns.

The period of breastfeeding. Therefore, it is necessary to consider or not breastfeed or do not take the drug, depending on the degree of need for the drug for the mother.

Interactive drug

Long -term oral high doses that slightly increases the anticoagulant effect of COMAARIN and indoplasm. It is necessary to pay attention to the likelihood of serious antipyretics in patients using simultaneously phenothiazine and cooling therapy. Drinking too much and long alcohol can increase the risk of liver toxicity. Anti -convulsions (Phenytoin, Barbiturat, Carbamazepin) cause enzyme induction in the liver microsom, which can increase liver toxicity due to increased drug conversion into toxic substances to the liver. In addition, simultaneously used with isoniazid can also lead to an increased risk of liver toxicity.

Monoamin oxydase inhibitors prolonged and increased the anti -secretion effect of acetylcholin of the drug. Ethanol or sedatives causing sleep can increase the central nervous inhibition effect. The drug inhibits phenytoin metabolism and can lead to phenytoin poisoning.

chloramphenicol: paracetamol can increase the selling time of chloramphenicol.

metoclopramid or domperidon: The absorption rate of paracetamol can be increased by metoclopramid or domperidon.

cholestyramin: Paracetamol's absorption speed may be reduced if used with cholestyramin.

Storage

Store in a cool dry place, temperatures below 30 ° C, avoiding light.

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