Ciprocore: (Ciprofloxacin)

Ciprofloxacin is a new quinolone drug used for both orally and parenterally.

CHEMISTRY

Molecular Formula:1-CYCLOPROPYL-6-FLUORO-1,4-DIHYDRO-4-OXO-7-(1-PIPERAZINYL)-3-QUINOLINECARBOXYLIC ACID HYDROCHLORIDE

Physical Properties:

  • Molecular Weight: Ciprofloxacin Monohydrate 385.82
  • Description: Finely yellowish to light crystals.
  • Solubility: Freely soluble in the water and slightly soluble in dehydrated alcohol.
  • PHARMACOKINETICS

    Distribution: the distribution volume of Ciprofloxatin is large and fat, exceeds the extra-cellular volume. This indicates that it must undergo concentration in parts of the body or bind to tissues or cells. The effects of 200 to 400 mg of ciprofloxacin given intravenously are linear; generally, drug accumulation does not occur when administered at 12 hours interval. However, oral dose of 750 mg a mean concentration of about 1.5 mg per gm is achieved in bone administered orally every 12 hours. Therapeutic concentration of the drug is reached in the peritoneal fluid after oral administration to patients undergoing chronic ambulatory peritoneal dialysis. Protein binding of ciprofloxacin has been calculated to be 20%-40%.

    PHARMACODYNAMICS

    Ciprofloxacin is a quinolone derivative. A Quinolone drug inhibits bacterial deoxyribonucleic acid (DNA) replication. A bactericidal effect can only occur in the presence of competent ribonucleic acid (RNA) and protein synthesis. The imbalance of inhibited DNA replication and continuing protein synthesis presumably leads to inhibition of cell division, but continued cell growth causes Fila mentation and cell death. Ciprofloxacin is active against a wide range of gram positive and gram-negative pathogens including strains resistant to penicillin, cephalosporin.

    MEDICAL USES

    Ciprofloxacin is being used to treat various infections such as:

  • Respiratory Tract Infection: Pneumonia, Bronchopneumonia, Infected pleurisy, Empyema, Lung abscess, Infected Bronchiectasis, Acute exacerbation of chronic bronchitis and lung infections in patients with cystic fibrosis.
  • Urinary Tract Infection: Acute and Chronic Pyelonephritis, Prostatitis, Cystitis, Epididymitis & Chronic Complicated or Recurrent UTI.
  • ENT Infection: Otitis media, Sinusitis, Mastoiditis.
  • Skin & Soft Tissue Infection: Infected ulcers, Wound infections, Abscesses, Otitis externa, Infected burns.
  • Gastrointestinal Tract Infections: Enteric fever, Bacterial diarrhoeas.
  • Intra-abdominal Infections: Peritonitis, Intra-abdominal abscess, Cholangitis, Cholecystitis, Empyema of gall bladder.
  • Bone & Joint Infections: Acute and chronic osteomyelitis, septic arthritis.
  • Severe Systemic Infections:Septicemia, Bacteremia, & Infection in immunocompromised patients.
  • Gonorrhoea: Includes urethral, rectal and pharyngeal, gonococcal infections even those caused by resistant gonococci.
  • Gynaecological Infections: Salpingitis, Endometritis, Pelvic Inflammatory disease.
  • PRECAUTIONS

    DCiprofloxacin may cause CNS stimulation; it should be used with caution in patient with CNS disorders such as severe arteriosclerosis epilepsy.

    Patients receiving this drug should be well hydrated to prevent crystalluria. Excessive alkalinisation of urine should be avoided. The dosages should be reduced in patients with renal impairment. Generally, the duration of treatment depends upon the severity of infection; however, it varies from 7 to 14 days.

    ADVERSE REACTION

    Ciprofloxacin is generally well tolerated. During clinical severity of the infection and should be determined by clinical and bacteriological response of the patient. For most injections, therapy should continue for at least 48 hours after the patient becomes asymptomatic. The usual duration is 1-2 weeks but severe complicated infections may require more prolonged therapy.

    OVERDOSE

    Overdose of ciprofloxacin may cause reversible renal toxicity. The treatment of overdose can be done bydischarging of the stomach through induced vomiting or even by gastric lavage. Therefore, experts recommend watchful monitoring and caring treatment.