Anne Marbun

8/3/2019 Anne Marbun

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Annajmiyatul Fitria

0911012052


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Disease evaluation and of Patophysiology CIN or Neoplasia intrapitelial serviks that is disease of

pra-cancer which attack epitel of uterus

There is nothing specific symptom for this disease, butcan happened haemorrahage in early disease andusually cancer just known by after continued stage ofdisease.


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Therapy and action By lifting of uterus that be preceded giving ofCiprofloxacin 500 mg 3 times one day during 7 day (20 grains)


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Pharmacology Aspect of Ciprofloxacin Mechanism of Activity:

Ciprofloxacin is bactericidal and acts by inhibiting theA subunit of DNA gyrase (topoisomerase) which is

essential in the reproduction of bacterial DNA. It has abroader spectrum of activity and is more potent invitro than the non-fluorinated quinolone nalidixicacid. Activity may be reduced in acid media.


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DoseThe usual adult oral dose of ciprofloxacin rangesfrom 250 to 750 mg twice daily depending onthe severity and nature of the infection.Modified-release preparations for once-daily

dosage are available in some countries. Theusual adult intravenous dose is 100 to 400 mgtwice daily, given over 30 to 60 minutes as asolution containing the equivalent of 1 to2 mg/mL (but see also under Administration. A

dose of 100 mg twice daily by mouth for 3 days issuitable in women with acute uncomplicatedcystitis. A 28-day course of treatment with adose of 500 mg twice daily should be given forchronic bacterial prostatitis.


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Side effects Trouble of GIT: queasyly, puking, diarrhoea, andstomachache.

Trouble of SSP : headache, dizzy, worried, insomnia,and euphoria.

hipersensitivity : Pruritus and urtikaria

Increasing of whereas value of enzym liver, especially

at patient which have experienced of damage of liver. Effect to renal : Interstisial Nefritis, fail kidney,

polyuria, haemorrahage of uretal, retention of urin


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Commemoration and Attention Neglectless giving to patient with kidney trouble Can cause uria crystal, so that dose may not be

abundant Don't consume product which contains calsiums

during using ciprofloxacin.

giving with antasid ( Al(OH)3) or of Mg(OH)2 will

decrease bioavaibility


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Pharmacokinetics Aspect Ciprofloxacin is rapidly and well absorbed from thegastrointestinal tract. Oral bioavailability isapproximately 70% and a peak plasma concentration

of about 2.5 micrograms/mL is achieved 1 to 2 hoursafter a dose of 500 mg by mouth. Absorption may bedelayed by the presence of food, but is notsubstantially affected overall. The plasma half-life isabout 3.5 to 4.5 hours and there is evidence of modestaccumulation.


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Half-life may be prolonged in renal impairmentavalue of 8 hours has been reported in end-stage renaldiseaseand to some extent in the elderly. There islimited information on the effect of hepaticimpairment; the half-life of ciprofloxacin has beenreported to be slightly prolonged in patients withsevere cirrhosis of the liver. With one or twoexceptions, most studies have shown thepharmacokinetics of ciprofloxacin to be not markedlyaffected by cystic fibrosis.


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Plasma protein binding ranges from 20 to 40%.Ciprofloxacin is widely distributed in the body andtissue penetration is generally good. It appears in theCSF, but concentrations are only about 10% of those inplasma when the meninges are not inflamed.Ciprofloxacin crosses the placenta and is alsodistributed into breast milk. High concentrations areachieved in bile.


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Ciprofloxacin is eliminated principally by urinaryexcretion, but non-renal clearance may account forabout a third of elimination and includes hepatic

metabolism, biliary excretion, and possiblytransluminal secretion across the intestinal mucosa. Atleast 4 active metabolites have been identified.Oxociprofloxacin appears to be the major urinarymetabolite and sulfociprofloxacin the primary faecalmetabolite


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Urinary excretion is by active tubular secretion as well asglomerular filtration and is reduced by probenecid; it is

virtually complete within 24 hours. About 40 to 50% of anoral dose is excreted unchanged in the urine and about 15%as metabolites. Up to 70% of a parenteral dose may beexcreted unchanged within 24 hours and 10% asmetabolites. Faecal excretion over 5 days has accounted for20 to 35% of an oral dose and 15% of an intravenous dose.Only small amounts of ciprofloxacin are removed by

haemodialysis or peritoneal dialysis.


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ANALYSIS OF CASE Usage of ciprofloxacin with dose 3x one day 500 mg during7 day ( 20 item) causing the happening of trouble to kidneyfunction where its degradation around 72% or remain 18%

functioning. Besides, Creatinin elements in its bloodincrease till 5,67 mg / dl and increase till 6,6 mg / dl. Thisrate not yet reached phase failed kidney ( till number 7 mg/ dl) so that not yet needed to clean blood. Usage cipro inhigher dose can cause kidney fuction trouble.


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If it was wanted using of cipro in higher dose ( 1500mg/ hari), so it was given with regimen 2x 750 mg / day.This matter relate to t / i2 elimiation which later willhave an effect on to generated effect andbioavailability.


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Usage of cipro with high dose have to get observationof doctor. during usage of cipro expected do notconsume beverage or food which contains calciumsantasida. pregnant Antacide.Antacide that containsAl(OH)3) or of Mg(OH)2 will degrade bioavaibilitas atmost 90%.


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