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Ciprofloxacin: use,side effect, mechanism of action, interaction, price ,history

What is ciprofloxacin?

Use of Ciprofloxacin

Ciprofloxacin is mainly used for the treatment of bacterial infection.
Ciprofloxacin belongs form quinolone antibiotic .for the gram-negative bacilli is more
Ciprofloxacin is more active .where Gram-positive bacteria are required more concentration for inhibition.
Ciprofloxacin is used to try for major infection and also use for a treat some difficult treatment process. Ciprofloxacin has Bactericidal activity, oral efficacy and good tolerability Ciprofloxacin is not use for minor cases or gram-positive or anaerobes are mainly caused the Infection.
If the patient is not taking the drug directly then use of intravenous injection and after some modifiy, you can use an oral dose.
Ciprofloxacin is for other diseases by a bacterial infection are
         1.    Urinary tract infection (UTI)  

       Ciprofloxacin is use for UTI treatment is highly cure rate 
    2.    Gonorrhea

    3.    Chancroid

    4.    Bacterial gastroenteritis

    5.    Typhoid


      Ciprofloxacin is almost given the patient who is suffer the typhoid.
      In India 95% S.typhi is Isolated which is sensitive to ciprofloxacin.
6                Ciprofloxacin is also use for the tritment of Bone ,soft tissue ,gynaecological and                    wound infection. Caused by resistance staph .and gram neagative bacteria.
                 6Respiratory infection

8              7. Tuberculosis

      Ciprofloxacin is use for the treatment Tuberculosis with a combination of another drug.
9              8.Gram –negative septicaemias
      Parenteral ciprofloxacin might be combined with cephalosporin and an  aminoglycoside.
                9. Meningiti

       Though penetration is CSF is not very good, ciprofloxacin has been successfully using for the Gram-negative bacteria.
1            10. Prophylaxis

            Infection in neutropenic and cancer and other susceptible patients.
1            11. Conjunctivitis

       Disease is occurs by gram-negative bacteria.
Ciprofloxacin 500 mg tablet
Ciprofloxacin 500 mg tablet

Types of bacteria are affected By ciprofloxacin

Ciprofloxacin is highly susceptible for the bacteria like
E.coli                                      K.pneumoniae
Enterobacter                          salmonella typhi
Other salmonella                    shigella
Proteus                                   Neisseria gonorrhea
    N.meningitidis                           H. influenza
    H.ducreyi                                 campylobacter jejuni
   Yersinia enterocolitica              Vibrio cholera
Ciprofloxacin is moderately susceptile for the bacteria like
Pseudomonas aeruginosa           Legionella
Staph.aureus                               Brucella
Listeria                                         staph.epidermidis
Bacillus anthracis                        Branhamella catrrhalis
Mycobact. Tuberculosis
Side effect of Ciprofloxacin

Ciprofloxacin side effect  occur in approximate 10% patients, generally side effect of ciprofloxacin is mild .
1          Nausea
             Vomiting
3              Bad taste
4              Anorexia
5              Diarrhoea
6              Dizziness
7              Headache
8              Restlessness
9              Anxiety
1                Inomania
1          Dexterity(don’t drive)
.           Tremor
1            Rash
1            Pruritus
1            Photosensitivity
          Urticarial
1            Swelling of lips
1            Tendonitis and tendon rupture

Ciprofloxacin affect during the pregnancy

When ciprofloxacin is given to Pregnant  women some case it show cartilage damage in weight bearing joint .ciprofloxacin is given to children he/she may be joint pain or swelling occurs.

Mechanism of Action Ciprofloxacin

Ciprofloxacin is first generation drug of fluoroquinolones .
Ciprofloxacin is florinated analauge  that means it contain fluorine .
Ciprofloxacin has the capacity of deep panitration to tissue so it called broad spectrum antibiotic it kills gram positive bacteria , gram negative  and intracellular organism 
.
Before I explain how it is act on bacteria first I explain how bacteria replicate.

Bacteria DNA is circular double strand DNA when it replicate by process name is transcription and translation.

Transcription

In the transcription process DNA are open for replication of MRNA.
Due to opening of DNA side are positive super coli at the of DNA.
In this situation Enzyme like DNA gyrase is helps to opening of Positive supercoil so replication done successfully.

How ciprofloxacin act on the bacteria

Ciprofloxacin is act on the DNA gyrase .
DNA gyrase is otherwise called topoisomerase.
DNA gyrase consists of Two A and Two B subunit. Two A subunit help to the cutting of positive supercoil and untwisted DNA .and TWO B subunit help to reconnect the DNA .
Ciprofloxacin is attached With TWO B subunit and stop the action of TWO B subunit.
The enzyme is only change the configuration of of DNA.   
So there are cutting process is continued so DNA is collapsed.
Finally, bacteria is dead.

Resistance of Ciprofloxacin

Due to unique mechanism of action Plasmid mediated Transferable resistance probably does not occour. As compare to other antibiotic .
Some bacteria are increasing his resistance like Salmonella, Pseudomonas, staphylococci, gonococci and pneumococci.
Ciprofloxacin is well absorption through GI Tract. Its oral bioavailability is about
About 60-80%, and plasma protein binding is 20-35 %.
volume of distribution in liter/Kg is 3-4, precent metabolized is 20.
Plasma half life or t1/2 is 3-5 hr ,
Ciprofloxacin is available in both oral and intravenous Injection.

Dose of ciprofloxacin

Normally ciprofloxacin oral dose is present from 250 mg to 750 mg.
And also available as injection 100 mg to 200 mg .
For Gonorrhoea  500 mg dose is curing the disease,
For chancroid  500 mg BD for 3 days for cure of disease.
For typhoid 500 mg to 750 mg BD for 10 days, if the patient unable to take drug orally may treated with 200 mg iV injection for 12 hourly 
.
Interaction of ciprofloxacin

Plasma concentration of theophylline, caffeine and warfarin are increased by take of ciprofloxacin. Due to inhibition of metabolism.
SometimeNSAIDs enhance the CNS toxicity of Fluoroquinolone.
Antacids, sucralfate and iron salts given reduce absorption of ciprofloxacin.

Some Brand name of Ciprofloxacin

CIFRAN,CIPLOX,CIPROBID, QUINTERO,CIPROLET ,
These all the drug are available in the market as 250 mg , 500 mg ,750 mg as tablets and 200 mg and 100 ml iv injection and 3 mg /ml as eye drops.

Price of Ciprofloxacin

Cipla is making ciprofloxacin 500 mg tablets in price approx. RS 38 rupees for 10 tablets.
Alkem manufacture ciprofloxacin as the name of ALCIPRO 500 mg tablets in the price of RS 37.00
Sun pharmaceutical manufacturer ciprofloxacin as the name of Cifran 500 mg tablets in price of RS 38.34 for 10 tablets.
Zydus healthcare ltd manufacture ciprofloxacin as name CIPROBID 500 mg tablets in price 38.30 for 10 tablets.
Overall ciprofloxacin 500 mg tablet price for single tablet is started RS 3.3 to RS 3.8 rupees

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Similar drug like ciprofloxacin

Norfloxacin and Ofloxacin are similar to a drug like ciprofloxacin.
But ciprofloxacin is well drug between all these three drug.

Histroy of Ciprofloxacin

As we discuss avobe all know ciprofloxacin is Fluoroquinolones derivative.
The  first generation of fluoroquinolones  is discovered in The 1980s and its one Fluoro substitution . in 1990s Compounds have been developed with additional fluoro and other substitution for more effective against the bacteria.


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