AZ 500 mg

Description

Indications:

AZ 500 mg Tablet is indicated for the treatment of various infections caused by susceptible organisms. These include:

• Respiratory Tract Infections: It is effective against lower respiratory tract infections such as bronchitis and pneumonia, as well as upper respiratory tract infections like sinusitis and pharyngitis/tonsillitis.
• Ear Infections: AZ is used to treat otitis media (middle ear infections).
• Skin and Soft Tissue Infections: It helps in treating infections of the skin and underlying tissues.
• Sexually Transmitted Infections: AZ is also indicated for non-gonococcal urethritis and cervicitis caused by Chlamydia trachomatis in both men and women.

Note: Always use AZ as per the advice of a registered medical professional.

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Pharmacology:

Azithromycin is a stable antibiotic that can be taken orally without being affected by gastric acids. It is rapidly absorbed, with better absorption when taken on an empty stomach. Peak plasma concentrations are reached within 2.1 to 3.2 hours after oral administration. Azithromycin is actively transported to the site of infection by phagocytes, where it is released in high concentrations, over 50 times higher in tissues than in plasma. This property allows azithromycin to stay effective at the site of infection for several days, even after a single dose.

Following a 500 mg dose, the plasma concentration of azithromycin decreases with a half-life of 68 hours, allowing it to maintain its bacteriostatic effects in tissues for an extended period. It is primarily eliminated through biliary excretion, with minimal amounts appearing in urine.

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Microbiology:

Azithromycin works by binding to the 50S ribosomal subunit of susceptible bacteria, thus inhibiting protein synthesis. It is effective against a wide range of microorganisms, including:

• Gram-positive bacteria: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes.
• Gram-negative bacteria: Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae.
• Other microorganisms: Chlamydia trachomatis, Mycoplasma pneumoniae, and Chlamydia pneumoniae.
• Anaerobic bacteria: Peptostreptococcus species, Prevotella bivia.

It is unaffected by beta-lactamase production, making it useful against resistant bacteria.

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Dosage:

For Adults:

• Standard Dose: 500 mg once daily for 3 days or a loading dose of 500 mg on day 1, followed by 250 mg daily for the next 4 days.
• For Chlamydia infections: A single dose of 1 gram, or 500 mg on day 1, followed by 250 mg daily for 2 more days.

For Children:

• General Dose: 10 mg/kg body weight once daily for 3 days (children over 6 months).
• Specific Dosage Based on Weight:
  • 200 mg (1 teaspoon) for 15-25 kg body weight.
  • 300 mg (1½ teaspoons) for 26-35 kg.
  • 400 mg (2 teaspoons) for 36-45 kg.
• Typhoid Fever: 500 mg once daily for 7-10 days.

For Injection (IV Infusion):

• Community-acquired Pneumonia: 500 mg intravenously for at least two days, followed by oral Azithromycin at 500 mg daily for 7-10 days.
• Pelvic Inflammatory Disease: 500 mg intravenously for 1-2 days, followed by 250 mg orally for 7 days.

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Administration:

Azithromycin oral suspension should be prepared as follows:

1. Shake the bottle to loosen the powder.
2. Add boiled and cooled water up to the water mark on the bottle label.
3. Shake until the powder is completely dissolved.

Azithromycin should be taken at least 1 hour before or 2 hours after a meal for optimal absorption.

Note: Always consult a registered doctor before using this medication.

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Interaction:

• Antacids: If using antacids, take Azithromycin at least 1 hour before or 2 hours after the antacid.
• Carbamazepine: No significant interaction with carbamazepine was observed.
• Cyclosporin: Use with caution. Monitor cyclosporin levels if co-administered.
• Digoxin: Raised digoxin levels can occur, so monitor digoxin levels.
• Ergot derivatives: These should not be used with Azithromycin due to the risk of ergotism.
• Warfarin: Azithromycin does not alter warfarin’s anticoagulant effect but should be monitored.

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Contraindications:

• Hypersensitivity: Do not use in patients allergic to Azithromycin or any other macrolides.
• Liver Disease: Not recommended for use in patients with hepatic conditions.
• Ergot Derivatives: Co-administration with ergot derivatives is contraindicated.

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Side Effects:

AZ is generally well tolerated, with mild to moderate side effects. Common adverse effects include:

• Gastrointestinal: Nausea, abdominal pain, vomiting, diarrhea.
• Allergic reactions: Rash, photosensitivity.
• Liver effects: Temporary elevation in liver enzymes, rare cholestatic jaundice.
• Hearing impairment: Reversible hearing loss has been observed with prolonged use at higher doses.

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Pregnancy & Lactation:

• Pregnancy: Category B. Animal studies show no harm to the fetus, but Azithromycin should be used during pregnancy only when necessary.
• Breastfeeding: It is unknown whether Azithromycin is excreted in breast milk. Caution is advised when administering to nursing women.

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Precautions & Warnings:

• Allergic Reactions: Severe allergic reactions like anaphylaxis and angioedema have been reported.
• Renal Impairment: No dosage adjustment needed for mild renal impairment. Use with caution in more severe cases.
• Liver Impairment: Azithromycin should not be used in patients with significant hepatic disease.

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Overdose Effects:

Signs of overdose may include severe nausea, vomiting, diarrhea, and hearing loss. General supportive care and gastric lavage are recommended.

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Storage:

• Keep in a cool, dry place, away from light and heat.
• Store out of reach of children.

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Chemical Structure:

• Molecular Formula: C38H72N2O12

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Common Questions about AZ 500 mg Tablet:

What is AZ 500 mg Tablet?
It is an antibiotic used to treat various bacterial infections by inhibiting the synthesis of essential proteins in bacteria.

What are the uses of AZ 500 mg Tablet?
It is used to treat infections like pneumonia, pharyngitis, and soft tissue infections.

What are the Side Effects?
Common side effects include diarrhea, abdominal pain, and vomiting. Serious side effects like allergic reactions are rare.

How should AZ 500 mg Tablet be stored?
Store in a cool, dry place in its original packaging, out of reach of children.

Can it cause diarrhea?
Yes, diarrhea is a possible side effect. Contact a doctor if it is severe or persistent.

Is AZ 500 mg Tablet safe?
Yes, it is safe when used as prescribed by your doctor.

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Quick Tips:

• Finish the full course of treatment even if you feel better.
• Take AZ 500 mg Tablet 1 hour before or 2 hours after meals.
• Avoid taking antacids within 2 hours of Azithromycin.
• Report severe side effects like rash, difficulty breathing, or swelling of the face immediately.

Note: Always take AZ under the supervision of a registered healthcare provider.