소아(1세 이상) 및 성인 : 이 약 3방울을 1일 2회씩 7일 동안 감염된 귀 안에 점적한다.
사용하기 직전 잘 흔들어서 사용한다.
차가운 용액을 귀 안으로 점적하면 현기증이 일어날 수도 있으므로 이를 피하기 위하여 용기를 1-2분정도 손으로 잡아 따뜻하게 한 후 투여한다. 환자는 감염된 귀가 위쪽으로 향하도록 누운 자세에서 본제를 점적하여야 한다. 약물이 보다 쉽게 귀 안으로 흡수될 수 있도록 이러한 자세를 30-60초간 유지하여야 한다. 필요하다면 반대쪽 귀에도 투여한다.
Ciprofloxacin에 대한 Mechanism_Of_Action 정보 The bactericidal action of ciprofloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV, which are required for bacterial DNA replication, transcription, repair, and recombination. Hydrocortisone에 대한 Mechanism_Of_Action 정보 Hydrocortisone binds to the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes. The anti-inflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which then binds to cell membranes preventing the phospholipase A2 from coming into contact with its substrate arachidonic acid. This leads to diminished eicosanoid production. The cyclooxygenase (both COX-1 and COX-2) expression is also suppressed, potentiating the effect. In another words, the two main products in inflammation Prostaglandins and Leukotrienes are inhibited by the action of Glucocorticoids. Glucocorticoids also stimulate the lipocortin-1 escaping to the extracellular space, where it binds to the leukocyte membrane receptors and inhibits various inflammatory events: epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst and the release of various inflammatory mediators (lysosomal enzymes, cytokines, tissue plasminogen activator, chemokines etc.) from neutrophils, macrophages and mastocytes. Additionally the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.
Pharmacology
Ciprofloxacin에 대한 Pharmacology 정보 Ciprofloxacin is a broad-spectrum antiinfective agent of the fluoroquinolone class. Ciprofloxacin has in vitro activity against a wide range of gram-negative and gram-positive microorganisms. The mechanism of action of quinolones, including ciprofloxacin, is different from that of other antimicrobial agents such as beta-lactams, macrolides, tetracyclines, or aminoglycosides; therefore, organisms resistant to these drugs may be susceptible to ciprofloxacin. There is no known cross-resistance between ciprofloxacin and other classes of antimicrobials. Notably the drug has 100 times higher affinity for bacterial DNA gyrase than for mammalian. Hydrocortisone에 대한 Pharmacology 정보 Hydrocortisone is the most important human glucocorticoid. It is essential for life and regulates or supports a variety of important cardiovascular, metabolic, immunologic and homeostatic functions. Topical hydrocortisone is used for its anti-inflammatory or immunosuppressive properties to treat inflammation due to corticosteroid-responsive dermatoses. Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger a variety of important cardiovascular, metabolic, immunologic and homeostatic effects. Glucocorticoids are distinguished from mineralocorticoids and sex steroids by having different receptors, target cells, and effects. Technically, the term corticosteroid refers to both glucocorticoids and mineralocorticoids, but is often used as a synonym for glucocorticoid. Glucocorticoids suppress cell-mediated immunity. They act by inhibiting genes that code for the cytokines IL-1, IL-2, IL-3, IL-4, IL-5, IL-6, IL-8 and TNF-alpha, the most important of which is the IL-2. Reduced cytokine production limits T cell proliferation. Glucocorticoids also suppress humoral immunity, causing B cells to express lower amounts of IL-2 and IL-2 receptors. This diminishes both B cell clonal expansion and antibody synthesis. The diminished amounts of IL-2 also leads to fewer T lymphocyte cells being activated.
Metabolism
Ciprofloxacin에 대한 Metabolism 정보 # Phase_1_Metabolizing_Enzyme:Cytochrome P450 1A2 (CYP1A2) Hydrocortisone에 대한 Metabolism 정보 # Phase_1_Metabolizing_Enzyme:Cytochrome P450 3A4 (CYP3A4)
Protein Binding
Ciprofloxacin에 대한 단백결합 정보 20 to 40% Hydrocortisone에 대한 단백결합 정보 95%
Half-life
Ciprofloxacin에 대한 반감기 정보 4 hours Hydrocortisone에 대한 반감기 정보 6-8 hours
Absorption
Ciprofloxacin에 대한 Absorption 정보 Rapidly and well absorbed from the gastrointestinal tract after oral administration. The absolute bioavailability is approximately 70% with no substantial loss by first pass metabolism. Hydrocortisone에 대한 Absorption 정보 Topical corticosteroids can be absorbed from normal intact skin. Inflammation and/or other disease processes in the skin increase percutaneous absorption.
Pharmacokinetics
Ciprofloxacin HCl의 약물동력학자료
흡수 : 경구 : 위장관에서 빠르게 흡수된다.
생체내이용률 : 50-80%
분포 : 태반 통과, 유즙 분비, 체내에 널리 분포
흔히 조직농도가 혈중농도보다 높다.
신장, 방광, 간, 폐, 부인과적 조직, 전립선에 높은 농도로 분포한다.
뇌척수액 대 혈액의 농도비 (%)
정상 뇌막 : 10
염증성 뇌막 : 14-37
단백결합 : 16-43%
대사 : 부분적으로 간대사
반감기 :
소아 : 2.5시간
정상 신기능의 성인 : 3-5 시간
혈중최고농도 도달시간 : 경구 : 0.5-2 시간
소실 : 30-50%가 미변화체로 신배설, 20-40%가 담즙을 통해 변배설
Hydrocortisone의 약물동력학자료
흡수 : 직장을 제외한 모든 투여경로에서 빠르게 흡수된다.
대사 : 간에서 대사된다.
생리적 반감기 : 8∼12시간
소실 : 주로 17-hydroxysteroids와 17-ketosteroids의 형태로 신배설된다.
용해성이 큰 다른 약물과 비교했을 때 hydrocortisone acetate는 작용발현시간은 느리지만 작용지속시간이 길다.
Hydrocortisone sodium succinate는 물에 쉽게 녹아 빨리 활성화된다.
Biotransformation
Ciprofloxacin에 대한 Biotransformation 정보 Hepatic. Four metabolites have been identified in human urine which together account for approximately 15% of an oral dose. The metabolites have antimicrobial activity, but are less active than unchanged ciprofloxacin. Hydrocortisone에 대한 Biotransformation 정보 Primarily hepatic via CYP3A4
Toxicity
Ciprofloxacin에 대한 Toxicity 정보 The major adverse effect seen with use of is gastrointestinal irritation, common with many antibiotics. Hydrocortisone에 대한 Toxicity 정보 Side effects include inhibition of bone formation, suppression of calcium absorption and delayed wound healing
Drug Interactions
Ciprofloxacin에 대한 Drug_Interactions 정보 Aluminium Formation of non-absorbable complexesMethotrexate Increases methotrexate toxicity Aminophylline The quinolone increases the effect of theophyllineAnisindione The quinolone increases the anticoagulant effectBismuth Formation of non-absorbable complexesCaffeine The quinolone increases the effect and toxicity of caffeineCalcium Formation of non-absorbable complexesClozapine Ciprofloxacin may increase clozapine serum levelsCyclosporine The quinolone increases the effect and toxicity of cyclosporineDicumarol The quinolone increases the anticoagulant effectDihydroxyaluminium Formation of non-absorbable complexesDyphylline The quinolone increases the effect of theophyllineDuloxetine Increases the effect/toxicity of duloxetineDyphylline The quinolone increases the effect of theophyllineEthotoin Decreases the hydantoin effectFoscarnet Increased risk of convulsionsFosphenytoin Decreases the hydantoin effectMagnesium oxide Formation of non-absorbable complexesMagnesium Formation of non-absorbable complexesMephenytoin Decreases the hydantoin effectAcenocoumarol The quinolone increases the anticoagulant effectOxtriphylline The quinolone increases the effect of theophyllinePhenytoin Decreases the hydantoin effectProcainamide The quinolone increases the effect of procainamideRasagiline Increases effect/toxicity of rasagilineRopinirole The quinolone increases the effect and toxicity of ropiniroleSevelamer Sevelamer decreases ciprofloxacin bioavailabilitySildenafil The quinolone increases sildenafil levelsSucralfate Formation of non-absorbable complexesTheophylline The quinolone increases the effect of theophyllineTizanidine Increases the effect/toxicity of tizanidineWarfarin The quinolone increases the anticoagulant effectIron Formation of non-absorbable complexesZinc Formation of non-absorbable complexes Hydrocortisone에 대한 Drug_Interactions 정보 Ambenonium The corticosteroid decreases the effect of anticholinesterasesEdrophonium The corticosteroid decreases the effect of anticholinesterasesNeostigmine The corticosteroid decreases the effect of anticholinesterasesPyridostigmine The corticosteroid decreases the effect of anticholinesterasesAspirin The corticosteroid decreases the effect of salicylatesBismuth Subsalicylate The corticosteroid decreases the effect of salicylatesSalicylate-magnesium The corticosteroid decreases the effect of salicylatesSalicylate-sodium The corticosteroid decreases the effect of salicylatesSalsalate The corticosteroid decreases the effect of salicylatesTrisalicylate-choline The corticosteroid decreases the effect of salicylatesWarfarin The corticosteroid alters the anticoagulant effectAcenocoumarol The corticosteroid alters the anticoagulant effectDicumarol The corticosteroid alters the anticoagulant effectAnisindione The corticosteroid alters the anticoagulant effectCholestyramine Cholestyramine decreases the effect of hydrocortisoneColestipol Cholestyramine decreases the effect of hydrocortisoneAmobarbital The barbiturate decreases the effect of the corticosteroidAprobarbital The barbiturate decreases the effect of the corticosteroidButabarbital The barbiturate decreases the effect of the corticosteroidButalbital The barbiturate decreases the effect of the corticosteroidButethal The barbiturate decreases the effect of the corticosteroidDihydroquinidine barbiturate The barbiturate decreases the effect of the corticosteroidHeptabarbital The barbiturate decreases the effect of the corticosteroidHexobarbital The barbiturate decreases the effect of the corticosteroidMethohexital The barbiturate decreases the effect of the corticosteroidMethylphenobarbital The barbiturate decreases the effect of the corticosteroidPentobarbital The barbiturate decreases the effect of the corticosteroidPhenobarbital The barbiturate decreases the effect of the corticosteroidPrimidone The barbiturate decreases the effect of the corticosteroidQuinidine barbiturate The barbiturate decreases the effect of the corticosteroidSecobarbital The barbiturate decreases the effect of the corticosteroidTalbutal The barbiturate decreases the effect of the corticosteroidRifampin The enzyme inducer decreases the effect of the corticosteroidPhenytoin The enzyme inducer decreases the effect of the corticosteroidMephenytoin The enzyme inducer decreases the effect of the corticosteroidFosphenytoin The enzyme inducer decreases the effect of the corticosteroidEthotoin The enzyme inducer decreases the effect of the corticosteroidMidodrine Increased arterial pressure
Ciprofloxacin에 대한 Food Interaction 정보 Take without regard to meals.Avoid milk, calcium containing dairy products, iron, magnesium, zinc, antacids, or aluminum salts 2 hours before or 6 hours after using antacids while on this medication.Take with a full glass of water.Avoid excessive quantities of coffee or tea (Caffeine). Hydrocortisone에 대한 Food Interaction 정보 Take with food to reduce irritation. Calcium, phosphorous, potassium, Vitamin A, C, D and zinc needs increased with long term use.
Ciprofloxacin에 대한 Description 정보 A broad-spectrum antimicrobial carboxyfluoroquinoline. [PubChem] Hydrocortisone에 대한 Description 정보 The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [PubChem]
Dosage Form
Ciprofloxacin에 대한 Dosage_Form 정보 Ointment OphthalmicSolution IntravenousSolution OphthalmicSuspension OralTablet OralTablet, extended release Oral Hydrocortisone에 대한 Dosage_Form 정보 Aerosol RectalCream TopicalEnema RectalLiquid TopicalLotion TopicalOintment OphthalmicOintment TopicalPowder, for solution IntramuscularPowder, for solution IntravenousTablet Oral
Drug Category
Ciprofloxacin에 대한 Drug_Category 정보 Anti-Infective AgentsAnti-InfectivesNucleic Acid Synthesis InhibitorsQuinolones Hydrocortisone에 대한 Drug_Category 정보 Anti-inflammatory Agents
Smiles String Canonical
Ciprofloxacin에 대한 Smiles_String_canonical 정보 OC(=O)C1=CN(C2CC2)C2=CC(N3CCNCC3)=C(F)C=C2C1=O Hydrocortisone에 대한 Smiles_String_canonical 정보 CC12CCC(=O)C=C1CCC1C3CCC(O)(C(=O)CO)C3(C)CC(O)C21
Smiles String Isomeric
Ciprofloxacin에 대한 Smiles_String_isomeric 정보 OC(=O)C1=CN(C2CC2)C2=CC(N3CCNCC3)=C(F)C=C2C1=O Hydrocortisone에 대한 Smiles_String_isomeric 정보 C[C@]12CCC(=O)C=C1CC[C@H]1[C@@H]3CC[C@](O)(C(=O)CO)[C@@]3(C)C[C@H](O)[C@H]21
InChI Identifier
Ciprofloxacin에 대한 InChI_Identifier 정보 InChI=1/C17H18FN3O3/c18-13-7-11-14(8-15(13)20-5-3-19-4-6-20)21(10-1-2-10)9-12(16(11)22)17(23)24/h7-10,19H,1-6H2,(H,23,24)/f/h23H Hydrocortisone에 대한 InChI_Identifier 정보 InChI=1/C21H30O5/c1-19-7-5-13(23)9-12(19)3-4-14-15-6-8-21(26,17(25)11-22)20(15,2)10-16(24)18(14)19/h9,14-16,18,22,24,26H,3-8,10-11H2,1-2H3/t14-,15-,16-,18+,19-,20-,21-/m0/s1
Chemical IUPAC Name
Ciprofloxacin에 대한 Chemical_IUPAC_Name 정보 1-cyclopropyl-6-fluoro-4-oxo-7-piperazin-1-ylquinoline-3-carboxylic acid Hydrocortisone에 대한 Chemical_IUPAC_Name 정보 (8S,9S,10R,11S,13S,14S,17R)-11,17-dihydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-2,6,7,8,9,11,12,14,15,16-decahydro-1H-cyclopenta[a]phenanthren-3-one
Drug-Induced Toxicity Related Proteins
CIPROFLOXACIN 의 Drug-Induced Toxicity Related Protein정보 Replated Protein:Alanine aminotransferase Drug:ciprofloxacin Toxicity:Fulminant hepatic failure. [바로가기]Replated Protein:Alanine aminotransferase Drug:ciprofloxacin Toxicity:significant haematological or biochemical toxicity. [바로가기]Replated Protein:Aspartate aminotransferase Drug:ciprofloxacin Toxicity:Fulminant hepatic failure. [바로가기]HYDROCORTISONE 의 Drug-Induced Toxicity Related Protein정보 Replated Protein:Interleukin-8 Drug:hydrocortisone Toxicity:inflammation. [바로가기]
사용자컨텐츠
항목
내용
최근정보수정일 2021-09-23
본 수정일 정보는 허가정보 이외의 기타정보 수정일을 의미하므로, 허가정보수정일은 본문에 표기된 날짜를 참조하시기 바랍니다.
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