Speniv

Indications

• Bacterial infections
• Streptococcal pharyngitis
• Otitis media
• Skin infections
• Prevention of rheumatic fever
• Prevention of secondary cases of invasive group A streptococcal infection

Dosage

Adults: 500 mg every 6 hours, increased if necessary up to 1 g every 6 hours; for urgent transfer to hospital, administer 1.2 g as a single dose prior to transfer

Mechanism of action

Phenoxymethylpenicillin inhibits the biosynthesis of cell wall mucopeptide by binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall. This binding is critical for cell wall synthesis and maintenance, leading to cell lysis as the bacterial cell wall integrity is compromised. The drug interferes with the synthesis of N-acetylmuramic acid mucopeptides and teichoic acids, essential components of the bacterial cell wall.

Pharmacodynamics

Phenoxymethylpenicillin exhibits bactericidal effects against a variety of bacteria by targeting their cell wall synthesis. It is effective against penicillin-sensitive strains of staphylococci (excluding penicillinase-producing strains), several groups of streptococci, and other specific bacteria such as Corynebacterium diphtheriae and Listeria monocytogenes. Its efficacy is particularly pronounced during the active multiplication of bacteria.

Pharmacokinetics

Phenoxymethylpenicillin is well absorbed from the gastrointestinal tract when taken orally, with peak plasma concentrations occurring within 1-2 hours after ingestion. The drug is distributed widely throughout body tissues and fluids, although penetration into the CNS is limited. It is primarily eliminated by renal excretion, with a half-life of approximately 30-60 minutes in healthy individuals. Dosage adjustments may be necessary for patients with renal impairment due to the risk of accumulation.

Adverse effects

• Jarisch-Herxheimer reaction
• Neurotoxicity
• Coma

Precautions

• Accumulation of sodium from injection can occur with high doses
• Caution in renal impairment due to risk of neurotoxicity

Pregnancy

Not known to be harmful.

Breast-feeding

Trace amounts in milk, but appropriate doses are considered safe.

Storage

Store at room temperature, protected from light. Keep out of reach of children.

Formulations

• Oral suspension
• Tablets
• Injection

Dosage

Children: Refer to the specific product guidelines for appropriate use, as dosages may vary depending on the product formulation.

Adults: Refer to the specific product guidelines for appropriate use, as dosages may vary depending on the product formulation.

Mechanism of action

Aspartame is metabolized into aspartic acid, phenylalanine, and methanol. These components are then absorbed into the bloodstream and utilized in normal physiological processes, similar to how these amino acids are used when derived from protein-rich foods.

Pharmacodynamics

Aspartame functions as a low-calorie sweetener, providing sweetness without significant caloric contribution. It is composed of naturally occurring amino acids, aspartic acid and phenylalanine, which are utilized by the body in the same way as those derived from dietary proteins. The sweetening effect of aspartame is primarily due to its high sweetness potency compared to sucrose.

Pharmacokinetics

Upon ingestion, aspartame is hydrolyzed in the gastrointestinal tract into its individual components: aspartic acid, phenylalanine, and methanol. These metabolites are then absorbed into the bloodstream. They do not accumulate in the body and are utilized in metabolic processes similar to those of their natural counterparts found in food.

Contra-indications

• Phenylketonuria (PKU)

Adverse effects

• Headaches
• Allergic reactions
• Gastrointestinal disturbances
• Mood changes

Precautions

• Use with caution in individuals with phenylketonuria due to phenylalanine content.

Pregnancy

Considered safe for use during pregnancy, but it is advisable to consult with a healthcare provider.

Breast-feeding

Considered safe for use during breastfeeding, but it is advisable to consult with a healthcare provider.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Tablets
• Powder
• Liquid sweeteners

Indications

• Food preservative
• Treatment of urea cycle disorders
• Metabolic disorders involving benzoyl-CoA

Dosage

Children: Refer to the BNF for Children for specific dosing guidelines based on condition.

Adults: Refer to the BNF for specific dosing guidelines based on condition.

Mechanism of action

Benzoate acts mainly by inhibiting the growth of bacteria and fungi through its ability to lower the pH, creating an environment that is less favorable for microbial growth. It is also involved in metabolic pathways where it helps in the conjugation of toxic substances, facilitating their excretion from the body.

Pharmacodynamics

Benzoate is known for its antimicrobial properties, which are particularly effective against a wide range of fungi and bacteria. Its efficacy as a preservative is due to its ability to penetrate microbial cell membranes and disrupt their metabolic processes. Additionally, it has been observed to modulate various metabolic pathways, particularly those associated with aromatic compound degradation.

Pharmacokinetics

After ingestion, benzoate is rapidly absorbed in the gastrointestinal tract. It is metabolized primarily in the liver, where it undergoes conjugation with glycine to form hippurate, which is then excreted in the urine. The half-life of benzoate varies depending on individual metabolic rates but is generally short due to its efficient conversion and excretion.

Pregnancy

There is limited data on the use of benzoate in pregnancy. Consultation with healthcare professionals is advised before use.

Breast-feeding

Limited data is available on the excretion of benzoate in breast milk. Caution is recommended when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Acidulant in food and beverages
• Preservative in pharmaceutical formulations
• pH adjuster in various chemical preparations

Dosage

Children: Refer to product-specific guidelines for appropriate dosing based on formulation and indication.

Adults: Refer to product-specific guidelines for appropriate dosing based on formulation and indication.

Mechanism of action

Citric acid acts by chelating metal ions, which can enhance the solubility of certain compounds and improve their bioavailability. It also contributes to the acidity of the environment, which can influence enzymatic activity and metabolic pathways, particularly in the degradation of citronellol.

Pharmacodynamics

Citric acid exhibits mild pharmacological effects primarily attributed to its role in metabolic processes. It aids in the regulation of pH levels, which can impact enzymatic reactions and biochemical pathways. The acid's chelating properties may help to reduce the toxicity of certain metal ions in biological systems.

Pharmacokinetics

Citric acid is rapidly absorbed after oral administration and is metabolized in the liver. It undergoes conversion to various metabolites in the citric acid cycle, contributing to energy production. The elimination primarily occurs through urine, with minimal accumulation in the body.

Pregnancy

Citric acid is generally regarded as safe during pregnancy when used in food amounts. However, consult a healthcare provider for advice on medicinal use.

Breast-feeding

Citric acid is considered safe during breastfeeding when consumed in food amounts. For medicinal use, consult a healthcare provider.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Food coloring agent
• Pharmaceutical coloring agent
• Diagnostic agent in certain imaging procedures

Dosage

Children: Refer to specific preparations for paediatric dosing as it may vary widely depending on the formulation and intended use.

Adults: Refer to specific preparations for adult dosing as it may vary widely depending on the formulation and intended use.

Mechanism of action

Erythrosine acts as a fluorescent dye, absorbing light in the visible spectrum and emitting it at a different wavelength. It binds to proteins and nucleic acids, which can affect biological processes such as cell division and apoptosis. Erythrosine's mechanism also involves interaction with cellular membranes, potentially influencing membrane integrity and function.

Pharmacodynamics

Erythrosine exhibits properties as a photosensitizer, with its efficacy increasing under light exposure. It can impact cellular activity by generating reactive oxygen species when activated by light, leading to oxidative stress in cells. This mechanism is utilized in certain therapeutic applications, although it is primarily recognized for its colorant properties.

Pharmacokinetics

Erythrosine is absorbed from the gastrointestinal tract when ingested, with peak plasma concentrations occurring shortly after administration. It is distributed throughout the body and is known to cross biological membranes. The compound is primarily excreted via urine, with some metabolites detected, indicating hepatic metabolism. The elimination half-life of erythrosine is variable and influenced by individual physiology and dosage.

Contra-indications

• Hypersensitivity to erythrosine or any of its components
• Thyroid disorders
• Patients with iodine allergy

Adverse effects

• Hypersensitivity reactions
• Thyroid dysfunction
• Nausea
• Vomiting
• Diarrhea
• Skin rashes

Interactions

• May interact with thyroid function tests, leading to false results
• Potential for interactions with other iodine-containing compounds

Precautions

• Use with caution in patients with a history of thyroid disease
• Monitor thyroid function in patients receiving long-term therapy
• Assess for allergic reactions prior to administration

Pregnancy

Erythrosine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult healthcare professional for advice.

Breast-feeding

It is not known whether erythrosine is excreted in human milk. Use with caution, considering the benefits and risks.

Storage

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

Formulations

• Oral suspension
• Injectable solution

Indications

• Digestive aid
• Anti-inflammatory treatment
• Support for wound healing
• Sinusitis relief
• Potential adjunct in cardiovascular health

Dosage

Children: Pediatric dosing for bromelain is not well established. It is important to consult with a healthcare professional for appropriate dosing in children.

Adults: The typical dosage of bromelain supplements varies, but is often in the range of 200 to 400 mg taken 2 to 3 times daily. It is advisable to refer to specific product labels and consult healthcare professionals for personalized dosing recommendations.

Mechanism of action

Bromelain, the primary active compound in pineapple, exerts its effects by breaking down proteins into amino acids and peptides. This proteolytic activity is thought to facilitate digestion and reduce inflammation. Additionally, bromelain may enhance the absorption of certain antibiotics and other medications by improving gastrointestinal tract conditions.

Pharmacodynamics

Bromelain has shown anti-inflammatory, analgesic, and antithrombotic effects. It may modulate immune responses, reduce swelling, and promote healing. The pharmacodynamic properties of pineapple are largely attributed to bromelain, which acts on various pathways, including the modulation of cytokine production and inhibition of pro-inflammatory mediators.

Pharmacokinetics

Bromelain is rapidly absorbed in the gastrointestinal tract following oral administration. The bioavailability of bromelain can be affected by food intake, with some studies suggesting that it is best absorbed on an empty stomach. The elimination half-life is not well-defined, but its effects can persist due to its interactions with various biological pathways.

Adverse effects

• Allergic reactions in sensitive individuals
• Diarrhea
• Nausea
• Abdominal pain
• Heartburn

Interactions

• May interact with anticoagulants due to bromelain content
• Potential interaction with certain antibiotics
• Can affect the metabolism of some drugs due to effects on cytochrome P450 enzymes

Precautions

• Use with caution in individuals with known allergies to pineapple or bromelain
• Should be used cautiously in individuals with gastrointestinal disorders
• Consider potential interactions with anticoagulant medications

Pregnancy

Generally considered safe in food amounts, but high doses or supplements should be avoided due to potential uterine contractions.

Breast-feeding

Likely safe in food amounts; however, high doses or supplements should be avoided as effects are not well studied.

Storage

Store in a cool, dry place away from direct sunlight. Fresh pineapple should be refrigerated and consumed promptly.

Formulations

• Fresh pineapple
• Canned pineapple
• Pineapple juice
• Bromelain supplements

Indications

• Providing energy in dietary supplementation
• Enhancing flavor in food products
• Replacement of carbohydrates in certain medical nutrition therapies

Dosage

Children: Refer to general dietary guidelines for carbohydrate intake in children. No specific dosing guidelines provided.

Adults: Refer to general dietary guidelines for carbohydrate intake. No specific dosing guidelines provided.

Mechanism of action

Sugar is metabolized in the body to provide energy. Upon ingestion, sucrose is broken down by the enzyme sucrase into its constituent monosaccharides, glucose and fructose, which are then absorbed into the bloodstream. These monosaccharides can be utilized by cells for energy or stored as glycogen in the liver and muscles.

Pharmacodynamics

As a simple carbohydrate, sugar elevates blood glucose levels rapidly after consumption, leading to increased insulin secretion from the pancreas. This insulin facilitates the uptake of glucose by tissues, promoting energy production. The rapid increase in blood sugar can provide quick energy but may also lead to potential negative effects on metabolism and weight if consumed in excess.

Pharmacokinetics

After oral administration, sugar is quickly hydrolyzed in the gastrointestinal tract. Peak plasma glucose concentrations typically occur within 30 minutes to 2 hours post-ingestion, depending on the amount consumed and individual metabolism. The half-life of glucose in the bloodstream is relatively short, as it is rapidly taken up by tissues or converted into glycogen.

Pregnancy

Sugar is generally considered safe for use during pregnancy, but excessive intake should be avoided to prevent gestational diabetes and excessive weight gain.

Breast-feeding

Sugar is safe during breastfeeding; however, excessive consumption should be avoided.

Storage

Store in a cool, dry place, away from moisture and direct sunlight.

Formulations

• Granulated sugar
• Brown sugar
• Powdered sugar
• Liquid sugar

Mechanism of action

Phenoxymethylpenicillin inhibits the biosynthesis of cell wall mucopeptide by binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which are critical in the cell wall synthesis and maintenance, as well as cell division. This disrupts the third and last stage of bacterial cell wall synthesis. This subsequently leads to cell lysis. Penicillins and breakdown products of penicillins act as haptens after their covalent reaction with proteins. The most important antigenic intermediate of penicillin appears to be the penicilloyl moiety, which is formed when the beta-lactam ring is opened. This is considered to be the major (predominant) determinant of penicillin allergy. /Penicillins/ Penicillin is known to interfere with synthesis of N-acetylmuramic acid mucopeptides and teichoic acids which are part of cell-wall material. ... Under favorable conditions penicillin exerts direct bactericidal action, & successful penicillin therapy may be relatively independent of immunity mechanisms of the host. /Penicillins/ The penicillins and their metabolites are potent immunogens because of their ability to combine with proteins and act as haptens for acute antibody-mediated reactions. The most frequent (about 95 percent) or "major" determinant of penicillin allergy is the penicilloyl determinant produced by opening the beta-lactam ring of the penicillin. This allows linkage of the penicillin to protein at the amide group. "Minor" determinants (less frequent) are the other metabolites formed, including native penicillin and penicilloic acids. /Penicillins/ Bactericidal; inhibit bacterial cell wall synthesis. Action is dependent on the ability of penicillins to reach and bind penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. Penicillin-binding proteins (which include transpeptidases, carboxypeptidases, and endopeptidases) are enzymes that are involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Penicillins bind to, and inactivate, penicillin-binding proteins, resulting in the weakening of the bacterial cell wall and lysis. /Penicillins/

Pharmacodynamics

Phenoxymethylpenicillin works against penicillin-sensitive microorganisms with bactericidal effects. It targets the bacteria during its active multiplication stage by interfering with bacterial cell wall peptidoglycan synthesis. _In vitro_, phenoxymethylpenicillin was shown to be active against staphylococci (except penicillinase-producing strains), streptococci (groups A, C, G, H, L and M), and pneumococci, as well as _Corynebacterium diphtheriae_, _Bacillus anthracis_, Clostridia, _Actinomyces bovis_, _Streptobacillus moniliformis_, _Listeria monocytogenes_, _Leptospira_, _Neisseria gonorrhoeae_, and _Treponema pallidum_.

Mechanism of action

180 to 200 times sweeter than sucrose, it is metabolized as a protein and its subsequent amino-acids used up in there respective mechanisms.

Pharmacodynamics

Aspartame (L-alpha-aspartyl-L-phenylalanine methyl ester) is a low-calorie sweetener used to sweeten a wide variety of low- and reduced-calorie foods and beverages, including low-calorie tabletop sweeteners. Aspartame is composed of two amino acids, aspartic acid and phenylalanine, as the methyl ester. Aspartic acid and phenylalanine are also found naturally in protein containing foods, including meats, grains and dairy products. Methyl esters are also found naturally in many foods such as fruits and vegetable and their juices. Upon digestion, aspartame breaks down into three components (aspartic acid, phenylalanine and methanol), which are then absorbed into the blood and used in normal body processes. Neither aspartame nor its components accumulates in the body. These components are used in the body in the same ways as when they are derived from common foods.