Penicillamine

'Penicillamine is a metabolite of penicillin, is an analogue of the amino acid cysteine. The drug can be resolved into D and L isomers, the D form is used clinically. It forms chelate with certain toxic metal and increases their excretion. Penicillamine is used in the treatment of metal poisoning and rehumatoid arthritis, wilson''s disease or to prevent formation of kidney stone.'

Brands

VISTAMIN

Adult Dose

Dose: 500 to 600 mg
Single Dose: 550 (550)
Frequency: 24 hourly
Route: PO
Instructions:

Neonatal

Dose: 5 mg/kg
Single Dose: 5 (5)
Frequency: 8 hourly
Route: Oral
Instructions: -

Paedriatic

Dose: 5 mg/kg
Single Dose: 5 (5)
Frequency: 8 hourly
Route: Oral
Instructions: -

Characteristics

Penicillamine also known as D-3- Mercaptovaline, D-3- Mercaptovaline. . It is of Semi Synthetic origin and belongs to Aminoacid. It belongs to Immune Modifiers pharmacological group on the basis of mechanism of action and also classified in Antidotes and Anti-inflammatory pharmacological group.The Molecular Weight of Penicillamine is 149.20. Its pKa is 1.8, 7.9, 10.5.

Contraindications

Penicillamine

Effects

'The severe or irreversible adverse effects of Penicillamine, which give rise to further complications include Rashes, Thrombocytopenia, Proteinuria, Myasthenia gravis, Hematuria.Penicillamine produces potentially life-threatening effects which include Thrombocytopenia, Neutropenia, Aplastic Anemia, Obliterative bronchiolitis, Goodpasture''s Syndrome. which are responsible for the discontinuation of Penicillamine therapy.The signs and symptoms that are produced after the acute overdosage of Penicillamine include Hemolysis.The symptomatic adverse reactions produced by Penicillamine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Skin rash, Loss of taste, GI disturbance.'

Indications

'Penicillamine is primarily indicated in conditions like All forms of epilepsy, Cystinuria, Deficiency of growth hormone in children, Hormone replacement for menopausal symptoms, Juvenile chronic arthritis, Lead poisoning, Myoclonus, Nausea and vomiting (due to migraine), Palindromic rheumatism, Parkinson''s disease (adjunctive with levodopa), Parkinson''s disease (monotherapy), Polyarthritis, Rheumatoid arthritis, Sclerosis, Severe active rheumatoid arthritis, Wilson''s disease, and can also be given in adjunctive therapy as an alternative drug of choice in Chronic active hepatitis, Minor surgical and medical procedures.'

Interactions

Penicillamine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcuronium (Cl)AzathioprineCephaloridineCephalothin (Na)ClozapineDimemorfan PhosphateHydroxychloroquine (Sulphate)Iron SaltsIron SaltsLevodopaMultiple VitaminsConcurrent use may decrease the absorption of Penicillamine.Separate your doses of Penicillamine as far as possible from doses of multi vitamins.NeostigminePyridostigmine (Br)coadministration may develop myasthenia gravisPyridoxineDose of pyridoxine needs to be increased.SulphamethizoleSince bacteriostatic drugs may interfere with the bactericidal effect of penicillins in the treatment of meningitis or in other situations where a rapid bactericidal effect is necessaryZinc gluconateAbsorption of zinc may be reduced. Zinc Sulphate These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Interfrence

Risks

Drug should not be given to Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

Storage

Tab Store in a well closed container, Below 40°C.

Warnings

Penicillamine should be used only if clearly needed during pregnancy. Avoid use during lactation. It should be used with caution in patients with any pre-existing kidney disease, blood disorders or if have any allergy.

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