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Drug Monograph on Rifampicin - page 4
Keywords: rifampicin, drug monograph, pharmacology, efficay, therapeutic uses, pharmacodynamics, Prophylaxis of meningococcal meningitis rifampin rifadin SA infections tuberculosis essay on rifampicin pharmacokinetics absorption distribution matabolism excretion bmj referecing
By Einstein10 on 30/12/2009
Level: Foundation Degree
Page Number: 4 of 11 pages: 1 2 3 4 5 6 7 8 9 10 110.04 and AST p 0.03. From this it can be said that there was no deterioration in liver function in response to therapy to Rifampicin. 17 74 % 16 of children that showed clinical improvement with Rifampicin which shows Rifampicin has an excellent efficacy in patient with cholestasis.
In SA Infections:
In a study done of 80 patients, 40 who were suffering from SA infections and 40 who were healthy adults. The carriers from group 1 were given 450-600 mg 3 times a day for 10 days as recommended in table 2 and the control group were not offered treatment. Out of the 13 of patients from the SA carriers, 10 were cured after treatment with Rifampicin where’s the patients that were not offered treatment went on to show skin infections’. 18 Therefore Rifampicin shows good efficacy with SA infections.
In Tuberculosis:
Rifampicin efficacy was tested in patient suffering from Tuberculosis and HIV at the same time. The drug was self-administered for 8 months with a follow up of a Chest X-ray, sputum check and clinical examination. Out of the 266 patients with a median CD4 count of 350/ ul-1 , 85% of all patients collected 80% of the drug and 96 % came back with a negative sputum culture, after self-administration of 10mg/Kg/day(As recommended by Table 2). The author concludes that an 8 month rifampicin containing therapy was well tolerated and effective treatment of HIV infected TB patients. 19
Pharmacokinetics
Absorption
Rifampicin absorption varies in relation to the functional condition of the GI tract. Normally the levels of blood found at the beginning of the treatment are higher compared to as the treatment continues in proportion biliary levels. 21
The drug is rapidly absorbed within 1.5 hours following oral administration. Following a typical 600mg dose maximum plasma concentration (Cmax) between 7-10 μg/ml is reached within approximately 2-4 hours in adults.22 In infants a 9-12 μg/ml plasma serum level is reached after 10mg/kg of Rifampicin in 2-3 hours.
Bioavailability of rifampicin is almost 50% in the fasting state compared to taking with or after and if the drug is taken with food absorption may be delayed and remain incomplete 23
Patient No. Fasting 2 After Meal Fasting 4 After Meal Fasting 6 After Meal
1 0.37 0 0.32 0 0 1.90
2 2.70 0 1.37 1.60 0.49 1.30
3 1.55 0 0.75 0.14 1.20 1.31
4 1.82 0 1.02 0 1.34 0.16
5 1.77 1.65 0.86 1.00 0.19 0.21
Table 4 - 18 SERUM LEVELS OF RIFAMPIN (μg/mL) AFTER ORAL ADMINISTRATION OF A SINGLE 150 mg DOSE
Figure 6- 23 Efflux Mediated absorption of Rifampicin
Figure 7- 23 Saturable Absorption of Rifampicin in the Intestine
It is believed that Efflux-mediated and
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