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All about: Aminosalicylate Sodium (Para-Aminosalicylate Sodium; PAS)

Big Image ( Para-Aminosalicylate Sodium ; PAS ) Pronouncation: (uh-MEE-no-suh-LIS-ih-late SO-dee-uhm)
Class: Antituberculosis agent

Trade Names:
Paser
- Granules, delayed-release 4 g

Mechanism of Action

Pharmacology

Competitively antagonizes metabolism of para-aminobenzoic acid, resulting in bacteriostatic activity against Mycobacterium tuberculosis .

Pharmacokinetics

Absorption

T max is about 6 h; C max is about 20 mcg/mL.

Distribution

About 50% to 60% is protein bound.

Elimination

80% is excreted in the urine with at least 50% excreted in acetylated form. The t 1/2 of free aminosalicylic acid is 26.4 min.

Special Populations

Renal Function Impairment

Drug and its acetyl metabolite may accumulate.

Indications and Usage

Treatment of tuberculosis (in combination with other antituberculous drugs) caused by susceptible strains of tubercle bacilli.

Contraindications

Severe hypersensitivity to aminosalicylate sodium and its congeners.

Dosage and Administration

Adults and Children

PO 150 mg/kg (max, 12 g/day).

General Advice

  • Sprinkle granules on acidic food or drink.
  • Do not use products that are brown or purple in color.

Drug Interactions

Digoxin

May reduce oral absorption and serum levels of digoxin.

Rifampin

May decrease absorption of rifampin.

Vitamin B 12

May decrease GI absorption of oral vitamin B 12 .

Laboratory Test Interactions

None well documented.

Adverse Reactions

GI

Nausea; vomiting; diarrhea; abdominal pain.

Metabolic

Goiter with or without myxedema.

Miscellaneous

Hypersensitivity (eg, fever, skin eruptions, infectious mononucleosis-like syndrome, leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, jaundice, hepatitis, encephalopathy, Loffler syndrome, vasculitis).

Precautions

Pregnancy

Category C .

Lactation

Excreted in breast milk.

Hypersensitivity

Stop medication if hypersensitivity symptoms develop. Restart cautiously.

Renal Function

Use with caution.

Hepatic Function

Use with caution.

CHF

Use with caution because of high sodium content (55 mg of sodium per 500 mg tablet).

Crystalluria

Maintain urine at neutral or alkaline pH to avoid crystalluria.

Gastric ulcer

Use with caution.

Patient Information

  • Instruct patient to take medication with meals or immediately after meals to minimize GI symptoms, and to maintain adequate fluid intake.
  • Explain to patient taking digoxin that dose may be increased while taking aminosalicylate sodium.
  • Instruct patient to report the following symptoms to health care provider: fever, sore throat, unusual bleeding or bruising, rash.
  • Teach patient importance of maintaining urine at neutral or alkaline pH and demonstrate method for testing urine pH.

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