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D-PENCILLAMINE: It is demethyl cystenie as a degradation product of penicilin. It is found ot have storng copper chelating property. When given to patients with metal toxicity, the excretion of metal is enhanced.
Indications: Cystinuria, Wilon’s disease.
Dosage: 0.5-1g, daily in divided doses 1hr before or 2hr after meals to avoid chelaton of dietary metals.
Contra Indications: Lupus erythematosus. Throm bocytopeia, agranucocytosis. Pregancy, lactation.
Special Precautions: Renal impairment, penicillin sensitivity. Monitor blood liver & renal functions.
Side effects: Nausea anorexia, fever rash loss of taste, proteinuria, heamaturia blood dyscrasias nephrotic syndorme, SLE myasthenia gravis.
Drug Interactions: Zinc, Gold or iron salts. Antimalarial or cytotoxic drugs phenylbutazone, antacids.