Ggrup “levosalbutamol”
Salmolin-L(tablet/syrup)
Description:
Levosakbutamol is a single isomer beta 2-agonist that differs from raceme
salbutamol by elimination of (S)-salbutamol. levosalbutamol is an effective
bronchodilator whose primary mechanism of acton is unimpeded by (S)-salbutamol.
Thus, when compared with racemic salvutamol, clinically comparable bronchodilation can be achieved with doses that substantantially lessen beta-mediated side effect.
Composition:
Salmolin-L1 tablet: each tablet contains levosalbutamol suphate INN equivalent to levosalbutamol 1mg.
Salmolin-L2 tablet: each tablet contains levoslbutamol sulphate INN equivalent to levosalbutamol 2mg.
Salmolin-L syrup: each 5ml syrup contains levosalbutamol suphate INN equivalent to levosalbutamol 1mg.
Indication:
Salmolin-L(levosalbutamol) is indicated for the treatment or prevention of
bronchospasm in audits, adolescents and children 6 years of age and older with
reversible obstructive airway disease.
Dosage and administration:
Tablet:
Adults: 5-10 ml three times daily.
Children (6-11 years): 5ml three times dily.
Syrup:
Adults and adolescents above 12 years: 1-2 mg three times daily.
Children (6-11 years): 1mg three.
Side effects:
Hypocalcaemia, palpation, fine tremors of the skeletal muscle and muscle
cramps may occur. The other likely side effects are nausea, vomiting, burning
substernal or epigastric pain and diarrhea.
Contraindication:
Levosalbutamol is contraindicated in patients with a history of hypersensitivity
to levsalbutamol or any of this comment.
Precaution:
Particular caution is advised in acute severe asthma as this effect may be
potentiated by hypoxia and by concomitant treatment with xanthenes derivatives,
steroids and diuretics serum potassium levels should be monitored
in such situation.
Use in pregnancy and lactation:
The drug should be sued during pregnancy only if the potential benefit
justifies the potential risk of the fetus. It is not known whether levosalbutamol
is excreted in human milk. Caution should be exercised when oral levosalbutamol is
administered to a nursing woman.
Overdose:
The expected symptoms with over dosage are those kof excessive beta-adrenergic
stimulation and the symptoms listed under side effects. In the event of serious
poisoning, the stomach should be emptied and, if necessary, a beta-blocker
administered with caution in patients with a history of bronchospasm.
Drug interaction:
Other short acting sympathomimetic bronchodilators or epinephrine should be used with caution with levosalbutamol. If additional adrenergic drug are to avoid deleterious cardiovascular effects.
Salmolin-L syrup: each glass bottle contains 60 ml syrup with a measuring spoon.
Keep all medicines out of reach of children.
Store in a cool and dry place, protect from light.
*further information is available on request*
Ggrup "prednisolone"
Cortan
Tablet and oral solution
Presentation:
Cortan 5 tablet: each tablet contains prednisolone BP 5mg.
Cortan 10 tablet: each tablet contains prednisolone BP 10mg.
Cortan 20 tablet: each tablet contains prednisolone BP 20mg.
Cortan oral solution: each 5 ml solution contains prednisolone sodium
phosphate USP equivalent to prednisolone 5mg
.
Indication and uses:
Allergy and anapylaxish: bronchial asthma, drug hypersensitivity reactions,
serum sickness, angioneurotic edema, anaphylaxis.
Respiratory disease: allergic pheumonitis, asthma, occupational asthma,
aspergillosis, pulmonary fibrosis, pulmonary alveoliis, aspiration of foreign body, aspiration contents, pulmonary sarocoid, drug induced lung disease, adult respiratory distress syndrome, spasmodic croup.
Rheumatic disorders: rheumatoid arthritis, polymyalgia rheumatic,juvenile
chronic arthritis, systemic lupus erythematosus, dermatomyositis, mixed
connective tissue disease.
arteritis/ collagenositis: giant cell arteritis/polymyalgia rheumatic,
mixed connective tissue disease, plyarterritis nodsa, polymyositis.
Blood disorders: hemolytic anemia (autoimmune), leukaemia (acute and
lymphocytic), lymphoma, multiple myeloma, idiopathic thrombocytopenic purpura.
Cardiovascular disorders: post myocardial infarction syndrome, rheumatic fever with severs cordites.
Endocrine disorders: primary and secondary adrenal insufficiency, congenital adrenal hyperplasia.
Gastro-intestinal disorders: crown’s disease, ulcerative colitis, persistent celiac syndrome, autoimmune chronic active hepatitis, multisystem disease affecting liver, Bellary peritonitis.
Infection: military tuberculosis, mumps orchitis (adult), tuberculosis meningitis, rickettsial disease.
Muscular disorders: polymyositis, dermatomyositis.
Neurological disorders: infantile spasms, shydrager syndrome, sub-acute
demyelinating polyneuropathy.
Ocular disease: sclerotis, posterior verities, retinal vacuities, pseudo
tambours of the orbit, malignant ophthalmic graves’ disease.
Renal disorders: lupus nephritis, acute interstitial nephritis, minimal change glomerulonephritis.
Skin disorders: pemphigus vulgaris, bulbous pemphigoid, systemic lupus
erythematosus, pyoderma gangrenous.
Miscellaneous: sarcoidosis, hyperpyrexia, behcets disease, immunosuppression in organ transplantation.
Dosage and administration: The intial dosage of cortan may vary from 5 mg to 60mg daily depending of the disorder being treated. Divided daily dosage is usually used. The appropriate individual dose must be determined by trial and error and must be re-evaluated regularly according to activity of the disease. In general, initial dosage shall be maintained or adjusted until the anticipated response is observed. The dose should be gradually reduced until the lowest dose; which will maintain an adequate clinical response is reached. During prolonged therapy, dosage may need to be temporarily increased during periods of stress or stress or during exacerbation of the disease. When the drug is to be stopped. It must be withdrawn gradually and not abruptly. Intermittent dosage regimen: a single dose of cortan in the morning on alternate days or at longer intervals is acceptable therapy for some patients. When this regimen is practical, the degree of pituitary-adrenal suppression can be
minimized.
Specific dosage guidelines:
Allergic and skin disorders: initial dosed of 5-15 mg daily are commonly adequate.
Collagenosis: initial doses of 20-30 mg daily are frequently effective. Those with more severe symptoms may require higher doses.
Rheumatoid arthritis: the usual initial dose is 10-15mg daily. The daily maintain dose compatible with tolerable symptomatic relief is recommended.
Blood disorders and lymphoma: an initial daily dose of 15-60 mg is often necessary with reduction after adequate clinical or hematological higher doses may be necessary to induce remission in acute leukemia.
Contraindications: Systemic infections unless specific anti-infective therapy is employed . hypersensitivity to any ingredient ocular herpes simplex because of possible perfotmation.
Side-effect: General side-effect includes leucocytosis, hypersensitivity including anaphylaxis, thromboembolism, nausea, and malaise.
Precaution:
Caution is necessary when oral corticosteroids, including prednisolone, are prescribed in patients with the following conditions like-tuberculosis, hypertension, congestive heart failure, renal insufficiency, and diabetes mellitus or in those with a family history of diskettes, osteoporosis, and patients with a history of severe affective disorders and particularly those with a precious history of steroid-induced psychoses, epilepsy, peptic ulceration, previous steroid myopathy. undesirable effects may be minimized by using the lowest effective dose for the minimum period and by administering the daily requirement as a single morning dose on alternate days. Frequent patient review is required to titrate the dose appropriately against disease activity.
Use in pregnancy and lactation:
Use in pregnancy: there is evidence of harmful effects on pregnancy in animals.
Use in lactation: corticosteroids are excreted in small amounts In breast milk and infants of mothers taking pharmacological doses of steroids should be monitored carefully for signs of adrenal suppression.
Use in children: Corticosteroids cause growth retardation in infancy, childhood and adolescence, which may be irreversible. Treatment should be administered where possible as a single dose in alternate days.
Drug interactions:
Hepatic microsomal enzyme inducers: drug which can cause liver enzyme induction such as phenobarbitone , phenytoin, rifampicin, carbamazepine, primidone and aminoglutethimide may reduce the therapeutic efficacy of corticosteroid by increasing the rate of metabolism.
Non-steroidal anti-inflammatory drug: concomitant administration of ulcerogentc drug such as indomethqacin during corticosteroid therapy may increase the risk of GL unctertion.
Anticoagulants: response anticoagulants may be reduced or, less often, enhanced by corticosteroids.
Vaccines: live vaccines should not be given to individuals with imparted immune immune responsiveness. The antibody response to other vaccines may be diminished.
Oestrogens: oestrogens may potentiate the effects of glucocorticoids and doges adjustment may be required if oestrogense are added to or withdrawn from a stable dosage regimen.
Other: the desired effects of hypoglycemic agents (including insulin), anti-hypertensive and diuretics are antagonised by corticosteroids and the hypokalaemic effect of acetazolamide, loop diuretics, thiazide diuretics and carbenoxolone are enhanced.
Overdose: Report of acute toxicity and/or death following overdose of glucocorticoids are rare. No specific antidote is available; treatment is supportive and symptomatic. serum Electrolytes should be monitored.
"Ketoconazole BP"
Ketoral
Ketoral (ketoconazole) is a synthetic imidazole derivative with a potent activity against dermatopytes,
yeasts and other pathogenic fungi, after oral administration.
Composition:
Ketoral tablet: each tablet contains ketoconazole BP 200mg.
Indication: 1.treatment of superficial and deep mycoses: •infection of the skin, hair and nails by dermatophytes and yeasts (dermatomycosis, onychomycosis, perionyxis, pityriasis versicolor, choronic mucocutaneous candidiasis etc.) especially when topical treamatment is difficult or not very effective,
owing to involvement of large skin surfaces or to lesions affecting deeper dermal layers, nails and hairs;
•yeast infection of the mouth (oral thrush, perleche) and the gastrointestinal tract;
•vaginal candidiasis, especially chronic recurrent cases or cases responding poorly to topical treatment;
•Systemic mycotic infection such as systemic candidiasis, paracoccidioidomycosis, histoplasmosis, coccidioidomycosis etc.
2.Maintenance treatment to prevent recurrence in systemic mycotic infections and in chronic
mucocutaneous candidiasis.
3.Prophylactic treatment to prevent mycotic infection in patients with reduced host defenses, e.g.,
patients with cancer, organ transplant and burns.
Dosage and administration: Vaginal candidiasis: 1 tablet b.i.d. for 5 days.
All other indications: adults: 1 tablet (200mg) once daily until at least one week after the symptoms have disappeared and the cultures have become negative.
Children: 3 to 5mg/kg/day
Duration of treatment:
Pityriasis versicolor : 1 to 6 weeks
Dermatomycoses: 2 to 8 weeks
Onychomyoses: 1 to 12 months
Mycoses of hair and scalp : 1 to 2 months
Chronic mucocutaneous candidiasis: 1 to 12 months
Oral mycoses: 5 to 10 days
Systemic candidiasis: 1 to 2 months
Paracoccidioidomycosis, histoplasmosis And other systemic mycosis 1 month to 2 years
Rematk: ketoconazole should be taken at meal times for maximal resorption. Because resorption
depends on intact gastric activity, the concomitant treatment with gents that reduce gastric secretion
(ant cholinergic drug, antacids, H2 blockers) should be avoided. When indicated, such drug should
be taken not earlier than two hours after ketoconazole may be doubled (400 mg once daily).
Adverse reactions:
Ketoconazole is very well tolerated. Nausea and itching may occasionally occur. In some patients, an idiosyncratic liver reaction may occur (incidence 1: 10,000).
Warnings:
In patients with a previous history of live disease, live enzyme levels should e monitored during treatment. When patients develop symptoms indicative of liver reaction such as nausea or fatigue, accompanied with pale faces, dark urine or jaundice, ketoral therapy should be stopped immediately.
Contraindications:
Ketoconazole is contraindicated in pregnancy and in patients with acute liver pathology.
Storage condition:
Store in a cool and dry place, protect from light and moisture.
Group “salbutamol”BP
D-butamol
Presentation:
D-butamol 2mg tablet : each tablet contains salbutamol sulphate BP. Equivalent to salbutamol 2mg.
D-butamol 4mg tablet: each tablet contains salbutamol sulphate BP equivalent to salbutamol 4mg.
D-butamol 100ml syrup: each 5ml contains salbutamol 2mg as salbutamol sulphate BP.
Indication:
on the heart, so it is used for the management of asthma.
D-butamol is indicated for the relief of acute & chronic bronchospasms.
Dosage & administration:
Oral:
Adults & twelve years old child:
2-4mg three to four times daily. Some patients may require up to 8mg.
Children: 2-6 years: 1 to 2 mg three to four times daily.
6-12 years: 2mg three to four times daily or as prescribed by the physician.
Side effect:
Side effects side effects are very few. In some cases headache palpitation & dilation of peripheral nerves may occur.
Contraindication:
Hypersensitivity to salbutamol contraindicates the use of D-nutamol.
Precaution:
D-butamol should be used with caution in patients with hyperthyroidism, diabetes & severe cardiovascular disorders or hypertension. Pharmaceutical precaution:
Storage:
Keep in a cool place, protected from light and moisture
Group “lactulose”
Avolac (lactulose concentrate oral-solution)
Composition:
100 g avolac contains 50g lactulose USP.
1 tea-spoon AVOLAC (5 ml = 6.7g) contains: lactulose 3.35g.
Properties and effectiveness:
Lactulose which is not broken down in the stomach and small intestine, begins its action in the
large intestine where it is broken down primarily by intestinal bacteria. In this degradation process,
lactic acid is produced; this in turn supports the growth of intestinal bacteria important for humans and hinders
the growth of putrefactive bacteria. Thus normalization of intestinal flora (eubiosis) results. In addition, the increase in increase in metabolic degradation products in the blood which connot be sufficiently detoxified
by the liver is reduced.
Lactulose improves the transter of calcium salts and phosphates from the intestines, stimulates intestinal peristalsis and lads to a softening of the stool. It also leads to healing and improvement in gum diseases through normalization of metabolic processes in the periodontal region.
Even long-term use of AVOLAC does not lead to habituation and thus there Is no loss of efficacy.
Indications:
1.Constipation (chronic constipation):
In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables
, salads, fruits, supplemts of linseeds, wheat germ, etc.) a generous amount of liquids and much physical exercise. AVOLAC is only to be taken when these measures prove insufficient.
2.Intestinal flora disturbances: in
Damage to intestinal flora, following therapy with broad spectrum antibiotic infants Gall bladder diseases
Intestinal diseases (colitis, diverticulitis, megacolon)
3.Increased bold ammonia levels
(hyperammoniemia in hepatopathy, portal systemic encephtopathy, precoma, coma)
4.Disease of the gums and the parodontic apparatus
(paradontosis, bleeding from the gums, inflammation, dystrophy)
5.Precoma.
Dosage & administration:
Dosage should be followed accurately unless otherwise otherwise specified. 1.In constipation
(chromic constipation):
Due to the fact that every organism fresponds differently to AVOLAC, each patient must determine
his/her won optimal dose in the course of time.
initially In long-term therapy
Adults 3-5 tea-spoons daily 1-5-6 tea-spoons daily
Children upto 14 years 3 tea-spoons daily 1-2 tea-spoons daily
Infants and toddlers 1-2 tea-spoons daily 1 tea-spoons daily
With AVOLAC a prompt laxative effect may be achieved by drinking a mixture of 3-9 tea-spoons in
1/8-1/4 liter water, coffee, tea fruit juice, of milk on an empty stomach after getting up in the morning. Normally, defecation takes place approximately 2 hours later in the form of a fluid pulpy mass
(increased defecation reflex).
2.In damaged intestinal flora (e. g. following long-term antibiotic treatment):
Adults: 1-2 tea-spoons daily
Children: 1 tea-spoon daily
3.For reduction of blood ammonia level (I hepatopathy): A maximum of 60-100g lactulose
daily, that is, 18-30 tea-spoons
4.In precoma: a maximum of 100g lactulose daily, that is 30 tea-spoons AVOLAC spread over
the course of the day.
5.Diseases of the gums and the parodontic apparatus (paradontopathy):
Adults: 3-6 tea-spoons AVOLAC daily.
Contraindications:
Hypersensitivity to either galactose and or lactose, galactose-free diet. Gastro-cardial symptom
complex (heart problems stemming from the gastro-intestinal tract), suspected intestinal obstruction.
Pregnancy and lactation:
Studies show that lactulose has no adverse effects.
Decisions regarding use during pregnancy and lactation must be made by a registered physician.
Side effect:
Occasionally flatulence can occur at the beginning of treatment, this is rapidly eliminated by reducing
the dose and or taking the daily dose I several smaller individual portions spread over the course of
the day. Over dosage can result in
abuse: loss of electrolytes (primarily potassium):
Interactions:
The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency I abuse.
Habit forming effects: none known.
Special note of warning concerning safe application:
Consult a doctor I case of pregnancy or side effects. AVOLAC contains a maximum of 11% galacrose
and maximum of 2% tagatose. This is to be taken into account in patients requiring a glactose-free diet. Diabetics may also use AVOLAC taking bead units into account (15 tea-spoons AVOLAC equal ¼
bread unit, diarrhea may occur in case of overdosis In such a case, AVOLAC use should be discontinud and care should be taken that the patient has an adequate supply of water and mineral while undergoing therapy with AVOLAC, foods that cause flatulence and excessive intake of carbonated drinks should be avoided.
In treating dysbacteria (disturbances of intestinal flora), a periodic course of treatment with AVOLAC (6-8 weeks) is generally recommended. Only after this period of time can the desired change in the intestinal environment be achieved. If AVOLAC is taken with or after meals, the laxative effects is laxative effects is reduced and the dose must be increased. The stool regulating effect of AVOLAC may last several days I some patients. Thus AVOLAC need only be taken every 2nd or 3rd day in such cases. The action of AVOLAC takes place without the aid of a special diet: nevertheless, a diet rich in vitamins and fibre the action of AVOLAC in obstinate constipation and parodontosis.
Group omeprazole BP
prevas
Presentation:
Prevas (omeprazole BP 20mg): each
prevas capsule contains enteric coated omeprazole pellets equivalent to 20 mg
omeprazole BP.
Prevas (omeprazole BP 40 mg): each
prevas capsule contains enteric coated omeprazole pellets equivalent to 4o mg
omeprazole BP.
Indication:
Prevas delayed release capsules is
indicated in the treatment of conditions where a reduction of gastric acid is
required such as; *duodenal lcer associated with helicobacter pylori *gastric
ulcer associated with helicobacter pylori *NSAIDs associated gastro duodenal
erosions *petic ulcer associated with helicobacter pylori *acid related
dyspepsia *gastro esophageal reflux disease *zollinger-ellison of H.pylori
*other uses; upper gastrointestinal bleeding, lesions associated with NSAIDs,
prevention of bleeding in critically ill patients, prevention acid aspiration
syndrome.
Dosage and administration:
·
Benign gastric
and duodenal ulcers, 20 mg once daily for 4 weeks in duodenal ulceration or 8
weeks in gastric ulceration; in severe or recurrent cases increase to 40 mg
daily;
·
Maintenance for
recurrent duodenal ulcer, 20 mg once daily; prevention of relapse in duodenal
ulcer, 10 mg daily increasing to 20 mg once daily if symptoms return.
·
NSAiDs associated
duodenal or gastric ulcer and gastro duodenal erosions, 20 mg once daily for 4
weeks, followed by a further 4 weeks if not fully healed; prophylaxis in
patients with a history of NSAIDs associated duodenal or gastric ulcers, gastro
duodenal lesions, or dyspeptic symptoms who require continued NSAIDs treatment,
20 mg once daily.
·
Duodenal ulcer
associated with helicobacter pylori – 20 mg twice daily.
·
Benign gastric
ulcer associated with H. pylori, omeprazole 40 mg daily in 1-2 divided doses
(plus amoxicillin 0.75-1g twice daily) for 2 weeks.
·
Zollinger-ellison
syndrome, initially 60 mg once daily; usual range 20-120 mg daily (above 80 mg
in 2 divided doses).
·
Gastro-esophageal
reflux disease, 20 mg once daily for 4 weeks, followed by a further 4-8 weeks
if not fully healed; 40 mg once daily has been given for 8 weeks in
gastro-oesophageal reflux disease refractory to other treatment; may be
continued at 20 mg once daily.
·
Acid reflux
disease (long-term management), 10mg daily increasing to 20 mg once daily if
symptoms return.
·
Acid related
dyspepsia, 10-20 mg once daily for 2-4 weeks according to response.
Child:
not recommended.
Side
effects:
Side
effects reported for omeprazole include headache, diarrhea, rashes, purities,
dizziness, urticaria, nausea and vomiting, constipation , flatulence, abdominal
pain, malaise, dry mouth etc.
Caution:
Prevas
should be used with caution in patients with liver disease, in pregnancy and
breast-feeding, proton pump inhibitors may mask symptoms of gastric cancer;
particular care is required in those whose symptoms change and in those over 45
years of age; the presence of gastric malignancy should be excluded before
treatment.
Use
in pregnancy and lection:
There
are no adequate controlled studies in pregnant women, although prevas (omeprazole)
has been shown to cross the placenta in mice and sheep. It is not known whether
omeprazole is excreted in human milk. So it is better to avoid prevas(
omeprazole) during pregnancy and lactation.
Drug interaction:
Prevas
competes with other drugs for the subfamily 2c of the cytochrome P450 system.
This reduces the rate of metabolism of diazepam, wartarin, carbamazepine and phenytoin. However, the
effect is minimal and is unlikely to be clinically important.
No comments:
Post a Comment