Medications in the Klinik Kesihatan

The following are amongst the list of drugs available in KKTE/ KKSB:

1. Achromycin
2. Actifed Syrup
3. Actifed Tab
4. Activated charcoal
5. Actrapid
6. Adalat
7. Adrenaline
8. Aldactone
9. Aldomet

   Generic Name :Methyldopa(aldomet) Route of Administration: Oral & IV Dose/Freq:Adult: PO HTN Monotherapy: Initial: 250 mg 2-3 times/day for 2 days; adjust accordingly not more than every 2 days. Maintenance: 0.5-2 g/day. Max: 3 g/day. IV As methyldopate HCl: 250-500 mg 6 hrly. Max: 1 g 6 hrly. Side effects:Peripheral oedema; drug fever, mental depression, anxiety, nightmares, drowsiness, headache; dry mouth; orthostatic hypotension, sinus bradycardia, sodium retention, sexual dysfunction, gynaecomastia, hyperprolactinaemia, thrombocytopenia, positive Coombs' test, transient leukopenia or granulocytopenia, cholestasis or hepatitis and heptocellular injury, increased liver enzymes, jaundice, cirrhosis, dyspnoea, SLE-like syndrome. Potentially Fatal: Hepatic necrosis, haemolytic anaemia. Drug Interactions:Reduced hypotensive effects with phenothiazines, TCAs and possibly, amphetamines. Additive hypotensive effects with levodopa; psychosis may also occur. Reduced absorption and effects with oral iron preparations. Reduced doses of general anaesthetics may be required. Effect of ephedrine may be reduced. Potentially Fatal: Increased risk of severe hypertension with MAOIs. Increased lithium toxicity. Contraindications: Phaeochromocytoma, active liver disease. Patients in whom previous methyldopa treatment resulted in liver abnormalities or direct Coombs' positive haemolytic anaemia.. Pregnancy category:Category B Special Precautions:History of haemolytic anaemia, depression, parkinsonism, renal or hepatic impairment. May impair ability to drive or operate machinery. Monitor blood counts and perform LFTs. Elderly. Mode of action: Methyldopa stimulates α2-adrenoceptors which results in reduced sympathetic tone and fall in BP. Onset: 4-6 hr. Duration: 48 hr (oral); 10-16 hr (IV). Absorption: Variable and incomplete from the GI tract, via amino acid active transport system (oral). Distribution: Crosses the placenta; penetrates the blood-brain barrier; enters the breast milk. Protein-binding: Minimal. Metabolism: Extensively hepatic. CNS: Decarboxylation to α-methyl-noradrenaline. Excretion: Via urine (as unchanged drug and as o-sulfate conjugate); prolonged in renal impairment; 1.7 hr (elimination half-life). Administration May be taken with or without food.

10. Alfacalcidol Cap

    Generic Name:Alfacalcidol (1-α-hydroxyvit D3) Route of Administration:Oral Dose/Freq:Cap Adult & childn >20 kg body wt Initial dose: 1 mcg daily. Drops Childn <20 kg body wt 0.05 mcg/kg/day. Neonate 0.1 mcg/kg/day. Elderly: 0.5 mcg daily. Side effects:Hypercalcaemia Drug interaction:Thiazides may increase the risk of hypercalcaemia. Some antiepileptics e.g. carbamazepine, phenobarbital, phenytoin and primidone may increase vitamin D requirements. Rifampicin, isoniazid and corticosteroids may reduce the efficacy of vitamin D Contraindications: Hypercalcemia ,metastatic calcification, hyperphosphataemia (except when occurring with hypoparathyroidism), hypermagnesaemia Pregnancy category:Category D Special Precautions: Pregnancy, lactation, renal impairment, infants, elderly. Mode of action: Alfacalcidol is rapidly converted in the liver to 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3], the metabolite of vitamin D3 which acts as a regulator of calcium and phosphate homeostasis. Onset: 3-6 hr Absorption: Adequately absorbed from the GI tract (oral). Metabolism: Hepatic; rapidly converted to calcitriol. Excretion: Faeces and urine (small amounts) Administration Should be taken with food

11. Aminophylline

    Generic Name:Aminophyline Route of Administration:Oral & IV Dose/Freq:Adult: PO Chronic bronchospasm As hydrate: Initial: 225-450 mg twice daily, increased if needed. IV Acute severe bronchospasm Loading dose: 5 mg/kg (ideal body wt). Maintenance: 0.5 mg/kg/hr. Rate should not exceed 25 mg/min. Side effects:Nausea, vomiting, abdominal pain, diarrhoea, headache, insomnia, dizziness, anxiety, restlessness; tremor, palpitations. Potentially Fatal: Convulsions, cardiac arrhythmias, hypotension and sudden death after too rapid IV injection. Drug Interactions:Other xanthines. Clearance reduced by allopurinol, some antiarrhythmics, cimetidine, disulfiram, fluvoxamine, interferon-α, macrolide antibiotics, quinolones, oral contraceptives, thiabendazole and viloxazine. Clearance increased by phenytoin, anticonvulsants, ritonavir, rifampicin, sulfinpyrazone, cigarette smoking. Corticosteroids, diuretics, β2-agonists. Potentially Fatal: Increased risk of cardiac arrhythmias with sympathomimetics and halothane. Tachycardia with pancuronium. β-blockers inhibit metabolism. Increased risk of convulsion with quinolones, ketamine Contraindications:Hypersensitivity Pregnancy category:Category C Special Precautions:Neonates, elderly, lactation, pregnancy, cardiac/hepatic diseases, peptic ulceration, hyperthyroidism, hypertension, epilepsy, heart failure, chronic alcoholism, acute febrile illness. Mode of action Aminophylline is a combination of theophylline and ethylenediamine. Ethylenediamine is inactive; it increases the solubility of theophylline in water. Theophylline relaxes bronchial smooth muscle. Suggested mechanisms are an increase in intracellular cAMP through inhibition of phosphodiesterase; adenosine receptor antagonism, prostaglandin antagonism and effects on intracellular calcium. Absorption: Rate of absorption delayed by food. Distribution: Crosses the placenta and enters breast milk. Metabolism: Undergoes hepatic metabolism. Excretion: Via urine. Administration Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food). (Take on an empty stomach at least 1 hr before or 2 hr after meals.)

12. Amoxil

    Generic Name:Amoxicilin Route of Administration:Oral & IV/IM Dose/Freq:Adult: PO Susceptible infections 250-500 mg 8 hrly. Uncomplicated gonorrhoea W/ probenecid: 3 g as a single dose. Dental abscesses 3 g, repeat once 8 hr later. Uncomplicated acute UTI 3 g, repeat once 10-12 hr later. Prophylaxis of endocarditis 2 or 3 g as a single dose, 1 hr before dental procedure. Severe or recurrent resp tract infections 3 g twice daily. H.pylori infection W/ either metronidazole or clarithromycin and a bismuth compound or an antisecretory drug: 500 mg 3 times/day. IV/IM Susceptible infections 500 mg 8 hrly. Listerial meningitis W/ other antibiotics: 2 g 4 hrly for 10-14 days. Side effects:Hyperactivity, agitation, insomnia, dizziness; maculopapular rash, exfoliative dermatitis, urticaria, hypersensitivity vasculitis; diarrhoea, nausea, vomiting; anaemia, thrombocytopenia, leucopenia, agranulocytosis. Potentially Fatal: Neuromuscular hypersensitivity; pseudomembranous colitis.. Drug Interactions:Increased levels with disulfiram and probenecid. Decreased effects with tetracyclines and chloramphenicol. Potentially Fatal: Increase effects of oral anticoagulants. Contraindications:Hypersensitivity Pregnancy category:Category B Special Precautions:Renal and hepatic disease; pregnancy, lactation; infectious mononucleosis. Mode of action: Amoxicillin inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall by binding to one or more of the penicillin-binding proteins (PBPs), thus inhibiting cell wall biosynthesis resulting in bacterial lysis. Absorption: Rapidly and completely absorbed from the GI tract with peak plasma concentrations after 1-2 hr (oral). Not inactivated by gastric acid and presence of food does not impair absorption. Distribution: Widely distributed, CSF (small concentrations except when the meninges are inflamed), bile (high concentrations); crosses the placenta and enters the breast milk (small amounts). Protein-binding: 20%. Metabolism: Converted to a limited extent to penicilloic acid. Excretion: Via the urine within 6 hr by glomerular filtration and tubular secretion (as penicilloic acid and 60% unchanged drug); via the faeces. May be removed by haemodialysis; 1-1.5 hr (elimination half-life) Administration May be taken with or without food. (May be taken w/ meals for better absorption & to reduce GI discomfort.)

13. Angised
14. Aprovel
15. Artane
16. Aspirin
17. Atropine
18. Atrovent solution
19. Atrovent inhaler
20. Augmentin Tab
21. B Complex
22. Bactrim Tab

    Generic name: trimethoprim/ sulfamethoxazole ROA : oral Dose: Adults: trimetoprim 160mg/sulfamethoxazole 800mg every 12 h for 5 days Children: trimetoprim 8mg/kg and sulfamethoxazole 40mg/kg daily in 2 dvided dose every 12 h for 5 days Indication: treatment for enteritis, P.carinii pneumonia, severe uncomplicated UTI caused by susceptible strains of bacteria Side effect: gastrointestinal disturbances (nausea, vomiting, anorexia) and allergic skin reactions (such as rash and urticaria) Contraindications: hypersensitivity to trimetoprim or sulfonamides; megaloblastic anemia caused by folate deficiency;pregnancy; lactation;infant younger than 2mo of agr;marked hepatic damage or renal insufficiency when renal function cannot be monitored Pregnancy: category C Mode of action: sulfamethoxazole inhibits bacterial synthesise of dihidrophobic acid by competing with PABA(para aminobenzoic acid). Trimetoprim blocks production of tetrahydrofolic acid by inhibiting the enzyme dihydrofolate reductase. In conclusion these two combination block synthesise of essensial nucleic acid and proteins and usually bactericidal

23. Beclomet inhalation

    Generic name: beclomethason dipropionate ROA: oral and nasal Dose: Treatment and prophylaxis for allergic and non allergic rhinitis : Adult: 100 mcg bid or 50 mcg 3-4 times daily in each nostril. Max: 400 mcg daily. Asthma prophylaxis: Adult: Initially, 600-800 mcg daily. Maintenance: 400 mcg daily in 2-4 divided doses. Child: As dipropionate: 50 or 100 mcg bid-qid or 100 or 200 mcg bid. Severe asthma: Adult: 250 mcg four times daily or 500 mcg bid. May be increased to 500 mcg 3-4 times daily if necessary. Max: 2 mg daily. Indication: Oral: maintainance prophylactic treatment of asthma in patient 5yr of age and older; asthma patients requiring systemic corticosteroid administration in which adding an inhaled corticosteroid may reduce or eliminate need for systemic corticsteroid Nasal: relief of symptoms of seasonal or perennial allergic and nonallergic rhinnitis;prevention of recurrence of nasal polyps following surgical removal Side effect: Loss of skin collagen and SC atrophy; local hypopigmentation of deeply pigmented skin; dryness, irritation, epistaxis, rarely ulceration or perforation of the nasal septum; smell and taste disturbances; hoarseness and candidiasis of the mouth or throat. Contraindication: Hypersensitivity. Acute infections uncontrolled by antimicrobial chemotherapy. Pregnancy: category c MOA: Beclometasone controls the rate of protein synthesis, depresses the migration of polymorphonuclear leukocytes, fibroblasts, reverses capillary permeability and lysosomal stabilisation at the cellular level to prevent or control inflammation

24. Becotide inhalation
25. Benadryl
26. Benzyl Benzoate
27. Betaloc
28. Betnovate cream
29. Bisolvon Tab
30. Bricanyl inhaler
31. Brufen
32. Buscopan injection
33. Buscopan Tab

    1) Generic Name : Hyoscine-N-butylbromide 2) Route of administration : Oral (Sugar coated) 3)Dosage for each route : 10 mg 4) Mode of Action (Pharmacodynamics/Pharmacokinetics): A competitive antagonist of the actions of acetylcholine and other muscarinic agonist.The drug is devoid of central nervous actions. The receptors affected by the drug are those of the peripheral structures that are either stimulated or inhibited by muscarine; such as exocrine glands and smooth and cardiac muscle. Cholinergic nerve stimulations are also inhibited but less readily than are responses to injected choline esters.Depending on the dose, hyoscine N-butylbromide may inhibit the secretions of the respiratory tract, GIT, and sweat glands; it may reduce the motility and tone in the GIT, ureter, urinary bladder and biliary tract. 5)Indications : treatment of spasm and hypermotility of the GIT, biliary and renal colic, and in spasmodic dysmenorrhea. It may also be used in patients with gastric or duodenal ulcer. 6) Side effects : Xerostomia,dyshidrosis,tachycardia,urinary retention,allergic reactions,skin reactions 7) Contraindications : Myasthenia gravis,megacolon,glaucoma,hypertrophy of prostate with/- urinary retention,mechanical stenosis of GIT 8) Pregnancy Category :Safe used in pregnancy has not been established. 9) Precautions (for example in children and breastfeeding :Narrow angle glaucoma,patients susceptible to intestinal urinary outlet obstructions,tachyarrhythmia patient 10) Drug interactions : -Intensifies anti-cholinergic effects of tricyclic anti-depressants,anti-histamines,qunidine,amantadine -Enhances tachycardia effects of beta-adrenergic agents -Dopamine antagonist reduce effects of drugs on GIT

34. Calamine Cream

    1) Generic Name :Topical anti-histamine and anti-pruritic. Calamine 6%, Zinc oxide 4% 2) Route of administration : Topical 3)Dosage : 60 ml 4) Mode of Action :has mild astringent and antipruritic actions 5)Indications : Skin irritations (insect bites,sunburns,minor heat)topical relief of itching, pain, and discomfort,nappy rashes 6) Side effects : May cause rash or irritation. 7) Contraindications : For external use only and not to be used on open wounds or burns. 8) Pregnancy Category :Can be safely used 9) Precautions : Discontinuing use and checking with physician if condition worsens, or does not improve within 7 days or if rash, irritation, or sensitivity develops 10) Drug interactions : -

35. Calamine Lotion

    1) Generic Name :Topical anti-histamine and anti-pruritic. Calamine 6%, Zinc oxide 4% 2) Route of administration : Topical 3)Dosage : 120 ml 4) Mode of Action :has mild astringent and antipruritic actions 5)Indications : Skin irritations (insect bites,sunburns,minor heat)topical relief of itching, pain, and discomfort,nappy rashes 6) Side effects : May cause rash or irritation. 7) Contraindications : For external use only and not to be used on open wounds or burns. 8) Pregnancy Category :Can be safely used 9) Precautions : Discontinuing use and checking with physician if condition worsens, or does not improve within 7 days or if rash, irritation, or sensitivity develops

36. Calcium Carbonate
37. Calcium Lactate

    1. Dosage Oral Adult: Expressed in terms of elemental calcium: 19-50 yr: 1000 mg/day and >50 yr: 1200 mg/day. Child: Expressed in terms of elemental calcium: 0-6 mth: 210 mg/day; 7-12 mth: 270 mg/day; 1-3 yr: 500 mg/day; 4-8 yr: 800 mg/day; 9-18 yr: 1300 mg/day. 2. Indication Nutritional supplement. 3. Group Electrolytes 4. Pharmacodynamics Absorbed mainly from the small intestine by active transport and passive diffusion. 5. Pharmacokinetics Excess calcium is mainly excreted renally. Unabsorbed calcium is removed in the faeces, along with that secreted in the bile and pancreatic juice 6. Side effects GI discomfort e.g. nausea, vomiting, constipation; bradycardia, arrhythmias. Dry mouth, increased thirst or increased urination. Mental confusion, milk-alkali syndrome. 7. Contraindications Conditions associated with hypercalcaemia and hypercalciuria

38. Canestan Pessary
39. Capoten
40. Celestone
41. Ceporex Cap
42. Chloromycetin Eye drop/ ointment
43. Chlorothiazide
44. Clarityne Tab
45. Co Approvel
46. Colchicine
47. Coumadin
48. Coversyl
49. Crystapen

    Generic name-benzylpenicillin sodium Route of administration-Intramuscular/ slow intravenous Dose/freq-600-3600mg daily in 4-6 divided dose(adult), 100mg/kg/day(child), max-4g/day Side effect- jarisch- herxheimer reaction, rashes, fever, serum sickness, rarely heamolytic anemia & granulocytopenia, agranulocytosis, leucopenia & thrombocytopenia, convulsion, interstitial nephritis Indication-wound, pyogenic skin, soft tissue and resp tract infection, generalized infection & septicemia, osteomylitis, bacterial endocarditis & meningitis, tetanus, actinomycosis, anthrax, rat bite fever, listerioasis & lyme disease, gonococcal infection, syphilis, diphtheria, brain abcess Contraindication-penicillin hypersensitivity, cross allergy to other B-lactam Pregnancy category-B Special precaution-Impaired renal function, diabetes, prolonged use, pseudomembranous colitis. Monitor electrolyte,blood count & renal function.Elderly Mode of action-By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, penicillin G inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that penicillin G interferes with an autolysin inhibition

50. Cyanocobalamin inj

    Generic name-Cyanocobalamin(vitamin B-12) Routes od admin-Intramuscular/ subcutaneous/oral Dose/freq- 1mg(inj), 50-105 microgram/day(oral) Indication -vitamin B-12 deficiency eg in case of pernicious anemia, gluteal enteropathy, tapeworm infestation, malignancy of pancrease or bowel and folic acid defiency or when there is increase in demand eg pregnancy. Side effect-Pain/redness at the injection site, mild diarrhea, itching, or a feeling of swelling all over the body may occur

    
    
51. Daktarin cream

    3)daktorin cream Generic name-miconazole nitrate Routes of administration-Topical cream Dose/ freq-twice daily for 2-6 weeks Indication -fungal skin infection eg dermatophytoses, mycoses, pityriasis versicolor,infection & superinfection, adjunct treatment of onychomycosis (tincture), napkin dermatitis,inguinal or interdigital infection Side effect-drowsiness, vomiting,diarrhea, rash, sometimes hepatotoxicity(esp in patient with liver dysfunction) and can causes cardiac arrest and anaphylaxis. contraindication-liver dysfunction Pregnancy category - Special precaution - Mode of action- interfere with fungal cell membrane permeability by inhibiting the synthesis of ergosterol. Long term used can lead to reisitance possibly via changes in the sensitivity of target enzymes. -oral absorption is 20%, volume distribution 20 l/kg, plasma protein binding is92%, hepatic metabolism,renal excretion account for 20% and plasma ½ life is 24.1 hr

52. Daonil

    daonil Generic name-glibenclamide Routes of administration-oral Dose/freq-initial dose is ½ or 1 tablet/ day(2.5- 5 mg) max 15mg/day Indication-type II DM whenever blood sugar cannot be controlled by non-pharmacological method Side effect-rash and other allergic reaction contraindication-use in patients with known hypersensitivity or idiosyncratic reaction to it Pregnancy category-c Special precaution-Perform regular monitoring of glucose levels in blood and urine,. Milder or absent symptom of hypoglycemic in patient with autonomic neuropathy, or taking B-blocker,clonidine, reserpine, guanethidine or other sympatholytic drugs. Mode of action -inhibit ATP- sensitive potassium channel in pancreatic beta-cell causes opening of voltage- dependent calcium channel which lead to increases in intracellular calcium and stimulate insulin release - oral absorption found to be 95&, Volume of distribution is found to be 0.15 l/kg and plasma protien binding is 99%, completely metabolized by liver, and renal excretion account for 80% and plasma ½ is 5.05/hr Administration-Take immediately before meals. To be taken before breakfast, any remaining portion to be taken before evening meals

53. Dapsone
54. DF 118
55. Diamicron
56. Diamicron MR
57. Diamox
58. Dilantin Cap
59. Dobutrex
60. Dulcolax
61. Duphalac
62. EES
63. Ephedrine
64. Epilim Tab
65. Erythrocin Susp
66. Esmeron
67. Essentiale
68. Expect Stimulant
69. Farlutal
70. Ferrous Fumarate

    MIMS Class : Vitamins & Minerals (Pre & Post Natal) / Antianemics Indication: Iron-deficiency anaemia. Dosage: Adult: PO Usual range: Up to 600 mg/day, up to 1.2 g/day if needed. Administration: Should be taken on an empty stomach. (Best taken on an empty stomach. May be taken w/ meals to reduce GI discomfort.) Overdosage: Symptoms: Nausea, vomiting, abdominal pain, diarrhoea, haematemesis and rectal bleeding. Hypotension, coma and hepatocellular necrosis may occur later. Treatment: Empty stomach contents by gastric lavage within 1 hr of ingestion. In severe toxicity, IV desferrioxamine may be given. Whole bowel irrigation may also be considered in severe poisoning. Special Precautions: Patients with intestinal strictures and diverticular disease. May worsen diarrhoea in patients with inflammatory bowel disease. May cause constipation and faecal impaction in elderly. Avoid prolonged admin (>6 mth) except in patients with continued bleeding, menorrhagia or repeated pregnancies. Not for routine use in treatment of haemolytic anaemia unless an iron-deficient state exists. Parenteral iron should not be used concurrently with oral iron treatment. Avoid use in patients receiving repeated blood tranfusions. Pregnancy. Adverse Drug Reactions: GI disturbance including constipation, diarrhoea, dark stools. Nausea and epi-gastric pain. Drug Interactions: Oral absorption of iron may be increased when taken with ascorbic acid. May reduce the absorption of quinolones and tetracyclines when taken concurrently via the oral route. Concurrent admin with antacids may reduce the absorption of ferrous fumarate from the GI tract. May reduce the absorption of penicillamine in the gut when taken concurrently. Mechanism of Action: Ferrous fumarate is an iron preparation that is used in the prevention and treatment of iron deficiency. The amount of elemental iron is 330 mg/g of ferrous fumarate. Absorption: GI iron absorption depends on the amount of stored iron in the body; absorption is higher when stored iron is low. Distribution: Ferrous iron passes through the GI mucosal cells, bind to transferrin and is then transported to the bone marrow and incorporated into haemoglobin. Excretion: Mainly through the faeces and desquamation of cells e.g. skin, hair or GI mucosa

71. Flagyl Tab
72. Flamazine
73. Folic Acid

    Dosage:Adult 1 tab daily for 4 mth; up to 3 tab daily in malabsorption states Indication:Treatment of megaloblastic anaemia due to folic acid deficiency. Group: vitamin/antianemics Special instruction whilst dispensing the drug:May be taken with or without food

74. Glucobay

    Generic name: acarbose Dosage: Initially 50 mg tds, up to 100 mg tds Indication: Additional therapy in association w/ diet in patients w/ DM Group: Antidiabetic agents Pharmacodynamic: In all species tested, acarbose exerts its activity in the intestinal tract. The action of acarbose is based on inhibition of the intestinal enzymes (α-glucosidase) involved in the degradation of disaccharides, oligosaccharides and polysaccharides. This leads to a dose-dependent delay in the digestion of these carbohydrates.Most importantly, glucose derived from carbohydrates is released and taken up into the blood more slowly. In this way, acarbose postpones and reduces the post-prandial rise in blood glucose. As a result of the balancing effect on the uptake of glucose from the intestine, the blood glucose fluctuations over the day are reduced and the mean blood glucose values decrease. Pharmacokinetic: Absorption and Bioavailability: The bioavailability is 1-2% only. This extremely low systemically available percentage of inhibitory substance is desirable, because acarbose acts only locally in the intestine. Thus, this low bioavailability has no relevance for the therapeutic effect. Side effects: Very common: flatulence; common: diarrhoea, GI & abdominal pain; uncommon: nausea, vomiting, dyspepsia, increase in liver enzymes; rare: oedema, jaundice Contraindications: Chronic intestinal disorders associated w/ distinct disturbances of digestion & absorption, conditions which may deteriorate as a result of increased intestinal gas formation. Pregnancy, lactation. Severe renal impairment. Safety in pregnancy: category B Special instruction whilst dispensing the drug:Should be taken with food (Swallow whole w/ a little liqd directly before meals or chew w/ the 1st few mouthfuls of meals.)

75. Glucophage

    Generic name: Metformin HCl Dosage: Adult Monotherapy & combination w/ other oral antidiabetic agents 500 or 850 mg bd-tds, adjust after 10-15 days. Max: 3 g daily. Combination w/ insulin 500 or 850 mg bd-tds, adjust insulin according to blood glucose measurements. Childn >10 yr & adolescent Monotherapy & combination w/ insulin 500 or 850 mg once daily, adjust dose after 10-15 days. Max: 2 g daily in 2 or 3 divided doses. Indication: Treatment of type 2 DM in adult when dietary management & exercise alone does not result in adequate glycaemic control. In adults, may be used as monotherapy or in combination w/ other oral antidiabetic agents or w/ insulin. In childn >10 yr & adolescent, may be used as monotherapy or in combination w/ insulin. A reduction of diabetic complications has been shown in overwt type 2 diabetic adults treated w/ metformin HCl as 1st-line therapy after diet failure. Group: Antidiabetic agent Pharmacodynamic: Metformin HCl is a biguanide with antihyperglycaemic effects, lowering both basal and postprandial plasma glucose. It does not stimulate insulin secretion and therefore, does not produce hypoglycaemia. Metformin HCl may act via 3 mechanisms: Reduction of hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis; in muscle, by increasing insulin sensitivity, improving peripheral glucose uptake and utilisation; and delay of intestinal glucose absorption. Metformin HCl stimulates intracellular glycogen synthesis by acting on glycogen synthase. Metformin HCl increases the transport capacity of all types of membrane glucose transporters (GLUTs) known to date. Pharmacokinetic:Absorption: After an oral dose of metformin HCl, Tmax is reached in 2.5 hrs. Absolute bioavailability of metformin HCl 500- or 850-mg tablet is approximately 50-60% in healthy subjects. After an oral dose, the non-absorbed fraction recovered in faeces was 20-30%. After oral administration, metformin HCl absorption is saturable and incomplete. It is assumed that the pharmacokinetics of metformin HCl absorption is nonlinear. At the recommended metformin HCl doses and dosing schedules, steady-state plasma concentrations are reached within 24-48 hrs and are generally <1 mcg/mL. Side effects:GI disturbances, taste disturbances, decrease of vit B12 absorption & serum levels during long-term use, erythema, pruritus, urticaria; liver function test abormalities, hepatitis. Rarely, lactic acidosis. Contraindications:Diabetic ketoacidosis, diabetic pre-coma; renal failure or dysfunction (CrCl <60 mL/min). Acute conditions w/ potential to alter renal function eg dehydration, severe infection, shock, intravascular administration of iodinated contrast agents. Acute or chronic disease which may cause tissue hypoxia eg cardiac or resp failure, recent MI or shock, hepatic insufficiency, acute alcohol intoxication, alcoholism. Pregnancy & lactation. Safety in pregnancy: category B Special instruction whilst dispensing the drug:Should be taken with food

76. Hartman's
77. Herbessar
78. Hibiscrub
79. Hydergine
80. Hydrocortisone Cream/ Ointment
81. Hyzaar
82. Imferon
83. Immucyst
84. Imuran Tab
85. Inderal Tab
86. Insulatard
87. Intropin
88. Ipecac
89. Isoniazid

    Isoniazid Group : antiTB drug MOA : Active against M tuberculosis, M bovis and some strains of M kansasii. One of its main mechanisms appears to be mycolic acid synthesis inhibition resulting in loss of acid-fastness and bacterial cell wall disruption. Indication : 1. Tuberculosis Adult : 5 mg/kg daily. Max: 300 mg daily.Similar doses may also be given via IM admin. For latent tuberculosis: 300 mg daily for 6 mth; alternatively, 5 mg/kg daily or 15 mg/kg twice wkly for 9 mth. Child : 10-15 mg/kg/day in 1-2 divided doses (max: 300 mg/day). For latent tuberculosis: 10-20 mg/kg/day or 20-40 mg/kg twice wkly for 9 mth. Max: 300 mg/dose for daily regimen and 900 mg/dose for intermittent regimens. Renal impairment: Reduce dose in severe renal impairment. 2. NonTB mycobacterial infection Adult : 5 mg/kg/day for at least 12 mth of culture-negative sputum; usually used with ethambutol and rifampin. Max: 300 mg/day. Similar doses may also be given via IM admin Administration : should be taken on empty stomach (best taken 1 hr before/2 hr after meal) Side effects : Peripheral neuritis, optic neuritis, psychotic reactions, convulsions, nausea, vomiting, fatigue, epigastric distress, visual disturbances, fever, rash, pyridoxine deficiency. Potentially Fatal: Hepatotoxicity. Contraindication : Acute liver disease or history of hepatic damage during INH therapy; hypersensitivity. Drug interaction : - May increase toxicity of carbamazepine, ethosuximide, phenytoin, diazepam and triazolam, chlorzoxazone, theophylline, clofazimine, cycloserine and warfarin - May increase metabolism of enflurane resulting in nephrotoxic fluoride levels - Reduced efficacy and increased risk of peripheral neuropathies and hepatotoxicity with alcohol - Reduced absoprtion with aluminium-containing antacids; give at least 1 hr before the antacid - Decreased serum levels with ketoconazole, zalcitabine - Increased risk of peripheral neuropathy with stavudine and zalcitabine - Potentially Fatal: Increased risk of hepatotoxicity with rifampicin and other hepatotoxic drugs

90. Isoptin Tab
91. Isordil
92. Ladogal
93. LanoxinTab
94. Largactil
95. Lasix inj
96. Lasix Tab
97. Lioresal
98. Lomotil
99. Lopid
100. Losec Cap
101. Luminal

     Generic name: Phenobarbital Dosage: Phenobarbital (and phenobarbital sodium) is manufactured and supplied in various forms: In Tablets of 15, 30, 60 and 100 mg (though not all are available in all countries: Indication and dosage: Adult: PO Generalised tonic-clonic seizures; Partial seizures 60-180 mg/day at night. Adjust according to response. Sedation 30-120 mg/day in 2-3 divided doses. Hypnotic 100-320 mg at bedtime. IV Status epilepticus Doses of 10 mg/kg. Max: 1 g. IV/IM/SC Hypnotic 100-320 mg/day at bedtime. IM Emergency management of acute seizures 200 mg repeated after 6 hr if needed. Sedation 30-120 mg/day in 2-3 divided doses. Pre-op sedation 100-200 mg 1-1.5 hr pre-op. group: anti-convulsant/ hypnotics or sedatives Pharmacodynamics:Phenobarbitone is a short-acting barbiturate. It depresses the sensory cortex, reduces motor activity, changes cerebellar function, and produces drowsiness, sedation and hypnosis. Its anticonvulsant property is exhibited at high doses. Pharmacokinetics: Onset: Hypnosis: Oral: 20-60 min; IV: Approx 5 min. Duration: Oral: 6-10 hr; IV: 4-10 hr. Absorption: Readily absorbed from the GI tract (oral); peak plasma concentrations in about 2 hr (oral), and within 4 hr (IM). Distribution: Crosses the placenta; enters breast milk. Protein-binding: 45-60%. Metabolism: Partly hepatic. Excretion: Via urine (as unchanged drug). Plasma half-life: 75-120 hr (adult), greatly prolonged (neonates), 21-75 hr (children). Side effects: Bradycardia, hypotension, syncope; drowsiness, lethargy, CNS excitation or depression, impaired judgment, hangover effect, confusion, somnolence, agitation, hyperkinesia, ataxia, nervousness, headache, insomnia, nightmares, hallucinations, anxiety, dizziness; rash, exfoliative dermatitis; nausea, vomiting, constipation; agranulocytosis, thrombocytopenia, megaloblastic anaemia; pain at inj site, thrombophlebitis (IV); oliguria: laryngospasm, respiratory depression, apnoea (especially with rapid IV admin), hypoventilation. Potentially Fatal: Stevens-Johnson syndrome. Contraindications: Severe renal and hepatic disorders. Severe respiratory depression, dyspnoea or airway obstruction; porphyria. Pregnancy. Special precautions: Elderly or debilitated patients, children. Withdraw gradually. Impaired renal, hepatic and respiratory function. Patients with acute pain and depressive disorders. May impair ability to drive or operate machinery. Lactation

102. Madopar

     Generic name: L-Dopa Dosage: Per Madopar 125 cap L-dopa 100 mg, benserazide HCl 25 mg. Per Madopar 250 cap L-dopa 200 mg, benserazide HCl 50 mg. Per Madopar HBS cap L-dopa 100 mg, benserazide HCl 25 mg Indication: Parkinson’s disease group: Antiparkinsonian drugs Administration: Should be taken on an empty stomach (Best taken at least 1/2 hr before or 1 hr after meals, whenever possible. GI discomfort which occurs mainly in the early stages of treatment may be controlled by taking w/ food or liqd or by increasing the dose slowly. Cap/HBS cap: Swallow whole, do not chew/ crush. ). Side effects: Anorexia, nausea, vomiting, diarrhea, taste disturbances; cardiac arrhythmias, orthostatic hypotension. Rarely skin reactions, hemolytic anemia, leukopenia, thrombocytopenia. Agitation, anxiety, insomnia, hallucinations & temporal disorientation in the elderly. Contraindications: Severely decompensated endocrine, renal, hepatic & cardiac disorders. Psychiatric diseases. Closed-angle glaucoma. Patients <25 yr. Pregnancy & lactation. Combination w/ MAOIs (except selegiline, lazabemide, meclobemide). Special precautions: Open-angle glaucoma. Monitor liver function & blood count. Diabetes. Discontinue 12-48 hr before surgery. Do not w/draw abruptly. Drug interactions: Neuroleptics, opioids, antihypertensives, reserpine, MAOI, sympathomimetics, antacid

103. Magnesium Trisilicate Tablet/ Mixture

     Generic name: Magnesium Trisilicate tab Group: Antacids, Antireflux Agents & Antiulcerants Dosage: Per tab Al(OH)3 250 mg, Mg trisilicate 500 mg Indication: Symptomatic relief of indigestion, upset stomach, heartburn & gastric hyperacidity. Administration: Adult Chew 1-2 tab after each meal or as required. Pharmacodynamics: Neutralize the HCL produce by stomach Side effects: Rarely, constipation, diarrhoea. Contraindications: Renal insufficiency. Drug interactions: Tetracyclines

104. Maxolon Tab

     Generic name: Metoclopramide HCL Group: Antiemetics Dosage: Total daily dosage of Maxolon, especially for children and young adults, should not normally exceed 0.5 mg/kg bodyweight. Indication: Used for the relief of nausea and vomiting, and for the treatment of diabetic gastroparesis. Pharmacodynamic: Maxolon stimulates activity in the upper gastrointestinal tract. Pharmacokinetics: Its onset of action after oral administration is 30-60 minutes, 10-15 minutes following intramuscular administration, and 1-3 minutes after intravenous administration.Maxolon is excreted from the body in the urine. Side effects: Common adverse drug reactions (ADRs) associated with metoclopramide therapy include: restlessness, drowsiness, dizziness, lassitude, and/or dystonia. Infrequent ADRs include: headache, extrapyramidal effects such as oculogyric crisis, hypertension, hypotension, hyperprolactinaemia leading to galactorrhoea, constipation, and/or depression. Rare but serious ADRs associated with metoclopramide therapy include: agranulocytosis, supraventricular tachycardia, hyperaldosteronism, neuroleptic malignant syndrome, akathisia and/or tardive dyskinesia Dystonic reactions are usually treated with benztropine or procyclidine.Contraindications: phaeochromocytoma, suspected bowel obstruction. Special precautions: Parkinson's disease since, as a dopamine antagonist, it may worsen symptoms. Long-term use should be avoided in patients with clinical depression as it may worsen mental state. In pregnancy: Metoclopramide has long been used in all stages of pregnancy with no evidence of harm to the mother or unborn baby. Metoclopramide crosses into breast milk Drug interactions: Effects antagonised by anticholinergics & narcotic analgesics. Increased sedation w/ CNS depressants. May impair absorption of digoxin, cimetidine & increase absorption of paracetamol, tetracyclines, levodopa. May alter insulin requirement

105. Mestinon
106. Methyl Salicylate Ointment
107. Methylene Blue 1% injection
108. Mevacor
109. Micardis

     Generic Name:Telmisartan(Micardis) Route of Administration:Oral Dose/Freq:Treatment of essential HTN Adult 40 mg once daily. Max: 80 mg once daily w/ or w/o diuretic. Severe HTN 160 mg alone or in combination w/ 12.5-25 mg hydrochlorothiazide. Reduction of CV morbidity Recommended dose: 80 mg once daily. Monitoring of BP is recommended & if appropriate, adjustment of medications that lower BP may be necessary. Side effects:UTI, upper resp tract infections, sepsis including fatal outcome, anaemia, eosinophilia, thrombocytopenia, anaphylactic reaction, hyperkalaemia, anxiety, insomnia, depression, syncope, visual disturbance, vertigo, bradycardia, tachycardia, hypotension, orthostatic hypotension, dyspnoea, abdominal pain, diarrhoea, dry mouth, dyspepsia, flatulence, stomach discomfort, vomiting, liver disorder, angioedema, eczema, erythema, pruritus, hyperhidrosis, urticaria, drug eruption, toxic skin eruption, rash, arthralgia, back pain, muscle spasms or pain in extremity, myalgia, tendon pain, renal impairment, chest pain, flu-like illness, asthenia. Drug Interactions:K-sparing diuretics, K supplements, salt substitutes containing K or other medicinal products that may cause hyperkalaemia (esp digoxin, lithium). May increase hypotensive effect of other antihypertensive agents. Contraindications:Biliary obstructive disorders, severe hepatic impairment. Pregnancy (2nd & 3rd trimesters), lactation Pregnancy category:Category C in 2nd & 3rd trimesters- Category D Special Precautions:Bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney, vol &/or Na depletion, severe CHF, aortic or mitral valve stenosis, obstructive hypertrophic cardiomyopathy, hepatic insufficiency. Monitor serum K & creatinine in renally impaired patients. Rare hereditary condition of fructose intolerance. Mode of action blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis. Absorption: Absorption of telmisartan is rapid although the amount absorbed varies. The mean absolute bioavailability for telmisartan is about 50%.. Distribution: largely bound to plasma protein (>99.5%), mainly albumin and α1-acid glycoprotein. Metabolism by conjugation to the glucuronide. No pharmacological activity has been shown for the conjugate Excretion: nearly exclusively excreted with the faeces, mainly as unchanged compound. Cumulative urinary excretion is <1% of dose Administration May be taken with or without food

110. Micardis Plus

     Generic Name:combination of Telmisartan & hydrochlorothiazide (micardis plus) Route of Administration:Oral Dose/Freq:Adult 1 tab once daily. Max: Telmisartan 160 mg & hydrochlorothiazide 25 mg daily Side effects:Resp disorders, UTI, sepsis including fatal outcome, blood dyscrasias, precipitation of gout or latent diabetes, electrolyte & fluid imbalance, metabolic & nutritional disorders, dizziness, vertigo, psychiatric & nervous system disorders, visual disturbances, CV & GI disorders, jaundice, renal disorders, arthralgia, myalgia, skin & allergic reactions, asthenia, anaphylactic reaction & hypersensitivity, drug eruption, toxic skin eruption Drug Interactions:Lithium, kaliuretic diuretics, laxatives, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G, salicylates, drugs that cause hyperkalaemia, digitalis glycosides, antiarrhythmic agents, drugs known to induce torsades de pointes, alcohol, barbiturates, narcotics, oral antidiabetics, insulin, anion-exchange resins, NSAIDs, nondepolarising skeletal muscle relaxants, pressor amines, allopurinol, Ca salts, β-blockers, diazoxide, anticholinergics, amantadine, cytotoxics. Contraindications:Cholestasis, biliary obstructive disorders, severe hepatic impairment, severe renal impairment (CrCl <30 mL/min), refractory hypokalaemia, hypercalcaemia. Pregnancy (2nd & 3rd trimesters) & lactation. Pregnancy category:Category C in 2nd & 3rd trimesters- Category D Special Precautions:Hepatic impairment, progressive liver disease, vol &/or Na depletion, severe CHF, aortic or mitral valve stenosis, obstructive hypertrophic cardiomyopathy, ischaemic cardiopathy, ischaemic CV disease, diabetes, gout, hereditary fructose intolerance. Patient w/ bilateral renal artery stenosis or stenosis of the artery to a single functioning kidney being treated w/ med that affect the renin-angiotensin-aldosterone system. Periodically monitor serum K, creatinine & uric acid in patients w/ mild to moderate renal impairment. Concomitant therapy w/ corticosteroids, ACTH, K-sparing diuretics, K supplements, K-containing salt substitutes. Pregnancy (1st trimester). Rare hereditary condition of fructose & galactose intolerance. Mode of action Concomitant administration of hydrochlorothiazide and telmisartan has no effect on the pharmacokinetic of either drug telmisartan:blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis. hydrochlorothiazide:affect the renal tubular mechanisms of electrolyte re-absorption, directly increasing excretion of sodium and chloride in approximately equivalent amounts. The diuretic action of hydrochlorothiazide reduces plasma volume, increases plasma renin activity, increases aldosterone secretion, with consequent increases in urinary potassium and bicarbonate loss, and decreases in serum potassium. Absorption: Absorption of telmisartan is rapid although the amount absorbed varies. The mean absolute bioavailability for telmisartan is about 50%. Distribution:telmisartan largely bound to plasma protein (>99.5%), mainly albumin and α1-acid glycoprotein. Hydrochlorothiazide is 64% protein bound in the plasma Metabolism: telmisartan by conjugation to the glucuronide. No pharmacological activity has been shown for the conjugate Hydrochlorothiazide not metabolised in man Excretion: telmisartan is nearly exclusively excreted with the faeces, mainly as unchanged compound. Cumulative urinary excretion is <1% of dose Hydroclorithiazide excreted almost entirely as unchanged drug in urine Administration May be taken with or without food

111. Minipress
112. Mixtard
113. Mixture Carminative
114. Modecate
115. Moduretic

     Generic name: Amiloride HCl 5 mg, hydrochlorothiazide 50 mg ROA: oral Dose: HTN & oedema of cardiac origin 1-2 tab once/day or in divided doses. Max: 4 tab/day. Hepatic w/ ascites 1 tab once/day. Max: 4 tab/day. Indication: HTN, oedema of cardiac origin & hepatic cirrhosis w/ ascites & edema. Suspected or anticipated K depletion. Side effect: Headache, weakness, nausea, anorexia, rash & dizziness; orthostatic effects. Contraindication: Hyperkalemia, other concomitant antikaliuretic therapy or K supplementation, renal insufficiency. Pregnancy, lactation, childn. Pregnancy: B MOA: Moduretic (hydrochlorothiazide and amiloride HCl, MSD) is a diuretic/antihypertensive combining the potent natriuretic action of hydrochlorothiazide with the potassium-conserving property of amiloride HCl. Administration: should taken with food

116. Morphine inj

     Generic name: morphine ROA and Dosage: PO Pain relief 5-20 mg 4 hrly. Intractable cough associated w/ lung cancer As oral soln: Initial: 5 mg 4 hrly. IV Pain associated w/ MI 10 mg, then a further dose of 5-10 mg if needed. Acute pulmonary oedema 5-10 mg. Unstable angina unresponsive to anti-ischaemic therapy 2-5 mg repeated every 5-30 mins as needed. Acute pain Initial: 2.5 mg 4 hrly, adjust according to response. IM/SC Acute pain 10 mg 4 hrly, adjust according to response. Premed in surgical procedures Up to 10 mg 60-90 mins pre-op. Analgesia during labour 10 mg. Intrathecal Moderate to severe pain 0.2-1 mg on a single occasion. Intraspinal Moderate to severe pain Initial: 5 mg epidural inj; after 1 hr, additional doses of 1-2 mg may be given if needed. Total dose: 10 mg/24 hr. Rectal Chronic pain As supp: 15-30 mg 4 hrly. Indication: listed in dosage Side effect: Convulsions; nausea, vomiting, dry mouth, constipation; urinary retention; headache, vertigo; palpitations; hypothermia; pruritus, urticaria; tachycardia, bradycardia; blurred vision; miosis; dependency; drowsiness; lightheadedness; dizziness; sweating; dysphoria; euphoria. Potentially Fatal: Respiratory depression; circulatory failure; hypotension; deepening coma; anaphylactic reactions Contraindication: Respiratory depression, acute or severe asthma; paralytic ileus; obstructive airway disease; acute liver disease; comatose patients; increased intracranial pressure; acute alcoholism. Pulmonary oedema resulting from a chemical respiratory irritant. Pregnancy: C MOA: Morphine is a phenanthrene derivative which acts mainly on the CNS and smooth muscles. It binds to opiate receptors in the CNS altering pain perception and response. Analgesia, euphoria and dependence are thought to be due to its action at the mu-1 receptors while respiratory depression and inhibition of intestinal movements are due to action at the mu-2 receptors. Spinal analgesia is mediated by morphine agonist action at the K receptor. Cough is suppressed by direct action on cough centre. Administration: May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)

117. Mycostatin Tab
118. Mycostatin Cream
119. Naprosyn
120. Narcan
121. Neo-mercazole
122. Nitro-bid
123. Nolvadex
124. Norvas
125. Nuelin
126. Oral Rehydration Salt
127. Orbenin Cap
128. Oroxine
129. Panadol Syrup/ Tab

     syrup/tablet panadol Generic name-acetaminophen Routes of administration-Oral Dose/freq-1 mg tds, up to 4 mg/day Indication- relief of headache, fever, pain,& discomfort due to cold/flu & following dental procedures. Side effect-rash and other allergic reaction contraindication-contraindicated for use in patients with known hypersensitivity or idiosyncratic reaction to it. Pregnancy category-B Special precaution-Renal & hepatic failure Mode of action-it is a p-aminophenol derivative that exhibits analgesic and antipyretic activity. It does not possess anti-inflammatory activity and thought to produce analgesia through a central inhibition of prostaglandin synthesis. - is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 10 to 60 minutes after oral administration, it is metabolised extensively in the liver and excreted in the urine mainly as inactive glucuronide and sulfate conjugates. Less than 5% is excreted unchanged. administration-Can be taken before or after meals

130. Papase
131. Pariet
132. Parlodel
133. Penadur L.A.
134. Penbritin Syrup
135. Penglobe
136. Penicillin V Tab
137. Persantin
138. Pethidine inj
139. Phenergan inj
140. Piriton inj
141. Piriton Syp/ Tab
142. Polycitra Syr
143. Ponstan

     Generic name: mefenamic acid Dosage:Adult 500 mg tds. Childn ≥6 mth 19.5-25 mg/kg in divided doses. Indication: Relief of mild to moderate pain including muscular, traumatic & dental pain, headache of most aetiology, dysmenorrhoea, post-op & post-partum pain. Pyrexia in childn. RA, osteoarthritis, menorrhagia. Group: NSAID Pharmacodynamic: An analgesic with anti-inflammatory properties, and a demonstrable antipyretic effect. It has also been shown to inhibit prostaglandin activity. Side effects:Diarrhoea, skin rash, allergic glomerulonephritis, non-oligouric renal failure. Rarely, thrombocytopenia, reversible haemolytic anaemia, bronchospasm. Contraindications:GI ulceration or inflammatory bowel disease. Renal or hepatic impairment Safety in pregnancy:category C Special instruction whilst dispensing the drug:Should be taken with food (Take immediately after meals.)

144. Potassium Chloride inj
145. Prednisolone Tab
146. Primaquine
147. Propylthiouracil
148. Provera
149. Pulmicort, Inflammide
150. Pyrazinamide
151. Renitec
152. Riboflavine
153. Rifadin
154. Salazopyrin
155. Salicylic Acid Ointment
156. Serenace Tab

     Generic name: Haloperidol Group: Antipsychotics / Antivertigo Drugs Indication and Dosage: Adult: PO Psychoses 0.5-5 mg 2-3 times/day, up to 100 mg/day in severe cases. Maintenance: 3-10 mg/day. Severe tics; Tourette's syndrome Initial: 0.5-1.5 mg 3 times/day, up to 10 mg/day in Tourette's syndrome. Adjunct in severe anxiety or behavioral disturbances 0.5 mg twice daily. Restlessness and confusion 1-3 mg 8 hrly. Intractable hiccup 1.5 mg 3 times/day. Administration: May be taken with or without food. (May be taken w/ meals to minimise GI irritation.) Pharmacodynamics: Haloperidol blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system and decreases the release of hypothalamic and hypophyseal hormones. It produces calmness and reduces aggressiveness with disappearance of hallucinations and delusions. Pharmacokinetics: Absorption: Readily absorbed from the GI tract (oral). Distribution: Crosses the blood-brain barrier; enters breast milk. Protein-binding: 92%. Metabolism: Hepatic via oxidative N-dealkylation and reduction of the ketone group; undergoes enterohepatic recycling. Excretion: Urine and faeces; 12-38 hr (elimination half-life). Side effects: Tardive dyskinesia; extrapyramidal reactions. Anxiety, drowsiness, depression, anorexia, transient tachycardia, postural hypotension, leukopenia; anticholinergic side effects. Potentially Fatal: Neuroleptic malignant syndrome. Contraindications: Severe toxic CNS depression; preexisting coma; Parkinson's disease; lactation. Special precautions: Parkinsonism; epilepsy, allergy, angle-closure glaucoma, benign prostatic hyperplasia; severe cardiac or hepatic disease; extremes in temp (hot and cold weather); presence of acute infections or leucopenia; hyperthyroidism; pregnancy, elderly, children. Patients receiving anticoagulants. Discontinue upon signs of neurological toxicity in patients taking haloperidol and lithium. In pregnancy: Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus. Drug interactions: Carbamazepine and rifampicin reduce plasma concentrations. Symptoms of CNS depression may be enhanced by CNS depressants e.g. alcohol, hypnotics, general anaesthetics, anxiolytics and opioids. May reduce antihypertensive action of guanethidine. May increase risk of arrhythmia when used with drugs that prolong QT interval or diuretics that can cause electrolyte imbalance. May increase plasma levels of haloperidol when used with clozapine or chlorpromazine. Potentially Fatal: Increases lithium blood levels and may predispose to neuroleptic malignant syndrome

157. Sinemet

     Generic name: Carbidopa and levodopa Contents: Per Sinemet 25/100 tab Carbidopa 25 mg, levodopa 100 mg. Per Sinemet 25/250 tab Carbidopa 25 mg, levodopa 250 mg. Per Sinemet CR 50/200 tab Carbidopa 50 mg, levodopa 200 mg. Group: Antiparkinsonian Drugs Dosage: Initial therapy: 1 tab of Sinemet 25/100 tds providing 75 mg of carbidopa/day. Maintenance Therapy should be individualized & adjusted according to the desired therapeutic response. At least 70-100 mg of carbidopa/day should be provided for optimal inhibition of extracerebral decarboxylation of levodopa Indication: Treatment of Parkinson's disease & syndrome. Patients w/ Parkinsonism taking vit B6 prep. Administration: Should be taken on an empty stomach (Take on an empty stomach if possible. If GI distress occurs, take w/ meals. CR tab: Swallow whole, do not chew/crush. 50/200 CR tab may be halved along the score-line only.). Pharmacodynamics: Sinemet CR is particularly useful to reduce "off" time in patients treated previously with a conventional levodopa/decarboxylase inhibitor combination who have had predictable peak-dose dyskinesias, and unpredictable motor fluctuations. Patients with Parkinson's disease treated with preparations containing levodopa may develop motor fluctuations characterized by end-of-dose failure, peak dose dyskinesia and akinesia. The advanced form of motor fluctuations ("on-off" phenomenon) is characterized by unpredictable swings from mobility to immobility. Although the causes of the motor fluctuations are not completely understood, it has been demonstrated that they can be attenuated by treatment regimens that produce steady plasma levels of levodopa. Levodopa relieves the symptoms of Parkinson's disease by being decarboxylated to dopamine in the brain. Carbidopa, which does not cross the blood-brain barrier, inhibits the extracerebral decarboxylation of levodopa, making more levodopa available for transport to the brain and subsequent conversion to dopamine. This normally obviates the necessity for large doses of levodopa at frequent intervals. The lower dosage reduces or may help eliminate gastrointestinal and cardiovascular side effects, especially those which are attributable to dopamine being formed in extracerebral tissues. Pharmacokinetics: Sinemet CR is designed to release the active ingredients over a 4- to 6-hr period. With this formulation, there is less variation in plasma levodopa levels and the peak plasma level is 60% lower than with conventional Sinemet. In clinical trials, patients with motor fluctuations experienced reduced "off" time with Sinemet CR when compared with Sinemet. Global ratings of improvement and activities of daily living in the "on" and "off" state, as assessed by both patient and physician, were better during therapy with Sinemet CR than with Sinemet. Patients considered Sinemet CR to be more helpful for their clinical fluctuations, and preferred it over Sinemet. In patients without motor fluctuations, Sinemet CR, under controlled conditions, provided the same therapeutic benefit with less frequent dosing than with Sinemet. Sinemet 25/100/Sinemet 25/250 improves overall therapeutic response as compared to levodopa. Sinemet provides effective long-lasting levodopa plasma levels at doses that are approximately 80% lower than those needed with levodopa alone. While pyridoxine HCl (vitamin B6) is known to accelerate the peripheral metabolism of levodopa to dopamine, carbidopa prevents this action Side effects: Dyskinesias, including choreiform, dystonic, & other involuntary movements & nausea. Muscle twitching & blepharospasm may be taken as early signs to consider dosage reduction. Syncope, chest pain, anorexia, cardiac irregularities &/or palpitation, orthostatic effects including hypotensive episodes, HTN, phlebitis, vomiting, GI bleeding, development of duodenal ulcer, diarrhea, dark saliva, leukopenia, hemolytic & non-hemolytic anemia, thrombocytopenia, agranulocytosis, angioedema, urticaria, pruritus, Henoch-Schonlein purpura, neuroleptic malignant syndrome, bradykinetic episodes (the "on-off" phenomenon), dizziness, somnolence including very rarely excessive daytime somnolence & sudden sleep onset episodes, paresthesia, psychotic episodes including delusions, hallucinations & paranoid ideation, depression w/ or w/o development of suicidal tendencies, dementia, dream abnormalities, agitation, confusion, increased libido, dyspnea, alopecia, rash, dark sweat, dark urine. Rarely, convulsions. Contraindications: MAOIs must be discontinued at least 2 wk prior to initiating therapy. May be administered concomitantly w/ an MAOI w/ selectivity for MAO type B (eg selegiline HCl). Hypersensitivity. Narrow-angle glaucoma. Should not be used in patients w/ suspicious undiagnosed skin lesions or a history of melanoma. Special precautions: Not recommended for treatment of drug-induced extrapyramidal reactions. The occurrence of dyskinesias in patients previously treated w/ levodopa alone may require dosage reduction. Dosage reduction may be required when involuntary movements & mental disturbances occur. All patients should be observed carefully for the development of depression w/ concomitant suicidal tendencies. Caution in patients w/ past or current psychoses. Use cautiously w/ psychoactive drugs. Severe CV or pulmonary disease, bronchial asthma, renal, hepatic or endocrine disease, or a history of peptic ulcer disease or of convulsions, history of MI & residual atrial, nodal, or ventricular arrhythmia, chronic wide-angle glaucoma. Observe carefully when the dosage is reduced abruptly or discontinued, esp if the patient is receiving neuroleptics. Patients should be informed of sudden onset of sleep during daily activities & advised to exercise caution while driving or operating machines during treatment w/ levodopa. Periodic evaluations of hepatic, hematopoietic, CV & renal function are recommended during extended therapy. Pregnancy, women of childbearing potential, lactation. Not recommended in patients <18 yr. Drug interactions: Antihypertensive agents; antidepressants: MAOIs; Fe; dopamine D2 receptor antagonists (eg phenothiazines, butyrophenones & risperidone) & INH, phenytoin & papaverine, selegiline & high protein diet. Use in pregnancy: Although the effects of Sinemet/Sinemet CR on human pregnancy are unknown, both levodopa and combinations of carbidopa and levodopa have caused visceral and skeletal malformations in rabbits. Therefore, use of Sinemet/Sinemet CR in women of childbearing potential requires that the anticipated benefits of the drug be weighed against possible hazards should pregnancy occur. Use in lactation: It is not known whether carbidopa is excreted in human milk. In a study of 1 nursing mother with Parkinson's disease, excretion of levodopa in human breast milk was reported. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in infants, a decision should be made whether to discontinue nursing or to discontinue the use of Sinemet/Sinemet CR, taking into account the importance of the drug to the mother

158. Slow-K

     Generic name: Potassium Chloride (KCL) Group: Electrolytes Dosage: Slow-K 600 mg: Adult 2-3 tab daily. In severe deficiency 9-12 tab daily. Indication: Potassium (K) deficiency Administration: Should be taken with food (Swallow whole, do not chew/crush.). Side effects: GI upsets. Contraindications: Hyperkalaemia. Marked renal failure. Concomitant treatment w/ K-sparing diuretics & patients in whom there is cause for arrest or delay in tab passage through the GI. Special precautions: Renal impairment. GI lesions. Treatment w/ ACE inhibitors or anticholinergics. Metabolic acidosis, history of peptic ulcer. Pregnancy. Monitor plasma electrolytes during prolonged therapy. Acute dehydration. Drug interactions: ACE inhibitors, cyclosporin, NSAIDs, β-blockers, heparin, digoxin, K-sparing diuretics

159. Sodium Bicarbonate inj

     Generic name: Sodium bicarbonate Group: Antidotes, Detoxifying Agents & Drugs Used in Substance Dependence Dosage: Cardiac arrest Initially 44.6-100 mEq by rapid IV. Less urgent metabolic acidosis : Adult & older childn 2-5 mEq/kg over 4-8 hr. Infant ≤2 yr & neonate 4.2% soln given IV, max 8 mEq/kg/day. Indication: Treatment of metabolic acidosis, drug intoxication, poisoning by salicylates or methyl alcohol, hemolytic reactions requiring alkalinization of urine, severe diarrhea. Pharmacodynamics: Intravenous sodium bicarbonate therapy increases plasma bicarbonate, buffers excess hydrogen ion concentration, raises blood pH and reverses the clinical manifestations of acidosis. Pharmacokinetics: Sodium bicarbonate in water dissociates to provide sodium (Na+) and bicarbonate (HCO3¯ ) ions. Sodium (Na+) is the principal cation of the extracellular fluid and plays a large part in the therapy of fluid and electrolyte disturbances. Bicarbonate (HCO3¯ ) is a normal constituent of body fluids and the normal plasma level ranges from 24 to 31 mEq/liter. Plasma concentration is regulated by the kidney through acidification of the urine when there is a deficit or by alkalinization of the urine when there is an excess. Bicarbonate anion is considered “labile” since at a proper concentration of hydrogen ion (H+) it may be converted to carbonic acid (H2CO3) and thence to its volatile form, carbon dioxide (CO2) excreted by the lung. Normally a ratio of 1:20 (carbonic acid; bicarbonate) is present in the extracellular fluid. In a healthy adult with normal kidney function, practically all the glomerular filtered bicarbonate ion is reabsorbed; less than 1% is excreted in the urine. Side effects: Metabolic alkalosis, hypernatremia. Tissue necrosis, ulceration or sloughing at inj site. Contraindications: Chloride loss due to vomiting, continuous GI suction or patients on diuretics producing hypochloremic alkalosis. Special precautions: CHF, edema w/ Na retention, oliguria, anuria, renal impairment. Concomitant treatment w/ corticosteroids or corticotropin. Pregnancy. Neonates & childn <2 yr. In pregnancy : Teratogenic Effects. Pregnancy Category C. Animal reproduction studies have not been conducted with sodium bicarbonate. It is also not known whether sodium bicarbonate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium bicarbonate should be given to a pregnant woman only if clearly needed. Drug interactions: Norepinephrine, dobutamine, Ca-containing soln

160. Statex inj

     Generic name: Morphine sulfate Group: Analgesics (Opioid) Dosage: I.M. or subcutaneous use – Adults: 5 to 20 mg/70 kg I.M. or subcutaneously q 4 hours p.r.n. I.V. use - Adults: 2 to 10 mg/70 kg I.V. p.r.n. given slowly over 4 to 5 minutes. As a continuous I.V. infusion, 0.1 to 1 mg/ml in dextrose 5% in water delivered by controlled-infusion device. Indication: Relief of moderate to severe pain, as a pre-op medication & as an analgesic adjunct in general anaesth. Administration: For best response, give at pain onset. • Give oral form with food or milk to minimize GI upset. • If desired, crush immediate-release form and mix with food or fluids. • Don't crush or break extended-release form; remind patient to swallow it whole. • If desired, open sustained-release capsules (Kadian) and sprinkle entire contents onto small amount of food (such as applesauce). Have patient consume mixture immediately without chewing, crushing, or dissolving pellets. • When giving by direct I.V., dilute in at least 5 ml of sterile water for injection or normal saline solution. Give 2.5 to 10 mg over 4 to 5 minutes. • For continuous I.V. infusion, use infusion pump or PCA pump. Titrate dosage to provide adequate pain relief. • Don't use parenteral form if it's cloudy or contains visible particulates. Pharmacodynamics: Interacts with opioid receptor sites, primarily in limbic system, thalamus, and spinal cord. This interaction alters neurotransmitter release, altering perception of and tolerance for pain. Side effects: CNS: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, nightmares CV: hypotension, bradycardia EENT: blurred vision, diplopia, miosis GI: nausea, vomiting, constipation, dry mouth GU: urinary retention Respiratory: apnea, respiratory depression, respiratory arrest Skin: flushing, itching, sweating Other: physical or psychological drug dependence, drug tolerance Contraindications: Hypersensitivity to drug, tartrazine, bisulfites, or alcohol • Acute bronchial asthma • Upper airway obstruction • Respiratory depression • GI obstruction, paralytic ileus Special precautions: Use cautiously in: • head trauma; increased intracranial pressure; severe renal, hepatic, or pulmonary disease; hypothyroidism; adrenal insufficiency; prostatic hypertrophy • elderly or debilitated patients • pregnant or breastfeeding patients. Drug interactions: Antihistamines, barbiturates, clomipramine, sedative-hypnotics, tricyclic antidepressants: additive CNS depression Buprenorphine, butorphanol, dezocine, nalbuphine, pentazocine: decreased analgesia Cimetidine: decreased morphine metabolism and increased effects MAO inhibitors: severe, unpredictable reactions Mixed opioid agonist-antagonists: precipitation of withdrawal symptoms in physically dependent patients Warfarin: increased anticoagulant effect

161. Stemetil inj
162. Stemetil Tab
163. Streptomycin inj
164. Stugeron
165. Tegretol
166. Tenormin
167. Tetanus Toxoid inj
168. Thiamine Tab
169. Ticlid
170. Tofranil
171. Trandate Tab
172. Transamin Cap
173. Trental
174. Valium inj
175. Valium Rectal 5mg
176. Valium Tab 2mg
177. Vaseline
178. Ventolin inhalation solution

     Generic name:Salbutamol sulfate Dosage:Relief of bronchospasm Tab/Syr Adult 4 mg, childn >12 yr 2-4 mg, 6-12 yr 2 mg, 2-6 yr 1-2 mg. Management of premature labor Tab 4 mg. Doses to be given tds-qds. Evohaler Prevention of allergen/exercise-induced bronchospasm Adult 1-2 puffs, childn 1 puff. Chronic therapy Adult & childn Max of 2 puffs qds. Respirator soln Intermittent treatment: Adult & childn Dilute 2.5-5 mg up to 2 or 2.5 mL final vol, then nebulise for 3-5 min. Max of 10 mg. Continuous administration: Dilute 50-100 mcg/mL then administer as aerosol at rate of 1-2 mg/hr. Nebules 2.5 mg, may increase to 5 mg. Inj Severe bronchospasm & status asthmaticus Adult Slow IV: 250 mcg, SC/IM: 500 mcg 4 hrly. Infusion Severe bronchospasm & status asthmaticus 3-20 mcg/min. Management of premature labor 10-45 mcg/min. Indication: Tab/Syr/Evohaler Relief & prevention of bronchospasm in bronchial asthma, chronic bronchitis, emphysema, acute dyspnoea. Tab Maintenance in premature labour. Respirator soln/Nebules Status asthmaticus & other forms of severe bronchospasm where intermittent +ve pressure ventilation is required. Inj Severe bronchospasm & status asthmaticus. Maintenance in premature labour. Group: anti-asthmatic Pharmacodynamic: Salbutamol is a selective β2-adrenoreceptor agonist. At therapeutic doses, it acts on the β2-adrenoreceptors of bronchial muscle, with little or no action on the β1-adrenoreceptors of cardiac muscle. It is suitable for the management and prevention of attack in asthma.Brochodilators should not be the only or main treatment in patients with severe or unstable asthma. Severe asthma requires regular medical assessment as death may occur. Patients with severe asthma have constant symptoms and frequent exacerbations, with limited physical capacity, and PEF values <60% predicted at baseline with >30% variability, usually not returning entirely to normal after a bronchodilator. These patients will require high dose inhaled (eg, >1 mg/day beclomethasone dipropionate) or oral corticosteroid therapy. Sudden worsening of symptoms may require increased corticosteroid dosage which should be administered under urgent medical supervision. Pharmacokinetic: Absorption: After oral administration, salbutamol is absorbed from the gastrointestinal tract and undergoes considerable first-pass metabolism to the phenolic sulfate. Both unchanged drug and conjugate are excreted primarily in the urine. The bioavailability of orally administered salbutamol is about 50%.Distribution: After administration by the inhaled oral route between 10% and 20% of the dose reaches the lower airways. The remainder is retained in the delivery system or is deposited in the oropharynx from where it is swallowed.The fraction deposited in the airways is absorbed into the pulmonary tissues and circulation but is not metabolised by the lungs.Salbutamol is bound to plasma-protiens to the extent of 10%.Metabolism: Upon reaching the systemic circulation, it becomes accessible to hepatic metabolism and is excreted, primarily in the urine, as unchanged drug and as the phenolic sulfate.The swallowed portion of the inhaled dose is absorbed from the gastrointestinal tract and undergoes considerable first-pass metabolism to the phenolic sulfate. Both unchanged drug and conjugate are excreted primarily in the urine.Elimination: Salbutamol administered IV has a half-life of 4-6 hrs and is cleared partly renally and partly by metabolism to the inactive 4'-0-sulfate (phenolic sulfate) which is also excreted primarily in the urine. The faeces are a minor route of excretion. The majority of a dose of salbutamol given IV, orally or by inhalation is excreted within 72 hrs. Salbutamol is bound to plasma proteins to the extent of 10%. Side effects:Fine tremor of skeletal muscle, feelings of tension, peripheral vasodilation, tachycardia, palpitations, cardiac arrhythmias, headache, transient muscle cramps, hypersensitivity reactions, potentially serious hypokalaemia, hyperactivity in childn. Inhaled salbutamol may cause paradoxical bronchospasm, & mouth & throat irritation Contraindications:Threatened abortion during 1st or 2nd trimesters of pregnancy. Toxaemia of pregnancy, placenta praevia, antepartum haemorrhage, placenta praevia. Safety in pregnancy:category C

179. Ventolin Inhaler
180. Ventolin Tab
181. Ventolin Syp
182. Vibramycin
183. Vitamin C
184. Volteran Tab
185. Xylocaine inj
186. Xylocaine Jelly
187. Xylocard inj
188. Zantac inj
189. Zantac Tab
190. Zentel 200mg Tab/ Syp
191. Zocor
192. Zovirax Tab Tab
193. Zyloric

During your sittings with the Pharmacist, please find out what are each of the drug's:

1. Generic Name
2. Dosage
3. Indication
4. Group
5. Pharmacodynamics (what a drug does to the body)
6. Pharmacokinetics (what the body does to the drug)
7. Side effects
8. Contraindications
9. Safety in Pregnancy and in Children
10. Special instructions given by Pharmacist to the patient whilst dispensing the drug