Treatment of following major Infections {Ceftriaxone}

Ceftriaxone Sodium USP.

Description:

Ceftriaxone is a board spectrum parenteral third generation cephalosporin antibiotic. The drug is highly resistant to bacterial beta-lactamase and has a good activity against many gram-positive and gram-negative aerobic and some anaerobic bacteria. It inhibits bacterial cell wall synthesis in a manner similar to that of penicillin.

Indication:

Ceftriaxone is indicated for the treatment of the following major infections when caused by susceptible organisms: 1.Renal & urinary tract infection;

2. Lower respiratory tract infection particularly pneumonia;

3. Gonococcal infection; 4.Skin, soft tissue, bone & joint infection;

5.Bacterial meningitis;

6.Serious bacterial infection e.g. septicemia; 7.ENT infection;

8.Infection in cancer patients; 9.Prevention of postoperative infection;

10.Pre-operative prophylaxis of infection associated with surgery;

11.Typhoid fever.

Dosage and Administration:

Adult: It is usually given to adults in a dose of 1 to 2 gm daily as a once daily dose or in two divided doses depending on the type and severity of infection. In severe infection up to 4 gm daily may be given. A single intramuscular dose of 250 mg is recommended for the treatment of uncomplicated gonorrhea in adult. For surgical prophylaxis in adults, single dose of 1 gm may be administered 0.5 to 2 hours prior to surgery.

Children: Suggested doses for infants and children are 50 to 75 mg per kg body weight once a day; for severe infection up to 80 mg per kg body weight daily may be given.

Neonates: The maximum dose should not exceed 50 mg per kg; intravenous doses in neonates should be given over 60 minutes.

Duration of Therapy: The duration of therapy varies according to the course of the diseases be continued for a minimum of 48-72 hours after the patients has become a febrile or evidence of bacterial eradication has been obtained.

Side effect:

Well tolerated, side effects are relatively infrequent, usually mild and transient. The most common side

Effects are gastro-intestinal consisting mainly of loose stool, diarrhea, nausea, vomiting steatites and

glossitis.

Contra-indication:

Ceftriaxone sodium should not give in patients with a history of hypersensitivity to cephalosporin antibiotics. It is contraindicated in premature infants and in full- term infants during the first 6 weeks of life

Treatment of Osteoarthritis of fingers, shoulder joints & weight bearing joints of the body.{Glucosamine + Chondroitin}

Glucosamine Sulfate 250 mg as Glucosamine Sulfate Potassium Chloride USP & Chondroitin Sulfate 200 mg as Chondroitin Sulfate Sodium

USP.

PHARMACOLOGY:

Glucosamine (2-amino-2-deoxy-alpha-D-glucose) is a natural amino-sugar, produced by the body and found in certain foods. It is the most fundamental building block required for biosynthesis of glycosaminoglycans (GAGs) like Hyaluronic Acid, Keratan Sulfate, and Chondroitin Sulfate. GAGs binds with protein and form proteoglycans, the essential building block of articular cartilage. When cartilage in a joint deteriorates, Osteoarthritis develops. It also helps to form ligaments, tendon, nails, and various other connective tissues. When we take artificially synthesized Glucosamine Sulfate supplement, it increases Glucosamine level in the body, thus facilitates production and repair of cartilage. Glucosamine also activates chondrocytes in the cartilage which help produce GAGs and proteoglycans.

Chondroitin Sulfate is a glycosaminoglycan (acid muco-polysaccharide) found in connective tissue, especially in the articular cartilage of all mammals. Chondroitin Sulfate supplement acts similarly as Glucosamine Sulfate, since it also provide substrate for proteoglycans. Chondroitin also protects existing healthy cartilage from premature decline by preventing the MMP (Matrix metalloproteinase) enzyme that breakdowns the proteoglycans. Combining Glucosamine with Chondroitin Sulfate shows synergistic effect. Data supports that this combination has been shown to be very much effective in severe cases of Osteoarthritis that treats both sign and symptoms of Osteoarthritis & modifies disease progression. It prevents

Osteoarthritis in case of normal adults. In Osteoarthritic pain it is as effective as NSAIDs with significantly better tolerability and clinical compliance. It is also helpful during the repair phase

of musculo-skeletal soft tissue injuries such as tendon or ligament strains.

INDICATION:

Treatment of Osteoarthritis of fingers, shoulder joints & weight bearing joints of the body. As a dietary supplement to prevent Osteoarthritis.

DOSAGE AND ADMINISTRATION

1 - 2 tablets, three times daily. Dose may be adjusted according to the response of the drug and body weight. Doses can be tapered after 60 days as per requirement of the individual and for cost convenience. Typical dosage recommendation, based on body weight is as follows-

Under 54 Kg: 800 mg Chondroitin Sulfate & 1000 mg Glucosamine Sulfate per day

54 Kg - 91 Kg: 1200 mg Chondroitin Sulfate & 1500 mg Glucosamine Sulfate per day

Over 91 Kg: 1600 mg Chondroitin Sulfate & 2000 mg Glucosamine Sulfate per day

CONTRAINDICATION:

There is no known contraindication to Glucosamine or Chondroitin. But proven hypersensitivity to these ingredients is a contraindication.

PRECAUTION:

Patients with Diabetes Mellitus are advised to monitor blood glucose levels regularly when taking Glucosamine. No special studies were formed in patients with renal or hepatic insufficiency. The toxicological and pharmacokinetic profile of Glucosamine and Chondroitin does not indicate limitations for these patients. However, administration to patients with severe hepatic or renal insufficiency should be under appropriate medical supervision. Children should not be supplemented with Glucosamine and Chondroitin.

SIDE EFFECT: Safety studies with Glucosamine Sulfate & Chondroitin Sulfate show no demonstrable side effects.Rarely occurring side effects (such as, mild & reversible intestinal flatulence) are almost like placebo.

USE IN PREGNANCY & LACTATION: Women who are pregnant or who could become pregnant should not supplement with Glucosamine Sulfate or Chondroitin Sulfate. Glucosamine and Chondroitin has not been studied enough to determine their effects on a developing fetus. No studies have evaluated the use of Glucosamine and Chondroitin during pregnancy or lactation. It should be taken with caution and medical advice during pregnancy and lactation.

Treatment of vascular headaches, classical migraine {Pizotifen}

Pizotifen Tablet: Each film-coated tablet contains Pizotifen Malate BP 0.725 mg equivalent to Pizotifen 0.50 mg

Pizotifen TS Tablet: Each film-coated Tablet contains Pizotifen Malate BP 2.175 mg equivalentto Pizotifen 1.50 mg

Pharmacology: Pizotifen is a tricyclic compound possessing structural similarities tocyproheptadine and the tricycles n antidepressants. The prophylactic effect of Pizotifen in migraine is associated with its ability to modify the humeral mechanisms of headache. It inhibits the permeability increasing effect of serotonin and histamine on the affected cranial vessels, thereby checking the transudation of plasmakinin so that the pain threshold of the receptors is maintained at normal levels. In the sequence of events leading to the migraine attack, depletion

of plasma serotonin contributes to loss of tone in the extracranial vessels. Pizotifen inhibits serotonin re-uptake by the platelets, thus maintaining plasma serotonin and preventing the loss of tone and passive diffusion of the extra cranial arteries.

Indication: Pizotifen is indicated in the Prophylactic treatment of recurrent vascular headaches, including classical migraine, common migraine and cluster headache.

Dosage and administration:

Adults: Usually 1.5 mg daily at night as a single dose or in three divided doses. Dosage should be adjusted to individual patient’s requirements up to a maximum of 4.5 mg daily. Maximum single daily dose at night 3 mg.

Children: Up to 1.5 mg daily, usually as a divided dose. Use of 1.5 mg at a time is not recommended, but up to 1 mg has been given as a single daily dose at night

Local treatment anti- Inflammatory and analgesic gel {diclofenac &Naproxen}

Description:

                 Diclofenac &Naproxen gel is an anti- Inflammatory, analgesic preparation designed for external use. The nongreasy gel preparation can easily be rubbed into the skin, which exerts soothing and cooling effects. When applied locally, the active substance penetrates the skin, accumulates the underlying tissue and controls both acute and chronic inflammatory reactions. In presence of traumatic or rheumatic inflammation, diclofenac &Naproxen gel reduces inflammatory swelling and also provides effective relief from tenderness and pain on movement.

 

Indication:

diclofenac &Naproxen gel is indicated for local treatment of traumatic inflammation of tendons, ligaments, muscles and joints due to sprains, strains and bruises and in localized forms of soft tissue rheumatism, e.g. tenosynovitis and bursitis. Also indicated in localized rheumatic disease e.g.

osteoarthrosis of peripheral joints and of the vertebral column periarthropathy.

Dosage and Administration:

Depending on the size of the area to be treated, 2-4 gm of diclofenac &Naproxen gel should be applied to the skin 3-4 times daily to the affected area gently. diclofenac &Naproxen gel may also be given in addition to treatment with other dosage forms of diclofenac &Naproxen.

Precaution:

diclofenac &Naproxen gel should be applied only to the intact skin surface and not to skin wounds or open injury. It shouldn't come in contact with eyes or mucous membrane. After application the hand should be washed well. It shouldn't be taken by mouth.

Contraindication:

diclofenac &Naproxen gel should not be given to the patient hypersensitive to diclofenac &Naproxen, Aspirin or other NSAIDs. In view of insufficient clinical data diclofenac &Naproxen gel is not recommended during pregnancy.

Side effect:

diclofenac &Naproxen gel is well tolerated. Reddening of the skin and skin rash may occasionally occur. Photosensitivity reactions have been observed in isolated cases, when applied to relatively large area of skin over prolonged period

Non-steroidal antiinflammatory drugs (NSAID) Diclofenac

Description:

Diclofenac Sodium is one of the most important member of non-steroidal

antiinflammatory drugs (NSAID). After taking Diclofenac, it absorbs from gastrointestinal tract and achieves peak plasma concentration within 2 hours. It inhibits the bio-synthesis of prostaglandin and thus acts as an analgesic.

Indication:

Diclofenac is indicated for Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute gout,lowback pain, dental pain, post operative pain, dysmenorrhoea, biliary colic etc. and other acute musculo-skeletal disorders such as: frozen shoulder, tendonitis, teno-synovitis, bursitis, sprain, strain and dislocation.

Dosage and Administration:

1 tablet 3 times daily after meal or 1 SR Capsule once daily. In severe cases, two SR capsule may be given at 12 hour interval.

Precaution:

This type of drug should be given with caution in pregnant woman, lactating mother and those patients having a history of liver and kidney dysfunction and peptic ulcer.

Contraindication:

Diclofenac is contraindicated in patients with peptic ulcer and in patients with known hypersensitivitis to Diclofenac. Besides if asthmatic attack increases due hypersensitivity to intake of Aspirin or this type of drug, in that case the drug must be avoided.

Side effect:

Disturbance in stomach and intestine eg. epigastric pain, nausea, diarrhoea, dizziness, headache etc. may occur. Occasionally skin rash, peripheral oedema and abnormalitis of serum transaminase have been reported.

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