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.

Online Doctor Services For Health: Treatment Pain and Inflammation in Osteoarthritis,...

Online Doctor Services For Health: Treatment Pain and Inflammation in Osteoarthritis,...:  Contraindication:                     Patients with known hypersensitivity to Etoricoxib or to any of the excipients of this medic...

Online Doctor Services For Health: Parenteral nutrition Treatment Of faster recovery ...

Online Doctor Services For Health: Parenteral nutrition Treatment Of faster recovery ...: Essential Amino Acids Specification Quantity L-Isoleucine USP 0.352 g L-Leucine USP 0.490 g L-Lysine Hydrochloride USP 0.430 g ...

Parenteral nutrition Treatment Of faster recovery in surgery, burns, renal insufficiency, hepatic insufficiency and effective management of cancer.{Amino Acid, D-Sorbitol and Electrolytes}

Essential Amino Acids Specification Quantity

L-Isoleucine USP 0.352 g

L-Leucine USP 0.490 g

L-Lysine Hydrochloride USP 0.430 g

L-Methionine USP 0.225 g

L-Phenylalanine USP 0.533 g

L- Threonine USP 0.250 g

L-Tryptophan USP 0.090 g

L-Valine USP 0.360 g

L-Histidine USP 0.250 g

L-Tyrosine USP 0.025 g

Non-Essential Amino Acids

L-Arginine USP 0.500 g

L-Aspartic Acid USP 0.250 g

L-Glutamic Acid BP 0.075 g

L-Alanine USP 0.200 g

L-Cysteine BP 0.010 g

Glycine USP 0.760 g

L-Proline USP 0.100 g

L-Serine USP 0.100 g

Carbohydrate

D-Sorbitol BP 5.000 g

Electrolytes (mmol/L)

Sodium (Na+) 35.5

Potassium (K+) 25.0

Magnesium (Mg++) 2.5

Chloride (CI-) 53.4

Acetate (CH3COO-) 25.0

Description

Amino Acid, D-Sorbitol and Electrolytes  is a sterile aqueous solution of crystalline Amino Acids and D-Sorbitol with electrolytes, which is

necessary as the nitrogen sources for parenteral nutrition. Nitrogen is provided in the form of essential and non-essential amino acids. The solution is clear, colorless, having a pH lying in the range of 5.7 to 7.0.

Clinical Pharmacology

Amino Acid, D-Sorbitol and Electrolytes contains all 18 essential and non-essential amino acid needed for protein synthesis. The amino acid composition is such that positive nitrogen balance can be achieved in the postoperative period and during extended periods of intravenous nutrition.

Indication

Amino Acid, D-Sorbitol and Electrolytes is indicated as a source of amino acids for protein synthesis in patients needing intravenous nutrition. Aminosin is particularly suitable for patients with basal amino acid requirements. Aminosin is also indicated in faster recovery in surgery, burns, renal insufficiency, hepatic insufficiency and effective management of cancer.

Dosage

Adult: The nitrogen requirement for maintenance of body protein mass depends on the patient's condition (nutritional state and degree of metabolic stress). The requirements are 0.10-0.15g nitrogen/kg/day (no or minor metabolic stress and normal nutritional state), 0.15-0.20g nitrogen/kg/day (moderate metabolic stress with or without malnutrition) and up to 0.20-0.25g nitrogen/kg/day (severe catabolism as in burns, sepsis and trauma). The dosage range 0.10-0.25g nitrogen/kg/day corresponds to 15-35 ml Aminosin/kg/day. In obese patients, the dose should be based on the estimated ideal weight. Depending upon patients requirements, 1000-2000 ml Aminosin may be infused intravenously per 24 hours. Aminosin should be infused slowly, at rates 1.4-2.8 ml (30-60 drops) per minute.

Infant and children:

In children and infants, the rate of infusion is 28-35 ml/kg body weight per day is recommended, with a step wise increase in the rate of administration during the first week.

Adverse Effect

Amino Acid, D-Sorbitol and Electrolytes is usually well tolerated. Nausea Occurs rarely. Vomiting, flushing and sweating have been observed during infusion of Aminosin at rates exceeding the recommended maximal rate. Transient

increases liver test during intravenous nutrition have been reported. The reasons are at present unclear.The underlying disease and the components and their amount in the intravenous feeding regimens have been suggested. Hypersensitivity reactions have been reported. As with all hypertonic infusion solution, thrombophlebitis may occur when peripheral veins are used. The Incidence may be reduced by the simultaneous infusion of 10% fat emulsion. If given to severely ill, premature infants, hyperphenylalaninemia may occur.

Contraindication

Amino Acid, D-Sorbitol and Electrolytes is contraindicated in patients with inborn errors of amino acids metabolism, irreversible liver damage and severe uremia when dialysis facilities are not available.

Use in Pregnancy

Successful and safe administration of amino acid solutions during pregnancy in the human has been reported. Animal reproduction studies have not been carried out with Amino Acid, D-Sorbitol and Electrolytes.

Drug Interaction

At the recommended dosage the amino acid in Aminosin solutions have no pharmacological effects and is not expected to interact with other medicaments.

Compatibility

Amino Acid, D-Sorbitol and Electrolytes containing amino acids should not be mixed with other preparations because of the increased risk of microbial contamination and incompatibility.

Precaution

Hyperphenylalaninemia has been noted in severely ill, premature infants. In these patients, monitoring of the phenylalanine levels is recommended and the infusion rate is adjusted as needed. Do not use if the solution is turbid or contains particles. Discard any unused portion 

Treatment Pain and Inflammation in Osteoarthritis, Rheumatoid Arthritis, Acute Gout and Ankylosing Spondylitis {Etoricoxib}

 Contraindication:

                    Patients with known hypersensitivity to Etoricoxib or to any of the excipients of this medicinal product, active peptic ulceration or gastro-intestinal bleeding, severe hepatic dysfunction, children under 16 years of age, inflammatory bowel disease, uncontrolled hypertension, breast feeding.

Indication:

Pain and Inflammation in Osteoarthritis, Rheumatoid Arthritis, Acute Gout and Ankylosing Spondylitis.

 

Dosage and Administration:

· Osteoarthritis, ADULT and CHILD over 16 years, 30 mg once daily, increased if necessary to 60 mg

once daily.

· Rheumatoid arthritis and ankylosing spondylitis, ADULT and CHILD over 16 years, 90 mg once daily.

· Acute gout, ADULT and CHILD over 16 years, 120 mg once daily for max. 8 days.

Precaution:

Decreased kidney function and liver function, dehydration, hypertension, history of heart failure,

perforation and people over 65 years of age.

Side Effect:

Dizziness, headache, gastro-intestinal disorders ( e.g. abdominal pain, flatulence, heart burn), palpitation,

fatigue, influenza-like symptoms, ecchymosis; less commonly dry mouth, taste disturbance, mouth ulcer,

appetite and weight change, atrial fibrillation, transient ischaemic attack, chest pain, flushing, cough,

dyspnoea, epistaxis, anxiety, mental acuity impaired, paraesthesia, electrolyte disturbance, myalgia and

arthralgia; very rarely confusion and hallucinations.

Drug Interaction:

Warfarin, ACE Inhibitor, Rifampicin, Lithium, Birth control pills, Methotrexate, Digoxin.

Use in Pregnancy and Lactation:

Not recommended.

Online Doctor Services For Health: Treatment Of Major Depressive illness Obsessive-co...

Online Doctor Services For Health: Treatment Of Major Depressive illness Obsessive-co...: DESCRIPTION Escitalopram is an orally administered Selective Serotonin Reuptake Inhibitor (SSRI). Escitalopram is the pure S-enant...

Treatment Of Major Depressive illness Obsessive-compulsive disorder Generalized anxiety disorder & Panic disorder {Escitalopram

DESCRIPTION

Escitalopram is an orally administered Selective Serotonin Reuptake Inhibitor (SSRI).

Escitalopram is the pure S-enantiomer of the recemic bicyclic phthalane derivative citalopram. Escitalopram is at least 100 fold more potent than the R-enantiomar with respect to inhibition of 5-HT reuptake and inhibition of 5-HT neuronal firing rate. Escitalopram has no or very low affinity for Serotonergic (5-HT1-7) or other receptors including alpha and beta-adrenergic, Dopamine (D1-5), Histamine (H1-3), Muscarinic (M1-5) and Benzodiazepine receptors.

INDICATION

Escitalopram is indicated for the treatment of major depressive disorder and maintenance therapy to prevent people with depression from suffering a relapse. A major depressive episode implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least five of the following nine symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor retardation or agitation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation.

DOSAGE AND ADMINISTRATION

Treatment Of Major Depressive illness, Generalized anxiety disorder & Obsessive-compulsive disorder : Adolescent, Adult over 18 years: 10 mg once daily increased if necessary to max. 20 mg daily; elderly: initially half adult dose, lower maintenance dose may be sufficient; children: not recommended.

  

Panic disorder :

Adult over 18 years: initially 5 mg once daily increased to 10 mg daily after 7 days; max. 20 mg daily;

elderly: initially half adult dose, lower maintenance dose may be sufficient.

Social anxiety disorder :

Adult over 18 years: initially 10 mg once daily adjusted after 2-4 weeks; usual dose 5-20 mg daily.

CONTRAINDICATION AND PRECAUTION

Escitalopram should not be used if the patient enters a manic phase, hypersensitive to escitalopram and any excipients of the product. The patient is taking monoamine oxidase inhibitor (MAOI), reversible MAOI (RIMA) and moclobemide Escitalopram should not be used.

SIDE EFFECT

The following additional adverse reactions have been reported: agitation or restlessness, blurred vision, diarrhea, indigestion, nausea, increased or decreased appetite, increased sweating, sexual difficulties(decreased sexual ability or desire, ejaculatory delay), taste alterations, tremor (shaking), weight changes.

USE IN PREGNANCY AND LACTATION

Pregnancy category C. The safety of Escitalopram during pregnancy and lactation has not been

established. Therefore, Escitalopram should not be used during pregnancy, unless, in the opinion of the physician, the expected benefits to the patients markedly outweigh the possible hazards to the fetus. Escitalopram is excreted in human milk. Escitalopram should not be administered to nursing mothers unless, in the opinion of the treating physician, the expected benefits to the patient markedly outweigh the possible hazards to the child.

Cough Syrup contains Guaiphenesin BP 100 mg Pseudoephedrine HCl BP 30 mg and Triprolidine HCl BP 1.25 mg with expectorant action.

Description

Guaiphenesin BP 100 mg,

Pseudoephedrine HCl BP 30 mg and Triprolidine HCl BP 1.25 mg

Syrup is a mixture of expectorant, bronchodilator / decongestant and antihistamine. 

Guaiphenesin has an expectorant action and is thought to reduce sputum viscosity

 by increasing the volume and water content of the bronchial secretion, thereby

 facilitating the expectoration of sputum. Pseudoephedrine has direct and indirect

 sympathomimetic activity and is an effective upper respiratory decongestant,

 producing decongestion within 30 minutes which lasts for at least 4 hours.

 Triprolidine is a potent competitive histamine H1-receptor antagonist of the pyrrolidine group.

Syrup is absorbed from the gastrointestinal tract. Guaiphenesin is metabolised and excreted

 in the urine. Pseudoephedrine is largely excreted unchanged in the urine together with 

small amount of its hepatic metabolite and Triprolidine is metabolised in the liver

 and excreted usually as metabolites in the urine.

Indication

Guaiphenesin BP 100 mg,

Pseudoephedrine HCl BP 30 mg and Triprolidine HCl BP 1.25 mg

Syrup is a cough preparation indicated for the symptomatic relief of

upper respiratory tract disorder accompanied by productive cough which are

benefited from the administration of an antihistamine, a decongestant and an

expectorant combination

Dosage and Administration

Adult and Children over 12 years : 2 teaspoonful 3 times daily.

Children

6-12 years : 1 teaspoonful 3 times daily

2-5 years : 1/2 teaspoonful 3 times daily or as directed by the physician

Precaution  

Guaiphenesin BP 100 mg,

Pseudoephedrine HCl BP 30 mg and Triprolidine HCl BP 1.25 mg cough syrup may
cause drowsiness; so patients should not drive or

operate machineries. Concomitant use of alcohol and other centrally active durg

should be avoided. Caution should be exercised in patients with hypertension,

heart disease, diabetes, hyperthyroidism, elevated intraocular pressure and

prostatic enlargement. The drug should not be used for persistent or chronic

cough as occur with smoking, asthma or emphysema or where cough is

accompanied by excessive secretions unless directed by a physician.

Use in pregnancy : Caution should be exercised by balancing the potential

benefit of treatment of the mother against any possible hazards to the

developing foetus.

Side effect

Central nervous system depression or excitation may occur, drowsiness being

reported most frequently. Sleep disturbance and rarely hallucination have been

reported. Skin rashes with or without irritation, tachycardia, dryness of mouth,

nose and throat have occasionally been reported. Urinary retention has been

reported occasionally in man receiving Pseudoephedrine; prostatic enlargement

could have been an important predisposing factor.

Contraindication 

Guaiphenesin BP 100 mg,

Pseudoephedrine HCl BP 30 mg and Triprolidine HCl BP 1.25 mg

is contraindicated in patients with a known hypersensitivity to

Guaiphenesin, Pseudoephedrine or Triprolidine. It is contraindicated in patients

with severe hypertension or severe coronary artery disease. Also,

contraindicated in persons who are taking or have taken monoamine oxidase

inhibitors within the preceding two weeks.