Carbamazepine

Indication

Carbamazepine is indicated for

• partial and secondary generalized tonicclonic

Seizures

• primary generalized tonic-clonic

Seizures

• trigeminal neuralgia

• prophylaxis of bipolar disorder

 is indicated for

• partial and secondary generalized tonicclonic

Seizures

• primary generalized tonic-clonic

Seizures

• trigeminal neuralgia

• prophylaxis of bipolar disorder

Dosage & Administration

 Epilepsy:

Adults and children over 12 years of age - Initial: Either 200 mg b.i.d. for tablets and XR tablets, or 1 teaspoon q.i.d. for suspension (400 mg/day).

Maintenance: usually 800-1200 mg daily. Children 6-12 years of age - Initial: Either 100 mg b.i.d. for tablets or XR tablets,

Contraindication & Precaution

 This medicine should not be used if anybody is allergic to one or any of its ingredients. It cannot be used also in the following conditions:

• Problems with the electrical message

pathways in the heart (atrioventricular

block).

. History of decreased blood cell production

by the bone marrow (bone marrow

depression).

• Hereditary blood disorders called

porphyrias.

• Allergy to tricyclic antidepressants, eg

amitriptyline.

• People who have taken a monoamineoxidase

inhibitor antidepressant (MAOI) in

the last 14 days.

Side Effect

Dizziness, drowsiness, ataxia, dry mouth, abdominal pain, nausea,

vomiting, anorexia, leucopenia, proteinuria, bradycardia, heart failure and hypotension. Erythematous skin rash, aplastic anemia may also be observed.

Use in Pregnancy & Lactation

 Pregnancy category D. Carbamazepine and its epoxide metabolite are transferred to breast milk. Because of the potential serious side Effects, decision should me made whether to discontinue nursing or discontinue the

drug.

Preparation

 200 mg Tablet, 200 mg CR Tablet, 100 mg/5 ml (100 ml) Suspension.

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Clopidogrel + Aspirin

Indication

Prevention of atherosclerotic events in patients with history of symptomatic atherosclerotic diseases (ischemic stroke, myocardial infarction or acute coronary syndrome).

Dosage and Administration

 Once daily.

Contraindication and Precaution

Hypersensitivity to any of the components or NSAIDs. Active pathological bleeding such as peptic ulcer or intracranial hemorrhage or bleeding disorders T7-T10 spinal segments. With the patient receiving the injection in the horizontal position and then turned supine, the blockade spreads to T4-T7 spinal segments. It should be understood that the level of spinal anesthesia achieved with any local anesthetic can be unpredictable in

a given patient. The Effects of Anespine exceeding 4 ml have not yet been studied and such volumes can therefore not be recommended.

Contraindication & Precaution

 Spinal anesthesia should only be undertaken by clinicians with the necessary knowledge and experience. Patients with hypovolemia due to any cause can develop sudden and severe hypotension during spinal

anesthesia. It is contraindicated in patients with a known hypersensitivity to it or to any local anesthetic agent of the amide type. The following conditions preclude the use of spinal anesthesia: severe haemorrhage,

severe hypotension or shock and arrhythmias, such as complete heart block, which severely restrict cardiac output.

Side Effect

 The safety of Bupivacaine is comparable to that of other local anesthetics used for spinal anesthesia. In rare cases Bupivacaine has been associated

with allergic reactions and anaphylactic shock. Spinal anesthesia itself can cause hypotension and bradycardia due to sympathetic blockade and/or vasovagal fainting. Systemic adverse reactions are characterized by  numbness of thetongue, Lightheadedness, dizziness and

tremors, followed by convulsions and cardiovascular disorders.

Use in Pregnancy & Lactation

Bupivacaine enters the mother’s milk but in such small quantities that there is generally no risk of affecting the child at therapeutic dose levels. There is no may be encountered during Losartan potassium treatment.

Use in Pregnancy & Lactation

 Losartan potassium should not be used in pregnancy and if pregnancy is detected Losartan potassium should be discontinued as soon as possible. Losartan potassium should not be used in lactating mother.

Drug Interaction

 No drug interaction of clinical significance has been identified.

Preparation:  25 mg, 50 mg & 100 mg Tablet.

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Tramadol

Indication

 Post-operative pain, Colic and spastic pain, Cancer pain, Joint pain,  of thrombo-embolic disorders such as myocardial infarction and stroke.

Dosage and Administration

 One tablet once daily.

Contraindication and Precaution

Hypersensitivity, Active pathological bleeding such as peptic ulcer or ntracranial hemorrhage.

Side Effect

 Hemorrhage, abdominal discomfort, nausea, vomiting, diarrhoea, headache, dizziness, vertigo, paraesthesia, rash, pruritus, hepatic and biliary disorder, neutropenia may occur.

Drug Interaction

 Aspirin, NSAIDs should be used with cautions to patients taking

Clopidogrel.

Use in Pregnancy and Lactation

Clopidogrel should be used in pregnant women and nursing mothers only if clearly needed.

Preparation:  75 mg Tablet.

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Metronidazole I V

Indication

Metronidazole  500 IV is indicated in the prophylaxis and treatment of infections in which anaerobic bacteria have been identified. It is indicated in:

1.The prevention of postoperative infections due to anaerobic bacteria

2.The treatment of septicemia, bacteraemia, peritonitis, brain abscess, necrotizing pneumonia, osteomyelitis, puerperal sepsis, pelvic abscess, pelvic cellulites, and post operative wound infections from which pathogenic anaerobes have been isolated.

Dosage & Administration

 Metronidazole  500 IV should be infused intravenously at an

approximate rate of 5 ml/min. Oral medication should be substituted as soon as feasible. Treatment for 7 days should be satisfactory for most patients, but the physician might decide to prolong treatment.

For bacterial infections:

Adults: 500 mg (100 ml) 8 hourly.

Children: 7.5 mg/kg (1.5 ml/kg) 8 hourly.

For treatment before and during surgery:

Adults: 500 mg (100 ml) shortly before operation, repeated 8 hourly

Children: 7.5 mg/kg (1.5 ml/kg) 8 hourly.

Side Effect

Pain, tenderness, redness or swelling over vein in which the medicine is

given. Other side Effects are unsteadiness, fever or chills, sore throat, headache, numbness, tingling pain or weakness in the hands or feet, pain, seizures, skin itching, unusual tiredness or weakness, vaginal irritation or discharge.

Drug Interaction

 Metronidazole shows drug interaction with the following:

alcohol or alcohol-containing beverages, barbiturates, carbamazepin, cimetidine, disulfiram, fluorouracil, lithium, methadone, phenytoin, warfarin etc.

Use in pregnancy & lactation

Studies have not been done in humans. Metronidazole has not been shown to cause birth defects in animal studies; however, use is not recommended during the first trimester of pregnancy. Use is not recommended in nursing mothers since metronidazole passes into the breast milk.

Precaution

Metronodazole should be given with caution in the following conditions- anemia or other blood disorders, liver disease, disease of nervous system, seizures etc.

Preparation

 100 ml solution of Metronidazole for intravenous infusion.

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