Metronidazole

Indication

• All forms of amoebiasis (intestinal and extra-intestinal disease including liver abscess and that of symptomless cyst passers)

• Trichomoniasis

• Giardiasis

• Bacterial vaginosis

• Acute ulcerative gingivitis

• Anaerobic infections including

septicaemia, bacteraemia, peritonitis,

brain abscess, necrotising pneumonia,

osteomyelitis, puerperal sepsis, pelvic

abscess, pelvic cellulitis etc.

• Anaerobically-infected leg ulcers and pressure sores

• Acute dental infections (e.g. acute pericoronitis and acute apical infections)

• Surgical prophylaxis (prevention of postoperative infections due to anaerobic bacteria, particularly species of bacteroides and anaerobic streptococci

• Chronic symptomatic peptic ulcer disease (as an agent of triple therapy to

eradicate H. pylori-the most important aetiological factor of peptic ulcer)

• Dosage and Administration

Indication	Duration of dosage in days	Adults and  children over10 years	Children 7-10 years 3-7 years 1-3 years
Trichomoniasis	7	200 mg t.i.d or 400 mg b.i.d	100 mg t.i.d	100 mg t.i.d	50 mg t.i.d
	2	800 mg in the morning and 1.2 gm at night
	1	2.0 gm as a single dose
Invasive intestinal amoebiasis	5	800 mg t.i.d.	400 mg t.i.d.	200 mg q.i.d.	200 mg t.i.d.
Extra intestinal amoebiasis (including liver abscess) and symptomless amoebic cyst passers	5-10	400 -800 mg t.i.d.	200 -400 mg t.i.d	100-200 mg q.i.d	100-200 mg q.i.d
Giardiasis	3	2.0 gm once daily 1.0 gm once daily 600-800 mg 500 mg	1.0 gm once daily	6 0 0 - 8 0 0 mg once daily	500 mg once daily
Acute ulcerative gingivitis	3	200 mg t.i.d. mg t.i.d.	100 mg	100 mg b.i.d.	50 mg t.i.d.
Acute dental infections	3-7	200 mg t.i.d.
Bacterial vaginosis	5-7	400–500 mg twice daily
	1	2.0 gm as a single dose
Leg ulcers and pressure sores	7	400 mg t.i.d.
Anaerobic infections	7	Either 400 mg every 8 hours or 500 mg every 8 hours	7.5 mg/kg t.i.d.	7.5 mg/kg t.i.d	7.5 mg/kg t.i.d
Surgical prophylaxis		400–500 mg 2 hours b e f o r e surgery; up to 3 further doses of 400–500 mg may be given every 8 hours for h i g h - r i s k procedures	7.5 mg/kg t.i.d.	7.5 mg/kg t.i.d.	7.5 mg/kg t.i.d.

Side Effect

Metalic taste, furred tongue, nausea, vomiting, diarrhoea, drowsiness, rashes and mild reversible leucopenia may be observed during treatment.

Drug Interaction

Metronidazole interacts with warfarin, nicoumalone, phenytoin, phenobarbitone, fluorouracil, disulfiram, lithium, cimetidine etc.

A   Use in Pregnancy & Lactation

      Not recommended during first & later trimesters. Breast feeding should be delayed until 48 hours after discontinuing metronidazole in the mother.

Presentation: 400 mg Tablet, 500 mg Tablet & 200 mg/5ml Suspension.

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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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