ACETAZOLAMIDE (anti epileptic,diuretic)
Acetazolamide is a carbonic anhydrase inhibitor. It produce a transient alkaline diuresis accompanied by mild metabolic acidosis,but its major clinical use is in the treatment of glaucoma where its action is not dependent on its diuretic effect.It is also used in some form of epilepsy and as prophylaxis against acute mountain sickness.Adverse effects include paraesthesia and drowsiness,and severe matabolic acidosis may occur in the elderly and in patients with reduced renal function.Blood dyscrasias occur rarely.
CONTRAINDICATIONS : Second and third degree AV heart block,pregnency,adrenal insufficinecy,severe renal impairment,sodium or potassium depletion,hyperchloraemic acidosis,Addisons disease,adrenal failure,hyponatremia,hypokalaemia.
PRECAUTION : may require potassium supplement ,if given with aspirin acidosis develops,long term use with phenytoin causes osteomalacia.
DOSE AND USE: 5 mg/kg/day in divided dose(diuretics). for hydrocephalus 50-70 mg/kg/day.As miotic and antiglaucoma 250 mg -1 gm in divided doses of 6 hours.As anti epileptic for adults,oral ,0.25-1gm daily in divided dose.For child,oral 5 mg/kg 4 times daily.
TRADE NAMES: Diamox,Zolamide,Glucocid.
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ACETYL SALICYCLIC ACID OR ASPIRIN
Aspirin is used for pain,fever,inflammation and prevention of myocardial infarction and stroke.Ther main adverse effects associated with aspirin are gastro-intestinal.Because of the risk of Reye's syndrome aspirin is used to a very little extent in children.
INDICATIONS : MIld to moderate pain,pyrexia,arthritis,rheumatic fever,headache,muscular pain,anti -inflammatory conditions,secondary prevention of myocardial infarction,prophylaxis against stroke and vascular occlusion.
CONTRAINDICATIONS: Asthma ,peptic ulcer,haemophilia,hyperparathyroidism,gastric mucosa lesion,breast feeding,lactation,impaired hepatic and renal function.
DOSE :
Adult dose: 300 - 900 mg orally.Maximum dose - 1 g daily.
Child dose: over 1 year(80 mg/kg/day in 4-5 divided doses)
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ADRENALINE OR EPINEPHRINE (anti asthmatics,anti allergic,cardiovascular)
Adrenaline is a direct acting sympathomimetic agent with more marked effects on beta-adrenoreceptors than alpha-adrenoreceptors. Major clinical applications of adrenaline include emergency management of anaphylaxis and anaphylactic shock and use in cardiopulmonary resuscitation. It is also frequently employed for its vasoconstrictor properties in local anaesthetics for dental use, Adverse effects of adrenaline are essentially those of adrenergic stimulation.
CONTRAINDICATIONS: Closed angle glaucoma.
DOSE AND USE: In cardio pulmonary resuscitation-0.5 mL dilut to 10 mL with NaCl injection IV or IC.
Adult: 0.2 -0.5 mL S.C or I.M ,Child dose-0.01 mL/kg ,Acute allergy and anaphylactic shock 1 in 1000-1 mL ampoule.Dose 0.5 ml I.M .In extreme emergency I.V. infusion 5-10 mL (0.5-1 mL) (1 in 10,000) diluted or intracardiac injection :1-2 mLof 1 in 10,000 given continuously.
TRADE NAMES
Epinephrine ,Medicreme,Midricin.
PRECAUTION:
Administration carefully to old people,in psychoneurotic patients and in pregnancy.Dangerous in status asthmaticus.In case of shocks,precaution should be taken in ischaemic heart disease,diabetes mellitus,hyperthyroidism,hypertension.Increased risk of arrhythmias with antidepressants,digoxin or quinidine.
DRUG INTERACTION: Use with tricyclic antidepressants or anti histamines is potentiated.
ADVERSE EFFECTS: On B.P and cardiac rhythm.
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AMIKACIN (anti bacterial,anti infective ,antibiotic)
Amikacin is an aminoglycoside which is active against many strains in gram negative bacteria a swell as some other bacteria including some strains of Staphylococci and Mycobacteria. It exhibits synery with betalactams against many organisms.It is not absorbed by mouth and is usually given intramuscularly or in travenously,in the treatment of severe infections,often in combination with another agents such as a betalactam.Amikacin is not susceptible to most of the enzymes produced by organisms resistant to other aminoglycosides,and may be useful against infections by strains resistant to Gentamycin or Tobramycin.Ototoxicity and nephrotoxicity are the chief adverse effects and monitoring of plasma concentration is recommended.
INDICATIONS: Serious Gram negative especially(Pseudomonas) infections resistant to Gentamicin.
CONTRAINDICATIONS: Pregnancy,myasthenia gravis.
DOSE: Adult : I.M or slow I.V ,15 mg/kg daily in 2-3 divided doses,upto a maximum of 1.5 g daily .
Child : I.M or I.V ,Initial loading dose of 10 mg/kg followed by 7.5 mg/kg every 12 hours.
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AMINOPHYLLINE (antiasthmatic)
Aminophylline is a combination of theophylline and ethylenediamine. It's action and use are similar to those of theophylline,but it is more soluble in water than theophylline and is preferred for intravenous administration in the treatment of acute severe asthma.
CONTRAINDICATIONS: Rapid intravenous administration of dose of aminophylline of 500 mg may result in sudden death due to cardiac arrythmias.20-40 minute time to avoid headache,dizziness,nausea,palpitaion,hypotension,precardial pain.Additional symptoms are tachycardia,severe restlessness,agitation and emesis.Low dose of Aminophylline for disease of liver.During breast feeding affects respiratory system of children.During pregnancy,during 3rd trimester,should be avoided.
DRUG INTERACTIONS: With Lithium drugs(Psychotropic),Increased Lithium excretion.
PRECAUTIONS: Should be precautioned in liver diseases,epilepsy,cardiac disease,breast feeding,elderly patients,peptic ulcer,hyperparathyroidism,hepatic dysfunction,chronic lung diseases,neonates.
DOSE AND USE: Tablet-100 mg Dose: 100-300 mg 3-4 times.Loading dose-5 mg/kg IV slowly over 20 minutes preferably while patient is receiving oxygen followed by 1 mg/kg/hr infusion.
Reversible airway obstruction ,severe acute asthma,left ventricular failure,status asthmaticus.
Maintenance dose of IV infusion 500 mg to be added to 500 mL of 5% dextrose or N-saline.
Concentration 1 mg/mL.
Child 12 mg/kg/day in divided doses.
TRADE NAMES
Anoasthma,Duphomin.Bronkolax,Daslin.
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AMPICILLIN (antibacterial,antiinfective,antibiotic)
Ampicillin is an aminopenicillin with a broader spectrum of activity than benzyl penicillin especially against gram negative bacilli.It is inactivated by beta lactamases and for this reason has been given with Sulbactam,a beta lactamase inhibitor.For broad spectrum empirical therapy it has often been given with an aminoglycoside.Ampicillin is acid stable and fairly well absorbed from the gastro intestinal tract.It can therefore be given by mouth as well as by injection.Hypersensitivity is the main adverse effect;maculopapular skin rashes also occur.
CONTRAINDICATIONS: Hypersensitivity to the drug.
PRECAUTIONS: Superinfection on prolonged use,patients with infectious mononucleosis,lymphatic leukemia,hyperuricaemia patients on allopurinol,erythematous rash in glandular fever and chronic lymphatic leukemia maculo-papular rashes.Diarrhoea is a frequent problem.
DRUG INTERACTIONS: Tetracycline,Erythromycin and Chloramphenicol antagonise the action of Ampicillin.
DOSE AND USE: New born : below 1 week -50 mg/kg/24 hours.
Child : 50-100 mg/kg/24 hrs 6 hourly.
Septicemia: 200 mg/kg/24 hrs 4 hourly and 12 g per day for adults.
TRADE NAMES: Amcill,Omni pen,Polycillin,Roscillin,Ampillin.
Aspirin is used for pain,fever,inflammation and prevention of myocardial infarction and stroke.Ther main adverse effects associated with aspirin are gastro-intestinal.Because of the risk of Reye's syndrome aspirin is used to a very little extent in children.Adrenaline is a direct acting sympathomimetic agent with more marked effects on beta-adrenoreceptors than alpha-adrenoreceptors. Major clinical applications of adrenaline include emergency management of anaphylaxis and anaphylactic shock and use in cardiopulmonary resuscitation. It is also frequently employed for its vasoconstrictor properties in local anaesthetics for dental use, Adverse effects of adrenaline are essentially those of adrenergic stimulation.
ADVERSE EFFECTS: On B.P and cardiac rhythm.
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Amikacin is an aminoglycoside which is active against many strains in gram negative bacteria a swell as some other bacteria including some strains of Staphylococci and Mycobacteria. It exhibits synery with betalactams against many organisms.It is not absorbed by mouth and is usually given intramuscularly or in travenously,in the treatment of severe infections,often in combination with another agents such as a betalactam.Amikacin is not susceptible to most of the enzymes produced by organisms resistant to other aminoglycosides,and may be useful against infections by strains resistant to Gentamycin or Tobramycin.Ototoxicity and nephrotoxicity are the chief adverse effects and monitoring of plasma concentration is recommended.
INDICATIONS: Serious Gram negative especially(Pseudomonas) infections resistant to Gentamicin.
CONTRAINDICATIONS: Pregnancy,myasthenia gravis.
DOSE: Adult : I.M or slow I.V ,15 mg/kg daily in 2-3 divided doses,upto a maximum of 1.5 g daily .
Child : I.M or I.V ,Initial loading dose of 10 mg/kg followed by 7.5 mg/kg every 12 hours.
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AMINOPHYLLINE (antiasthmatic)
Aminophylline is a combination of theophylline and ethylenediamine. It's action and use are similar to those of theophylline,but it is more soluble in water than theophylline and is preferred for intravenous administration in the treatment of acute severe asthma.
CONTRAINDICATIONS: Rapid intravenous administration of dose of aminophylline of 500 mg may result in sudden death due to cardiac arrythmias.20-40 minute time to avoid headache,dizziness,nausea,palpitaion,hypotension,precardial pain.Additional symptoms are tachycardia,severe restlessness,agitation and emesis.Low dose of Aminophylline for disease of liver.During breast feeding affects respiratory system of children.During pregnancy,during 3rd trimester,should be avoided.
DRUG INTERACTIONS: With Lithium drugs(Psychotropic),Increased Lithium excretion.
PRECAUTIONS: Should be precautioned in liver diseases,epilepsy,cardiac disease,breast feeding,elderly patients,peptic ulcer,hyperparathyroidism,hepatic dysfunction,chronic lung diseases,neonates.
DOSE AND USE: Tablet-100 mg Dose: 100-300 mg 3-4 times.Loading dose-5 mg/kg IV slowly over 20 minutes preferably while patient is receiving oxygen followed by 1 mg/kg/hr infusion.
Reversible airway obstruction ,severe acute asthma,left ventricular failure,status asthmaticus.
Maintenance dose of IV infusion 500 mg to be added to 500 mL of 5% dextrose or N-saline.
Concentration 1 mg/mL.
Child 12 mg/kg/day in divided doses.
TRADE NAMES
Anoasthma,Duphomin.Bronkolax,Daslin.
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CONTRAINDICATIONS: Hypersensitivity to the drug.
PRECAUTIONS: Superinfection on prolonged use,patients with infectious mononucleosis,lymphatic leukemia,hyperuricaemia patients on allopurinol,erythematous rash in glandular fever and chronic lymphatic leukemia maculo-papular rashes.Diarrhoea is a frequent problem.
DRUG INTERACTIONS: Tetracycline,Erythromycin and Chloramphenicol antagonise the action of Ampicillin.
DOSE AND USE: New born : below 1 week -50 mg/kg/24 hours.
Child : 50-100 mg/kg/24 hrs 6 hourly.
Septicemia: 200 mg/kg/24 hrs 4 hourly and 12 g per day for adults.
TRADE NAMES: Amcill,Omni pen,Polycillin,Roscillin,Ampillin.
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