Amino Glycosides - Angelfire
Anti-infectives
(Antibiotics, Anti-viral, Antifungal)
Antibiotics are drugs [pic]used to kill or harm [pic]specific bacteria. [pic]Antibiotics were [pic]discovery in the [pic]1930s; since then antibiotics have [pic]cured [pic]diseases caused by [pic]bacteria such as [pic]pneumonia, [pic]tuberculosis, and [pic]meningitis - saving the [pic]lives of millions of [pic]people around the [pic]world. [pic]
[pic] But antibiotics must be [pic]used wisely. Because [pic]bacteria are living [pic]organisms, they are [pic]always changing in an [pic]effort to resist the drugs [pic]that can kill them. [pic]When antibiotics are [pic]used incorrectly, [pic]bacteria can adapt and [pic]become resistant. [pic]Antibiotics are then no [pic]longer useful in [pic]fighting them. [pic]Antibiotic resistance is [pic]now a major public [pic]health issue. The [pic]correct use of these [pic]drugs is the best way to [pic]ensure that antibiotics [pic]remain useful in [pic]treating infections.
Antibiotics can be either primarily bacteristatic or primarily bactericidal. Bacteristatic drugs include: sulphonamides, tetracycline, chloramphenicol, erythromycin (low concentration), PAS (sodium aminosalicylate), lincomycin, clindamycin and fusidic acid; while bactericidal antibiotics include: penicillin, cephalosporin, aminglycosidees. Co-trimazole, erythromycin (high concentration), isoniazide, rifampicin and vancomycin.
Proper antibiotic is chosen according to site of infection and the susceptible organism invading that site; accordingly the dose and duration of treatment is specified . Refer to table 1 (Antimicrobial Drugs of Choice)
In the following study antibiotics are classified into eleven groups: amonglycosides, cephalosporin (1st, 2nd, 3rd generation), lincosamides, macrolides (erythromycin, spiramycin), nitroimidazole, penicillin (penicillin A, penicillin M, penicillin IV, penicillin combined with β lactactamase), quinolones, cycline (doxycycline, tetracycline, lymeccline, minocyclin), sulfonamide with trimethoprim, antituberculosis. Although phenicol (chloramphenicol, thiamphenicol…) used to play an important role in treating diseases, the following study will not focus on the drugs containing phenicol as they were deleted from the market.
Antiviral agents can be classified into: aciclovir, famciclovir (famvir), ganciclovir (cymevene), penciclovir (vectavir), HIV treatment (3TL, crixivan, hivid, norvir, retrovir, valtrex, videx, zerit, interferon (intron A, referin A). However, the following study focuses on the drugs available in the pharmacy.This holds true with antifungal.
[pic]Antibiotics
Aminoglcosides
|Generic name |Trade name |Dose\ Pharmaceuti-cal |Indication |Side Effects |
| | |form | | |
|Gentainicin |Garamycin |15g cream, 15g oint |-cream and ointment are useful in infected |Transient irritation |
|(Gentamici) | | |skin cyst,skin ulcer, infected skin bite, wet| |
| | | |oozing 1st infection(impetigo, ecthyma.. | |
| | | |,greasy 2nd infection (pastular psoriasis, | |
| | |80mg IM, IV, 20mg |seborrheic dermatitis) | |
| |Cidomycin |(pediatric), 5mg |-urinary tract infection, chest, septicaemia,| |
| | |intrathecal |infected traumatic wounds, baterial | |
| | | |meningitis and other bacterial infection of | |
| | | |CNS | |
|Amikacin sulfate |Amikin |500mg IM, IV (2ml) |Septicemia,respiratory, bones, joints, CNS, |Auditory, vestibular, renal toxicity, |
| | | |skin and soft tissue, urinary tract infection|neurotoxicity, nephrotoxicity, skin |
| | | | |rash,drug fever, tremor, anemia… |
|Spectinomy-cin |Togamycin |2g powder IM |Acute gonorrheal urethritis and proctitis in |Soreness, urticaria, dizziness, nausea, |
| | | |male and female |chills, fever,anaphy-axis |
|Tobramycin sulfate |Nebcin |40mg\ml IM, IV(2ml) |Septicemia, lower respiratory tract, |Neurotoxicity, nephrotoxicity, anemia, |
| | | |meningitis, intra- abdominal infection, skin |fever rash, itching, nausea, vomiting… |
| | | |and bone structure urinary tract infection | |
Cephalosporin
1st Generation
|Generic name |Trade name |Dose\ Pharmaceutical form |Indication |Side Effects |
|Cefadroxil |Biodroxil |500mg capsule, 1000mg film coated tablet, |URT, LRT, urogenital |GI discomfort (nausea, vomiting, diarrhea….) |
| | |125mg\250mg\500mg\5ml oral suspension |tract, infection of |dermatological symptoms (pruritis, drug fever, |
| | | |soft tissue, skin, |joint pain, vaginal mycosis, increase ALT, AST |
| | |500mg capsule, 1g f\c T, 250mg oral |bone, joint |(transaminase), |
| | |suspension, | |Hypersensitivity. |
| | | | | |
| |Cefadril |500mg T, 125mg\250mg\5ml suspension, | | |
| | |100mg\ml powder | | |
| |Curicafe | | | |
| | |250mg, 500mg capsule, 1g f.c.T | | |
| | | | | |
| | | | | |
| | | | | |
| |Duricef | | | |
|Cephalexin |Cephadar forte |250mg\500mg capsule, 125mg\250mg suspension |ENT, RT, obstetrical,|GI disturbance (pseudomemdraneous colitis…), |
| | | |genitourinary tract |allergic manifestation,transient hepatitis, |
| |Keflex |1g T, 500mg T\cap, 250mg T\cap\chewable T, |infection, bone, |cholestatic jaundice, eosinophilia, vaginitis, |
| | |125mg chewable T, granules to obtain |joint, skin, soft |dizziness, fatigue, |
| | |60ml\100ml suspension |tissue infection, | |
| | |250mg\5ml suspension |dental, otitis media | |
| | | |infection | |
| |Oralexin |250mg capsule, 500mg\1g f.c.T | | |
| | | | | |
| |Ospexin | | | |
|Cephradine |Eskacef |-500mg\250mg cap, 125mg\250mg\5ml suspension|URT, LRT, urinary |GI discomfort, skin and hypersensitivity |
| | | |tract, GI, skin and |(rash, erythema…), neutropenia, leukopenia, |
| | |500mg cap |soft tissue |eosinophilia, increase liver enzyme |
| | | |infection, |(transaminase, alkaline phospatase…) and |
| |Zeefra Ge |250mg\500mg\1g IV, IM |septicemia, bone |bilirubin, increase in BUN |
| | | |infection | |
| |Velosef | | | |
|Cefazolin |Kefzol |1g IV, IM |RT infection, |GI discomfort (pseudomembraneous colitis…), |
| | | |genitourinary tract, |neutropenia, leukopenia, thrombocythemia, |
| | | |skin, soft tissue, |increase BUN |
| | | |biliary tract, bone, | |
| | | |toint, septicemia | |
2nd Generation
|Generic name |Trade name |Dose\pharmaceutical form |Indication |Side Effects |
|Cefprozil |Cefzil |250mg\500mg T, 125mg\250mg\5ml suspension |URT, LRT, skin and skin |GI discomfort, cholestatic |
| | | |structure |jaundice, hypersensitivity, |
| | | | |dizziness, headache, |
| | | | |eosinophilia, elevated BUN, |
| | | | |genital pruritis, |
| | | | |thrombocytopenia |
|Cefaclor |Cloracef |250mg\500mg cap, 125mg\5ml suspension |URT, LRT, otitis media, |GI disturbance, hypersensitivity,|
| | | |intraabdominal infection, skin |disturbance in liver enzyme, |
| | |500mg\375mg\750mg T |and soft tissue, urinary tract |transient hepatitis, cholestatic |
| |Ceclor MR | |infection, gonorrhea, bone and |jaundice, eosinophilia, blood |
| | | |joint infection, gonococcal |disorder, dizziness, reversible |
| |Zeflox |250mg\500mg cap, 125mg\250mg chewable T, |urethritis |interstitial nephritis, elevated |
| | |125mg\187.5mg\250mg\375mg\5ml suspension | |BUN |
|Cefuroxime |Zinnat |125mg\250mg\500mg T |URT, LRT, genitourinary tract, |GI disturbance (pseudomembrance |
| | | |skin and soft tissue infection,|colitis…), increase hepatic |
| |Zinacef |750mg\3ml IM, 750mg\6ml IV |gonorrhoea |enzymes, hyper sensitivity |
3rd Generation
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Cefixime |Suprax |200mg\400mg cap, 100mg\5ml |Pharyngitis, tonsillitis, sinusitis, |Diarrhoea, abdominal pain, nausea, |
| | | |bronchitis, otitis media, urinary tract|vomiting, skin rash, increase liver |
| | | |infection, urethral and cervical |enzyme… |
| | | |gonorrhoea | |
|Ceftriaxone |Triaxone |0.25mg\0.5mg\1g\2g powder in vial |Sepsis, meningitis, bone and joint |GI complaints, eosinophilia, |
| | |(IV) |infection, skin, soft tissue wounds, |leukopenia, allergic dermatitis, |
| | | |abdominal infection, renal and urinary |elevated liver enzyme, elevated |
| |Rocephin |0.25mg\0.5mg\1g\ 2ml or 3.5ml |tract infection, RT, ENT, pneumonia |creatinine, pseudomembrance |
| | |powder +1% lidocaine solution, 2g | |enterocolitis |
| | |IV infusion | | |
|Cefpodoxime |Orelox |100mg f.c.T |Sore throat, pharyngitis, sinusitis, |Diarrhoea, nausea, vomiting, headache,|
| | | |bacterial pneumonia, obstructive |allergic symptoms, hematologic events,|
| | | |bronchopneumonia |elevated urea, creatinine, liver |
| | | | |enzyme |
Lincosamides
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Clindamycin |Dalacin C |75mg\150mg\300mg cap, 75mg\5ml |URT, LRT, skin and soft tissue, bone and |GI discomfort, hyper- sensitivity, |
| | |syrup, 150mg\5ml sterile solution |joint infection, gynecological infection,|jaundice, pruritis, vaginitis, |
| | |IM |septicemia, intra-abdominal infection |eosinophilia, hpotension |
|Lincomycin |Lincocin |500mg cap, 250mg\5ml syrup IM, IV |URT, LRT, skin and soft tissue, bone and |GI discomfort, leukopenia, |
| | | |joint infection, septicemia, bacillary |thrombocytopenia, neutropenia, |
| | | |dysentery |hpersensitivity |
Macrolides
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Erythromycin |Erythromycin | |Sensitive bacteria |Digestive problems: nausea, diarrhoea |
| | | | |Hypersensitivity: cutaneous allergy |
| |Propiocine |500mg tab | | |
|Spiramycin |Rovamycin |3 M.U.I\tab f.c.tab, 1.5 |ENT, bronchopulmonary, |Nausea, vomiting, diarrhoea, pseudomembrance |
| | |M.U.I\tab f.c.tab |cutaneous, stomatologic, |colitis, allergic reaction (rash, itching), |
| | | |nongonococcal genital |angioedema, transient paresthesia |
| | | |manifestation, toxoplasmosis | |
| | | |in pregnant women, prevention | |
| | | |of meningococcal meningitis, | |
| | | |relapses of rheumatic fever | |
|Clarithromycin |Klacid |60ml\100ml bottle with |Infection of nasopharyngeal |GI disturbances (nausea, heart burn, |
| | |dispenser (for infants above|tract (tonsillitis, |diarrhoea), headache, skin rashes; transient |
| | |6 month use pediatric |pharyngitis and of paranasal |increase in SGOT\SGPT\cholestatic hepatitis |
| | |suspension 15mg\kg\day; |sinuses), LRT (bronchitis, | |
| | |125mg\5ml) |bacterial pneumonia, atypical | |
| | | |pneumonia), skin infection | |
| | | |(impetigo, septic wounds…) | |
|Roxithromcin |Rulid |100mg tab |Bacterial infection |GI reaction (nausea, vomiting), dizziness, |
| | | | |headache, elevated hepatic enzyme, severe |
| | | | |hypersensitivity, shortness of breath |
|Azithromycin |Zithromax |250mg cap, 600mg\900mg\ |URT, LRT, |Allergic reaction (anaphlaxis, angioedema), |
| | |1200mg for oral suspension |odontostomatological, skin and|GI (diarrhoea, loose stools, cramp, nausea, |
| | |after reconstitution |soft tissue, nongonococcal |vomiting, flatulence), pseudomembrance |
| | |200mg\5ml |urethritis (clamydia |colitis, elevated transaminase, hepatitis, |
| | | |trachomatis) |decreased neutrophil count and |
| | | | |thrombocytopenia |
Nitroimmidazole
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Metronidazole |Elysol |250mg\500mg tab, 500mg |Trichomonas vaginalis, nonspecific vaginitis, |Digestive upset, allergic reaction |
| | |vaginal tab, 25mg\ml, |amoebiasis (intestinal and extraintestinal |(itching, rash), fever, angioedema, |
| | |400mg\ml |manifestation caused by infection with |anaphylactic shock, glossitis (inflammation|
| | | |entamoeba histolica), intestinal giardiasis, |of tongue with feeling of dry mouth), |
| | | |Crohn’s disease, ulcerative gingivitis, |haematologic disorder (leucopenia, |
| | | |infection involving sensitive anaerobic |agranulocytosis), reversible cholestatic |
| | | |micro-organism (infection caused by |hepatitis, peripheral and CNS disorders |
| | |500mg tab, 250mg f.c.tab,|metronidazole sensitive pathogen like: |(headache, unconsciousness, vertigo, |
| | |500mg vaginal supp. |inta-abdominal and liver abscess, skin and |ataxia), reddish brown coloration of urine,|
| |Flagyl | |soft tissue infection, gynecological |flattening of T wave in ECG |
| | | |infection, bacterial septicemia, bone and | |
| | | |joint infection, CNS infection including | |
| | | |meningitis, LRT, endocarditis, anti-bacterial | |
| | | |prophylaxis | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | |250mg\500mg f.c.tab, | | |
| | |infusion bottle (100ml | | |
| | |contains 500mg) | | |
| | | | | |
| |Supplin | | | |
Penicillin
Penicillin A
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Amoxicillin |Acti-mox |250mg\500mg cap, 125mg\5ml or |Infection of lung and respiratory tract|Nausea, vomiting, diarrhoea, skin |
| | |250mg\5ml oral suspension |(chronic bronchitis), ENT, urogenital |rash, redness, itching, |
| | | |tract (kidney, anal pelvis, cystitis, |pseudomembrance colitis, joint pain, |
| | | |prostate, ovarian, gonorrhoea), acute |erythemia multiforme, leukopenia and |
| | | |and chronic infection of biliary tract |eosinophilia, anaemia, elevated |
| | | |and GI, gynecological infection |SGOT\SGPT |
| | |375mg\500mg\750mg\1000mg tab, bottle|(abortion, septic…), typhoid fever, | |
| | |40g granulate for 80ml syrup 5%, |paratyphoid, syphilis, pericarditis, | |
| |Amoximex |bottle 50g granulate for 100ml syrup|endocarditis, shigellosis, skin and | |
| | |5% |soft tissue infection (eptospirosis, | |
| | | |acute and latent listeriosis), infected| |
| | | |wounds, pre\post operative treatment | |
| | | | | |
| | |500mg cap | | |
| | | | | |
| | | | | |
| | | | | |
| |Amoxil |250mg\500mg tab | | |
| | | | | |
| | |250mg\500mg cap, 125mg\5ml (5%)\\ | | |
| | |250mg\5ml (2,5%) powder for oral | | |
| |Flemoxin |suspension, 100mg\ml pediatric O.S | | |
| | | | | |
| |Hiconcil | | | |
| | | | | |
| | |500mg\750mg\1000mg f.c.tab, | | |
| | |250mg\375mg\500mg cap, | | |
| | |125mg\250mg\375mg\5ml granules | | |
| | |(60ml\100ml suspension), 100mg\ml | | |
| | |granules (30ml pediatric drop) | | |
| | | | | |
| | | | | |
| |Ospamox | | | |
|Ampicillin |Ampicillin |500mg | | |
| | | | | |
| |Penbritin |500mg cap | | |
|Amoxycillin |Flumox | |Respiratory tract infection, ENT |Diarrhoae, skin rash |
|Flucloxacillin | | |(otitis media, sinusitis, tonsillitis, | |
| | | |pharyngitis), enteritis, typhoid, | |
| | | |paratyphoid, intra-abdominal abscess, | |
| | | |genitourinary tract infection, | |
| | | |cystitis, prostatitis | |
|Ampicillin |Ampiclox | | | |
|Cloxacillin | | | | |
Penicillin M
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Cloxacillin |Orbenin |250mg\500mg cap, 250mg\500mg\1g |Respiratory tract infection, ENT, skin and |Occasional rash, transient diarrhoea, |
| | |vial, bottle containing 60ml\100ml |soft tissue, infected wounds, septicaemia, |ingestion |
| | |syrup (125mg\5ml) |endocarditis, staphylococci enterocolitis, | |
| | | |meningitis, osteomyclitis | |
Penicillin IV
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Phenoxy-methlpenicillin |Ospen |500 (500000 I.U)\100 (1 M.I.U)\1500|ENT, infection of skin, bite |Hypersensitivity, nausea, diarrhoea, |
| | |(1.5 M.I.U) f.c.tab |wounds, burns, prevention of |vomiting, fullness of stomach, |
| | | |streptococcal infection |glossitis, eosinohpilia, hemolytic |
| | | |(streptococcal infection, bacterial|anaemia |
| | | |endocarditis in patients with | |
| | | |congenital or rheumatic heart | |
| | | |disease, pneumococcal infection | |
Penicillin combined with β lactamase inhibitor
|Generic name |Trade name |Dose\Pharmaceutical form|Indication |Side Effects |Posology |
|Amoxicillin |Augmentin |Amoxicillin\ |URT, sinusitis, |Diarrhoea, vomiting, colonization |Adult+Child >12 years: |
|Clavulanic acid | |Clavulanic acid: |tonsillitis, otitis |of intestine by candida and |Mild+moderate infection: 1 |
| | |875mg\125mg, 250mg\125mg|media, skin and soft |isolated cases of pseudomembrance |(375mg) tab 3 times daily |
| | |tab, 50mg\12.5mg\ml |tissue infection, |colitis, hypersensitivity (skin |Severe infection: 1 (625mg) tab |
| | |drop, 125mg\31.25mg\5ml |boils\abscesses, wound |rash, pruritis, urticaria, fever, |3 times daily or 2 (375mg) tab 3|
| | |syrup (156mg), |infection, |joint pain, angioneurotic edema, |times daily |
| | |250mg\62.5mg\5ml syrup |intra-abdominal sepsis, |erythema multiforme, Steven |Child: |
| | |(312mg) |LRT, chronic bronchitis, |–Johnson syndrome, exofoliative |a)5-12 years: 156mg syrup; 10ml |
| | | |pneumonia, cystitis, |dermatitis), leukopenia, |3 times daily or 312mg syrup 5ml|
| | | |urothriris, septic |thrombocytopenia, eosinophilia, |3 times daily |
| | | |abortion, pelvic |increased urea nitrogen or |b)1-5 years: 156.25mg syrup 5ml |
| | | |infection, osteomyelitis,|creatinine, change of hepatic |3 times daily |
| | | |septicaemia, post |function (SGOT, SGPT) transient |c)9 month-1 year: 156.25mg 2.5ml|
| | | |operative infection |hepatitis and jaundice |3 times daily |
| | | | | |d)0-9 month: 62.5mg drop: |
| | | | | |25mg\kg\day |
| | | | | | |
| | | | | |Adult+Child>12 years: |
| | | | | |Mild+moderate infection: 1 curam|
| | |Amoxicillin\ | | |(375mg tab) 3 times daily |
| | |Clavulanic acid: | | |Severe infection+RT: 1 (625mg |
| | |500mg\125mg\5ml (625mg) | | |tab) 3 times daily |
| | |f.c.tab, | | |Child: |
| | |125mg\31.25mg\5ml | | |a)7-12years: 10ml (156.25mg\5ml)|
| | |(156.25mg\5ml), | | |suspension 3 times daily or |
| | |250mg\62.5mg\5ml | | |312.5mg\5ml 3 times daily |
| |Curam |(312.5\5ml) powder for | | |b)2-7years: 156.25mg\5ml |
| | |O.S | | |suspension 3 times daily |
| | | | | |c)9 month-2years: 2.5ml |
| | | | | |(156.25mg\5ml suspension 3 times|
| | | | | |daily |
Quinolones
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |
| | |form | | |
|Ciprofloxacine |Ciprobay |500mg f.c.tab |LRT, urinary tract infection (urethritis, |Nausea, vomiting, diarrhoea, abdominal pain, |
|(fluroquinolones) | | |cystitis), bone and joint infection, skin |dyspepsia, headache, dizziness, restlessness, |
| |Ciprocin |250mg\500mg\750mg tab,|and soft tissue infection, biliary tract |rash, pruritis, photosensitivity, |
| | |20ml\40ml boxes of |infection, infectious diarrhoea, typhoid |crystalluria, elevated creatinine\BUN\ALT\AST,|
| | |1\50\100 vials |and paratyphoid fever, prostitis, |renal, genitourinary and cardiovascular\ |
| | | |gonorrhoea, chancroid, meningococcal |respiratory side effects (rare), blurred |
| | | |meningitis prophylaxis, sexually |vision, disturbed vision, diplopia, joint pain|
| | | |transmitted disease, chronic sinusitis and|and stiffness |
| | | |otitis externa, septicaemia | |
| | |250mg\500mg f.c.tab | | |
| | | | | |
| | | | | |
| |Ciprodar | | | |
| | | | | |
| | |250mg\500mg\750mg tab,| | |
| | |100mg\200mg\5ml | | |
| | |infusion | | |
| | | | | |
| |Ciprolon | | | |
| | |250mg\500mg tab | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| |Estecina | | | |
|Flumequine |Apurone |400mg tab |Urinary tract infection |Nausea, diarrhoea, local irritation, edema |
|Levofloxacin |Tavanic |500mg tab |Acute sinusitis, inflammation of lower |Skin reaction (itching, rash), cramping of |
| | | |airways, complicated urinary tract |bronchi, sudden drop in BP or shock (rare), |
| | | |infection, skin and soft tissue infection |headache, vertigo, dizziness, paraesthesia, |
| | | | |vision, hearing disorder, abnormal rapid |
| | | | |beating of heart, circulatory collapse, tendon|
| | | | |pain, tendon rupture, increase liver enzyme, |
| | | | |increase bilirubin\ serum creatinine, |
| | | | |inflammation of liver, allergic reaction, |
| | | | |eosinophilia, leukopenia, neutropenia, |
| | | | |agranulocytosis, asthenia, fever, allergic |
| | | | |inflammation of lung, vasculitis |
|Norfloxacin |Noroxin |400mg tab |Upper and lower (acute and chronic urinary|GI disturbances (nausea, vomiting, heart burn)|
| | | |tract infection (cyslitis, pyelitis, |neuropsychiatric, skin reaction, headache, |
| | | |cytopyelitis, pyelonephritus prostates, |dizziness, anxiety, irritability, abdominal |
| |Uroctal |400mg tab |epididnitis and infection 2º to urologic |pain, cramp, joint and muscle pain, diarrhoea,|
| | | |surgery, nephrolithiasis), acute bacterial|sleep disturbances, anorexia, hallucination, |
| | | |gastroenteritis (gonococcal urethritis |elevated ALAT (SGPT), ASAT (SGOT), |
| | | |caused by penicillase and nonpenicillase |eosinophilia, neutropenia, angioedema, |
| |Urobacid |400mg f.c.tab |neisseria gonorrhoea), typhoid fever, |urticaria, photosensitivity, Steven-Johnson |
| | | |prophylaxis of sepsis with profound |syndrome, toxic epidermal neurolysis, |
| | | |neutropenia and bacterial gastroenteritis |pseudomembrance colitis, increase BUN\ |
| | | | |bilirubin\ creatinine |
|Ofloxacin |Tarivid |200mg f.c.tab |Acute and chronic lower respiratoy tract |Stomach upset, abdominal pain, nausea, |
| | | |(Haemophilus influenza, staphylococcus |vomiting, diarrhoea, jaundice, hepatitis, |
| | | |aureus), pneumonia (E.coli, Klebsiella, |severe liver damage (rare), headache, |
| | | |pseudomonas), chronic and recurrent |dizziness, agitation, drowsiness, tachycardia,|
| |Uro Tarivid |100mg f.c.tab |infection of ENT (pseudomonas, |reduction in RBC due to increase destruction, |
| | | |staphylococcus), infection of soft tissue |impairement of renal function, itching, skin |
| | | |and skin, bone and joint infection, |rash, erythemia, hypersensitivity, fever, |
| | | |abdominal infection including infection on|eosinophilia, inflammation of lung |
| | | |pelvis, minor and bacterial enteritis, | |
| | | |infection of kidney\ urinary tract\ | |
| | | |genital organ, gonorrhoea | |
|Pefloxacine |Peflacine |400mg f.c.tab |Antibacterial activity, essential cystitis|Gastralgia, nausea, vomiting, diarrhoea, |
| | | |in women under 65 caused by susceptible |photosensitivity, erythemia, pruritis, |
| | | |organism, gonococcal urethritis in men |tendonitis, myalgia, arthralgia, joint |
| | | | |effusion, convulsion, vigiliance, |
| | | | |hallucination, myoclonia, headache, vertigo, |
| | | | |urticaria, increase transaminase, |
| | | | |creatininemia |
Cycline
Doxycyclin
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Doxycyclin |Dotur |100mg cap |Respiratory tract infection |Nausea, vomiting, diarrhoea, | |
| | | |(pharyngitis, tonsillitis, otitis |loss of appetite, | |
| | | |madia, bronchitis, sinusitis), |pseudomembrance colitis, | |
| | | |pulmonary infection (lobar and |dermatitis, stomatitis | |
| | | |multilober pneumonia), infection |photosensitivity, erythematous | |
| |Doxylag |100mg tab, 100mg |of urinary tract, urogenital tract|rashes, urticaria, | |
| | |cap, 10mg\ml syrup |(pyelonephritis, pelitis, |angioneurotic edema, Quincke’s | |
| | | |cystitis, urethritis), infection |edema (swelling of face and | |
| | | |of intestinal tract and bile duct,|throat), hemolytic anemia, | |
| | | |infection of skin and soft tissue |neutropenia, eosinophilia, | |
| | |100mg coated tab |(impetigo, abscess, infected |thrombocytopenia, genital | |
| | |(film coated, scored|wounds, paronychia), joints, |fungal infection, risk of renal| |
| |Granudoxy |tab) |specific infection like |toxicity or tooth staining are |Adult: 100-200mg\day |
| | | |brucellosis, anthrax, borreliosis,|lower with doxycyclin than with|Child >8: 4mg\kg\day |
| | | |traveler’s diarrhoea, malaria, eye|other teracyclines, increase |Acne: 100mg\day for 10-15 |
| | | |infection, acne vulgaris (papular |BUN, super infection by |days then increased to |
| | | |form)or conglobata with |organism resistant to |50mg\day |
| | | |amebicides, treatment of |anti-biotic are possible, | |
| | |100mg cap |leptospirosis, selective |inhibition of tooth enamel | |
| | | |prophylaxis of cholera, |development when admininstered | |
| | | |rickettsia, rocky mountain spotted|to children below 8 | |
| | | |fever, typhus fever and typhus | | |
| |Retadox | |group, tick fever | | |
| | | | | | |
| | |100mg cap |Retadox: when penicillin is | | |
| | | |contraindicated it is used for | | |
| | | |Neisseria gonorrhoea, Treponema | | |
| | | |pallidum, Clostrodium, Bacillus | | |
| |Farmadoxi | |anthracis | | |
| | | | | | |
| | |100mg cap | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Vibramycin | | | | |
|Tetra-cycline |Tetramed |250mg\500mg cap, |G -ve bacillary infection, |Anorexia, nausea, vomiting, | |
| | |125mg\250mg\5ml |rickettsial disease, G +ve |glossitis, inflammatory | |
| | |suspension, 3% oint |infection resistant to penicillin |lesiens, maculopapular and | |
| | | |and susceptible bacterial |erythmatous rashes, exfoliative| |
| | | |infection, urinary tract infection|dermatitis, photosensitivity, | |
| | | |due to E.coli, A. aerogenes, |increase in BUN, urticaria, | |
| | | |staphylococci, streptococci, |angioneuretic edema, | |
| | | |infection of skin |anaphylaxis | |
|Lyme-cycline |Tetralysal |150mg cap |Infection of germs sensitive to |Diarrhoea, nausea, allergic | |
| | | |cyclines, pulmonary\ genital\ |reaction, photosensitivity | |
| | | |cutaneous\ ORL manifestation | | |
|Mino-cycline |Minocin |50mg cap | | | |
Sulfonamides with Trimethoprim
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Sulfamethoxazole |Bactekod |4g\100ml suspension |Acute and chronic |Nausea, vomiting, stomach ache, skin rash with |
|Trimethoprim | | |infection due to |itching, urticaria, blister, burning (Lyell syndrome, |
| | | |sensitive organism|Steven-Johnson syndrome), polymorphous erythemia, |
| | | | |hepatitis, pseudomembrance colitis, Change in blood |
| | | | |count taking form of nose or gum bleeding, unexplained|
| | | | |fever, intense tiredness, angioneurotic edema (type of|
| | | | |urticaria with sudden fluid infiltration of face and |
| |Bactrim Forte |Sulfamethoxazole\ | |neck), fever, cases of impaired renal function, |
| | |Trimethoprim: 800mg\160mg f.c.tab | |neurological events |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| |Septrin DS | | | |
Other Antibacterials
|Generic name |Trade name |Dose\Pharmaceutical form|Indication |Side Effects |
|Mupirocin |Bactroban |15g oint. |Bacterial skin infection: impetigo, |Burning sensation, stinging, itching, cutaneous |
| | | |folliculitis, furunculosis |sensatisation, systemic allergic reaction |
|Sod. Fusidate |Fucidin |250mg tab, 50mg\ml oral |Infection by susceptible organism: |Dyspepsia, nausea, vomiting, diarrhoea, |
| | |suspension, cream, |staphylococci (osteomelitis, septicaemia, |reversible jaundice, allergic reaction |
| | |oint.,gel |endocarditis, cystic fibrosis, pneumonia, | |
| | | |skin and soft tissue infection, surgical | |
| | | |and traumatic wound infection | |
|Tinidazolum |Fasigyn |500mg f.c.tab |GI infection, vaginitis (Gardnerella |GI (anorexia, metallic taste, diarrhoea, nausea,|
| | | |vaginalis), intestinal and liver infection|vomiting), headache, tiredness, dark urine, skin|
| | | |(Entamoeba histolytica) |rash, pruritis, stomatitis, dizziness, vertigo, |
| | | | |ataxia, leukopenia, candidal overgrowth in |
| | | | |vagina |
Anti-tuberculosis Agents
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Rifampicin |Rifadin |300mg cap |Infection caused by |Epigastric pain, anorexia, nausea, vomiting, |
| | | |micro-organism susceptible to |cramp, diarrhoea, headache, asthenia, vertigo, |
| | | |rifampicin and in particular to|visual disturbance, cutaneous rash, urticaria, |
| | | |mycobacterium tuberculosis and |pruritis, eosinophilia, ulcerative stomatitis, |
| | | |other mycobacteria |glossitis, thrombocytopenia, leucopenia, |
| | | | |haemolytic anaemia, hepatitis with jaundice, renal|
| | | | |insufficiency, haematuria, haemogloinuria, |
| | | | |alkaline phosphatase, transaminase |
|Pyrazinamide |Perilene |500mg tab |TB |Digestive troubles, loss of appetite, nausea, |
| | | | |vomiting, increase uric acid, hepatitis |
|Isoniazide |Rimifon |50mg\150mg tab |TB |Fever, loss of appetite, nausea, vomiting, |
| | | | |allergy, increase hepatic enzymes, neurological |
| | | | |troubles |
Combined Anti-bacterial
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |
|Spiramycin |Rodogyl |Spiramycin\ |Treatment of |Stomach cramp, nausea, vomiting, diarrhoea, urticaria,|
|Metronidazole | |Metronidazole: 750000 I.U\ 125mg |buccodental infection |itching, Quinke’s edema, metallic taste in mouth, |
| | |f.c.tab |(dental abscess, |inflammation of tongue with sensation of dry mouth, |
| | | |phlegmons, infection of|inflammation of oral mucosa, anorexia, headache, |
| | | |salivary gland), |dizziness, confusion, convulsion, pancreatitis, |
| | | |preventive treatment of|reddish-brown coloration, of urine, due to presence of|
| | | |local infection after |water soluble pigments derived from metabolism of |
| | | |stomatological and |medicine, leukopenia, altered perception of sensation |
| | | |dental surgery |which have always diminished on stopping the treatment|
Topical Anti-bacterial
Alone
|Generic name |Trade name |Dose\Pharmaceutical|Indication |Side Effects | |
| | |form | | | |
|Clindamycin |Dalacin T |10mg\ml topical |Antibacterial | | |
| | |solution | | | |
| |Eyfluid | | | | |
| |Erythromycin | | | | |
|Silver sulfadiazine |Flamazine |1% cream |Treatment of leg ulcer, |Leucopenia in patients with |Burn: burn wound should be |
| | | |burn, skin graft, incision|large area burns, rash (in some|cleaned and silver sulfadiazine |
| | | |and other clean lesions, |patients); for larger body |applied over all affected area |
| | | |abrasions, minor cuts and |surfaces (greater than 20% body|to depth 3-5mm; applied at least|
| | | |wounds; it is especially |surface area) significant |every 24hrs. |
| | | |indicated in treatment and|amount of SSD are systemically |Hand burn + finger injuries: |
| | | |prophylaxis of infection |absorbed; therefore, it is |apply to burn and whole hand is |
| | | |in serious burn victim |possible that any adverse |enclosed in clear plastic bag or|
| | | | |reactions associated with |glove which then closed to at |
| | | | |sulfonamide may occur |wrist; dressing should be |
| | | | | |changed every 3 days or when |
| | | | | |excessive exudates has |
| | | | | |accumulated |
| | | | | |Leg ulcer: fill cavity of ulcer |
| | | | | |with sulfadiazine to depth at |
| | | | | |least 3-5mm, the cream should be|
| | | | | |followed by an adsorbent pad or |
| | | | | |gauze dressing with further |
| | | | | |application of pressure |
| | | | | |bandaging as appropriate for |
| | | | | |ulcer; dressing should be |
| | | | | |changed every 2-3 days with |
| | | | | |cleaning and debriding being |
| | | | | |before appication; avoid |
| | | | | |spreading cream onto |
| | | | | |nonulcerated area |
| |Fucidin | | | | |
|Gentamicin |Garamycin |1mg (0.1%) |Treatment of both 1º and | |Apply 3-4 times\day; cover with |
| | |cream\oint |2º infection due to | |gauze dressing if desired |
| | | |susceptible bacteria | |Impetigo contagiosa: crust |
| | | | | |should be removed before |
| | | |1º infection: impetigo | |application to permit maximum |
| | | |contagiosa, superficial | |contact between antibiotic and |
| | | |folliculitis, erythyma, | |infection; concomitant treatment|
| | | |furunulosis, sycosis | |of skin around ulcer with |
| | | |barbae, pyoderma | |topical corticosteroid helps |
| | | |gangorenosum | |control inflammation |
| | | |2º skin infection: | | |
| | | |infectious eczematoid | | |
| | | |dermatitis, pustular acne,| | |
| | | |pustular psoriasis, | | |
| | | |infected seborrheic | | |
| | | |dermatitis, infected | | |
| | | |contact dermatitis, | | |
| | | |infected excoriation and | | |
| | | |bacterial superinfection | | |
| | | |of fungal or viral | | |
| | | |infection; used in | | |
| | | |treatment of infected | | |
| | | |stasis, other skin ulcer, | | |
| | | |infected superficial burn,| | |
| | | |paronychia, infected | | |
| | | |insect bite and stings, | | |
| | | |scrapes and wounds from | | |
| | | |minor surgery | | |
|Azelaic acid |Skinoren |0.2 cream |Anti-acne | | |
|Tetracycline |Tetramed |3% oint |Antibiotic | | |
|Tyrothricin |Tyrosur |0.1g\100g oint \ |Help prevent and treat |Hypersensitivity to tyrothricin|Apply several times per day; in |
| | |nasal oint \ powder|wound infection; tissue |and cetypyridinium chloride |large or strongly weeping wounds|
| | | |lesions due to surgery, | |the use of dressing, which |
| | | |burn, erosive | |should be changed after 1-2 days|
| | | |(superficial) or ulcerous | |is advisable |
| | | |lesions of skin and | |Apply powder thinly 1-2 times |
| | | |mucosa, microbial and 2º | |daily to affected area and cover|
| | | |infected eczema, purulent | |with bandage |
| | | |skin inflammation and | | |
| | | |thrush fungus infection of| | |
| | | |skin | | |
Combined
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Bacitracin |Baneocin |10g powder, 20g oint |Infection caused by neomycin or |Allergic reaction (redness |Powder: apply 2-4 times |
| | | |bacitracin sensitive bacteria |and dryness of skin, skin |daily |
| | | |Powder: |rash, chronic dermatoses |Oint: 2-3 times daily |
| | | |1)bacterial skin infection: herpes |(baneocin promotees | |
| | | |simplex, herpes zoster, wetting |sensitization to various | |
| | | |impetigo contagiosa, infected |other drugs including | |
| | | |circular ulcer, prevention of |neomycin), | |
| | | |umbilical infection in newborn, |vestibular and cochlear | |
| | | |adjuvant treatment in post operative |damage, nephrotoxicity, | |
| | | |care (after surgical procedure) |neuromuscular blockade | |
| | | |Oint: | | |
| | | |1)focal bacterial skin infection like| | |
| | | |carbancles | | |
| | | |2)bacterial skin infection like | | |
| | | |impetigo, burns, skin grafting | | |
| | | |3)after major or minor surgical | | |
| | | |procedures | | |
|Bacitracin |Batramycin |Bacitracin\ |antibiotic | | |
|Neomycin | |Neomycin: 300IU\5mg | | | |
| | |oint | | | |
With other substances
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Betamethasone |*Betnovate N |Betamethasone\ |Topical treatment of |Burning, itching, irritation,|Apply 2-3 times daily |
|Neomcin | |Neomycin: 0.1% \0.5% |steroid responsive |acneform eruption, skin | |
| | |w\w cream\oint\lotion |dermatoses where 2º |atrophy and allergic contact | |
| | | |infection is present; |dermatitis have been | |
| | | |treatment of following |occasionally reported | |
| | | |conditions where 2º | | |
| | | |bacterial infection is | | |
| | | |present, suspected or | | |
| | | |likely to occur; eczyma | | |
| | | |including atopic, | | |
| | | |infantile, discoid, stasis| | |
| | | |eczyma, prurigo; | | |
| | | |psoriasis, seborrhoeic | | |
| | | |dermatitis, contact | | |
| | | |sensitivity reaction, | | |
| | | |discoid lupus | | |
| | | |erythematosus management | | |
| | | |of insect bite, sunburn, | | |
| | | |pickly heat, anal and | | |
| | | |vulval pruritus and otitis| | |
| | | |externa | | |
|Betamethasone |Fucicort |Betamethasone\ |Anti-bacterial, | | |
|Fusidic acid | |Fusidic acid: 1mg \ |anti-inflammatory and | | |
| | |20mg cream |anti-pruritic agent | | |
|Hydrocortisone |Fucidin H |Hydrocortisone\ |Anti-bacterial, | | |
|Fusidic acid | |Fusidic acid: 10mg \ |anti-inflammatory | | |
| | |20mg cream | | | |
|Triamcinolone |Kenacomb |Triamcinolone\ |Antibiocorticotherapy | | |
|Neomycin | |Neomycin\ | | | |
|Gramicidin | |Gramicidin\ | | | |
|Nystatin | |Nystatin: 0.1% \ 0.25% | | | |
| | |\ 0.025% \ 100000units | | | |
| | |cream, 0.1% \ 0.25% \ | | | |
| | |0.025% \ 100000 units | | | |
| | |oint | | | |
|Neomycin |Pulvo 47 neomycin |Neomycin\ |In surgery and |Neomcin: contact dermatitis, |1 application before each |
|Catalasic fraction of | |Catalasic fraction of |traumatology (super |crossed hyper-sensitivity |dressing; 1 spray daily or |
|horse liver | |horse liver: 160mg \ |infection of burns and |with other aminoglycoside |every 2 days in dry wound; 1 |
| | |800000 IU powder |superficial wounds) |antibiotic |spray 1-2 times daily on oozing|
| | | | |Catalase: anaphylaxis |wounds; limited to 8 days, |
| | | | | |avoid applying to extensive |
| | | | | |areas |
| | | | | | |
| | | | | |Cleanse wound with |
| | | | | |physiological saline or acid |
| | | | | |antiseptic solution; dab the |
| | | | | |wound dry with a gauze compress|
| | | | | |before applying pulvo 47 |
| | | | | |neomycin, shake bottle before |
| | | | | |use; at distance 20cm from |
| | | | | |wound spray a thin film by |
| | | | | |pressing 2-3 times for few |
| | | | | |fraction of second; apply a |
| | | | | |dressing |
Anti-viral
|Generic name |Trade name |Dose\Pharmaceutical form|Indication |Side Effects |
|Acyclovir |Zovirax |200mg\400mg\800mg tab, |Treatment of herpes simplex virus infection |Skin rash, nausea, vomiting, abdominal pain, |
| | |200mg\400mg\5ml |of skin and mucus membranes including initial|reversible neuralgia, dizziness, confusional |
| | |suspension |and recurrent genital herpes, suppression of |states, hallucination, somnolence, fits and |
| | | |recurrent herpes simplex in patients with |psychosis, increase of bilirubin, liver enzymes,|
| | | |normal immune function, prophylaxis of herpes|serum urea, creatinine, slight fall in blood |
| | | |simplex infection in immune-compromised |count, loss of hair, headache, fatigue |
| | |200mg tab |patients, treatment of herpes zoster | |
| | | |infection, has beneficial effect on | |
| |Supraviran | |zoster-associated pain, treatment of | |
| | | |chickenpox | |
| | | | | |
| | |200mg\400mg tab | | |
| | | | | |
| |Cyclovex | | | |
|Valaciclovir |Valtrex |500mg tab |Treatment of herpes zoster (shingles), |Mild headache, nausea, renal insufficiency, |
| | | |treatment of herpes simplex (HSV) of skin and|microangiopathic haemolytic anaemia and |
| | | |mucus membranes including initial and |thrombocytopenia |
| | | |recurrent genital herpes | |
Antifungal
Systemic Anti-fungal
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |
| | |form | | |
|Fluconazole |Diflucan |50mg\150mg\200mg |Cryptococcosis including cryptococcal |Nausea, abdominal pain, diarrhoea, flatulence, |
| | |cap, 5mg\ml syrup, |meningitis and infection of other sites (it can|rash, headache, change in renal and |
| | |200mg\100ml IV, |be used as maintenance therapy to prevent |hematological functional events, hepatic |
| | |100mg\50ml IV |elapse of cryptococcal disease in patients with|abnormalities and cases of hepatotoxicity |
| | | |AIDS, organ transplantation, other causes of |(patients with AIDS, CANCER), exfoliative skin |
| | | |immunosuppression), genital candiasis, systemic|disorders, seizure, leukopenia including |
| | | |candiasis including candidemix, disseminated |neutropenia, agranulocytosis, thrombocytopenia, |
| | |50mg\150mg cap |candiasis and other forms of invasive candidal |alopecia, azole, anaphylactic reaction |
| | | |infection including infection of peritoneum, | |
| | | |endocardium, eye, pulmonary and urinary tract | |
| | | |(patients with malignancy and in intensive care| |
| |Flunazol | |unit), mocosal candiasis which include | |
| | | |oropharyngeal, esophageal, noninvasive | |
| | | |bronchopulmonary infection, urinary tract as | |
| | | |well as mouth in case of chronic oral atrophic | |
| | | |candiasis, candiduria, mucocutaneous candiasis | |
| | | |(children with compromised immune function), | |
| | | |prevention of fungal infection in children with| |
| | | |malignancy who are predisposed to such | |
| | | |infection as a result of cytotoxic chemotherapy| |
| | | |or radiotherapy, dermatocandiasis including | |
| | | |tinea pedis, tinea corporis, tinea cruris, | |
| | | |pityriasis versicolor and dermal candiasis, | |
| | | |deep endemic mycosis including | |
| | | |coccidioidomycosis, paracoccidioidomycosis, | |
| | | |sporotrichosis and histoplasmosis in | |
| | | |immunocompetent patients | |
|Griseofalvin |Griseo-fuline |250mg\500mg tab |Treat disease of skin, nail, scalp due to |Headache, vertigo, nausea, irritability, |
| | | |various microscopic fungi |confusion, insomnia, drowsiness, antabuse effect|
| | | | |in presence of alcohol, reduction of appetite, |
| | | | |alteration of taste, thirst, skin allergy, |
| |Griseo-fulvin |500mg tab | |alteration of liver function, risk and worsening|
| | | | |of the manifestation of systemic lupus |
| | | | |erythematosus |
|Itraconazole |Fonginox |100mg cap |Treatment of fungal infection including |Dyspepsia, nausea, abdominal pain, constipation,|
| | | |candidosis, gynaecological indication |headache, reversible increased hepatic enzyme, |
| |Sporanox |100mg cap |(Vulvovaginal candiasis), dermatological \ |menstrual disorder, dizziness, allergic reaction|
| | | |ophthalmological indication (pityriasis |(pruritis, rash, urticaria), peripheral |
| | | |versicolor, dermatomycosis, fungal keratitis |neuropathy, Steven-Johnson syndrome |
| | | |and oral candiasis, onychomycosis caused by | |
| | | |dermatophytes or yeast, systemic mycosis | |
| | | |(systemic aspergillosis and candidosis, | |
| | | |cryptococcosis, sporotrichosis, paracoccidioid | |
| | | |mycosis, blastomycosis and other rarely | |
| | | |occurring systemic or topical mycoses | |
|Ketoconazole |Ketonaz |200mg tab |Treatment of candiasis, oral thrush, chronic |Nausea, vomiting, abdominal pain, pruritis, |
| | | |mucocutaneous candiasis, candiduria, |headache, dizziness, jaundice, gynecomastia, |
| | | |histoplasmosis, pilyriasis versicolor |transient elevation of serum liver enzymes |
|Terbinafine |Lamisil |250mg tab, 10mg\g |Shouldn’t be used to treat extensive, severe, |Bloated feeling, nausea, mild abdominal pain, |
| | |solution, 10mg\g |ringworm infection and infection of skin caused|diarrhoea, loss of appetite, dyspepsia, rash, |
| | |spray solution, 1 % |by genus candida where oral therapy is |urticaria, Steven-Johnson, malaise and headache,|
| | |cream (15g) |considered appropriate owing to the site, |impairement of sense of taste, hepatitis, |
| | | |severity or extent of infection, onychomycoses |cholestasis, neutropenia and thrombocytopenia |
| | | |due to infection with dermatophyte organism, | |
| | | |oral lamisil is not effective against vaginal | |
| | | |candiasis or pitriasis versicolor | |
|Nystatin |Mycostatin |30ml\60ml suspension|Treatment of oral and intestinal mycotic |Diarrhoea, GI pain |
| | | |infection caused by Candida albicans and other | |
| | | |candida species | |
|Ketoconazole |Nizoral |20mg tab, 20mg\ml |Tab + suspension: |Tab + suspension: |
| | |suspension, 100ml |1)Infection of skin, hair, nails induced by |Dyspepsia, nausea, abdominal pain, diarrhoea, |
| | |shampoo, tube of 15g|dermatophytes or yeasts provided these |headache, increased hepatic enzymes, menstrual |
| | |and 30g cream |infections can’t be treated topically because |disorders, dizziness, photophobia, paraesthesia,|
| | | |of site or extension of lesion, deep affection |allergic reaction, thrombocytopenia, alopecia |
| | | |of skin or if they fail to respond to local | |
| | | |therapy | |
| | | |2)yeast infection of GI | |
| | | |3)chronic, recurrent vaginal candiasis | |
| | | |4)systemic fungal infection | |
| | | |5)prophylactic treatment of patients with | |
| | | |decreased defense mechanism | |
| | | |pityriasis capitis | |
Topical Antifungal
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Ciclopirox |Batrafen |3g solution |Fungal infection of nail |Redness and scaling | |
| | | | |where batrafen nail | |
| | | | |lacquer has come in | |
| | | | |contact with skin | |
| | | | |adjacent to nail | |
|Clotrimazole |Canestene |0.01g cream, |All dermatomycoses due to |Burning, stinging, |Apply 2-3 times daily |
| | |0.01g\ml solution |dermatophytes (Trichopyton |redness |Duration: |
| | | |species), all dermatomycoses | |Dermatomycoses: 3-4 weeks |
| | | |due to yeast (Candida | |C. vulvitis and C. balanitis: 1-2 |
| | | |species), dermatomycoses due | |weeks |
| | | |to mould and other fungi; | |Erythrasma and pityriasis versicolor:|
| | | |skin diseases showing | |3 weeks |
| | | |superinfection with these | |Fungal infection of feet and to |
| | | |fingi. To dermatomycoses ex: | |prevent relapses: 2 week free |
| | | |interdigital mycosis | |symptoms |
| | | |(athlete’s foot), paronychias| | |
| | | |(associated with nail | |Solution: |
| | | |mycoses), mycoses in skin | |Apply thinly 2-3 times daily, few |
| | | |folds, C. vulvitis, C. | |drops are sufficient |
| | | |balanitis, pityriasis | |Dermatomycoses: 3-4 weeks |
| | | |versicolor, erythrasma | |Erythrasma and pityriasis versicolor:|
| | | | | |3 weeks |
| | | | | |Fungal infection of feet and to |
| | | | | |prevent relapses: 2 week free |
| | | | | |symptoms |
|Miconazole |Daktarin |20mg\1g cream\oral |Antifungal; oral and |Mild gastro-intestinal |6 years and above: 1\2 teaspoonful 4 |
| | |gel\lotion\ |intestinal candiasis; may be |disturbances may occur |times daily after meals |
| | |powder\ |used prophylactically in | |2-6 years: 1\4 teaspoonful 4 times |
| | |tincture |patients at high risk of | |daily |
| | | |opportunistic fungal | |< 2 years: 1\4 teaspoonful 2 times |
| | | |infection | |daily |
| | |20mg\1g oral gel | | | |
| |Miconaz | | | | |
|Imidazole |Ketonaz |Antifungal, |Seborrhoeic dermatitis, |Pruritus, dryness of | |
| | |anti-dandruff shampoo |pityriasis versicolor |skin | |
|Terbinafine |Lamisil |1 % cream (15g) |Fungal infection caused by |Redness, itching, | |
| | | |dermatophytes such as |stinging may occur at | |
| | | |Trihophyton (T. rubrum, T. |site of application; | |
| | | |mentagrophytes, T. |however treatment | |
| | | |verrucosum, T.violaceum, |rarely has to be | |
| | | |Microsporum canis and |discontinued for this | |
| | | |Epidermophyteon floccosum, |reason, allergic | |
| | | |Pityriasis (tines), |reaction | |
| | | |versicolor due to | | |
| | | |pityrosponeum orbiculare also| | |
| | | |known as Malassezia furfur | | |
|Nystatin |Mycostatin |100000 IU cream\oint |Antifungal | | |
|Ketoconazole |Nizoral |Cream (15g-30g), 100ml |Topical: |Topical: | |
| | |shampoo |Treatment of dermatophyte |Irritation, burning | |
| | | |infection of skin (tinea |sensation, allergic | |
| | | |corporis, tinea cruris, tinea|local skin phenomenon | |
| | | |manus, tinea pedis due to |such as contact | |
| | | |Trichophyton rubrum, |dermatitis | |
| | | |Trichophyton mentagrophytes, |Shampoo: | |
| | | |Microsporum canis and |Local burning, | |
| | | |Epidermophyton floccosum), |irritation, oily hair, | |
| | | |treatment of cutaneous |discoloration of hair | |
| | | |candidosis and tinea | | |
| | | |versicolor, treatment of | | |
| | | |seborrhoeic dermatitis, skin | | |
| | | |condition related with | | |
| | | |presence of pityrosporum | | |
| | | |circule | | |
| | | |Shampoo: | | |
| | | |Treatment and prophylaxis of | | |
| | | |infection in which the yeast | | |
| | | |pityrosporum is involved such| | |
| | | |as pityriasis versicolor, | | |
| | | |seborrhoeic dermatitis and | | |
|Selenium sulfide |Selsun |2.5g\100ml lotion |Antifungal | | |
|Isoconazole |Travacort |Isoconazole\ |Antimycotic and corticoid | | |
|Diflucortolone | |Diflucortolone: 10mg \ |additives | | |
| | |1mg per gram cream | | | |
|Isoconazole |Travagen |10mg\g cream |Antimycotic | | |
|Octopirox (piroctone |Hongolid |Octopirox \ |For skin care and hygiene as |Occular irritation; has| |
|olamine) | |Undecyclenic acid |a protector against fungal or|no irritative effect on| |
|Undecyclenic acid | |derivative: 0.5% \ 2% |bacterial cutaneous |mucosa or skin | |
|derivative | |liquid soap |infection, it is especially | | |
| | | |recommended when such local | | |
| | | |places as gymnasium, swimming| | |
| | | |pools, hotel, etc to be | | |
| | | |visited when infection risk | | |
| | | |may be v.high | | |
Non Steroidal Anti-inflammatory Drugs (NSAID)
Indolic
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |Posology |
|Indomethacin |Indocid |25mg cap, 100mg supp |Rheumatoid arthritis, |Headache, dizziness, |Adult: 150-200mg\day or |
| | | |osteoarthritis, |light headedness, |4mg\kg\day |
| | | |degenerative joint |confusion, dyspepsia, GI|Children: 2mg\kg\day |
| | | |disease of hip, |bleeding, disturbed | |
| | | |ankylosing spondylitis, |renal and hepatic | |
| | | |gout, acute |function, fatigue, | |
| | | |musculoskeletal disorder |insomnia, anaphylactic |1 cap 1-2 times daily |
| | |75mg cap |(synovitis, sprains, |reaction, haematouria, | |
| |Indocid retard | |strains…), lumbago, |anorexia, convulsions, |2-6 cap |
| | | |fever, oedema, dental |bleeding | |
| |Tresortil |25mg cap |procedures, 1º | |1-2 tab\12 hrs |
| | | |dysmenorrhea | | |
| |Flexin continus |25mg\50mg\75mg tab | | | |
|Sulindac |Clinoril |200mg tab |Osteoarthritis, |GI disturbance |200-400mg |
| | | |rheumatoid arthritis, |(dyspepsia, nausea, | |
| | | |bursitis, tendonitis, |anorexia, GI cramp, | |
| | | |tenosynovitis |flatulence..), | |
| | | | |dermatological (rash, | |
| | | | |pruritis), dizziness, | |
| | | | |headache, tennitis, | |
| | | | |oedema | |
|Etodolac |Lodine 300 |300mg tab |Rheumatoid arthritis, |GI toxicity (bleeding, |1 tab 2 times daily |
| | | |osteoarthitis |ulceration..), | |
| | | | |impairment of renal or | |
| | | | |hepatic function, | |
| | | | |anemia, oedema | |
Aryl Carboxylic
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |Posology |
|Aceclo-fenac |Airtal |100mg tab |Odontalgia, | |2 tab divided into 2 intakes; 1 tab|
| | | |post-traumatic | |every 12 hrs |
| | | |tumefaction, malgia, | | |
| | | |extra-articular | | |
| | | |rheumatism, rheumatoid | | |
| | | |arthritis, ankylosing | | |
| | | |spondylitis, arthrosis | | |
|Diclof-enac |Arthrotec 50 |diclofenac\misoprostol:50mg\200mg tab|Rheumatoid arthritis, |Abdominal pain, | |
| | | |osteoarthritis, |diarrhoea, nausea, | |
| | | |ankylosing spondylitis, |vomiting…, disturbance| |
| | |20mg\50mg enteric coated, 100mg |swelling following |in liver enzymes(SGPT,| |
| |Diclogesic 50 |f.c.tab\cap, 50mg\100mg supp, gel, |dental and orthopaedic |SGOT..), renal |100mg-150mg divided in 2-3 doses |
| | |75mg IM, 12.5 mg pediatric supp, eye |surgery, gout, post |failure, vaginal | |
| | |drop |traumatic, post |bleeding, headache | |
| | | |operative pain, |dizziness, skin rash, | |
| | | |gynecology and 1º |vertigo, hemolytic | |
| | | |dysmenorrhea, joint |anaemia, | |
| | |100mg cap |capsule, neuralgia, ENT |thrombo-cytopenia, | |
| | | |(adjuvant), antipyretic,|asthma, hypotension, | |
| | | |cervical syndrome, |impaired hearing, | |
| |Dicloretard | |lumbago, lumbalgia, |black discoloration of|100mg\day |
| | |500mg f.c.tab, 100mg supp |invertebral arthrosis, |stool, swelling of | |
| | | |migrane (Voltaren supp) |feet\face, insomnia, | |
| | | | |peripheral oedema, | |
| |Grofenac | | |bronchial spasm, |1-3 f.c.tab (50mg\day), 1 supp |
| | | | |papillary |(100mg) at night+1 |
| | | |misoprostol: prophylaxis|necrosis,local |f.c.tab(50mg\day) |
| | | |of gastric ulceration |irritation (supp), | |
| | | | |intestinal ulcer, | |
| | |25mg\50mg lactab, 50mg\100mg | |nightmare, tremor, | |
| | |rectocap, 100mg depocap, 75mg\2ml amp| |eczyma, | |
| | | | |photo-sensitivity, | |
| | | | |anaphylactic shock, |Adult: 50-150mg\day |
| |Olfen | | |chest pain, |Children:1-3mg\kg\day |
| | | | |hypertension, |Up to 2 injection\ day |
| | | | |congestive heart | |
| | | | |failure | |
| | | | | | |
| | | | | | |
| | |50mg cap, 120mg supp, 90mg\3ml amp | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | |1 cap 2-3 times daily, 1 supp |
| | | | | |(100mg)+1 cap (50mg), 1 amp 1-2 |
| |Tratul | | | |times daily |
| | | | | | |
| | | | | | |
| | | | | | |
| | |25mg\50mg tab, 12.5mg\100mg supp | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | |100-150mg |
| | |25mg\50mg tab, 25mg\100mg supp | | | |
| | | | | | |
| |Voltaren | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Xenid Ge | | | | |
|Ibupr-ofen |Advil |200mg coated tab |Relief of headache, |Interstitial |1-2 tab every 4 hrs |
| | | |toothache, menstrual |nephritis, nephritic | |
| | | |pain, pain associated |syndrome, renal | |
| | | |with arthritis, muscles,|failure, dyspepsia, GI| |
| | | |joint, backache, |intolerance, bleeding,|1200mg-1800mg in divided doses |
| |Brufen |400mg\200mg\600mg tab, 500mg supp, |reduction of fever, |skin rash, | |
| | |100mg\50ml\100ml\ 200ml\1000ml syrup |minor aches, soft tissue|thrombocyt-openia, | |
| | | |injuries, relief of |heartburn | |
| | | |migrane, dysmenorrhoea, | | |
| | | |athletic injuries | | |
| | | | | |1200-1600mg in 3-4 divided doses |
| | | | | |(anti-rheumatic), 200mg-400mg in |
| | |200mg\400mg\600mg tab, 100mg\5ml | | |4-6 hrs (anti-pyretic), 20-40mg\kg |
| | |pediatric suspension | | |(children, enfant) |
| |Prifinal | | | | |
|Ketop-rofen |Biprofenid |150mg scored tab |Rheumatic disorder, |Cutaneous allergy, |1-2 divided doses\day |
| | | |osteoarthritis, joint |respiratory allergy, | |
| | | |inflammation, lumbar |burlous lesions, GI |2 cap 2-3 times daily, 1-2 supp |
| |Flexen |50mg cap, 100mg supp, 30g\50g 2.5% |pain, gout, dislocation,|bleeding, nausea, |daily, 2-3 application gel, 1-2 amp|
| | |gel, 100mg amp IM\IV |ankylosing spondilitis, |vomiting, diarrhoea, |IV\IM |
| | | |thrombo-phlebitis,scia-t|headache , dizziness, | |
| | | |ica, sprains; |oedema, changes in |50mg 3-6 cap\day(150mg-300mg |
| | | |amp: musculo-skeletal |laboratory, |daily), 100mg supp 1-3 supp dail |
| | | |system |photo-sensitization, |(100mg-300mg\day |
| | | | |decrease consistency | |
| | |50mg cap, 100mg supp, 2.5% gel | |of faeces….. | |
| |Profenid | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | |200mg cap | | | |
| | | | | | |
| |Oruvail | | | | |
|Napro-xen |Proxen |250mg\500mg f.c.tab, 500mg supp, |Arthritis, ankylosing |GI complaints, CNS |1-2 f.c.tab(125-500mg) divided in |
| | |250mg\5ml syrup |spondylitis, soft tissue|disorder, itching, |2-3 doses |
| | | |rheumatism, painful |ulcer, kidney | |
| | | |complaints during |disorder, impaired | |
| | | |menstruation |hearing and vision, | |
| | | | |loss of hair | |
|Tiapro-fenac |Surgam |100mg\300mg tab |Rheumatoid arthritis, |Cystitis, dysuria, |300mg twice daily |
| | | |osteoarthritis, |haematuria, GI | |
| | | |ankylosing spondylitis, |disorder | |
| | | |low back pain, | | |
| | | |musculo-skeletal | | |
| | | |disorders, soft tissue | | |
| | | |inflammation | | |
Oxicam
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |Posology |
|Meloxicam |Mobic |7.5mg\15mg tab, 7.5mg\15mg |Painful osteoarthritis,|GI discomfort |7.5-15mg |
| | |supp |rheumatoid arthritis, |(dyspepsia, nausea, | |
| | | |ankylosing spondylitis |vomiting, constipation,| |
| | | | |flatulence, diarrhoea, | |
| | | | |elevated transaminase | |
| | | | |and bilirubin, | |
| | | | |gartro-duodenal ulcer, | |
| | | | |gastrointestinal | |
| | | | |perforation), anemia, | |
| | | | |leukopenia, | |
| | | | |thrombo-cytopenia, | |
| | | | |pruritis, skin rash, | |
| | | | |stomatitis, | |
| | | | |photo-sesitization, | |
| | | | |acute asthma, | |
| | | | |light-headedness, | |
| | | | |headache, drowsiness, | |
| | | | |oedema, increase BP, | |
| | | | |palpitation, flushes, | |
| | | | |abnormal renal | |
| | | | |function, elevated | |
| | | | |serum creatinine and | |
| | | | |urea | |
|Pirocicam |Brexin |20mg scored tab\double pocket|Acute painful |GI disturbance, | |
| | |sachets\supp |condition, rheumatoid |hypersensitivity, | |
| | | |arthritis, |headache, asthenia, | |
| | |2\6 amp, 10mg\20mg tab, |osteoarthritis, |elevated BUN, gastric | |
| |Feldene |10mg\12mg supp |ankylosing spondylitis,|ulcer, vomiting, | |
| | | |musculo-skeletal |elevated cutaneous | |
| | |10mg cap, 0.5% gel |disorder, gout, |photo-sensitivity, | |
| | | |following acute trauma,|aplastic anemia, | |
| |Piroxicalm | |relief of fever and |thrombo-cytopenia, |Rheumatoid arthritis, |
| | | |pain associated with |hematic alteration, |osteoarthritis, ankylosing |
| | | |acute URT, 1º |elevated liver |spondylitis (20-30mg\day), |
| | | |dysmeno-rrhoea |parameters, renal |musculo-skeletal disorder, gout |
| | | | |insufficiency, |(40mg for 1 week), relief of fever |
| | | | |cardio-circulatory, |and pain associated with acute URT |
| | | | |stomatitis, alopecia |(10-20mg\day), sprains and lumbago |
| | | | | |(3-4 times daily gel) |
| | | | | | |
| | | | | |20-30mg\day |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | |10mg\20mg cap, 20mg supp | | | |
| | | | | | |
| | | | | | |
| |Vitaxicam | | | | |
|Teno-xicam |Tilcotil |20mg tab, 20mg supp, 20mg |Rheumatoid arthritis, |Gastralgia, heart burn,| |
| | |vial |osteoarthritis, |nausea, diarrhoea, | |
| | | |ankylosing spondylitis,|constipation, ulcer, | |
| | | |acute gout, |dizziness, rash, | |
| | | |extra-articular |erythema, elevated BUN | |
| | | |disorder (tendonitis, |and creatinine, | |
| | | |periarthritis of |disturbance liver | |
| | | |shoulder or hip, |enzymes, | |
| | | |strains, sprains….) |hypersensitivity | |
| | | | |(asthma, angioedema, | |
| | | | |vasculitis and | |
| | | | |hepatitis | |
Fenamates
|Generic name |Trade name |Dose\Pharma-ceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Celecoxib |Celebrex |100mg-200mg cap |Osteoarthritis, rheumatoid|GI discomfort, back pain, |Osteoarthritis (100mg cap 2 times\day |
| | | |arthritis, reduce the |peripheral oedema, injury |or 200mg cap), rheumatoid arthritis |
| | | |number of adenomatous |accidental, dizziness, |(100-200mg 2 times\day, FAP (400mg) |
| | | |colorectal polyp in |headache, insomnia, | |
| | | |familial adenomatous |pharyngitis, rhinitis, | |
| | | |polyposis (FAP) |sinusitis, URT, rash | |
|Morniflumate (niflumic|Nifluril |400mg paediatric supp, |Rheumatic disease, dental |Stomach pain, vomiting, |Adult: 1 supp morning and evening |
|acid) | |700mg adult supp, 3% |pain, ENT, sore throat, |skin rash, itching, asthma|Child: 1-2 supp\day |
| | |cream |acute otitis media |attack, local reddness |Cream: 3 times daily |
| | | |(adjuvant), nephretic | | |
| | | |colic, sprains, venous | | |
| | | |inflammation | | |
|Rofecoxib |Vioxx |25mg\12.5mg\50mg tab |Reduce pain and discomfort|Stomach pain, dizziness, |12.5-25mg once a day |
| | | |incase of osteoarthritis |swelling of the legs, | |
| | | | |elevated BP, heartburn, | |
| | | | |diarrhoea, headache, itchy| |
| | | | |skin, abdominal bloating, | |
| | | | |weakness, chest pain, | |
| | | | |constipation, ringing in | |
| | | | |ear, wt gain, muscle | |
| | | | |cramp, depression, | |
| | | | |swelling of face, tongue | |
| | | | |or throat | |
NSAID + Corticosteroids
|Generic name |Trade name |Dose\Pharma-ceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Indomethacin\Dexa-methaso|Dexa-tresortil |25mg\0.25mg cap |Rheumatoid arthritis, |Headache, dizziness, |2-6 cap\day |
|ne | | |ankylosing spondylitis, |light-headedness, | |
| | | |gout, bursitis, tendinitis,|confusion dyspepsia, GI | |
| | | |tenosynovitis |bleeding, ulceration, | |
| | | | |fluid retention, fatigue, | |
| | | | |drowsiness, insomnia, | |
| | | | |anaphylactic shock | |
|Vit B12\Dexa-methasone+ |Trabit |2500mcg\4mg+400mg; |Painful episodes of |GI ulcer, skin reaction, |1-2 tab for 3 days; 2-3 rectocap|
|phenyl-butazone | |500mcg\0.25mg+62.5mg; |rheumatism, lumbago, |oedema, disturbed |for 3 days; 1 amp daily |
| | |2000mcg\1mg+200mg |cervical symptoms, |haemopoiesis, liver | |
| | |tab\rectocap\ amp |sciatica, muscle tension |damage, Cushing’s | |
| | | | |syndrome, diabetes | |
| | | | |mellitus, inactivation of | |
| | | | |adrenal cortex, aseptic | |
| | | | |bone necrosis, vasculitis,| |
| | | | |pancreatitis, growth | |
| | | | |retardation in children | |
Anti-histamine
Histamine is a natural occurring amine of great interest to pharmacologists and of increasing importance to physicians. It occurs naturally in an inactive bound form in most body tissues and pharmacologically active free histamine is released in response to injury, such as physical trauma or any kind of antigen-antibody reactions. The physiological roles of histamine are still not completely known. Histamine acts as a local hormone similarly to serotonin or prostaglandin, i.e. it is a local chemical transmitter between the cell from which it is released and cells in the immediate vicinity. In the cortex of gastric secretion, for example, stimulation of receptors on the histamine-containing cell causes release of histamine which in turn acts on receptors on parietal cells which then secrete H ions.
The functions of histamine are suggested by its distribution in the body. In body surface membranes-the alimentary canal, the respiratory tract and in the skin-its role is reactive against foreign substances. In glands-gastric, intestinal, lacrimal, salivary-it mediates part of the secretory process. In most cells near blood vessels it plays role in regulating the microcirculation. The actions of histamine which are clinically important are those on:
1.Gastric secretion: Histamine increases the acid and pepsin content of gastric juice
2. Smooth muscle: In general histamine stimulates smooth muscle (excepting arterioles, but including the larger arteries) throughout the body.
3. Arteriols: are dilated, with a consequent fall in blood pressure. The characteristic throbbing headache that occurs after histamine injections is due to stretching of pain sensitive structures in the dura mater by the alterations in pressure in blood vessels and cerebrospinal fluid.
4. Capillaries: dilate and their permeability to plasma increases
5.Suprarenal medulla: is stimulated to release adrenaline and noreadrenaline in amounts which are insignificant in normal subjects but which are sufficient to raise the blood pressure in patients with phaeochromocytoma in whom i.v. injection of histamine was in former times as a diagnostic test.
6. Itch: histamine release in the skin can cause itch
Anti-histamine also affects the central nervous system, usually to depress but sometimes to stimulate. Thus, they can be beneficial in Parkinsonism and motion sickness and this may be attributable to their anticholinergic effects.
The effect of histamine can be opposed in four ways:
1.By using a drug with opposite effects, e.g. histamine constricts bronchi, causes vasodilatation and increased capillary permeability. Adrenaline opposes these effects. This is physiological antagonism; used to reverse the effects of histamine after it has been released.
2.By preventing histamine from reaching its site of action (receptors), e.g. by competition, the H1- and H2-receptor antagonists; more effective if used before histamine has been liberated.
3.By preventing the release of histamine; adrenal steroids and cromoglycate can suppress the effects on the tissues of antigen-antibody reactions.
4.By accelerating the destruction of histamine in the body. Attempts have been made to use the enzyme histaminase (di-amine oxidase) for this purpose, but it has not proved effective
There are at least two types of histamine receptor:
1. H2-receptor: effect on gastric secretion (and some effect on blood pressure)
2. H1-receptor: the other effects of histamine including some on blood pressure
Thus histamine antagonists may now be classified into:
1. H1-receptor antagonists: see table 2
2. H2-receptor antagonists: cimetidine and rantidine
The term “anti-histamine” is still often used as referring to H1-receptor antagonists alone since for many years there were the only antagonists available.
Anticholinergic
|Generic name |Trade name |Dose\Pharmacological|Indication |Side effects |Posology |
| | |form | | | |
|Hydroxy-zine |Atarax |10mg\25mg cap, |Anti-histaminic |Sedation, drowsiness, |Anxiety: |
| | |10mg\5ml syrup, |anti-cholinergic, |vertigo-like sensation due|Adult: (50-100mg\day) 2-4 tab (25mg\day) or 1\2|
| | |100mg amp |antipruritic, relief of |to depressive action on |tab (100mg) in evening at bed time |
| | | |anxiety, premedication to |CNS, dry mouth, urinary |General anesthesia: (100mg-200mg\day) 1-2 tab |
| | | |general anesthesia, pruritis |retention due to |(100mg) at bed time the night before surgery or|
| | | |of allergic origin |anti-cholinergic effect, |1-2 inj amp (100mg) 1 hr before surgery |
| | | | |tremor and convulsion |Pruritis: |
| | | | | |(30-100mg\day) 3 tab (10mg) or 4 tab (25mg\day)|
| | | | | | |
|Promethazine* |Codopalm |5mg syrup |Bronchitis and acute common |Drowsiness, nausea, |Adult: 1-3 teaspoonful 2-4 times\day; |
| | | |tracheobronchitis, woop |vomiting, dizziness, |nocturenal cough: 2-3 teaspoonful at bed time |
| | | |cough, nocturnal |allergic skin reaction, |Child: 1\2 to 1 teaspoonful 2-4 times\day |
| | | |pertussis-like cough and |dry mouth, urine |Child over 5: 1-2 teaspoonful 2-4 times\day |
| | | |cough accompanied by |retention, constipation | |
| | | |vomiting; cough in asthma, | | |
| | | |cough associated with | | |
| | | |irritation, smokers’ cough, | | |
| | | |cough causing insomnia. | | |
| | | |allergic cough, vasomotor, | | |
| | | |rhinitis, hay fever, post | | |
| | | |influenzal cough, infection | | |
| | | |of URT, common cold | | |
| | | |Rhinathiol: spasmodic | | |
| | | |tracheobronchitis,spasmodic | | |
| | | |cryza | |Adult: 3 table-spoonful daily |
| | | | | |Child: |
| | | | | |a)Child >5: 3-6 teaspoonful daily |
| |Rhinathiol |Pro-methazine\ | | |b)Child 12 years: |
| |Lorine |(1mg\ml); 10mg tab |disorders |nervousness |Tab: 1 tab( 10mg ) once daily |
| | | | | |Syrup: 2 teaspoonful (10ml) once daily|
| | | | | |Child between 2 and 12 years: 2 |
| | | | | |teaspoonful once daily body wt > 30kg |
| | | | | |; one teaspoonful (5mg-5ml) once daily|
| | | | | |for body wt < 30 kg |
| | | | | | |
| | | | | | |
| | | | | |Adult+child > 12 years: |
| | | | | |1 tab or 2 teaspoonful once daily |
| | |10mg tab, 5mg\5ml | | |Child between 2 and 12 years: 2 |
| | |syrup | | |teaspoonful once daily body wt > 30kg |
| | | | | |; one teaspoonful (5mg-5ml) once daily|
| |Loratidine | | | |for body wt < 30 kg |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | |Adult+Child30kg: 10mg (2 teaspoonful) syrup |
| | |10mg tab | | |once daily |
| | | | | |b)wt≤30kg: 5mg( 1 teaspoonful) syrup |
| | | | | |once daily |
| | | | | | |
| |Restamine | | | | |
|Ebastine |Ebastel |10mg tab |Symptomatic relief of allergic |Cephalagia, asthenia, |Adult: 1 tab (10mg)\day |
| | | |condition; allergic rhinitis or|nervous excitement, |Child: |
| | | |conjunctivitis both stationary |gastric intolerance, |a)(6-11 years): 1\2 tab (5mg)\day |
| | | |and perennial (nasal discharge,|diarrhoea. constipation |b)2-5years: solution |
| | | |nose, itching, weeping, | | |
| | | |sneezing, eye itching, chronic | | |
| | | |urticaria, allergic dermatitis | | |
|Di-metindenum |Fenistil |1mg coated tab, 1mg |Skin condition with itching, |Transient and mild signs |3-6mg \day; 20-40 drops 3 times daily;|
| | |drops, 1mg gel |insect bite, mild sun burn over|of local inflammation such|apply 2-4 times daily |
| | | |small areas, mild superficial |as dryness, burning | |
| | | |burns, allergic dermatoses, |sensation, red patches | |
| | | |urticaria, allergies or URT, |accompanied by itching, | |
| | | |hay fever, pernial rhinitis, |drowsiness, GI | |
| | | |food+drug allergy (adjuvant), |disturbance, dryness of | |
| | | |pruritis (due to cholestasis), |mouth and throat, vertigo,| |
| | | |pruritis in eruptive skin |excitation, headache, | |
| | | | |cutaneous eruption, | |
| | | | |muscular spasm, | |
| | | | |respiratory disturbance | |
|Cetirizine |Zyrtec |10mg tab, 1 % drop, |Anti-histaminic; prevents | | |
| | |0.1 % solution |eosinophil migration | | |
Others:
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side effect |Posology |
|Triprolidine |Actified |2.5mg\60mg tab; |Conservative management |CNS depression, excitation, |Adult: 10 ml 3 times daily |
| | |Triprolidine\ |of secretory otitis |drowsiness, sleep |Child: |
| | |pseudo-ephedrine\ |media and helping to |disturbance, hallucination, |a)6-12 years: 5ml 3 times daily |
| | |dextro-methorphan: |decrease gagging in |skin rash with or without |b)1-5years:2.5 |
| | |1.25mg\30mg\ |patients undergoing |irritation, tachcardia, |ml 3 times daily |
| | |10mg\5ml syrup; |dental procedure, |dryness of the mouth, nose, |c)6 months: 1.25ml 3 times daily |
| | | |symptomatic relief of |throat, urinary retention, | |
| | | |URT benefited by |prostatic enlargement | |
| | | |combination of histamine|(pseudoehedrine),; nausea, | |
| | | |H1 receptor antagonist, |vomiting, GI disturbance | |
| | | |nasal decongestant, |(dextrometherpan); insomnia | |
| | | |anti-tussive, sinuses, | | |
| | | |Eustachian tubes, | | |
| | | |allergic rhinitis, | | |
| | | |vasomotor rhinitis, hay | | |
| | | |fever, nasal congestion | | |
| | | |, common cold | | |
|Mepyramine |Citramin |5mg coated tab |Febrile catarrhal |Fatigue, dryness of mouth, |Adult: 1-2 coated tab 3 times daily|
| | | |diseases, influenza and |CNS disorder, impaired |at meal time |
| | | |concomitant symptoms |vision, GI setups, |Child: 1 coated tab 2-3 times daily|
| | | |such as runny nose, |difficulty in urination, | |
| | | |cough, headache, pain in|glaucoma, hypersensitivity | |
| | | |the limbs |of skin, changes in blood | |
| | | | |picture and excitability, | |
| | | | |avoid alcohol beaverages and| |
| | | | |driving vehicle | |
|Diphen-hydramine |Calamine |0.5g lotion |Treatment of insect | | |
| | | |stings, skin irritation,| | |
| |Bebecal |0.3g\100c.c syrup |allergic skin reaction | | |
| | | |caused by food | | |
| | | |(strawberries, tomatoes,| | |
| | |15-30g gel |shellfish), drug, | | |
| |Pellit | |cosmetics, plants, |Sub. Contained in |Apply in a thin layer at desired |
| | | |animals, minor burns, |preparation cause |area |
| | | |repelling stinging |hypersensitivity reaction of| |
| | | |insects |skin | |
| | | | | | |
| | | | | | |
| | | |Symptomatic relief and | | |
| | | |speedy recovery from | | |
| | | |discomfort associated | | |
| | | |with cold and influenza,| | |
| | | |nasal, sinus, | | |
| | | |congestion, headache, | | |
| | | |fever, acting limbs, | | |
| | |Diphen-hydramine\ |sneezing, coughing, | | |
| |Uniflu |phenylephrine\ |runny nose; 1st signs of|Headache, drymouth, blurred |1 tab swallowed whole with water |
| | |codeine\ |sneezing, dry throat, |vision, stomach upset, |and 1 Gregovite tab swallowed, |
| | |paracetamol\ |aching limbs, headache, |urinary retention, rash, |sucked, chewed; dosage repeated |
| | |vit.C: |cold shivers |high BP |every 6 hrs. until symptoms |
| | |15mg\10mg\10mg\500mg\300mg| | |disappear (adult), and 8 hrs. |
| | |tab | | |(child) |
| | |(anti-histamine\de-congest| | | |
| | |ant\ | | | |
| | |analgesic\ | | | |
| | |gregovite C | | | |
|Dimenhydrinate |Gravol |50mg tab\chewable tab, |Relief of nausea, |Drowsiness, avoid alcohol |Adult: 1-2 tab\4hr |
| | |10mg cap\supp (adult); |vomiting, dizziness |and beverages, excitability |Child 6-12 years: 1\2-1 tab every |
| | |f.c.tab\chewable | | |6-8 hrs up to a max 3 tab in 24 |
| | |tab\liq.\supp (child) | | |hrs. |
|Carbocysteine |Mucotal |Syrup |Disorder of the |Nausea, headache, gastric |Adult: 500mg 3 times daily |
| | | |repiratory tract |discomfort, diarrhoea, GI |Child: a)100-125mg 3 times daily |
| | | |associated with excess |bleeding, skin rash |b)> 5 years: 200-250mg 3 times |
| | | |mucus; spasmodic | |daily |
| | | |phenomena resulting in | | |
| | | |irritation, cough, | | |
| | | |sneezing, particularly: | | |
| | | |1)spasmodic | | |
| | | |tracheo-bronchitis | | |
| | | |2)spasmodic cryza |Carbocysteine: | |
| | | | |Nausea, stomach pain |Adult: 3 tablespoonful daily |
| | | | |Promethazine: risk of |Child: |
| |Rhinathiol |Cardocisteine\ | |drowsiness, nausea, |a)Child >5: 3-6 teaspoonful daily |
| | |promethazine: 2g\0.05g | |vomiting, dizziness, |b)Child 12 years: |
| | |inhaler |emphysema and other lung diseases where|palpitation, urticaria and exanthema,|0.5mg increased to 1.5mg |
| | | |bronchospasm is complicating factor |sleep disturbances, behavioral |(in severe cases) |
| | | | |disturbances, agitation, |shouldn’t exceed 6mg \24 |
| | | | |hyperactivity, restlessness, |hrs. |
| | | | |bronchospasm |Child (3-12years): 0.5mg |
| | | | | |increased to 1 mg (single|
| | | | | |dose) and shouldn’t |
| | | | | |exceed 4mg\24 hrs. |
|Formoterol fumarate |Oxis Turbu-haler|4.5 micro-gram or 9 |Treatment and prevention of reversible |Headache, agitation, reslessness, |Adult+elderly: 4.5-9 |
|dihydrate | |micro-gram |airway obstruction; it is intended for |sleep disturbances, palpitation, |micro-gram 1-2 times |
| | |inhalation powder |use in maintenance therapy in addition |tachycardia, tremor, muscle cramp, |daily in morning or night|
| | | |to anti-inflammatory |exanthema, urticaria, brochospasm, |OR 18 micro-gram 1-2 |
| | | | |paradoxical bronchospasm |times daily |
|Salmeterol |Serevent |25 micro-gram\ | | | |
| | |actuation | | | |
*Corticosteroid by Oral Inhalation
|Generic name |Trade name |Dose\ |Indication |Side effect |Posology |
| | |Pharma-ceutical form | | | |
|Beclo-methasone |Clenil |50 micro-gram aerosol |Bronchial asthma, asthmatic |Candiasis, hoarseness, mouth |Adult: 2 puff 4 times daily; not |
| | | |bronchitis |dryness, depression of adrenal |exceed 20 puff (1mg) |
| | | | |function, osteoporosis, peptic |Child: 1-2 puff (50-100micro-gram)|
| | | | |ulcer, signs of 2º adrenocortical |2-4 times daily; not exceed 10 |
| | | | |insufficiency such as hypotension,|puff (0.5mg) |
| | | | |loss of wt, hypoadrenalism | |
| | | | | | |
| | | | | | |
| | | | | |Adult: 2 puff 2 times daily |
| | | | | | |
| | | | | | |
| | |250 micro-gram aerosol| | | |
| |Clenil forte | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Becloforte inhaler| | | | |
| | | | | | |
| |Beclotide | | | | |
|Budesonide |Pulmocort |100\200\400 |Bronchial asthma that requires|Mild irritation in throat, | NS treatment, inhaled |
| |Turbu-haler |micro-gram\dose powder|maintenance treatment with |coughing and hoarsness, candida |glucocorticsteroid |
| | |inhaler |corticosteroid for control of |infection in oropharynx, immediate|Adult: 400-800 micro-gram daily |
| | | |the underlying airways |and delayed hypersensitivity |Child: 400 micro-gram daily |
| | | |inflammation |reaction including rash, contact | |
| | | | |dermatitis, urticaria, angioedema,|Oral glucoco-rticosteroid |
| | | | |bronchospasm, psychiatric symptoms|Adult: 800-1600 micro-gram daily |
| | | | |such as nervousness, reslessness, |Child: 400-800 micro-gram daily |
| | | | |depression as well as behavioral | |
| | | | |disturbances, skin bruising | |
| | | | |following treatment with inhaled | |
| | | | |glucocorticosteroid, bronchospasm,| |
| | | | |hypofunction of adrenal gland | |
| | | | |occur with inhaled | |
| | | | |glucocorticosteroid | |
|Fluticasone |Flixotide |25\50\125\ |Prophylactic management in |Candiasis of the mouth, |Adult + child < 16 years: 100-1000|
| | |250mg inhaler |mild asthma; patients |hoarseness, paradoxical |micro-gram 2 time daily |
| | | |requiring intermittent |bronchospasm, |Child >4: 50-100micro-gram 2 times|
| | | |symptomatic asthma medication;| |daily |
| | | |patients requiring regular | |Onset of action 4-7 days |
| | | |asthma medication (moderate | | |
| | | |asthma), patients with severe | | |
| | | |chronic asthma; child who | | |
| | | |require preventive asthma | | |
| | | |medication including patients | | |
| | | |with controlled currently | | |
| | | |available prophylactic | | |
| | | |medication | | |
Anti-cholenergics by oral inhalation
|Generic name |Trade name |Dose\ |Indication |Side effect |Posology |
| | |Pharma-ceutical | | | |
| | |form | | | |
|Ipratropium |Atem |4mg spray |Bronchial asthma, chronic obstructive |Dryness of oropharynx, cough, |2 puff 3-4 times daily (regular |
| | | |airway disease (COPD) with asthmatic |nausea, dizziness, headache, |every 4hrs) |
| | | |characteristics including chronic |blurred vision\difficulty in |Asthma: 2-3 puff every 2hrs |
| | | |bronchitis and emphysema; brochodilator|accomodation, tachycardia, |Drug activity: starts 3-5 min |
| | | |for maintenance treatment of |palpitation, drowsiness, |after administeration |
| | | |bronchospasm; used concomitantly with |urinary retention, | |
| | | |inhaled β-agonist in treatment of acute|constipation, GI motility, | |
| | | |bronchospasm associated with chronic |mucosal ulcer, paradoxical | |
| | | |abstructive pulmonary disease including |bronchoconstriction | |
| | | |chronic bronchitis and asthma | | |
| | | | | |Adult+adolescent > 12 years: 1 |
| | | | | |unit dose vial 3-4 times\ day |
| |Atrovent |500mg\2ml unit dose| | | |
| | |vial | | | |
Others
|Generic name |Trade name |Dose\ |Indication |Side effect |Posology |
| | |Pharma-ceutical | | | |
| | |form | | | |
|Zafirlukast |Accolate |20mg tab |asthma |Hypersensitivity including |Adult+child > 12 years: 20mg tab 2 |
| | | | |urticaria and angioedema, rash,|times daily |
| | | | |bruising, bleeding disorder |Elderly: caution is recommended |
| | | | |including menorrhagia, |Child < 12 years: contraindicated |
| | | | |thrombocytopenia and | |
| | | | |agranulocytosis, increased | |
| | | | |serum transaminase, hepatitis, | |
| | | | |increased bilirubin | |
|Sod.cromoglycate |Intal\Intal 5 |20mg micronised |Preventive treatment of bronchial |Occasional throat irritation or|Single dose cartridge (inhalation of |
| |inhaler |powder (3 sachets |asthma which may be due to |coughing may occur in some |drug is controlled by patients |
| | |of 10 spincap |allergy, exercise, cold air or |patients sensitive to the |inspiratory effort); 2 inhalations 4 |
| | |cartridges), 5mg |chemical and occupational |inhalation of dry powder, in |times daily either |
| | |inhaler |irritants; it prevents both the |rare cases severe bronchospasm |a)1 inhalation 4 times daily |
| | | |immediate and late asthmatic |has been reported, usually at |OR |
| | | |response to immunological stimuli |the beginning of treatment |b)2 inhalations 6-8 times daily |
| | | |(cromoglycate inhibits the |necessitating withdrawal of | |
| | | |realease from sensitized mast cell|drug | |
| | | |of mediators of allergic reacion) | | |
|Monte-lukast |Singulair |10mg f.c tab |Block leukotriene which causes |Abdominal pain and headache, |Once a day by mouth at bed time; |
| | | |narrowing of airways and |fever, trauma, infectious |10mg\day |
| | | |inflammation in lungs which lead |GI-enteritis, toothache, nasal | |
| | | |to asthma; treat asthma and |congestion, cough, influenza, | |
| | | |prevents asthma symptoms which are|weakness, tiredness, | |
| | | |triggered by exercise |reslessness, irritability, | |
| | | | |joint pain, dizziness, dry | |
| | | | |moth, indigestion, drowsiness, | |
| | | | |dream abnormalities, muscle | |
| | | | |pain, diarrhoea, nausea, | |
| | | | |vomiting, allergic reaction, | |
| | | | |swelling of the face\ lip, | |
| | | | |tongue\ throat, itching, rash, | |
| | | | |hives, difficulty in breathing | |
|Nedocromil |Tilade |2mg aerosol |Bronchial asthma |Headache, URT (nausea, |Adult+child > 6 years: 2 actuations |
| | |inhalation | |vomiting, dyspepsia, abdominal |(4mg) 4 times daily |
| | | | |pain), may produce cough or |Maintenance dose is 2 actuations 2 |
| | | | |bronchospasm |times daily |
|Ketotifen |Zaditen |1mg scored tab, |Long term prevention of bronchial |Sedation, dry mouth, slight |Adult: 1 zaditen SRO tab (2mg) in |
| | |2mg SRO tab, |asthma, allergic bronchitis, |dizziness, CNS stimulant |evening, 1 zaditen cap (1mg) or 1 |
| | |0.2mg\ml syrup, |asthmatic symptoms associated with|(excitation, irritability, |zaditen (1mg) 2 times daily in |
| | |1mg\ml infant drop|hay fever, prevention and |insomnia, nervousiness, wt |morning and evening with meals |
| | | |treatment of multisystem allergic |gain, increase liver enzyme and|Child: |
| | | |disorders: acute and chronic |hepatitis, severe skin reaction|a)6 month- 3 years: 0.05mg\kg body wt|
| | | |urticaria, atopic dermatitis, |(erythema multiforme, |2 times daily |
| | | |allergic rhinitis and |Steven-Johnson syndrome) |b)>3 years: 5ml (teaspoonful) syrup, |
| | | |conjunctivitis | |1 cap, 1 tab 2 times daily with |
| | | | | |morning and evening meal, 1 tab SRO |
| | | | | |(2mg) in evening |
Gastro-Intestinal Tract Drugs
The remarkable ability of the stomach to secrete hydrochloric acid has interested pharmacologists and clinicians for many years. Peptic ulcer disease is related to acid secretion. On average, patients with duodenal ulcer produce about twice as much as normal subjects, but there is much overlap and about half the patients with duodenal ulcer have acid outputs in the normal range. Patients with gastric ulcer produce normal or reduced amounts of acid. Duodenal ulceration does not occur at very low rates of acid formation but gastric ulcer does. Where there is anacidity, no peptic ulcers form, i.e. the maxim, “no acid-no ulcer” holds. Drugs can affect gastric secretion in the following ways:
Reduction: anticholinergics and histamine H2-receptor antagonists
Neutralization: antacids
Stimulation: to test the capacity of the stomach to secrete acid
Antacids relieve the pain of peptic ulcer which occurs when the pH falls below 3.5. Clinical trials have showed that antacids don’t accelerate the rate of healing in gastric ulcer. The case may be different for duodenal ulcer and may depend on the vigour of the antacid regimen. The benefit of antacids probably depends on protecting the ulcer from acid (neutralization) and from pepsin (raising pH and in the case of Al, Ca, Bi, precipitating pepsin). Neutrailisatin of acid reflexly increases gastric acid secretion, perhaps by releasing gastrin, particularly in the case of calcium-containing antacids. Continuous sucking of antacid tablets are the most effective methods of neutralization.
The purpose of giving antacids is to remove H ion. This is achieved by chemical neutralization (sodium bicarbonate, magnesium oxide and hydroxide, calcium carbonate) or by reversible chemical combination (aluminium hydroxide gel, magnesium trisilicate). Total neutralisation is generally imposible by antacids alone, taken intermittently, but it is not necessary for relief of pain.
Antacids may be classified as:
1.non-systemic: not significantly absorbed, and so will not disturb acid-base balance of the body; Al, Mg salts, Ca carbonate
2.systemic: absorbed, and can cause metabolic alkalosis; sodium bicarbonate
No single antacid is satisfactory; mixture are often used. They often consist of sodium bicarbonate for quickest effect, supplemented by magnesium hydroxide or carbonate. Sometimes magnesium trisilicate or aluminium hydroxide is added, but these are often used alone. For intermittent use, liquids or powders are more efficient than tablets. Tablets are best sucked to give a continuous flow of antacid. This is sepecially useful in reflux oesophagitis.
Healing of peptic ulcer may be promoted by variety of drugs. It is promoted by
1.Histamine H2-receptor antagonists: cimetidine, ranitidine
2.Liquorice derivatives: Crude liquorice contains two sources of anti-ulcer activity, one related to glycyrrhizin (a glycoside) and one that remains after glycyrrhizin is removed
3.Miscellaneous drugs: Colloidal bismuth accelerates peptic ulcer healing. Its mode of action may be partly physically by forming a protective coating on the gastric mucosa and on the ulcer base, and partly due to to an antacid action by combing with chloride ion. Oestrogen may be helpful in reducing recurrences of duodenal ulcer.
The aim of therapy are to achieve relief of pain, healing, and prevention of recurrences
1.Relief of pain by raising gastric pH: use antacids (food, drugs); avoidance of substance that increase gastric secretion or irritate the gastric mucous membrane. These include alcohol and tobacco, excess of tea or coffee, salicylates; anticholinergic drugs can be used
2.To promote healing: stop smoking; colloidal bismuth, carbenoxolone, cimetidine
3.Prevention of recurrences: This involves inviting the patient to behave sensibly about food, e.g. small frequent meals, avoiding only foods that the patient knows by experience cause pain.
Antacid:
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Dosage |
|Mag. Hydroxide |Diovol plus |Mag. Hydroxide\ |Relief heart burn+ acid indigestion+flatulence |Chew 2-4 tab as needed |
|Alum. Hydroxide | |Alum. Hydroxide\ | |between meals and at bed |
|Mag. Carbonate | |Mag. Carbonate: | |time |
| | |100mg\300mg\300mg chewable | | |
| | |tab | | |
|Mag. Hydroxide |Maalox |Mag. Hydroxide\ |Antacid + antiflatulence, non constipation; relief of acid|2-4 teaspoonful 4 times |
|Alum. Hydroxide | |Alum. Hydroxide: 200mg\225mg |indigestion, heart burn, sour stomach accompanied by gas, |daily taken 20 min-1hr. |
| | |suspension |upset stomach associated with these symptoms |after meals and at bed |
| | | | |time |
| | |Mag. Hydroxide\ | | |
| |Maalox Plus |Alum. Hydroxide\ Simethicone:| | |
| | |200mg\225mg\25mg suspension | | |
|Ca. Carbonate |Rennie |Ca. Carbonate\ |Relief of the symptoms due to gastric hyperacidity, heart |1-2 tab sucked or chewed |
|Mag. Carbonate | |Mag. Carbonate: 680mg\80mg |burn, upset stomach, gastric pain, feeling of epigastric | |
| | |tab |heaviness or fulliness, nausea | |
|Bicarbonate |Fawar |Bicarbonate\ |Antacid, flatulence, indigestion associated with |Adult: 1 sachet added to |
|Tartaric acid | |Tartaric acid\ |hyperchlorhydria, render the urine alkaline in treatment |1\2 water taken while eff.|
|Citricacid | |Citricacid: 2.8g\1.33g\0.28g |of inflammatory condition of urinary tract associated with|After meals |
| | |eff.tab |acidic urine; in gout therapy (adjuvant with uricosuric |Child (3-12 years): 1\2 |
| | | |agents), prevention of crystalluria during treatment with |adult dose |
| | | |sulfonamide | |
Anti-ulcer
a)H2-receptor antagonist:
|Generic name |Trade name |Dose\Pharmaceutical form|Indication |Side Effects |Dosage |
|Nizatidine |Axid |150mg\300mg cap |Active duodenal ulcer (for |Hepatocellular injury, |Duodenal ulcer: 300mg once daily in |
| | | |period of 8 weeks); benign |elevated liver enzyme, |evening up to 8 weeks or 150mg 2 |
| | | |gastric ulcer; care should |cholestatic injury with |times daily |
| | | |nbe taken to exclude |jaundice, short episodes of |Benign gastric ulcer: 300mg once |
| | | |malignant gastric |asymptomatic ventricular |daily in evening or 150mg 2 times |
| | | |ulceration, maintenance |tachcardia, reversible mental |daily during 4-8 weeks duodenal |
| | | |therapy for duodenal ulcer |confusion, impotence and |healed ulcer: 150mg once daily in |
| | | |at reduced dosage of |decrease libido, fatal |evening |
| | | |150mg\da treatment of |thromboctopenia, bronchospasm,|Gastroesophageal reflux disease: |
| | | |erosion and ulceration due |laryngeal edema, rash, |150mg 2 times daily or 300mg\day may |
| | | |to to gastroesophageal |eosinophilia, sweating, |be used |
| | | |reflux disease (upto 12 |urticaria, rash, hyperuricemia| |
| | | |weeks) |unassociated with gout or | |
| | | | |nephrolithiasis, fever, nausea| |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
|Cimetidine |Cimetril |400mg\200mg tab |Active duodenal ulcer, |Diarrhoea, muscle pain, |Active duodenal ulcer: 400mg in |
| | | |benign gastric ulcer, |dizziness, skin rashes, |morning and 400mg in evening or 800mg|
| | | |prophylaxis of recurrent |reversible confusional states |in evening for 4 weeks |
| | | |ulcer, jejunal peptic |especially in elderly or |Active gastric ulcer: 400mg in |
| | | |ulcer, peptic reflux |debilitated patients, allergic|morning and 400mg in evening or 800mg|
| | | |oesophagitis and |reaction, gnecomastia, fever, |in evening for 6 weeks |
| | | |pathological hypersecretory|acute pancreatitis, cardiac |Prophylaxis of recurrent ulcer: 400mg|
| | | |condition such as |arrythemia, loss of libido, |at bed time |
| | | |Zollinger-Ellison sndrome; |serum\ creatinine\ |Reflux oesophagitis\pathological |
| | | |Amp: indicated in cases of |transaminase levels are |hypersecretory condition |
| | | |haemorrhage in upper GI ex:|temporarily elevated |(Zollinger-Ellison syndrome): 400mg 3|
| | | |acute erosion of oesophagus| |times\day and 400mg at bed time for |
| | | |of stomach or duodenum, | |4-8 weeks |
| | | |gastro duodenal ulceration | | |
| | | |(duodenal ulcer, benign | | |
| | | |round ulcer) | | |
| | | | | |Cap 200mg: 1cap 3 times daily with |
| | | | | |meals OR 2 cap at bed time (till |
| | | | | |symptoms are gone) OR 2 cap (long |
| | | | | |term therapy) at bed time increased |
| | | | | |to 4 times |
| | | | | |Retard 350mg: 2 tab at bed time OR 1 |
| | | | | |tab in morning OR 1 tab at bed time |
| | | | | |(till symptoms disappear), 1 tab at |
| | |200mg cap, 350mg SR tab,| | |bed time (long term) |
| |Neutronorm |229mg =200mg\2ml | | |Amp 200mg: injected as single dose |
| | |amp\IV\infusion | | |and repeated 4-6 hrs. |
| | | | | |Infusion: 100mg\hr., 200mg repeated |
| | | | | |every 4-6 hrs. |
| | | | | |Cont.infusion: 75mg\hr. |
|Famotidina |Gastrodomina |20mg\40mg tab |Duodenal ulcer, benign |Diarrhoea, headache, |Duodenal ulcer: 40mg tab\day before |
| | | |gastric ulcer, |dizziness, tirediness, |sleep OR 20mg tab ever 12 hrs. for |
| | | |hypersecretory sndrome such|constipation, dry mouth, |4-8 weeks |
| | | |as Zollinger-Ellison |nausea, vomiting, intestinal |Benign gasric ulcer: 40mg\day before |
| | | |syndrome, maintenance |disturbances, flatulence, loss|sleep for 4-8weeks |
| | | |therapy for decreasing |of appetite and skin eruption,|Zollinger-Ellison syndrome: 20mg |
| | | |recurrences of duodenal |anorexia |every 6 hrs |
| | | |ulcer, mild and moderately | | |
| | | |severe reflux esophagitis | | |
| | | | | | |
| | | | | |40mg tab\day at night for 4-8 weeks |
| | | | | |Maintenance therapy: 20mg tab\day at |
| |Pepcidin |20mg\40mg tab, 20mg\5ml | | |night |
| | |vial | | |Zollinger-Ellison syndrome: 20mg 6hrs|
| | | | | |Mild-severe esophagitis: 20-40mg 2 |
| | | | | |times\day |
|Ranitidine |Rantag |150mg\300mg tab; |Duodenal ulcer, benign |Headache, malaise, nausea, |Adult: 150mg tab 2 times daily |
| | |50mg\2ml amp |gastric ulcer, |constipation, dizziness and |Duodenal and gastric ulceration: |
| | | |gastro-esophageal reflux, |skin rash, elevated serum |300mg tab at bed time |
| | | |relief of persistant |transaminase and plasma |Zollinger-Ellison: 150mg tab 3 times |
| | | |dyspepsia with or with out |creatinine, hypersensitivity |daily |
| | | |peptic ulceration, |reaction, reversible hepatitis|Gastroesophageal reflux: 150mg tab 2 |
| | | |pathological hypersecretory|with or with out jaundice, |times daily |
| | | |condition such as |reversible leucopenia and |Amp: IV\IM 45-60 min before |
| | | |Zollinger- Ellison syndrome|thrombocytopenia, bradcardia, |induction of general anaesthesia |
| | | |Amp: prophylaxis of GI |mental confusion | |
| | | |hemorrhage from stress | | |
| | | |ulceration in ill patients,| | |
| | | |prophylaxis of recurrent | |Duodenal gastric ulceration: 150mg |
| | | |hemorrhage in patients with| |tab 2 times daily in morning and |
| | | |bleeding peptic ulcers | |evening OR 300mg at bed time (single |
| | | |before general anaesthesia | |dose) |
| | |150mg\300mg tab |in patients at risk of acid| |Zollinger-Ellison: 150mg 3 times |
| |Zantac | |aspiration (Mendelson’s | |daily increased to 6g\day |
| | | |syndrome) | |Obstetric patients: 150mg followed by|
| | | | | |150mg at 6hr. interval |
| | | | | |Children (8-18years): 150mg 2 times |
| | | | | |daily |
b)Proton Pump Inhibitor:
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |Dosage |
| | |form | | | |
|Omeprazole |Epirazole |20mg cap |Duodenal ulcer, gastric ulcer,|Nausea, diarrhoea, abdominal |Duodenal and gastric ulcer+reflux |
| | | |reflux oesophagitis, treatment|colic, headache, |oesophagitis: 20mg once daily |
| | | |of Zollinger-Ellison syndrome,|constipation, flatulence, |Zollinger-Ellison: syndrome: |
| | | |gastro-oesophagic reflux |skin rash, elevated liver |60mg\day |
| | | |maintenance treatment; |enzyme, urticaria, pruritis, | |
| | | |helicobacter pylori associated|dizziness, paraesthesia, |Duodenal ulcer: 20mg (1 cap) once |
| | | |with peptic ulcer disease |somnolence, insomnia, |daily |
| |Gastrimut |20mg cap |(adjuvant with clarithromycin,|vertigo, malaise, muscular |Zollinger-Ellison syndrome: 60mg (3 |
| | | |amoxicillin, metronidazole); |weakness, mylagia, reverible |cap) once daily |
| | | |prophylaxis of NSAID- |mental confusion, agitation, |Gastric ulcer: 20mg (1 cap) once |
| | | |associated gastric and |depression, hallucination, |daily; 40mg once daily (refractory |
| | | |duodenal ulcer; maitenance |stomatitis and GI |gastric ulcer) |
| | | |therapy to avoid recurrence of|candidiasis, leukopenia, |Gastro-oesophagic reflux: 20mg (1 |
| | | |peptic ulcer and reflux |thrombocytopenia, blurred |cap) once daily |
| | | |esophagitis in predisposed |vision, peripheral edema, |Maintenance treatment: 20mg once |
| | | |patients |encephalopathy with severe |daily increased to 40mg\day |
| | | | |liver diseases, hepatitis | |
| | | | |with or with out jaundice, | |
| | | | |hepatic failure, angioedema, | |
| | | | |fever, bronchospasm, taste |Duodenal ulcer: 20mg once daily |
| | | | |disturbance, |Gastric ulcer: 20mg once daily |
| | | | |photosensitivity, alopecia, |Helicobacter pylori associated with |
| | | | |increase sweating, dry mouth |peptic ulcer: 40-80mg daily with |
| | | | | |amoxicillin 1.5g daily in divided |
| | | | | |doses for 2 weeks |
| | | | | |Reflux oesophagitis: 20mg once daily|
| |Omepral |20mg enteric coated | | |Zollinger-Ellison syndrome: 60mg |
| | |microgranules (cap) | | |once daily |
| | | | | | |
| | | | | |Duodenal ulcer: 20mg once daily 2-4 |
| | | | | |weeks |
| | | | | |Gastric ulcer and reflux |
| | | | | |oesophagitis: 20mg once daily 4-8 |
| | | | | |weeks |
| | | | | |Reflux oesophagitis (maintenance |
| | | | | |dose): 20mg daily up to 12 months |
| | | | | |Prophlaxis of NSAID-associated |
| | | | | |ulcer: 20mg once daily |
| | | | | |H.pylori: 20mg 1-2 times daily with |
| | | | | |amoxycillin 1.5-3g daily and |
| | |20mg tab | | |clarthromycin 0.5-1g daily |
| | | | | |Zollinger-Ellison syndrome: 60mg |
| |Oprazole | | | |once daily before breakfast |
| | | | | | |
| | | | | | |
| | | | | |Duodenal ulcer, gastric ulcer and |
| | | | | |reflux esophagitis: 1 cap (20mg) |
| | | | | |once daily in morning increased to 1|
| | | | | |cap in morning and evening OR 1 cap |
| | | | | |(40mg) in morning |
| | | | | |Maintenance therapy: 10mg-20mg |
| | | | | |Gastric hypersecretory condition: up|
| | | | | |to 120mg daily in divided doses, |
| | | | | |antacid may be given concomitantly |
| | | | | |to aid in relief of pain |
| | | | | | |
| | | | | | |
| | | | | |Reflux esophagitis and peptic ulcer:|
| | | | | |1-2 cap once daily in morning for |
| | | | | |2-8 weeks |
| | | | | |Zollinger-Ellison syndrome: up to 6|
| | | | | |cap 2-3 divided doses\day |
| | | | | | |
| | | | | | |
| | |10mg\20mg\40mg enteric | | | |
| | |coated microgranules | | |Duodenal ulcer: 20mg 4 times daily |
| |Risek | | | |Gastric ulcer: 20mg (1 cap) 4-6 |
| | | | | |times |
| | | | | |Zollinger-Ellison syndrome: 60mg (3 |
| | | | | |cap)\day |
| | | | | |Reflux oesophagitis: 20mg (1 |
| | | | | |cap)\day 4 times |
| | | | | | |
| | | | | |Duodenal ulcer: 20mg once daily |
| | | | | |Gastric ulcer: 20mg once daily |
| | | | | |NSAID associated with gastric ulcer,|
| | | | | |duodenal ulcer, gastroduodenal |
| | | | | |erosion: 20mg once daily |
| | | | | |H.pylori: |
| | | | | |20mg + 1g amoxicillin+ |
| | |20mg cap | | |500mg clarithromycin 2 times daily |
| | | | | |20mg+250mg clarithromycin+400mg |
| | | | | |tinidazole 2 times a day |
| | | | | |40mg once+ (500mg amoxicillin+ |
| |Ulstop | | | |400mg metronidazole) 3 times a day |
| | | | | |Reflux esophagitis: 20mg once daily |
| | | | | |Symptomatic gastro-esophagitis |
| | | | | |reflux: 20mg daily |
| | | | | |Zollinger-Ellison syndrome: 60mg |
| | | | | |daily |
| | |20mg cap | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Zimor | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Losec | | | | |
|Panto-prazole |Inipomp |40mg enteric coated tab|Active duodenal ulcer, active |Headache, diarrhoea, itching,|1 tab daily in morning before or |
| | | |gastric ulcer, oesophagitis |flushing, feeling of |during breakfast |
| | | |due to gastro-oesophageal |dizziness | |
| | | |refux (presence of erosions or| | |
| | | |ulceration due to oesophagitis| | |
|Lanso-prazole |Lanzor |30mg cap |Gastric, duodenal ulcer of an |Diarrhoea, nausea, vomiting, |Gastroduodenal ulcer: 1 cap daily |
| | | |esophagitis or |abdominal pain, constipation,|for 4-6 weeks |
| | | |Zollinger-Ellison syndrome |cehpalagia, vertigo feeling, |Esophagitis: 1 cap daily for 4-8 |
| | | | |itching, rash, urticaria, |weeks |
| | | | |elevated transaminase |Zollinger-Ellison syndrome: 2 cap |
| | | | |(hepatic enzyme), platelet |daily |
| | | | |and WBC, gynecomastia, | |
| | | | |decrease sod. | |
|Rabe-prazole |Pariet |10mg\20mg tab |Active duodenal ulcer, active |Headache, diarrhoea, nausea, |Active duodenal ulcer and benign |
| | | |benign gastric ulcer, |rhinitis, abdominal pain, |gastric ulcer: 20mg once daily in |
| | | |symptomatic erosive or |asthenia, flatulence, |morning |
| | | |ulcerative gastro-oesophageal |pharyngitis, vomiting, |Erosive or ulcerative |
| | | |reflux disease (GORD), |nonspecific back pain, |gastro-oesophageal reflux diseases: |
| | | |gastro-oesophageal reflux |dizziness, flu-like syndrome,|20mg once daily 4-8 weeks |
| | | |disease |infection, cough, |Gastro-oesophageal reflux diseases: |
| | | | |constipation, insomnia, rash,|(long term management) 10-20mg once |
| | | | |mylagia, chest pain, dry |daily |
| | | | |mouth, dyspepsia, |Taken in morning before eating |
| | | | |nervousness, somnolence, | |
| | | | |bronchitis, sinusitis, | |
| | | | |chills- enuctation, leg | |
| | | | |cramp, urinary tract | |
| | | | |infection, arthralgia, fever,| |
| | | | |anorexia, gastritis, wt gain,| |
| | | | |depression, pruritis, vision | |
| | | | |or taste disturbance, | |
| | | | |stomatitis, sweating, | |
| | | | |leukocytosis, | |
| | | | |thrombocytopenia, | |
| | | | |neutropenia, leukopenia, | |
| | | | |increase hepatic enzymes, | |
| | | | |erythema | |
|Lanso-prazole |Takepron |15mg\30mg cap |Duodenal ulcer, benign gastric|Diarrhoea, abdominal pain, |Adult |
| | | |ulcer, reflux esophagitis, |dyspepaia, nausea, vomiting, |Duodenal ulcer: 15-30mg\day for 4 |
| | | |Zllinger-Ellison syndrome, |dry mouth, flatulence, |weeks |
| | | |benign peptic ulcer, |constipation, headache, |Benign gastric ulcer: 30mg\day up to|
| | | |unresponsive to H2 receptor |dizziness, fatigue, rash, |8 weeks |
| | | |antagonists and anti-biotics |urticaria, pruritis, elevated|Reflux esophagitis: 30mg\day for 8 |
| | | |for H.pylori eradication, |liver function, leukopenia, |weeks |
| | | |maitenance treatment (severe |thrombocytopenia |Zollinger-Ellison syndrome: 60mg\day|
| | | |oesophagitis, prevention of | |Maintenance: 15mg\day |
| | | |recurrence of duodenal ulcer) | |H.pylori: 30mg 2 times\day for 7-10 |
| | | | | |days with anti-biotics |
c)Prostaglandin analogue
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Misoprostol |Cytotec |200 micro.gram tab |Duodenal ulcer and gastric ulcer |Diarrhoea, abdominal pain with or |Healing of duodenal ulcer, |
| | | |including those induced by NSAID |with out associated dyspepsia or |gastric ulcer and NSAID-induced|
| | | |in arthritic patients at risk |diarrhoea, dyspepsia, flatulence, |peptic ulcer: 800 micro.gram |
| | | |whilst continuing their NSAID |nausea, vomiting, menorrhagia, |daily in 2-4 divided doses with|
| | | |therapy; prophylaxis of NSAID |vaginal bleeding, intermenstrual |breakfast and at bed time with |
| | | |induced ulcer |bleeding in pre and |each main meal |
| | | | |post-menopausal women, skin rash, |NSAID-induced peptic ulcer: 200|
| | | | |dizziness |micro. gram 2 times daily 3-4 |
| | | | | |times |
Laxative
Lubricant laxative
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |Dosage |
|Liquid parafin|Lansoyl |78.23g oral gel |Treatment of occasional |Oily oozing (red coloured) in|Adult: 1 tablespoonful 1-3 times\24 hrs. not |
| | | |constipation |anus; irritation in anus |exceed 3 tablespoons\24 hrs |
| | | | | | |
| | | | | | |
| |Glycerine | | | | |
Mucilage Laxative
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |Dosage |
| |Mucofalk | | | | |
Osmotic Laxative
|Generic name |Trade name |Dose\Pharmaceutical form|Indication |Side Effects |Dosage |
|Lactulose |Duphalac |300ml\67g\100ml syrup |Hepatic precoma: 30-50ml |Doesn’t cause |Adult: |
| | | |(40-67g) 3 times daily; |habituation |Severe cases: 30-45ml\day for 3 days |
| | | |chronic costipation | |decreased to 15-25ml |
| | | | | |Moderate: 15-30ml decreased to 10-15ml |
| | | | | |Mild cases: 15ml decreased to 10ml |
| | | | | |Child (6-14ears): 15ml decreased to 10ml |
| | | | | |Child (1-6years): 5-10ml decreased to 5-10ml|
| | | | | |Infant: 5ml |
| |Epsom salt | | | | |
|Macrogol 4000 |Forlax |10g powder for oral |Symptomatic treatment of | |Each sachet dissolved in a glass of water |
| | |solution |constipation in adult | | |
|Macrogol 4000 |Fortran |Macrogol 4000\ |Lavage before endoscopy |Nausea, vomiting |Dissolve sachet in 1 liter water |
|Sod.bicarbonate | |Sod.bicarbonate\ |or clean colon | | |
|Sod.sulfate | |Sod.sulfate\ | | | |
|Sod.chloride | |Sod.chloride\ | | | |
|Pot.chloride | |Pot.chloride: | | | |
| | |64000g\1680g\5700g\1460g| | | |
| | |\ | | | |
| | |0.75g sachet poder | | | |
|Lactitol monohydrate |Importal |10g\sachet |Symptomatic treatment of |Flatulence, |Constipation:taken once in morning and |
| | | |constipation; treatment |abdominal upset |evening at meal time and mixed with food; |
| | | |of chronic or episodic |such as distention|taken once with 1-2 glasses of liquid (about|
| | | |portal-systemic |or cramp, nausea, |200ml each); laxative effect may not start |
| | | |encephalopathy |borborygmus and |until 2nd or 3rd day after 1st dose |
| | | | |anal pruritis, |Adult: 20g (2 sachet) followed by 10g |
| | | | |diarrhoea |daily\sachet |
| | | | | |Child: 0.25g\kg\day |
| | | | | |a)1-6 years: 1\4-1\2 sachet daily (2.5-5g) |
| | | | | |b)6-12 years: 1\2-1 sachet daily (5-10g) |
| | | | | |c)12-16 years: 1-2 sachet daily (10-20g) |
| | | | | |dose adjusted to obtain 1 stool daily |
| | | | | |chronic and acute portal systemic |
| | | | | |encephalopathy: 0.5-0.7g\kg body wt in 3 |
| | | | | |divided doses |
|Macrogol 3350 |Klean-prep |Macrogol 3350\ |Iso-osmotic bowel |Cause |Reconstituted in 1 liter water; drink 250ml |
|Sod.sulfate | |Sod.sulfate\ |cleansing |diarrhoea-like |every 10-15 min; liquid bowel movement occur|
|Sod.bicarbonate | |Sod.bicarbonate\ | |watery bowel |1-2 hrs.of starting to drink Klean-prep. |
|Sod.chloride | |Sod.chloride\ | | | |
|Pot.chloride (PEG + | |Pot.chloride: | | | |
|electrolye) | |59g\5.685g\1.685g\1.465g| | | |
| | |\0.743g | | | |
|Macrogol 3350 |Movicol |Macrogol 3350\ |Constipation; helps u |Stomach ache, |Constipation1 sachet 2-3 times daily for 2 |
|Sod.bicarbonate | |Sod.bicarbonate\ |have comfortable bowel |numbles, allergic |weeeks |
|Sod.chloride | |Sod.chloride\ |movement enen if u have |reaction, feel |Focccal impaction: 8 sachet\day |
|Pot.chloride | |Pot.chloride: |been constipated for a |weak, breathless, | |
| | |13.125g\178.5mg\350.7mg\|long time, focal |v.thirsty with | |
| | |46.6mg after |impaction (v.bad |headache or get | |
| | |reconstitution in 125ml |constipation) |puffy ankles | |
| | |water: | | | |
| | |sod.\chloride\bicarbonat| | | |
| | |e\pot.: | | | |
| | |65mmol\53mmol\17mmol\5.4| | | |
| | |mmol\1liter | | | |
Stimulant laxative
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Side Effects |Dosage |
|Bisacodyl |Contalax |5mg enteric coated tab |Occasional |Diarrhoea, abdominal |Adult: 1-2 tab\day |
| | | |constipation; pre and |discomfort, irritable |Child > 6 years: 1 tab\day |
| | | |post-operative |colon, hypokalaemia, | |
| | | |treatment and in cases |coloration of the urine| |
| | | |which require | | |
| | | |defecation to be | | |
| | |5mg coated tab, 10mg supp, 5mg |facilitated | | |
| |Dulcalax |paediatric supp | | |Constipation |
| | | | | |a)Coated tab (taken at night) |
| | | | | |Adult+Child> 10 years: 1-2 coated tab |
| | | | | |(5-10mg) |
| | | | | |Child (4-10 years): 1 coated tab (5mg) |
| | | | | |Child10 years: 1 supp (10mg) |
| | | | | |Child 4 years: 1 tab in evening and 1 |
| | | | | |supp on following morning |
|Cascara |Mucinum |Cascara\ |Contact laxative |Abdominal pain, |1-2 tab at bed time |
|Senna | |Senna\ |stimulates intestinal |diarrhoea, decreased | |
|Boldo leaves | |Boldo leaves: 40mg\30mg\50mg coated|evacuation required for|pot. in blood, unusual | |
|(herbal) | |tab |short time treatment of|shade of urine | |
| | | |adult (Casual | | |
| | | |constipation) | | |
|Sterculia |Normacol | |Gentle laxative | |Adult: 1-2 sachet taken 1-2 times daily |
|Frangula | | | | |after meals |
| | | | | |Child (6-12 years): 1\2 above dose |
| | | | | | |
| | | | | | |
| | | | | |Adult: 1-2 heaped 5ml spoonful taken 1-2|
| | | | | |times daily after meals or as directed |
| |Normacol Plus |Sterculia\ | | |by doctor |
| | |Frangula: 62%\8% granules (500g) | | |Child (6-12 years): decreased dosage |
|Senna fructus |Prunasine |400mg\5ml syrup |Contact laxative |Abdominal discomfort, |Adult: 2 teaspoonful\day |
|extr. | | |(Constipation) |diarrhoea, pot. |Child>10 years: 1-2 teaspoonful\day |
| | | | |depletion, change in | |
| | | | |color of the urine | |
Rectal Route Laxative
|Generic name |Trade name |Dose\Pharmaceutical form |Indication |Dosage |
|Monobasic sod.phosphate |Fleet enema |Monobasic sod.phosphate\ |Relief of occasional constipation or |Adult+child >12 years: 1 bottle no more than once|
|Dibasic sod.phosphate | |Dibasic sod.phosphate: 19g\7g |bowel cleansing before rectal |daily |
| | |(4.4g\dose) |examination; bowel movement occurs in|Child between 2 and 12 years: 1\2 adult dose |
| | | |2-5 min |daily |
Intestinal peristaltis products
|Generic name |Trade name |Dose\Pharmaceutical form|Indication |Side Effects |Dosage |
|Pyridostigmine |Mestinon |10mg tab, 60mg coated |Intestinal atony, |Muscarine-type side effects can |Intestinal atony, atonic |
| | |tab |atonic constipation, |manifest themselves as nausea, |constipation: 1 dragee interval |
| | | |myasthenia gravis |vomiting, diarrhoea, stomach cramp,|of 4 hrs |
| | | |pseudoparalytica |increase perstalsis and bronchial |Myasthenia gravis |
| | | | |secretion, salivation, lacrimation |pseudoparalytica: 1-3 dragee 2-4|
| | | | |as well as brady cardia and miosis;|times daily |
| | | | |Nicotine type side effects consist | |
| | | | |mainly of muscle spasm, muscle | |
| | | | |twitches and muscle weakness | |
Dermatological Diseases
The traditional advice, if it’s wet, dry it; if it’s dry, wet it,contains enough truth to be worth repeating. One or two applications a day are all that is usually necessary unless common sense dictates otherwise.
Adrenal steroids topically are effective in a variety of skin diseases, particularly where there is an allergic factor; they may act b reducing the response of the skin to injury. They also reduce epidermal cell division, which is useful in psoriasis. Since the cause of the lesion is not affected it is not surprising that relapse often follows when they are withdrawn. The difficulties and dangers of systemic adrenal steroid therapy are sufficient to restrict such use to serious conditions (such as pemphigus and generalized exofoliative dermatitis) not responsive to other forms of therapy.
For this reason, the following useful guidelines have been proposed:
1. Employ the weakest preparation that will control the disorder, especially if long term use is likely
2. In case likely to be resistant, use a high potency preoaration for three weeks to gain control, after which change to a less potent preparation
3. Advise the patient to apply the formulation very thinly, just enough to make the skin surface shine slightly
4. Prescribe in small amounts so that serious overuse is unlikely to occur without the doctor knowing, e.g. weekly quantity by group: high potency 15g: potent 30g: others 50g
5. Occlusive dressing should only be used briefly
High potency preparations are commonly needed for lichen planus and discoid lupus erythematous. Potent preparations for psoriasis and weaker preparations are usually adequate for eczema; where a skin disorder requiring a corticosteroid is already infected, a preparation containing an antimicrobial is used. When the infection is eliminated the corticosteroid may be continued alone. It is inappropriate to use corticosteroid\antimicrobial preparations in the absence of initial infection. (Refer to table 3)
The following study will be focused only on two dermatological diseases: acne and psoriasis
Acne (sebaceous gland disorder):
Acne is defined as common skin condition in which the skin pores become clogged, leading to pimples and inflammed, infected abscesses (collection of pus); usually it is developed in teenagers due to the interaction among hormones, skin oils and bacteria. Acne can be either black heads, which is due to incomplete blockage or white heads, which is due to complete blockage.
There are two types of acne
1. Deep acne: the inflammed pimples project down into the underlying skin and pus filled cysts appear that may rupture and develop into larger abscesses; the infection will spread producing larger red raised inflammed areas, puss filled cyst and abscess
2. Superficial acne: the pimples, pustules are without abscesses; it usually leaves a scar
Treatment guideline includes:
1.washing affected area several times\day has little effect except to improve the appearance of an oily face
2. Soap: -no added benefit is achieved using antibacterial soap
-abrasive soap will dry and irritate the skin
-hot water softens comedons and render them easy to remove using sterile
needle or schamberg loop extracter
3. Antibiotics: Clindamycin, erythromycin with or without an irritant (retinoic acid), tetracycline, minpcyclin, doxycyclin used to treat superficial acne but person have to take the drug for months or years; patients suffering from deep acne should use tetracycline, minocycline, erythromycin which may cause candidal vaginitis in teenage girl (vaginal yeast infection)
4. Sunlight: dries skin and causes light scaling that accelerates healing; that is why acne is worse in winter and better in summer
5. Tretinoin (cream, gel, liquid) dries the skin but used caustiously because it causes severe irritation if exposed to light; it should be applied lightly over face, avoiding eyes
6. Benzoyl peroxide (nonprescription topical drug) and sulfur resorcinol: should be applied two times daily at night and morning
7. Isotetenoin: can harm fetus
8. Corticosteroid
9. X-ray and topical corticosteroid may worsen acne
10. Contraceptives: used for 4-6 months
Acne therapy preparation
Soap
|Generic Name |Trade Name |Dose\Pharmaceutical form |Indication |Posology |
|Glycerine |Neutrogena |Original formula, original|Clean-rinsing and won’t leave any | |
|TEA-stearate | |fragrance free, oily skin,|pore clogging residue; its | |
|Triethanolamine | |dry skin, dry skin |hypoallergic formula contains no | |
|Sod.tallowate | |fragrance free, acne-prone|harsh detergent, dyes or hardeners | |
|Coamide DEA Sod.ricinoleate| |skin formula | | |
|Irgasan DP 300 |Gamophen |1.5% anhydrous soap |Antiseptic soap | |
|Salicylic acid |Fostex |2 % |Dries and cleans acne blemishes, |Wash entire affected area 1-3 times\day; if|
| | | |black heads and white heads as it |dryness or peeling occurs decrease to 1 per|
| | | |cleans deep to remove dirt and oil; |day or every other day; after washing apply|
| | | |active ingredient is proven to |fostex 10% benzoyl peroxide gel for day and|
| | | |penerate pore to control acne |night acne treatment |
| | | |blemishes and helps prevent and keep | |
| | | |skin clear of new acne blemishes, | |
| | | |black heads and white heads | |
|Salicylic acid |Acnebar |Salicylic acid\ |Antibacterial, anti-acne; helps kill |Use 2 times daily |
|Sulfur | |Colloidal sulfur: 1% BP\ |bacteria that can cause acne and | |
| | |1% USP (85 g) |prevent new pimples before the | |
| | | |appear; its drying action promotes | |
| | | |peeling to help clear your skin; | |
| | | |topical aid for control of acne | |
| | | |vulgaris | |
|Sulfated surfactant blend |Acne-aid |Sulfated surfactant blend |Gentle soap and an effective |Adult + child >12 years: wash affected |
| | |6.3% |synthetic cleanser that helps cleanse|areas using warm water, rinse off |
| | | |the skin gently and thoroughly; | |
| | | |useful in acne and greasy skin | |
| | | |conditions; may be used for | |
| | | |shampooing oily scalps | |
|Triclocarban |Nobacterie |1 % |Medicated soap; effective against | |
| | | |build up of germs | |
| |Nobacter | | | |
| | | | | |
| |Cidal | | | |
Topical Acne Therapy
|Generic Name |Trade Name |Dose\Pharmaceutical|Indication |Side Effects |Posology |
| | |form | | | |
| |Locacid | | | | |
|Azelaic acid |Skinoren |0.2g\100g cream |Anti-acne; acne in its various |Skin irritation, |Beginning of treatment: (during 1st |
| | | |forms characterized by presence|itching, burning |week) apply only once a day; later 2-3|
| | | |of comedones (black heads), |sensation; therefore |times\day; to favour absorption the |
| | | |papules, pustules, small |should interrupt |cream application can be preceded by a|
| | | |nodules |application for 1-2 |pack or hot shower when the lesions |
| | | | |days |are on large areas such as chest, |
| | | | | |shoulders, back |
|Benzoyl peroxide |Cutacnyl |5% (5g\100g)\10% |Local acne, acne vulgaire |Local reaction: | |
| | |(10g\100g) lotion, | |desquamation, burning | |
| | |2.5% \ 5% \ 10% gel| |sensation… | |
| | | | | | |
| | | | | | |
| | |5g (45g) \10g gel | | | |
| | | | | | |
| | | | | | |
| | |2.5% \ 5% \ 10% gel| | | |
| |Eclaran | | | |1-2 applications\day |
| | | | | | |
| | |5% \ 10% gel | | | |
| | | | | | |
| |Oxinac | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Uvacnyl | | | | |
|Erthromycin |Eryfluid |4% lotion |Acne |Allergic reaction: |1-2 applications\day |
| | | | |irritation, reddness | |
| | | | | |1-2 applications\day; onset of action:|
| |Erythromycin |4% solution | | |4-8 hrs. |
|Erythromcin-Zinc |Zineryt |Erythromycin\Zinc |Moderate to serious forms of |Burning or irritating |Apply a layer of zinert with the |
|coplex | |complex: 40mg\ |acne (pimples) for which |sensation or slight |applicator into skin of pimples 2 |
| | |12mg lotion |topical treatment with out |redness of skin; this |times\day before and after make up in |
| | | |antibiotic has provided no or |is usually not serious |morning and evening; improvement |
| | | |insufficient results or not |and disappear |starts after 10-12 weeks |
| | | |tolerated |automatically | |
|Erythro-mycin |Benzamycin |23.3g topical gel | | | |
|Benzoyl peroxide | |(Erythromycin\ | | | |
| | |Benzoyl peroxide: | | | |
| | |30mg 3 % \ 50mg 5%)| | | |
|Erythro-mycin |Retinomycin |Erythromycin\ |Avne vulgaris: |Local reaction: |Beginning of treatment: 1 |
|Tretinoin | |Tretinoin: |1.polymorph acne: with |irritative phenomenon |application\day for 3 months |
| | |4g\0.025g gel |microcystics and inflammation |(dry erythema), |Follow up of treatment: 1 |
| | | |predominance |pustular eruption, |application\day for 2-3 days |
| | | |2.monomorph acne: with |increase sensitivity to|Gel must be used in evening 15 min |
| | | |papulo-pustular predominance |UV |after washing face or after bath or |
| | | |Acne conglobata: in association| |perfectly dry skin; wash hands after |
| | | |with other specific therapies | |that; increased dose may lead to local|
| | | |3.other acnes: medicamental | |irritation |
| | | |acnes caused by | | |
| | | |corticosteroides, vitamin like,| | |
| | | |vit B12, vit D, isoniazide, | | |
| | | |iodine, bromine, barbiturate, | | |
| | | |chloralhydrate | | |
| | | |4.Contact and professional | | |
| | | |acnes: detergents, oils | | |
|Tretinoin |Retacnyl |50mg cream |All forms of acne with |Irritation (dry, slight|1 application in evening daily or |
| | | |exception of acne rosacea, |overheaded erythema, |every other day (1-2 applications) |
| | | |keratinisation, in particular |sited mainly in the |Keratinisation disorder: 1-2 |
| | | |forms of parakeratosis, |perioral and neck |applications\day according to patients|
| | | |hyperkeratosis and |origin), possible |or every other day |
| | | |dyskeratosis, 1º of |re-eruption of acne may| |
| | | |genetic\hereditary\ family |occur notably in form | |
| | | |origin inaccessible to |of small white- headed |Adults: |
| | |0.05% cream, 0.01% |conventional treatment |pustules, burning, |Once daily (over saturation should be |
| |Retin A |\ 0.025% gel, 0.1%| |stinging, warmth, |avoided); excess use: reddnes, |
| | |solution, | |erythema, pruritis, |discontinue for several days before |
| | | | |rash, peeling and |resuming therapy; treated area should |
| | | | |temporay hpo |not be washed more than 2 times daily,|
| | | | |andhperpigmentation, |after washing skin dry at least 20-30 |
| | | | |blistering and crushing|min before application; can use |
| | | | |of skin, eye irritation|cosmetic but wash thoroughly before |
| | | | |and edema, tru contact |application of retin A |
| | | | |allergy (rare) | |
Systemic Acne Therapy
|Generic Name |Trade Name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Cyproterone acetate |Diane 35 |Cyproterone acetate\|Signs of adrogenization in female;|Headache, gastric upset, |Control examination should |
|Ethinylestradiol | |Ethinylestradiol: |treatment of androgen-dependant |nausea, feeling of tension in |be conducted at intervals |
| | |2mg\0.035mg coated |disease in women such as acne |breast, changes in body wt and|about 6 months during long |
| | |tab |especially those pronounced and |libido or depressive moods, |term treatment; start |
| | | |those accompanied by seborrhea or |brownish patches on face made |taking tab on 1st day of |
| | | |by inflammation of nodes (acne |worse by long exposure to sun,|bleeding; 1 tab\day for 21 |
| | | |papulopustulosa, androgenetic |poor tolerance of contact |days preferably after |
| | | |alopcia and mild forms of hirutism|lenses |breakfast or meal; after |
| | | | | |the 21 days a tab- free |
| | | | | |interval of 7 days follows;|
| | | | | |after those 7 days |
| | | | | |tab-taking is resumed (3 |
| | | | | |weeks) 1 week off |
| |Dotur |100mg cap |Respiratory tract infection |Nausea, vomiting, diarrhoea, | |
| | | |(pharyngitis, tonsillitis, otitis |loss of appetite, | |
| | | |madia, bronchitis, sinusitis), |pseudomembrance colitis, | |
| | | |pulmonary infection (lobar and |dermatitis, stomatitis | |
| | | |multilober pneumonia), infection |photosensitivity, erythematous| |
| |Granudoxy |100mg coated tab |of urinary tract, urogenital tract|rashes, urticaria, |Adult: 100-200mg\day |
| | |(film coated, scored|(pyelonephritis, pelitis, |angioneurotic edema, Quincke’s|Child >8: 4mg\kg\day |
| | |tab) |cystitis, urethritis), infection |edema (swelling of face and |Acne: 100mg\day for 10-15 |
| | | |of intestinal tract and bile duct,|throat), hemolytic anemia, |days then increased to |
| | | |infection of skin and soft tissue |neutropenia, eosinophilia, |50mg\day |
| | | |(impetigo, abscess, infected |thrombocytopenia, genital | |
| | | |wounds, paronychia), joints, |fungal infection, risk of | |
| | | |specific infection like |renal toxicity or tooth | |
| | | |brucellosis, anthrax, borreliosis,|staining are lower with | |
| | |100mg cap |traveler’s diarrhoea, malaria, eye|doxycyclin than with other | |
| | | |infection, acne vulgaris (papular |teracyclines, increase BUN, | |
| |Farmadoxi | |form)or conglobata with |super infection by organism | |
| | | |amebicides, treatment of |resistant to anti-biotic are | |
| | | |leptospirosis, selective |possible, inhibition of tooth | |
| | |100mg cap |prophylaxis of cholera, |enamel development when | |
| | | |rickettsia, rocky mountain spotted|admininstered to children | |
| |Vibramycin | |fever, typhus fever and typhus |below 8 | |
| | | |group, tick fever | | |
|Isotretinoin (13-cis |Roaccutane |10mg\20mg cap |Severe forms of acne especially |Dryness of skin and mucus |0.5mg\kg body wt increased |
|retinoic acid) | | |nodulucystic acne and forms of |membranes, dryness of nasal |after 4 weeks to 1mg\kg\day|
| | | |acne with tendency to scarring |mucosa and throat may lead to |(1 cap\day) |
| | | | |epistaxis and hoarseness; | |
| | | | |rash, pruritis, facial | |
| | | | |dermatitis, facial | |
| | | | |hyperpigmentation, pyogenic | |
| | | | |granulomas, increase | |
| | | | |production of granulation | |
| | | | |tissue in acne lesions, local | |
| | | | |or systemic infection with | |
| | | | |G+ve bacteria, paronchia and | |
| | | | |nail atrophy, reversible hair | |
| | | | |loss, irreversible hirutism, | |
| | | | |increase sensitivity to sun | |
| | | | |burn, acne fulminans and | |
| | | | |lymphadenopathy, dryness of | |
| | | | |eyes, conjunctivitis, | |
| | | | |reversible corneal clouding, | |
| | | | |cataract, visual disturbances,| |
| | | | |photophobia, keratitis, muscle| |
| | | | |and joint pain, bone changes, | |
| | | | |hyperostoses, spinal | |
| | | | |hyperostoses, tendonitis, | |
| | | | |calcification of spinal | |
| | | | |ligament which lead to spinal | |
| | | | |cord suppression, nausea, | |
| | | | |headache, sweating, hearing | |
| | | | |impairment, convulsion, benign| |
| | | | |intercranial hypertension, | |
| | | | |colitis, hemorrhage, elevated | |
| | | | |transaminase, elevated TG + | |
| | | | |cholesterol, decrease HDL, | |
| | | | |pancreatitis, change in RBC, | |
| | | | |decrease WBC, change in | |
| | | | |platelet count, elevated ESR, | |
| | | | |vasculitis, bronchospasm, | |
| | | | |hyperprolactinemia | |
Others
|Generic Name |Trade Name |Dose\Pharmaceutical form |Indication |Posology |
|Benzoyl peroxide |Acne Mask (Neutrogena) |5% natural clay mask |Unique potentiated formula treats acne blemishes and |Used once daily using circular |
| | | |provides long lasting anti-bacterial control; absorbs|motion; let dry 20 min then rinse |
| | | |excess skin surface oils with out overdrying or |thoroughly with warm water and dry |
| | | |irritating skin; helps deliver benzoyl peroxide deep |with towel |
| | | |down into pores where acne bacteria can hide and | |
| | | |leaves your skin clean and soft; provides long | |
| | | |lasting antibacterial control and minimize irritation| |
| | | |and excess dryness | |
|Salicylic acid |Acne sol |Salicylic acid, sulfur, |Antiseptic solution that reduces the size and |Cleanse skin thoroughly, apply |
|Sulfur | |zinc oxide, camphor, |severity of any blemish; it exfoliate dead cells from|directly to blemish with help of |
|Zinc oxide | |isopropanol |pores allowing natural agents to penetrate and treat |cotton bud; apply once in evening |
| | |Concealer cream (Beewax, |infection; the synergistic combination of natural |and leave overnight |
| | |titanium dioxide, dimethicone,|ingredients initiates the healing process immediately| |
| | |iron oxide….) | |Concealer cream: apply in morning |
| | | | |on blemish using a cotton bud or |
| | | | |with your fingertip to cover the |
| | | | |undesired mark |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
Psoriasis:
Psoriasis is a chronic, recurring disease recognized by silvery bumps and various-sized plaques (raised patches). In psoriasis there is increased epidermal cell proliferation with consequent increased numbers of horn cells that contain abnormal keratin. The cause is attributed to immune mechanism; it runs in the families. The sites of attack are: scalp, elbows, knees, back, buttocks (can break out around and under nails making them thick and deformed), eye brows and arm pits. Flaking may be mistaken for severe dandruff but patchy nature of psoriasis with flaking areas interspersed among completely normal ones distinguishes the disease from dandruff.
There are four types of psoriasis: limited psoriasis (produces flaking), psoriatic arthritis or extensive psoriasis (similar to rheumatoid arthritis), pustular psoriasis (characterized by large and small pusfilled pimples or pustules that are formed on palm of hands and soles of feet and sometimes scattered on body), and the fourth one will cover the entire body and produces exofoliative psoriatic dermatitis (skin will be entirely inflamed). Formation of new plaques is stimulated by severe sun burn, skin irritation, antimalaria drugs, lithium, β blocker, streptococcal infection, bruises and scratches. Diagnosis is accomplished through skin biopsy (removal of skin and examination under the microscope).
To treat psoriasis ointments and creams (emollient) are applied once to two times daily; usually ointments contain corticosteroids, vitamin D creams, ointments and creams containing salicylic acid, coal tar, zinc dipyrithione and selenium sulfide are used. Anthralin irritates the skin and strains sheets and clothing. Methotrexate interferes with the growth of skin cell.
Drugs are used to dissolve keratin (keratolysis) and to inhibit cell division. Keratin may be removed by scrubbing followed by a dithranol (antimitotic) in Zinc and Salicylic acid (keratolytic) Paste, B.P. (Lassar’s Paste) beginning with 0.1% and increasing to 1%; it stains skin and fabrics. Tar preparations are useful alternatives, and are commonly used for psoriasis of the scalp. Tretinoin (retinoic acid, vit A derivative) may be effective. If the lesions are eczematised, local adrenal steroid is used.
Adrenal steroids reduce epidermal cell division and local application, especially under occlusive dressings, can be effective. Many dermatologists feel that these preparations should only be used if dithranol or tar-containing preparations have failed or produced complications. Systemic corticosteroid administration should be avoided if at all possible, for high doses are needed to suppress the disease, which is liable to recur when treatment is withdrawn, as it must be if complications of long-term steroid therapy are to be avoided.
A psoralen followed by UV (PUVA) is used in severe cases. Folic acid antagonists also suppress epidermal activity temporarily, but they are too toxic for use unless the psoriasis is life-threatening or severely disabling, and preferably patients should be past their reproductive years.
People with psoriasis, eczema and other scaling diseases can use baby shampoo to wash away dead skin.
Local
|Generic Name |Trade Name |Dose\Pharmaceutical form|Indication |Side Effects |Posology |
|Calcipotriol |Daivonex |50mcg\ml scalp |Psoriasis vulgaris|Transient local irritation and |Applied sparingly to affected skin lesions |
| | |lotion\cream | |v.rarely facial dermatitis |2 times daily |
| | | | | |Weekly dose shouldn’t exceed 100g |
|Tazarotene |Zorac |0.1% gel |Psoriasis |Desquamation, cutaneous eruption, |Once\daily |
| | | | |aggravation of psoriasis | |
Systemic
|Generic Name |Trade Name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Methoxsalen |Oxsoralen |10mg cap |Photochemotherapy (methoxsalen with |Nausea, nervousness, |Vertigo: |
| | | |long wave UVA) indicated for |insomnia, |2 cap (10mg each) 2-4 hrs before |
| | | |symptomatic contral of severe, |psychological |UV exposure |
| | | |recalcitrant disabling psoriasis not |depression |Psoriasis: 2 hrs. before UVA with |
| | | |responding to other forms of therapy;| |food or milk |
| | | |photochemotherapy is indicated for | | |
| | | |repigmentation of idiopathic vertigo | | |
*Topical corticosteroid
Alone
|Generic Name |Trade Name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |form | | | |
|Beta-methasone |Betnovate |0.1 % cream\ oint |Active topical corticosteroid |Local atropic changes in skin|2-3 times daily |
| | | |used in case of psoriasis, |such as striae, thinning, | |
| | | |eczema including atopic and |dilatation of superficial BV,| |
| | | |discoid eczema, prurigo |particularly when occlusive | |
| | | |nodularis, psoriasis excluding |dressings used or when skin | |
| | | |widespread plaque psoriasis, |folds are involved, | |
| | | |neurodermatoses including |hypercorticism and | |
| | | |lichen planus, seborrheic |suppression of HPA axis | |
| | | |dermatitis, contact sensitivity|(especially in child, infant,| |
| | | |reaction, discoid lupus |occlusive dressing), | |
| | | |erythematosus |hypersensitivity | |
|Fluticasone |Cutivate |0.005% oint, cream |Relief of inflammatory and |Long burning, pruritis, |Apply 2 times per day |
| | | |pruritic manifestation of |prolonged and intensive | |
| | | |corticosteroid responsive |treatment may cause local | |
| | | |dermatoses such as eczema |atrophic changes in skin such| |
| | | |including atopic, infantile, |as thinning, striae, | |
| | | |discoid eczema prurigo |dilatation of superficial BV,| |
| | | |nodularies, psoriasis excluding|hypertrichosis, | |
| | | |widespread plaque psoriasis, |hypopigmentation, 2º | |
| | | |neurodermatoses including |infection, allergic contact | |
| | | |lichen simplex, lichen planus, |dermatitis, systemic | |
| | | |seborrheic dermatitis, contact |absorption produce features | |
| | | |sensitivity reaction, discoid |of hypercortismn, treatment | |
| | | |erythematosus, insect bite |of psoriasis with | |
| | | |reaction, pricky heat |corticosteroid has provoked | |
| | | | |the pustular form of disease | |
|Clobetasol |Decloban |0.5mg oint |Treatment of more resistant |Any pituitary-adrenal |Apply 1-2 times daily |
| | | |dermatoses such as |suppression is likely to be | |
| | | |psoriasis\excluding widespread |transient with a rapid return| |
| | | |plaque psoriasis, recalcitrant |to normal values once the | |
| | | |eczema, lichen planus, discoid |short course of steroid |Apply 1-2 times per day |
| |Dermovate |0.05 %w\w cream\oint |lupus, erythematosus and other |therapy has ceased; atrophic | |
| | | |conditions which do not respond|changes such as thinning of | |
| | | |satisfactorily to less active |skin, dilatation of | |
| | | |steroids |superficial BV particularly | |
| | | | |when occlusive dressings are | |
| | | | |used, treatment of psoriasis | |
| | | | |with corticosteroids is | |
| | | | |thought to have provoked the | |
| | | | |pustular form of disease | |
|Dexa-methasone |Dexalocal |0.1 % oint\lotion |Allergic eczema (dermatitis | |Apply 2-3 times\ |
| | | |solaris, dermatitis | |day |
| | | |seborrhoica, radiodermatitis), | | |
| | | |neurodermatitis (Circumscripta | | |
| | | |and disseminata), infantile | | |
| | | |eczema (Crusta lacteal and | | |
| | | |nappy rash) | | |
| |Diprosone | | | | |
|Hydro-cortisone |Efficort |0.127g |Eczema, psoriasis, cutaneous |Fragility of skin, acne, |Apply 1-2 times\day |
|aceponate | | |allergy |irritation of mouth, change | |
| | | | |in coloration of skin | |
|Mometasone |Elocom |0.1% cream, oint, |Relief of inflammatory, |Cream: paraesthesia, |Apply thin film of cream once |
| | |lotion |pruritic, manifestation of |pruritis, sign of skin |daily; appl few drops of |
| | | |corticosteroid, responsive |atrophy |lotion once daily |
| | | |dermatoses such as psoriasis, |Oint: burning, pruritis, | |
| | | |atopic dermatoses; lotion |stinging, signs of skin | |
| | | |formulation applied to scalp |atrophy | |
| | | |lesions |Lotion: burning, | |
| | | | |folliculitis, acneform, | |
| | | | |pruritis and signs of skin | |
| | | | |atrophy, irritation, | |
| | | | |hypertrichosis, | |
| | | | |hypopigmentation, perioral | |
| | | | |dermatitis, allergic contact | |
| | | | |dermatitis, maceration of | |
| | | | |skin, 2º infection, striae, | |
| | | | |milaria | |
|Hydro-cortisone |Hydrocort |0.5% cream |Eczyma, seborrheic dermatitis |Coloration of skin |Apply 1-2 times daily |
| | | | | | |
| |Hydrosone |1 % cream, oint |Topical treatment of psoriasis,|Burning, itching, irritation,|Apply 2-3 times per day |
| | | |anal and vulval pruritis and |acneform eruption, 2º | |
| | | |allergic dermatitis, also in |infection, skin atrophy, | |
| | | |management of insect bite, |allergic contact dermatitis | |
| | | |otitis externa (only if eardrum| | |
| | | |is intact | | |
| |Locoid |30g oint\cream (0.1%), |Treatment of superficial skin |Burning sensation or |Apply 1-3 times daily, not |
| | |1mg scalp lotion |diseases in which itching, |irritation of skin treated |exceed 1-2 tubes of 30ml |
| | | |redness or scaling are often |with locoid lotion; rash or |locoid lotion\week |
| | | |present, lotion is especially |pimples, discoloration of | |
| | | |suitable for treatment of hairy|skin | |
| | | |scalp | | |
| | | | | | |
| | | |Locoid lipocream may be used | | |
| | | |for treatment of superficial | | |
| | | |skin diseases, itching, | | |
| | | |redness, scaling; lipocream | | |
| | | |contains more fat than cream | | |
| | | |and is used to treat skin | | |
| | | |disorders in which skin is | | |
| | | |partly dry and partly still | | |
| | | |moist | | |
|Diflu-cortolone |Nerisone |Diflucortolone\ |Skin diseases with bacterial or|Local concomitant symptoms |Apply 2-3b times \day |
|Chlor-quinaldol | |Chlorquinaldol: |mycotic superimposition |such as atrophy, skin, | |
| | |1mg\10mg (0.1%) cream, |(seborrhoeic eczema, |telangiectasis, striae, acne | |
| | |oint, gel |dyshidrotic eczema, eczema in |form, changes of skin, | |
| | | |varicose syndrome, bacterial, |perioral dermatitis, increase| |
| | | |eczematoid), intial treatment |growth of body hair and | |
| | | |of bacterial infection with |systemic effects of | |
| | | |highly inflammatory concomitant|corticoid, allergic skin | |
| | | |symptoms (impetigo, |reaction; side effects can’t | |
| | | |erythrasma), initial and |be excluded in neonates if | |
| | | |interim treatment of |mothers are treated with | |
| | | |dermatomycoses caused by |nerisone | |
| | | |dermatophytes, yeast, | | |
| | | |yeast-like fingi | | |
|Fluocinolone acetonide |Synalar |0.25mg cream, oint, |Non infected inflammatory, |Dermal irritation, smarting, |Apply 1-2 times daily not more|
| | |gel, lotion |pruritic and allergic skin |pruritis, dryness, |than 2-3 weeks |
| | | |diseases indicated in acute and|hypersensitivity, dermal | |
| | | |subacute stages in weeping |atrophy, striae distensae, | |
| | | |process and for greasy skin, |telangiectasis, purpura, | |
| | | |the non aqueous synalar oint is|decreased skin pigmentation, | |
| | | |suitable for chronic and dry |steroid acne, manifestation | |
| | | |process; lotion is indicated in|of irritation, perioral | |
| | | |acute, weeping and seborrheic |dermatitis, contact | |
| | | |dermatoses, the lotion is |dermatitis, 2º infection, | |
| | | |particularly suitable for |dermal maceration, | |
| | | |intertriginous and hairy parts |folliculitis, hypertrichosis,| |
| | | |of body; the gel is suitable |suppression of endogenic | |
| | | |for exposed parts of body |corticosteroid synthesis, | |
| | | | |hypercorticosteroidism with | |
| | | | |edema, manifestation of | |
| | | | |previously latent diabetes | |
| | | | |mellitus, osteoporosis, | |
| | | | |growth disturbance in child | |
With other substances
|Generic Name |Trade Name |Dose\Pharmaceutical form |Indication |Side Effects |Posology |
|Betamethasone |Beta-micoter |Betamethasone\ |Tinea pedis, tinea cruris, |Corticosteroid: burning, |Apply 2 times in morning |
|Clotrimazole | |Clotrimazole: 0.5mg\10mg |tinea corporis caused by |itching, irritation, |and evening 2-4 weeks |
| | |(0.05g\1g per 100g cream) |Trichophyton rubrum, |dryness, folliculitis, |relief: after 3-5 days |
| | | |Trichophyton mentagrophytes, |perioral hypertrichosis, | |
| | | |Epidermophyton floccosum and |acneform eruption, | |
| | | |microsporum caris; |hypopigmentation, perioral| |
| | | |paraesthesia, maculopapular |dermatitis, contact | |
| | | |eruption, edema, 2º infection |allergic dermatitis, | |
| | | | |maceration of skin, 2º | |
| | | | |infection, skin atrophy, | |
| | | | |striae, miliaria | |
| | | | |Clotrimazole: erythema, | |
| | | | |edema, itching, urticaria,| |
| | | | |general irritation of skin| |
|Betamethasone |Betasone N |Betamethasone\ |Topical treatment of |Burning, itching, |Apply 2-3 times daily |
|Neomycin | |Neomycin: 0.1% \ 0.35% |steroid-responsive dermatoses |irritation, acneform | |
| | |cream\oint |where 2º infection is present |eruption, skin atrophy and| |
| | | | |allergic contact | |
| | | | |dermatitis | |
|Betamethasone |Betnovate C |Betamethasone\ |Condition where 2º bacterial |Burning, itching, |Apply 2-3 times daily |
|Clioquinol | |Clioquinol: 0.1% \3% |infection is present, suspected|irritation, acneform | |
| | |cream\oint |or likely to occur: eczema, |eruption, skin atrophy and| |
| | | |prurigo, psoriasis, |allergic contact | |
| | | |neurodermatoses including |dermatitis have been | |
| | | |lichen simplex, lichen planus, |occasionally reported | |
| | | |seborrheic dermatitis, | | |
| | | |intertrigo, contact sensitivity| | |
| | | |reaction, discoid lupu | | |
| | | |erythematosus, generalized | | |
| | | |erythroderma, insect nite, sun | | |
| | | |burn, prickly heat, anal and | | |
| | | |vulval pruritus and otitis | | |
| | | |externa | | |
|Hydrocortisone |Daktacort |Hydrocortisone\ |Bactericidal and fungicide |Irritation of burning |Apply 1-2 times daily |
|Miconazoli nitras | |Miconazoli nitras: |broad spectrum, antifungal\ |sensation associated with | |
| | |10mg\20mg\g cream |anti-inflammatory + |application of Daktacort | |
| | | |anti-pruriginous properties; |crem, allergic reaction | |
| | | |infection of skin by |may occur | |
| | | |dermatophytes of candida | | |
| | | |species in which inflammatory | | |
| | | |symptoms are prominent; | | |
| | | |indicated for initial stages of| | |
| | | |treatment, once the | | |
| | | |inflammatory symptoms have | | |
| | | |disappeared treatment may be | | |
| | | |continued with Daktarin cream; | | |
| | | |product may also be continued | | |
| | | |for mycotic effect with | | |
| | | |bacterial superinfection | | |
| |Dexalocal F | | | | |
|Dexamethasone |Dexasalyl |Dexamethasone\ |Subacute and chronic |Avoid contact with eyes |Apply 2-3 times\ |
|Salicylic acid | |Salicylic |particularly dermatoses, | |day |
| | |acid\alc.isopropylicus: 0.12%|chronic exogenous eczema of | | |
| | |\ 2% \37% lotion, |every etiology, professional | | |
| | |Dexamethasone\ |eczema, neurodermitis, lichen | | |
| | |Salicylic acid: 0.12% \ 3% |chronicus, lichen rubber, | | |
| | |oint |psoriasis vulgaris, lupus | | |
| | | |erythematodes rhonicus | | |
|Betamethasone |Diprogenta |Betamethasone\ |Relief of inflammatory |Burning, itching, |Apply 2 times in morning |
|Gentamicin | |Gentamicin: 0.5mg\1mg |manifestation of corticosteroid|irritation, folliculitis, |and at night |
| | |cream\oint |responsive dermatooses when |hypertrichosis, acneform | |
| | | |complicated by 2º infection |eruption, | |
| | | |caused by organism susceptible |hypopigmentation, perioral| |
| | | |to gentamicin or when the |dermatitis, allergic | |
| | | |possibility of such infection |contact dermatitis | |
| | | |is suspected; such disorders | | |
| | | |include: psoriasis, contact | | |
| | | |dermatitis, atopic dermatitis, | | |
| | | |neurodermatitis, eczema | | |
| | | |including nummular eczema, hand| | |
| | | |eczema, eczematous dermatitis, | | |
| | | |intertrigo, dyshidrosis, | | |
| | | |seborrheic dermatitis, | | |
| | | |exofoliative dermatitis, solar | | |
| | | |dermatitis, stasis dermatitis, | | |
| | | |anogenital and sensile pruritus| | |
|Betamethasone |Diprosalic |Betamethasone\ |Lotion: relief of inflammatory |Burning, itching, |Oint: apply 2 times daily|
|Salicylic acid | |Salicylic acid: 0.5mg \ 20mg |manifestation of psoriasis and |irritation, folliculitis, |in morning and evening |
| | |lotion, 0.5mg \ 30mg oint |seborrhea of scalp; nonscalp |hypertrichosis, acneform |Lotion: few drops and |
| | | |lesions of psoriasis, and other|eruption, |message gently and |
| | | |corticosteroid responsive |hypopigmentation, perioral|thoroughly 2 times in |
| | | |dermatoses |dermatitis, allergic |morning and evening |
| | | |Oint: relief of inflammatory |contact dermatitis | |
| | | |manifesttion of hyperkeratotic |Salicylic acid: cause | |
| | | |and dry corticosteroid |irritation | |
| | | |responsive dermatoses such as | | |
| | | |psoriasis, chronic atopic | | |
| | | |dermatoses, neurodermatoses, | | |
| | | |seborrheic dermatitis of scalp,| | |
| | | |ichthyosis vulgaris and other | | |
| | | |ichthyotic condition | | |
|Betamethasone |Fucicort |Betamethasone\ |Anti-bacterial, | | |
|Fusidic acid | |Fusidic acid: 1mg \ 20mg |anti-inflammatory and | | |
| | |cream |anti-pruritic agent | | |
|Hydrocortisone |Fucidin H |Hydrocortisone\ |Anti-bacterial, | | |
|Fusidic acid | |Fusidic acid: 10mg \ 20mg |anti-inflammatory | | |
| | |cream | | | |
|Triamcinolone |Kenacomb |Triamcinolone\ |Antibiocorticotherapy | | |
|Neomycin | |Neomycin\ | | | |
|Gramicidin | |Gramicidin\ | | | |
|Nystatin | |Nystatin: 0.1% \ 0.25% \ | | | |
| | |0.025% \ 100000units cream, | | | |
| | |0.1% \ 0.25% \ 0.025% \ | | | |
| | |100000 units oint | | | |
|Flumetasone |Locacorten Vioform|Flumetasone\ |Initial treatment for |Irritation, contact |Apply thin film 2-3 times|
|Clioquinol | |Clioquinol: 0.02% \ 3% cream\|corticosteroid responsive |allergy, change in skin |depending on severity of |
| | |oint |inflammatory skin disease of |pigmentation |disease |
| | | |varying type and location in | | |
| | | |which 2º infection with | | |
| | | |micro-organism sensitive to | | |
| | | |Clioquinol has occurred ex: | | |
| | | |seborrheic eczema, contact | | |
| | | |eczema, atopic dermatitis, | | |
| | | |localized neurodermatitis, | | |
| | | |intertigo, impetigo, 2º | | |
| | | |infection, | | |
|Flumetasone |Locasalen |Flumetasone\ |Subacute and chronic skin |Irritation, mild skin |Apply 1-2 times daily |
|Salicylic acid | |Salicylic acid: 0.02% \ 3% |disease of varying type, when |atrophy, contact allergy, | |
| | |oint |associated with hyperkeratosis |change in skin | |
| | | |ex: seborrheic eczema, contact |pigmentation, 2º | |
| | | |eczema, atopic dermatitis, |infection, striae rubrae | |
| | | |localized neurodermatitis, |distensae, purpura or | |
| | | |psoriasis vulgaris, lichen |steroid acne | |
| | | |planus, hyperkeratosis of palm | | |
| | | |and soles | | |
|Betamethasone |Lotriderm |Betamethasone\ | | | |
|Clotrimazole | |Clotrimazole: 0.5mg \ 10mg | | | |
| | |cream | | | |
Anti-epileptic Drugs
Epilepsy has never been more accurately defined by Hughlings Jackson a long time ago when he said it was a sudden, excessive and rapid discharge in grey matter of the brain. Most forms of epilepsy have a focal origin, the form of the seizures depending on the site of the focus in the brain, the regions to which the discharge spreads, and the effects of post-ictal paralysis of these regions. Although the exact relationship of the abnormal and excessive excitation to normal neuronal activity is not yet understood, it has long been known that general depressant of nervous activity will diminisf or abolish epileptic activity.
Antiepileptics are drugs which inhibit discharge or its spread with minimal general depressing or hypnotic effect. They may act by altering permeability of cell membranes to ions and by modifying neurotransmitters, e.g. increasing brain concentration of the inhibitory gamma-aminobutyric acid (GABA), or by altering concentrations of serotonin or glycine.
Principles in the general treatment of epilepsy include:
1. Treatment of causative factors, e.g. cerebral neoplasm
2. Avoidance of precipitating factors, e.g. alcohol, stress
3. Anticipation of natural variations, e.g. fits may occur only at night or shortly after waking
4. Antiepileptic drugs
Drugs of choice in epilepsy include:
1. Major seizures (grand mal) and focal (partial) seizures including temporal lobe epilepsy
First choice: phenytoin
Second choice: carbamazepine, phenobarbitone, primidone, sodium valproate, pheneturide, clonazepam
2. Minor seizures (petit mal)
First choice: sodium valproate or ethosuximide
Second choice: clonazepam, troxidone
3. Myoclonus: clonazepam, sodium valproate, primidone
4. Status epilepticus: diazepam or clonazepam, i.v.
|Generic name |Trade name |Dose\Pharmaceutical |Indication |Side Effects |Posology |
| | |Form | | | |
|Phenytoin sodium |Epanutin |100mg cap |Simple Jackson seizures and |Diplopia, nystagmus, impairment|100mg cap 3 times\day (300-400mg) |
| | | |complex temporal seizures |in movement co-ordination, | |
| | | |(partial seizures, focal |dizziness, increase | |
| | | |seizures and 1º generalized |nervousiness, multiple tremor, | |
| | | |tonic clonic seizures (grand |depression, verbal | |
| | | |mal ), sleep epilepsy, diffuse|incompetence, lost appetite, wt| |
| | | |epilepsy, combined epileptic |loss, allergic skin rash, | |
| | | |seizures with grand mal |leukopenia, impairment in | |
| | | |symptoms, seizures prophylaxis|hepatic function, swollen | |
| | | |and treatment in |lymphatic node, fever, excess | |
| | | |cerebrocranial trauma |pigmentation, osteomalacia, | |
| | | | |irreversible cerebellar atrophy| |
|Valproic |Depakine |500mg f.c.tab |Anti-epileptic; 1º generalized|Hepatic damage, pancreatic | |
|acid\Valproate | | |seizures |damage, disturbance of | |
| | | |a- petit mal epilepsy: |consciousness, nausea, | |
| | | |pyknoleptic absences, |vomiting, anorexia, and stomach| |
| | | |myoclonic astatic seizures |pain, temporary hair loss, | |
| | | |(Lennox syndrome), infantile |slight tremor of hand, | |
| | | |spasm (West’s syndrome), |menstrual period disorder, wt | |
| | |50mg\ml syrup |impulsive petit mal |gain, increase appetite, | |
| |Convulex | |b- Grand mal epilepsy: |gastralgia, gastrospasm, |15mg\kg body wt increased to |
| | | |seizures on awakening, |diarrhea, constipation, |5-10mg\kg per week |
| | | |photosensitive forms, partial |sedation, vertigo, depressive |General dosage: 30mg\kg body wt |
| | | |focal seizures especially |deterioration, aggretion, |per day |
| | | |characterized by complex |involuntary movement, |Child: 3-18 ml accor-ding to wt |
| | | |symptoms with generalization |hyperactivity, tonic cramp, | |
| | | | |coordination disturbance, | |
| | | | |dipoplia confusion, coma, | |
| | | | |nystagmus, decrease | |
| | | | |platelets\WBC\RBC\ | |
| | | | |fibrinogen, bone marrow | |
| | | | |depression, elevated | |
| | | | |ammoniemia, decrease | |
| | | | |creatinine, allergic reaction, | |
| | | | |galactorrhea | |
|Carba-mazepine |Tegretol |200mg tab, 200mg\400 |Partial seizures with complex |Dizziness, ataxia, fatigue, |100-200mg once or twice daily |
| | |mg CR tab, 100mg\5ml |or simple symptomatology, 1º |headache, diarrhea, dryness of | |
| | |syrup |generalized epilepsy or 2º |mouth, drowsiness, dizziness, | |
| | | |generalized seizures with a |diplopia, tremor, muscle | |
| | |300mg sustained |tonic- clonic component; mania|weakness, peripheral neuritis, | |
| | |release tab |and prophylactic treatment in |visual hallucination, |Child+adult: 1\2 tab 2 times\day |
| |Neurotop retard | |manic depressive (bipolar) |depression, loss of appetite, |(increase in evening) |
| | | |disorders, alcohol withdrawl |agitation, pruritis, acne, |1-5 years: 1\2 tab in morning and |
| | | |syndrome, idiopathic |sweating, hair loss, |evening |
| | | |trigeminal neuralgia due to |leukopenia, thrombocytopenia, |6-10 years: 1\2 tab in morning and|
| | | |multiple sclorosis, painful |aplastic anemia, folic acid |evening+1\2-1 tab in evening |
| | | |diabetic neuropathy, diabetic |deficiency, nausea, vomiting, | |
| | | |insipidus centralis polyuria, |stomatitis, aseptic meningitis,| |
| | | |and polydipsia of |peripheral eosinophilia, | |
| | | |neurohormonal origin |thromboembolism, fluid | |
| | | | |retention, wt gain, mental | |
| | | | |confusion, urinary retention, | |
| | | | |sexual disturbance, cramp, | |
| | | | |pulmonary hypersensitivity, | |
| | | | |disturbance in liver enzyme, | |
| | | | |hepatocellular jaundice, | |
| | | | |swelling of lymph nodes, | |
| | | | |decrease T3+ T4, hypocalcemia, | |
| | | | |hypersensitivity of lungs, | |
| | | | |aseptic meningitis, hypotension| |
| | | | |or hypertension, fever | |
|Pheno-barbital |Gardenal |10mg\50mg\100mg tab |According to judgment of |Drowsiness, difficult walking, |Adult: 2-3mg\kg |
| | | |physcian |speech difficulty, skin |Child: 3-4mg\kg |
| | | | |reaction, paradoxical | |
| | | | |excitation in child, | |
| | | | |neurological disorder in | |
| | | | |elderly | |
|Benzo- |a.Rivotril |a.2.5mg\ml drop, |Epilepsy in infant, children |Tiredness, sleepness, muscular |Adult and child over 30 kg: |
|diazepine | |0.5mg\2ml tab, 5 amp |in particular typical and |hypotonia, dizziness, light |1-2mg\day increased to 2-4 mg |
| | |1mg\ml IV\IM |atypical absences (Lennox |headedness, pruritis, rash, |daily |
|a. Clona-zepam | | |syndrome), nodding spasm, 1º |angioedema, pharyngeal oedema, |Child (10-16 years): 1.5-3mg daily|
| | | |and 2º generalized |hair loss, pigmentation |Infant: 0.01-0.03mg\ kg daily |
|b. Diazepam | | |tonic-clonic spasm; Rivotril |changes, nausea, headache, |increased to 0.05-1mg\kg |
| | | |IV\IM is a drug of choice in |chest pain, decrease blood | |
| | | |all forms of status |platelets, decrease sexual |5-20mg daily |
| | | |epilepticus; Rivotril can be |drive, premature 2º sexual | |
| | | |used in adult epilepsy and |characteristics in children, | |
| | | |focal seizures |anaphylactic shock, respiratory| |
| | | | |depression, brain damage, | |
| | | | |double vision, elevated saliva | |
| | | | |and bronchial secretion…… | |
| | | | | | |
| | | | | | |
| | | | |Fatigue, drowsiness, muscle | |
| | | | |weakness, confusion, | |
| | | | |constipation, depression, | |
| | | | |diplopia, headache, hpotension,| |
| | | | |increase to decrease libido, | |
| | | |Symptomatic relief of anxiety,|nausea, hypersalivation, | |
| | | |agitation, tension due to |urinary retention, skin rash, | |
| | | |psychoneurotic states and |tremor, vertigo, blurred | |
| | | |transient situational |vision, slurred speech, brady | |
| | |b.2mg\5mg\ |disturbances; used |cardia, elevated transaminase, | |
| | |10mg scored tab |adjunctively in major mental |alkaline phosphatase, jaundice,| |
| | | |and organic disorders; useful |anxiety, sleep disturbance, | |
| |b.Valium | |adjunct for relief of reflex |hallucination, respiratory | |
| | | |muscle spasm due to local |depression | |
| | | |trauma (injury, | | |
| | | |inflammation…), used to combat|NB: abrupt withdrawl of drug | |
| | | |spasticity arising from damage|should be avoided; otherwise, | |
| | | |to spinal and supraspinal |tremor, anxiety, sweating, | |
| | | |interneurons such as cerebral |agitation…; treatment with | |
| | | |palsy…. |benzodiazepine can lead to | |
| | | | |dependance and ability to drive| |
| | | | |is impaired (effect is | |
| | | | |aggravated by consumption of | |
| | | | |alcohol | |
|Lamotrigine |Lamictal |25mg\50mg\100mg\200 |Anti-epileptic drug indicated |Skin rash, angioedema, |50mg\ |
| | |mg tab |for the treatment or partial |Stevens-Johnson syndrome, |day for 2 weeks |
| | | |seizures and generalized tonic|diplopia, blurred vision, | |
| | | |clonic seizures not |dizziness, drowsiness, | |
| | | |satisfactorily controlled with|headache, unsteadiness, | |
| | | |other antiepileptic drugs |tiredness, GI disturbance, | |
| | | | |irritability, aggression | |
|Vigabatrin |Sabril |500mg tab\powder for |Anti-epileptic for adult and |Allergy | |
| | |solution |enfant | | |
|Gabapentin |Neurontin |30mg\100mg\400mg cap |Anti-epileptic; additional |Sleepness, fatigue, dizziness, | (300mg\ |
| | | |therapy in adults with simple |ataxia, nystagmus, headache, |day): 1 cap (100mg) 3 times daily |
| | | |and complex partial seizures |blurred vision, double vision |(600mg\ |
| | | |with or without 2º generalized|(diplopia), tremor, impaired |day): 2 cap (100mg) 3 times daily |
| | | |seizures who don’t become |speech, thought disturbance, |(900mg\ |
| | | |seizure free under standard |impaired memory, convulsion, |day): 3 cap (100mg) 3 times daily |
| | | |therapy with 1º or more drugs |nervousness, depression, |or 1 cap (300mg) 3 times daily |
| | | | |emotional instability, | |
| | | | |leukopenia, vasodilatation, | |
| | | | |nausea, vomiting, constipation,| |
| | | | |stomache ache, wt gain, | |
| | | | |increase appetite, rhinitis, | |
| | | | |cough, muscle pain, back pain, | |
| | | | |oedema, dental anomalies, skin | |
| | | | |itching, pruritis | |
|Topiramate |Topamax |25mg\50mg\100mg\200 |Adjunctive therapy in patients|Ataxia, confusion, dizziness, |50mg for 1 week (nighty) inceased |
| | |mg tab |with partial onset seizures |fatigue, paraesthenia, |50-100mg in 2 divided doses |
| | | |with or without secondarily |somnolence, agitation, | |
| | | |generalized seizures |anorexia, depression, nausea, | |
| | | | |speech disorder, vision | |
| | | | |abnormality, wt decrease, | |
| | | | |thromboembolic events | |
Corticostroids
Hormones normally produced by the adrenal cortex include hydrocortisone (cortisol), corticosterone, aldosterone and some androgens but not cortisone. Cortisone is biologically inert and must be converted to hydrocortisone for biological activity. Numerous other steroids have been isolated from the gland and many more have been made in the laboratory
Adrenal steroids are chiefly used in medicine for their anti-inflammatory and immunosuppressive effects. These are only obtained when the drugs are given in doses far above those needed for physiological effect. Their metabolic effects, which are of the greatest importance to the normal functioning of the body, then become adverse effects. Much successful effort has gone into separating glucocorticoid from mineralocorticoid effects and some steroids (prednisolone, dexamethasone) have virtually no mineralocorticoid activity. It has not yet proved possible to separate most of the glucocorticoid effects from each other, so that if a steroid is used for its anti-inflammatory action the risks of osteoporosis, diabetes, etc., remain. But one important physiological effect, sodium retention, has been eliminated by the introduction of a double bond which transforms hydrocortisone to prednisolone.
Choice of adrenal steroid can be summarized in three points: For replacement therapy in adrenocortical insufficiency, hydrocortisone or cortisone should be used to supply mineralocorticoid and some glucocorticoid activity. Prednisolone on its own is not effective replacement therapy. In Addison’s disease a small dose of a hormone with only mineralocorticoid effect (fludrocortisone) is normally needed in addition. For anti-inflammatory and anti-allergic effect, prednisolone, triamcinolone or dexamethasone. It is not possible to rank these in firm order of merit. For hypothalamic-pituitary-adrenocortical suppression, e.g. in adrenal hyperplasis, prednisolone or dexamethasone.
Adrenal steroids are used for:
1. Replacement
2. Inflammation suppression
3. Immunosuppression
4. pituitary suppression (uncommon)
Topical coticosteroids can decrease inflammation (swelling, itching and reddness). Corticosteroids are most effective for rashes caused by allergic or inflammatory reaction to poison, metal and cloth; they lower resistance to bacterial and fungal infection; therefore they shouldn’t be used on infected areas or wounds. When mixed with antifungal they decrease itching caused by a fungus. Corticosteroid plus antibiotic are seldom used because they increase risk of an allergic reaction that can complicate the problem.
|Generic name |Trade name |Dose\ |Indication |Side Effects |Posology |
| | |Pharma-ceutical form | | | |
|Beta-methasone |Celestone |6mg injection |Relief of inflammatory and pruritic |Burning, itching, irritation, | |
| | | |manifestation of |hypopigmentation, 2º infection, | |
| | | |corticosteroid-responsive dermatoses,|skin atrophy, sensation of pain, | |
| | |0.05%\0.5%mg |psoriasis, seborrhea of scalp, |fluid retention, muscle weakness,| |
| |Diprosone |cream\oint |rheumatoid arthritis, osteoarthritis,|aseptic necrosis, steroid |2 times daily morning and |
| | | |ankylosing spondylitis, sciatica, |myopathy, osteoporosis, peptic |night |
| | | |lumbago, fascilitis, bronchial |ulcer, pancreatitis, ulcerative | |
| | | |asthma, hay fever, serum sickness, |esophagitis, increase sweating, | |
| | |0.5mg\20mg lotion |insect bite, allergic dermatitis |erythema, convulsion, vertigo, |2 times daily morning and |
| | | |(alopecia, cystic acne…), |headache, psychic disturbance, |night |
| |Diprosalic | |collegen diseases (scleroderma….), |decrease CHO tolerance, | |
| | |7mg\ml (2ml amp) |neoplastic diseases (leukemia, |suppression of growth in | |
| | |IM\Intra-articular\ |lymphoma…), ulcerative colitis, |children, menstrual |1-2ml |
| | |intrabursal\ |nephritis, nephritic syndrome |irregularities, glaucoma, | |
| |Diprofos |intradermal\ | |posterior cataract, negative N | |
| | |intralesional\soft | |balance, myocardial rupture, | |
| | |tissue injection | |hypersensitivity, wt gain, | |
| | | | |increase appetite, nausea, | |
| | | | |malaise, hiccup, thromboembolism | |
|Dexa-methasone |Corticetine |Dexa-methsone\ |Anti-inflammatory + anti-biotic, |Local irritation, deafness, |3-5 drops 3 times daily |
| | |Framycetin sulfate: |eczymatous infection of auditory |disorder of tympanic membrane, | |
| | |100mg\100ml\\630000 |canal; condition where inflammatory |development of fugal infection, | |
| | |IU\100ml ear drop |immunosuppressive effect of |fluid retention (sod. retention, | |
| | | |corticosteroid are desirable, |hypokalemic alkalosis…), muscle | |
| | |0.5mg tab, 0.5mg\5ml |dermatitis (seborrhoica, |weakness, aseptic necrosis, | |
| | |Elixir |radiodermatitis…), neurodermatitis, |steroid myopathy, osteoporosis, | |
| | | |infantile eczyma (nappy rashes…), |peptic ulcer, pancreatitis, |0.75-15mg |
| | |Dexa-methasone\ |adrenal cortical insufficiency, |ulcerative esophagitis, increase | |
| |Decadron |Framycetin: 5-20g |adrenogenital syndrome, rheumatoid |sweating, impaired wound healing,| |
| | |oint\cream |arthritis, nephritic syndrome, |erythema, convulsion, vertigo, |apply 2-3 times daily on |
| | | |hypersensitivity, prevention of scar,|headache, psychic disturbance, |affected area |
| | |0.05mg\ml pediatric |insect bite, hay fever, autoimmune |decrease CHO tolerance, |varies according to age |
| |Dexalocal |Elixir |hemolytic anemia, Hodgkin disease, |suppression of growth in |and day of treatment |
| | | |aplastic anemia, TB meningitis, |children, menstrual | |
| | | |persistant hypoglycemia, lmphocytic |irregularities, glaucoma, | |
| | | |anemia |posterior cataract, negative N | |
| | | | |balance, myocardial rupture, | |
| | | | |hypersensitivity, wt gain, | |
| |Oradexon Chapa | | |increase appetite, nausea, | |
| | | | |malaise, hiccup, thromboembolism,| |
| | | | |hirsutism | |
|Prednisone |Cortancyl |5mg tab |Anti-inflammatory, anti-allergy- |Swelling, redness of the face, wt|Dose cal. individ-ually |
| | | |immunosuppressant agent, treatment of|gain, increase BP, sleep |for each person |
| | | |endocrine and rheumatic disorders, |disturbance, bone fragility, | |
| | | |allergic states and dermatologic |impaired adrenal function, | |
| | | |diseases |menstrual disorder, disturbance | |
| | | | |of growth in children, muscle | |
| | | | |weakness, ulcer, GI disturbance, |Adult: 5-60mg\day |
| |Predicor |5mg\10mg\ | |glaucoma… |Child: depend on severity |
| | |20mg\50mg tab | | |of reaction |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | |50mg tab | | | |
| |Prednisone | | | | |
| | | | | | |
|Methyl-prednisone |Depo-medrol |40mg\ml sterile |Endocrine disorders: 1º and 2º |fluid retention (sod. retention, |40mg every 2 weeks |
| | |aqueous suspension, |adrenocortical insufficiency, |hypokalemic alkalosis…), muscle | |
| | |40mg\2ml syringe, |congenital adrenal hyperplasia, |weakness, aseptic necrosis, | |
| | |40mg\2ml vial. |nonsuppurative thyroiditis, |steroid myopathy, osteoporosis, | |
| | |40mg\5ml vial IM, |hypercalcemia associated with cancer,|peptic ulcer, pancreatitis, | |
| | |inta-articular, |rheumatic disorder (rheumatoid |ulcerative esophagitis, increase | |
| | |periarticular, |arthritis, gouty arthritis, |sweating, impaired wound healing | |
| | |intrabursal, |ankylosing spondylitis), collagen |erythema, convulsion, vertigo | |
| | |intralesional, |diseases |,headache, psychic disturbance, | |
| | |intra-rectal |( rheumatic carditis, good pasture’s |decrease CHO tolerance, | |
| | |(80mg\2ml syringe) |syndrome, giant cell arthritis), |suppression of growth in | |
| | | |dermatological disorder (mycosis |children, menstrual | |
| | |4mg\16mg\ |fungoides, sever psoriasis, atopic |irregularities, glaucoma, | |
| | |32mg\100 |dermatitis, ..), bronchial asthma, |posterior cataract, negative N | |
| | |mg tab |contact and atopic dermatitis, serum |balance, myocardial rupture, | |
| | | |sickness, ophthalmic diseases (optic |hypersensitivity, wt gain, | |
| | | |neuritis, keratitis,optic neuritis, |increase appetite, nausea, | |
| | | |allergic conjunctivitis..), |malaise, hiccup, thromboembolism,| |
| |Medrol | |ulcerative colitis, aspiration |opportunistic infection |4-48mg\ |
| | | |pneumonitis, symptomatic sarcoidosis,| |day depend on disease |
| | | |hematologic disorders (hemolytic | | |
| | |40mg\125 |anemia, 2º thrombocytopenia, | | |
| | |mg\250mg sterile |erythroblastopenia, hpoplastic | | |
| | |powder (2 component |anemia, neoplastic diseases (acute | | |
| | |amp) IV\IM, |leukemia, terminal cancer, lymphoma | | |
| | |500mg\1000mg\2000mg |in adult..), edematous diseases, NS | | |
| | |sterile powder (2 |diseases (cerebral oedema, head | |10-500mg depend on |
| |Solu-medrol |component amp) IV\IM |trauma…), cardiovascular conditions | |clinical problem |
| | | |(hemorrhagic, traumatic, surgical | | |
| | | |shock unresponsive to standard | | |
| | | |therapy…), TB meningitis, | | |
| | | |Trichinosis, organ transplantation | | |
|Fludro-cortisone |Florinef |0.1mg tab |1º and 2º adrenocortical |fluid retention (sod. retention, |0.05-0.3mg for adult |
| | | |insufficiency in Addison’s disease, |hypokalemic alkalosis…), muscle | |
| | | |treatment of salt losing |weakness, aseptic necrosis, | |
| | | |adrenogenital syndrome |steroid myopathy, osteoporosis, | |
| | | | |peptic ulcer, pancreatitis, | |
| | | | |ulcerative esophagitis, increase | |
| | | | |sweating, impaired wound healing | |
| | | | |erythema, convulsion, vertigo | |
| | | | |,headache, psychic disturbance, | |
| | | | |decrease CHO tolerance, | |
| | | | |suppression of growth in | |
| | | | |children, menstrual | |
| | | | |irregularities, glaucoma, | |
| | | | |posterior cataract, negative N | |
| | | | |balance, myocardial rupture, | |
| | | | |hypersensitivity, wt gain, | |
| | | | |increase appetite, nausea, | |
| | | | |malaise, hiccup, thromboembolism | |
|Hydro-cortisone |Hydrocortisone |10mg tab |Endocrine disorder (nonsuppurative | | |
| | | |thyroiditis), rheumatic disorder | | |
| | | |(adjuvant: synovitis of | | |
| |Solu-cortef | |osteoarthritis, rheumatoid arthritis,| | |
| | |100mg\250mg\2ml |gouty arthritis, ankylosing | |100mg over period of 30 |
| | |sterile powder, |spondylitis, junenile rheumatoid | |sec to 10 min |
| | |500mg\4ml sterile |arthritis, rheumatic carditis, | | |
| | |powder, 1g\8ml |dermatological diseases (seborrheic, | | |
| | |sterile powder (2 |psoriasis…), bronchial asthma, atopic| | |
| | |component vial) |dermatitis, herpes zoster, | | |
| | | |sympathetica ophthalemia, ulcerative | | |
| | | |colitis, aspiration pneumonitis, | | |
| | | |hemolytic anemia, leukemia, edematous| | |
| | | |state, synovitis of osteoarthritis, | | |
| | | |gouty arthritis, epicondylitis acute | | |
| | | |allergic disorder following | | |
| | | |epinephrine, medical emergencies, 2º | | |
| | | |adrenocortical insufficiency, | | |
|Triam-cinoline |Kenacort A |40mg |Endocrine disorder (nonsuppurative | |Adult: 60mg |
| | | |thyroiditis), rheumatic disorder | |Child: 40mg |
| | | |(adjuvant: synovitis of | | |
| | | |osteoarthritis, rheumatoid arthritis,| | |
| | | |gouty arthritis, ankylosing | | |
| | | |spondylitis, junenile rheumatoid | | |
| | | |arthritis, rheumatic carditis, | | |
| | | |dermatological diseases (seborrheic, | | |
| | | |psoriasis…), bronchial asthma, atopic| | |
| | | |dermatitis, herpes zoster, | | |
| | | |sympathetica ophthalemia, ulcerative | | |
| | | |colitis, aspiration pneumonitis, | | |
| | | |hemolytic anemia, leukemia, edematous| | |
| | | |state, synovitis of osteoarthritis, | | |
| | | |gouty arthritis, epicondylitis | | |
Table 1
Table2
Table 3
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