iD R U G I N D E X

Generic/ Brand Name

Dosage Mode of Action Indications Contraindications Adverse Effects

Acetazolamide 250-375 mg/day250-1000 mg 24 hrly8-30 mg/kg/day

the drug forces the kidneys to excrete bicarbonate, the conjugate base of carbonic acid. By increasing the amount of bicarbonate excreted in the urine, the blood becomes more acidic. Acidifying the blood stimulates ventilation, which increases the amount of oxygen in the blood

Prophylaxis of high altitude sickness, Acute closed angle glaucoma, Epilepsy

Hypersensitivity to sulphonamides; sodium or potassium depletion, hepatic insufficiency; hepatic cirrhosis; hyperchloraemic acidosis; severe renal impairment; severe pulmonary obstruction; chronic noncongestive angle-closure glaucoma; adrenocortical insufficiency. Pregnancy, lactation

Drowsiness, paraesthesia, ataxia, dizziness, thirst, anorexia, headache; confusion, malaise, depression; GI distress, metabolic acidosis, polyuria, hyperuricaemia, renal calculi, nephrotoxicity, hepatic dysfunction.Potentially Fatal: Rarely, skin reactions or blood dyscrasias.

Acetylsalicylic acid(Aspirin)

325 mg/tab or 80 mg/tab

Antithrombotic, analgesic/antipyretic Inhibits prostaglandin synthesis, resulting in analgesia, anti-inflammatory activity and platelet aggregation inhibition; reduces fever by aacting on the brain’s heat-regulating canter to promote vasodilation and sweating.

Prophylaxis of thromboembolic disorder; prevention of MI & stroke

Use with caution in patients prone to dyspepsia or known to have a lesion of the gastric mucosa. Do not administer to patients with hemophilia and is not recommended to infants <1 year. Caution is necessary when renal or hepatic function is impaired and particularly in children who are dehydrated

Gastric hemorrhage, hypersensitivity and thrombocytopenia may occur

Allopurinol(Allomaron, Allurase, Alpurase, Elavil, Llanol, Lopric, Lopurine, Loricid, Purinase)

300mg / tab Adult 2-10 mg/kg BW/day.Mild 100-200 mg daily. Moderately severe 300-600 mg daily

Absorption of most oral penicillins is impaired by food (except amoxicillin), and should be administered 1-2 hours before a meal. Intravenous route is preferred because of irritation and local pian produced by the intramuscular injection of large doses. Penicillin is rapidly excreted by the kidney into the urine, small amounts excreted via other routes

Pregnancy & lactation. Hepatic or renal impairment (reduce dose). Initiate therapy after acute gout attack has subsided

Rash or hypersensitivity reactions (discontinue). Acute attack of gouty arthritis in early stages of therapy. GI disturbance. Blood & lymphatic system disorders. Fever, general malaise, headache, vertigo, ataxia.

Amikacin 200mg Thru IM OD Inhibits protein synthesis in susceptible bacteria by binding to 30s ribosomal subunits

For bacterial septicemia including neonatal sepsis

Hypersensitivity to amino glycosides Ototoxicity and nephrotoxicity. Rarely, fever and paresthesia

Amino acids(Dipeptiven)

1.5-2ml/kg BW/day, max 3 wk

As a supplement to amino acid solutions or an amino acid-containing infusion regimen in parenteral nutrition for hypercatabolic or hypermetabolic patients

Monitor hepatic function in patients with compensated hepatic insufficiency. Pregnancy and lactation , children

Amoxicillin 500 mg/ cap P.O Inhibit cell wall synthesis. Beta lactamase inhibitor and protect hydrolysable penicillins from inactivation.

Respiratory tract, skin & soft tissue infections

Contraindicated in patients with penicillin hypersensitivity. Superinfections involving pseudomonas or candida. Pregnancy and lactation.

Effects: diarrhea, nausea, skin rashes, urticaria, vaginitis, abdominal discomfort, flatulence, headache

AmoxiclavClavulanic acid - Amoxicillin

1 g tab once a day Inhibit cell wall synthesis. Beta lactamase inhibitor and protect hydrolysable penicillins from inactivation.

Contraindicated in patients with penicillin hypersensitivity. Superinfections involving pseudomonas or candida. Pregnancy and lactation

Diarrhea, nausea, skin rashes, urticaria, vaginitis, abdominal discomfort, flatulence, headache

Ampicillin 100mg Thru IM Q12 Inhibit cell wall synthesis. Beta lactamase inhibitor and protect hydrolysable penicillins from inactivation.

Treatment of infections caused by susceptible gm+ve and gm-ve microorganism

Contraindicated in patients with penicillin hypersensitivity. Superinfections involving pseudomonas or candida.

Diarrhea, nausea, skin rashes, urticaria, vaginitis, abdominal discomfort, flatulence, headache

Ascorbic acid 500 mg/ tab Necessary for collagen formation and tissue repair; involved in some oxidation-reduction reactions as well as other metabolic pathways

Prevent and treat scurvy Hyperoxaluria None

Asparaginase(Elspar, Oncaspar, Erwinase)

Adults and children: 200 IU/KG intravenously daily for 28 days

Hypersenstivity. Pregnancy: Use only if potential benefit justifies risk to the fetusBreast Feeding: Discontinue nursing or the drug

Nausea, vomiting, headache, fever, abdominal pain, hyperglycaemia leading to coma, hypersensitivity, renal damge, coagulation defects, thrombosis, CNS depression or hyperexcitability, acute hemorrhagic pancreatitis

Atorvastatin CaLipitor

10 mg/tab Inhibitor of HMG-CoA reductase, the rate limiting enzyme in cholesterol synthesis, result in compensatory increase in expression of LDL receptors on hepatocyte membranes & stimulation of LDL catabolism

primary hypercholesterolemia. Active liver disease, pregnancy and lactation.

Nausea & vomiting, diarrhea abdominal pain, constipation, dyspepsia, flatulence, headache, myalgia, insomnia, muscle cramps, peripheral edema

Bacillus clausal 2billion/5ml Antidiarrheal Treatment of acute diarrhea with N/A N/A

(Erceflora) Adult : 2~3 vials/day, children : 1~2vials/day

duration of ≤14 days due to infections, drugs or poisons or for chronic or persistent diarrhea with duration of ≥14 days

Betahistine(Serc)

Adult: 8-16mg 3x/day. Administration with meals is recommended.

Vestibular nerve suppressant. Meniere’s disease, Meniere-like syndrome characterized by attacks of vertigo, tinnitus & sensorineural deafness, peripheral vertigo.

Phaeochromocytoma or bronchial asthma, history of peptic ulcer.

Mild gastric complains. very rarely, rash, pruritus, urticaria.

Bromazepam Lexotan

1.5 mg/tab TID Binds to stereo specific benzodiazepine receptors on the post synaptic GABA neuron at the several sites within the CNS. Enhancement of the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to chloride ions.

Anxiety & tension state, depressive mood, nervous tension, agitation, insomnia, functional state of CV & respiratory system. Adjuvant to psychotherapy in psychoneurosis

Early pregnancy, lactation, myasthenia gravis

Acute anxiety, hallucinations, excitation.

Bromazepam(Lexotan)

1.5-3 mg up to tid6-12 mg bid-tid

Bromazepam is a "classical" benzodiazepine. Anxiety & tension states, depressive mood, nervous tension, agitation & insomnia. Adjuvant to psychotherapy in psychoneurosis

Early pregnancy, lactation. Myasthenia gravis

Acute anxiety, hallucinations, insomnia or excitation.

Cefazolin 0.5~1gram every 5~12 hoursMax 6g/day

Bind to PBPs on bacterial cell membranes to inhibit bacterial cell wall synthesis by mechanisms similar to those of the penicillins

Bone & joint infection, bronchitis, gonorrhea, meningitis, otitis media, peritonitis, pharyngitis, sinusitis, skin infection, surgical infection, UTI

Hypersensitivity to cephalosporin Shock, hypersensitivity reaction, granulocytopenia, eosinophilia, thrombocytopenia, GI disturbance, convulsion, HA, dizziness, malaise

Cefoxitin sodium(Monowel)

1g IV every 8 hours Active against g+ cocci (pneumococci, streptococci and staphylococci) and g- organisms. Active against B fragilis and some Serratia species but less active against H influenzae. Exhibit in vitro activity against enterobacter species, but should not be used to treat infections caused by these organisms because resistant mutants constitutively express a chromosomal beta-lactamase that hydrolyzes these compounds are readily selected.

2nd generation cephalosporin Patients with transient persistent reduction of urinary output due to renal insufficiency. Precaution when used for neonates

Hypotension, phlebitis, thrombophlebitis, pseudomembranous colitis, nausea, vomiting, diarrhea, acute renal failure, transient neutropenia, dyspnea, maculopapular and erythematous rash, urticaria, hypersensitivity reactions, serum sickness, anaphylaxis, fever

Ceftriaxone 1~2 g once a daily Bind to PBPs on bacterial cell membranes to inhibit bacterial cell wall synthesis by mechanisms similar to those of the penicillins

Lower respiratory tract. Acute bacterial otitis media, skin & skin structure, urinary tract, meningitis & surgical prophylaxis

Hypersensitivity to cephalosporin Hypersensitivity reaction, urticaria, eosinophilia, serum sickness-like fever, anaphylaxis, neutropenia, thrombocytopenia, ATN, acute intestinal nephritis

Cefuroxime(Zinnat)

500mg every 12 hoursIV, oral

Bind to PBPs on bacterial cell membranes to inhibit bacterial cell wall synthesis by mechanisms similar to those of the penicillins

Bone & joint infection, bronchitis, gonorrhea, meningitis, otitis media, peritonitis, pharyngitis, sinusitis, skin infection, surgical infection, UTI

hypersensitive to the drug or other nitroimidazole derivatives and in patients in 1st trimester of pregnancy

GI disturbances, occasionally pseudomembranous colitis; hypersensitivity reactions. Eosinophilia. Headache. Superinfection or eythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis

Ciprofloxacin HCl Prozine

500mg / tabCystic fibrosis20mg/kg, max 750mg BIDGonorrhea500mg OD

Inhibits DNA-gyrase in susceptible organism; inhibit relaxation of supercoiled DNA and promotes breakage of double-stranded DNA

Gram negative infection.Treatment of wide range of infections including anthrax, biliary tract infection, bone & joint infections, brucellosis, infected bites & stings, cat scratch disease, chancroid, exacerbations of cystic fibrosis, gastroenteritis, gonorrhea, legionnaire’s disease, otitis media & externa, peritonitis, Q fever, lower respiratory tract infection

Pregnancy & lactation, methicillin-resistant S.aureus infections

Nausea, vomiting, diarrhea, abdominal pain, dyspepsia. Headache, dizziness, restlessness, tremor, drowsiness, rarely insomnia, visual & other sensory disturbances. Rash, pruritus, elevated liver enzyme values, jaundice, hepatitis. Eosinophilia, leucopenia, thrombocytopenia, hemolytic anemia or agranulocytosis. Transient increase in serum creatinine or BUN

Citicholine;cytidine 5'-diphosphocholine

200-600 mg for head injuryCerebrovascular disordersAdult: 200-600 mg daily in divided doses.Oral

Citicoline increases blood flow and O2 consumption in the brain. It is also involved in the biosynthesis of lecithin

Head injuryCerebrovascular disordersParkinsonismCerebrovascular disorders

hypersensitivity reactionParasympathetic hypertonia.

Stomach pain, diarrhea; hypotension, tachycardia, bradycardia.

ParkinsonismAdult: 200-600 mg daily in divided doses.Parenteral

Clonidine(Catapres)

Oral: 0.1,0.2,0.3 mg tabletsPatche: release 0.1,0.2,0.3 mg/24 hrs

Partial alpha-2 antagonist. Decrease preganglionic sympathetic outflow from brain resulting in decrease in blood pressure

Decrease dose with renal insufficiency Orthostatic hypotension, rash, drowsiness, dry mouth, constipation, headache, impaired ejaculation

Co-amoxiclav(Augmentin)

625mg / capBID or TID

Clavunate blocks the beta lactamae enzymes, thus, rendering the organisms sensitive to the amoxicillin’s rapid bactericidal effect at concentrations readily attainable in the body. Clavunalate by itself has little bactericidal activity; however, in association with amoxicillin, it produces an antibiotic agent of broad spectrum

Side effects are uncommon and mainly of a mild and transitory nature

Diclofenac K(Cataflam)

50~150mg /day Nonsteroidal Anti0inflammatory Drugs Short term treatment of post-traumatic & post op pain & inflammation, dysmenorrheal, migraine, adnexitis

Known hypersensitivity to diclofenac or other NSAIDs, gastric or intestinal ulcer

Occasionally, GI disorder, HA, dizziness, vertigo, rash, elevation of serum transaminase

Diltiazem HClDilzem

90 mg/ tab OD Calcium antagonistInhibits movement of calcium ions across cell membrane in systemic and coronary vascular smooth muscle; slows calcium ion movement across cell membranes in both cardiac muscle and cardiac pacemaker cells, decreasing sinoatrial and atrioventricular conduction

Management of Angina pectoris & hypertension

Sick sinus syndrome, 2nd or 3rd degree AV block, hypotension, pregnancy acute MI

Peripheral edema, hypotension bradycardia, angina, AV block, abnormal ECG, arrhythmias; CNS: dizziness, lightheadedness, headache, weakness, shakiness, somnolence, asthenia; DERM: dermatitis, photosensitivity, petechiae, rash; GI: nausea, vomiting, constipation, abdominal discomfort, cramps, dyspepsia, dry mouth.

Diphenhydramine(Benadryl)

50mg/mL for injection

H1 receptor antagonist / AntihistamineCompetes with histamine for H1-receptor sites on effector cells in the gastrointestinal tract, blood vessels, and respiratory tract

Allergic reaction; motion sicknessSymptomatic relief of condition like urticaria, angioedema, rhinitis, conjunctivitis, inpruritic skin disorder

GIT ulceration or inflammation GI disturbances, bleeding, drowsiness, dizziness

Diphenhydramine 1mg/kg/dose Competes with histamine for H1 receptor sites on effector cells in the GIT, blood vessels & respiratory tract

Allergic reactions; motion sickness Acute asthma attacks, premature infants or neonates & nursing mothers

Urticaria, rashes, anaphylactic shock, photosensitivity, excessive perspiration

Domperidone(Motilium)

10mg, 1mg/ml1tab TID

Peripheral dopamine receptor blocking properties. It increase esophageal peristalsis and increase lower esophageal sphincter pressure, increase gastric motility and peristalsis and enhances gastroduodenal coordination, therefore, facilitating gastric emptying and decrease small bowel transit time

Dyspeptic symptom complex associated with delayed gastric emptying, GERD, esophagitis eg epigastric sense of fullness, early satiety, feeling of abdominal distention, upper abdominal pain; bloating, erucation, flatulence; heartburn w/ or w/o regurgitations of gastric contents in the mouth. Nausea & vomiting of functional, organic, infectious or dietetic origin or induced by radio or drug therapy

GI hemorrhage, mechanical obstruction or perforation; in patients w/ prolactin-releasing pituitary tumor (prolactinoma). Known intolerance to the drug.

Rarely, increased prolactin levels. GI disorders. Very rarely, transient intestinal cramps. Galactorrhea. Gynecomastia. Amenorrhea.

Doxorubicin(Adriblastina, Adrim, Axibin, Caelyx, Dactorubin, Rubidox)

IV 60-75 mg/m2 as single dose at 21 day interval

Doxorubicin prevents DNA replication. The exact mechanism is still being studied, but it may be a "topoisomerase inhibitor". Topoisomerases are enzymes that temporarily cut one strand of DNA during replication to help unwind the double helix.. Doxorubicin prevents the topoisomerase from reattaching the cut ends

Close observation is required esp during initial treatment. Monitor cardiac function. Myelosuppression & immunosuppression. Hepatic impairment, obesity & extravasation

Cardiotoxicity. GI & dermatologic disturbances. Myelosuppression & leucopenia. Dehydration & facial flushing

Enoxaparin sodium Causes higher anti-factor Xa to antithrombin activities (anti-factor IIa) ration than heparin, which may prevent thrombosis

Use with caution in patients prone to dyspepsia or known to have a lesion of the gastric mucosa. Do not administer to patients with hemophilia and is not recommended to infants <1 year. Caution is necessary when renal or hepatic function is impaired and particularly in children who are dehydrated

Derma: local eythema, Hema: hemorrhage, thrombocytopenia, anemia, Other: local irritation and pain; hematoma; nausea, confusion, fever, edema, peripheral edema

Erceflora 2billion/5ml Antidiarrheal Treatment of acute diarrhea with N/A N/A

Bacillus clausal Adult : 2~3 vials/day, children : 1~2vials/day

duration of ≤14 days due to infections, drugs or poisons or for chronic or persistent diarrhea with duration of ≥14 days

Esomeprazole(Nexium)

40 mg/tab suppresses gastric acid secretion by specific inhibition of the H+/K+ ATPase in the gastric parietal cell.

Erosive esophagitis, peptic ulcer, ZES, GERD

Hypersensitivity Headache, diarrhoea, abdominal pain, nausea, flatulence, dry mouth, constipation, hyponatraemia, photosensitivity, angioedema, anaphylaxis.

Etoricoxib(Arcoxia)

90 mg/tab OD For relief of acute or chronic pain Advanced renal disease; preexisting edema, hypertension or heart failure; liver dysfunction; previous acute asthmatic attacks, urticaria or rhinitis precipitated by salicylates or nonselective COX inhibitors

Asthenia/fatigue, dizziness, lower extremity edema, hypertension, dyspepsia, heartburn, nausea, increased ALT & AST

Ferrous sulfate 1 tab Replaces iron, found in hemoglobin, myoglobin, and other enzymes; allows the transportation of oxygen via hemoglobin

Prevention & treatment of iron deficiency anemia

Thalassemia, Sideroblastic anemia, hemochromatosis

GI disturbances, allergic reactions, hyperbilirubinemia

Flenax forte 550mg / tab BID Nonsteroidal Anti-inflammatory Drugs ( NSAIDs) Relief of mild to moderately sever pain & fever w/ or w/o inflammation eg musculoskeletal trauma, post-op pain & post dental extraction

Aspirin or other NSAIDs induced asthma, rhinitis or urticaria. Children under 2 y/o

Abdominal discomfort, epigastric distress, GI reaction, peptic ulceration, HA, nausea, peripheral edema

Furosemide(Fremid, Fretic, Frusema, Furoscan, Fusimex, Lasix)

Initially 20-40 mg IV/IM. If diuretic effect is not satisfactory, dose may be increased stepwise, at 2-hrly interval by 20 mg each time until satisfactory diuresis is obtained, the dose should then be given once-bid

Frusemide primarily inhibits sodium and chloride absorption in the thick ascending limb of the loop of Henle

Hypotension, latent or manifest diabetes mellitus, gout, obstruction of urinary passages; hepatic cirrhosis w/ concomitant renal insufficiency; hypoproteinaemia; premature infant. Pregnancy, lactation

Symptomatic hypotension, dehydration, hemoconcentration; hypokalemia, hyponatremia, metabolic acidosis; increase of blood lipid levels, urea, uric acid; reduced glucose tolerance; hearing disorders, tinnitus; pancreatitis, GI symptoms; fever, vasculitis, interstitial nephritis; hemolytic or aplastic anemia, leukocytopenia, agranulocytosis, thrombocytopenia

Gentamycin 1~1.7mg/kg every 8 hours

Aminoglycoside Bone & joint infection. CNS. Burnn & wound infection. UTI. Acute & chronic suppurative otitis media, pneumonia, septicemia * sinusitis

Hypersensitivity to amynoglycosides Nephritic (renal) effects, dizziness, tinnitus, vertigo, numbness, skin tingling, muscle twitching, respiratory depression, lethargy, confusion.

Hydrocortisone 5mg/kg/dose Decreases inflammation by suppression of migration of PMNs and reversal of increased capillary permeability

Endocrine, hematologic, rheumatic and collagen disorders

TB skin infections, herpes simplex, vaccinia, hypersensitivity

Allergic reactions

Hydrocortisone sodium succinate(Solu-cortef)

100mg IV every 8 hours

Corticosteroids enter the cell and bind to cytosolic receptors that transport the steoid into the nucleus. The steroid-receptor complex alters gene expression by binding to glucocorticoid response elements (GREs) or mineralocorticoid-specific elements. Tissue-specific responses to steroids are made possible by the presence in each tissue of different protein regulators that control the interaction between the hormone-receptor complex and particular response elements

Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be decreased resistance and inability to localize infection when corticosteroids are used. Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infectionsCorticosteroids should be used cautiously in patients with ocular herpes simplex for fear of corneal perforation.

Sodium retention, fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, hypertension, increased calcium excretion, steroid myopathy. Increase in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT) and alkaline phosphatase, these changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation

Hydroxyurea(Hydab, Krabinex, Litalir)

Myeloproliferative disorders 20-30 mg/kg daily. Acute leukemia 50-75 mg/kg

Cuases cell death by specific inhibition of DNA synthesis. This action cuases regressions in chronic myeloid leukemia and other malignancies and psoriasis. The S-phase-specifec action of hydroxyrea can deplete bone marrow precurso cells associated with megaloblastic changes

Monitor hematological parameters during treatment. Chickenpox or herpes infection, active infection or dental disease, marked renal dysfunction, gout or nephrolithiasis, patients who have received radiation or cytotoxic therapy

Anemia, neutropenia, leukopenia, thrombocytopenia; burning, redness or pain at site of radiation therapy; erythema, maculopapular rash, sore mouth or lips, skin rash; fever or chills, cough or sore throat; constipation or

causing myelosuppression diarrhea; stomatitis; difficulty in micturition, nausea, vomiting, low back pain, fatigue, hyperuricemia

Hyoscine-N-butylbromide(Buscopan)

10mg/tab, 20mg/amp1~2 tab / amp IV several times

Reversible .blockade of the actions of cholinomimetics at muscarinic receptors

Acute GI, biliary & genitourinary spasm, including biliary & renal colic. Parenterally also as an aid in diagnostic & therapeutic procedures eg gastroduodenal endoscopy, radiology

Avoid driving and operating machinery after parenteral administration

Xerostomia, tachycardia, urinary retention, allergic reactions, skin reactions

Isosorbide-5-mononitrate(Imdur)

325 mg/tab or 80 mg/tab

Inhibits prostaglandin synthesis, resulting in analgesia, anti-inflammatory activity and platelet aggregation inhibition; reduces fever by acting on the brain’s heat-regulating canter to promote vasodilation and sweating

Patients prone to dyspepsia or known to have a lesion of the gastric mucosa. Do not administer to patients with hemophilia and is not recommended to infants <1 year. Caution is necessary when renal or hepatic function is impaired and particularly in children who are dehydrated.

Gastric hemorrhage, hypersensitivity and thrombocytopenia may occur

Isoxsuprine HCl(Isoxilan)

Isoxsuprine, a ß-adrenoceptor agonist, is an orally and perenterally active peripheral vasodilator. It has a strong relaxing action on arteries and to a certain extent, also on cutaneous blood vessels. In addition to this, it had a direct relaxant effect on the smooth muscle tissue of the uteru

Recent arterial hemorrhage, heart disease, severe anemia. Parenterally, hypotension, tachycardia, premature rupture of membranes or immediately post partum

After oral administration, side effects are rare; palpitations, chest pains, mild flushing, dizziness, nausea, vomiting and rash have been reported. Parenteral administration can result in tachycardia, palpitations, hypotension, dizziness and flushing which can be controlled by dose reduction and by supine position of the patient and reversed if necessary by parenteral administration of noradrenaline.

Ketoprofen(Orudis)

100-300 mg IV daily for a max of 48 hrs

Analgesic Renal impairment GI disorders, headache, drowsiness, dizziness, edema, bullous dermatoses

Ketorolac trometamol(Toradol)

30 mg IV TID Analgesic, can also replace morphine in situations involving mild to moderate pot op pain

Special Precautions: in patients with impaired renal function. History of GIT disease, anaphylactoid reactions, elderly, coagulation disorders. Avoid driving and operating machinery

GI reactions, nausea, dyspepsia, drowsiness, headache, sweating edema, bradycardia, palpitation, hypotension, chest pain

Lactulose(Duphalac)

3.3g/5mlStartingAdult : 15~45mlChild :5~15mlMaintenanceAdult : 10~25mlChild :5~20ml

Laxative; the fecal bulk is increased and softened and peristalsis is stimulated, by which normal bowel action is restored. Lactulose does not irritate gut mucosa

Constipation associated with ped problems, post-op; pregnancy & postnatal period; bedridden & geriatric patients; surgical procedures; painful rectal & anal conditions; laxative dependence; barium x-ray investigation; drug-induced constipation

Galactosemia, bowel obstruction, hypersensitivitySpecial concerns in lactose intolerance

Initial dosing may produce flatulence and meteorism, which are usually transient and disappear under continued therapyDiarrhea

Loperamide(Diatabs, Imodium)

2mg/cap, 2cap followed by 1cap after unformed stool

Directly acts on intestinal muscles to inhibit peristalsis and prolongs transit time enhancing fluid & electrolyte movement through intestinal mucosa; reduces fecal volume, increase viscosity & diminishes fluid and electrolyte loss; demonstrates antisecretory activity; exhibits peripheral action

Anti-diarrhealSymptomatic control of acute & chronic diarrhea, ileostomy

Constipation, acute ulcerative, pseudomembranous colitis, acute dysentery

Constipation, nausea, vomiting, tiredness, drowsiness or dizziness, dry mouth

MaaloxAl(OH)3 200mg,Mg(OH)2 200mg

Chewtab 2~4Susp 2~4tspQID

Antacids, antireflux & antiulcerants agents Symptomatic relief of hyperacidity Severe debilitation, kidney failure Rarely, GI disturbance

Mannitol 0.2 g/kg over 3-5 mins50-100 g in a 24-hr period via infusion0.25-2 g/kg over 30-60 mins

Mannitol increases urinary output by inhibiting tubular reabsorption of water and electrolytes. It raises the osmotic pressure of the plasma allowing water to be drawn out of body tissues.Onset: Diuresis: 1-3 hr. Reduction in intracerebral pressure: around 15 min.Duration: Reduction in intracerebral pressure: 1.5-6 hr.Absorption: Small amounts are absorbed from the GI tract.Distribution: Concentrated in extracellular compartments. It does not penetrate the blood-brain barrier nor the eye.

Oliguric phase of renal failure, Raised intracranial pressure, Cerebral oedema, Transurethral prostatic resection

Pulmonary congestion or oedema; intracranial bleeding; CHF; metabolic oedema with abnormal capillary fragility; anuria due to severe renal disease; severe dehydration

Fluid and electrolyte imbalance; acidosis (with high doses). Nausea, vomiting, thirst; headache, dizziness, convulsions, chills, fever; tachycardia, chest pain; blurred vision; urticaria and hypotension or hypertension; acute renal failure; skin necrosis; thrombophloebitis.

Mefenamic acid 500 mg/cap P.O Inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclooxygenase, which results in decrease formation of the protaglandin precursor

Pain, headache, muscular and traumatic pain, dental pain, post-op & post partum pain, dysmenorrhea

GIT ulceration or inflammation GI disturbances, bleeding, drowsiness, dizziness

Methotrexate(Biomedis Methotrexate soln, Emthexate vial, Methobax vial, Pfizer Methotrexate vial)

Induction 3.3 mg/m2 w/ prednisolone 60 mg/m2 daily. Maintenance therapy 30 mg/m2 IM twice wkly or 2.5 mg/kg IV every 14 days

Inhibits dihydrofolic acid reductase and therefore interferes with DNA synthesis and cell replication. Actively multiplying cells such as malignant cells, bone marrow, foetal cells, buccal and intestinal mucosa and cells in urinary bladder are more sensitive. In patients with rheumatoid arthritis, mehtotrexate reduces joint swelling and tenderness

Preexisting liver damage or impaired hepatic function. Malignant disease w/ preexisting bone marrow aplasia, leucopenia, thrombocytopenia or anaemia. Infection, peptic ulcer, ulcerative colitis, debility & extreme youth & old age. Monitor renal function & serum levels when giving high dose; give Ca folinate, hydration & urine alkalinisation

Dermatological & hypersensitivity reactions. Bone marrow depression, leucopenia, neutropenia, thrombocytopenia, decreased serum albumin, anemia, pancytopenia, hypogammaglobulinemia. Mucositis, anorexia, nausea, vomiting, diarrhea, abdominal distress, hematemesis, melena, Renal failure, azotemia, cystitis, hematuria, urogenital or menstrual dysfunction

Methylergometrine hydrogen maleate(Methergin)

125~250mg orally TID

Similar smooth muscle actions as seen with ergotamine; however, affects primarily uterine smooth muscle producing sustained contractions and thereby shorten the third stage of labor

Completion of 3rd stage labor. Uterine atony/hemorrhage

Abnormal presentation, before delivery of child is completed & in multiple birth not before the last child has bee delivered.

Headache, HTN, skin eruptions, abdominal pain

Methylergonovine(Syntocinon)

Produces rhythmic uterine contractions and can stimulate the gravid uterus; has vasopressive and antidiuretic effects; can control postpartum bleeding or hemorrhage by increasing postpartum myometrial tonus

Documented hypersensitivity; pregnant patients with severe toxemia, unfavorable fetal positions, and a contracting uterus with hypertonic or hyperactive patterns; labor in which vaginal delivery should be avoided, such as invasive cervical carcinoma, cord presentation or prolapse, active herpes genitalis, total placenta previa, and vasa previa

xerostomia, tachycardia, urinary retention, allergic reactions, skin reactions

Metoclopramide HCl(Reglan, Plasil)

10mg/tab, 5mg/5ml susp.10-15mg QID, 30 minutes before food intak IV, Tab, Syrup

Metoclopramide stimulates motility of the upper GIT without stimulating gastric, biliary or pancreatic secretions. Its mode of action is unclear. It seems to sensitize tissues to the action of acetylcholine. The effect of metoclopramide on motility is not dependent on intact vagal innervation, but it can be abolished by anticholinesterase. Blocks dopamine and serotonin in the CTZ of the CNS, which is responsible for its antiemetic action. Also increases LES tone

Antiemetic, prokinetic agentDisturbances of GI motility including GERD & diabetic gastroparesis. Nausea & vomiting of central & peripheral origin associated with surgery, metabolic disease, infectious disease, migraine headache or drugs including cancer chemotherapy. Facilitate small bowel intubation & radiological procedure of GIT

GI hemorrhage, mechanical obstruction or perforation, pheochromocytoma, epileptics

In approximately 10% restlessness, drowsiness, fatigue and lassitude. Less frequently, insomnia, headache, dizziness, nausea or bowel disturbances may occur

Metoprolol(Neobloc)

The ß-blocking activity primarily affects the cardiovascular system (decreases heart rate, decreases contractility, decreases BP) and lungs (promotes bronchospasm)

Lactation: excreted in breast milk; Children: safety and efficacy not established; Anaphylaxis: Deaths have occurred; aggressive therapy may be required; AV block, slows AV conduction and may cause heart block; Bradycardia

CV: hypotension, edema, flushing; bradycardia; CNS: headache, fatigue, dizziness, depression, lethargy, drowsiness, forgetfulness; sleepiness; vertigo, paresthesia; DERM: rash, facial erythema; alopecia, urticaria, pruritus; EENT: dry eyes, visual disturbances; GI: Nausea, vomiting, diarrhea; GU: impotence, urinary retention, difficulty with urination

Metronidazole 500mg every 8 hours IV, Oral

A direct acting trichomonacide and amebecide that works at both intestinal and extraintestinal sites. Thought to enter the cells of microorganisms that contain nitroreductase. Unstable compounds are then formed that bind to DNA and inhibit synthesis, causing cell death

Amoebiasis, giardiasis, urethritis & vaginitis due to trichomonas, aerobic infection

Hypersensitive to the drug or other nitroimidazole derivatives and in patients in 1st trimester of pregnancy

vertigo, headache, ataxia, dizziness,syncope, confusion, irritability,weakness, depression

Midazolam(Dormicum)

½ tablet initially then ½ tablet every 2 hours prior to operation

Acute narrow angle glaucoma, premature infants

Sedation, hypnosis, anesthesia, anticonvulsant, muscle relaxant

Moxifloxacin(Avelox)

400mg / tab once a day

Inhibits DNA gyrase and Topoisomerase IV. This results in inhibition of DNA replication and translation, DNA repair, recombination and transposition, which causes bacterial cell death

Antibiotic / Quinolone Caution for use with other QTc prolonging drugs and corticosteroids. May aggravate myasthenia gravis

Dizziness (3%) Nausea (7%) Diarrhea (6%)

Myrin 300/150/75 mg tab Oral chemotherapeutic agent which is specially effective Ethambutol may produce decrease in

(Ethambutol HCl, Rifampicin, Isoniazid)

once a day against actively growing microorganisms of the genus Mycobacterium

visual acuity which appear to be due to optic neuritis and to be related to dose and duration of treatment. The effects are generally reversible when administration of the drug is discontinued promptly.Isoniazid: peripheral neuropathy is the most common toxic effect. It is dose-related, occurs most often in the malnourished and in those predisposed to neuritis, and is usually preceded by paresthesias of the feet and hand. Pyridoxine has been used successfully for prophylaxis and treatment of isoniazid induced peripheral neuritis. Severe and sometimes fatal hepatitis associated with isoniazid therapy may occur and may develop even after many months of treatment. The risk of developing hepatitis is age-related and is increased with daily consumption of alcohol. Urinary disturbance in the male, constipation and dryness of the mouth have been reported.Rifampicin: GI disturbances, headache, drowsiness, fatigue, menstrual disturbances, ataxia, dizziness, fatigue, metal disturbances. Chronic liver disease, alcoholism and old age appear to increase the incidence of severe hepatic problems when rifampicin is given alone or concurrently with isoniazid

Nalbuphine(Nubain)

5 mg IM 0.15-0.2 mg/kg BW

Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression. Decrease in moderate and severe pain

Opioid Analgesic Impaired renal or hepatic function, biliary tract surgery, impaired respiration, MI, labour and delivery

Sedation, infrequently sweating, GI upsets, vertigo, dizziness, dry mouth, headache, allergic reactions

Nicardipine(Cardepine)

Oral: 20,30 mgParenteral: 2.5 mg/mL

Potent peripheral vasodilator. Little depression of nodes. Causes reflex increase in heart rate and output

Severe aortic stenosis Peripheral edema; dizziness, nausea, transient hypotension, MI, reflex tachycardia, pulmonary edema, fewer myocardial infarctions, more palpitations

Nifedipine(Adalat, Calibloc, Calchek, Nelapine, Nifelan)

10mg TID or 30mg OD (Extended release tablets) max 120-180mg/day

Inhibits calcium ion from passing through slow channels on voltage sensitive areas of both smooth muscle and myocardium, causing coronary vasodilation, stabilizes cell membranes. Increases myocardial oxygen sypply

Hypersensityvity to any component of nifedipine tablet or capsule.Do not use short acting nifedipine in cases of emergency, serious side effects such as0020CVD, syncope, heart block, stroke, AMI, etc.), Avoid with concurrent intake of grapefruit juice. Do not withdraw abruptly in Hypertensive patients

Flushing, Edema, Headache, dizziness, Weakness, transient hypotension

OMX ProbioticsProbiotics 12+ Professional Formula

2~10 cap per day Normalizes the micro flora (lactic acid bacteria) in the intestinal tract, Reestablishes the colon's optimum pH level and Probiotics 12 plus, Suppresses the growth of bad bacteria, stimulates the immune system, fortifies the body's ability to absorb nutrients, provides complex B vitamins, antioxidants, minerals & amino acids.

Effective in vitro against the most virulent pathogens including: MRSA - the Methicillin-resistant Staphylococcus aureus superbug, E coli-157 (cause of food poisoning), Bacillus cereus (cause of intestinal anthrax), H. pylori (the cause of peptic ulcers), and L clostridium, that results in morning sickness, migraine and cluster headaches.

Orofar(Benzoxonium Cl 0.5 mg, lidocaine HCl 0.5 mg)

Soln After morning & evening meals, gargle or rinse mouth for 30-60 sec w/ 1 tbsp of undiluted soln (do not swallow). If continued treatment is indicated, the soln may be used more often or may be replaced by loz during the day. Childn >4 yr Dose should be reduced. Max: 6 loz/day. Use only 1 tsp of soln to rinse or gargle

Pregnancy & lactation. Not for childn <4 yr

Isolated cases of skin rash; occasional & transient cases of mild local irritation

Oxytocin(Syntocinon)

Produces rhythmic uterine contractions and can stimulate the gravid uterus; has vasopressive and antidiuretic effects; can control postpartum bleeding or hemorrhage by increasing postpartum myometrial tonus

Documented hypersensitivity; pregnant patients with severe toxemia, unfavorable fetal positions, and a contracting uterus with hypertonic or hyperactive patterns; labor in which vaginal delivery should be avoided, such as invasive cervical carcinoma, cord presentation or prolapse, active herpes genitalis, total placenta previa, and vasa previa

Xerostomia, tachycardia, urinary retention, allergic reactions, skin reactions

Pankreatoflat(Pancreatin, dimethicone)

170/80 mg tab OD Pancreatin corrects the fermentative and putrefactive process that are the main causes of pathological formation of gas. Activated dimethylpolysiloxane eliminates foam, facilitating the absorption of pathological accumulation of gas in the intestine

Hypersensitivity reactions have been reported; these may be sneezing, lacrimation or skin rashes

Pantoprazole(Ulcepraz, Pantoloc)

20-40mg 1x a day Inhibits H+/K+ ATPase pump in parietal cells, inhibiting acid secretion. Also reduces in-vitro counts of H. pylori by more than 4x at pH of 4

Proton Pump Inhibitor Safety and efficacy not established beyond 16 weeks. Prolonged treatment may lead to Vit B12 malabsorption

Chest pain (I.V. < or =6%), Pain, migraine, anxiety, dizziness, headache (I.V. >1%) Rash (I.V. 6%), pruritus (I.V. 4%) Hyperglycemia (1%), hyperlipidemia, Diarrhea (4%), constipation, dyspepsia, gastroenteritis, nausea, rectal disorder, vomiting, abdominal pain (I.V. 12%), Urinary frequency, urinary tract infection, Liver function test abnormality, increased SGPT Injection site pain (>1%) Weakness, back pain, neck pain, arthralgia, hypertonia, Bronchitis, increased cough, dyspnea, pharyngitis, rhinitis, sinusitis, upper respiratory tract infection, Flu syndrome, infection

Paracetamol(Biogesic)

500mg/tab, 250mg/5ml 250~500mg every 3~6hrs

Inhibit the synthesis of prostaglandins in the CNS & peripherally blocks pain impulse generation; produces antipyresis from inhibition of hypothalamic heat-regulating center

Relief of fever, minor aches & pains Anemia, cardiac & pulmonary disease. Hepatic or severe renal disease

Allergic skin reaction & GI disturbances

Paracetamol 150mg/ml2~3ml every 4 hours for adult1~2ml every 4 hours for child

Inhibit the synthesis of prostaglandins in the CNS & peripherally blocks pain impulse generation; produces antipyresis from inhibition of hypothalamic heart-regulating center

Pyrexia of unknown origin. Fever & pain associated with common childhood disorders, tonsillitis, upper resp tract infections post-immunization reactions, after tonsillectomy & other conditions. Prevention of febrile convulsion. Headache, cold, sinusitis, muscle pain, arthritis & toothacke

Anemia, cardiac & pulmonary disease. Hepatic or severe renal disease

Hematological, skin & other allergic reactions

Pethidine HCl(Demerol)

25 mg IV Exert its analegic effects by the same mechanism as morphine, by acting as an agonist at the u-opioid receptor.

For moderate to severe pain, pre op medication, analgesia

Head injury, increased intracranial pressure, acurte asthma, atrial flutter, convulsive disorders, acute abdominal conditions

Respiratory depression, circulatory depression, resp. arrest, shock, cardiac arrest, GI disturbance. Dizziness, sedation, headache, dysphoria, tremor, agitation, hallucination, disorientation

Potassium citrate(Acalka)

1080 mg / Tablet TID

Inhibitor of crystallization; used in treatment of patients with renal lithiasis and hypocitraturia, chronic formers of calcium oxalate, phosphate calculi; uric acid lithiasis alone or accompanied by calcium lithiasis, and renal tubular acidosis with calcium nephrolithiasis.

Treatment of patients with renal lithisis & hypocitraturia, chornic formers of Ca oxalate, phosphate calculi. Uric acid lithiasis alone alone or accompanied by Ca lithiasis. Renal tubular acidosis with

Patients with altered potassium excretion mechanism, hyperpotassemia may appear. In patients with renal insufficiency, an increased risk of appearance of hyperpotassemia

Slight gastrointestinal disorders may appear which can be palliated by means of concomitant administration with food.

Ca nephrolithiasis.ProzineCiprofloxacin HCl

500mg / tabCystic fibrosis20mg/kg, max 750mg BIDGonorrhea500mg OD

Inhibits DNA-gyrase in susceptible organism; inhibit relaxation of supercoiled DNA and promotes breakage of double-stranded DNA

Gram negative infection.Treatment of wide range of infections including anthrax, biliary tract infection, bone & joint infections, brucellosis, infected bites & stings, cat scratch disease, chancroid, exacerbations of cystic fibrosis, gastroenteritis, gonorrhea, legionnaire’s disease, otitis media & externa, peritonitis, Q fever, lower respiratory tract infection

Pregnancy & lactation, methicillin-resistant S.aureus infections

Nausea, vomiting, diarrhea, abdominal pain, dyspepsia. Headache, dizziness, restlessness, tremor, drowsiness, rarely insomnia, visual & other sensory disturbances. Rash, pruritus, elevated liver enzyme values, jaundice, hepatitis. Eosinophilia, leucopenia, thrombocytopenia, hemolytic anemia or agranulocytosis. Transient increase in serum creatinine or BUN

Ranitidine(Ulcin / Zantac)

50mg SIV TID Inhibits action of histamine at the H2 receptor site located primarily in the gastric parietal cells

Histamine H2 Antagonist, Antiulcer Renal impairment, hepatic impairment, pregnancy, lactation, or children

Headache, dizziness, nausea and vomiting

Rofecoxib(Vioxx)

50mg tab BID Produces anti-inflammatory, analgesic and antipyretic effects, possibly by inhibiting prostaglandin synthesi

Contraindicated in patients hypersensitive to drug or its components and in those who have experienced asthma, urticaria, allergic reactions after taking aspirin or other NSAIDs. Also contraindicated in patients with advanced renal disease or moderate or severe hepatic insufficiency and in pregnant women because it may cause ductus arteriosus to close prematurely

Headache, asthenia, fatigue, dizziness, hypertension, leg edema, sinusitis, diarrhea, dyspepsia, epigastric discomfort, heartburn, nausea, abdominal pain, UTI, back pain, bronchitis, URTI, flu syndrome

Salbutamol(Asmalin)

2mg/tab, 2mg/5ml susp.1tab TID, 2.5 ~ 5ml TID

Prevention & relief from bronchospasm associated with reversible obstructive airway disease eg bronchial asthma

Special precaution : coronary insufficiency, cardiac arrhythmias, hypertension, convulsive disorder, hyperthyroidism, diabetes mellitus; pregnancy, lactation.

Palpation, tachycardia, increased BP, headache, nervousness, dizziness, heartburn, epistaxis, cough, GI discomfort, throat irritation & tremor

Salbutamol(Ventolin)

Inhalant: 40 micrograms/puff aerosolOral: 2,4 mg tablets; 2 mg/mL syrup

Beta adrenergic receptor agonist - causes bronchodilationInhalational: Onset < 15 m, dur 3-4 hPO: onset <30m, dur 4-8 hours

Treatment & prevention of bronchial asthma, bronchitis, emphysema with associated reversible airway obstruction.

Threatened abortion during 1st or 2nf trimesters of pregnancy. Toxaemia of pregnancy, antepartum haemorrhage, placenta praevia.

Thyrotoxicosis, inhaled salbutamol prep are not appropriate for managing premature labour. Pregnancy, lactation. Acute severe asthma. Monitor fluid balance, cardiorespiratory function & ECG

Simvastatin(Vidastat, Zocor)

10~80mg tab OD Statins inhibit the enzyme HMG-CoA reductase which is the rate limiting step in the synthesis of cholesterol. Intake of statins results in lowering of LDL and elevation of HDL. Statins have been demonstrated to be cardioprotective and reduces risk of cardiovascular events

The most common side effect of statins is in the gastrointestinal system, with reports of constipation and nausea. May also affect the liver, causing drug induced hepatitis

Sulbactam-Ampicillin(Unasyn)

375 mg/tab BID Inhibition of cell wall synthesis Overgrowth of non-susceptible organism. Check periodically for organ system dysfunction during prolonged therapy

GI disturbances, phlebitis, skin rashes, itching, blood disorders, anaphylaxis, superinfection

Tramadol(Dolotral, Silverol, TDL, Tradonal, Trama)

50-100mg every 4-6 hours, not to exceed 400mg/day

Binds to Mu Opiate receptors in the brain and spinal cord, which alters sensation and response to pain. Also inhibits reuptake of serotonin and norepinephrine, which also results in alteration in pain signal transmission

Relief of moderate to moderately-severe pain.

Extended release of formulation are indicated for patients requiring around-the-clock management of moderate to moderately-severe pain for an extended period of time.

Hypersensitivity to tramadol or any component of the tablets or Ampoule solution. Patients intoxicated with alcohol or other sedating drugsUse with extreme precaution among patients taking other CNS drugs particularly sedatives or CNS depressants

Most common side effects are CNS related: Headaches, dizziness, somnolence, vertigo. May cause vasodilaton and hypotonia

Tranexamic Acid 250-500mg/cap 1-2 cap TID/QID250-500mg IV slow push

Competitively inhibits activation of plasminogen to plasmin, which inhibits fibrinolysis. Also inhibits plasmin proteolytic activity

Menorrhagea, Metrorrhagea, valvular heart surgery, GI hemorrhage, Hereditary angioneurotic edema

Acquired defective color vision, active intravascular clotting, subarachnoid hemorrhage, Concurrent factor IX complex or anti-inhibitor coagulant concentrates, patients with cardiovascular, renal, CVD, and thromboembolic disease

Gastrointestinal >10% (nausea, diarrhea, vomiting), Cardiovascular and Ocular 1% to 10% (Hypotension, thrombosis, blurred vision)

Valdecoxib(Bextra)

20mg / tab once daily

Inhibition of cyclooxygenase-2 (COX-2) pathway Patients with known hypersensitivity to Valdecoxib. Patients who have demonstrated allergic-type reactions to sulfonamides. Patient who have experienced asthma, urticaria, allergic type reactions after taking NSAIDS including other COX-2 inhibitors

Dry mouth, hypertension, peripheral edema, , abdominal fullness, abdominal pain, diarrhea, dyspepsia, nausea, anemia, sinusitis, rash

Valproic acid(Depakene)

250mg, 15ml NGT 30ml/day

Valproic acid and its derivative, divalproex, are oral drugs that are used for the treatment of convulsions, migraines and bipolar disorder. The active ingredient in both products is valproic acid or valproate. Scientists do not know the mechanism of action of valproate. The most popular theory is that valproate exerts its effects by increasing the concentration of gamma-aminobutyric acid (GABA) in the brain. Gamma-aminobutyric acid is a neurotransmitter, a chemical that nerves use to communicate with one another

Should not take this drug if you have liver disease or your liver is not functioning properly, or if you have had an allergic reaction to it.

The most common side effects with valproic acid therapy are drowsiness, dizziness, nausea, vomiting, indigestion, diarrhea, weight loss and tremors.Liver injury, pancreatitis and abnormal bleeding

Vasaltarn/ Hydroclorothiazide(Co-Diovan)

80/12.5 mg tab160/12.5 mg tab320/12.5 mg tab320/25 mg tab

Hydrochlorothiazide belongs to the thiazide class of diuretics, acting on the kidneys to reduce sodium (Na) reabsorption in the distal convoluted tubule. This increases the osmolarity in the lumen, causing less water to be reabsorbed from the collecting ducts. This leads to increased urinary output

Hypertension Pregnancy & severe hepatic impairment, biliary cirrhosis & cholestasis. Anuria, severe renal impairment (CrCl <30 mL/min). Refractory hypokalemia, hyponatremia, hypercalcemia & symptomatic hyperuricemia.

Headache, dizziness, fatigue. Hydrochlorothiazide: Hypokalemia, hyperuricemia, electrolyte disturbances, postural hypotension, rise in blood lipids

Vincristine(Alcavixin, Biomedis Vincristine, Nevexitin, Pfizer Vincristine)

Adult 0.4-1.4 mg/m2

BSA. Childn 1.5-2 mg/m2 BSA, <10 kg or BSA <1 m2 0.05 mg/kg wkly

vincristine and other vinca alkaloids exert their cytotoxic effects by binding to tubulin, the protein subunit of the microtubles that form the mitotic spindle. The formation of vincristine-tublin complexes prevent the polymerization of the tubulin subunits into microtublues and induces depolymerization of microtubules resulting in inhibition of microtubule assembly and cellular metaphase arrest. In high concentrations, the drug also exerts complex effects on nucleic acid and protein synthesis. Vincristine exerts some immunosuppressive activity

Biliary obstruction, preexisting neuropathies, liver dysfunction or jaundice & elderly. Extravasation, nephrotoxicity, hepatic impairment. Pregnancy, lactation. Fatal if given intrathecally

Neurotoxicity. CNS effects eg depression, agitation, insomnia, hallucinations & episodes of altered consciousness. Rare hypersensitivity. Leucopenia, anemia, thrombocytopenia. GI effects. Hyperuricemia, uric acid nephropathy, polyuria, dysuria & urinary retention due to bladder atony. Alopecia. Increased urinary Na excretion. Hypertension, hypotension. Fever, headache

Vitamin ARetinol palmitate

25,000iu Supplementation Treatment of vit A deficiency Special precaution in pregnancy. Excessive doses may lead to hypervitaminosis

Vitamin EDI-a-tocopheryl acetate(Mira E )

300iu, 400iu Supplementation Maintains healthy skin & eyes. Protects against artherosclerosis & CV disorders. Improves nerve functions & prevents onset of neuromuscular degenerative diseases

Vitamin K 1mg IM Promotes liver synthesis of clotting factors (II, VII,IX,X). Prophylaxis and therapy of hemorrhagic disease of the newborn

Coumarin and indanedione derivatives Allergic reactions, including anaphylactoid reaction, pain, swelling

New Additions:Diazepam(Valium)

Adjunct in seizuresAdult: 2-60 mg daily in divided doses.Elderly: Dose reduction may be required. Renal impairment: Dosage adjustments may be needed.

Diazepam is a long-acting benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant and amnestic properties. It increases neuronal membrane permeability to chloride ions by binding to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron within the CNS and enhancing the GABA inhibitory effects resulting in hyperpolarisation and stabilisation.Absorption: Readily and completely absorbed from the GI tract, peak plasma concentrations after 30-90 min (oral). Rapidly absorbed, peak plasma concentrations after 10-30 min (rectal).Distribution: Readily crosses the blood-brain barrier; redistributed into fat depots and tissues. Protein-binding: 98-99%.Metabolism: Extensively hepatic; converted to desmethyldiazepam, oxazepam and temazepam.

Severe anxiety, Insomnia associated with anxiety, Premedication before anaesthesia, Adjunct in seizures, Muscle spasms, Alcohol withdrawal syndrome, Muscle spasms, Alcohol withdrawal syndrome

Hypersensitivity; myasthenia gravis, preexisting CNS depression or coma, respiratory depression; acute pulmonary insufficiency or sleep apnoea syndrome; severe hepatic impairment; acute narrow angle glaucoma; children <6 mth (oral); pregnancy and lactation.

Psychological and physical dependence with withdrawal syndrome, fatigue, drowsiness, sedation, ataxia, vertigo, confusion, depression, GI disturbances, changes in salivation, amnesia, jaundice, paradoxical excitation, elevated liver enzyme values; muscle weakness, visual disturbances, headache, slurring of speech and dysarthria, mental changes, incontinence, constipation, hypotension, tachycardia, changes in libido, pain and thrombophlebitis at inj site (IV).Potentially Fatal: Respiratory and CNS depression, coma.

Excretion: Urine (as free or conjugated metabolites). Elimination half-life: Rapid (initial), 1-2 days (terminal), 2-5 days (desmethyldiazepam).

KCl (Kalium durule)

Adult & elderly Prophylaxis 2 durules daily. Hypokalemia Adjust dosage according to serum K level. Suggested dose: 2 durules bid or more until serum K is restored to normal, then prophylactic dosage.

Potassium is the predominant cation (approximately 150 to 160 mEq per liter) within cells. Intracellular sodium content is relatively low. In extracellular fluid, sodium predominates and the potassium content is low (3.5 to 5 mEq per liter). A membrane-bound enzyme, sodium-potassium–activated adenosinetriphosphatase (Na +K +ATPase), actively transports or pumps sodium out and potassium into cells to maintain these concentration gradients. The intracellular to extracellular potassium gradients are necessary for the conduction of nerve impulses in such specialized tissues as the heart, brain, and skeletal muscle, and for the maintenance of normal renal function and acid-base balance. High intracellular potassium concentrations are necessary for numerous cellular metabolic processes.

Hypokalemia. Prophylaxis during treatment w/ diuretics.

Renal insufficiency, hyperkalemia, untreated Addison's disease, constriction of the esophagus &/or obstructive changes in the alimentary tract.

Hyperkalemia (confusion; irregular or slow heartbeat; numbness or tingling in hands, feet, or lips; shortness of breath or difficult breathing; unexplained anxiety; unusual tiredness or weakness; weakness or heaviness of legs)

PHENYTOIN(Dilantin)

Adult Initially 100 mg tid. Maintenance: 300-400 mg daily in equally divided doses. Childn ≥6 yr Initially 100 mg tid, subsequent dosage should be adjusted according to therapeutic response. Pedia Initially 5 mg/kg/day in 2-3 equally divided doses. Max: 300 mg daily. Maintenance: 4-8 mg/kg/day. Susp Initially 125 mg/5 mL tid, subsequent dosage adjusted according to therapeutic response. An increase to 625 mg (25 mL) daily may be made if necessary.

Phenytoin acts as an anticonvulsant by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses; thus stabilising neuronal membranes and decreasing seizure activity. It acts as an antiarrhythmic by extending the effective refractory period and suppressing ventricular pacemaker automaticity, shortening action potential in the heart.Absorption: Slow but almost complete from the GI tract (oral); much slower absorption (IM).Distribution: Widely distributed. Protein-binding: 90%.Metabolism: Extensively hepatic; converted to inactive metabolites.Excretion: Via urine as hydroxylated metabolite; elimination half life at steady state: 22 hr.

Cap/susp: Control of grand mal & complex partial seizure, prevention & treatment of seizure during or following neurosurgery, migraine, trigeminal neuralgia, certain psychoses, cardiac arrhythmias, digitalis intoxication, post-event treatment of MI. Inj: Control of status epilepticus of the grand mal type, prevention & treatment of seizures during or post neurosurgery/severe head injury.

History of hypersensitivity to phenytoin or other hydantoins. Sinus bradycardia, SA block, 2nd- & 3rd-degree AV block. Patients w/ Adams-Stokes syndrome. Seizures due to hypoglycemia or other metabolic causes.

Hypersensitivity, rashes. Hypotension. Nystagmus, ataxia, slurred speech, decreased coordination, mental confusion. GI disturbances, hepatitis, dizziness, gingival hyperplasia, hypertrichosis, Peyronie's disease, hyperglycemia, osteomalacia. Inj: Local irritation, inflammation, tenderness, necrosis, sloughing.

Patient Name : Clerk-in-Charge :