Amlodipine

  Amlodipine:-
          It is a channel antagonist of the dihydropyridine group. Iy inhibits the transmembrane influx of calcium ion into cardiac & decrease blood pressure. It has also coronary effect resulting in decreased frequency & severty of attaks of angina. It has slow onset of action & long duration of action.
Dose:-
     Adult: hypertention: 5mg od,              increase 10mg od          
     Angina: 5-10mg

  

Hormone

Hormone:-

         Hormones are specific chemical substance secreted by endocrine glands and conveyed in the blood to regulate the functions of tissues and organs ekse where in the body. They include insulin, sex hormones like steroids and thyroxine. Hormones are largely used in medicine as substitution therapy eg. Administration of insulin in disease.

      Hormones are secreted by indocrine of ductless glands of the body.
1) pitutary
2) Thyroid
3) Parathyroid
4) pancreas
5) Adrenals
6) Gonads

Calcium

Calcium:

      It is essential for the functioning of cells. More then 90% of calcium in the body is preserved in the skeletal structure. 700mg of calcium is turnover daily of the minerals in bone, as the bone is continuously remodeled.

Sources of calcium:-

      Milk, dairy product.

Daily requirement:-

      Adult: 800mg/day

      Pregnancy and lactation: 1200mg/day

Vitamin E

Vitamin E:-
       It is a fat soluble vitamin. It has anti sterility factor. It is essential for normal cell structure to maintain certain enzymes and for the formation of blood cells. It is found in diffrent substances among of them tocopherol and alpha tocopherol used in clinical practice.

Vitamin K

Vitamin K:-
         Vitamin k (Menadine)
         Vitamin k1( Phytomenafione)
         Vitamin k2 ( Menaoquinone)
                  It is a fat soluble vitamin, so malsbsorption of fat lids to vitamin deficiency. It is essential for formation of substances in liver which promotes blood clotting. It id wedely distributed in foods and it id also synthesized by microorganism in the intestine.

Vitamin D

Vitamin D:-
       Vitamin D2 (Ergocalciferol)
       Vitamin D3 ( Cholecalciferol)
    It is a pre homone which is converted in the body in to a number of biological active metabolites. It is a family of sterol derivatives. Deficency may develop in those who are deprived of sunlight. Other cause may be liver kidney disorder.

vitamin A

Vitamin A:-
        It is an alcohol of high molecular weight that is stored in the liver.it is necessary for normal function and structure of all epithelial cells and for the synthesis of visual purple in the retinal rods. It is requred for normal vision, cell structure, bone growth and normal growth.
 

Runners Plants

Runners:
         The runnerd arise as an axilliay buds and creeps some distance away from the mother plants, then strikes roots and grows into new plabts. When these runners separate, number of new plants are formed e.g. Cynadon, Fragsria, Oxalis etc.
           

Runner of OXalis

Anti Histamine

Histamine
         Histamine (histos-tisue) is a bio-chemical present in animal tissued and even in certain plants. Histamine is present in storage granules of mast cells. It is also present in skin, gastric, intestinal, mucosa, lungs, liver, placenta and also blood and pathological fluids
   

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Anti Spasmodic Drugs

      The peristalsia of smooth mudcle in the GIT is controlled by paradymphathetic stimulation on the muscarinic receptor in the GI smooth muscle. The over spasm of the GI smooth muscle sometimes result in pathological state with the symptomes of abdominal pain. Anti-spadmodoc drugs are used to relief the pain due to the spasm of smooth mudcle in the GIT. These drugs basically inhibit the binding of acetylcholine with the muscrinic receptors in the GI smootb muscle and thus reducing the paradympathetic rffect in it. This result in the relaxation of the GI smooth muscle and relives the pain due to it's spasmd       

(1) Atropine

(2) Hyoscine Butylbromide

(3) Dicyclomine

(4) Alverine

(5) Mebeverine

Paracetamol/Acetaminophen

       It is synthetic non-opiate derivatives of para-aminophenol which produces analgesia and antipyresia and it has no/weak anti inflammatory activity. Unlike salisylates it does not have uricosuric activity. Paracetamol produces analgesic action by elevation of the pain threshold & antipyretic through action on the hypothalamic heat regulating centre.

Indication:

• Pyrexia (fever)
• Mild to moderate pain
• Toothache, bodyache
• After minor surgery (to reduce the pain)
• Musculoskeletal disorder
• Post vaccination pain & fever of children
• This makes it a particularly useful alternative for people who suffer from peptic ulcer or who can not tolerance Aspirin.

Dose:
      Adult: 500mg-1000mg tid/qid sos
      Child: less than 3 months: 10mg/kg;above 3 months;1o-15mg/dose(3-4doses

Aspirin

Aspirin:

       The main example of Salicylate drug is ASPIRIN this drug was obtained from bark of willow, and is currently synthesized. Other agents include Methy Salicylate which is a popular ingredient in most of the topical analgesic preparation. In 1897 Hoffman & Dressler isolated & chemically modified the active compound to synthesize Acetylsalicylic acid, which was marketed as Aspirin in 1899.                                               

Indication:

1.      Mild to moderate pain.

2.      Inflammation.

3.      Anti-platelet effect: prophylaxis in thrombo-embolic disorders.

4.      Prevention of vascular mortality during suspected acute MI.

5.      Prevention of MI in patients with angina.

6.      Prevention  of recurrent MI.

7.      Rheumatic fever, rheumatoid arthritis.

8.      Adjunctive treatment of Kawasaki disease.

Preparation:

        It is usually available in tablet form such as:

        Aspirin tablet: 300mg, 100mg, 75mg, 50mg

Dose:

        Adult: 300mg-900mg 4-6 hourly, maximum 4g daily

        Child: acute rheumatic fever and rheumatoid arthritis only: 90-120mg/kg/day

Ofloxacian

           Ofloxacian

Ofl           Oflaxacian is a broad-spectrum most potent bactericidal drug. It is a  a latest drug of fluro                           coquinoloness. It is  highly effective against chlamydia salmonella, klebsiela,,proteus, anaerobes like           bacteroides, clostridiu, gar  denella, peptococcus  and peptostreptococcus.

Me         mechanism of action: Same as Nalidixic acid       

Idi    Reaction:   

1.                     Typhoid and paratyphoid fever

2.                      Urinary tract infection

3.                      Ear,nose and throat infection

4.                      Respiratory tract infection

5.                     Skin and soft tissue infection

6.                     Gonorrhoea

7.                     Chlamydial infection

8.                     Peritonitis

9.                     Prostatitis

        It is also used in multi drug resistance tuberculosis

 Preparation:

I      It is usually available in tablet and suspensions such as:

fl      ofloxacin tablet 100mg, 200mg and 400mg,

        ofloxacian suspension 50mg/100mg/5ml

        ofloxacin IV influsion 200mg/100ml

d   Dose:

         Adult 200-400mg bid for 5 to 10 days.

         enteric fever: 20mg/kg/day in 2 equally divided dose (upto 600mg/day)

     Adverse effect:

     CNS:

:          Somnolence,seizures,depression,sleep disorder GIT:nausea,dry mouth,abdominal pain,disguise,

P          seudoebranous colitis

            Miscellaneous anaphylaxis,chest pain,trunk pain,phlebitis

      Drug infections:

            Ofloxacin  may increase the blood levels of Theophylin.

            Antacids, Irons alts, Zinc salts decreases absorption of ofloxacin.

           Contraindication:Hypersensitivity to fluoroquinolones,epilepsy

Urine Examination

Urine Examination

Normal urine is a clear, Yellow or amber coloured fluid having a specific gravity varying between 1.003 to 1.003. It is usually slightly acidic and has a faintly aromatic odour. It consists of 96% water and 4% solid content. Solid contents include urea. Creatinine,uric acid,iron,chlorides, sodium,calcium and phosphate.

Urine examination is also divided into physical and chemical examination.

                                                                             

Physical Examination

Volume                                                1200-2000 ml                                      it is increased in polyuria and decreased in  

                                                                                                                   Renal disease.

Specific gravity                                  1.005- 1.025                                        Specific gravity is high in diabetes and low in                                                                                                                                          nephritis.     

Colours

                                                                Milky                                            Genito-urinary tract disease

                                                                Orange                                                 Urobilinogenuria

                                                                Red                                               Haematuria

                                                                Greenish                                        Jaundice

Chemical Examination

pH                                                          4.8-7.5 with                                      pHis less than 4.8 in diabetes,striation and febrile in children.

                                                                An average of 6

Protein                                                  Abnormal constituent                            Nephritis

                                                                                                                       Nepphrosis

                                                                                                                       Pregnancy

Sugar                                                     Abnormal                                            DIabetes,Cachexia,

                                                                                                                        Panereatic disease,

                                                                                                                          CNS  dysfunctio 

Bile pigment                                              Abnormal                                             Jaundice

                                                                Constituent.

Kenton  Bodies

(Acetone,acetoacetic                            Abnormal                                            Diabetes,CacheXia,

Acid and                                              constituent                                         post anaesthesia

B-hydroxybutyric acid)                                                                                  vomiting

Blood cells                                            Abnormal                                            Haematuria

                                                           Constituent                                       

Calcium                                               Abnormal                                            Hyperthyroidism

                                                           constituent

               

Tetracycline

     These are broad spectrum bacteriostatic short action antibacterial. It is partially absorbed from GIT and excreted mainly Unchanged in Urine and should be avoided in renal disease.

Mechanism of action:

        Tetracycline is the protein synthesis inhibitor. It binds to the 30s subunit of the bacterial ribosomes as a result of which blocks the binding of amino acyl-tRNA to the receptor site on mRNA- ribosome

Complex.

        It prevents making the amino acid for the growing peptide chain and because of not binding to ribosomes permanently, it is an bacteriostatic anti-biotic.

Indication:

Ø Veneral disease (syphilis)

Ø Mycoplasma

Ø Rickettsia

Ø Lyme disease, relapsing fever

Ø Chlamydial infections

Ø Respiratory tract infection

Ø Atypical pneumonia due to Mycoplasma pneumonia

Ø Urinary tract infection

Ø Lymphogranuloma venereum

Ø Aphthous ulcer

Ø Brucellosis

Ø Anthrax

Ø Pelvic inflammatory disease (PID)

Ø Plague

Ø Bacterial diarrhea

Ø Prevention of exacerbations of chronic bronchitis

Preparation:

        It is available in the forms of capsule, injection & ointment such as:

        Tetracycline Capsule 250mg and 500mg

        Tetracycline 250mg vial for I.V. inj.

        Oxytetracycline capsule 250mg and 500mg

        Doxycycline capsule and 100mg

Cefixime

          It is bacteriocidal antibiotic and is stable to hydrolysis by many betalactamase. It is active against betalactamase producing bacteria but not effective against pseudomonas, proteus & enterococci. The rate of absorption may be decreased in presence of food.
Indication:c

1. Otitis media
2. Gonorrhoea
3. Phaeyngitis
4. Lower respiratory tract infection 
5. Uncomplicated gonorrhoea

Prepration:
         It is available in the from of tablet such as;
         Cefixime tablet 200mg
Dose:
       Adult: 200mg-400mg daily as a single dose or in two divided doses orally.
       Child: Under 50kg body weight: 8mg/kg of body weight daily
       Note: Does should be reduced in patient with moderate to severe renal impairment (kidney                  disease).
Drug interaction:

• It may increases prothrombin time if given with anticoagulants

Azithromycin

It has greater activity than Erythromycin against some gram negative microorganism as Haemophilus influenza, and Moraxella catarrhalis but less active then Erythromycin against Streptococci macrophages & polymorphs. Effective against intracellular pathogens such as mycoplasma, chlamydia, legionella & salmonella. it is a nitrogen conataining macrolide
.

   

Mechanism of Action:                                                                                                                                     It has mainly bacteriostatic activity. It is obtained from Streptomyces erythreus in 1952. It is highly effective against Streptococcus and Staphylococcus infection. Various Erythromycin Derivatives are made as film and enteric coated tablets as to protect from HCL of the stomach. it is bitter in taste.

Indication:

•  Micobacterium avium complex (MAC) infection 
•  Upper respiratory tarct infection (Laryngitis, tonsilitis, sinusitis) 
•  Enteric fever (typhoid)
•  Lower respiratory tract infection  (bronchitis, pneumonia)
•  Genitourianry tract infection 
•  Otitis media 
•  Uncomplicated genital clamidial infections
•    Skin and soft tissue infection   

Does:

        Adult: 500mg as a single dose for 3 days.or (alternatively initial dose of 500mg and followed by 

        250mg daily of a further 4 days).Uncomplicated genital infection 1gm as a single dose but 2gm 

        for uncomplicated gonorrhoea. for MAC infection 1.2gm  once weekly 

        Enteric fever 20mg/kg/day Od (upto 1gm/day)

        Child; 5-10mg/kg/day for three days 

Adverse effect;

      CNS: dizziness, headache, vertigo, agitation

      GIT: nausea, vomiting, epigastric discomfort, diarrhoea 

      Liver: cholestatic jaundice,elevation in hepatic enzymes

      Urinary: nephritis, acute renal failure

      CVS: palpitation, ventricular arrhythmias, hypotension 

      Ear: ototoxicity 

      Skin: rashes, urticaria, angioedema, Stevens-johnson syndrome

Drug interaction:

• Concurrent administration of antacid can reduce the rate of absorption of Azithromycin.

Contraindication:

         Hepatic important, Hypersensivity to maceolides.

LIfe Saving Drugs

The U.S food and drug Administration (FDA),an agency of the U.S Department of Health services, advances the nation's welfare by protecting consumers against health hazards that usually are beyond an individual's control the food and drug Administration (FDA) was the first regulatory agency established in the United States with consumer protection as its principle mission.
           October 1995, notifies the following life saving drugs for the purpose of the said 29, namely:
(A) Drugs used in Anaplylactic Shock:
       Inj. Epinephrine Hydrochloride (Adrenaline)
       Inj. Sodabicarb,
       Inj. Dexamethazone sodium phosphat.
(B) Druge Used in Myocardial infarction and cardiogenic shock:
      Inj. Isoprenaline.
      Inj. Amino Caproic Acid.
      Inj. Streptokinase.
      Inj. Morphine sulpahte.
      Inj. Mperadine Hydrocloride (Pethidine)
      Inj. Calcium chloride.
      Inj. Dopamine Hydrochloride
      Inj. Heparin
      Inj. Nitroglycerine
      Inj. Propranolol.
      Inj. Digoxin.
      Inj. protamine Sulphate.
      Inj. Lignocaine Hydrochloride 2 percent
      Cap. nifedine.
(C) Drugs used in peripheral circulatory collapse:
       Inj. Dopamine Hydrochloride.
       Inj. Glucose 25 percent.
        Oxygen gas
       I.V. Ringer Lactate I.V. Normal SAline
(D) Drugs used in status eplipticus:
       Inj. Phenytoin Sodium
       Inj. Dizepam.
       Inj. Phenobarbitone.
(E) Drugs used in acute respiratory failure:
      Inj. Nikenamide.
      Oxygen gas