Drug Study 3a

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hydrocortisone
> Indication & Dosage > Administration > Contraindications > Special Precautions > Adverse Drug Reactions > Drug Interactions > Food Interaction > Pregnancy Category (US FDA) > Storage > Mechanism of Action > MIMS Class > ATC Classification
Related Information
hydrocortisone Full Info
See related hydrocortisone informationAbbreviation Index Indication & Dosage Oral Replacement therapy in adrenocortical insufficiency Adult: 20-30 mg daily in 2 divided doses. Child: 400-800 mcg/kg/day, in 2-3 divided doses. Intravenous As supplement in adrenal insufficiency during minor surgery under general anaesthesia Adult: In patients taking >10 mg of prednisolone or its equivalent by mouth daily. 25-50 mg at induction. Resume with usual oral corticosteroid after surgery. Intravenous As supplement in adrenal insufficiency during moderate or major surgery Adult: In patients taking >10 mg of prednisolone or its equivalent by mouth daily. Usual oral corticosteroid dose on the morning of the surgery followed by 25-50 mg at induction, then similar doses of hydrocortisone tid for 24 hr after moderate surgery or 48-72 hr after major surgery. Resume oral therapy once injections are stopped. Intravenous Acute adrenocortical insufficiency Adult: 100-500 mg 3-4 times/24 hr according to the severity of the condition and patient response. Fluids and electrolytes should be administered as needed to correct any metabolic disorder. Doses may also be given via IM inj but the response may be slower. Child: <1 yr: 25 mg; 1-5 yr: 50 mg; 6-12 yr: 100 mg. Fluids and electrolytesshould be administered as needed to correct any metabolic
disorder. Doses may also be given via IM inj but the response may be slower. Injection Soft tissue inflammation Adult: As Na phosphate or Na succinate esters: 100-200 mg as local inj. Intra-articular Joint inflammations Adult: As acetate: 5-50 mg depending on size of affected joint. Topical/Cutaneous Corticosteroid-responsive dermatoses Adult: Apply a 0.1-2.5% cream/ointment/lotion onto affected area. Administration Should be taken with food. Contraindications Viral/fungal infections, tubercular or syphilitic lesions, bacterial infections unless used in conjunction with appropriate chemotherapy. Special Precautions Adverse Drug Reactions CHF, hypertension, DM, epilepsy, elderly, patients on prolonged therapy. Gradual withdrawal, pregnancy and lactation. Sodium and fluid retention. Potassium and calcium depletion. Muscle wasting, weakness, osteoporosis. GI disturbances and bleeding. Increased appetite and delayed wound healing. Bruising, striae, hirsutism, acne, flushing. Raised intracranial pressure, headache, depression, psychosis, menstrual irregularities. Hyperglycaemia, glycosuria, DM, obesity, moonface, buffalo hump. Suppression of pituitary-adrenocortical system. Growth retardation in childn (prolonged therapy). Increased susceptibility for infection. Topical use: Dermal atrophy, local irritation, folliculitis, hypertrichosis. Inhaled corticosteroids: May cause hoarseness, candidiasis of mouth and throat. Topical application to the eye: Can produce corneal ulcers, raised IOP and reduced visual function. Intralesional injection: Local hypopigmentation of deeply pigmented skin. Intra-articular injection: Joint damage, fibrosis esp in load bearing joints. Potentially Fatal: Abrupt withdrawal leading to acute adrenal insufficiency. Rapid IV Inj may cause CV collapse.
Drug Interactions Thiazides may enhance hyperglycaemia and hypokalaemia caused by corticosteroids. Increased incidence of peptic ulcer or GI bleeding with concurrent NSAIDs admin. Response to anticoagulants altered. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum conc of salicylates and antimuscarinic agents. Ethanol may enhance gastric mucosal irritation. Reduced efficacy with concurrent use of carbamazepine,phenytoin, primidone, barbiturates and rifampicin. Mutual inhibition of metabolism between ciclosporin and corticosteroids increase plasma conc of both drugs. Enhanced effect in women taking oestrogens or oral contraceptives. Potentially Fatal: Thiazides may enhance hyperglycaemia and hypokalaemia caused by corticosteroids. Increased incidence of peptic ulcer or GI bleeding with concurrent NSAIDs admin. Response to anticoagulants
altered. Dose of antidiabetics and antihypertensives needs to be increased. Decreases serum conc of salicylates and antimuscarinic agents. Ethanol may enhance gastric mucosal irritation. Reduced efficacy with concurrent use of carbamazepine,phenytoin, primidone, barbiturates and rifampicin. Mutual inhibition of metabolism between ciclosporin and corticosteroids increase plasma conc of both drugs. Enhanced effect in women taking oestrogens or oral contraceptives. Click to view more hydrocortisone Drug Interactions Food Interaction Pregnancy Category (US FDA) Interferes with calcium absorption.
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
in 1st trimester. Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective). Storage Injection: Store at 15-30C. Intra-articular: Store at 1530C. Intravenous:Store at 15-30C. Oral: Store at 1530C. Topical/Cutaneous: Store at 15-30C. Hydrocortisone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency. Absorption: Readily absorbed from the GI tract (oral); sodium phosphate and sodium succinate esters are rapidly absorbed but the free alcohol and its lipid soluble ester are slowly absorbed (IM); Acetate is slowly absorbed (intra-articular inj); absorbed from the skin (denuded areas). Distribution: Crosses the placenta. Protein-binding: >90%. Metabolism: Hepatic (metabolised to hydrogenated and degraded forms). Excretion: Via urine (as conjugates and glucuronide, with small portion as unchanged drug). Corticosteroid Hormones / Eye Corticosteroids / Topical Corticosteroids A07EA02 - hydrocortisone ; Belongs to the class of corticosteroids acting locally. Used in the treatment of intestinal inflammation. D07XA01 - hydrocortisone ; Belongs to the class of weak (group I) corticosteroids in other combinations. Used in the treatment of
Mechanism of Action
MIMS Class ATC Classification
dermatological diseases. S01BA02 - hydrocortisone ; Belongs to the class of corticosteroids. Used in the treatment of inflammation of the eye. H02AB09 - hydrocortisone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations. S01CB03 - hydrocortisone ; Belongs to the class of corticosteroids/antiinfectives/mydriatics combinations. Used in the treatment of eye diseases. C05AA01 - hydrocortisone ; Belongs to the class of products containing corticosteroids for topical use. Used in the treatment of hemorrhoids and anal fissures. S02BA01 - hydrocortisone ; Belongs to the class of corticosteroids used in the treatment of inflammation of the ear. D07AA02 - hydrocortisone ; Belongs to the class of weak (group I) corticosteroids. Used in the treatment of dermatological diseases. A01AC03 - hydrocortisone ; Belongs to the class of local corticosteroid preparations. Used in the treatment of diseases of the mouth. Related hydrocortisone information: Drugs interacting with hydrocortisone Find hydrocortisone in other countries Search hydrocortisone in Google Search hydrocortisone in PubMed Search related pubmed documents for hydrocortisone by indication/synonym: Joint inflammations Replacement therapy in adrenocortical insufficiency Corticosteroid-responsive dermatoses As supplement in adrenal insufficiency during minor surgery under general anaesthesia As supplement in adrenal insufficiency during moderate or major surgery Acute adrenocortical insufficiency Soft tissue inflammation
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Drug Info > P > Pantoloc

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Common Name
pantoprazole
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DIN (Drug Identification Number)

02241804 02229453 PANTOLOC 20MG TABLET PANTOLOC 40MG TABLET
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How does this medication work? What will it do for me?

Pantoprazole belongs to the family of medications called proton pump inhibitors (PPIs). Proton pump inhibitors are used to treat conditions such as stomach ulcers, intestinal ulcers, and gastroesophageal reflux disease (GERD, reflux esophagitis) by reducing the amount of acid the stomach produces. Pantoprazole is also sometimes used along with antibiotics to treat stomach ulcers that are caused by bacteria known as H. pylori. Pantoprazole can also be used to treat or reduce the risk of stomach ulcers due to medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), which irritate the stomach. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you
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How should I use this medication?

The recommended dose of pantoprazole to treat reflux esophagitis is 40 mg once daily in the morning for 4 to 8 weeks. Treatment may be maintained at a dose of 20 mg to 40 mg once daily. To treat GERD or heartburn, the recommended dose is 40 mg once daily for up to 4 weeks. To prevent stomach ulcers associated with NSAID use, the dose is 20 mg once daily in the morning. To treat duodenal (intestinal) ulcers, the recommended dose is 40 mg once daily in the morning for 2 to 4 weeks. To treat gastric (stomach) ulcers, the recommended dose is 40 mg once daily in the morning for 4 to 8 weeks. To treat duodenal (intestinal) ulcers caused by H. pylori in adults, the dose of pantoprazole is 40 mg twice daily taken with amoxicillin 1,000 mg twice daily and clarithromycin 500 mg twice daily, or pantoprazole 40 mg twice daily taken with metronidazole 500 mg twice daily and clarithromycin 500 mg twice daily. The usual duration of this treatment is 7 days. Do not chew or crush the tablets, and take them with a glass of water in the morning either before, during, or after breakfast. Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. Store this medication at room temperature and keep it out of the reach of children. Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
What form(s) does this medication come in?

20 mg Each enteric-coated, yellow, oval, biconvex tablet, marked "P20" on one side, contains pantoprazole 20 mg (pantoprazole sodium sesquihydrate 22.6 mg). Nonmedicinal ingredients: anhydrous sodium carbonate, calcium stearate, crospovidone, ferric oxide, mannitol, methylhydroxypropyl cellulose, poly (ethylacrylate, methacrylic acid), polysorbate 80, polyvidone, propylene glycol, sodium lauryl sulfate, titanium dioxide, and triethyl citrate. 40 mg Each enteric-coated, yellow, oval, biconvex tablet, marked "P40" on one side, contains pantoprazole 40 mg (pantoprazole sodium sesquihydrate 45.1 mg). Nonmedicinal ingredients: anhydrous sodium carbonate, calcium stearate, crospovidone, ferric oxide, mannitol, methylhydroxypropyl cellulose, poly (ethylacrylate, methacrylic acid), polysorbate 80, polyvidone, propylene glycol, sodium lauryl sulfate, titanium dioxide, and triethyl citrate.
Who should NOT take this medication?

Pantoprazole should not be taken by anyone who:
is allergic to pantoprazole or to any of the ingredients of the medication is also using the medication atazanavir
Other medications like this
Pantoprazole magnesium(Tecta, ...) Lansoprazole (Prevacid, ...) Rabeprazole (Pariet, ...) Omeprazole (Losec, ...) Esomeprazole (Nexium, ...)
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STUVWXYZ
OPICS
& Child Health
Health
n's Health ' Health
on
Brand Name
Pantoloc
sing Spondylitis
s (Rheumatoid)
ibrillation
Common Name
pantoprazole
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r (Overactive)
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d Flu
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asonal) y NEW!
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ood Pressure
idrosis nence
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Health
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DIN (Drug Identification Number)

02241804 02229453 PANTOLOC 20MG TABLET PANTOLOC 40MG TABLET
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How does this medication work? What will it do for me?

Pantoprazole belongs to the family of medications called proton pump inhibitors (PPIs). Proton pump inhibitors are used to treat conditions such as stomach ulcers, intestinal ulcers, and gastroesophageal reflux disease (GERD, reflux esophagitis) by reducing the amount of acid the stomach produces. Pantoprazole is also sometimes used along with antibiotics to treat stomach ulcers that are caused by bacteria known as H. pylori. Pantoprazole can also be used to treat or reduce the risk of stomach ulcers due to medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), which irritate the stomach. Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without
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consulting your doctor. Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
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ES
Expert
Trials nity Forum
features
How should I use this medication?

The recommended dose of pantoprazole to treat reflux esophagitis is 40 mg once daily in the morning for 4 to 8 weeks. Treatment may be maintained at a dose of 20 mg to 40 mg once daily. To treat GERD or heartburn, the recommended dose is 40 mg once daily for up to 4 weeks. To prevent stomach ulcers associated with NSAID use, the dose is 20 mg once daily in the morning. To treat duodenal (intestinal) ulcers, the recommended dose is 40 mg once daily in the morning for 2 to 4 weeks. To treat gastric (stomach) ulcers, the recommended dose is 40 mg once daily in the morning for 4 to 8 weeks. To treat duodenal (intestinal) ulcers caused by H. pylori in adults, the dose of pantoprazole is 40 mg twice daily taken with amoxicillin 1,000 mg twice daily and clarithromycin 500 mg twice daily, or pantoprazole 40 mg twice daily taken with metronidazole 500 mg twice daily and clarithromycin 500 mg twice daily. The usual duration of this treatment is 7 days. Do not chew or crush the tablets, and take them with a glass of water in the morning either before, during, or after breakfast. Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. Store this medication at room temperature and keep it out of the reach of children. Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
What form(s) does this medication come in?

20 mg Each enteric-coated, yellow, oval, biconvex tablet, marked "P20" on one side, contains pantoprazole 20 mg (pantoprazole sodium sesquihydrate 22.6 mg). Nonmedicinal ingredients: anhydrous sodium carbonate, calcium stearate, crospovidone, ferric oxide, mannitol, methylhydroxypropyl cellulose, poly (ethylacrylate, methacrylic acid), polysorbate 80, polyvidone, propylene glycol, sodium lauryl sulfate, titanium dioxide, and triethyl citrate. 40 mg Each enteric-coated, yellow, oval, biconvex tablet, marked "P40" on one side, contains pantoprazole 40 mg (pantoprazole sodium sesquihydrate 45.1 mg). Nonmedicinal ingredients: anhydrous sodium carbonate, calcium stearate, crospovidone, ferric oxide, mannitol, methylhydroxypropyl cellulose, poly (ethylacrylate, methacrylic acid), polysorbate 80, polyvidone, propylene glycol, sodium lauryl sulfate, titanium dioxide, and triethyl citrate.
Who should NOT take this medication?

Pantoprazole should not be taken by anyone who:
is allergic to pantoprazole or to any of the ingredients of the medication is also using the medication atazanavir
Pantoloc
GO

alphabetically
STUVWXYZ
OPICS
& Child Health
Health
n's Health ' Health
on
Brand Name
Pantoloc
sing Spondylitis
s (Rheumatoid)
Common Name
pantoprazole
ibrillation
ealth ealth
ting
r (Overactive)
ealth
od Vaccinations
erol s & Colitis
d Flu
ic Procedures
sion NEW! es
ve Health
alth Disorders
alth
asonal) y NEW!
y Skin
ood Pressure
idrosis nence
on
Health
ealth tions and your
ause
Health e Sclerosis NEW!
and mentary y
What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time. Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
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diarrhea dizziness flu-like symptoms headache itching nausea
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Although most of these side effects listed below don't happen very often, they could lead
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to serious problems if you do not check with your doctor or seek medical attention. Check with your doctor as soon as possible if any of the following side effects occur:
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symptoms of liver damage (such as yellow skin or eyes, abdominal pain, dark urine, claycoloured stools, loss of appetite)
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Stop taking the medication and seek immediate medical attention if any of the following occur:
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any changes in vision severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins) symptoms of a serious allergic reaction (such as swelling of the face or throat, hives, or difficulty breathing) symptoms of muscle damage (unexplained muscle pain, tenderness or weakness, or brown or discoloured urine - especially if you also have a fever or a general feeling of being unwell)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY April 4, 2013

Health Canada has issued new information concerning the use of pantoprazole. To read the full report, visit Health Canada's website at www.hc-sc.gc.ca. Previous advisories on pantoprazole were issued on February 16, 2012 and on October 19, 2012. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca. Kidney disease: People with severe kidney disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Liver disease: People with severe liver disease should generally not take more than 20 mg of pantoprazole daily. People with severe liver disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and
effectiveness of this medication, and whether any special monitoring is needed. Severe stomach problems: If you have recurrent vomiting, difficulty swallowing, blood in the stool, significant unintentional weight loss, fatigue (anemia), or are coughing up blood, check with your doctor right away. Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking pantoprazole, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Children: The safety and effectiveness of using pantoprazole has not been established for children.
What other drugs could interact with this medication?

There may be an interaction between pantoprazole and any of the following:
amoxicillin atazanavir clarithromycin ketoconazole methotrexate tetracycline warfarin
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
stop taking one of the medications, change one of the medications to another, change how you are taking one or both of the medications, or leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
Pantoloc
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PANTOLOC
Generic name Pantoprazole Sodium Classification antacids and antiulcerants Indications Symptomatic treatment of mild reflux esophagitis; long term management and prevention of relapse of reflux esophagitis; duodenal and gastric ulcers, reflux esophagitis; eradication of H. pylori. Action Inhibits proton pump activity by binding to hydrogen-potassium adenosine triphosphatase, located at secretory surface of gastric parietal cells, to suppress gastric acid secretion. Adverse Frequently: headache, Rarely: nausea, upper abdominal pain, flatulence, skin rash, pruritus or dizziness. Nursing Considerations alert: dont confuse with protonix tablet, prisolec, prozac, or prevacid drug can be given without regard to meals drug shouldnt be used for maintenance therapy beyond 16 weeks. symptomatic response to therapy doent preclude the presence of gastric malignancy. reactions diarrhea
Nurses
SATURDAY, MAY 13, 2006
ZITHROMAX
Generic Name Azithromycin Classification Macrolide anti-infective Action Binds to the 50S subunit of bacterial ribosomes, blocking protein synthesis; bacteriostatic or bactericidal, depending on concentration. Indications Acute bacterial exacerbations of COPD caused by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, or Streptococcus pneumoniae; mild community-acquired pneumonia caused by H. influenzae or S. pneumoniae; uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, streptococcus pyogens, or S. agalactiae; second-line therapy of pharyngitis or tonsillitis caused by S. pyogens.; Nongonococcal urethritis or
cervicitis caused by Chlamydia trachomatis; prevention of disseminated Mycobacterium avium complex (MAC) disease in patients with advanced HIV infection; urethritis and cervicitis due to Neisseria gonorrhoeae; genital ulcer disease in men due to Haemophilus ducreyi (chancroid) Adverse Reactions Common: nausea, vomiting, diarrhea, abdominal pain Uncommon: dizziness, vertigo, headache, fatigue, somnolence, palpitations, chest pain, dyspepsia, flatulence, melena, cholestatic jaundice, psuedomembranous colitis, candidiasis, vaginitis, nephritis, rash, photosensitivity, angioedema Nursing Considerations Use cautiously in patients with impaired hepatic function Obtain specimen for culture and sensitivity test before first dose. therapy may begin pending results Administer capsules 1 hour before or 2 hours after meals; do not administer with antacids. Oral suspension can be taken with or without food. Monitor for superinfection. May cause overgrowth of nonsusceptible bacteria or fungi.
Concise Info Full Info
tamsulosin
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tamsulosin Full Info
See related tamsulosin informationAbbreviation Index
Indication & Dosage
Oral Benign prostatic hyperplasia Adult: As HCl: As modified-release preparation: 400 mcg once daily. May increase to 800 mcg once daily after 2-4 wk if necessary. If therapy is interrupted for several days, restart with 400 mcg once daily. Dose to be taken 30 minutes after the same meal each day. CrCl (ml/min) Dosage Recommendation 10 No dose adjustment needed. <10 Not studied. Hepatic impairment: Moderate hepatic impairment (Child-Pugh classification A and B): No dose adjustment needed. Severe hepatic impairment: Avoid. Orodispersible extended release tab: Should be taken with food. Take after meals. Place on the tongue & allow to dissolve. Then, swallow w/ saliva or water. Prolonged release tab: May be taken with or without food. Swallow whole, do not chew/crush. Cap: Should be taken with food. Take hr following the same meal daily. Swallow whole, do not open/chew/crush. Hypotension, headache. Keep in supine position to restore BP and heart rate. If needed, admin of IV fluid and vasopressors. Dialysis unlikely to be of benefit. Prostate carcinoma should be ruled out before starting the therapy. Risk of intraoperative floppy iris syndrome in patients who undergo cataract surgery. May cause orthostatic hypotension or syncope especially with first dose, if dosage is increased or an antihypertensive drug or a phosphodiesterase-5 inhibitor is added to the treatment regimen. Caution when used in patients with sulfa allergy. May cause priapism (rare); immediate medical attention is recommended. Pregnancy. Postural hypotension, dizziness and vertigo, malaise, headache, rhinitis, pharyngitis, cough, sinusitis, diarrhoea, nausea, infection, asthenia, back pain, tooth disorder, chest pain, somnolence, insomnia, decreased libido, abnormal ejaculation, priapism, blurred vision. Risk of intraoperative floppy iris syndrome during phacoemulsification surgery.
Administration
Overdosage
Contraindications Hypersensitivity to sulfonamide, severe hepatic impairment, lactation. Special Precautions
Adverse Drug Reactions
Drug Interactions Concomitant admin with moderate or strong inhibitors of CYP2D6 (eg. fluoxetine) or CYP34A (eg. ketoconazole, cimetidine) increases serum concentration. Potentially Fatal: Concomitant admin with moderate or strong inhibitors of CYP2D6 (eg. fluoxetine) or CYP34A (eg. ketoconazole, cimetidine) increases serum concentration. Click to view more tamsulosin Drug Interactions Food Interaction Food reduced extent and rate of absorption.
Pregnancy Category (US FDA)
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animalreproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1sttrimester (and there is no evidence of a risk in later trimesters). Oral: Store at 25C. Tamsulosin is a selective 1 adrenoreceptor-blocking agent. Smooth muscle tone is mediated by the sympathetic nervous stimulation of 1adrenoreceptors, which are abundant in the prostate, prostatic capsule, prostatic urethra, and bladder neck. Blockade of these adrenoceptors can cause smooth muscles in the bladder neck and prostate to relax, resulting in an improvement in urine flow rate and reduction in symptoms in BPH. Absorption: Completely absorbed from the GI tract. Peak plasma concentrations after 1 hr; 6 hr (modified-release preparation). Distribution: Protein-binding: 99%. Metabolism: Metabolised slowly in the liver primarily by CYP2D6 and CYP3A4. Excretion: Excreted in urine (76%) and faeces (21%). Plasma elimination half life: 4-5.5 hr; as modified-release preparation : 10-13 hr. Drugs for Bladder & Prostate Disorders G04CA02 - tamsulosin ; Belongs to the class of alpha-adrenoreceptor antagonists. Used in the treatment of benign prostatic hypertrophy.
Storage Mechanism of Action
MIMS Class ATC Classification
Related tamsulosin information: Drugs interacting with tamsulosin Find tamsulosin in other countries Search tamsulosin in Google Search tamsulosin in PubMed Search related pubmed documents for tamsulosin by indication/synonym: Benign prostatic hyperplasia
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tamsulosin hydrochloride
(tam soo low' sin) Flomax
Pregnancy Category B
Drug class
Alpha-adrenergic blocker (peripherally acting)

Therapeutic actions
Blocks the smooth muscle alpha1-adrenergic receptors in the prostate, prostatic capsule, prostatic urethra, and bladder neck, leading to relaxation of the bladder and prostate and improving the flow of urine in cases of BPH
Indications
Treatment of the signs and symptoms of BPH
Contraindications and cautions
Contraindicated with hypersensitivity to tamsulosin, prostate cancer, pregnancy, lactation. Use cautiously with hypotension.
Available forms
Capsules0.4 mg
Dosages ADULTS
0.4 mg PO daily 30 min after the same meal each day; if response is not satisfactory in 24 wk, dosage may be increased to 0.8 mg PO daily 30 min after the same meal each day. If therapy is interrupted for any reason for several days, resume dosing at 0.4 mg PO daily.
PEDIATRIC PATIENTS
Safety and efficacy not established.

Pharmacokinetics
Route Oral Onset Varies Peak 46 hr
Metabolism: Hepatic; T1/2: 915 hr Distribution: May cross placenta; enters breast milk Excretion: Urine and feces
Adverse effects
CNS: Somnolence, insomnia CV: Orthostatic hypotension, syncope GI: Nausea, dyspepsia GU: Abnormal ejaculation, decreased libido, increased urinary frequency Other: Cough, sinusitis, rhinitis
Interactions
Drug-drug Increased hypotensive effects with other alpha-adrenergic antagonists Risk of increased toxic effects of cimetidine
Nursing considerations CLINICAL ALERT!
Name confusion has occurred between Fosamax (alendronate) and Flomax (tamsulosin); use caution.
Assessment
History: Allergy to tamsulosin; pregnancy, lactation; prostatic cancer, hypotension Physical: Body weight; skin color, lesions; orientation, affect, reflexes; ophthalmologic examination; P, BP, orthostatic BP; R, adventitious sounds, status of nasal mucous membranes; voiding pattern, normal output, urinalysis
Interventions
Ensure that patient does not have prostatic cancer before beginning treatment. Administer once a day, 30 min after the same meal each day. Resume therapy at 0.4 mg daily if therapy is interrupted for any reason.
Ensure that patient does not crush, chew, or open capsule. Capsule should be swallowed whole. Monitor patient carefully for orthostatic hypotension; chance of orthostatic hypotension, dizziness, and syncope is high with the first dose. Establish safety precautions as appropriate.
Teaching points
Take this drug exactly as prescribed, once a day. Do not chew, crush, or open capsules; capsules must be swallowed whole. Use care when beginning therapy; the chance of dizziness or syncope is greatest at that time. Change position slowly to avoid increased dizziness. Take the drug 30 min after the same meal each day. You may experience these side effects: Dizziness, weakness (more likely when you change position, in the early morning, after exercise, in hot weather, and when you have consumed alcohol; some tolerance may occur after you have taken the drug for a while; avoid driving or engaging in tasks that require alertness; change position slowly, use caution in climbing stairs, lie down if dizziness persists); GI upset (eat frequent small meals); impotence (discuss this with your health care provider); stuffy nose. Most of these effects will disappear gradually with continued therapy. Report frequent dizziness or fainting, worsening of symptoms. Adverse effects in Italic are most common; those in Bold are life-threatening.
Concise Info Full Info Manufacturer Info
Concise Prescribing Information of:
Dolfenal

Manufacturer Distributor Contents Indications Dosage Administration Contraindications Warnings Special Precautions Adverse Drug Reactions Drug Interactions Pregnancy Category (US FDA) Storage
Mechanism of Action MIMS Class ATC Classification Poison Schedule Presentation/Packing

Dolfenal Concise Info
Related Information:
Abbreviation Index
Manufacturer Distributor Contents Indications
Westmont United Lab Mefenamic acid Relief of mild to moderately severe somatic & neuritic pain; headache, migraine, traumatic pain, postpartum pain, post-op pain, dental pain, & in pain & fever following various inflammatory conditions; dysmenorrhea; menorrhagia accompanied by spasm or hypogastric pain. Click to view Dolfenal detailed prescribing infomation 250-500 mg tid. Max: 7 days. Click to view Dolfenal detailed prescribing infomation Should be taken with food. Take immediately after meals.
Dosage Administration
Contraindications GI ulceration or inflammation. Kidney or liver impairment. Click to view Dolfenal detailed prescribing infomation Warnings For additional cautionary notes to warn of the potential risk of using the medicine... click to view Dolfenal detailed prescribing infomation Peptic ulcer, asthma, dehydration. Click to view Dolfenal detailed prescribing infomation GI disturbances & hemorrhage, blood dyscrasias. Drowsiness, dizziness, headache, visual disturbances. Skin reactions, nephropathy. View ADR Monitoring Form
Special Precautions Adverse Drug Reactions
Drug Interactions Oral anticoagulant, highly protein-bound drugs. Pregnancy Category (US FDA)
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
(in 3rd trimester or near delivery) Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective). Storage Mechanism of Action MIMS Class ATC Classification View Dolfenal storage conditions for details to ensure optimal shelf-life. View Dolfenal mechanism of action for pharmacodynamics and pharmacokinetics details. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) M01AG01 - mefenamic acid ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, fenamates.
Poison Schedule 250 mg:Non-Rx;500 mg:Rx Presentation/Packing Form Photo Dolfena l tab 250 mg Packing/Price 100's (P1082.86/pack )
Dolfena l tab 500 mg
100's (P2084.94/pack )
Manufa West cturer: mont Distrib Unite utor: d Lab
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Viewing: Philippines (Change Region) Search for: Drugs | Images | News & CME Search drug monographs using drug name
Generic Name: Mefenamic Acid Brand Name: Dolfenal Classification Therapeutic Classification: anti-inflammatory, analgesic, and antipyretic activities related to inhibition of prostaglandin synthesis; exact mechanisms of action are not known. Pharmacologic Classification: NSAID (fenamate). Suggested Dose: Usual Adult Dose for Pain: 500 mg orally followed by 250 mg every 6 hours as needed, not to exceed 7 days Usual Adult Dose for Dysmenorrhea: 500 mg orally followed by 250 mg every 6 hours starting with the onset of menses Usual Pediatric Dose for Pain: 14 to 18 years: 500 mg orally followed by 250 mg every 6 hours as needed, not to exceed 7 days Mode of Action: Aspirin-like drug that has analgesic, antipyretic and anti-inflammatory activities. These activities appear to be due to its ability to inhibit cyclooxygenates and also antagonize certain effects of prostaglandins. Mefenamic Acid displays central and peripheral activities. Indications: - Relief of moderate pain when therapy will not exceed 1 week - Treatment of primary dysmenorrhea Contraindications: - Contraindicated with hypersensitivity to mefenamic acid, aspirin allergy, and as treatment of perioperative pain with coronary artery bypass grafting. - Use catiously with asthma, renal or hepatic impairment, peptic ulcer disease, GI bleeding, hypertension, heartfailure, prengnacy, lactation. Drug Interactions drug-drug: increased risk of GI bleeds with ASA, anticoagulants drug-lab. results: False-positive reaction for urinary bile using the Diazo tablet test Side Effects: CNS: Headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus, ophthalmic effects
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GI: Nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence. GU: Dysuria, renal impairment Hematologic: Bleeding, platelet inhibition with higher doses, neutropenia, eosinophila, leucopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia, decreased Hgb or Hct, bone marrow depression, menorrhagia Respiratory: Dyspnea, hemoptysis, Pharyngitis, bronchospasm, rhinitis Other: Peripheral edema, anaphylactoid reactions to anaphylactic shock Nursing Responsibilities: 1. 2. 3. 4. 5. 6. 7. Give with milk or food to decrease GI upset. Arrange for periodic ophthalmologic examinations during long-term therapy. Instruct the client to take only the prescribed dosage and not to take the drug longer than 1 week. Instruct the client to discontinue drug and consult the health care provider if rash, diarrhea, or digestive problems occur. If dizziness or drowsiness can occur (avoid driving and using dangerous machinery). Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision; black, tarry stools; severe diarrhea, right upper abdominal pain, flulike symptoms. Recommend abstinence of alcohol when taking medication

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