Supply:10% 20ml//Amp(MAGNESIUM SULFATER)
Use:Prevention or control seizures in severe pre-eclampsia or eclampsia and in convulsions associated with epilepsy, glomerulonephritis and hypothyroidism; used to prevent or correct magnesium deficiency in TPN.
Contraindication:Heart block, myocardial damage, serious renal impairment.
Adverse effect:Safe in mothers' infusion for eclampsia immediately before, during, and after delivery. The milk/plasm ratio is 1.9. No adverse effect to nursing infant reported.
Usual dosage:Flushing, sweating, depressed reflexes, hypo-tension, circulatory collapse, cardiac and CNS depression.
POTASSIUM CHLORIDE A
Supply:15% 5ml/Amp(POTASSIUM CHLORIDER)
Use:Potassium depletion, corticosteroid therapy, hypokalemia in digitalis intoxication.
Contraindication:Addison's disease, acute dehydration, acute or chronic renal disease, hyperkalemia, severe renal impairment with azotemia or oligouria.
Adverse effect:Hyperkalemia, flaccid paralysis, mental confusion, cardiac depression, cardiac arrhythmias.
Usual dosage:Prevention of hypokalemia (20mEq/day) Potassium depletion (40-100mEq/day).
POTASSIUM GLUCONATE
Supply:595mg/Tab(Radi-kR)
Use:Hypokalemia
Contraindication:Hyperkalemia
Usual dosage:3-8 tab daily in 2-3 divided doses
Special precautions:Impaired renal function.
SODIUM BICARBONATE C
Supply:7% 20ml/Amp(SODIUM BICARBONATER)
DEXTROSE
Supply:10% 500ml/Bag(DEXTROSER), 5% 500ml/Bot(DITROSER), 5% 500ml(GLUCOSER), 0.33% 500ml(
Use:Sodium depletion, hypertonic used for shock, anti-ketogenic action used for acidosis, provide calories (5%, 10%, 20%, 50% infusion), 50 % dextrose for insulin hypoglycemia.
Contraindication:Intracranial or intraspinal hemorrhage; diabetic coma, glucose-galactose malabsorption syndrome.
Adverse effect:Thrombophlebitis, hyperglycemia, glycosuria.
Usual dosage:IV depend on the age, weight and clinical condition. The maximum rate is 0.5g/kg/hr.
GELAFUNDIN
Supply:500ml/Bot(GELAFUNDINR)
Use:Primary vol replacement in hypovolaemia & shock due to acute blood or fluid loss, burn & sepsis; prophylaxis of hypotension during epidural or spinal anaesth; haemodilution & autologous transfusion; extracorporeal circulation
Contraindication:Hypervolaemia, hyperhydration, severe cardiac disturbances
Adverse effect:all colloidal vol substitutes, allergic, (anaphylactic or anaphylactoid) reactions of varying severity can occur after infusion of Gelafundin/Gelofusine.
Usual dosage:Prophylaxis & treatment of hypovolaemia & hypotension 500-1000 ml. Severe hypovovlaemia 1000-2000ml. Haemodilution Max 20 ml/kg body wt/day
GLYCEROL C
Supply:250ml/Bot(FRUCEOLR)
Use:Treatment of intracranial edema, and increased intracranial pressure, reduction of brain or eyeball volume during brain or eye surgery.
Contraindication:Patients with hereditary fructose intolerance.
Adverse effect:Occult blood in urine, hemoglobinuria, headache.
Usual dosage:Usual adult dose: 200-500mg QD or Q12H IV infusion for 2-3 hours, duration of administration: 1-2 weeks.
GLYCEROSTERIL C
Supply:10% 250ml/Bot(GLYCEROSTERILR)
Use:Treatment of cerebral oedema
Contraindication:Hyperosmolar coma, haemolytic anaemia lowered osmotic RBC resistance, decompensated cardiac insufficiency, impaired renal function(oliguria, anuria), general fluid losses (dehydration conditions)
Usual dosage:40 drops/min or 125 ml/hr/70 kg body wt. Max: 500ml/day/70 kg body wt.
RINGER
Supply: Inj 500ml/Bot
Each 100ml contains:
Sodium Chloride 860 mg
Potassium Chloride 30 mg
Calcium Chloride anhydrous 33 mg
Electrolyte content given in meq/L
Each 100ml contains
Na
K
Ca
Cl
147
4
5
156
Use:Sodium deficiency, potassium deficiency, acidosis, alkalosis, renal failure, maintenance fluid therapy.
Contraindication:Circulatory overload, edema due to sodium excess.
Usual dosage:500ml/day.
SODIUM CHLORIDE
Supply: 0.45% 500 ml/Bot, 20 ml/Amp (77 mEq of NaCl/L, 154 mOsm/L), 3 % 500ml/Bot (513 mEq of NaCl/L, 1026 mOsm/L), 0.9% 500 ml/Bot (Plastic bag/Glass bot)
Use:Hypotonic sodium chloride solution (0.45%): fluid replacement when fluid losses exceed electrolyte depletion. Isotonic solution(0.9%): water and sodium retention. Hypertonic solution (3%): hyponatremia, hypochloremia.
Contraindication:Congestive heart failure, severe renal impairment, edema with sodium retention.
Usual dosage:Dose in dependent on age, weight and clinical condition of patient : 6-10g/day.
CALCIUM SALTS
Supply:CALCIUM CARBONATE: 250mg/Cap(OS-CALR), 500mg/Tab(CALCIUM CARBONATER), 1250mg/Tab(CALCIUM FROM OYSTER SHELLR) 500mg/Tab equiv to elemental Ca200mg
CALCIUM CITRATE:950mg/Tab(CALBOR)equiv to elemental Ca200mg CALCIUM GLUCONATE:10% 10ml/Vial(CALGLONR) equiv to elemental Ca89.2mg
Use:Calcium salts are useful in treating a variety of conditions including hypocalcemia, osteoporosis, tetany, and leg cramps.
Place in therapy: Oral calcium supplementation, in conjunction with estrogen therapy, is effective in preventing postmenopausal bone loss.
Contraindication:Patient with hypercalcemia, renal failure or GFR<50 ml/min
Adverse effect:One of the more common side effects of calcium is constipation; hypercalcemia may result in nephrolithiasis, anorexia, nausea, vomiting, and ocular toxicity.
Usual dosage:500mg bid
Special precautions:Hypercalciuria; renal impairment, previous renal calculi
Pharmacokinetics: Following absorption, 99% of calcium is deposited in bone and about 40% to 45% of serum calcium is bound to plasma proteins.
CALCIUM PHOSPHATE
Supply:300mg/Tab(BIO-CALR)
Tab contains
Calcium phosphate 802 mg (calcium 300mg)
Cholecalciferol 62.5IU(1.56mcg)
Note: It consists of a variable mixture of hydrous and anhydrous calcium phosphates. Each g of hydrated calcium phosphate represents approximately 9.7-10 mmol of calcium. Hydrated calcium phosphate 2.51-2.58 g is approximately equivalent to 1 g of calcium.
Use:Calcium salts are useful in treating a variety of conditions including hypocalcemia, osteoporosis, tetany, and leg cramps.
Place in therapy: Oral calcium supplementation, in conjunction with estrogen therapy, is effective in preventing postmenopausal bone loss.
Contraindication:Patient with hypercalcemia, renal failure or GFR<50 ml/min
Adverse effect:One of the more common side effects of calcium is constipation; hypercalcemia may result in nephrolithiasis, anorexia, nausea, vomiting, and ocular toxicity.
Usual dosage:1-2 Tab PO BID
Vitamins
CALCIUM FOLINATE C
Supply:30mg/Amp(ANTREXR), 50mg/5ml/Vial(LEUCOVORINR)
Use:Cellular rescue from the adverse effects of high-dose methotrexate therapy.
Contraindication:It is an improper therapy for pernicious anemia secondary to lack of Vitamin B12, because hemologic remission may occur while neurologic mainifestations remain progress.
Adverse effect:Allergic sensitization.
Usual dosage:Rescue of methotrexate therapy: 10mg/m2 IM or IV every 6 hours until methotrexate serum levels are below 10-8 M.
*FURSULTIAMINE
Supply:50mg/S.C.Tab(ALINAMIN-F50R), 50mg/20ml/Amp(ALINAMIN-F50R)
Use:Neuralgia, neuritis, eye's fatigue, nervous cystitis; post-op intestinal paralysis, vit B1 deficiency.
Adverse effect:Rarely, nausea, vomiting & rumbling; shock, hypersensitivity, headache or pollakiuria (decrease dose or stop use)
Usual dosage:Amp 20ml once-bid slow IV. Tab 1-3 tab daily.
PYRIDOXAL PHOSPHATE
Supply:30mg/Tab(PYRIDOXALR)
Use:Acute eczema, atopic dermatitis, hyperemesis gavidarum peripheral nerve disorders.
Adverse effect:Long term use may result in paresthesia, somnolence and low serum folic acid levels.
PYRIDOXINE HCL
Supply:10mg/Tab(VIT B6)
Use:1. For pyridoxine deficiency, 2. For treatment of irradiation sickness and nausea and vomiting of pregnancy.
Contraindication:Sensitivity to pyridoxine.
Adverse effect:Paresthesia, somnolence and low serum folic acid level.
Usual dosage:Prophylactic: 1-2mg, QD. Therapeutic: 30-150mg. QD.
FOLIC ACID
Supply:5mg/Tab(FOLIC ACIDR)
Use:For megaloblastic anemias, anemias of nutritional origin, pregnancy, infancy or childhood.
Contraindication:It is an incomplete therapy for pernicious anemia, it should not be employed because of the menace of neurological complications various types of leukemias.
Adverse effect:Allergic sensitization
Usual dosage:10-30mg in divided doses.
MECOBALAMIN
Supply:1000mcg/Amp(MECOBALR),
250mcg, 500mcg/Tab(YOUCOBALR)
Use:Pernicious anemia and related macrocytic anemias.
Contraindication:Hypersensitivity to cyanocobalamine.
Adverse effect:Anaphylactic shock, itching, peripheral vascular thrombosis, polycythemia vera, etc.
Usual dosage:Nutritional deficiency: 10-250mg QD. Vit B12 deficiency: 1000mg QD, PO; IM, 30mg QD, for 5-10 days, followed 10-200mg monthly.
Drugs used for dyslipidemia
ACIPIMOX
Supply:250mg/Cap(OLBETAMR)
Use:Type IIa (elevated plasma levels of cholesterol), IIb, III, IV (elevated plasma levels of triglycerides), V(elevated plasma levels of cholesterol and triglycerides) hyperlipoproteinemia.
Place in therapy: Acipimox is a derivative of niacin. It has a longer duration of action and greater hypolipidemic activity than niacin, and it is better tolerated than niacin with a low incidence of adverse effects. It is most valuable in the treatment of Type IV hyperlipoproteinemia, which is primarily manifest as hyper-triglyceridemia.
Contraindication:Peptic ulcer, hypersensitivity.
Adverse effect:Flushing, gastric upset, headache, vomiting, hypotension, heartburn, loose stools, itching, rash, tingling of the extremities, cutaneous blisters.
Usual dosage:Adults: PO 250mg BID or TID, or 500mg QD.
BEZAFIBRATE
Supply:200mg/Tab(BEZALIPR), 400mg/Tab(BEZALIP RETARDR)
Use:For treatment of hypertriglyceridaemia and hyper-cholesterolaemia.
Contraindication:Liver and gall bladder disease, cholelithiasis, severe renal impairment, pregnancy and lactation.
Adverse effect:GI distubance, pruritus, urticaria, muscular pain, and weakness.
Usual dosage:200mg TID PC.
ETOFIBRATE
Supply:500mg/(LIPO-MERZ RETARDR)
Use:Severe primary & secondary hyperlipidemia
Contraindication:Liver disease (expect fatty liver beging a frequent concomitant symdrome in hypertriglyceridemia),gallbladder diseases, severe renal insufficiency, decompensated heart failure, acute cardiac infarct, acute bleedings. Pregnancy & lactation.
Adverse effect:Flush syndrome & reactions to flush, GI disorders
Usual dosage: 1 cap daily
FENOFIBRATE C
Supply:100mg/Cap(FENOFIBRATER, LIPOLINR, SYNPIDR)
Use:Hyperlipidemia
Contraindication:Liver & renal impairment, pregnancy, lactation. Hyperlipidaemia Type I.
Adverse effect:Elevation of transaminases, muscular pains, GI disturbances, skin reactions, headache.
Usual dosage:1 cap tid
Supply:300mg/Cap(GEMBITR, GEMNPIDR, URAGEMR), 600mg/F.C.Tab(GEMBRILR)
Use:Hyperlipoproteinemia. It decreases the level of LDL and VLDL, and elevates HDL cholesterol of patients with hyperlipoproteinemia.
Place in therapy: It is an effective antihyperlipidemic agent in type IV and V hyperlipidemia, and for type IIb patient without history or symptoms of existing coronary heart disease.
Contraindication:Patient with hepatic or severe renal dysfunction, or pre-existing gall bladder disease.
Adverse effect:The common adverse effects with genfibrozil are gastrointestinal effects: epigastric pain, dry moth, constipation, diarrhea, and flatulence. Other side effects include : CNS ( fatigue, vertigo, headache, paresthesias, hypesthesia ), ophthalmic( blurred vision ), dermatologic ( eczema, rash ), hematologic ( slight decrease in hemoglobin, hematocrit and leukocyte count ) and atrial fibrillation.
Usual dosage:900-1500mg/day( usually 1200mg ) BID, AC( 30 min before the morning and evening meal).
LOVASTATIN
Supply:20mg/Tab(DELIPICR)
Use:Lovastatin is an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase, the rate limiting enzyme in cholesterol synthesis. In some patients, combination therapy with colestipol, bile-acid binding resins, or ileal bypass may be necessary to reduce cholesterol levels to 240mg/dL or lower.
Contraindication:Patient with hypersensitivity to lovastatin and those with active liver disease should not receive the drug.
Adverse effect:Lovastatin is well tolerated. But there are some case reported Adverse effect: insomnia, headache, diarrhea, cholestatic jaundice, elevated liver enzymes, blurred vision, myopathy.
Usual dosage:Initial dose: 20mg QD; the maximum recommended daily dose is 80mg/day.
PRAVASTATIN X
Supply:5mg/Tab(MEVALOTINR)
Use:Pravastatin is a competitive inhibitor of HMG-CoA reductase. Treatment of familial and non-familial hyper-cholesterolemia; clinical studies have suggested that pravastatin, simvastatin, and lovastatin are similar in efficacy and toxicity. Fluvastatin appears to be slightly less effective than pravastatin when equipotent doses are used.
Place in therapy: The HMG-CoA reductase inhibitors, including pravastatin, are recommended for treatment of patient with primary hypercholesterolemia. Its lipid-lowering effect shows dose-dependence.
Contraindication:Previous hypersensitivity to pravastatin. Active liver disease, or persistent, unexplained liver function enzyme elevations. Pravastatin is specifically contraindicated in pregnant or lactating females.
Adverse effect:Reversible elevations in liver enzymes have been reported rarely; other adverse effects have included gastrointestinal disturbances, headache, weakness.
Usual dosage:Initial dose: PO 10- 20mg QN; elderly and patients with significant renal or hepatic disease: 10mg QN; maintenance dose: 10-40mg QN. Once daily dosing at bedtime is marginally more effective than once daily dosing in the morning, possibly because peak hepatic cholesterol synthesis occurs between midnight and 3 AM.
SIMVASTATIN X
Supply:20mg/F.CTab(ZOCORR)
Use:Simvastatin is an HMG-CoA reductase inhibitor that is structurally related to lovastatin. Simvastatin is indicated for primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Frederickson types IIa and IIb). Simvastatin is also indicated for patients with coronary heart disease and hypercholesterolemia to reduce the risk of coronary death, nonfatal myocardial infarction, myocardial revascularization procedures, and stroke.
Place in therapy: Simvastatin is superior to fibrates, cholestyramine and probucol in lowering total and LDL cholesterol levels; however, it does not appear to offer any advantage over lovastatin. Simvastatin had similar activity and adverse-effect profile compared to lovastatin.
Contraindication:Simvastatin is contraindicated in patient with active liver disease, unexplained elevations of serum transaminases, hypersensitivity, pregnancy, and lactation.
Adverse effect:Common adverse effects include headache and gastrointestinal complaints. Elevations in transaminases greater than 3 times the upper limit of normal were reported in 1% of patients. Elevations in creatine phosphokinase have also been reported.
Usual dosage:Adults: 5-40 mg PO QD, administered in the evening
Pharmacokinetics: Simvastatin is administered as a prodrug, which is hydrolyzed in the liver to its active form. Peak serum levels of active drug occur 1 to 2 hours after oral administration; excretion is primarily via the biliary tract.
Use:Supply of amino acids, nutrition and water
Contraindication:Hypersensitivity to those components, hepatic coma, renal insufficiency.
Adverse effect:Fever, flushing, allergic reaction, convulsion, hypotension, thrombosis.
Usual dosage:500-1000ml/day; IV infusion rate: 150ml/hr.
Use:Aminopoly H, a branch chain amino acid is used in parenteral nutrition. It is used in patient with hepatic encephalopathy. But this type of therapy is controversial.
Contraindication:Anuria, congenital defect in metabolism of branch chain amino acids: maple syrup urie disease, isovaleric acidemia.
Adverse effect:BUN imbalance, diluted hypocalcemia, fever, thrombophlebitis.
Usual dosage:500ml mixed with 50% dextrose 80ml through central vein infusion.
Miscellaneous
ALFA-CALCIDOL B
Supply:0.25mcg/Cap(ALFACALCIDOLR), 0.5mcg/Tab(LONPRYLR)
Use:1a-hydroxyvitamin D3 is and analog of vitamin D. It can be used in familial hypophosphatemia, hypoparathyroidism, and vitamin D resistant rickets. It is also effective in chronic renal failure patients.
Contraindication:Hypersensitivity, and evidence of vitamin D toxicity or hypercalcemia .
Adverse effect:Execessive doses will result in hypercalcemia or hypercalciuria.
Usual dosage: 0.5 to 1.0mg/day.
CLODRONATE
Supply:60mg/ml 5ml/Amp(BONEFOSR)
Use:Clodronate is effective in the treatment of cancer-related hypercalcemia, Paget's disease, hyperparathyroidism, and osteolytic bone metastases.
Contraindication:Previous hypersensitivity to clodronate.
Adverse effect:Gastrointestinal disturbances are the primary adverse effects following oral doses; hypocalcemia, nephrotoxicity, leukemia has been observed rarely, unlike etidronate, clodronate does not impair the mineralization of bone.
Usual dosage:Doses of 300mg IV daily for 5 consecutive days (infused over at least 2 hours) or 800 to 3200mg/day PO are usually indicated in the treatment of cancer-associated hypercalcemia; in Paget's disease, oral doses of 800 to 1600mg/day have been effective.
Administration: Diluted in 500ml of NS and given as an IV infusion over a minimum of 2 hours (generally 2-3 hours), to minimize the risk of renal toxicity
RALOXIFENE
Supply:60mg/Tab(EVISTAR)
Use:Treatment & prevention of osterporosis in postmenopausal women.
Contraindication:Pregnancy & lactation, women with child bearing potential; active or history of venous thromboembolic events; severe hepatic impairment.
Adverse effect:Hot flushes, leg cramps, peripheral edema, venous thromboembolic events
Usual dosage:1 tab daily
CALCITONINA SALMMON C
Supply:1400IU/ml(CALCITONAINA SPRAY NASALE ARMOURR),
50IU/Amp(STEOCINR)
Use:Postmenopausal osteoporosis, Paget's disease of bone, hypercalcemia
Contraindication:Pregnancy. Lactation. Chronic rhinitis.
Adverse effect:Nausea; flushing(transient); occasionally, hypersensitivity.
Usual dosage:100 IU daily
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