Supply:50mg/Tab(GLUCOBAYR)
Use:Acarbose is an inhibitor of intestinal a-glucosidases. It is indicated as monotherapy or in combination with sulfonylureas for treating patients with non-insulin dependent diabetes mellitus.
Place in therapy: It acts via competitive inhibition of a-glucosidases which delays absorption of monosaccharides and reduces post-prandial blood glucose.
Contraindication:1.Hypersensitivity. 2.Diabetic ketoacidosis. 3. Cirrhosis. 4.Digestive diseases associated with marked problems in absorption or digestion. 5.Conditions which may worsen as a result of increased intestinal gas. 6.Partial bowel obstruction or predisposition to bowel obstruction. 7.Inflammatory bowel disease. 8.Colon ulcerations.
Adverse effect:GI disturbances include flatulence, meteorism, abdominal pain and distention, diarrhea, and borborygmi are the main adverse effects. Isolated cases of elevated liver enzymes have been reported.
Usual dosage:Initial 25 mg TID with meal, maintenance dose 50-100 mg TID
Pharmacokinetics: Approximately 0.7 to 2% is absorbed from GI tract. Acarbose is not metabolized systemically, but it may be degraded by the influence of intestinal bacteria and the degradation products are absorbed.
GLIBENCLAMIDE C
Supply:5mg/Tab(GLIBENR)
Use:Mild or moderately severe uncomplicated non-insulin dependent diabetes mellitus.
Contraindication:Patients complicated by fever, trauma or gangrene, and with impaired renal or hepatic functions or serious impairment of thyroid or adrenal function, insulin-dependent diabetes mellitus.
Adverse effect:GI disturbances, dizziness, jaundice, skin rashes and blood disorders.
Usual dosage:Initial dose 5mg/day, may be gradually increased if necessary, up to 20mg daily.
GLICLAZIDE
Supply:80mg/Tab(DIAMICRONR, GLIZIDER)
Use:All types of maturity onset diabetes.
Contraindication:Patients complicated by fever, trauma or gangrene, and with impaired renal or hepatic functions or serious impairment of thyroid or adrenal function, insulin-dependent diabetes mellitus.
Adverse effect:Skin reaction, headache, GI disturbances.
Usual dosage:Initial dose 40-80mg/day, gradually increased if necessary up to 320mg/day.
GLIPIZIDE
Supply:5mg/Tab(MINIDIABR)
Use:Non-insulin dependent diabetes mellitus (Type II) patients whose hyperglycemia cannot be controlled by diet alone.
Contraindication:Patients complicated by fever, trauma or gangrene, and with impaired renal or hepatic functions or serious impairment of thyroid or adrenal function, insulin-dependent diabetes mellitus.
Adverse effect:Nausea, anorexia, vomiting, pyrosis, gastralgia, diarrhea, constipation, allergic skin reaction, dizziness, drowsiness, headache.
Usual dosage:PO 2.5mg to 20mg QD, administered approximately 30 minutes before meals; maximum dose: 40mg/day
GUAR GUM
Supply:5gm/Sachet(GUAREM GRANULESR)
Use:Listed in dosage
Contraindication:Patients with esophageal or intestinal obststion
Adverse effect:GI disturbances
Usual dosage:Diabetes 1 sachet tid with meals. Hypercholesterolemia 1 sachet 2-5 times
METFORMIN HCL
Supply:250mg/F.C.Tab(GLUCOMINR), 500mg/F.C.Tab(GLUCOFITR, GLUBINR, GLUCOMINR), 500mg/Tab(GLUCOPHAGER), 850mg/Tab(METFORMINR)
Use:May be used as insulin or sulfonylurea replacement or supplement in severe as well as mild adult diabetes. Because of toxicity (lactacidosis) use severely restricted.
Contraindication:Diabetic coma and ketoacidosis; renal impairment; chronic liver disease; cardiac failure & recent MI; alcoholism; hypoxemia; history of lactic acidosis; hypersensitivity; shock.
Adverse effect:GI disturbances, skin rash, and lactacidosis.
Usual dosage:0.75-1.5g daily.
Special precautions:Pregnancy, lactation, stop therapy 2-3 days before surgery, conditions which may cause dehydration, patients with serious infection or trauma. Regular renal monitoring is needed
Insulins
INSULIN(RECOMBINANT DNA) B
Supply:Human NPH insulin 100 IU/ml, 10 ml/Vial;
Human RI 100 IU/ml, 10 ml/Vial
MIXTARD Humulin 70/30 Inj 100U/ml, 10ml/Vial, 70% Human insulin isophans, 30% Human insulin
Use:Treatment of insulin-dependent diabetic patients.
Contraindication:Hypoglycemia.
Adverse effect:Lipodystrophy, insulin resistance and hypersensitivity reaction have rarely been reported.
Usual dosage:1. Humulin R: SC, IM, IV; onset of action occurs at approximately 30 minutes with a duration of 5 to 7 hours and peak activity at 1 to 3 hours.
2. Humulin N: SC, IM; onset of action occurs at approximately 1 hour with a duration of 18 to 20 hours and peak activity at 2 to 8 hours may be given as a single dose before breakfast.
Special precautions:Psychic stress, infection or other disease that increase insulin requirement. Pregancy.
Thyroid hormones
THYROXIN SOD. B
Supply:100mcg/Tab(ELTROXINR)
Use:Hypothyroidism.
Contraindication:Thyrotoxicosis.
Adverse effect:Anginal pain, cardiac arrhythmia, tachycardia, diarrhea, flushing, sweating, and muscular weakness.
Usual dosage:50-300mg/day.
Special precautions:Elderly; those with myocardial insufficiency or ECG evidence of MI; diabetes mellitus or insipidus. Initiate corticosteroid therapy befors giving thyroxine to patients with panhypopituitarism or other cause predisposing to adrenal insufficiency, pregnancy, lactation.
Antithyroid drugs
CARBIMAZOLE
Supply:10mg/Tab(NEWMAZOLER)
Use:Hyperthyroidism.
Contraindication:Patient in treated with radioactive iodine.
Adverse effect:Headache, rash, and GI upsets.
Usual dosage:5-10mg TID or QID.
METHIMAZOLE D
Supply:5mg/Tab(TAPAZOLER)
Use:Treatment of hyperthyroidism
Contraindication:Pregnancy & lactation
Adverse effect:Skin rash, urticaria, nausea, vomiting, epigastric distress, hair loss, myalgia, edema, janudice, sialadenopathy, lymphadenopathy & much less frequency of inhibition of myelopoiesis.
Usual dosage:Adult Mild hyperthyroidism 15 mg daily in 3 divided doses 8 hrly. Maintenance: 5-15 mg daily
Special precautions:Agranulocytosis
PROPYLTHIOURACIL D
Supply:50mg/Tab(PROCILR)
Use:Hyperthyroidism
Contraindication:Patients with hypersensitive to the drug.
Adverse effect:Skin disorder, agranulocytosis, thrombocytopenia, jaundice, edema.
Usual dosage:Initial 50-100mg TID, maintenance 100-150mg TID.
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