Supply:5MG/E.C.TAB(DULCOLAXR)
Use:All type of functional constipation, preparation for surgery and some intestinal examination.
Contraindication:Acute abdominal pain or cramps, intestinal obstruction.
Adverse effect:Severe abdominal cramps, irritation, excessive purgation.
Usual dosage:PO 2-3 Tabs HS.
Special precautions:Child; pregnancy.
LACTULOSE
Supply:667MG/ML 300ML(DUPHALAC LIQUIDR)
Use:Constipation, hepatic encephalopathy.
Contraindication:Patients on a galactose-free diets, with intestinal obstruction, abdominal pain, nausea, or vomiting.
Adverse effect:Nausea, diarrhea, flatulence, hypernatraemia.
Usual dosage:Constipation: Adult, 15ml BID, Child(5-10 yr.), 10ml BID; Child(less than 5 yr.), 5ml BID; Infant, 2.5ml BID. Hepatic encephalopathy: 30-50ml TID.
PSYLLIUM HYDROPHILIC MUCILLOID
Supply:1GM/PG(KONSYLR)
Use:Treatment of constipation or non-specific diarrhea.
Usual dosage:Adult 1 sachet 1-3 times daily. Child greater than or equal to 6 yr 1/2 the adult dose or less.
*NORMACOL PLUS GRANULES 7GM GR.
Content:STERCULIA 62%, FRANGULA 8%
Use:Treatment of constipation, particularly hypotonic or slow transit constipation resistant to bulk alone .The initiation and maintenance of bowel action after rectal surgery and after haemorrhoitectomy
Contraindication:Intestinal obstruction, fecal impaction, and total atony of the colon.
Adverse effect:Abdominal distention. Intestinal obstruction is possible if the product is taken in overdosage or is not adequately washed down with fluid.
Usual dosage:Adults : 1 or 2 sachets once or twice daily after meals. Child(6-12 years):A reduced amount may be given at the discretion of the physician.
Special precautions:Ulcerative colitis. Not to be taken immediately before retiring. Adequate fluid intake required. Not to be taken for > 4 days if there has been no movement of the bowels.
Digestants
LACTOBACTERIA
Supply:BIOFERMINR
Use:ional intestinal disorder and nutritional disturbance in children. Nonspecific ingestion & nonspecific enteritis with diarrhea, funct
Usual dosage:1-3 Tabs TID with meal
PANZYNORM
Supply:PANZYNORMR
Use:Deficient enzymatic secretion of the pancreas, stomach and intestine digestive disturbance with putrefactive and fermentative process, enteritis, gastritis, disease of gallbladder and liver.
Contraindication:Hypersensitivity to any component, biliary obstruction.
Adverse effect:Slight stool looseness or nausea.
Usual dosage:1-2 Tabs TID with meal. Don't crush or chew.
Content:Policresulen 100mg, cinchocaine hydrochloride 2.5mg
Use:Hemorrhoids esp those associated with inflammatory conditions; anal fissures & rhagades; anal pruritus & eczema; wound treatment following proctologic surgery.
Adverse effect:Mild local discomfort
Usual dosage:1 supp bid-tid after defecation; maintenance:1 supp daily
XYLMOL B
Content:each gm of Lidocaine 50mg, Aluminal acetate 35mg,
Zinc Oxide 180mg, hydrocortisone acetate 2.75mg
Use:Hemorrhoids, anal rhagades & inflammatory conditions, perianal abscess, proctoptosis.
Usual dosage:Insert 1 supp in the morning, evening & after evacuation
Miscellaneous
CISAPRIDE C
Supply:5,10mg/Tab(AsamoxR), 5mg/Tab(CisaR), 5mg/Tab(Cisap)
Use:Treatment of nocturnal symptoms of gastroesophageal reflux disease (GERD), also demonstrated effectiveness for gastroparesis, refractory constipation, and nonulcer dyspepsia
Contraindication:Hypersensitivity, and cases as gastrointestinal hemorrhage, obstruction, and perforation
Adverse effect:Abdominal cramps, dyspepsia, epigastric pain, flatulence, diarrhea, nausea, and dry mouth, dizziness, and sleep disturbances.
Usual dosage:Initial: 10mg 4 times/day at least 15 minutes befor mealss and at bedtime; in some patients the dosage will need to be increased to 20 mg to obtain a satisfactory result
Mechanism: Enhances the release of acetylcholine at the myenteric plexus. In vitro studies have shown cisapride to have serotonin-4 receptor agonistic properties which may increase gastrointestinal motility and cardiac rate; increase lower esophageal sphincter pressure and lower esophageal peristalsis; accelerates gastric emptying of both liquids and soilds
METOCLOPRAMIDE B
Supply:10mg/2ml/Amp(PRIMPERANR), 5mg/Tab(PRIPRAMR, PASPERTASER)
Use:Symptomatic treatment of diabetic gastric stasis, gastroesophageal reflux. Stimulate gastric emptying, significant relief of nausea, vomiting, anorexia & abdominal fullness, prevention of cancer chemotherapy-induced emesis
Contraindication:GI hemorrhage, mechanical obstruction or perforation, pheochromocytoma, current use of MAO inhibitors, tricyclic antidepressants or sympathomimetic drug cause extrapyramidal reaction
Adverse effect:Constipation, diarrhea, drowsiness, lassitude, extrapyramidal reaction, galactorrhea, dizziness, anxiety, periorbital oedema & skin rash.
Usual dosage: PO 5-10mg TID-QID AC, maximum dose: 0.5mg/kg.
For the prevention of cancer chemotherapy-induced emesis, IV infusion 2mg/kg is given initially 30 minutes before administration of a highly emetogenic drug and repeated twice at 2 hour intervals following the initial dose.
Patient information:May impair mental altertness or physical coordination; avoid alcohol, barbiturates or other CNS depressants; take 30 minutes before 30 minutes before meals; notify physician if involuntary movements occur
Mechanism: Blacks dopamine receptors in chemoreceptor trigger zone of the CNS; enhances the response to acetylcholin of tissue in upper GI tract causing enhances motility and accelerated gastric emptying without stimulating gastric, biliary, or pancreatic secretions
Proton pump inhibitor
OMEPRAZOLE C
Supply:20MG/CAP(LOSECR), 40MG/AMP(OMEZOLLYOR, LOSECR)
Use:Omeprazole suppresses gastric acid secretion by binding to the proton pump of the parietal cell.
Contraindication:Hypersensitivity; symptomatic response to omeprazole therapy does not preclude the presence of gastric malignancy.
Adverse effect:It is well tolerated but elevations of liver enzymes have been reported in patients with pre-existing liver disease. Long-term safety has not been established. In most cases drug therapy should be limited to short-term (less than 8 weeks) treatment.
Usual dosage:Duodenal, gastric, jejunal or esophageal ulcers: 20-30mg QD; 2 to 4 weeks for duodenal ulcers, 4-8 weeks for gastric ulcers or duodenal ulcer's patients who smoke.
Special precautions:Exclude malignancy if gastric ulcer is suspected.
PANTOPRAZOLE
Supply:40MG/ GASTRO-RESISTANT TAB(PANTOLOC R)
Use:Pantoprazole is a proton pump inhibitor. Gastric and duodenal ulcers, moderate and severe reflux esophagitis; acute treatment only, not indicated for maintenance therapy.
Place in therapy: Pantoprazole is a potent inhibitor of gastric acid secretion. Animal and in vitro studies have demonstrated it to be comparable to or more potent than omeprazole, with less potential for interactions with P450 cytochromes and better acid stability.
Contraindication:Hypersensitivity to pantoprazole; Severe hepatic insufficiency; Cirrhosis
Adverse effect:headache (1.3%), diarrhea (1.5%), dizziness (0.7%), pruritis (0.5%), and asthenia (0.3%)
Usual dosage:Adults: gastric ulcer, duodenal ulcer and reflux esophagitis: 40 mg PO QD; Dosage reductions are not necessary for patients with renal insufficiency or on dialysis; the maximum daily dose: 40 milligrams.
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