Category: Generics

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Telmisartan Tablet | An Angiotensin Receptor Blocker

telmisartan, town pharmacy, angiotensin II receptor

Introduction
Telmisartan available under the brand names of Telsarta, Misar, Talam etc. is a prescription drug used to treat high blood pressure (hypertension). It is an angiotensin receptor blocker (ARB) that works by blocking the action of a hormone called angiotensin II, which constricts blood vessels and raises blood pressure. Telmisartan is available in tablet form and is commonly marketed under the brand name Micardis.

In this article, we will discuss the uses, machanism of action, dosage, side effects, precautions, and interactions of Telmisartan tablets.

Mechanism of action
Telmisartan binds reversibly and selectively to the receptors in vascular smooth muscle and the adrenal gland, interfering with the binding of angiotensin II to the angiotensin II AT1-receptor. Blocking the effects of angiotensin II lowers systemic vascular resistance because it is a vasoconstrictor that also increases aldosterone synthesis and release. The angiotensin converting enzyme, other hormone receptors, or ion channels are not inhibited by telmisartan.5 Additionally, studies indicate that telmisartan is a partial agonist of PPAR, a known target for anti-diabetic medications. This shows that telmisartan can reduce insulin resistance and enhance carbohydrate and lipid metabolism without having the negative effects of complete PPAR activators.

Uses
Telmisartan is primarily used to treat hypertension. It can be used alone or in combination with other drugs, such as diuretics, to lower blood pressure. Lowering blood pressure can help reduce the risk of strokes, heart attacks, and kidney problems.

In addition to treating hypertension, Telmisartan may also be used to treat other conditions, such as heart failure and diabetic kidney disease. It may also help reduce the risk of cardiovascular events in patients with a high risk of developing them.

Dosage
Telmisartan tablets come in various strengths, including 20mg, 40mg, and 80mg. The recommended dosage of Telmisartan varies depending on the patient’s age, medical history, and the severity of their condition.

For adults with hypertension, the usual starting dose is 40mg once daily. The dosage may be increased to 80mg once daily, depending on the patient’s response to the drug. If the patient’s blood pressure is not adequately controlled with Telmisartan alone, a diuretic may be added to the treatment.

For patients with heart failure, the recommended starting dose is usually 40mg once daily. The dose may be increased to 80mg once daily, depending on the patient’s response to the drug.

For patients with diabetic kidney disease, the recommended starting dose is usually 80mg once daily.

It is important to follow your doctor’s instructions regarding the dosage and administration of Telmisartan tablets. Do not increase or decrease your dosage without consulting your doctor.

Side Effects
Like all medications, Telmisartan may cause side effects in some patients. Common side effects of Telmisartan include:

  • Dizziness
  • Headache
  • Fatigue
  • Diarrhea
  • Nausea
  • Upper respiratory tract infections

These side effects are usually mild and go away on their own after a few days or weeks. However, if these side effects persist or worsen, contact your doctor.

In rare cases, Telmisartan may cause more serious side effects, such as:

  • Allergic reactions, such as rash, itching, or swelling of the face, lips, tongue, or throat
  • Severe dizziness or fainting
  • Jaundice (yellowing of the skin or eyes)
  • Kidney problems, such as decreased urine output or swelling of the feet or ankles
  • Liver problems, such as abdominal pain, nausea, or jaundice
  • Vision problems, such as blurred vision or loss of vision in one or both eyes

If you experience any of these side effects, seek medical attention immediately.

Precautions
Before taking Telmisartan tablets, inform your doctor if you have any of the following conditions:

  • Kidney disease
  • Liver disease
  • Heart disease
  • High levels of potassium in your blood
  • Dehydration or low blood volume
  • Pregnancy or breastfeeding

Telmisartan may not be suitable for some patients with these conditions, or the dosage may need to be adjusted.

Telmisartan may also interact with other medications, including:

  • Other blood pressure medications
  • Potassium supplements or salt substitutes containing potassium
  • Nonsteroidal anti-inflammatory drugs (NSA
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Lithium
  • Diuretics
  • Antidiabetic medications

It is important to inform your doctor of all medications you are taking, including prescription drugs, over-the-counter medications, and herbal supplements.

Telmisartan may also cause dizziness, especially when standing up quickly from a sitting or lying position. To avoid falls or injuries, get up slowly and steady yourself before standing.

Alcohol may also worsen the side effects of Telmisartan, such as dizziness or lightheadedness. It is recommended to limit alcohol consumption while taking this medication.

Pregnant women should avoid taking Telmisartan as it may harm the developing fetus. It is important to inform your doctor if you become pregnant while taking Telmisartan. It is also not recommended to breastfeed while taking Telmisartan, as it may pass into breast milk and harm the nursing infant.

Interactions

Telmisartan may interact with other medications, including prescription drugs, over-the-counter medications, and herbal supplements. It is important to inform your doctor of all medications you are taking, including:

  • Other blood pressure medications, such as ACE inhibitors or beta-blockers
  • Potassium supplements or salt substitutes containing potassium
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Lithium
  • Diuretics
  • Antidiabetic medications

These medications may interact with Telmisartan, increasing the risk of side effects or reducing the effectiveness of the medication. Your doctor may need to adjust your dosage or recommend an alternative medication.

Conclusion

Telmisartan is a prescription medication used to treat hypertension, heart failure, and diabetic kidney disease. It is an angiotensin receptor blocker that works by blocking the action of a hormone called angiotensin II, which constricts blood vessels and raises blood pressure.

Telmisartan tablets come in various strengths, and the dosage depends on the patient’s age, medical history, and the severity of their condition. It is important to follow your doctor’s instructions regarding the dosage and administration of Telmisartan tablets.

Like all medications, Telmisartan may cause side effects in some patients. Common side effects include dizziness, headache, fatigue, diarrhea, nausea, and upper respiratory tract infections. In rare cases, Telmisartan may cause more serious side effects, such as allergic reactions, severe dizziness or fainting, liver or kidney problems, and vision problems.

Before taking Telmisartan, inform your doctor if you have any medical conditions or are taking any medications. Telmisartan may interact with other medications, increasing the risk of side effects or reducing the effectiveness of the medication.

Overall, Telmisartan is an effective medication for treating hypertension and related conditions. However, it is important to follow your doctor’s instructions and report any side effects or concerns.

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Nebivolol | A Novel Beta Blocker

Town Pharmacy, nebivolol a novel beta blocker

Introduction
Nebivolol a novel beta blocker, available under the brand names of Nebil, Nebix and Byvas etc.  is more selective for beta1-adrenergic receptors than other drugs in this class and has a unique, not found in other beta-blockers now available to doctors, nitric oxide (NO)-potentiating, vasodilatory effect.

Nebivolol is a medication primarily used to treat hypertension (high blood pressure) and certain heart conditions. As a beta-blocker, it works by blocking the effects of adrenaline on the heart and blood vessels, resulting in decreased heart rate and relaxed blood vessels. In this blog post, we will delve into the details of nebivolol, exploring its uses, benefits, and potential side effects.

Definition and mechanism of action
Although the precise method by which beta-blockers lower blood pressure is not fully understood, possible processes include a heart-rate-related effect, suppression of the sympathetic nervous system, and inhibition of the renin-angiotensin system. A brand-new, highly selective beta-blocker with nonadrenergic vasodilating qualities is nebivolol. In Europe, it has been licenced for the treatment of congestive heart failure and essential hypertension, while the US is now reviewing it for the management of hypertension.

How it differs from other beta-blockers
According to clinical studies, nebivolol is ten times more effective than atenolol when compared on a weight-for-weight basis. In one study, using a double-blind, crossover design and a parallel, placebo group (n=7), the effects of doses of nebivolol (2.5 mg/day, 5.0 mg/day, and 10.0 mg/day) on exercise-induced increases in heart rate and blood pressure in 25 male hypertensive volunteers were compared with those of atenolol (50 mg/day and 100 mg/day) and of placebo. Nebivolol and atenolol both reduced heart rates (at rest and during submaximal activity) and sitting and standing diastolic and systolic blood pressures to the same extent at 24 hours following dose.

Approved medical conditions for nebivolol usage

Managing Hypertension with Nebivolol
Nebivolol as a first-line treatment for hypertension
Dosage and administration guidelines
Efficacy of nebivolol compared to other antihypertensive drugs
Nebivolol’s role in reducing cardiovascular events and mortality

Nebivolol for Heart Failure
Nebivolol’s unique properties for heart failure management
How nebivolol improves symptoms and quality of life in heart failure patients
Considerations and precautions when using nebivolol in heart failure patients

Potential Benefits Beyond Hypertension and Heart Failure
Exploring nebivolol’s role in endothelial dysfunction and vascular health
Nebivolol’s impact on nitric oxide production and vasodilation
Research on nebivolol’s potential for treating erectile dysfunction

Safety Profile and Side Effects
Common side effects of nebivolol and how to manage them
Rare but serious side effects and their associated risks
Precautions for specific patient populations (e.g., elderly, pregnant women, those with liver or kidney disease)

Drug Interactions and Contraindications
Medications that may interact with nebivolol
Contraindications and precautions for concurrent use of nebivolol with other drugs
Importance of consulting a healthcare professional before starting nebivolol

Patient Guidelines and Considerations
Recommendations for patients taking nebivolol
Importance of regular monitoring and follow-up appointments
Lifestyle modifications to complement nebivolol therapy (e.g., diet, exercise, stress management)

Recent studies on nebivolol’s effects on arterial stiffness and endothelial function
Potential role of nebivolol in reducing inflammation and oxidative stress
Emerging research on nebivolol’s impact on neuroprotection and cognitive function
Investigating the use of nebivolol in combination with other drugs for enhanced therapeutic outcomes

Comparing Nebivolol to Other Beta-Blockers
Differentiating nebivolol from other commonly used beta-blockers
Comparative efficacy, safety, and side effect profiles
Factors to consider when choosing between nebivolol and other beta-blockers for specific patient populations

Nebivolol in Special Populations
Nebivolol usage in the elderly population: benefits and considerations
Nebivolol safety and effectiveness in pregnant and breastfeeding women
Adjusting nebivolol dosage in patients with impaired liver or kidney function
Nebivolol use in pediatric patients: current evidence and potential applications

Personal Experiences and Testimonials
Real-life stories and experiences from patients using nebivolol
Insights into the impact of nebivolol on their daily lives and overall well-being
Patient perspectives on managing side effects and adhering to nebivolol therapy

Can nebivolol be used for anxiety or migraines?
What should I do if I miss a dose of nebivolol?
Can nebivolol cause weight gain?
Is nebivolol safe for long-term use?

Conclusion
Nebivolol is a valuable medication used in the management of hypertension, heart failure, and potentially other conditions. Its unique mechanism of action and favorable safety profile make it a popular choice among healthcare professionals. However, like any medication, nebivolol has potential side effects and interactions that should be considered. It is important for patients to work closely with their healthcare providers to determine the appropriate dosage, monitor for adverse effects, and optimize its benefits. By understanding nebivolol’s uses, benefits, and precautions, patients can make informed decisions and enhance their overall cardiovascular health.
Recap of key points discussed throughout the blog post
Encouragement for readers to consult healthcare professionals for personalized advice
Acknowledgment of nebivolol’s significant contribution to the field of cardiovascular medicine
Hope for continued research and advancements in the understanding of nebivolol’s benefits and potential applications
By expanding on these additional sections, the blog post will provide a more comprehensive overview of nebivolol, covering its latest research, comparisons with other beta-blockers, considerations for special populations, and real-life experiences from patients. This well-rounded perspective will equip readers with a deeper understanding of nebivolol’s uses, benefits, and potential implications for their cardiovascular health.

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Cephradine | A Cephalosporin Antibiotic

cephradine,velosef, town pharmacy

Cephradine is a cephalosporin antibiotic that is used to treat various bacterial infections. It is available in capsule form, and is also known by its brand name, Velosef. Cefradine capsules are prescribed by doctors to treat a wide range of bacterial infections, including respiratory tract infections, skin and soft tissue infections, urinary tract infections, and more.

The active ingredient in cefradine capsules is cefradine, which belongs to the cephalosporin class of antibiotics. Cephalosporins work by interfering with the bacteria’s ability to form a cell wall, ultimately leading to the bacteria’s death.

Cefradine capsules are typically taken orally, with or without food, and the dosage and duration of treatment will vary depending on the severity of the infection and the patient’s medical history. It is important to follow the instructions provided by your doctor or pharmacist and to complete the full course of treatment, even if symptoms improve before the end of the treatment period.

It is also important to let your doctor or pharmacist know if you are taking any other medications or have any underlying medical conditions before starting treatment with cefradine capsules. Some medications, such as antacids, can interfere with the absorption of cefradine and reduce its effectiveness.

In addition to its use in treating bacterial infections, cefradine capsules are also used for prophylaxis (prevention) of infection in certain surgical procedures, such as dental extractions or tonsillectomies. In these cases, cefradine capsules are typically taken before the procedure to prevent infection.

Cefradine capsules are available by prescription only and should only be taken under the supervision of a healthcare professional. If you have any questions or concerns about cefradine capsules or their use, you should speak to your doctor or pharmacist.

Mechanism of Action

Cefradine is a beta-lactam antibiotic that works by inhibiting bacterial cell wall synthesis. It does this by binding to specific enzymes called penicillin-binding proteins (PBPs) that are involved in the cross-linking of peptidoglycan in the bacterial cell wall. This leads to the inhibition of bacterial cell wall synthesis and ultimately the death of the bacteria.

Cefradine is effective against a wide range of gram-positive and gram-negative bacteria, including Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, and Klebsiella pneumoniae.

Clinical Efficacy

Cefradine has been shown to be effective in treating a variety of bacterial infections in clinical trials. In a study of patients with community-acquired pneumonia, cefradine was found to be as effective as amoxicillin in achieving clinical cure rates.

Cefradine has also been shown to be effective in treating urinary tract infections. In a study of patients with uncomplicated urinary tract infections, cefradine was found to be as effective as trimethoprim-sulfamethoxazole in achieving clinical cure rates.

Cefradine has been used successfully in the treatment of skin and soft tissue infections. In a study of patients with cellulitis, cefradine was found to be as effective as erythromycin in achieving clinical cure rates.

Adverse Effects

As with all antibiotics, cefradine can cause side effects in some patients. The most common side effects reported in clinical trials include gastrointestinal disturbances, such as nausea, vomiting, and diarrhea. Other less common side effects include allergic reactions, such as rash and hives, and hypersensitivity reactions, such as anaphylaxis.

Cefradine may also cause a variety of other adverse effects, including headache, dizziness, and skin rashes. In rare cases, cefradine may cause serious adverse effects, such as pseudomembranous colitis, a severe and potentially life-threatening inflammation of the colon.

Drug Interactions

Cefradine may interact with other medications and drugs, including other antibiotics, anticoagulants, and probenecid. Patients should inform their healthcare provider of all medications they are currently taking before starting treatment with cefradine.

Contraindications

Cefradine is contraindicated in patients who have a history of hypersensitivity reactions to cephalosporin antibiotics or any of the ingredients in the medication. It should also be used with caution in patients with a history of liver disease or renal impairment.

Pregnancy and Lactation

Cefradine is classified as a category B medication by the U.S. Food and Drug Administration (FDA), which means that it has not been shown to cause harm to a developing fetus in animal studies. However, there have been no well-controlled studies of cefradine in pregnant women, and it should only be used during pregnancy if the potential benefits outweigh the potential risks to the fetus.

Cefradine is excreted in human milk and may cause adverse effects in nursing infants

In conclusion, cefradine capsules are a commonly prescribed antibiotic used to treat bacterial infections. They work by interfering with the bacteria’s ability to form a cell wall, ultimately leading to the bacteria’s death. Cefradine capsules are generally safe and effective for most people, but there are some situations in which they may not be suitable. If you have any questions or concerns about cefradine capsules or their use, you should speak to your doctor or pharmacist.

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Secnidazole | Nitroimidazole | An Antibacterial and Antiprotozoal Agent

secnidazole,secnidal,dyson, town pharmacy

Introduction:

Secnidazole avaiable under the brand name of Secnidal, Dysen is an antibacterial and antiprotozoal agent used for treating bacterial and protozoal infections. It belongs to the nitroimidazole group of drugs, which work by inhibiting the growth and replication of bacteria and protozoa. This drug is available in the form of tablets and is prescribed by doctors for the treatment of a wide range of infections.

In this article, we will discuss the uses, side effects, dosage, precautions, and interactions of Secnidazole tablets.

Uses:

Secnidazole tablets are mainly used for the treatment of bacterial and protozoal infections such as:

Bacterial vaginosis: This is a common vaginal infection caused by an overgrowth of bacteria in the vagina. Symptoms include a fishy odor, vaginal discharge, and itching.

Trichomoniasis: This is a sexually transmitted infection caused by a parasite called Trichomonas vaginalis. Symptoms include vaginal discharge, itching, and pain during sex.

Giardiasis: This is an intestinal infection caused by a parasite called Giardia lamblia. Symptoms include diarrhea, stomach pain, and nausea.

Amoebiasis: This is an intestinal infection caused by a parasite called Entamoeba histolytica. Symptoms include diarrhea, stomach pain, and fever.

Secnidazole tablets are also used for the treatment of other infections caused by anaerobic bacteria, such as dental infections, skin infections, and respiratory tract infections.

Side Effects:

Like all drugs, Secnidazole tablets may cause side effects. The most common side effects include:

Nausea
Headache
Dizziness
Diarrhea
Abdominal pain
Vomiting
If any of these side effects persist or worsen, you should contact your doctor immediately.

Less common but more severe side effects of Secnidazole tablets include:

Allergic reactions such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
Seizures or convulsions
Neuropathy
Peripheral neuropathy
Leukopenia
Stevens-Johnson Syndrome
If you experience any of these symptoms, you should seek medical attention immediately.

Dosage:

The dosage of Secnidazole tablets depends on the type and severity of the infection. It is important to take the tablets exactly as prescribed by your doctor. Do not take more or less than the recommended dose.

For the treatment of bacterial vaginosis, the usual dosage is one 2-gram tablet of Secnidazole taken orally once daily for 2 days.

For the treatment of trichomoniasis, the usual dosage is one 2-gram tablet of Secnidazole taken orally as a single dose.

For the treatment of giardiasis, the usual dosage is one 2-gram tablet of Secnidazole taken orally once daily for 3 days.

For the treatment of amoebiasis, the usual dosage is one 2-gram tablet of Secnidazole taken orally once daily for 3 days.

Precautions:

Before taking Secnidazole tablets, it is important to inform your doctor if you have any medical conditions or allergies. You should also inform your doctor of any other medications or supplements you are taking.

Secnidazole tablets may not be suitable for everyone, and your doctor may need to adjust the dosage or prescribe an alternative medication if you have:

A history of allergic reactions to nitroimidazole drugs
Blood disorders
Liver disease
Kidney disease
Seizures or epilepsy
Secnidazole tablets should not be taken during pregnancy or while breastfeeding.

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Ramipril | An ACE inhibitor

ramipril ramipace town pharmacy

Ramipril sold under the brand name of Ramipril, Tritace is a medication used to treat high blood pressure, heart failure, and to improve survival after a heart attack. It belongs to a group of medications called ACE inhibitors (angiotensin-converting enzyme inhibitors).

What is Ramipril?

Ramipril is an oral medication that is available in the form of a tablet. It is used to treat hypertension (high blood pressure), congestive heart failure, and to improve survival after a heart attack. Ramipril works by blocking the action of an enzyme called angiotensin-converting enzyme (ACE), which is responsible for the production of a hormone called angiotensin II. This hormone causes the blood vessels to narrow, which increases blood pressure. By blocking the action of ACE, Ramipril causes the blood vessels to relax, which lowers blood pressure.

Ramipril is sold under the brand name Altace and is available in several different strengths, ranging from 1.25 mg to 10 mg. It is usually taken once a day, with or without food.

Uses of Ramipril

Hypertension:
Ramipril is used to treat hypertension (high blood pressure). Hypertension is a condition where the blood pressure in the arteries is consistently high. This can cause damage to the blood vessels, the heart, and other organs. Ramipril works by relaxing the blood vessels, which lowers blood pressure.

Heart failure:
Ramipril is also used to treat congestive heart failure. Congestive heart failure is a condition where the heart is unable to pump blood effectively to the rest of the body. This can cause symptoms such as shortness of breath, fatigue, and swelling of the legs and ankles. Ramipril helps to reduce the workload on the heart, which can improve symptoms of heart failure.

Improving survival after a heart attack:
Ramipril is also used to improve survival after a heart attack. A heart attack occurs when the blood supply to the heart is blocked, which can cause damage to the heart muscle. Ramipril can help to reduce the risk of further heart attacks and improve survival after a heart attack.

Dosage of Ramipril

The dosage of Ramipril will depend on the condition being treated, the patient’s age, and other factors such as the patient’s kidney function. The usual starting dose for hypertension is 2.5 mg once a day, which may be increased to a maximum of 10 mg once a day if necessary. The usual starting dose for congestive heart failure is 2.5 mg once a day, which may be increased to a maximum of 10 mg once a day if necessary. The usual starting dose for improving survival after a heart attack is 2.5 mg twice a day, which may be increased to a maximum of 10 mg twice a day if necessary.

Ramipril should be taken at the same time each day, with or without food. It is important to follow the dosage instructions provided by your doctor and not to exceed the recommended dose.

Side effects of Ramipril

Like all medications, Ramipril can cause side effects. Some common side effects of Ramipril include:

Dizziness
Headache
Fatigue
Dry cough
Nausea
Vomiting
Diarrhea
Abdominal pain
Rash
These side effects are usually mild and go away on their own. However, if you experience any severe or persistent side effects, you should contact your doctor immediately.

In rare cases, Ramipril can cause more serious side effects, such as:

Swelling of the face, lips, tongue, or throat (which can be a sign of an allergic

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Propranolol | A Beta-Adrenergic Receptor Antagonist

propranolol inderal

 

IntroductionPropranolol, available under the brand name of Inderal is  a non-selective beta adrenergic antagonist is used to treat a variety of conditions, including hypertension, angina, atrial fibrillation, myocardial infarction, migraine, essential tremor, and hypertrophic subaortic stenosis.
PharmacodynamicsPropranolol belongs to a beta-adrenergic receptor antagonist is used to treat hypertension. Given once or twice daily, depending on the indication, propranolol has a long duration of action. Patients who quit taking propranolol abruptly risk worsening of their angina and myocardial infarctions.
The S(-)-enantiomer of propranolol, a racemic combination of two enantiomers, has roughly 100 times the binding affinity for beta adrenergic receptors than the R(-)-enantiomer. 9 The most prevalent illness for which propranolol is prescribed is hypertension.
Mode of ActionNonselective beta-adrenoreceptor antagonist Propranolol is also categorized as a class II antiarrhythmic. It responds by competitively blocking the heart’s normal epinephrine and norepinephrine-induced beta-1 and beta-2 adrenergic activation.

On cardiac myocytes, including the sinoatrial and atrioventricular nodes, there are beta-1 receptors. These receptors are activated, which results in an increase in cyclic AMP and an increase in intracellular calcium. Increased muscle fiber contractility results from this mechanism. Beta-adrenergic receptor blockade causes the heart’s overall workload to be reduced, which in turn lowers oxygen consumption and causes myocardial remodeling. [8]
On the other hand, beta-2 receptor activation results in an increase in cyclic AMP, which activates protein kinase A and causes smooth muscle cells in many organs and arteries to relax. Therefore, there is a slight vasoconstriction when beta-2 receptors are inhibited. Due to this action, it can be difficult for asthmatics to administer emergency epinephrine since it prevents epinephrine from potentially binding to pulmonary receptors. [9] Beta-blockers have a Vd of approximately 4 to 6 L/kg and are well distributed throughout the body. They are also highly protein-bound.

IndicationsHypertension can be treated with propranolol. Additionally, myocardial infarction, atrial fibrillation, migraine, essential tremor, hypertrophic subaortic stenosis, pheochromocytoma, and proliferating infantile hemangioma are all conditions for which propranolol is prescribed.
Availability & UsageBeta-blockers are processed mostly in the liver, like the majority of drugs ( both the active and inactive compounds). Due to first-pass metabolism in the hepatic circulation, only around 25% of the medicine consumed enters the systemic circulation.

Propranolol’s active metabolite, 4-hydroxypropranolol, is created via hydroxylation with the help of the CYP2D6 enzyme.
Additionally, propranolol, like the majority of ingested drugs, is primarily eliminated by the kidneys, having a half-life of between 3 and 6 hours in people with healthy renal systems.

You can administer propranolol intravenously or orally. Continuous ECG monitoring should be done while a gradual infusion is administered intravenously. This method of administration is most frequently used in inpatient settings.

The dosage of propranolol varies, mainly depending on the ailment it is used to treat.

Side EffectsBradycardia, gastrointestinal problems, abdominal pain, nausea, erectile dysfunction, and wheezing/bronchospasms are some of the most typical side effects of using propranolol. Use of propranolol may also result in weariness, drowsiness, and cold extremities. Hallucinations, insulin resistance, and allergic reactions are a few severe side effects to be aware of. Before writing a propranolol prescription for a patient, prescribers must go over all the side effects with them.
Drug Interation
(while taking with other medicine)
Important WarningIn some cases, propranolol may result in heart failure. If you experience chest pain or discomfort, dilated neck veins, intense exhaustion, erratic breathing, an irregular heartbeat, swelling of the face, fingers, feet, or lower legs, or weight gain, consult your doctor immediately once.
Available BrandsInderal

 

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Atenolol | A Second-Generation beta-1-selective adrenergic antagonist

 

IntroductionAtenolol, available under brand names of Tenormin, Blokium, Zafnol is Synthetic beta-1 selective blocker. Atenolol is used to treat hypertension, chronic angina, and to lower mortality in individuals with known or suspected myocardial infarction who are hemodynamically stable.
Class of MedicineAtenolol is a second-generation beta-1-selective adrenergic antagonist lowers myocardial contractility, blood pressure, and heart rate.
Mode of ActionBecause it selectively binds to the 1-adrenergic receptor as an antagonist up to a reported 26 fold more than 2 receptors, atenolol is a cardioselective beta-blocker. 15 Due to the greater population of this receptor in cardiac tissue, selective action at the 1 receptor results in cardioselectivity. Therapeutic doses can still cause some binding to 2 and potentially 3 receptors, but the effects caused by antagonising these receptors are greatly diminished compared to those caused by non-selective drugs. Due to the Gs coupling between the 1 and 2 receptors, inhibiting their activation decreases the activity of adenylyl cyclase and the downstream signalling that it produces via cyclic adenosine monophosphate and protein kinase A.
PKA is hypothesised to mediate the activation of ryanodine receptors and L-type calcium channels in cardiomyocytes by phosphorylating these proteins. The release of calcium from the sarcoplasmic reticulum (SR) and an increase in contractility can then be caused by the 16 L-type calcium channels, which can first cause an increase in intracellular calcium. By phosphorylating phospholamban, which in turn enhances the SR Ca2+ ATPase’s affinity to promote calcium reuptake into the SR, PKA also contributes to the termination of contraction. Additionally, it phophorylates troponin I to lessen the protein’s affinity for calcium. Both of these occurrences result in a contraction reduction, which when combined with the initial contraction increase, enables faster cycling and, as a result, a higher heart rate with increased contractility.
PKA is hypothesised to mediate the activation of L-type calcium channels and ryanodine receptors in cardiomyocytes by the phosphorylation of these proteins. The ryanodine receptors are then triggered to release calcium that has been held in the sarcoplasmic reticulum (SR), leading to enhanced contractility, after an initial spike in intracellular calcium is provided by 16 L-type calcium channels. The phosphorylation of phospholamban by PKA, which enhances the SR Ca2+ ATPase’s affinity to promote calcium absorption into the SR, contributes to the termination of contraction as well. In order to lessen troponin I’s affinity for calcium, it also phophorylates the protein. When combined with the initial rise in contraction, both of these occurrences result in a contraction reduction, enabling faster cycling and, as a result, a greater heart rate with increased contractility.
IndicationsA second-generation beta-1-selective adrenergic antagonist called atenolol is used to treat acute myocardial infarction, angina pectoris, and hypertension. Treatment of arrhythmias, migraine prevention, paroxysmal supraventricular tachycardia, alcohol withdrawal, thyrotoxicosis prevention, and prophylaxis against subsequent myocardial infarction are only a few of the non-FDA authorised uses. In cases of infantile hemangiomas, atenolol may also be used instead of propranolol, though further study is necessary before use.
Avaiability & UsageFor oral treatment, atenolol comes in 25 mg, 50 mg, and 100 mg tablets; 0.5 mg/mL is also available for intravenous injection. Depending on the indication, a different dosage and administration method is used.

Hypertension
Atenolol’s starting dose for adults is 50 mg per day, either either as a single tablet or along with diuretic medication. After a few weeks, if there hasn’t been a significant therapeutic response, the dosage may be increased to one 100 mg tablet taken once daily. Higher daily doses are unlikely to result in additional advantages.  If the patient has a creatinine clearance of less than 15 ml/min, a lower dose of 25 mg per day may be utilised for elderly or renally impaired patients. Before giving them a new dose, careful blood pressure monitoring is required.

Chronic chest pain
The initial adult dose for non-vasospastic angina is 50 mg once daily. One 100 mg pill should be used each day if, after a week, the patient has not had the best results. For the best therapeutic outcome, some patients could require 200 mg per day. The patient should be observed and told to reduce their physical activity during this period since withdrawal should be accomplished gradually. [

Myocardial Infarction Acute
Within 12 hours after the myocardial infarction, intravenous injection should take place as soon as the patient enters the hospital.

For instance, the FDA advises giving an adult a 5-minute IV atenolol injection followed by a 10-minute IV injection of another 5-mg dose. After 12 hours, an oral dose of 50 mg should be taken. Then, for the following 6 to 9 days or until the patient is discharged from the hospital, oral dose might be either 50 mg twice daily or 100 mg once daily.

Migraine Prevention
The initial adult dose is 25 mg once daily, which is increased to 100 mg once daily over the course of 1-2 weeks.

T-wave supraventricular rhythm
The first dose of atenolol for adults, as recommended by the ACC and AHA, is 25 to 50 mg per day, which is increased to 100 mg once daily based on tolerance and response.

Coronary infarction
Most patients should begin taking beta-blockers within 24 hours of their myocardial infarction, and they should continue taking them for secondary prophylaxis, gradually increasing their dose up to 50 mg twice day depending on their blood pressure, heart rate, and side effects.

Thyrotoxicosis
The initial dose is 25–50 mg once daily, which is increased as necessary to a maximum of 100 mg twice daily in order to treat tachycardia, palpitations, and trembling.

Employing in the Particular Patient Populations
Patients with hepatic impairment: The manufacturer’s labelling does not mention changing the dosage. Additionally, as was already mentioned, atenolol undergoes very little hepatic metabolism.
Patients with Impairment of Renal Function: Patients with impaired renal function should be watched closely, and the dose has to be changed in accordance with creatinine clearance.
No dose change is required if creatinine clearance is more than 30 mL/min.
Creatinine clearance 10–30 mL/min: 50 mg/day as the maximum dose.
Maximum dose up to 25 mg per day for creatinine clearance 10 mL/minute.
Those undergoing hemodialysis Hemodialysis effectively removes atenolol; provide atenolol after hemodialysis.

Considerations for Pregnancy:
Former FDA pregnancy category D drug is atenolol. [19] Atenolol is not advised during pregnancy, under the recommendations of The American College of Obstetricians and Gynecologists (ACOG), due to the possibility of growth restriction and low birth weight. Labetalol is the chosen beta blocker for pregnant women with persistent hypertension.

Considerations When Breastfeeding: Plasma protein binding is primarily responsible for the excretion of beta blockers in breast milk Drugs like atenolol (10% PPB), which have low plasma protein binding, are extensively excreted in breast milk.

Side EffectsThe following are atenolol’s side effects, per the product label.

Avoid stopping atenolol suddenly because doing so could make your angina, acute myocardial infarction, or ventricular arrhythmias worse. It is advised that the dose be reduced gradually.
It is advised that atenolol be swiftly reintroduced briefly if angina worsens or acute coronary insufficiency develops.
Bradycardia, dizziness, constipation, confusion, dyspnea, headaches, erectile dysfunction, nausea, lethargy, paraesthesia, peripheral numbness, rash, sleep disturbances, syncope, visual impairment, and bronchospasm are a few of the more typical adverse effects.
Alopecia, dry mouth, postural hypotension, psychosis, psoriasis, thrombocytopenia, depression, moderate transaminitis, and depression are uncommon adverse reactions.
Severe bradycardia, renal failure, atrioventricular blockage, shock, and hyperkalemia are the traits of the BRASH syndrome. If you suspect BRASH syndrome, stop taking atenolol.

Drug Interaction
CautionIn some cases, atenolol may result in cardiac failure. If you experience discomfort or pain in your chest, consult a doctor right once; Swelling of the face, fingers, feet, or lower legs; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; weight gain; or wheezing
Available BrandsTenormin
Blokium
Zafnol

 

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Duloxetine | SNRI | Anti-Depressant

IntroductionDuloxetine available under brand names of Dulan, Duron, Cymbalta is used off-label for conditions like stress incontinence and peripheral neuropathy brought on by chemotherapy. Major depressive disorder (MDD), generalised anxiety disorder (GAD), fibromyalgia, diabetic peripheral neuropathy, and chronic musculoskeletal pain are all conditions that can be treated with duloxetine.
Class of MedicineIt belongs to the group of drugs known as SNRIs, or serotonin and norepinephrine reuptake inhibitors. This activity explains the benefits of duloxetine as a treatment for a variety of illnesses, how it works, and when it should not be used.
Mode of ActionDuloxetine treats depression and anxiety by inhibiting serotonin and norepinephrine reuptake, integrating two therapeutic processes in a single drug. Additionally, dopamine levels in the prefrontal brain are raised by duloxetine. The blockage of norepinephrine transporters is the mechanism of action for the rise in dopamine levels. These transporters are able to function on both dopamine and norepinephrine because they have a strong affinity for dopamine. As a result, blocking norepinephrine transporters may result in a rise in dopamine. The prefrontal cortex, which lacks dopamine transporters and mainly relies on norepinephrine transporters for reuptake, is the location of this surge in dopamine.
Duloxetine works to treat depression and anxiety by inhibiting the reuptake of serotonin and norepinephrine. This combines two therapeutic methods into a single medication. Duloxetine raises dopamine levels in the prefrontal cortex as well. Norepinephrine transporters are inhibited as part of the mechanism of action for the rise in dopamine levels. The fact that these transporters can function on both dopamine and norepinephrine is due to their high affinity for dopamine. Inhibiting norepinephrine transporters can therefore result in a rise in dopamine. The prefrontal cortex, which has less dopamine transporters and a higher reliance on norepinephrine transporters for reuptake, is where this surge in dopamine is concentrated.
Medical UsesIbuprofen is a common pain reliever used to treat a variety of aches and pains, such as back pain, period pain, and toothache. It also helps with inflammation from strains and sprains, as well as arthritis discomfort. It comes in the form of tablets, capsules, and a syrup that you ingest.
Avaiability & UsageDue to its excellent oral absorption, duloxetine is most frequently administered in capsules, either with or without food. It is not advised to chew or crush duloxetine. Duloxetine, however, may hold its stability for up to two hours after being opened and sprinkled on apple juice or apple sauce, according to tests.

Treatment for fibromyalgia:
30 mg taken once day for a week, followed by an increase to 60 mg taken once daily. Another option is to use a titration strategy, starting with a dose of 20 mg per day and gradually increasing it by 20 mg each week, up to 60 mg, as tolerated. The daily maximum is 60 mg.
Treatment for generalised anxiety disorder (GAD): The starting dose is 60 mg, but depending on the patient’s tolerance, the dose may be reduced to 30 mg once daily for a week before being increased to 60 mg once daily. Increasing doses above 60 mg/day have been reported to offer benefits by certain experts, despite research showing no extra benefits.
Treatment for unipolar major depressive disorder (MDD): A single dose of 40 to 60 mg/day or two divided doses are both acceptable. It might be essential to start with 30 mg/day for a week before increasing the dosage to 60 mg/day. 60 milligrammes per day for maintenance.

Initially, 60 mg can be given to treat the pain brought on by diabetic peripheral neuropathy; however, depending on the patient, lower starting doses may be more suitable. The daily maximum is 60 mg.

Chronic musculoskeletal pain treatment:
Low back pain: As an adjuvant therapy, 30 mg can be used once daily for a week before being increased to 60 mg once day as tolerated. The daily maximum is 60 mg.

Knee pain:
When an additional therapy, 30 mg once day for a week can be administered, and as tolerated, up to 60 mg once daily

Side EffectsCommon adverse effects of duloxetine include:

Headache
Drowsiness
Fatigue
Nausea
Xerostomia
Abdominal pain
Weight loss
Weakness
Insomnia
Dizziness
Chane in libido
Diaphoresis
Constipation
Decreased appetite
Tremor
Diarrhea
Erectile dysfunction

Caution
(while taking with other medicine)		Patient Pregnant
Due to the FDA pregnancy category C of duloxetine, there is a possibility of danger to foetal development. Duloxetine showed negative effects on embryo/fetal development in animal reproduction studies. As a result, the doctor should only recommend duloxetine if the advantages outweigh the possible risks to the foetus.Women Who Breastfeed
Duloxetine can have affects on breastfeeding infants because it is secreted in breast milk. The relative infant dose (RID) of duloxetine, according to certain research, is 2.3%. When compared to the mother’s dose, the RID is the dose consumed by breast milk. Breastfeeding is acceptable with a RID of less than 10%. Some sources state that if the mother is taking psychiatric medication, nursing should only be encouraged if the RID is less than 5%.

Nevertheless, it is important to keep an eye out for behavioural changes, sleep disturbances, feeding abnormalities, growth, and neurodevelopment in a baby who is nursed by a woman who uses duloxetine .[7]

Elderly
Numerous instances of clinically severe hyponatremia in older persons are correlated with the use of SSRIs and SNRIs. Duloxetine should only be prescribed with caution to elderly patients. However, it is not necessary to change the dosage based on the patient’s age .[8]

Important WarningDeaths have resulted from dosages as low as 1000 mg. Serotonin syndrome, seizures, coma, somnolence, syncope, tachycardia, autonomic instability, diarrhoea, and vomiting are all indications of an overdose. Agitation, restlessness, confusion, diaphoresis, heat, tachycardia, nausea, vomiting, tremor, rigidity of the muscles, hyperreflexia, myoclonus, dilated pupils, dry mucous membranes, and increased bowel noises are all symptoms of serotonin syndrome. Serotonin syndrome is particularly prone to clonus and hyperreflexia.

An overdose of duloxetine cannot be reversed. Cyproheptadine and cooling techniques may be utilised if the patient has serotonin syndrome. Patients with aberrant vital signs require observation, and serious instances can necessitate ICU-level treatment.

Available BrandsDulan
Duron
Cymbalta

 

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Fluconazole | An Antifungal Triazole

fluconazole

 

IntroductionFluconazole, available under brand names of Zolanix, Fungone, Triazoline is a triazole antifungal is used to treat a variety of fungal infections, such as candidiasis, blastomycosis, coccidiodomycosis, cryptococcosis, histoplasmosis, dermatophytosis, and pityriasis versicolor. Fluconazole, also referred to as Diflucan, is an antifungal medication used to treat superficial and systemic fungal infections in a range of tissues.
Class of MedicineFluconazole is an antifungal triazole class . It functions by inhibiting the development of infection-causing fungus.
Mode of ActionA fluorine-substituted bis-triazole antifungal agent is called fluconazole. Similar to other azoles, it works by attaching to fungal cytochrome P-450 and then disrupting fungal membranes, which prevents lanosterol from being converted to ergosterol.
The fungus (or yeast) that is causing the infection is eliminated by fluconazole. The medication kills the fungus by rupturing the cell membrane and allowing the insides to escape. Your symptoms will improve as a result of this treatment for the infection.
Medical UsesCandida infection is treated and prevented using fluconazole. An infection with one of the various varieties of the fungus Candida is what causes this illness. Vaginal yeast infection and oral yeast infection are two examples of candidiasis (thrush).

Additionally, infections in your throat, oesophagus, lungs, and blood can be brought on by candidiasis. Fluconazole may be used to treat bone marrow transplant recipients in order to prevent candidiasis. This is due to the fact that their immune systems are compromised, which increases their risk of contracting a severe form of candidiasis.

Infection of the brain and spinal cord brought on by the fungus Cryptococcus is similarly treated with fluconazole.

Avaiability & UsageFluconazole is available in the following dosage forms and doses:

Oral Tablet: 50 mg, 100 mg, 150 mg, 200 mg.
IV Solution (Injection): 200 mg/100 ml, 400 mg/200 ml, 100 mg/50 ml.
Liquid Suspension: 200 mg/100 ml, 400 mg/200 ml, 100 mg/50 ml.

Fluconazole must be administered multiple times to treat a fungus, with the exception of vaginal candidiasis. Based on how the patient reacts to the treatment, the dose is changed. Until the infection is entirely cured, be sure to periodically consult the doctor to assess the effectiveness of the therapy.
The following is a list of fluconazole dosages that are suggested for specific conditions:
Vaginal Candidiasis: One oral dose of 150 mg.
Those who have oropharyngeal and esophageal candidiasis may begin treatment with a dose of 200 mg the first day, followed by 100 mg once each day.

200 mg the first day for Candida peritonitis, then 50 to 200 mg once daily after that.
Infections of the urinary tract: 200 mg the first day, then 50 to 200 mg once daily.
Blood Candida Infections: 400 mg daily maximum.
Up to 400 mg/day for the prevention of fungal infections (candidiasis) in patients receiving bone marrow transplants.

Side EffectsThe most frequent adverse effect of fluconazole administration is sleepiness, along with the following effects:

Headache.
Diarrhea.
Nausea or abdominal pain
Vomiting.
A significant rash appears on people with weakened immune systems.
Among the damaging side effects include
Liver Damage: The following signs and symptoms could indicate that your liver is damaged.
Whites of the eyes or skin become yellow.
Rough skin.
Sickness or vomiting
Torsions with points: (a life-threatening heartbeat condition).
Symptoms consist of
Irregular, quick heartbeat.
Fainting and dizziness
Seizures.

Caution
(while taking with other medicine)		Before using fluconazole, tell your doctor if any of the following problems exist:

Allergy: Previous history of allergy to fluconazole or any other azole-class drugs.

Fluconazole might be harmful to the foetus if used during pregnancy and while nursing. Therefore, let your doctor know if you plan to become pregnant or plan to breastfeed during the first three months of your pregnancy. The doctor could suggest using birth control during treatment and for a week after the last dose to prevent pregnancy.

Heart Diseases: Let your doctor know if you have a history of heart illness, especially if you have an irregular heartbeat or low potassium levels. This is due to the fact that fluconazole has been linked to alterations in heartbeat. Consequently, precautions should be made before giving the drug.

Skin Rashes: Contact your doctor right away if any skin rashes appear after using this medication.

Surgery: Before having any type of surgery, including dental surgery, tell your doctor that you’ve been taking fluconazole.

Endocrine Issues: Fluconazole has been linked to alterations in the quantities of hormones generated by the adrenal glands. Once the medicine is stopped, this is reversible, and the levels revert to normal.

Important WarningAdrenal gland issues could result from this medication. If you have diarrhoea, dizziness, fainting, lack of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting, consult your doctor immediately once.
Available BrandsZolanix,
Fungone
Triazoline

 

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Levosulpiride | A Prokinetic Agent

IntroductionLevosulpiride avaiable under the brand of Levopraid, is an atypical antipsychotic medication. It is used to treat psychiatric disorders such as depression, schizophrenia, vertigo, and hallucinations. However, it can also be used to treat digestive issues such as GERD, IBS, indigestion, and chronic heartburn. It is also prescribed by doctors to prevent premature ejaculation.
Class of MedicineLevosulpride | A Prokinetic Agent,  belongs to the antipsychotic medication class (also known as neuroleptics or tranquillizers). It is mostly used to treat hallucinations, schizophrenia, bipolar disorder, anxiety, and vertigo, among other mental illnesses.
Mode of ActionThe main mechanism of action of levosulpiride is to block the D2 dopaminergic receptors, which are preferentially located on the presynaptic membranes in the brain’s dopaminergic pathways; this means that sulpiride is a selective autoreceptor blocker.
Medical UsesLevosulpiride is used to treat the following conditions:

Psychosis
Schizophrenia’s negative symptoms
Anxiety problems
Dysthymia
Vertigo
Dyspepsia
Irritable bowel syndrome (IBS)
Ejaculation occurs too soon.
In the United Kingdom and other European countries, levosulpiride is not currently approved for the treatment of premature ejaculation.

Avaiability & UsageLevosulpride is available in tablet form. Should be taken only on your doctor’s prescription. Take LEVOSULPIRIDE with or without food. The tablet form of LEVOSULPIRIDE should be swallowed as a whole, do not crush, or break the tablet.
Side EffectsPatients taking levosulpiride frequently experience the following side effects:

Amenorrhea is the absence of menstrual periods.
Gynecomastia is a condition in which men’s breasts become enlarged.
Changes in sex motivation
Galactorrhea is the discharge of milk from the nipples when a woman is not breastfeeding.
If levosulpiride is not taken as directed, it can cause serious health problems.

The following are rare but serious side effects:

A potentially fatal condition characterised by a high fever
Breathing and heart rate are both fast.
Pulse irregularity
Confusion
Sweating
Neuroleptic malignant syndrome is characterised by a significantly altered mental state.

Important WarningPatients with a history of neuroendocrine tumours, epilepsy, manic states, abnormally high levels of prolactin in the blood, painful, lumpy breasts, heart disease, any allergy, and during pregnancy and breastfeeding should exercise caution.
Available BrandsLevopraid