INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(74, 74, '<p>Amantadine Hydrochloride is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Treatment of parkinsonism</li>\r\n	<li>Treatment of drug-induced extrapyramidal reactions</li>\r\n	<li>Prophylaxis and treatment of signs and symptoms of infection caused by various strains of influenza A virus</li>\r\n</ul>', '<p>The mechanism by which amantadine exerts its antiviral activity is not clearly understood. It appears to mainly prevent the release of infectious&nbsp;viral&nbsp;nucleic acid&nbsp;into the host cell by interfering with the function of the transmembrane domain&nbsp;of the viral M2 protein. In certain cases, amantadine is also known to prevent virus assembly during virus replication. It does not appear to interfere with the immunogenicity of inactivated influenza A virus vaccine.<br />\r\n<br />\r\nAmantadine inhibits the replication of influenza A virus isolates from each of the subtypes, i.e., H1N1, H2N2 and H3N2. It has very little or no activity against influenza&nbsp;B virus&nbsp;isolates. A quantitative relationship between the&nbsp;in vitrosusceptibility of influenza A virus to amantadine and the clinical response to therapy has not been established in man.&nbsp;Sensitivity&nbsp;test results, expressed as the concentration of amantadine required to inhibit by 50% the growth of virus (ED50) in tissue culture vary greatly (from 0.1 &micro;g/mL to 25.0 &micro;g/mL) depending upon the assay protocol used, size of virus inoculum, isolates of influenza A virus strains tested, and the cell type used. Host cells in tissue culture readily tolerated amantadine up to a concentration of 100 &micro;g/mL.</p>', '<p><strong>Parkinson&#39;s disease</strong>:</p>\r\n\r\n<ul>\r\n	<li>Adult: Initially, 100 mg/day, increased to 100 mg bid after a wk or more. Max dose: 400 mg daily.</li>\r\n	<li>Elderly: &gt;65 yr: Lowest effective dose.</li>\r\n</ul>\r\n\r\n<p><strong>Prophylaxis of influenza A</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 100 mg daily for up to 6 wk; when used with influenza vaccination: only up to 3 wk after vaccination.</li>\r\n	<li><strong>Child</strong>: 10-15 yr: 100 mg daily.</li>\r\n</ul>\r\n\r\n<p><strong>Influenza A</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 100 mg daily for 5 days.</li>\r\n	<li><strong>Elderly</strong>: &gt;65 yr: Daily dose of 1 day.</li>\r\n</ul>\r\n\r\n<p><strong>Herpes zoster in immunocompromised patients</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: 100 mg bid for 14 days, continued for another 14 days if pain persists.</li>\r\n</ul>', '<p>Concurrent administration of Amantadine and anticholinergic agents or levodopa may increase confusion, hallucinations, nightmares, gastro-intestinal disturbances, or other atropine-like side effects. Psychotic reactions have been observed in patients receiving Amantadine and Levodopa.<br />\r\n<br />\r\nConcurrent administration of Amantadine and drugs or substances (e.g. alcohol) acting on the CNS may result in additive CNS toxicity. Close observation is recommended.</p>', '<p>Amantadine is contraindicated in patients with known hypersensitivity to the active substances or to any of the excipients.</p>', '<p>The adverse effects of Amantadine are generally mild and, when they occur, may diminish or cease after a week or more on the medication. The most commonly reported side effects include nausea, dizziness/ lightheadedness, and insomnia.<br />\r\n<br />\r\nOther side effects may include edema of ankles, livedo reticularis; anxiety, elevation of mood, headache, lethargy, hallucinations, ataxia, slurred speech, blurred vision, loss of concentration, nervousness, depression, myalgia, palpitations, orthostatic hypotension, dry mouth, anorexia, constipation and diaphoresis.</p>', '<p>Pregnancy category C. No well-controlled studies have been done in pregnant women to evaluate Amantadine&#39;s safety. Amantadine may be used during pregnancy when the potential benefits outweigh the potential but unknown risks to the fetus.<br />\r\n<br />\r\nAmantadine is excreted into breast milk in low concentrations. As no information is available on the effects in infants, therefore amantadine should be used cautiously in women who are breastfeeding.</p>', '<p>Amantadine should not be discontinued abruptly in patients with Parkinson&#39;s disease since a few patients have experienced a parkinsonian crisis, i.e., a sudden marked clinical deterioration, when this medication was suddenly stopped. The dose of anticholinergic drugs or of Amantadine Hydrochloride should be reduced if atropine-like effects appear when these drugs are used concurrently. Abrupt discontinuation may also precipitate delirium, agitation, delusions, hallucinations, paranoid reaction, stupor, anxiety, depression and slurred speech.</p>', NULL, '<p>Respiratory viral infections (Influenza)</p>', '<p>Amantadine Hydrochloride is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Treatment of parkinsonism</li>\r\n	<li>Treatment of drug-induced extrapyramidal reactions</li>\r\n	<li>Prophylaxis and treatment of signs and symptoms of infection caused by various strains of influenza A virus</li>\r\n</ul>', '<p><strong>Patients with renal impairment</strong>: &nbsp;The dose should be reduced. This can be achieved by either reducing the total daily dose, or by increasing the dosage interval in accordance with the creatinine clearance. For example:</p>\r\n\r\n<ul>\r\n	<li><strong>CrCl &lt;15 ml/min</strong>: Contraindicated</li>\r\n	<li><strong>CrCl 15-35&nbsp;ml/min</strong>:&nbsp;100 mg every 2 to 3 days</li>\r\n	<li><strong>CrCl &gt;35&nbsp;ml/min</strong>:&nbsp;100mg every day</li>\r\n</ul>\r\n\r\n<p><strong>Patients with hepatic impairment</strong>: Use with caution</p>', '2022-02-14 06:43:01', '2022-03-15 05:52:45'),
(75, 75, '<p>Ambrisentan is indicated for the treatment of&nbsp;pulmonary arterial hypertension&nbsp;(PAH) (WHO Group 1):</p>\r\n\r\n<ul>\r\n	<li>To improve exercise ability and delay clinical worsening.</li>\r\n	<li>In combination with tadalafil to reduce the risks of disease progression and hospitalization for worsening PAH, and to improve exercise ability.</li>\r\n</ul>\r\n\r\n<p>Studies establishing effectiveness included predominantly patients with WHO Functional Class II&ndash;III symptoms and etiologies of&nbsp;idiopathic&nbsp;or&nbsp;heritable&nbsp;PAH (60%) or PAH associated with&nbsp;connective tissue&nbsp;diseases (34%).</p>', '<p>Endothelin-1 (ET-1) is a potent autocrine and paracrine peptide. Two receptor subtypes, ETA and ETB, mediate the effects of ET-1 in the vascular smooth muscle and endothelium. The primary actions of ETA are&nbsp;vasoconstriction&nbsp;and cell proliferation, while the predominant actions of ETB are&nbsp;vasodilation, antiproliferation, and ET-1 clearance.<br />\r\n<br />\r\nIn patients with&nbsp;PAH, plasma ET-1 concentrations are increased as much as 10-fold and correlate with increased mean right atrial pressure and disease severity. ET-1 and ET-1 mRNA concentrations are increased as much as 9-fold in the lung tissue of patients with PAH, primarily in the endothelium of pulmonary arteries. These findings suggest that ET-1 may play a critical role in the&nbsp;pathogenesis&nbsp;and progression of PAH.<br />\r\n<br />\r\nAmbrisentan is a high-affinity (Ki=0.011 nM) ETA receptor&nbsp;antagonist&nbsp;with a high selectivity for the ETA versus ETB receptor ( &gt; 4000-fold). The clinical impact of high selectivity for ETA is not known.</p>', '<p>Initial treatment is 5 mg once daily, and can be increased to 10 mg once daily if 5 mg is tolerated. Ambrisentan may be administered with or without food.</p>', '<p>Multiple dose co-administration of Ambrisentan and Cyclosporine resulted in an approximately 2-fold increase in Ambrisentan exposure in healthy volunteers; therefore, limit the dose of Ambrisentan to 5 mg once daily when co-administered with Cyclosporine.</p>', '<p>Ambrisentan may cause fetal harm when administered to a pregnant woman. Ambrisentan is contraindicated in women who are or may become pregnant. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus. Pregnancy must be excluded before the initiation of treatment with Ambrisentan and prevented during treatment and for one month after stopping treatment. Ambrisentan is contraindicated in patients with Idiopathic Pulmonary Fibrosis (IPF) including IPF patients with pulmonary hypertension (WHO Group 3).</p>', '<p>Decreases in hemoglobin concentration and hematocrit have followed administration of other endothelin receptor antagonists and were observed in clinical studies with Ambrisentan.</p>', '<p>Pregnancy Category X. It is not known whether Ambrisentan is excreted in human milk. Breastfeeding while receiving Ambrisentan is not recommended.</p>', '<p><strong>Fluid Retention</strong>: Peripheral edema is a known class effect of endothelin receptor antagonists, and is also a clinical consequence of PAH and worsening PAH.<br />\r\n<br />\r\n<strong>Pulmonary Veno-occlusive Disease</strong>: If patients develop acute pulmonary edema during initiation of therapy with vasodilating agents such as Ambrisentan, the possibility of pulmonary veno-occlusive disease should be considered, and if con_rmed. Ambrisentan should be discontinued.<br />\r\n<br />\r\n<strong>Hematological Changes</strong>: Decreases in hemoglobin concentration and hematocrit have followed administration of other endothelin receptor antagonists and were observed in clinical studies with Ambrisentan.</p>', NULL, '<p>Anti-hypertensive, Endothelin receptor antagonist</p>', '<p>Store in a cool and dry place, below 30&deg; C. Protect from light and moisture.</p>', '<p><strong>Pediatric patients:</strong>&nbsp;Safety and effectiveness of Ambrisentan in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Hepatic impaired patient:</strong>&nbsp;Ambrisentan is not recommended in patients with moderate or severe hepatic impairment.</p>', '2022-02-14 06:43:19', '2022-03-15 05:57:44'),
(76, 76, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Productive cough</li>\r\n	<li>Acute and chronic inflammatory disorders of upper and lower respiratory tracts associated with viscid mucus including acute and chronic bronchitis</li>\r\n	<li>Inflammatory disease of rhinopharyngeal tract (laryngitis, pharyngitis, sinusitis and rhinitis) associated with viscid mucus</li>\r\n	<li>Asthmatic bronchitis bronchial asthma with thick expectoration</li>\r\n	<li>Bronchiectasis</li>\r\n	<li>Chronic pneumonia etc.</li>\r\n</ul>', '<p>Ambroxol is the active metabolite of bromhexine and it has been proven that this metabolite possesses a greater bronchosecretolytic effect than bromhexine. It improves sputum rheology by hydrating mechanism leading to liquefaction of mucus in the lumen of respiratory tract, thus facilitating expectoration of mucus and reducing dyspnea. It stimulates production of phospholipids of surfactant by alveolar cells, thus contributing to the lowering of superficial tension in the alveoli. It also reduces bronchial hyperactivity. Ambroxol has anti inflammatory properties owing to the inhibitory effect on the production of cellular cytokines and arachidonic acid metabolites. In patients with COPD it traditionally improves airway patency.</p>', '<p>Average daily dose (preferably after meal):<br />\r\n<br />\r\nPediatric Drops:</p>\r\n\r\n<ul>\r\n	<li><strong>0-6 months</strong>: 0.5 ml 2 times a day</li>\r\n	<li><strong>6-12 months</strong>: 1 ml 2 times a day</li>\r\n	<li><strong>1-2 years</strong>: 1.25 ml 2 times a day</li>\r\n</ul>\r\n\r\n<p>Syrup:</p>\r\n\r\n<ul>\r\n	<li><strong>2-5 years</strong>: 2.5 ml (1/2 teaspoonful) 2-3 times a day</li>\r\n	<li><strong>5-10 years</strong>: 5 ml (1 teaspoonful) 2-3 times a day</li>\r\n	<li><strong>10 years and adults</strong>: 10 ml (2 teaspoonful) 3 times a day.</li>\r\n</ul>\r\n\r\n<p>Sustained release capsule: Adult and children over 12 years old: 1 capsule once daily.</p>', '<p>Ambroxol should not be taken simultaneously with antitussives (e.g.Codeine) because phlegm, which has been liquefied by Ambroxol might not be expectorated.</p>', '<p>Contraindicated in known hypersensitivity to Ambroxol or Bromhexine.</p>', '<p>Gastrointestinal side effects like epigastric pain, stomach overfill feeling may occur occasionally. Rarely allergic responses such as eruption, urticaria or angioneurotic edema have been reported.</p>', '<p>Teratogenic and fetal toxicity studies have shown no harmful effect of Ambroxol. However, it is advised not to use it in pregnancy, especially during the1st trimester. Safety during lactation has not been established yet.</p>', '<p>Ambroxol should be given cautiously to patients with gastric and duodenal ulceration or convulsive disorders. Patients with hepatic and renal insufficiency should take it with caution.</p>', NULL, '<p>Cough expectorants &amp; mucolytics</p>', '<p>Protect from direct light exposure, Store in a dry place at a temperature not exceeding 30&deg;C, Keep out of the reach of children.</p>', NULL, '2022-02-14 06:43:42', '2022-03-15 06:01:50'),
(77, 77, '<p>Amikacin is indicated in the short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria. Amikacin is effective in bacterial septicemia (including neonatal sepsis); in serious infections of the respiratory tract, bones and joints, central nervous system (including meningitis) and skin and soft tissue; intra-abdominal infections (including peritonitis); and in burns and postoperative infections (including postvascular surgery). Clinical studies have shown Amikacin also to be effective in serious complicated and recurrent urinary tract infections due to those organisms.<br />\r\n<br />\r\nAmikacin was effective in infections caused by gentamicin and/or tobramycin-resistant strains of Gram-negative organisms, particularly Proteus rettgeri, Providencia stuartii, Serratia marcescens, and Pseudomonas aeruginosa.<br />\r\n<br />\r\nAmikacin has also been shown to be effective in staphylococci infections and may be considered as initial therapy under certain conditions in the treatment of known or suspected staphylococcal disease such as, severe infections where the causative organism may be either a Gram-negative bacterium or a staphylococcus.</p>', '<p>Amikacin Sulfate is a semi-synthetic aminoglycoside antibiotic. Amikacin is active in vitro against pseudomonas species, Escherichia coli, Proteus species, Providencia species, Klebsiella-Enterobacter species, Acinetobacter species, and Citrobacter freundii. When strains of the above organisms are found to be resistant to other aminoglycosides, including Gentamicin, TobrAmykin and KanAmykin, many are susceptible to Amikacin. Amikacin sulfate is active in vitro against penicillinase and nonpenicillinase-producing Staphylococcus species including methicillin-resistant strains.</p>', '<p><strong>Adults and children</strong>: 15 mg/kg/day in two equally-divided doses (equivalent to 500 mg bid in adults). Use of the 100 mg is recommended for children for the accurate measurement of the appropriate dose.<br />\r\n<br />\r\n<strong>Neonates and premature children</strong>: An initial loading dose of 10 mg/kg followed by 15 mg/kg/day in two equally divided doses.<br />\r\n<br />\r\n<strong>Elderly</strong>: Amikacin is excreted by the renal route. Renal function should be assessed whenever possible and dosage adjusted as described under impaired renal function.<br />\r\n<br />\r\n<strong>Life-threatening infections and/or those caused by Pseudomonas</strong>: The adult dose may be increased to 500 mg every eight hours but should neither exceed 1.5g/day nor be administered for a period longer than 10 days. A maximum total adult dose of 15g should not be exceeded.<br />\r\n<br />\r\n<strong>Urinary tract infections</strong>&nbsp;(other than pseudomonal infections): 7.5mg/kg/day in two equally divided doses (equivalent to 250 mg b.i.d. in adults).<br />\r\n<br />\r\n<strong>Impaired renal function</strong>: In patients with impaired renal function, the daily dose should be reduced and/or the intervals between doses increased to avoid accumulation of the drug.</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Intramuscular or intravenous administration</strong>: For most infections the intramuscular route is preferred, but in life threatening infections, or in patients in whom intramuscular injection route is not feasible the intravenous route may be used.<br />\r\n<br />\r\n<strong>Intraperitoneal use</strong>: Amikacin may be used as an irrigant after recovery from anesthesia in concentration of 0.25%.</p>', '<p>Concurrent administration of Amikacin with myorelaxants leads to potentiation of their effects and there is a possibility of cessation of the breathing. The combination with other Aminoglycoside antibiotics should be avoided because of the augmentation of their ototoxic and nephrotoxic effects. Concurrent administration of Amikacin with fast acting diuretics increases the risk of ototoxicity in patients with renal failure. Combination with Cephalosporins or Polymixins increases the risk of nephrotoxicity.</p>', '<p>Amikacin Injection is contraindicated in patients with a known history of hypersensitivity to Amikacin, any constituents of the injection.</p>', '<p>The adverse effects have been reported with the use of Amikacin are tinnitus, vertigo, partial reversible or irreversible deafness, skin rash, drug fever, headache, paraesthesia, nausea and vomiting.</p>', '<p>Amikacin rapidly crosses the placenta into the foetal circulation and amniotic fluid and there is a potential risk of ototoxicity in the foetus. There is no information available regarding the safety of this drug during breastfeeding.</p>', '<p>Since Amikacin is present in high concentrations in the renal excretory system, patients should be well hydrated to minimize chemical irritation of the renal tubules. If azotemia increases, treatment should be stopped. Monitoring of renal function during treatment with aminoglycosides is particularly important.</p>', '<p>In the event of overdose or toxic reaction, peritoneal dialysis or haemodialysis will aid in the removal of Amikacin from the blood.</p>', '<p>Aminoglycosides</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness of Amikacin for injection in children or adolescents under 16 years have not been established</p>', '2022-02-14 06:43:55', '2022-03-15 06:07:50'),
(78, 78, '<p>Parenteral amino acid supply in severe forms of hepatic failure (liver insufficiency) with and without encephalopathy. For supply of amino acids as part of a parenteral nutrition regimen when oral or enteral nutrition is impossible or insufficient or contraindicated.</p>', NULL, '<ul>\r\n	<li>For intravenous infusion.</li>\r\n	<li>Usual dose: 1.0 to 1.25 ml/kg/hour.</li>\r\n	<li>Max. dosage: 1.5 g amino acids/kg/day = 1300 ml/day at 70 kg body weight.</li>\r\n	<li>Constant checking of serum electrolytes, fluid balance and acid-base balance is mandatory.</li>\r\n	<li>Amino Acid 8% is used as long as required by therapy.</li>\r\n</ul>', '<p>Because of the increased risk of microbiological contamination and incompatibilities, amino acid solutions should not be mixed with other drugs. Should it become necessary to add other nutrients like carbohydrates, lipid emulsions, electrolytes, vitamins or trace elements to Amino Acid 8% for complete nutrition, care should be given to hygienic admixing, good blending and, in particular, to compatibility.</p>', '<p>Disturbance of amino acid metabolism, metabolic acidosis, fluid overload, hyponatremia, hypokalemia, renal insufficiency, decompensated cardiac insufficiency, shock, hypoxia. No specific studies have been performed to assess the safety of Amino Acid 8% in pregnancy and lactation.</p>', '<p>Due to the special composition of this preparation, use in indications other than those recommended may result in amino acid imbalances and severe metabolic disorders.</p>', NULL, NULL, NULL, '<p>Parenteral nutritional preparations</p>', '<p>Amino Acid 8% should not be stored after the addition of other components. Do not store above 25&deg;C. Do not freeze. Shelf Life: 36 months. Do not use Amino Acid after the expiry date. Do not use if the solution is cloudy or if the container is damaged. Keep out of the reach of children.</p>', NULL, '2022-02-14 06:44:12', '2022-03-15 06:17:31'),
(79, 79, '<p>Prevention and therapy of damages due to faulty or deficient protein metabolism in chronic renal insufficiency in connection with limited protein in food of 40 g/day (for adults) ie, generally in patients with a glomerular filtration rate (GFR) 25 mL/minutes.</p>', '<p>This tablet allows the intake of essential amino acids while minimising the amino-nitrogen intake. Following absorption, the keto- and hydroxy-analogues are transaminated to the corresponding essential amino acids by taking nitrogen from non-essential amino acids, therby decreasing the formation of urea by re-using the amino group. Hence, the accumulation of uraemic toxins is reduced. Keto and hydroxy acids do not induce hyperfiltration of the residual nephrons. Ketoacid containing supplements exert positive effect on renal hyper phosphataemia and secondary hyperparathyroidism. Moreover, renal osteodystrophy may be improved. The use of this tablet in combination with a very low protein diet allows to reduce nitrogen intake while preventing the deleterious consequences of inadequate dietary protein intake and malnutrition.</p>', '<p><strong>Adults (70 kg body weight)</strong>: If not otherwise prescribed, take 4 to 8 tablets three times a day during meals. Swallow whole and must not be chewed. Ingestion during meals facilitates proper absorption and the metabolisation into the corresponding amino acids.<br />\r\n<br />\r\n<strong>Duration of Application</strong>: This tablets are given as long as the glomerular filtration rate (GFR) is between 5 and about 15 mL/minute. Simultaneously food should contain 40 g/day protein or less (adults).</p>', '<ul>\r\n	<li>Concomitant administration of calcium-containing drugs may cause or aggravate elevated serum calcium levels.</li>\r\n	<li>Drugs that form hardly soluble compounds with calcium (e.g. tetracyclines, quinolines such as ciprofloxacin and norfloxacin as well as drugs containing iron, fluoride or estramustine) should not be taken at the same time with this tablet to avoid disturbed absorption of the active substances. An interval of at least two hours should elapse between the ingestion of this tablet and these drugs.</li>\r\n	<li>The susceptibility to cardioactive glycosides, and hence the risk for arrhythmia will increase if this tablet produces elevated serum calcium levels.</li>\r\n	<li>Uraemic symptoms improve under therapy with this tablet. Thus, in case of aluminium hydroxide administration, the dose of this drug has to be reduced if necessary. Serum phosphate levels should be monitored for a decrease.</li>\r\n</ul>', '<p>Hypersensitivity to the active substances or to any of the excipients. Hypercalcaemia. Disturbed amino acid metabolism.</p>', '<p>Hypercalcemia may develop. In this case it is recommended to decrease Vitamin D intake. If hypercalcaemia persists, reduce the dosage of this tablet as well as other source of calcium. The serum calcium level should be monitored regularly. Ensure sufficient calorie intake. No experience has been gained so far with the administration in paediatric patients.</p>', '<p>There are no adequate data from the use of this tablet in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/foetal development, parturition or postnatal development. Caution should be exercised when prescribing to pregnant women. No experience has been made so far with the use during lactation. No case of overdose has been reported.</p>', '<ul>\r\n	<li>The serum calcium level should be monitored regularly.</li>\r\n	<li>Ensure sufficient calorie intake.</li>\r\n	<li>In the presence of hereditary phenylketonuria, attention should be given to the fact that this tablet contains phenylalanine.</li>\r\n	<li>Monitoring of the serum phosphate levels is needed in case of concomitant administration of aluminium hydroxide.</li>\r\n</ul>', NULL, '<p>Drugs used in chronic kidney dialysis</p>', '<p>Do not store above 30&deg; C. Store in the original package and keep the blisters tightly closed to protect contents from moisture.</p>', NULL, '2022-02-14 06:44:29', '2022-03-15 06:22:15'),
(80, 80, '<p>Amino acid is indicated as a source of amino acids for protein synthesis in patients needing intravenous nutrition. Amino acid is particularly suitable for patients with basal amino acid requirements. Amino acid is also indicated in faster recovery in surgery, burns, renal insufficiency, hepatic insufficiency and effective management of cancer.</p>', '<p>This IV solution is a sterile aqueous solution of crystalline Amino Acid and D-Sorbitol with electrolytes, which are necessary as the nitrogen source for parenteral nutrition. Nitrogen provided in the form of essential and non-essential amino acids. This IV solution contains all 18 essential and non-essential amino acids needed for protein synthesis. The amino acid composition is such that positive nitrogen balance can be achieved in the postoperative period and during extended periods of intravenous nutrition. The solution is clear, colorless to pale yellow colored, having a p H lying in the range of 5.0 to 7.0.</p>', '<p>The nitrogen requirement for maintenance of body protein mass depends on the patient&#39;s condition (nutritional state and degree of metabolic stress).</p>\r\n\r\n<ul>\r\n	<li><strong>No or minor metabolic stress and normal nutritional state</strong>: 0.10-0.15 g nitrogen/kg/day,&nbsp;</li>\r\n	<li><strong>Moderate metabolic stress with or without malnutrition</strong>: 0.15-0.20 g nitrogen/kg/day,&nbsp;</li>\r\n	<li><strong>Severe catabolism as in burns, sepsis and trauma</strong>: up to 0.20-0.25 g nitrogen/kg/day.&nbsp;</li>\r\n</ul>\r\n\r\n<p>The dosage range 0.10-0.25 g nitrogen/kg/day corresponds to 15-35 ml Amino acids&nbsp;IV/kg/day.&nbsp;<br />\r\n<br />\r\nIn obese patients, the dose should be based on the estimated ideal weight. Depending upon patients requirements, 1000-2000 ml Amino acids IV may be infused intravenously per 24 hours. Amino acids IV should be infused slowly, at rates 1.4-2.8 ml (30-60 drops) per minute.<br />\r\n<br />\r\n<strong>In children and infants</strong>: The rate of infusion is 28-35 ml/kg body weight per day is recommended, with a step-wise increase in the rate of administration during the frst week.</p>', '<p>At the recommended dosage the amino acid have no pharmacological effects and is not expected to interact with other medicaments.</p>', '<p>This is contraindicated in patients with inborn errors of amino acids metabolism, severe liver dysfunction and in severe uremia when dialysis facilities are not available. Due to the content of glucose, Amino Acids IV infusion and 10% Glucose with Electrolytes is contraindicated in patients with hyperosmolar nonketotic diabetic coma.</p>', '<p>This preparation is usually well tolerated. Nausea occurs rarely. Vomiting, flushing and sweating have been observed during infusion of Amino acid at rates exceeding the recommended maximal rate. Transient increases liver test during intravenous nutrition have been reported. The reasons are at present unclear. Hypersensitivity reactions have been reported. As with all hypertonic infusion solutions, thrombophlebitis may occur when peripheral veins are used. The incidence may be reduced by the simultaneous infusion of 10% fat emulsion. If given to severely ill, premature infants, hyperphenylalaninemia may occur.</p>', '<p>Successful and safe administration of amino acid solutions during pregnancy in the human has been reported. Animal reproduction studies have not been carried out with Amino acid.</p>', '<p>IV infusion of amino acids is accompanied by increased urinary excretion of the trace elements copper and in particular zinc, which should be taken into account in the dosing of trace elements, particularly during long-term IV nutrition. Hyperphenylalaninemia may occur in severely ill, premature infants. In these patients, monitoring of the phenylalanine level is recommended and the infusion rate adjusted as needed. Amino Acids IV infusion and 10% Glucose with Electrolytes should be used with caution in patients with diabetes mellitus, severe heart failure or with renal function in combination with fluid restrictions or oliguria/anuria of another origin. In patients with hyperglycemia, administration of exogenous insulin might be necessary. In severely malnourished patients refeeding carbohydrates can trigger thiamine (vitamin B1 ) deficiency syndrome. Those at high risk are patients with a history of alcohol abuse, anorexia nervosa, prolonged fasting or starvation and pregnant women with hyperemesis gravidarum. In this kind of patients, parenteral nutrition containing glucose should be given with caution and parenteral administration of thiamine should be considered before and during the administration of glucose. Monitoring of serum potassium and blood glucose is recommended if Amino Acids IV infusion and 10% Glucose with electrolytes is infused rapidly or in a large quantity. For patients with hypophosphatemia, an additional supply of phosphate is recommended.</p>', NULL, '<p>Parenteral nutritional preparations</p>', '<p>Protect from light and store between 15&deg;C to 25&deg;C temperature. Avoid freezing. Keep out of reach of children.</p>', NULL, '2022-02-14 06:45:03', '2022-03-15 06:26:10'),
(81, 81, '<p>This is used for a source of amino acids, glucose and electrolytes in adult and pediatric patients needing IV nutrition. This&nbsp;is particularly suitable for patients with basal amino acid requirements.</p>', NULL, '<p><strong>Adults</strong>: The nitrogen requirement for maintenance of body protein mass depends on the condition of the patient (nutritional state and degree of metabolic stress). The requirements are 0.1-0.15 g nitrogen/kg body weight/day (no or minor metabolic stress and normal nutritional state), 0.15-0.2 g nitrogen/kg body weight/day (moderate metabolic stress with or without malnutrition) and up to 0.2-0.25 g nitrogen/kg body weight/day (severe catabolism as in burns, sepsis and trauma). The dosage range 0.1-0.25 g nitrogen/kg body weight/day corresponds to 11-27 mL Amino Acid IV Infusion with 10% Glucose and Electrolytes /kg body weight/day, respectively.&nbsp;<br />\r\n<br />\r\n<strong>Obese patient</strong>: In obese patients, the dose should be based on the estimated ideal weight. Depending upon patient requirements, up to 1000-2000 mL of Amino Acid IV Infusion with 10% Glucose and Electrolytes may be infused IV per 24 hrs. Amino Acid IV Infusion with 10% Glucose and Electrolytes should be infused slowly, at a rate not exceeding 1000 mL in 6 hrs corresponding to approximately 2.8 mL/min. In patients with basal amino acids requirements, the less concentrated Amino Acid IV Infusion with 10% Glucose and Electrolytes may be used.&nbsp;<br />\r\n<br />\r\n<strong>Infants and Children</strong>: In children and infants, a maximal rate of infusion of 30 mL Amino Acid IV Infusion with 10% Glucose and Electrolytes/kg body weight/day is recommended, with a stepwise increase in the rate of administration during the 1st week of treatment.</p>', '<p>At the recommended dosage the amino acid have no pharmacological effects and is not expected to interact with other medicaments.</p>', '<p>Patients with inborn errors of amino acid metabolism, severe liverdysfunction and in severe uremia when dialysis facilities are not available. Due to the content of glucose,this drug is contraindicated in patients with hyperosmolar nonketotic diabetic coma.</p>', '<p>Nausea occurs rarely. Transient increases in liver tests during IV nutrition have been reported. Hypersensitivity reactions have been reported with amino acid solutions. As with all hypertonic infusion solutions, thrombophlebitis may occur when peripheral veins are used. Hyperphenylalaninemia may occur in severely ill, premature infants.</p>', '<p>No specific studies have been performed to assess the safety of Amino Acids+Electrolytes+Glucose in pregnancy and lactation. The prescriber should consider the benefit/risk relationship before administering this combination to pregnant or breastfeeding women.</p>', '<p>This IV infusion is accompanied by increased urinary excretion of the trace elements copper and, in particular zinc, which should be taken into account in the dosing of trace elements, particularly during long-term IV nutrition. Hyperphenylalaninemia has been noted in severely ill premature infants. In these patients, monitoring of the phenylalanine level is recommended and the infusion rate adjusted as needed. This should be used with caution in patients with diabetes mellitus, severe heart failure or with renal function in combination with fluid restrictions or oliguria/anuria of other origin. In patients with hyperglycemia, administration of exogenous insulin might be necessary.</p>', '<p>If Amino Acid, Glucose &amp; Electrolytes combination is administered at a higher rate than recommended, there is an augmented risk for nausea, vomiting and sweating. When peripheral veins are used thrombophlebitis may occur. Osmotic diuresis with dehydration may occur if the dosage recommendations are exceeded. There is also a risk of symptoms related to hyperglycemia. In case of symptoms due to overdose, the infusion should be slowed down or discontinued.</p>', '<p>Parenteral nutritional preparations</p>', '<p>Protect from light and store between 15&deg;C to 25&deg;C temperature. Avoid freezing.</p>', NULL, '2022-02-14 06:45:28', '2022-03-15 06:32:24'),
(82, 82, '<p>This is indicated as a source of amino acids, glucose and electrolytes in adult and pediatric patients needing IV nutrition. This&nbsp;is particularly suitable for patients with basal amino acid requirements.</p>', '<p>A crystalline amino acid solution provides crystalline amino acids to promote protein synthesis and wound healing, and to reduce the rate of endogenous protein catabolism. Amino Acids given by central venous infusion in combination with concentrated dextrose, electrolytes, vitamins, trace metals, and ancillary fat supplements, constitutes total parenteral nutrition (TPN). Amino Acids can also be administered by peripheral vein with dextrose and maintenance electrolytes.</p>', '<p><strong>Adults</strong>: The nitrogen requirement for maintenance of body protein mass depends on the condition of the patient (nutritional state and degree of metabolic stress). The requirements are 0.1-0.15 g nitrogen/kg body weight/day (no or minor metabolic stress and normal nutritional state), 0.15-0.2 g nitrogen/kg body weight/day (moderate metabolic stress with or without malnutrition) and up to 0.2-0.25 g nitrogen/kg body weight/day (severe catabolism as in burns, sepsis and trauma). The dosage range 0.1-0.25 g nitrogen/kg body weight/day corresponds to 11-27 mL Amino Acid IV Infusion with 10% Glucose and Electrolytes /kg body weight/day, respectively.<br />\r\n<br />\r\n<strong>Obese patient</strong>: In obese patients, the dose should be based on the estimated ideal weight. Depending upon patient requirements, up to 1000-2000 mL of Amino Acid IV Infusion with 10% Glucose and Electrolytes may be infused IV per 24 hrs. Amino Acid IV Infusion with 10% Glucose and Electrolytes should be infused slowly, at a rate not exceeding 1000 mL in 6 hrs corresponding to approximately 2.8 mL/min. In patients with basal amino acids requirements, the less concentrated Amino Acid IV Infusion with 10% Glucose and Electrolytes may be used.<br />\r\n<br />\r\n<strong>Infants and Children</strong>: In children and infants, a maximal rate of infusion of 30 mL Amino Acid IV Infusion with 10% Glucose and Electrolytes/kg body weight/day is recommended, with a stepwise increase in the rate of administration during the 1st week of treatment.</p>', '<p>At the recommended dosage the amino acid have no pharmacological effects and is not expected to interact with other medicaments.</p>', '<p>Patients with inborn errors of amino acid metabolism, severe liverdysfunction and in severe uremia when dialysis facilities are not available. Due to the content of glucose,this drug is contraindicated in patients with hyperosmolar nonketotic diabetic coma.</p>', '<p>Nausea occurs rarely. Transient increases in liver tests during IV nutrition have been reported. Hypersensitivity reactions have been reported with amino acid solutions. As with all hypertonic infusion solutions, thrombophlebitis may occur when peripheral veins are used. Hyperphenylalaninemia may occur in severely ill, premature infants.</p>', '<p>No specific studies have been performed to assess the safety of Amino Acids + Electrolytes + Glucose in pregnancy and lactation. The prescriber should consider the benefit/risk relationship before administering this combination&nbsp;to pregnant or breastfeeding women.</p>', '<p>This IV infusion is accompanied by increased urinary excretion of the trace elements copper and, in particular zinc, which should be&nbsp;taken into account in the dosing of trace elements, particularly during long-term IV nutrition. Hyperphenylalaninemia has been noted in severely ill premature infants. In these patients, monitoring of the phenylalanine level is recommended and the infusion rate adjusted as needed. This&nbsp;should be used with caution in patients with diabetes mellitus, severe heart failure or with renal function in combination with fluid restrictions or oliguria / anuria of other origin. In patients with hyperglycemia, administration of exogenous insulin might be necessary.</p>', '<p>If Amino Acid, Glucose &amp; Electrolytes combination is administered at a higher rate than recommended, there is an augmented risk for nausea, vomiting and sweating. When peripheral veins are used thrombophlebitis may occur. Osmotic diuresis with dehydration may occur if the dosage recommendations are exceeded. There is also a risk of symptoms related to hyperglycemia. In case of symptoms due to overdose, the infusion should be slowed down or discontinued.</p>', '<p>Parenteral nutritional preparations</p>', '<p>Protect from light and store between 15&deg; C to 25&deg; C temperature. Avoid freezing.</p>', NULL, '2022-02-14 06:45:56', '2022-03-15 06:37:08'),
(83, 83, '<p>Amino acid keto analogues film coated tablet is indicated for chronic renal insufficiency with the following conditions: Given with high calorie, low protein food &lt;40 g daily; Compensated or decompensated retention; Glomerular filtration rate (GFR) of 5-50 mL/minute.</p>', '<p>Amino Acid Ketoanalogue used for nutrition therapy in chronic kidney disease. In absorption process, the keto- and hydroxy-analogues are transaminated to the corresponding essential amino acids by taking nitrogen from non-essential amino acids, thereby decreasing the formation of urea by re-using the amino group. Hence, the accumulation of uraemic toxins is reduced. Amino Acid Ketoanalogue do not induce hyperfiltration of the residual nephrons. Amino Acid Ketoanalogue containing supplements exert a positive effect on renal hyperphosphataemia and secondary hyperparathyroidism. Moreover, renal osteodystrophy may be improved. The use of Amino Acid Ketoanalogue in combination with a very low protein diet allows to reduce nitrogen intake while preventing the deleterious consequences of inadequate dietary protein intake and malnutrition.<br />\r\n<br />\r\nThe plasma kinetics of essential amino acids and their integration in the metabolic pathways are well established. It should nevertheless be noted that in uraemic patients, the cause of the changed plasma levels, which occur frequently in these patients, does not seem to be the absorption of the supplied amino acids, i. e. the absorption itself is not disturbed. The changed plasma levels seem to be due to impaired post-absorptive kinetics, which can be detected in a very early stage of the disease. Gastrointestinal absorption is thus very rapid. The simultaneous increases in the levels of the Amino Acid Ketoanalogue and the corresponding amino acids show that the Amino Acid Ketoanalogue are transaminated very rapidly. Due to the physiological utilisation pathways of Amino Acid Ketoanalogue in the body it is likely that exogenously supplied Amino Acid Ketoanalogue are very rapidly integrated into the metabolic cycles. Ketoacids follow the same catabolic pathways as classical amino acids. No specific study on Amino Acid Ketoanalogue excretion has been performed to date.</p>', '<p>For oral administration. Swallow whole, do not chew/crush. This dosage is for adults with Body Weight (BW) &gt;70 kg.</p>\r\n\r\n<ul>\r\n	<li><strong>Chronic renal insufficiency</strong>: Unless otherwise prescribed, 4-8 tablets 3 times daily, taken during meals.</li>\r\n	<li><strong>Compensated retention</strong>: Unless otherwise prescribed, 4-8 tablets 3 times daily, along with low protein (500-600 mg protein/kg BW per day close to 35-45 grams) and high calorie nutrition [150-170 KJ (35-40 kcal)/kg BW per day].</li>\r\n	<li><strong>Decompensated retention</strong>: Unless otherwise prescribed, 4-8 tablets 3 times daily, along with low protein (300-400 mg protein/kg BW per day close to 20-30 grams) and high calorie nutrition [150-170 KJ (35-40 kcal)/kg BW per day].</li>\r\n</ul>', '<p>With the alleviation of uremic symptoms by Amino Acid Ketoanalogue, reduce the use of Aluminium hydroxide. Observe the reduction of serum phosphate. Concomitant use with drugs forming poor dissolution compound in calcium (e.g. Tetracycline) can inhibit Amino Acid Ketoanalogue absorption.</p>', '<p>Hypercalcemia, disorder of amino acid metabolism.</p>', '<p>May cause hypercalcemia, therefore monitor the serum calcium level periodically.</p>', NULL, '<p>Give enough calories to the patient. Concomitant use with other calcium containing drugs must be given with attention, as it may cause hypercalcemia. Therefore, the serum calcium level must be monitored periodically. Not to be given along with drugs which are slightly soluble in calcium (e.g. Tetracycline). There is no report about usage on pregnancy and children.</p>', '<p>No specific information is available on the treatment of overdose with Amino Acid Ketoanalogue Film Coated Tablet</p>', '<p>Other genito-urinary preparations</p>', '<p>Store at a temperature not exceeding 30&deg;C. Store in a dry place. Protect from heat and moisture.</p>', NULL, '2022-02-14 06:46:17', '2022-03-15 22:06:04'),
(84, 84, '<p>Aminocaproic acid used to treat excessive postoperative bleeding, especially after procedures in which a great amount of bleeding is expected, such as cardiac surgery. It can be given orally or intravenously. A meta-analysis found that lysine analogs like Aminocaproic acid significantly reduced blood loss in patients undergoing coronary artery bypass grafting. Aminocaproic acid can also be used to treat the overdose and/or toxic effects of the thrombolytic pharmacologic agents tissue plasminogen activator and streptokinase.</p>', '<p>The fibrinolysis-inhibitory effects of Aminocaproic acid appear to be exerted principally via inhibition of plasminogen activators and to a lesser degree through antiplasmin activity.</p>', '<p>Dosage of&nbsp; Aminocaproic acid must be adjusted to individual cases according to the severity of the hemmohagic event. It must however born in mind that Aminocaproic acid cleared rapidly by renal rough, so that administration must be repeated every 4-6 hours. The average dose is 8-16 gm a day.i.e. 1 ampule of Aminocaproic acid according to the case, every 6 hours.<br />\r\n<br />\r\nAminocaproic acid is equally effective by mouth and intarvenous injection. In cases of particular severity, or when it is sought to obtain a high blood concentration quickly it is advisable to start treatment by intravenous rough, with slow injection of two Aminocaproic acid ampules with an interval of 30-60 minutes between them, continuing with divided doses until a dosage of 20-25 grams in the 24 hour is reached.<br />\r\n<br />\r\nIn any case, administration of the drug must be continued until complete cessation of all symptoms. Aminocaproic acid could be intravenously administered, following suitable dilution in Physiological solution.</p>', NULL, '<ul>\r\n	<li>Aminocaproic acid should not be used when there is evidence of an active intravascular clotting process.</li>\r\n	<li>When there is uncertainty as to whether the cause of bleeding is primary fibrinolysis or disseminated intravascular coagulation (DIC), this distinction must be made before administering Aminocaproic acid Injection.</li>\r\n	<li>The following tests can be applied to differentiate the two conditions:</li>\r\n	<li>Platelet count is usually decreased in DIC but normal in primary fibrinolysis.</li>\r\n	<li>Protamine paracoagulation test is positive in DIC; a precipitate forms when protamine sulfate is dropped into citrated plasma. The test is negative in the presence of primary fibrinolysis.</li>\r\n	<li>The euglobulin clot lyses test is abnormal in primary fibrinolysis but normal in DIC.</li>\r\n	<li>Aminocaproic acid Injection must not be used in the presence of DIC without concomitant heparin.</li>\r\n</ul>', '<p>Mild muscle pain or weakness; headache, tired feeling; nausea, vomiting, stomach pain, diarrhea; (in men) decreased amount of semen when having an orgasm; stuffy nose, watery eyes; vision problems, ringing in your ears; or Mild skin rash.</p>', '<p>Pregnancy Category C. Animal reproduction studies have not been conducted with aminocaproic acid. It is also not known whether aminocaproic acid can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Aminocaproic Acid Injection should be given to a pregnant woman only if clearly needed.</p>', '<p>Safety and efficacy have not been established in patients younger than 18 years.</p>', NULL, '<p>Anti-fibrinolytic drugs, Haemostatic drugs</p>', '<p>Store in a cool, dry place, protected from light. Store the suspension below 30&deg; C. Keep out of reach of children.</p>', NULL, '2022-02-14 06:46:50', '2022-03-15 22:10:11');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(85, 85, '<p>It is indicated for the treatment and prophylaxis of bronchospasm associated with asthma, emphysema and chronic bronchitis. Also indicated in adults for the treatment of cardiac asthma and left ventricular or congestive cardiac failure.</p>', '<p>Aminophylline is a combination of theophylline and ethylenediamine. Ethylenediamine is inactive; it increases the solubility of theophylline in water. Theophylline relaxes bronchial smooth muscle. Suggested mechanisms are an increase in intracellular cAMP through inhibition of phosphodiesterase; adenosine receptor antagonism, prostaglandin antagonism and effects on intracellular calcium.</p>', '<p><strong>Oral</strong>:<br />\r\nChronic bronchospasm:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: As hydrate: Initially, 225-450 mg bid, increased if necessary.</li>\r\n	<li><strong>Child</strong>: &gt;3 yr: As modified-release hydrate: 12 mg/kg daily increased to 24 mg/kg daily in 2 divided doses after 1 wk.</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous</strong>:<br />\r\nAcute severe bronchospasm:</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>: Loading dose: 5 mg/kg (ideal body weight) or 250-500 mg (25 mg/ml) by slow inj or infusion over 20-30 min. Maintenance infusion dose: 0.5 mg/kg/hr. Max rate: 25 mg/min.</li>\r\n	<li><strong>Child</strong>: Loading dose: same as adult dose. Maintenance dose: 6 mth-9 yr: 1 mg/kg/hr and 10-16 yr: 0.8 mg/kg/hr.</li>\r\n	<li><strong>Elderly</strong>: Dose reduction may be necessary.</li>\r\n	<li><strong>Hepatic impairment</strong>: Dose reduction may be necessary.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Tablets should be swallowed whole and not chewed because of the structure of the tablet.</p>', NULL, '<p>Aminophylline should not be administered to patients with hypersensitivity to xanthines or ehylenediamine. It should not be administered to patients with active peptic ulcer, since it may increase the volume and acidity of gastric secretions.</p>', '<p>The most common adverse effects are gastric irritation, nausea, vomiting, diarrhea, hematemesis, epigastric pain and tremor. These are usually early signs of toxicity; however, with high doses, ventricular arrhythmias or seizures may be the first signs to appear and reactivation of peptic ulcer, headache, irritability, restlessness, insomnia, twitching, convulsion and reflex hyperexcitability, palpitation, tachycardia, hypotension, circulatory failure, ventricular arrhythmias, and flushing, albuminuria, diuresis and hematuria. Also inappropriate ADH syndrome may occur.</p>', '<p>Use of aminophylline in pregnant women should be balanced against the risk of uncontrolled disease.</p>', '<p>Aminophylline should be given with caution to patients with peptic ulceration, hyperthyroidism, hypertension, cardiac arrhythmias or other cardiovascular disease, or epilepsy, as these conditions may be exacerbated. They should also be given withcaution to patients with heart failure, hepatic dysfunction, chronic alcoholism, acute febrile illness, and to neonates and the elderly, since in all of these circumstances theophylline clearance may be decreased, resulting in increases in serum-theophylline concentrations and serum half-life.</p>', NULL, '<p>Bronchodilator, Methyl xanthine derivatives, Respiratory stimulants: analeptics, Theophylline &amp; related drugs</p>', NULL, NULL, '2022-02-14 06:49:46', '2022-03-15 22:13:54'),
(86, 86, '<p>Amiodarone Hydrochloride is an antiarrhythmic agent indicated for initiation of treatment and prophylaxis of frequently recurring ventricular fibrillation (VF) and hemodynamically unstable ventricular tachycardia (VT) in patients refractory to other therapy.</p>', '<p>Amiodarone is generally considered a class III antiarrhythmic drug, but it possesses electrophysiologic characteristics of all four Vaughan Williams classes. Like class I drugs, amiodarone blocks sodium channels at rapid pacing frequencies, and like class II drugs, amiodarone exerts a noncompetitive antisympathetic action. One of its main effects, with prolonged administration, is to lengthen the cardiac action potential, a class III effect. The negative chronotropic effect of amiodarone in nodal tissues is similar to the effect of class IV drugs. In addition to blocking sodium channels, amiodarone blocks myocardial potassium channels, which contributes to slowing of conduction and prolongation of refractoriness. The antisympathetic action and the block of calcium and potassium channels are responsible for the negative dromotropic effects on the sinus node and for the slowing of conduction and prolongation of refractoriness in the atrioventricular (AV) node. Its vasodilatory action can decrease cardiac workload and consequently myocardial oxygen consumption.</p>', '<p>The recommended starting dose is about 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen:</p>\r\n\r\n<ul>\r\n	<li>Initial Load: 150 mg per 100 mL (in D5W or Normal Saline) infused over 10 minutes</li>\r\n	<li>Followed by: 1 mg/min for 6 hours</li>\r\n	<li>Followed by: 0.5 mg/min thereafter</li>\r\n</ul>\r\n\r\n<p>In the event of breakthrough episodes of VF or hemodynamically unstable VT:</p>\r\n\r\n<ul>\r\n	<li>Repeat the Initial Load described above as needed (infused over 10 minutes)</li>\r\n</ul>\r\n\r\n<p>Increase the rate of maintenance infusion to achieve effective arrhythmia suppression.</p>', '<p>Since amiodarone is a substrate for CYP3A and CYP2C8, drugs/substances that inhibit these isoenzymes may decrease the metabolism and increase serum concentration of amiodarone.<br />\r\n<br />\r\nAmiodarone inhibits p-glycoprotein and certain CYP450 enzymes, including CYP1A2, CYP2C9, CYP2D6, and CYP3A. This inhibition can result in unexpectedly high plasma levels of other drugs which are metabolized by those CYP450 enzymes or are substrates for p-glycoprotein.</p>\r\n\r\n<ul>\r\n	<li>If simvastatin is co-administered with amiodarone, do not exceed doses greater than 20 mg daily of simvastatin.</li>\r\n	<li>If lovastatin is co-administered with amiodarone, do not exceed doses greater than 40 mg daily of lovastatin.</li>\r\n</ul>\r\n\r\n<p>Fluoroquinolones, macrolide antibiotics, and azoles are known to cause QTc prolongation. There have been reports of QTc prolongation, with or without TdP, in patients taking amiodarone when fluoroquinolones, macrolide antibiotics, or azoles were administered concomitantly.</p>', '<p>Amiodarone Hydrochloride is contraindicated in patients with :</p>\r\n\r\n<ul>\r\n	<li>Known hypersensitivity to any of the components of Amiodarone, including iodine</li>\r\n	<li>Cardiogenic shock</li>\r\n	<li>Marked sinus bradycardia</li>\r\n	<li>Second- or third-degree atrio-ventricular (AV) block unless a functioning pacemaker is available.</li>\r\n</ul>', '<ul>\r\n	<li>The most common adverse reactions (1-2%) leading to discontinuation of intravenous amiodarone therapy are hypotension, asystole/cardiac arrest/pulseless electrical activity, VT, and cardiogenic shock. (6)</li>\r\n	<li>Other important adverse reactions are, torsade de pointes (TdP), congestive heart failure, and liver function test abnormalities.</li>\r\n</ul>', '<p>Use Amiodarone during pregnancy only if the potential benefit to the mother justifies the risk to the fetus.&nbsp; miodarone and one of its major metabolites, desethylamiodarone (DEA), are excreted in human milk, suggesting that breast-feeding could expose the nursing infant to a significant dose of the drug. Advise mothers to discontinue breast feeding.</p>', '<ul>\r\n	<li>Hypotension: Treat initially by slowing the infusion; additional standard therapy may be needed, including the following: vasopressor drugs, positive inotropic agents, and volume expansion.</li>\r\n	<li>Bradycardia and AV block: Treat by slowing the infusion rate or discontinuing Amiodarone Hydrochloride.</li>\r\n</ul>', '<p>There have been cases, some fatal, of amiodarone overdose. Effects of an inadvertent overdose of intravenous amiodarone include hypotension, cardiogenic shock, bradycardia, AV block, and hepatotoxicity. Treat hypotension and cardiogenic shock by slowing the infusion rate or with standard therapy: vasopressor drugs, positive inotropic agents, and volume expansion. Bradycardia and AV block may require temporary pacing. Monitor hepatic enzyme concentrations closely. Amiodarone is not dialyzable.</p>', '<p>Potassium channel blockers</p>', '<p>Store at 20&deg; to 25&deg;C. Protect from light and excessive heat. Use carton or blister pack to protect contents from light until used.</p>', '<p><strong>Pediatric use</strong>: The safety and efficacy of amiodarone in the pediatric population have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Clinical studies of amiodarone did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Carefully consider dose selection in an elderly patient. In general, start at the low end of the dosing range in the elderly to reflect the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant disease or other drug therapy.</p>', '2022-02-14 06:50:10', '2022-03-15 22:18:20'),
(87, 87, '<p>Amiodarone is used for many serious arrhythmias of the heart including ventricular fibrillation, ventricular tachycardia, atrial fibrillation, and atrial flutter.</p>', '<p>Amiodarone Hydrochloride is used to correct abnormal rhythms of the heart. Amiodarone is considered a &quot;broad spectrum&quot; antiarrhythmic medication. The most important electrical effects of the drug includes : a delay in the rate at which the heart&rsquo;s electrical system &quot;recharges&quot; after the heart contracts (repolarisation); a prolongation in the electrical phase during which the heart&rsquo;s muscle cells are electrically stimulated (action potential); a slowing of the speed of electrical conduction (how fast each individual impulse is conducted through the heart&rsquo;s electrical system); a reduction in the rapidity of firing of the normal generator of electrical impulses in the heart (the heart&rsquo;s pacemaker); and a slowing of conduction through various specialised electrical pathways (called accessory pathways). In addition to being an antiarrhythmic medication, Amiodarone also causes blood vessels to dilate. Because of this effect it also may be of benefit in patients with&nbsp; congestive heart failure. This effect can result in drop of blood pressure.</p>', '<p>The oral dose is 200 mg 3 times daily for 1 week reduced to 200 mg twice daily or the minimum required to control arrhythmia. Amiodarone is usually given in several daily doses to minimize stomach upset which is seen more frequently with higher doses. For this same reason, it is also recommended that Amiodarone should be taken with meals.</p>', '<p>Amiodarone may interact with b blockers such as Atenolol, Propranolol, Metoprolol, or certain calcium channel blockers, such as Verapamil or Diltiazem, resulting in an excessively slow heart rate. Amiodarone increases the blood levels of Digoxin when the two drugs are given together. Flecainide blood concentrations increase by more than 50% with Amiodarone. Procainamide and Quinidine concentrations increase by 30-50% during the first week of Amiodarone therapy. Amiodarone also can interact with tricyclic antidepressants (TCA). Amiodarone interacts with Warfarin and increases the risk of bleeding. Amiodarone inhibits the metabolism of Dextromethorphan.</p>', '<p>Amiodarone is contraindicated in patients with cardiogenic shock; severe sinus-node dysfunction, causing marked sinus bradycardia; second- or third degree atrioventricular block; and when episodes of bradycardia have caused syncope (except when used in conjunction with a pacemaker). Amiodarone is contraindicated in patients with a known hypersensitivity to the drug or to any of its components, including iodine.</p>', '<p>The most severe side effects of Amiodarone therapy are related to the lungs. These reactions can be fatal. Patients should report any symptoms of cough, fever, or painful breathing. Although quite rare, fatal liver toxicity may occur with Amiodarone therapy. Reversible corneal microdeposits (sometimes with night glare), rarely impaired vision due to optic neuritis; peripheral neuropathy and myopathy (usually reversible on withdrawal); bradycardia and conduction disturbances; phototoxicity and rarely persistent skin discolouration; hypothyroidism, hyperthyroidism; raised serum transaminases; jaundice, hepatitis and cirrhosis are reported. Other rare complaints are nausea, vomiting, metallic taste, tremor, sweating, vertigo, headache, sleeplessness, fatigue, alopecia, benign raised intracranial pressure, ataxia, rashes, vasculitis, renal involvement, thrombocytopenia, haemolytic or aplastic anaemia. In some cases, dose of Amiodarone may be reduced. In other cases, Amiodarone therapy may need to be stopped.</p>', '<p>In general, Amiodarone should not be administered during pregnancy because there have been reports of hypo or hyperthyroidism in infants from oral Amiodarone use during pregnancy. If Amiodarone use is considered essential, however, the patient should be warned of the risk to the foetus. The safe use of Amiodarone in lactating women has not been established.</p>', NULL, NULL, '<p>Potassium channel blockers</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 06:50:33', '2022-03-15 22:22:00'),
(88, 88, '<p>Amisulpride is indicated for the treatment of acute and chronic schizophrenic disorders, in which positive symptoms (such as delusions, hallucinations, thought disorders) and/or negative symptoms (such as blunted affect, emotional and social withdrawal) are prominent, including patients characterized by predominant negative symptoms.</p>', '<p>Amisulpride binds selectively to the human dopaminergic D2 and D3 receptor subtypes without any affinity for D1, D4 and D5 receptor subtypes. Unlike classical and atypical neuroleptics, amisulpride displays low affinity for serotonin, &alpha;- adrenergic, histamine receptor subtypes, muscarinic receptors and sigma sites. In the rodent, it preferentially blocks post synaptic D2 receptors located in the limbic structures as compared to those in the striatum as indicated by its reversal of d-amphetamineinduced hyperactivity without affecting stereotypies. In addition, it does not induce catalepsy and it does not produce D2 hypersensitivity after repeated treatment.<br />\r\n<br />\r\nMoreover, it preferentially blocks pre-synaptic D2/D3 dopamine receptors, producing dopamine release responsible for its disinhibitory effects. This atypical pharmacological profile may explain amisulpride&rsquo;s antipsychotic effect at higher doses through post-synaptic dopamine receptor blockade located in the limbic areas and its efficacy against negative symptoms, at lower doses, through presynaptic dopamine receptor blockade. In addition, the reduced tendency of amisulpride to produce extrapyramidal side effects may be related to its preferential limbic activity.</p>', '<p>For acute psychotic episodes, oral doses between 400 mg/d and 800 mg/d are recommended. In individual cases, the daily dose may be increased up to 1200 mg/d. Doses above 1200 mg/d have not been extensively evaluated for safety and therefore should not be used. Doses above 800 mg/d have not been shown to be superior to lower doses and may increase the incidence of adverse events. No specific titration is required when initiating the treatment with amisulpride.<br />\r\n<br />\r\nDoses should be adjusted according to individual response. Doses should preferably be administered before meals. Amisulpride should be administered twice daily for doses above 400 mg. For patients with mixed positive and negative symptoms, doses should be adjusted to obtain optimal control of positive symptoms. Maintenance treatment should be established individually with the minimally effective dose. For patients characterized by predominant negative symptoms, oral doses between 50 mg/d and 300 mg/d are recommended. Doses should be adjusted individually.</p>', NULL, '<p>Hypersensitivity to the active ingredient or to other ingredients of the product. Concomitant prolactin-dependent tumours e.g. pituitary gland prolactinomas and breast<br />\r\ncancer. Phaeochromocytoma. Children up to puberty. Lactation.</p>', NULL, '<p>pregnancy Category C. The safety of amisulpride during human pregnancy has not been established, and therefore use of amisulpride is not recommended during pregnancy and in women of child bearing potential not using effective contraception, unless the benefits justify the potential risks and the administered dose and duration of treatment should be as low and as short as possible. Amisulpride has been found in the breast milk of treated women. Breast-feeding is contraindicated.</p>', '<p>Neuroleptic Malignant Syndrome (NMS) is a potentially fatal syndrome that has been reported in association with anti psychotic medicines, including amisulpride. Neuroleptic malignant syndrome is characterised by hyperthermia, muscle rigidity, autonomic instability, and elevated CPK, may occur. In the event of any symptoms which could suggest NMS, in particular hyperthermia, particularly with high daily doses, all antipsychotic medicines including amisulpride should be discontinued. Amisulpride can lower the seizure threshold. Therefore patients with a history of seizures should be closely monitored during amisulpride therapy.</p>', NULL, '<p>Atypical neuroleptic drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Elderly</strong>: Amisulpride should be used with particular caution because of a possible risk of hypotension or sedation.<br />\r\n<br />\r\n<strong>Children</strong>: The efficacy and safety of amisulpride from puberty to the age of 18 years have not been established: there are limited data available on the use of amisulpride in adolescents in schizophrenia. Therefore, the use of amisulpride from puberty to the age of 18 years is not recommended. In children up to puberty, the use of amisulpride is contraindicated<br />\r\n<br />\r\n<strong>Use in hepatic impairment</strong>: The impact of hepatic impairment on hepatic metabolism and hepato-biliary excretion of amisulpride has not been studied. Amisulpride should be used with caution in patients with moderate or severe hepatic impairment.<br />\r\n<br />\r\n<strong>Use in renal impairment</strong>: Amisulpride is eliminated by the renal route. In cases of renal insufficiency, the dose should be decreased and intermittent treatment should be considered</p>', '2022-02-14 06:50:51', '2022-03-15 22:25:39'),
(89, 89, '<p>This is indicated for the treatment of patients with moderate to severe depression associated with moderate to severe anxiety. Symptoms likely to respond in the first week of treatment include insomnia, feelings of guilt or worthlessness, agitation, psychic and somatic anxiety, suicidal ideation and anorexia.</p>', '<p>Amitriptyline is a tricyclic antidepressant and Chlordiazepoxide is an anxiolytic. Amitriptyline inhibits the reuptake of norepinephrine and serotonin in the brain. This interference with the reuptake is responsible for the antidepressant activity of Amitriptyline. Chlordiazepoxide works by enhancing GABA-mediated chloride influx through GABA receptor channels, causing membrane hyperpolarization. The net neuro-inhibitory effects result in the observed sedative and anxiolytic effect.</p>', '<p>Optimum dosage varies with the severity of the symptoms and the response of the individual patient. When a satisfactory response is obtained, the dosage should be reduced to the smallest amount needed to maintain the remission. The larger portion of the total daily dose may be taken at bedtime. In some patients, a single dose at bedtime may be sufficient. This tablet in an initial dosage of 3 or 4 tablets daily in divided doses is satisfactory. Or directed by the physican.</p>', '<p>Because of its Amitriptyline component, this preparation may block the antihypertensive action of guanethidine or compounds with a similar mechanism of action.</p>', '<p>This is contraindicated in patients with hypersensitivity to either benzodiazepines or tricyclic antidepressants. It should not be given concomitantly with a monoamine oxidase inhibitor.</p>', '<p>Side effects: Many symptoms common to the depressive state, such as anorexia, fatigue, weakness, restlessness and lethargy, have been reported as side effects of treatment with this preparation.<br />\r\n<br />\r\nAdverse reactions: Most frequently reported were drowsiness, dry mouth, constipation, blurred vision, dizziness and bloating. Less commonly included vivid dreams, impotence, tremor, confusion and nasal congestion.</p>', '<p>Safe use of this preparation during pregnancy and lactation has not been established.</p>', '<p>Use with caution in patients with a history of seizures. Close supervision is required when this preparation is given to hyperthyroid patients or those on thyroid medication. The usual precautions should be observed when treating patients with impaired renal or hepatic function. All pediatric patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality and unusual changes in behavior.</p>', '<p>Deaths may occur from overdosage with this class of drugs. Critical manifestations of Amitriptyline overdose include cardiac dysrhythmias, severe hypotension, convulsions and CNS depression, including coma. Manifestations of benzodiazepine overdosage include somnolence, confusion, coma and diminished reflexes.<br />\r\n<br />\r\nWithdrawal symptoms, similar in character to those noted with barbiturates and alcohol (convulsions, tremor, abdominal and muscle cramps, vomiting and sweating), have occurred following abrupt discontinuance of Chlordiazepoxide. Generally, milder withdrawal symptoms (eg, dysphoria and insomnia) have been reported following abrupt discontinuance of benzodiazepines taken continuously at therapeutic levels for several months. Withdrawal symptoms (e.g., nausea, headache and malaise) have also been reported in association with abrupt Amitriptyline discontinuation.</p>', '<p>Combined anxiolytics &amp; anti-depressant drugs</p>', '<p>Store in a cool and dry place, protected from light. Keep all medicines out of reach of the children.</p>', '<p><strong>Pediatric Use</strong>: Safety and effectiveness in the pediatric population have not been established. Anyone considering the use of Chlordiazepoxide and Amitriptyline Hydrochloride Tablets in a child or adolescent must balance the potential risks with the clinical need.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: In elderly and debilitated patients it is recommended that dosage be limited to the smallest effective amount to preclude the development of ataxia, over sedation, confusion or anticholinergic effects.</p>', '2022-02-14 06:51:31', '2022-03-15 22:31:03'),
(90, 90, '<p>Amlexanox is indicated for the treatment of aphthous ulcers in people with normal immune system.</p>', '<p>The mechanism of action by which Amlexanox accelerates healing of aphthous ulcers is unknown. In vitro studies have demonstrated Amlexanox to be a potent inhibitor of the formation and release of inflammatory mediators (histamine and leukotrienes) from mast cells, neutrophils and mononuclear cells. Given orally to animals, Amlexanox has demonstrated anti-allergic and anti-inflammatory activities and has been shown to suppress both immediate and delayed type hypersensitivity reactions. The relevance of these activities of Amlexanox to its effects on aphthous ulcers has not been established.</p>', '<p><strong>Adults (over 18 years of age)</strong>: Apply the paste as soon as possible after noticing the symptoms of an aphthous ulcer. Continue to use the paste four times daily, preferably following oral hygiene after breakfast, lunch, dinner, and at bedtime. Dry the ulcer(s) by gently patting it with a soft, clean cloth. Wash hands before applying. Moisten the tip of the index finger &amp; squeeze a dab of paste approximately &frac14; inch (0.5 cm) on to the finger tip. Gently dab the paste on to each ulcer. Repeat the process if more than one ulcer are present. Wash hands after application. Use the paste until the ulcer heals. If significant healing or pain relief has not occurred in 10 days, consultation with the physician is required.</p>', NULL, '<p>Amlexanox oral paste is contraindicated in patients with known hypersensitivity to Amlexanox or other ingredients in the formulation.</p>', '<p>The most common side effects are transient pain, stinging and/or burning at the site of application. The less frequent side effects are contact mucositis, nausea, and diarrhea.</p>', '<p><strong>Pregnancy</strong>&nbsp;category B. No adverse fetal effects were observed during teratological studies on animals, but there are no adequate and well-controlled studies in pregnant women. So this drug should be used during pregnancy only if clearly needed.<br />\r\n<br />\r\n<strong>Lactation</strong>: Amlexanox was found in the milk of lactating rats; therefore, caution should be exercised when administering Amlexanox oral paste to a nursing woman.</p>', '<p>Wash hands immediately after applying Amlexanox oral paste directly to ulcers with thefinger tips. Wash eyes promptly if they should come in contact with the paste. In the event that a rash or contact mucositis occurs, discontinue us</p>', '<p>Ingestion of a full tube would result in systemic exposure below the maximum nontoxic dose of Amlexanox in animals. Gastrointestinal upset such as diarrhea and vomiting could result from an overdose.</p>', '<p>Drugs for Aphthous ulcer</p>', '<p>Store in a cool &amp; dry place. Protect from light. Keep out of reach of the children</p>', '<p>Safety and effectiveness of Amlexanox oral paste in pediatric patients have not been established.</p>', '2022-02-14 06:51:51', '2022-03-15 22:35:07'),
(91, 91, '<p><strong>Essential hypertension</strong>: Amlodipine is efficacious as monotherapy in the treatment of hypertension. It may be used in combination with other antihypertensive agents.<br />\r\n<br />\r\n<strong>Angina pectoris</strong>: Amlodipine is indicated for the treatment of chronic stable angina pectoris and is efficacious as monotherapy. It may be used in combination with other antianginal agents.<br />\r\n<br />\r\n<strong>Vasospastic angina</strong>: Amlodipine is indicated for the treatment of confirmed or suspected vasospastic angina. It may be used as monotherapy or in combination with other antianginal drugs.</p>', '<p>Amlodipine is a dihydropyridine calcium-channel blocker, with a long duration of action, used for the treatment of hypertension and angina pectoris. Amlodipine influences the myocardial cells, the cells within the specialized conducting system of the heart, and the cells of vascular smooth muscle. Administration of Amlodipine results primarily in vasodilation, with reduced peripheral resistance, blood pressure and afterload, increased coronary blood flow and a reflex increase in coronary heart rate. This in turn results in an increase in myocardial oxygen supply and cardiac output.</p>', '<p><strong>Hypertension</strong>: Usual dose is 5 mg once daily. The maximum dose is 10 mg once daily. Elderly patients with hepatic insufficiency may be started on 2.5 mg once daily; this dose may also be used when adding Amlodipine to other antihypertensive therapy.<br />\r\n<br />\r\n<strong>Angina (Chronic stable or Vasospastic)</strong>: 5 to 10 mg, using the lower dose for elderly and in patients with hepatic insufficiency. Most patients require 10 mg.<br />\r\n<br />\r\nAdministrations: May be taken without regard to meals.</p>', '<p>Drug Interactions-</p>\r\n\r\n<ul>\r\n	<li><strong>Potentially hazardous interactions</strong>: Little or no data are available in patients with markedly impaired cardiac left ventricular function; however, as with other calcium antagonist drugs, the combination of Amlodipine and p-blockers should be avoided in such patients.</li>\r\n</ul>\r\n\r\n<p>Other Significant Interactions-</p>\r\n\r\n<ul>\r\n	<li><strong>Digoxin</strong>: Absence of any interaction between Amlodipine and Digoxin in healthy volunteers has been documented in a controlled clinical study.</li>\r\n	<li><strong>Cimetidine</strong>: An unpublished clinical study indicated no interaction between, Amlodipine and Cimetidine in healthy volunteers.</li>\r\n	<li><strong>Warfarin</strong>: An unpublished clinical study in healthy volunteers indicates that Amlodipine did not significantly alter the effect of Warfarin on prothrombin time.</li>\r\n	<li><strong>Food</strong>: Food does not alter the rate or extent of absorption of Amlodipine.</li>\r\n</ul>', '<p>Hypersensitivity to dihydropyridine derivatives. Pregnant woman.</p>', '<p>The most common adverse effects of amlodipine are associated with vasodilatory action, such as dizziness, flushing, headache, hypotension and peripheral edema. Gastrointestinal disturbances, increased micturition frequency, lethargy, eye pain and mental depression may also occur. A paradoxical increase in ischaemic chest pain may occur at the start of the treatment and in a few patients excessive fall in blood pressure has led to cerebral or myocardial ischaemia or transient blindness. Rashes, fever and abnormalities in liver function due to hypersensitivity reaction of Amlodipine may occur.</p>', '<p>Pregnancy Category C. There are no adequate and well-controlled studies of Amlodipine in pregnant women. Amlodipine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Amlodipine is excreted in human milk. In the absence of this information, it is recommended that nursing be discontinued while Amlodipine is administered.</p>', '<p>Precaution should be taken in patients with hepatic impairment and during pregnancy and breast feeding.</p>', '<p><strong>Symptoms</strong>: Available data suggest that large overdosage could result in excessive peripheral vasodilatation and possibly reflex tachycardia. Marked and probably prolonged systemic hypotension up to and including shock with fatal outcome have been reported.<br />\r\n<br />\r\n<strong>Management</strong>: Clinically significant hypotension due to amlodipine overdosage calls for active cardiovascular support including frequent monitoring of cardiac and respiratory function, elevation of extremities, and attention to circulating fluid volume and urine output.&nbsp;<br />\r\n<br />\r\nA vasoconstrictor may be helpful in restoring vascular tone and blood pressure, provided that there is no contraindication to its use. Intravenous calcium gluconate may be beneficial in reversing the effects of calcium channel blockade. Gastric lavage may be worthwhile in some cases. In healthy volunteers the use of charcoal up to 2 hours after administration of amlodipine 10 mg has been shown to reduce the absorption rate of amlodipine. Since amlodipine is highly protein-bound, dialysis is not likely to be of benefit.</p>', '<p>Calcium-channel blockers</p>', '<p><strong>Essential hypertension</strong>: Amlodipine is efficacious as monotherapy in the treatment of hypertension. It may be used in combination with other antihypertensive agents.<br />\r\n<br />\r\n<strong>Angina pectoris</strong>: Amlodipine is indicated for the treatment of chronic stable angina pectoris and is efficacious as monotherapy. It may be used in combination with other antianginal agents.<br />\r\n<br />\r\n<strong>Vasospastic angina</strong>: Amlodipine is indicated for the treatment of confirmed or suspected vasospastic angina. It may be used as monotherapy or in combination with other antianginal drugs.</p>', '<p><strong>Children with hypertension from 6 years to 17 years of age</strong>: 2.5 mg once daily as a starting dose, up-titrated to 5 mg once daily if blood pressure goal is not achieved after 4 weeks. Doses in excess of 5 mg daily have not been studied in pediatric patients.<br />\r\n<br />\r\n<strong>Children under 6 years old</strong>: &nbsp;The effect of amlodipine on blood pressure in patients less than 6 years of age is not known.<br />\r\n<br />\r\n<strong>Elderly</strong>: Amlodipine used at similar doses in elderly or younger patients is equally well tolerated. Normal dosage regimens are recommended in the elderly, but increase of the dosage should take place with care.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Changes in amlodipine plasma concentrations are not correlated with degree of renal impairment, therefore the normal dosage is recommended. Amlodipine is not dialysable.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Dosage recommendations have not been established in patients with mild to moderate hepatic impairment; therefore dose selection should be cautions and should start at the lower end of the dosing range. The pharmacokinetics of Amlodipine have not been studied in severe hepatic impairment. Amlodipine should be initiated at the lowest dose (2.5 mg once daily) and titrated slowly in patients with severe hepatic impairment.</p>', '2022-02-14 06:52:09', '2022-07-02 05:34:59'),
(92, 92, '<p>This is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Patients with essential hypertension</li>\r\n	<li>Patients with angina pectoris &amp; hypertension as co-existing diseases</li>\r\n	<li>ln post Ml patients</li>\r\n	<li>ln patients with refractory angina pectoris where nitrate therapy has failed.</li>\r\n</ul>', '<p>This is a fixed-dose combination of Amlodipine and Atenolol. Amlodipine is a dihydropyridine calcium antagonist that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle; it has a greater effect on vascular smooth muscle than on cardiac muscle. Amlodipine is a peripheral vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure. Amlodipine reduces tone, decreases coronary vasoreactivity and lowers cardiac demand by reducing afterload.<br />\r\n<br />\r\nAtenolol is a cardioselective&nbsp;beta-blocker. The cardio-selectivity is dose-related. Atenolol causes a reduction in blood pressure by lowering cardiac output, decreasing the plasma renin activity and sympathetic outflow from CNS. Atenolol also causes a reduction in myocardial oxygen demand by virtue of its negative inotropic and negative chronotropic effects.</p>', '<p>The recommended dosage is Amlodipine and Atenolol 5/25 mg tablet once daily. If necessary, the dosage may be increased to 5/25 mg two tablets daily or as advised by the physicians. The dosage however should be individualized.</p>', '<p><strong>Disopyramide</strong>: Atenolol reduces the clearance of disopyramide by 20%. Additive negative inotropic effects on the heart may be produced.<br />\r\n<br />\r\n<strong>Ampicillin</strong>: at doses of 1 gm and above may reduce Atenolol levels.<br />\r\n<br />\r\n<strong>Oral antidiabetics and insulin</strong>: Beta-blockers may decrease tissue sensitivity to insulin and inhibit insulin secretion e.g. in response to oral antidiabetics. Atenolol has less potential for these actions.</p>', '<p>Hypersensitivity to either component, sinus bradycardia, second and higher degrees of heart block, cardiogenic shock, hypotension, congestive heart failure, poor left ventricular function.</p>', '<p>The combination of Amlodipine and Atenolol is well tolerated. Overall side-effects include<br />\r\nfatigue, headache, edema, nausea, drowsiness, anxiety and depression.</p>', '<p>The combination should be used during pregnancy only if the expected benefit outweighs the potential fetal risk. The combination should not be used by nursing mothers. If its use is considered necessary, breast-feeding should be stopped.</p>', '<p><strong>Bronchospasm</strong>: The combination should be used with caution in patients with airway obstruction.<br />\r\n<br />\r\n<strong>Renal impairment</strong>: The combination can be used in patients with renal impairment. However, caution may be necessary if the creatinine clearance is less than 30 ml/min because of possible reduction in the excretion of unchanged Atenolol.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Caution may be necessary in the use of the combination in patients with severe liver damage because of prolongation of the elimination half-life of Amlodipine.<br />\r\n<br />\r\n<strong>Drug withdrawal</strong>: Since coronary heart disease may exist without being recognized, patients should be warned against stopping the drug suddenly. Any discontinuation should be gradual and under observation.</p>', '<p>Though not documented, hypotension and less frequently congestive cardiac failure may occur in cases of overdosage. Unabsorbed drugs may be removed by gastric lavage or administration of activated charcoal. Symptomatic treatment is suggested.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 06:52:30', '2022-03-15 22:42:39'),
(93, 93, '<p><strong>Amlodipine</strong>:</p>\r\n\r\n<ul>\r\n	<li>Hypertension</li>\r\n	<li>Chronic Stable Angina</li>\r\n	<li>Vasospastic Angina (Prinzmetal&#39;s or Variant Angina)</li>\r\n</ul>\r\n\r\n<p><strong>Atorvastatin</strong>:</p>\r\n\r\n<ul>\r\n	<li>Heterozygous Familial and Nonfamilial Hypercholesterolemia</li>\r\n	<li>Elevated Serum TG Levels</li>\r\n	<li>Primary Dysbetalipoproteinemia</li>\r\n	<li>Homozygous Familial Hypercholesterolemia</li>\r\n</ul>', '<p><strong>Amlodipine</strong>&nbsp;is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.<br />\r\n<br />\r\n<strong>Atorvastatin</strong>&nbsp;is a synthetic lipid lowering agent. It is an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA). This enzyme catalyzes the conversion of HMG-CoA to mevatonate, an early and rate limiting step in the synthesis of cholesterol.</p>', '<p><strong>Amlodipine (Adult)</strong>: The usual initial antihypertensive oral dose is 5 mg once daily with a maximum dose of 10 mg once daily. Elderly individuals or patients with hepatic insufficiency may be started on 2.5 mg once daily dose and this dose may be used when adding Amlodipine to other antihypertensive therapy. Dosage should be adjusted according to each patient&#39;s need. The recommended dose for chronic stable or vasospastic angina is 5-10 mg, with the lower dose suggested in the elderly and in patients with hepatic insufficiency.<br />\r\n<br />\r\n<strong>Atorvastatin (Adults)</strong>: The patient should be placed on a standard cholesterol-lowering diet before receiving Atorvastatin and should continue on this diet during treatment with Atorvastatin Hypercholesterolemia (Heterozygous Familial and Nonfamilial) and Mixed Dyslipidemia (Fredrickson Types IIa and IIb): The recommended starting dose of Atorvastatin is 10 mg daily. The dosage range is 10 to 80 mg once daily. Atorvastatin can be administered as a single dose at any time of the day with or without food.<br />\r\n<br />\r\n<strong>Homozygous Familial Hypercholesterolemia</strong>: The dosage of Atorvastatin in patients with homozygous FH is 10 to 80 mg daily.</p>', '<p>Drug interaction with atorvastatin: The risk of myopathy during treatment with drugs of this class is increased with concurrent administration of cyclosporine, fibric acid derivatives, niacin (nicotinic acid), erythromycin, azole antifungals. When atorvastatin and antacid suspension containing magnesium and aluminum hydroxide were co administered, plasma concentrations of atorvastatin decreased approximately 35%. However, LDL-C reduction was not altered. Plasma concentrations of atorvastatin decreased approximately 25% when colestipol and atorvastatin were co administered. However, LDL-C reduction was greater when atorvastatin and colestipol were co-administered than when either drug was given alone. When multiple doses of atorvastatin and digoxin were co-administered, steady state plasma digoxin concentrations increased by approximately 20%. Patients taking digoxin should be monitored appropriately. In healthy individuals, plasma concentrations of atorvastatin increased approximately 40% with co- administration of atorvastatin and erythromycin. Co- administration of atorvastatin and an oral contraceptive increased AUC values for norethindrone and ethinylestradiol by approximately 30% and 20%. These increases should be considered when selecting an oral contraceptive for a woman taking atorvastatin.<br />\r\n&nbsp;<br />\r\nDrug interaction with amlodipine: Amlodipine may potentiate the effect of other antihypertensive (e.g.Beta-blockers, ACE inhibitors, Alpha-1-blockers and Diuretics). In clinical interaction studies, Amlodipine did not affect the pharmacokinetics of Atorvastatin, Digoxin, Warfarin or Cyclosporine.</p>', '<p>Combination of amlodipine and atorvastatin is contraindicated in patients with known hypersensitivity to any component of this medication. Combination of amlodipine and atorvastatin contains atorvastatin and is therefore contraindicated in patients with active liver disease which may include unexplained persistent elevations of serum transaminases.</p>', '<p>In general, treatment with amlodipine and atorvastatin combination is well tolerated. Some common side effects include headache, dizziness, tiredness, sleepiness, stomach pain, nausea, upset stomach, diarrhea, edema, flushing, arrhythmia, palpitation, muscle and joint pain, tendon problems etc.</p>', '<p><strong>Pregnancy:</strong>&nbsp;category X. Combination of amlodipine and atorvastatin should be administered to women of childbearing age only when such patients are highly unlikely to conceive and have been informed of the potential hazards.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether amlodipine or atorvastatin is excreted in human milk. Because of the potential for adverse reactions in nursing infants, women taking combination of amlodipine and atorvastatin should not breast-feed.</p>', '<p>Increased Angina and/or Myocardial Infarction Rarely, patients, particularly those with severe obstructive coronary artery disease, have developed documented increased frequency, duration and/or severity of angina or acute myocardial infarction on starting calcium channel blocker therapy or at the time of dosage increase. The mechanism of this effect has not been elucidated. Liver Dysfunction. HMG-CoA reductase inhibitors, like some other lipid-lowering therapies, have been associated with biochemical abnormalities of liver function.</p>', NULL, '<p>Anti-anginal &amp; lipid lowering drugs</p>', '<p>Store in a cool and dry place. Protect from light and moisture. Keep all medicines out of the reach of children.</p>', '<p><strong>Patients with renal insufficiency</strong>: Renal disease has no influence on the plasma concentrations or lipid effects of Atorvastatin; thus no adjustment of dose is required. Hemodialysis is not expected to significantly enhance the clearance of Atorvastatin since the drug is extensively bound to plasma proteins.<br />\r\n<br />\r\n<strong>Patients with hepatic dysfunction</strong>: In patients with moderate to severe hepatic dysfunction, the therapeutic response to Atorvastatin is unaffected but exposure to the drug is greatly increased.</p>', '2022-02-14 06:52:57', '2022-03-15 23:06:47');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(94, 94, '<p>This combination is indicated for the treatment of hypertension. This fixed combination drug is not indicated for the initial therapy of hypertension.</p>', '<p>The combination of Amlodipine and Benazepril is used to treat high blood pressure. Benazepril and benazeprilat inhibit angiotensin-converting enzyme (ACE) in human subjects and in animals. While the mechanism through which Benazepril lowers blood pressure is believed to be primarily suppression of the renin-angiotensin aldosterone system, Benazepril has an antihypertensive effect even in patients with low-renin hypertension. Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slow channel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Amlodipine inhibits calcium ion influx across cell membranes selectively, with a greater effect on vascular smooth muscle cells than on cardiac muscle cells. Amlodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.<br />\r\n<br />\r\nThe rate and extent of absorption of Benazepril and Amlodipine are not significantly different, respectively, from the rate and extent of absorption of Benazepril and Amlodipine from individual tablet formulations. Following oral administration of this capsule, peak plasma concentrations of Benazepril are reached in 0.5-2 hours. Peak plasma concentrations of Amlodipine are reached 6-12 hours after administration of this capsule; the extent of absorption is 64%-90%. Over 700 patients received Benazepril/Amlodipine once daily in five double-blind, placebo-controlled studies. Benazepril/Amlodipine lowered blood pressure within 1 hour, with peak reductions achieved 2-8 hours after dosing. The antihypertensive effect of a single dose persisted for 24 hours. Once-daily doses of Benazepril/Amlodipine using Benazepril doses of 10-20 mg and Amlodipine doses of 2.5-10 mg decreased seated pressure (systolic/diastolic) 24 hours after dosing by about 10-25/6-13 mmHg.</p>', '<p>Amlodipine is an effective treatment of hypertension in once-daily doses of 2.5-10 mg while Benazepril is effective in doses of 10-80 mg.<br />\r\n<br />\r\nIt is usually appropriate to begin therapy with this capsule only after a patient has either-</p>\r\n\r\n<ul>\r\n	<li>Failed to achieve the desired antihypertensive effect with one or the other monotherapy, or</li>\r\n	<li>Demonstrated inability to achieve adequate antihypertensive effect with Amlodipine therapy without developing edema.</li>\r\n</ul>\r\n\r\n<p><strong>Dose Titration Guided by Clinical Effect</strong>: A patient whose blood pressure is not adequately controlled with Amlodipine (or another dihydropyridine) alone or with Benazepril (or another ACE inhibitor) alone may be switched to combination therapy with this capsule. All patient groups benefit from the reduction in Amlodipine-induced edema. Dosage must be guided by clinical response; steady-state levels of Benazepril an Amlodipine will be reached after approximately 2 and 7 days of dosing respectively.<br />\r\n<br />\r\nIn patients whose blood pressures are adequately controlled with Amlodipine but who experience unacceptable edema, combination therapy may achieve similar (or better) blood-pressure control without edema. Especially in nonblacks, it may be prudent to minimize the risk of excessive response by reducing the dose of Amlodipine as Benazepril is added to the regimen.<br />\r\n<br />\r\n<strong>Replacement Therapy</strong>: For convenience, patients receiving Amlodipine and Benazepril from separate tablets may instead wish to receive this capsule containing the same component doses. In small, elderly, or hepatically impaired patients, the recommended initial dose of Amlodipine, as monotherapy or as a component of combination therapy, is 2.5 mg.</p>', '<p><strong>Diuretics</strong>: Patients on diuretics, especially those in whom diuretic therapy was recently instituted, may occasionally experience an excessive reduction of blood pressure after initiation of therapy with Benazepril/Amlodipine.<br />\r\n<br />\r\n<strong>Potassium Supplements and Potassium-Sparing Diuretics</strong>: Benazepril can attenuate potassium loss caused by thiazide diuretics. Potassium-sparing diuretics (Spironolactone, Amiloride, Triamterene and others) or potassium supplements can increase the risk of hyperkalemia. If concomitant use of such agents is indicated, they should be given with caution, and the patient&#39;s serum potassium should be monitored frequently.<br />\r\n<br />\r\n<strong>Others</strong>: Benazepril has been used concomitantly with oral anticoagulants, beta-adrenergic-blocking agents, calcium-blocking agents, Cimetidine, diuretics, Digoxin, Hydralazine, and Naproxen without evidence of clinically important adverse interactions.<br />\r\n<br />\r\nIn clinical trials, Amlodipine has been safely administered with thiazide diuretics, beta blockers, ACE inhibitors, long-acting nitrates, sublingual nitroglycerin, Digoxin, Warfarin, nonsteroidal anti-inflammatory drugs, antibiotics, and oral hypoglycemic drugs.</p>', '<p>This capsule is contraindicated in patients who are hypersensitive to Benazepril, to any other ACE inhibitor, or to Amlodipine.</p>', '<p>Benazepril/Amlodipine has been evaluated for safety in patients with hypertension for at least 6 months and more than 1 year. The reported side effects were generally mild and transient, and there was no relationship between side effects and age, sex, race or duration of therapy. Discontinuation of therapy due to side effects was required in approximately 4% of patients treated with Benazepril/Amlodipine and in 3% of patients treated with placebo. The most common reasons for discontinuation of therapy with Benazepril/Amlodipine in U.S. studies were cough and edema. The side effects considered possibly or probably related to study drug that occurred in U.S. placebo-controlled trials in more than 1% of patients treated with Benazepril/Amlodipine are cough, headache, dizziness and edema.<br />\r\n<br />\r\nThe incidence of edema was statistically greater in patients treated with Amlodipine monotherapy than in patients treated with the combination. Edema and certain other side effects are associated with Amlodipine monotherapy in a dose-dependent manner, and appear to affect women more than men. The addition of Benazepril resulted in lower incidences as shown in study; the protective effect of Benazepril was independent of race and (within the range of doses tested) of dose.<br />\r\n<br />\r\nOther rare side effects are angioedema, asthenia, fatigue, insomnia, nervousness, anxiety, tremor, decreased libido, flushing, hot flashes, rash, skin nodule, dermatitis, dry mouth, nausea, abdominal pain, constipation, diarrhea, dyspepsia, esophagitis, hypokalemia, pharyngitis etc.</p>', '<p>Pregnancy Categories C (first trimester) and D (second and third trimesters). ACE inhibitors can cause fetal and neonatal morbidity and death when administered to pregnant women. Several dozen cases have been reported in the world literature. When pregnancy is detected, this capsule should be discontinued as soon as possible. Minimal amounts of unchanged Benazepril and of benazeprilat are excreted into the breast milk of lactating women treated with Benazepril, so that a newborn child ingesting nothing but breast milk would receive less than 0.1% of the maternal doses of Benazepril and benazeprilat. It is not known whether Amlodipine is excreted in human milk. In the absence of this information, it is recommended that nursing be discontinued while this capsule is administered.</p>', '<p><strong>Impaired Renal Function</strong>: This capsule should be used with caution in patients with severe renal disease.<br />\r\n<br />\r\n<strong>Hyperkalemia</strong>: This may occur in only a few patients but generally are reversible.<br />\r\n<br />\r\n<strong>Patients With Hepatic Failure</strong>: Since Amlodipine is extensively metabolized by the liver and the plasma elimination half-life (t &frac12;) is 56 hours in patients with impaired hepatic function, caution should be exercised when administering this capsule to patients with severe hepatic impairment.<br />\r\n<br />\r\n<strong>Cough</strong>: ACE inhibitor-induced cough should be considered in the differential diagnosis of cough.<br />\r\n<br />\r\n<strong>Surgery/Anesthesia</strong>: In patients undergoing surgery or during anesthesia with agents that produce hypotension, Benazepril will block the angiotensin II formation that could otherwise occur secondary to compensatory renin release. Hypotension that occurs as a result of this mechanism can be corrected by volume expansion.<br />\r\n<br />\r\n<strong>Carcinogenesis, Mutagenesis, Impairment of Fertility</strong>: No evidence of carcinogenicity, mutagenicity or impairment of fertility was found when the Benazepril/Amlodipine combination were given orally.</p>', '<p>Human overdoses with any combination of Amlodipine and Benazepril have not been reported. In scattered reports of human overdoses with Benazepril and other ACE inhibitors, there are no reports of death.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Keep below 25&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Geriatric Use</strong>: Clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '2022-02-14 06:53:34', '2022-03-15 23:11:42'),
(95, 95, '<p>This is indicated for the treatment of hypertension, alone or with other antihypertensive agents. It may also be used as initial therapy in patients who are likely to need multiple drugs to achieve their blood pressure goals.</p>', '<p>This is a fixed dose combination of Telmisartan and Amiodipine. Telmisartan, a non-peptide angiotensin receptor blocker (ARB), is specific angiotensin II antagonist acting on the AT1 subtype. Angiotensin II is the principal pressor agent of the renin-angiotensin system, with effects that include vasoconstriction, stimulation of synthesis and release of aldosterone, cardiac stimulation, and renal reabsorption of sodium, which leads to an increase in blood pressure (hypertension). Telmisartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Therefore, Telmisartan dilates blood vessels and reduces blood pressure without affecting pulse rate. Telmisartan has much greater affinity (&gt;3,000 fold) for the AT1 receptor than for the AT2 receptor. It does not bind or block other hormone receptors or ion channels known to be important in cardiovascular regulation.<br />\r\n<br />\r\nAmiodipine, a dihydropyridine calcium-channel blocker (CCB), inhibits the transmembrane influx of calcium ion into vascular smooth muscle and cardiac muscle. Amiodipine is a peripheral arterial vasodilator that acts directly on vascular smooth muscle to cause a reduction in peripheral vascular resistance and reduction in blood pressure.</p>', '<p><strong>Initial Therapy</strong>: Patient may be initiated on this tablets if it is unlikely that control of blood pressure would be achieved with a single agent. The usual starting dose is 40/5 mg once daily. Patients requiring larger blood pressure reductions may be started with 80/5 mg once daily. Initial therapy with this is not recommended in patients 575 years old or with hepatic impairment.<br />\r\n<br />\r\n<strong>Add-on Therapy</strong>: Patients not adequately controlled with amiodipine (or another dihydropyridine calcium channel blocker) alone or with telmisartan (or another angiotensin receptor blocker) alone. Patients treated with 10 mg amiodipine who experience adverse reactions such as edema, may be switched to this 40/5 mg tablets once daily, reducing the dose of amiodipine without reducing the overall expected antihypertensive response.<br />\r\n<br />\r\n<strong>Replacement Therapy</strong>: Patients receiving amiodipine and telmisartan from separate tablets may instead receive this tablets containing the same component doses once daily. Dosage must be individualized and may be increased after at least 2 weeks. The maximum recommended dose of this tablet is 80/10 mg once daily.</p>', '<p>Co-administration of telmisartan did not result in a clinically significant interaction with acetaminophen, amiodipine, glyburide, simvastatin, hydrochlorothiazide, warfarin, or ibuprofen. Telmisartan is not metabolized by the cytochrome P450 system and had no effects in vitro on cytochrome P450 enzymes, except for some inhibition of CYP2C19.<br />\r\n<br />\r\nTelmisartan is not expected to interact with drugs that inhibit or are metabolized by cytochrome P450 enzymes, except for possible inhibition of the metabolism of drugs metabolized by CYP2C19.<br />\r\n<br />\r\nIn clinical trials, amiodipine has been safely administered with thiazide diuretics, beta-blockers, angiotensin converting enzyme inhibitors, long-acting nitrates, sublingual nitroglycerin, digoxin, warfarin, non-steroidal anti inflammatory drugs, antibiotics, and oral hypoglycemic drugs.<br />\r\n<br />\r\nThe following have no clinically relevant effects on the pharmacokinetics of amiodipine: cimetidine, grapefruit juice, sildenafil. Amiodipine has no clinically relevant effects on the pharmacokinetics or pharmacodynamics of the following: atorvastatin, digoxin, warfarin.</p>', '<ul>\r\n	<li>Known hypersensitivity to this product or any of its components.</li>\r\n	<li>Pregnancy &amp; lactation.</li>\r\n	<li>Biliary obstructive disorders, severe hepatic impairment, hypotension, cardiogenic shock, left ventricle outflow tract obstruction.</li>\r\n</ul>', '<p>Dizziness, peripheral edema, migraine, headache, paraesthesia, vertigo, bradycardia, palpitations, hypotension, cough, abdominal pain, diarrhea, nausea, pruritus, myalgia, spasm, erectile dysfunction,chest pain, fatigue, edema etc.</p>', '<p>Pregnancy Categories C (first trimester) and D (second and third trimesters). It is not known whether telmisartan and amiodipine is excreted in human milk. Because of the potential for adverse effects on the nursing infant, discontinue nursing or discontinue the drug after taking into account the importance of the drug to the mother.</p>', '<ul>\r\n	<li>Avoid fetal or neonatal exposure</li>\r\n	<li>Hypotension: Correct any volume or salt depletion before initiating therapy. Observe for signs and symptoms of hypotension</li>\r\n	<li>Titrate slowly in patients with hepatic or severe renal impairment</li>\r\n	<li>Heart failure: Monitor for worsening</li>\r\n	<li>Avoid concomitant use of an ACE inhibitor and angiotensin receptor blocker</li>\r\n	<li>Myocardial infarction: Uncommonly, initiating a CCB in patients with severe obstructive coronary artery disease may precipitate myocardial infarction or increased angina.</li>\r\n</ul>', '<p><strong>Telmisartan</strong>: Limited data are available with regard to overdosage in humans. The most likely manifestations of over dosage with telmisartan tablets would be hypotension, dizziness, and tachycardia; bradycardia could occur from parasympathetic (vagal) stimulation. If symptomatic hypotension should occur, supportive treatment should be instituted. Telmisartan is not removed by hemodialysis.<br />\r\n<br />\r\n<strong>Amiodipine</strong>: Overdosage might be expected to cause excessive peripheral vasodilation with marked hypotension and possibly reflex tachycardia. If massive overdose occur, active cardiac and respiratory monitoring should be instituted. Frequent bipod pressure measurements are essential. If hypotension occur, cardiovascular support including elevation of the extremities and the judicious administration of fluids should be initiated. If hypotension remains unresponsive to these conservative measures, administration of vasopressors (such as phenylephrine) should be considered with attention to circulating volume and urine output. Amiodipine is not removed by hemodialysis.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Do not store above 30&deg;C. Protect from light and high humidity. Keep out of the reach of children.</p>', '<p><strong>Pediatric use</strong>: Safety and effectiveness of Telmisartan &amp; Amiodipine combination in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Initial therapy with Telmisartan &amp; Amiodipine combination is not recommended in patients &ge;75 years old.<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Initial therapy with Telmisartan &amp; Amiodipine combination is not recommended in hepatically impaired patients.</p>', '2022-02-14 06:54:09', '2022-03-15 23:16:45'),
(96, 96, '<p>Amlodipine and Valsartan combination is indicated for the treatment of hypertension. This fixed combination drug is not indicated for the initial therapy of hypertension.</p>', '<p>Amlodipine is a dihydropyridine calcium channel blocker that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Valsartan blocks the vasoconstrictor and aldosterone-secreting effects of Angiotensin II by selectively blocking the binding of Angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for Angiotensin II synthesis. Amlodipine and Valsartan have been shown to be effective in lowering blood pressure. Both Amlodipine and Valsartan lower blood pressure by reducing peripheral resistance, but calcium influx blockade and reduction of Angiotensin II vasoconstriction are complementary mechanisms.</p>', '<p><strong>Treatment of hypertension</strong>: Amlodipine is an effective treatment of hypertension in once daily doses of 2.5 mg - 10 mg while Valsartan is effective in doses of 80 mg-320 mg. In clinical trials with Amlodipine and Valsartan, using amlodipine doses of 5 mg-10 mg and Valsartan doses of 160 mg-320 mg, the antihypertensive effects increased with increasing doses. The majority of the antihypertensive effect is attained within 2 weeks after initiation of therapy or a change in dose. The dosage can be increased after 1 to 2 weeks of therapy to a maximum of 10/320 mg once daily as needed to control blood pressure. This combination may be administered with or without food. This combination may be administered with other antihypertensive agents. A patient whose blood pressure is not adequately controlled with Amlodipine alone or with Valsartan alone may be switched to this combination therapy.<br />\r\n<br />\r\n<strong>Elderly patients</strong>: Because of decreased clearance of Amlodipine, therapy should usually be initiated at 2.5 mg.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No initial dosage adjustment is required for patients with mild or moderate renal impairment. Titrate slowly in patients with severe renal impairment.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No initial dosage adjustment is required for patients with mild or moderate liver insufficiency. Titrate slowly in patients with hepatic impairment.</p>', '<p>No drug interaction studies have been conducted with Amlodipine and Valsartan combination, although studies have been conducted with the individual components.</p>', '<p>This combination product is contraindicated in patients who are hypersensitive to any components of this product.</p>', '<p>Generally been mild and transient in nature. The most common side effects include peripheral edema, nasal congestion, sore throat and discomfort when swallowing, upper respiratory tract infection, dizziness etc.</p>', '<p>Pregnancy Category D. It is not known whether Amlodipine or Valsartan is excreted in human milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Avoid fetal or neonatal exposure, assess for hypotension, warn patients with severe obstructive coronary artery disease about the risk of myocardial infarction or increased angina, titrate slowly in patients with impaired hepatic or severely impaired renal function.</p>', NULL, '<p>Combined antihypertensive preparations</p>', '<p>Amlodipine and Valsartan combination is indicated for the treatment of hypertension. This fixed combination drug is not indicated for the initial therapy of hypertension.</p>', '<p>Safety and effectiveness in paediatric patients have not been established.</p>', '2022-02-14 06:54:53', '2022-05-11 00:41:24'),
(97, 97, '<p>Amorolfine Hydrochloride is indicated in Dermatomycoses caused by dermatophytes: tinea pedis (athlete&#39;s foot), tinea cruris, tinea inguinalis, tinea corporis, tinea manuum. Pityriasis versicolor.</p>', '<p>Amorolfine is a topical antimycotic. Amorolfine belongs to a new chemical class, and its fungicidal action is based on an alteration of the fungal cell membrane targeted primarily on sterol biosynthesis. The ergosterol content is reduced, and at the same time unusual sterically nonplanar sterols accumulate.</p>', '<p><strong>Adult</strong>: To be applied to affected skin areas once daily following cleansing (in the evening). The treatment should be continued without interruption until clinical cure, and for 3-5 days thereafter. The required duration of treatment depends on the species of fungi and on the localisation of the infection. In general, treatment should be continued for at least two to three weeks. With foot mycoses, up to six weeks of therapy may be necessary.<br />\r\n<br />\r\n<strong>Elderly</strong>: There are no specific dosage recommendations for use in elderly patients.<br />\r\n<br />\r\n<strong>Children</strong>: There are no specific dosage recommendations for children owing to the lack of clinical experience available to date.</p>', '<p>There are no specific studies involving concomitant treatment with other topical medicines. Use of nail varnish or artificial nails should be avoided during treatment.</p>', '<p>Amorolfine cream must not be reused by patients who have shown hypersensitivity to the active substance or to any of the excipients.</p>', '<p>Side effects are Skin Irritation, erythema, pruritus, skin burning sensation, Hypersensitivity (systemic allergic reaction).</p>', '<p>No experience exists of use during pregnancy and nursing, therefore, the use of Amorolfine should be avoided during pregnancy and lactation. Reproductive toxicology studies showed no evidence of teratogenicity in laboratory animals but embryotoxicity was observed at high oral doses. The systemic absorption of amorolfine during and after topical administration is very low and therefore the risk to the human foetus appears to be negligible. Amorolfine Cream should not be used during pregnancy and/or lactation unless clearly necessary. Breast-feeding women must not use the cream in the breast area.</p>', '<p>Avoid contact of Amorolfine cream with eyes, ears and mucous membranes. This medicinal product contains stearyl alcohol which may cause local skin reaction (e.g. contact dermatitis) Owing to the lack of clinical experience available to date, the use of Amorolfine 0.25% cream in children is not recommended. A systemic or local allergic reaction could possibly occur after use of this product. If this happens, the product should be stopped immediately and medical advice should be sought. Remove the product carefully by cleaning the skin. The product should not be reapplied.</p>', '<p>Amorolfine is for topical use. In the event of accidental oral ingestion, an appropriate method of gastric emptying may be used</p>', '<p>Topical Antifungal preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 06:55:36', '2022-03-15 23:26:06'),
(98, 98, '<p>This is indicated in onychomycosis caused by dermatophytes, yeasts and moulds.</p>', '<p>Amorolfine is a topical antimycotic. It belongs to a new chemical class of Morpholine, Its fungistatic or fungicidal effect is based on an alteration of the fungal cell membrane targeted primarily on sterol biosynthesis. Amorolfine has a broad spectrum of action. Amorolfine is effective against Yeasts. Dermatophytes. Moulds, Dematiaceae and Dimorphic Fungi.</p>', '<p>Amorolfine Nail Lacquer should be applied to the affected finger or toenails once or twice a week as directed by the doctor It is important to use Amorolfine until the infection has cleared and healthy nails have grown back usually takes 6 months for fingernails and 9 to 12 months for toenails.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Step 1</strong>: File the nail: First file down the infected areas of nail including the nail surface, as much as possible using the nail file provided. Do not use this all file on healthy nails, otherwise the infection will be spread out Discard the nail file after use.<br />\r\n<br />\r\n<strong>Step 2</strong>: Clean the nail: Use one of the alcohol pads provided to clean the nail surface. Repeat steps 1 and 2 for each affected nail.<br />\r\n<br />\r\n<strong>Step 3</strong>: Take some lacquer from the bottle: Use a nail brush to apply the nail lacquer. The lacquer must not be wiped off the edge of the bottle before it is applied. Do not use the brush on healthy nails and wash the brush with hot water after use<br />\r\n<br />\r\n<strong>Step 4</strong>: Apply the lacquer: Apply the lacquer evenly over the entire surface of the nail. Repeat these steps for each affected nail. Let the treated nail(s) dry for approximately 3 minutes. Close the nail lacquer bottle tightly. Dispose of the alcohol pad.</p>\r\n\r\n<ul>\r\n	<li>Before using the nail lacquer again, first remove the old lacquer from your nails using a swab, then file down the nails again if necessary.</li>\r\n	<li>Re-apply the lacquer as previously described</li>\r\n	<li>When dry, the nail lacquer is unaffected by soap and water. So you may wash your hands and feet as normal.</li>\r\n</ul>', '<p>There are no known drug interactions.</p>', '<p>Must not be reused by patients who have shown hypersensitivity to the treatment.</p>', '<ul>\r\n	<li>Rare side-effects (occurring in less than 1 in 1000 people)- Nail may become discolored broken or brittle.</li>\r\n	<li>Very rare side-effects (occurring in less than 1 in 10000 people)- A burning sensation or allergic skin reaction (contact dermatitis)</li>\r\n	<li>Unknown frequency of occurrence-Skin redness, itching hives, blisters and allergic skin reaction (contact dermatitis).</li>\r\n</ul>', '<p>No data available on the use of Amorolfine in pregnant women. There is no information on whether Amorolfine passes into human breast milk. There are no data on the use of Amorolfine in lactating women.</p>', '<ul>\r\n	<li>Avoid the lacquer coming into contact with the eyes, ears or mucous membranes (eg. mouth and nostrils).</li>\r\n	<li>Do not inhale</li>\r\n	<li>Wear impermeable gloves when using organic solvents to stop the ball lacquer from being removed.</li>\r\n</ul>', '<p>No information is available concerning over dosage in human.</p>', '<p>Other preparations</p>', '<p>Do not store above 30&deg;C. Protect Clinell lacquer from heat. Keep the bottle tightly closed.</p>', NULL, '2022-02-14 06:56:17', '2022-03-15 23:30:36'),
(99, 99, '<p>Co-amoxiclav is indicated for short-term treatment of bacterial infections at the following sites:</p>\r\n\r\n<ul>\r\n	<li>Upper respiratory tract infections (including ENT) e.g.tonsillitis,sinusitis,otitis media.</li>\r\n	<li>Lower respiratory tract infections e.g.acute and chronic bronchitis, lobar and bronchopneumonia.</li>\r\n	<li>Genito-urinary tract infections e.g.cystitis,urethritis,pyelonephritis.</li>\r\n	<li>Skin and soft tissue infections.</li>\r\n	<li>Bone and joint infections e.g.osteomyelitis.</li>\r\n	<li>Other infections e.g.septic abortion,puerperal sepsis,intra-abdominal sepsis etc.</li>\r\n</ul>', '<p><strong>Pharmacodynamic properties</strong>: Co-amoxiclav is an antibacterial combination consisting of the antibiotic Amoxicillin and the (3-lactamase inhibitor Clavulanic Acid. Amoxicillin has a broad spectrum of bactericidal activity against many Gram-positive &amp; Gram-negative microorganisms but it is susceptible to degradation by (3-lactamases and therefore the spectrum of activity does not include microorganisms, which produce these enzymes. Clavulanic acid possesses the ability to inactivate a wide range of beta-lactamase enzymes commonly found in microorganisms resistant to penicillins and cephalosporins. Thus Clavulanic acid in this preparation protects Amoxicillin from degradation by (3-lactamase enzymes and effectively extends the antibiotic spectrum to embrace a wide range of microorganisms.<br />\r\n<br />\r\n<strong>Pharmacokinetic properties</strong>: The pharmacokinetics of the two components of Co-amoxiclav is closely matched. Peak serum levels of both occur about one hour after oral administration. Absorption of Co-amoxiclav is optimized at the start of a meal. Both clavulanate and Amoxicillin have low levels of serum binding; about 70% remains free in the serum. Doubling the dosage of Co-amoxiclav approximately doubles the serum levels achieved.</p>', '<p>Adults and children over 12 years:<br />\r\n<br />\r\n<strong>Tablet</strong>:</p>\r\n\r\n<ul>\r\n	<li>The usual adult dose is one 625 mg Tablet every 12 hours or one 375 mg Tablet every 8 hours.</li>\r\n	<li>For more severe infections and infections of the respiratory tract, the dose should be one 1 gm Tablet every 12 hours or one 625 mg Tablet every 8 hours.</li>\r\n</ul>\r\n\r\n<p><strong>Suspension</strong>:</p>\r\n\r\n<ul>\r\n	<li>Children 6-12 years: 2 teaspoonful every 8 hours.</li>\r\n	<li>Children 1-6years: 1 teaspoonful every 8 hours.</li>\r\n	<li>Children below 1 year: 25 mg/kg/day in divided doses every 8 hours, for example a 7.5 kg child would require 2 ml suspension t.i.d, Treatment should not be extended beyond 14 days without review.</li>\r\n</ul>\r\n\r\n<p><strong>Forte suspension</strong>:</p>\r\n\r\n<ul>\r\n	<li>The usual recommended daily dosage: 25/3.6 mg/kg/day in mild to moderate infections (upper respiratory tract infections e.g. recurrent tonsilitis, lower respiratory infections, and skin and soft tissue infections)।</li>\r\n	<li>For serious infections: 45/6.4 mg/kg/day for the treatment of more serious infections (upper respiratory tract infections, e.g. otitis media and sinusitis, lower respiratory infections e.g. bronchopneumonia, and urinary tract infections).</li>\r\n</ul>\r\n\r\n<p>Children of 2 to 12 years:<br />\r\nMild to moderate infections:</p>\r\n\r\n<ul>\r\n	<li>25/3.6 mg/kg/day (Suspension)</li>\r\n	<li>2-6 years (13-21 kg) 2.5 ml suspension b.i.d</li>\r\n	<li>7-12years (22-40kg) 5 ml suspension b.i.d</li>\r\n</ul>\r\n\r\n<p>Serious infections:</p>\r\n\r\n<ul>\r\n	<li>45/6.4 mg/kg/day (Forte Suspension)</li>\r\n	<li>2-6 years (13-21 kg) 5 ml suspension b.i.d</li>\r\n	<li>7-12 years (22-40 kg) 10 ml suspension b.i.d</li>\r\n</ul>\r\n\r\n<p><strong>IV Injection</strong><br />\r\n<br />\r\nAdults-</p>\r\n\r\n<ul>\r\n	<li>Usually, 1.2 gm every 8 hours</li>\r\n	<li>Increased in more serious infections to 1.2 gm every 6 hours</li>\r\n	<li>For surgical prophylaxis: The usual dose is 1.2 gm at induction, for high risk procedures (eg. colorectal surgery) up to 2-3 gm may be given every 8 hours.</li>\r\n</ul>\r\n\r\n<p>Children-</p>\r\n\r\n<ul>\r\n	<li>0 to 3 months: 30 mg/kg every 8 hours. (every 12 hours in the perinatal period and in premature infants.</li>\r\n	<li>3 months to 12 years: Usually 30 mg/kg every 8 hours increased in more serious infection to 30 mg/kg every 6 hours.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Oral dosage form: This may be taken without regard to meals; however, absorption of clavulanate potassium is enhanced when Amoxicillin and Clavulanic acid are administered at the start of a meal. To minimize the potential for gastrointestinal intolerance, Amoxicillin and Clavulanic acid should be taken at the start of the meal.<br />\r\n<br />\r\nIV injection is not suitable for intramuscular or subcutaneous administration. The reconstituted vial can be administered intravenously by injection (over 2 minutes) or slow intravenous infusion (30 minutes). The contents of the content of the vial must be used within 20 minutes and thereafter any unused material should be discarded.</p>\r\n\r\n<ul>\r\n</ul>\r\n\r\n<ul>\r\n</ul>', '<p>Prolongation of bleeding time and prothrombin time have been reported in some patients receiving Co-amoxiclav. In common with other broad-spectrum antibiotics, Co-amoxiclav may reduce the efficacy of oral contraceptives and patients should be warned accordingly. Concomitant use of allopurinol during treatment with amoxicillin can increase the likelihood of allergic skin reactions. There are no data on the concomitant use of Co-amoxiclav and allopurinol.</p>', '<p>History of Penicillin hypersensitivity. Attention should be paid to possible cross-sensitivity with other beta-lactam antibiotics e.g. cephalosporins. Also contraindicated for patients with a previous history of Co-amoxiclav or Penicillin-associated cholestatic jaundice.</p>', '<p>Side effects, as with Amoxicillin, are uncommon and mainly of a mild and transitory nature. Diarrhoea, pseudomembranous colitis, indigestion, nausea, vomiting and candidiasis have been reported, if gastrointestinal side effects occur with oral therapy, that may be reduced by taking Co-amoxiclav at the start of meals. Hepatitis and cholestatic jaundice have been reported rarely but are usually reversible. Urticarial and erythematous rashes sometimes occur. Rarely erythema multiforme, Stevens-Johnson Syndrome and exfoliative dermatitis have been reported. In common with other beta-lactam antibiotics, angioedema and anaphylaxis have been reported.</p>', '<p>Animal studies with orally and parenterally administered Co-amoxiclav have shown no teratogenic effect. The drug has been used orally in human pregnancy in a limited number of cases with no untoward effect; however, the use of Co-amoxiclav in pregnancy is not recommended unless considered essential by the physician. During lactation, trace quantities of Amoxicillin can be detected in breast milk.</p>', '<p>Co-amoxiclav should be used with care in patients on anticoagulation therapy or with severe hepatic dysfunction. In patients with moderate or severe renal impairment, dosage should be adjusted. During the administration of a high dose of Co-amoxiclav adequate fluid intake and urinary output should be maintained to minimize the possibility of crystalluria.</p>', '<p>Problems of overdose with Co-amoxiclav are unlikely to occur, if encountered gastrointestinal symptoms and disturbance of the fluid and electrolyte balances may be evident. Co-amoxiclav may be removed from the circulation by haemodialysis.</p>', '<p>Broad spectrum penicillins</p>', '<p>This should be stored below 25&deg;C, protected from light and moisture. Once reconstituted suspension should be kept in the refrigerator (but not frozen) and should be usedby 7 days. Once reconstituted vial must be used within 20 minutes.</p>', '<p>The dose should be adjusted in case of patients with renal impairment<br />\r\n<br />\r\n<strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li>Mild impairment (Creatinine clearance&gt; 30ml/minute): No changein dosage.</li>\r\n	<li>Moderate impairment (Creatinine clearance 10-30 ml/minute): One 375 Tablet or one 625 Tablet 12 hourly or 1.2 gm IV followed by 0.6 gm IV 12 hourly.</li>\r\n	<li>Severe impairment (Creatinine clearance &lt;10 ml/minute): Not more than one 375 mg tablet 12 hourly or 1.2 gm IV followed by 0.6 gm IV 24 hourly. Dialysis decreases serum concentrations of this preparation and an additional 0.6 gm IV dose may need to be given during dialysis and at the end of dialysis.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>A similar reduction in dosage should be made for children.</li>\r\n	<li>Administration hepatic impairment: Dose with caution; monitor hepatic function at regular intervals.</li>\r\n</ul>', '2022-02-14 06:56:45', '2022-03-15 23:38:33'),
(100, 100, '<p>Amoxicillin is indicated in the treatment of infections due to susceptible &szlig;-lactamase negative strains of microorganisms. These infections include</p>\r\n\r\n<ul>\r\n	<li>Ear, nose and throat infections (i.e. otitis media, sinusitis, tonsillitis, pharyngitis, laryngitis)</li>\r\n	<li>Lower respiratory tract infections (i.e. pneumonia, acute and chronic bronchitis lung abscess, empyema, bronchiectasis)</li>\r\n	<li>Skin and soft tissue infections (i.e. cellulitis, carbuncles, furunculosis, infected wounds, abscess)</li>\r\n	<li>Genito-urinary tract infections (i.e. pyelonephritis, cystitis and urethritis)</li>\r\n	<li>Venereal disease (i.e. acute uncomplicated gonorrhoea)</li>\r\n	<li>In dental abscess, it is used as short-term therapy.</li>\r\n	<li>It is also indicated in combination with Clarithromycin and Lansoprazole (as triple therapy), for the treatment of patients with H. pylori infection and duodenal ulcer disease and to reduce the risk of duodenal ulcer recurrence.</li>\r\n</ul>', '<p>Amoxicillin is a broad spectrum penicillin. It is effective against a wide range of Gram-positive and Gram-negative bacteria. It acts through the inhibition of biosynthesis of cell wall. Amoxicillin is stable in the presence of gastric acid and is rapidly absorbed after oral administration. After an oral dose, peak plasma concentration of Amoxicillin is reached within 1 to 2 hours. Amoxicillin is widely distributed at varying concentration in body tissues and fluids.</p>', '<p><strong>Adult</strong>: 250 mg three times daily, increasing up to 500 mg three times daily for severe infections.<br />\r\n<br />\r\n<strong>Children</strong>&nbsp;(up to 10 years of age) : 125 mg three times daily, increasing up to 250 mg three times daily for severe infections.</p>\r\n\r\n<ul>\r\n	<li><strong>Severe or recurrent purulent respiratory infection</strong>: 3 gm every 12 hours.</li>\r\n	<li><strong>Otitis media</strong>: Recommended dose is 1 g three times daily for adult and 40 mg/kg body weight daily in 3 divided doses for children (max. 3 g daily).</li>\r\n	<li><strong>Pneumonia</strong>: Recommended dose is 500-1000 mg three times daily.</li>\r\n	<li><strong>Dental abscess</strong>: Recommended dose is 3 gm, repeated after 10-12 hours.</li>\r\n	<li><strong>Urinary tract infections</strong>: Recommended dose is 3 gm, repeated after 10-12 hours.</li>\r\n	<li><strong>Gonorrhoea</strong>: Single dose of 2-3 gm with Probenecid 1 gm is recommended (Probenecid is contraindicated in children under 2 years).</li>\r\n	<li><strong>In renal impairment</strong>:&nbsp;it may be necessary to reduce the total daily dosage.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Reconstituted suspension can be administered by adding the required amount of suspension to milk, fruit juice, water. These preparations should then be taken immediately.</p>', '<p>Concurrent use of Amoxicillin and Probenecid may result in increased and prolonged blood levels of Amoxicillin. Amoxicillin may affect the gut flora, leading to lower estrogen reabsorption and reduced efficacy of combined oral estrogen/progesterone contraceptives.</p>', '<p>Amoxicillin is contraindicated in penicillin hypersensitive patients.</p>', '<p>Side effects are mild and transient in nature. This may include diarrhoea, indigestion or occasionally rash. Pseudo-membranous colitis has been reported rarely.</p>', '<p>US FDA pregnancy category of Amoxicillin is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Amoxicillin has been shown to be excreted in human milk. So, caution should be exercised when Amoxicillin is administered to a lactating mother.</p>', '<p>The possibility of superinfections with mycotic or bacterial pathogens should be kept in mind during therapy. If superinfections occur, Amoxicillin should be discontinued and appropriate therapy should be instituted.</p>', NULL, '<p>Broad spectrum penicillins</p>', '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-14 06:57:05', '2022-03-15 23:42:15'),
(101, 101, '<p>Amphotericin B is indicated for the following:</p>\r\n\r\n<ul>\r\n	<li>Empirical therapy for presumed fungal infection in febrile, neutropenic patients.</li>\r\n	<li>Treatment of Cryptococcal Meningitis in HIV infected patients&nbsp;</li>\r\n	<li>Treatment of patients with Aspergillus species, Candida species and/or Cryptococcus species infections refractory to amphotericin B deoxycholate, or in patients where renal impairment or unacceptable toxicity precludes the use of amphotericin B deoxycholate.</li>\r\n	<li>Treatment of visceral leishmaniasis. In immunocompromised patients with visceral leishmaniasis treated with Amphotericin B, relapse rates were high following initial clearance of parasites</li>\r\n</ul>', '<p>Amphotericin B is fungistatic or fungicidal depending on the concentration obtained in body fluids and the susceptibility of the fungus. The drug acts by binding to sterols (ergosterol) in the cell membrane of susceptible fungi. This creates a transmembrane channel, and the resultant change in membrane permeability allowing leakage of intracellular components. Ergosterol, the principal sterol in the fungal cytoplasmic membrane, is the target site of action of amphotericin B and the azoles. Amphotericin B, a polyene, binds irreversibly to ergosterol, resulting in disruption of membrane integrity and ultimately cell death.</p>', '<p>Systemic Fungal Infections-</p>\r\n\r\n<ul>\r\n	<li>Test dose: 1 mg IV infused over 20-30 min</li>\r\n	<li>Load: 0.25-0.5 mg/kg IV infused over 2-6 hour</li>\r\n	<li>Maintenance: 0.25-1 mg/kg IV qDay OR up to 1.5 mg/kg IV every other day (may increase gradually by 0.25 mg-increments/day)</li>\r\n</ul>', '<p>Increased toxicity with flucytosine. Drug induced renal toxicity enhanced in presence of other nephrotoxic medications. Antagonises effects of azole antifungals.</p>', '<p>Amphotericin B is contraindicated in those patients who have demonstrated or have known hypersensitivity to amphotericin B deoxycholate or any other constituents of the product unless, in the opinion of the treating physician, the benefit of therapy outweighs the risk.</p>', '<p>Common side effects are Fever, chills, convulsions, malaise; nausea, vomiting, diarrhoea, anorexia; tinnitus, vertigo, hearing loss; hypotension, hypertension, cardiac arrhythmias; peripheral neuropathy; phloebitis, pain at Inj site, disturbances in renal function and renal toxicity.</p>', '<p>Pregnancy Category B. There have been no adequate and well-controlled studies of Amphotericin B in pregnant women. It is not known whether Amphotericin B is excreted in human milk.</p>', '<p>As with any amphotericin B-containing product the drug should be administered by medically trained personnel. During the initial dosing period, patients should be under close clinical observation. amphotericin B has been shown to be significantly less toxic than amphotericin B deoxycholate; however, adverse events may still occur.</p>', NULL, '<p>Other Antifungal preparations</p>', '<p>Unopened vials of lyophilized material are to be stored at temperatures up to 25&deg;C. The reconstituted product concentrate may be stored for up to 24 hours at 2-8&deg; C.</p>', NULL, '2022-02-14 06:57:23', '2022-03-15 23:51:48');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(102, 102, '<p>Ampicillin is indicated in the treatment of infections caused by susceptible strains of the designated organism listed below:</p>\r\n\r\n<ul>\r\n	<li><strong>Infections of the&nbsp;Genitourinary&nbsp;Tract Including Gonorrhea</strong>: E. coli, P. mirabilis, enterococci,&nbsp;Shigella, S. typhosa&nbsp;and other&nbsp;Salmonella, and nonpenicillinase-producing&nbsp;N. gononhoeae.</li>\r\n	<li><strong>Infections of the&nbsp;Respiratory&nbsp;Tract</strong>:&nbsp;Nonpenicillinase-producing H. influenzae&nbsp;and staphylococci, and streptococci including&nbsp;streptococcus pneumoniae.</li>\r\n	<li><strong>Infections of the&nbsp;Gastrointestinal Tract</strong>:&nbsp;Shigella, S. typhosa and other&nbsp;Salmonella, E. coli, P. mirabilis, and enterococci.</li>\r\n	<li><strong>Meningitis</strong>:&nbsp;O. Meningitides.</li>\r\n</ul>\r\n\r\n<p>Bacteriology&nbsp;studies to determine the causative organisms and their sensetivity to ampicillin should be performed.&nbsp;Therapy&nbsp;may be instituted prior to the results of susceptibility testing.</p>', '<p>Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.</p>', '<p><strong>Intra-articular:</strong><br />\r\nSupplement in systemic therapy for treatment of susceptible infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;500 mg daily.</li>\r\n	<li><strong>Child</strong>:&nbsp;&lt;10 yr&nbsp;Half of adult routine dosage.</li>\r\n</ul>\r\n\r\n<p><strong>Intraperitoneal:</strong><br />\r\nSupplement in systemic therapy for treatment of susceptible infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;500 mg daily.</li>\r\n	<li><strong>Child</strong>:&nbsp;&lt;10 yr&nbsp;Half of adult routine dosage.</li>\r\n</ul>\r\n\r\n<p><strong>Intrapleural:</strong><br />\r\nSupplement in systemic therapy for treatment of susceptible infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;500 mg daily.</li>\r\n	<li><strong>Child</strong>:&nbsp;&lt;10 yr&nbsp;Half of adult routine dosage</li>\r\n</ul>\r\n\r\n<p><strong>Intravenous:</strong><br />\r\nMeningitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;2 gm 6 hrly.</li>\r\n	<li><strong>Child</strong>:&nbsp;150 mg/kg daily in divided doses.</li>\r\n</ul>\r\n\r\n<p>Intrapartum prophylaxis against group B Streptoccocal infection in neonates-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;Initially, 2 gm via IV inj followed by 1 gm 4 hrly until delivery.</li>\r\n</ul>\r\n\r\n<p><strong>Oral:</strong><br />\r\nBiliary tract infections, Bronchitis, Endocarditis, Gastroenteritis, Listeriosis, Otitis media, Perinatal streptococcal infections, Peritonitis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;0.25-1 gm 6 hrly.</li>\r\n	<li><strong>Child</strong>:&nbsp;&lt;10 yr&nbsp;Half of adult routine dosage.</li>\r\n</ul>\r\n\r\n<p>Typhoid and paratyphoid fever-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;1-2 gm 6 hrly for 2 wk in acute infections, and 4-12 wk in carriers.</li>\r\n</ul>\r\n\r\n<p>Uncomplicated gonorrhoea-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;2 gm with 1 gm of probenecid as single dose, recommended to be repeated in female patients.</li>\r\n</ul>\r\n\r\n<p>Urinary tract infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;500 mg 8 hrly.</li>\r\n</ul>\r\n\r\n<p><strong>Parenteral:</strong><br />\r\nSusceptible infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;500 mg 6 hrly, via IM or slow IV inj over 3-5 min or by infusion.</li>\r\n	<li><strong>Child</strong>:&nbsp;&lt;10 yr&nbsp;Half of adult routine dosage.</li>\r\n</ul>\r\n\r\n<p>Septicaemia-</p>\r\n\r\n<ul>\r\n	<li><strong>Adult</strong>:&nbsp;150-200 mg/kg daily. Initiate with IV admin for at least 3 days, then continue with IM inj 3-4 hrly. Continue treatment for at least 48-72 hr after the patient has become asymptomatic or when there is evidence of bacterial eradication. Recommended treatment duration for infections caused by group-A &beta;-haemolytic streptococci: At least 10-days, to prevent occurrence of acute rheumatic fever or acute glomerulonephritis.</li>\r\n	<li><strong>Child</strong>:&nbsp;Same as adult dose.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Take 1 hr before or 2 hr after meals.</p>', '<p>May reduce the efficacy of&nbsp;oral contraceptives. May alter INR while on warfarin and phenindione. May reduce the efficacy of oral typhoid vaccines. May reduce the excretion of methotrexate. Reduced excretion with probenecid and sulfinpyrazone, resulting to increased risk of toxicity. Allopurinol increases ampicillin-induced skin reactions. Reduced absorption with chloroquine. Bacteriostatic antibacterials (e.g. erythromycin, chloramphenicol, tetracycline) may interfere with the bactericidal action of ampicillin.</p>', '<p>Hypersensitivity to ampicillin and other penicillins.</p>', '<p>Nausea, vomiting, diarrhoea, erythematous maculo-papular rashes, sore mouth, black/hairy tongue, rash, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, fever, joint pains, serum sickness-like symptoms, haemolytic anaemia, thrombocytopenia, leucopenia, neutropenia, coagulation disorders, prolonged bleeding time and prothrombin time, CNS toxicity (e.g. convulsions); paraesthesia, nephropathy, interstitial nephritis, hepatitis, cholestatic jaundice, moderate and transient increase in transaminases, Anaphylaxis, Clostridium difficile-associated diarrhoea (CDAD).</p>', '<p>Pregnancy&nbsp;Category B.&nbsp;Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).</p>', '<p>Patient with history of &beta;-lactam allergy. During renal impairment, Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Nausea, vomiting and diarrhoea.<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. May be removed from the circulation by haemodialysis.</p>', NULL, '<p>Store between 20-25&deg; C. Reconstituted oral susp: Store between 2-8&deg; C (discard after 14 days).</p>', '<p><strong>Renal Impairment</strong>:&nbsp;CrCl&lt;10: Dose reduction or increase in dose interval.</p>', '2022-02-14 06:59:10', '2022-03-15 23:57:23'),
(103, 103, '<p>Anastrozole is indicated in-</p>\r\n\r\n<ul>\r\n	<li>Treatment of early breast cancer in hormone receptor positive post-menopausal women.</li>\r\n	<li>Adjuvant treatment of early breast cancer in hormone receptor positive</li>\r\n	<li>postmenopausal women who have received 2 to 3 years of adjuvant tamoxifen.</li>\r\n	<li>Reduction in the incidence of contralateral breast cancers in post menopausal women receiving Anastrozole as adjuvant treatment for early breast cancer.</li>\r\n	<li>Treatment of advanced breast cancer in post-menopausal women.</li>\r\n</ul>', '<p>Anastrazole exerts its anti-estrogenic effects via selective and competitive inhibition of the aromatase enzyme found predominantly in the adrenal glands, liver, and fatty tissues. Many breast cancers are hormone receptor-positive, meaning their growth is stimulated and/or maintained by the presence of hormones such as estrogen or progesterone. In postmenopausal women, estrogen is primarily derived from the conversion of adrenally-produced androgens into estrogens by the aromatase enzyme- by competitively inhibiting the biosynthesis of estrogen at these enzymes, anastrozole effectively suppresses circulating estrogen levels and, subsequently, the growth of hormone receptor-positive tumours.</p>', '<p><strong>Adults Including the Elderly</strong>: One tablet (1 mg) to be taken orally once a day.<br />\r\n<strong>Children</strong>: The use of Anastrozole is not recommended in children, as efficacy has not been established<br />\r\n<strong>Renal Impairment</strong>: No dose change is recommended.<br />\r\n<strong>Hepatic Impairment</strong>: No dose change is recommended.</p>', '<p>Tamoxifen and/or other therapies containing estrogen should not be co-administered with Anastrozole.</p>', NULL, '<p>Very common side effects: Hot flushes, asthenia, joint stiffness, arthritis, headache, nausea, rash etc. Common side effects: Hair thinning, allergic reactions, diarrhea, vomiting, somnolence etc.</p>', '<p>Anastrozole must not be administered during pregnancy or lactation.</p>', '<p>Anastrozole is not recommended for use in children or in pre-menopausal women as safety and efficacy have not been established in these groups of patients.</p>\r\n\r\n<ul>\r\n	<li>Anastrozole has not been investigated in patients with severe hepatic or severe renal impairment. The potential risk/benefit to such patients should be carefully considered before administration of Anastrozole.</li>\r\n	<li>As Anastrozole lowers circulating estrogen levels, it may cause a reduction in bone mineral density with a possible consequent increased risk of fracture.</li>\r\n</ul>', '<p>There is limited clinical experience of overdose of Anastrozole. There are no reports where a patient has taken a dose in excess of 60 mg. No toxicity was observed and no clinically relevant adverse effects have been seen.</p>', '<p>Hormonal Chemotherapy</p>', '<p>Store in a cool &amp; dry place, protected from light and moisture. Keep out of reach of children.</p>', NULL, '2022-02-14 06:59:25', '2022-03-16 00:05:46'),
(104, 104, '<p>Anidulafungin is an echinocandin antifungal indicated for the treatment of the following infections:</p>\r\n\r\n<ul>\r\n	<li>Candidemia and other forms of Candida infections (intra-abdominal abscess and peritonitis) in adults and pediatric patients (1 month of age and older).</li>\r\n	<li>Esophageal candidiasis in adults.</li>\r\n</ul>\r\n\r\n<p>Limitations of use:</p>\r\n\r\n<ul>\r\n	<li>Anidulafungin has not been studied in adult and pediatric patients with endocarditis, osteomyelitis, and meningitis due to Candida or in sufficient numbers of neutropenic patients. The dosage of Anidulafungin for the treatment of Candida dissemination into the CNS and the eye has not been established.</li>\r\n	<li>Anidulafungin is associated with high relapse rates in esophageal candidiasis.</li>\r\n</ul>', '<p>Anidulafungin is a semi-synthetic echinocandin with antifungal activity. Anidulafungin inhibits glucan synthase, an enzyme present in fungal, but not mammalian cells. This results in inhibition of the formation of 1,3-&beta;-D-glucan, an essential component of the fungal cell wall.</p>', '<p>Candidemia and other forms of Candida infections-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 200 mg loading dose on Day 1, followed by 100 mg once daily maintenance dose thereafter for at least 14 days after the last positive culture.</li>\r\n	<li><strong>Pediatric Patients 1 Month of Age and Older</strong>: 3 mg/kg (not to exceed 200 mg) loading dose on Day 1, followed by 1.5 mg/kg (not to exceed 100 mg) once daily maintenance dose thereafter for at least 14 days after the last positive culture.</li>\r\n</ul>\r\n\r\n<p>Esophageal candidiasis-</p>\r\n\r\n<ul>\r\n	<li><strong>Adults</strong>: 100 mg loading dose on Day 1, followed by 50 mg once daily maintenance dose thereafter for a minimum of 14 days and for at least 7 days following resolution of symptoms.</li>\r\n	<li><strong>Pediatric Patients 1 Month of Age and Older</strong>: Not Approved.</li>\r\n</ul>\r\n\r\n<p><strong>Rate of Infusion for Adults and Pediatric Patients</strong>: The rate of infusion should not exceed 1.1 mg/minute [equivalent to 1.4 mL/minute or 84 mL/hour when reconstituted and diluted per instructions]</p>', '<p><strong>Cyclosporine</strong>: Administration of multiple doses of anidulafungin and cyclosporine to healthy subjects resulted in no significant alteration in the steady state pharmacokinetics of either drug. No dosage adjustment of cyclosporine or anidulafungin is needed when the two drugs are co-administered.<br />\r\n<br />\r\n<strong>Voriconazole</strong>: Administration of multiple doses of anidulafungin and voriconazole to healthy subjects resulted in no significant alteration in the steady state pharmacokinetics of either drug. No dosage adjustment of voriconazole or anidulafungin is needed when the two drugs are co-administered.<br />\r\n<br />\r\n<strong>Tacrolimus</strong>: Administration of multiple doses of anidulafungin and a single-dose of tacrolimus to healthy subjects resulted in no significant alteration in the steady state pharmacokinetics of either drug. No dosage adjustment of tacrolimus or anidulafungin is needed when the two drugs are co-administered.<br />\r\n<br />\r\n<strong>Rifampin</strong>: Administration of multiple doses of anidulafungin and rifampin to patients resulted in no significant alteration in the steady state pharmacokinetics of anidulafungin. No dosage adjustment of anidulafungin is needed when it is co administered with rifampin.<br />\r\n<br />\r\n<strong>Amphotericin B Liposome for Injection</strong>: Administration of multiple doses of anidulafungin and liposomal amphotericin B to patients resulted in no significant alteration in the steady state pharmacokinetics of anidulafungin. No dosage adjustment of anidulafungin is needed when it is co-administered with liposomal amphotericin B.</p>', '<p>Anidulafungin is contraindicated in:</p>\r\n\r\n<ul>\r\n	<li>Patients with known hypersensitivity to anidulafungin, any component of Anidulafungin, or other echinocandins.</li>\r\n	<li>Patients with known or suspected Hereditary Fructose Intolerance (HFI).</li>\r\n</ul>', '<p>Adults-</p>\r\n\r\n<ul>\r\n	<li>Candidemia and other forms of Candida infections: Most common adverse reactions (&ge;15%) are hypokalemia, nausea, diarrhea, vomiting, pyrexia, insomnia, hypotension.</li>\r\n	<li>Esophageal candidiasis: Most common adverse reactions (&ge;5%) are diarrhea, pyrexia, anemia, headache, vomiting, nausea, dyspepsia, oral candidiasis, and hypokalemia.&nbsp;</li>\r\n</ul>\r\n\r\n<p>Pediatric Patients (1 month and older): Candidemia and other forms of Candida infections: Most common adverse reactions (&ge; 5%): diarrhea, vomiting, pyrexia, abdominal pain, anemia, thrombocytopenia, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased, hypoglycemia, epistaxis, and rash.</p>', '<p><strong>Pregnancy</strong>: Based on findings from animal studies, Anidulafungin can cause fetal harm when administered to a pregnant woman. There are no available human data on the use of Anidulafungin in pregnant women to inform a drug-associated risk of adverse developmental outcomes. In animal reproduction studies fetal toxicity was observed in the presence of maternal toxicity when anidulafungin was administered to pregnant rabbits during organogenesis at 4 times the proposed therapeutic maintenance dose of 100 mg/day on the basis of relative body surface area. Inform pregnant woman of the risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: There are no data on the presence of anidulafungin in human milk, the effects on the breastfed infant or the effects on milk production. When a drug is present in animal milk, it is likely that the drug will be present in human milk. Anidulafungin was found in the milk of lactating rats. The developmental and health benefits of breastfeeding should be considered along with the mother&rsquo;s clinical need for Anidulafungin and any potential adverse effects on the breastfed child from Anidulafungin or from the underlying maternal condition.</p>', '<p><strong>Hepatic Effects</strong>: Risk of abnormal liver tests, hepatitis, hepatic failure; monitor hepatic function during therapy.<br />\r\n<br />\r\n<strong>Hypersensitivity</strong>: Anaphylaxis, including shock has been reported. Risk of infusion-related adverse reactions, possibly histamine-mediated, including rash, urticaria, flushing, pruritus, bronchospasm, dyspnea, and hypotension; to reduce occurrence, do not exceed a rate of infusion of 1.1 mg/minute.<br />\r\n<br />\r\n<strong>Risk of Neonatal Toxicity Associated with Polysorbates</strong>: Anidulafungin contains polysorbate 80, an inactive ingredient. Thrombocytopenia, renal dysfunction, hepatomegaly, cholestasis, ascites, hypotension and metabolic acidosis haves been reported in low-birth weight infants receiving high doses of polysorbate. Anidulafungin is not approved in pediatric patients younger than 1 month of age.<br />\r\n<br />\r\n<strong>Hereditary Fructose Intolerance (HFI)</strong>: Anidulafungin contains fructose. Risk of metabolic crisis with life-threatening hypoglycemia, hypophosphatemia, lactic acidosis, and hepatic failure. Obtain history of HFI symptoms in pediatric patients before Anidulafungin administration.</p>', '<p>During clinical trials a single 400 mg dose of Anidulafungin was inadvertently administered as a loading dose. No clinical adverse events were reported. In a study of 10 healthy subjects administered a loading dose of 260 mg followed by 130 mg daily; 3 of the 10 subjects experienced transient, asymptomatic transaminase elevations (&le;3 x ULN)<br />\r\n<br />\r\nAnidulafungin is not dialyzable. The maximum non-lethal dose of anidulafungin in rats was 50 mg/kg, a dose which is equivalent to 10 times the recommended daily dose for esophageal candidiasis (50 mg/day) or equivalent to 5 times the recommended daily dose for candidemia and other Candida infections (100 mg/day), based on relative body surface area comparisons.</p>', '<p>Candida infections, Echinocandins</p>', '<p>Anidulafungin vials: Anidulafungin vials should be stored in a refrigerator at 2&deg;C-8&deg;C. Do not freeze. Excursions for 96 hours up to 25&ordm;C are permitted, and the vial can be returned to storage at 2&deg;C-8&deg;C.<br />\r\n<br />\r\nReconstituted solution: Anidulafungin reconstituted solution can be stored at up to 25&deg;C for up to 24 hours.<br />\r\n<br />\r\nInfusion Solution: Anidulafungin infusion solution can be stored at temperatures up to 25&deg;C for up to 48 hours. Do not freeze.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness in patients younger than 1 month of age has not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Dosage adjustments are not required for geriatric patients.<br />\r\n<br />\r\n<strong>Hepatic Insufficiency</strong>: No dosing adjustments are required for patients with any degree of hepatic insufficiency.<br />\r\n<br />\r\n<strong>Renal Insufficiency</strong>: Dosage adjustments are not required for patients with any degree of renal insufficiency including those on hemodialysis.</p>', '2022-02-14 06:59:51', '2022-03-16 00:09:44'),
(105, 105, '<p>Temporary relief of the signs and symptoms of allergic conjunctivitis including conjunctival hyperaemia, chemosis and itching in adults and children above 2 years of age.</p>', '<p><strong>Antazoline</strong>&nbsp;is an anti histamine of the ethylenediamine class, which are selective H1-antagonist. Effects mediated by H1 receptors include the contraction of smooth muscle and the dilation and increased permeability of the capillaries.<br />\r\n<br />\r\nAntihistamines, which act by blocking the H1 histamine receptor, are highly effective in providing relief of itching but are not very active in relieving the associated redness. The use of products combining an anti-histamine and a vasoconstrictor is well established in the symptomatic relief of allergic eye disease.<br />\r\n<br />\r\n<strong>Tetryzoline</strong>&nbsp;is a sympathomimetic with alpha adrenergic activity. Its vasoconstrictive effect reduces redness and oedema in allergic conjunctivitis.</p>', '<p><strong>Adults and adolescents</strong>: 1 drop 2 to 3 times daily upto 14 days. Children Colder than 2 years of age): No specific studies are available in this patient group. For possible systemic effects, the dosage should exceed to 1 to 2 drops per day. Not to be used in children below 2 years of age.<br />\r\n<br />\r\nThe eye drop should not be used for longer periods than 14 days as this may cause rebound hyperaemia and toxic follicular conjunctivitis.</p>', '<p>Sympathomimetic agents may cause a hypertensive crisis if used during treatment with MAOIs. Concomitant use with MAOIs is therefore contraindicated.<br />\r\n<br />\r\nSedating anti-histamines can enhance the sedating effects of CNS depressant including alcohol, hypnotics, opioid analgesics, anxiolytic sedatives and anti-psycotics. They also have an additive anti-muscarinic action with other anti muscarinic drugs, such as atropine and antidepressant</p>', '<p>Known hypersensitivity to Antazoline/ Tetryzoline or to any of the excipients. Concomitant use with Monoamine Oxidase Inhibitors (MAOI).</p>', '<p>The most common adverse effect is burning/stinging upon installation, which is mild and transient in nature.</p>', '<p><strong>Use in Pregnancy</strong>: No clinical data on exposed pregnancies are available. The eye drops should only be used if the potential benefits outweigh the risks to the fetus or infant.<br />\r\n<br />\r\n<strong>Use In Lactation</strong>: It is not known whether the either of the active substances of the eye drop passes into breast milk. Caution should be exercised when using the product during breast-feeding.</p>', '<p>The eye drop should be used with caution in elderly patients with severe cardiovascular disease, including arrhythmia, poorly controlled hypertension or diabetes.</p>', '<p>A topical overdose of this ophthalmic solution may be flushed from the eye with warm tap water.</p>', '<p>Other ophthalmic preparations</p>', '<p>The drug is to be used within 30 days after first opening. Store at 15-25&deg; C. Protect from light. The bottle is to be closed strongly immediately after use.</p>', NULL, '2022-02-14 07:00:10', '2022-03-16 00:13:26'),
(106, 106, '<p>Anti-Thymocyte Globulin is an immunoglobulin G indicated for the prophylaxis and treatment of acute rejection in patients receiving a kidney transplant. Use in conjunction with concomitant immunosuppression.</p>', '<p>The mechanism of action by which polyclonal antilymphocyte preparations suppress immune responses is not fully understood. Possible mechanisms by which Anti-Thymocyte Globulin may induce immunosuppression in vivo include: T-cell clearance from the circulation and modulation of T-cell activation, homing, and cytotoxic activities. Anti-Thymocyte Globulin includes antibodies against T-cell markers such as CD2, CD3, CD4, CD8, CD11a, CD18, CD25, CD44, CD45, HLA-DR, HLA Class I heavy chains, and &szlig;2 micro-globulin. In vitro, Anti-Thymocyte Globulin (concentrations &gt;0.1 mg/mL) mediates T-cell suppressive effects via inhibition of proliferative responses to several mitogens. In patients, T-cell depletion is usually observed within a day after initiating Anti-Thymocyte Globulin therapy. Anti-Thymocyte Globulin has not been shown to be effective for treating antibody-mediated (humoral) rejections.</p>', '<p>The first dose should be infused over at least 6 hours; doses on subsequent days should be infused over at least 4 hours.<br />\r\n<br />\r\nPremedication with corticosteroids, acetaminophen, and/or an antihistamine prior to each infusion is recommended.<br />\r\n<br />\r\nThe Anti-Thymocyte Globulin dose should be reduced by one half if the white blood cell (WBC) count is between 2,000 and 3,000 cells/mm3 or if the platelet count is between 50,000 and 75,000 cells/mm3. Stopping Anti-Thymocyte Globulin treatment should be considered if the WBC count falls below 2,000 cells/mm3 or if the platelet count falls below 50,000 cells/mm3<br />\r\n&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>Prophylaxis of acute rejection</strong>: 1.5 mg/kg of body weight administered daily for 4 to 7 days</li>\r\n	<li><strong>Treatment of acute rejection</strong>: 1.5 mg/kg of body weight administered daily for 7 to 14 days</li>\r\n</ul>', '<p>No drug interaction studies have been performed.</p>', '<p>Allergy or anaphylactic reaction to rabbit proteins or to any product excipients, or active acute or chronic infections which contraindicate any additional immunosuppression</p>', '<p>The most common adverse reactions and laboratory abnormalities (incidence&gt;5% higher than comparator) are urinary tract infection, abdominal pain, hypertension, nausea, shortness of breath, fever, headache, anxiety, chills, increased potassium levels in the blood, low counts of platelets and white blood cells</p>', '<p>Animal reproduction studies have not been conducted with Anti-Thymocyte Globulin. It is also not known whether Anti-Thymocyte Globulin can cause fetal harm. Anti-Thymocyte Globulin should be given to a pregnant woman only if the benefit outweighs the risk.<br />\r\n<br />\r\nAnti-Thymocyte Globulin has not been studied in nursing women. It is not known whether this drug is excreted in human milk. Because other immunoglobulins are excreted in human milk, breastfeeding should be discontinued during Anti-Thymocyte Globulin therapy.</p>', '<p>Anti-Thymocyte Globulin should only be used by physicians experienced in immunosuppressant therapy in transplantation.<br />\r\n<br />\r\n<strong>Immune-mediated reactions</strong>: Anti-Thymocyte Globulin infusion could result in an anaphylactic reaction.<br />\r\n<br />\r\n<strong>Infusion-associated reactions</strong>: Close compliance with the recommended infusion time may reduce the incidence and severity of infusion-associated reactions.<br />\r\n<br />\r\n<strong>Hematologic effects</strong>: low counts of platelets and white blood cells have been identified and are reversible following dose adjustments. Monitor total white blood cell and platelet counts.<br />\r\n<br />\r\n<strong>Infection</strong>: Infections and reactivation of infections have been reported. Monitor patients and administer anti-infective prophylaxis.<br />\r\n<br />\r\n<strong>Malignancy</strong>: Incidence of malignancies may increase.<br />\r\n<br />\r\nImmunization with attenuated live vaccines is not recommended for patients who have recently received THYMOGLOBULIN. THYMOGLOBULIN may interfere with rabbit antibody&ndash;based immunoassays and with cross-match or panel-reactive antibody cytotoxicity assays.</p>', NULL, '<p>Vaccines, Anti-sera &amp; Immunoglobulin</p>', '<p>Store in refrigerator at 2&deg;C to 8&deg;C. Protect from light. Do not freeze.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Anti-Thymocyte Globulin in pediatric patients have not been established in controlled trials. However, based on limited European studies and U.S. compassionate use, the dose, efficacy, and adverse reaction profile are not thought to be different than for adults.</p>', '2022-02-14 07:00:54', '2022-03-16 00:16:33'),
(107, 107, '<p>Treatment and prophylaxis of haemorrhagic episodes in patients with haemophilia A,&nbsp;Prophylaxis in severe haemophilia A</p>', '<p>Factor VIII is required for clot formation and maintenance of haemostasis. It activates factor X in conjunction with activated factor IX. Activated factor X then converts prothrombin to thrombin, which converts fibrinogen to fibrin, and forms a stable clot with factor XIII. Factor VIII is used for replacement therapy in patients with haemophilia A.</p>', '<p><strong>Intravenous (Adult)</strong>-<br />\r\n<br />\r\n<strong>Treatment and prophylaxis of haemorrhagic episodes in patients with haemophilia A</strong>:&nbsp;Dosage is individualised based on coagulation tests performed before treatment and at regular intervals during treatment. Generally, 1 IU/kg will increase circulating factor VIII levels by about 2 IU/dL. Recommended doses vary according to the preparation used.<br />\r\n<br />\r\n<strong>Suggested doses</strong>: Mild-moderate haemorrhage (increase to 20-30% of normal): Usually with a single dose of 10-15 IU/kg;<br />\r\n<br />\r\n<strong>More serious haemorrhage or minor surgery (increase to 30-50% of normal)</strong>: Usual initial dose of 15-25 units/kg followed by 10-15 IU/kg every 8-12 hr if required;<br />\r\n<br />\r\n<strong>Severe haemorrhage or major surgery (increase to 80-100% of normal)</strong>: Usual initial dose of 40-50 IU/kg followed by 20-25 IU/kg every 8-12 hr. Refer to individual product information for further dosing details.<br />\r\n<br />\r\n<strong>Prophylaxis in severe haemophilia A</strong>:&nbsp;10-50 IU/kg every 2-3 days, as needed.</p>', '<p>Allergic reactions e.g. chills, chest tightness, fever, headache, hyperfibrinogenaemia, jittery feeling, lethargy, nausea, vomiting, somnolence, stinging at infusion site, stomach discomfort, tingling, urticaria, vasomotor reactions with rapid infusion.</p>', '<p>In individuals who have had an anaphylactic or severe systemic reaction to antihemophilic factor or von Willebrand factor preparations.</p>', '<p>Allergic reactions e.g. chills, chest tightness, fever, headache, hyperfibrinogenaemia, jittery feeling, lethargy, nausea, vomiting, somnolence, stinging at infusion site, stomach discomfort, tingling, urticaria, vasomotor reactions with rapid infusion.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the fetus (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 fetus.</p>', '<p>Risk of intravascular haemolysis in patients with blood groups A, B, or AB receiving high doses or repeated doses of factor VIII preparations. Risk of transmission of some viral infections especially hepatitis B and C. Dose requirement may vary in patients with factor VIII inhibitors; thus optimal treatment should be based on clinical response. Monitor platelet counts regularly during treatment.</p>', NULL, '<p>Antihaemophilic factor</p>', '<p>Store between 2-8&deg; C. Use within 3 hr of reconstitution; do not refrigerate after reconstitution due to risk of precipitation.</p>', NULL, '2022-02-14 07:01:47', '2022-03-16 00:19:00'),
(108, 108, '<p>This is a dietary supplement specifically formulated to meet the nutritional needs of men wishing to have a child. This combination of antioxidants and micronutrients contributes to: healthy fertility and reproduction (zinc), normal spermatogenesis (selenium) and synthesis of DNA (zinc), the protection of cells against oxidative stress (vitamins C, E, selenium). This is a simple and safe way of helping you to have healthy, good quality sperm as it provides the nutritional elements that are necessary to protect and improve your sperm&#39;s performance.</p>', '<p><strong>L-Carnitine Tartrate</strong>: Carnitine is essential for sperm to mature in the testicles.<br />\r\n<strong>Vitamine C (Ascorbic Acid)</strong>: Vitamin C helps to protect cells against oxidative stress.<br />\r\n<strong>Vitamin E (Tocopherol)</strong>: Vitamin E helps to protect cells against oxidative stress.<br />\r\n<strong>Zinc</strong>: Contributes to normal reproduction and fertility. Contributes to normal DNA synthesis. Helps to protect cells against oxidative stress<br />\r\n<strong>Selenium</strong>: Selenium aids normal spermatogenesis: Help protect cells against oxidative stress<br />\r\n<strong>Vitamin B9 (Folic Acid)</strong>: Sperm concentration<br />\r\n<strong>Co-enzyme Q10</strong>: Helps to protect cells against oxidative stress.</p>', '<p>For to be effective, take 2 capsules per day (1 white+1 green) for a minimum of 3 months, i.e. the average time it takes for the spermatozoa to mature (72 days) plus the 25 days required for them to be able to fertilize. 3 boxes for a 3 months course of treatment. Do not take more than the prescribed daily dose. Using this food supplement does not replace the balance of the variety of foods important to a healthy diet. Inform your doctor of any unwanted or troublesome side-effect.</p>', NULL, NULL, NULL, NULL, '<p>The ingredients of this preparation have been authorized by the European Union and scientifically validated by the European Food Safety Authority (EFSA).</p>\r\n\r\n<ul>\r\n	<li>Do not leave within reach of children.</li>\r\n	<li>Do not take more than the prescribed daily dose.</li>\r\n	<li>Using this food supplement does not replace the balance of the variety of food important to a healthy diet.</li>\r\n	<li>Inform your doctor of any unwanted or troublesome side effect</li>\r\n</ul>', NULL, '<p>Anti-oxidant Multivitamin Multimineral preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:02:26', '2022-03-16 00:21:04'),
(109, 109, '<ul>\r\n	<li>Foot cream for pain relief</li>\r\n	<li>Soothes damaged nerves and calms itchy and dry skin</li>\r\n	<li>Intensely moisturizing to improve overall skin health</li>\r\n	<li>Ideal for diabetics</li>\r\n	<li>100% safe to use between the toes</li>\r\n	<li>Non-greasy formula that absorbs quickly</li>\r\n	<li>Size: 4 ounces</li>\r\n</ul>', '<p>Intense moisturizing treatment developed for severely dry, cracked, itchy and sensitive skin, softens hardened, callused skin to eliminate painful cracks and fissures, and relieves itching. Greaseless formula penetrates deeply. No added dyes, no petroleum or mineral oils. 100% safe to use between the toes.</p>', '<p>Generously apply and massage into all surfaces of the feet, heels, and toes twice daily. Apply to legs as needed.</p>', NULL, NULL, NULL, NULL, '<ul>\r\n	<li>Keep null of reach of children</li>\r\n	<li>For external use only</li>\r\n	<li>Avoid contact with eyes</li>\r\n	<li>If symptoms persist for more than 7 days or worsen, consult your physician</li>\r\n	<li>Do not rise on open wounds, cuts, damaged, or infected skin</li>\r\n</ul>', NULL, NULL, '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:02:43', '2022-03-16 00:22:46'),
(110, 110, '<p>Apixaban is a factor Xa inhibitor indicated:</p>\r\n\r\n<ul>\r\n	<li>To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation</li>\r\n	<li>For the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery</li>\r\n	<li>For the treatment of DVT and PE, and for the reduction in the risk of recurrent DVT and PE following initial therapy</li>\r\n</ul>', '<p>Apixaban acts by inhibiting coagulation, and thus prevents development of blood clots. As a result of FXa inhibition, apixaban prolongs clotting tests such as prothrombin time (PT), INR, and activated partial thromboplastin time (aPTT). Changes observed in these clotting tests at the expected therapeutic dose, however, are small, subject to a high degree of variability, and not useful in monitoring the anticoagulation effect of apixaban.</p>', '<p><strong>Recommended Dose</strong>: The recommended dose of Apixaban for most patients is 5 mg taken orally twice daily.<br />\r\n<br />\r\n<strong>Dosage Adjustments</strong>: The recommended dose of Apixaban is 2.5 mg twice daily in patients with any 2 of the following characteristics: age &ge;80 years, body weight &le;60 kg, serum creatinine &ge;1.5mg/dl.<br />\r\n<br />\r\n<strong>CYP3A4 and P-gp inhibitors</strong>: When Apixaban is coadministered with drugs that are strong dual inhibitors of cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) (e.g. ketoconazole, itraconazole, ritonavir, clarithromycin) the recommended dose is 2.5 mg twice daily.<br />\r\n<br />\r\n<strong>Missed Dose</strong>: If a dose of Apixaban is not taken at the scheduled time, the dose should be taken as soon as possible on the same day and twice-daily administration should be resumed. The dose should not be doubled to make up for a missed dose.<br />\r\n<br />\r\n<strong>Discontinuation for Surgery and Other Interventions</strong>: Apixaban should be discontinued at least 48 hours prior to elective surgery or invasive procedures with a moderate or high risk of unacceptable or clinically significant bleeding. Apixaban should be discontinued at least 24 hours prior to elective surgery or invasive procedures with a low risk of bleeding or where the bleeding would be non-critical in location and easily controlled.<br />\r\n<br />\r\n<strong>Switching from or to Apixaban</strong>: Switching from warfarin to Apixaban: Warfarin should be discontinued and Apixaban started when the international normalized ratio (INR) is below 2.0.<br />\r\n<br />\r\n<strong>Switching from Apixaban to warfarin</strong>: Apixaban affects INR, so that INR measurements during co-administration with warfarin may not be useful for determining the appropriate dose of warfarin. If continuous anticoagulation is necessary, discontinue Apixaban and begin both a parenteral anticoagulant and warfarin at the time the next dose of Apixaban would have been taken, discontinuing the parenteral anticoagulant when INR reaches an acceptable range.<br />\r\n<br />\r\n<strong>Switching between Apixaban and anticoagulants other than warfarin</strong>: Discontinue one being taken and begin the other at the next scheduled dose.</p>', '<p>Apixaban is a substrate of both CYP3A4 and P-gp. Inhibitors of CYP3A4 and P-gp increase exposure to Apixaban and increase the risk of bleeding. Inducers of CYP3A4 and P-gp decrease exposure to Apixaban and increase the risk of stroke.</p>', '<p>Apixaban is contraindicated in patients with the following conditions: Active pathological bleeding. Severe hypersensitivity reaction to Apixaban (i.e. anaphylactic reactions).</p>', '<p>Apixaban can cause a skin rash or severe allergic reaction.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well-controlled studies of Apixaban in pregnant women. Treatment is likely to increase the risk of hemorrhage during pregnancy and delivery. Apixaban should be used during pregnancy only if the potential benefit outweighs the potential risk to the mother and fetus.<br />\r\n<br />\r\n<strong>Labor and Delivery</strong>: Safety and effectiveness of Apixaban during labor and delivery have not been studied in clinical trials. Consider the risks of bleeding and of stroke in using Apixaban in this condition.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is unknown whether Apixaban or its metabolites are excreted in human milk. Women should be instructed either to discontinue breastfeeding or to discontinue Apixaban therapy, taking into account the importance of the drug to the mother.</p>', '<p>Increased Risk of Stroke with Discontinuation of Apixaban Discontinuing Apixaban in the absence of adequate alternative anticoagulation increases the risk of thrombotic events. An increased rate of stroke was observed during the transition from Apixaban to warfarin in clinical trials in patients with nonvalvular atrial fibrillation. If Apixaban must be discontinued for a reason other than pathological bleeding, consider coverage with another anticoagulant.</p>', '<p>There is no antidote to Apixaban. Overdose of Apixaban increases the risk of bleeding. Activated charcoal may be useful in the management of Apixaban overdose.</p>', '<p>Anti-coagulants, Anti-platelet drugs, Fibrinolytics (Thrombolytics), Oral Anti-coagulants</p>', '<p>Keep in a dry place and store below 30&deg;C. Protect from light and keep out of the reach of children.</p>', '<p><strong>Hepatic Impairment</strong>: No dose adjustment is required in patients with mild hepatic impairment. Because patients with moderate hepatic impairment may have intrinsic coagulation abnormalities and there is limited clinical experience with Apixaban in these patients, dosing recommendations cannot be provided Apixaban is not recommended in patients with severe hepatic impairment<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: The dosing adjustment for moderate renal impairment is described above. No data inform use in patients with creatinine clearance &lt;15 ml/min or on dialysis.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness in pediatric patients have not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total subjects in clinical studies of Apixaban, &gt;69% were 65 and older, and &gt;31% were 75 and older. The effects of Apixaban on the risk of stroke and major bleeding compared to warfarin were maintained in geriatric subjects.</p>', '2022-02-14 07:03:18', '2022-03-16 00:27:01'),
(111, 111, '<p>Apremilast is indicated for the treatment of adult patients with active psoriatic arthritis and moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy.</p>', '<p>Apremilast is a novel, orally available small molecule inhibitor of type-4 cyclic nucleotide phosphodiesterase (PDE-4). PDE-4 is a cyclic adenosine monophosphate (cAMP)-specific phosphodiesterase that is predominantly located in inflammatory cells. By inhibiting PDE-4, apremilast increases intracellular levels of cAMP and thereby inhibits the production of multiple proinflammatory mediators including PDE-4, TNF-alpha, interleukin-2 (IL-2), interferon-gamma, leukotrienes, and nitric oxide synthase. By targeting a central component of the inflammatory signaling cascade rather than a single inflammatory marker, PDE-4 inhibition may restore the homeostatic balance between pro- and anti-inflammatory signalling.</p>', '<p>The recommended initial dosage titration of Apremilast from Day 1 to Day 5 is shown below. Following the 5-day titration, the recommended maintenance dosage is 30 mg twice daily taken orally starting on Day 6. This titration is intended to reduce the gastrointestinal symptoms associated with initial therapy. Apremilast can be administered without regard to meals.<br />\r\n<br />\r\n<strong>Day 1</strong>: 10 mg in morning<br />\r\n<strong>Day 2</strong>: 10 mg in morning and 10 mg in evening<br />\r\n<strong>Day 3</strong>: 10 mg in morning and 20 mg in evening<br />\r\n<strong>Day 4</strong>: 20 mg in morning and 20 mg in evening<br />\r\n<strong>Day 5</strong>: 20 mg in morning and 30 mg in evening<br />\r\n<strong>Day 6</strong>: 30 mg twice daily<br />\r\n<br />\r\nDosage adjustment in patients with severe renal impairment.&nbsp;Apremilast dosage should be reduced to 30 mg once daily in patients with severe renal impairment. For initial dosage titration, it is recommended that Apremilast be titrated using only the morning schedule and the evening doses be skipped.</p>', '<p>Co-administration of strong cytochrome P450 enzyme inducer Rifampin resulted in a reduction of systemic exposure of Apremilast.Therefore.the use of cytochrome P450 enzyme inducers (e.g. Rifampin, Phenobarbital,Carbamazepine, Phenytoin) with Apremilast is not recommended.</p>', '<p>Apremilast is contraindicated in patients with a known hypersensitivity to Apremilast or to any of the excipients in the formulation.</p>', '<p>The most frequently occurring side effects of Apremilast are nausea, diarrhea and headache. Other less frequent side effects are upper respiratory tract infection, vomiting, naospharyngitis, abdominal pain, hypersensitivity, gastroesophageal reflux disease, dyspepsia, fatigue, decrease appetite, cough, rash, insomnia.</p>', '<p>Pregnancy Category C. It is not known whether Apremilast or its metabolites are present in human milk; however, Apremilast was detected in milk of lactating mice. Caution should be exercised when Apremilast is administered to a nursing woman.</p>', '<p>Treatment with Apremilast is associated with an increase in adverse reactions of depression. Patients, their caregivers and families should be advised of the need to be alert for the emergence or worsening of depression, suicidal thoughts or other mood changes and if such changes occur to contact their healthcare provider. Prescribers should carefully evaluate the risks and benefits of continuing treatment with Apremilast if such events occur.<br />\r\n<br />\r\nDuring the controlled period of the studies in psoriatic arthritis, weight decrease between 5-10% of body weight was reported in 10% of subjects treated with Apremilast 30 mg twice daily compared to 3.3% treated with placebo.</p>', NULL, '<p>Disease-modifying antirheumatic drugs (DMARDs)</p>', '<p>Store at cool &amp; dry place, protected from light &amp; moisture. Keep the medicine out of the reach of children.</p>', '<p><strong>Use in Paediatric patient</strong>: The safety and effectiveness of Apremilast in paediatric patients less than 18 years of age have not been established.</p>', '2022-02-14 07:03:37', '2022-03-16 00:31:45');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(112, 112, '<p>Aprepitant is indicated for-</p>\r\n\r\n<ul>\r\n	<li>Prevention of postoperative nausea and vomiting (PONV)</li>\r\n	<li>Prevention of Chemotherapy Induced Nausea and Vomiting (CINV)</li>\r\n</ul>', '<p>Aprepitant is a selective high affinity antagonist of human substance P neurokinin 1 (NK1) receptors. When substance P attaches to these receptors, it causes nausea and vomiting. Aprepitant stops substance P from binding to the NK1 receptors. By blocking the receptors, Aprepitant can prevent nausea and vomiting, which often happens after chemotherapy or as a complication of surgery.</p>', '<p><strong>Post Operative Nausea and Vomiting</strong>: The recommended oral dosage of Aprepitant is 40 mg within 3 hours prior to induction of anesthesia.<br />\r\n<br />\r\n<strong>Chemotherapy-Induced Nausea and Vomiting</strong>:<br />\r\n<br />\r\n** The following regimen should be used for the prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy-</p>\r\n\r\n<ul>\r\n	<li><strong>Day 1</strong>: Aprepitant 125 mg orally, Dexamethasone 12 mg orally, 5-HT3 antagonist (Ondansetron): 24 mg 30 minutes before the start of chemotherapy.</li>\r\n	<li><strong>Day 2</strong>: Aprepitant 80 mg orally, Dexamethasone 8 mg orally</li>\r\n	<li><strong>Day 3</strong>: Aprepitant 80 mg orally, Dexamethasone 8 mg orally</li>\r\n	<li><strong>Day 4</strong>: Dexamethasone 8 mg orally</li>\r\n</ul>\r\n\r\n<p>Aprepitant is administered orally 1 hour prior to chemotherapy treatment on Day 1 and in the morning on Days 2 and 3. Dexamethasone is administered 30 minutes prior to chemotherapy treatment on Day 1 and in the morning on Days 2 through 4. The dose of dexamethasone accounts for drug interactions.<br />\r\n<br />\r\n** The following regimen should be used for the prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy:</p>\r\n\r\n<ul>\r\n	<li><strong>Day 1</strong>: Aprepitant 125 mg orally, Dexamethasone 12 mg orally, 5-HT3 antagonist (Ondansetron): one 8 mg tablet 30 minutes before chemotherapy followed by an 8 mg dose 8 hours later.</li>\r\n	<li><strong>Day 2</strong>: Aprepitant 80 mg orally, 5-HT3 antagonist (Ondansetron): 8 mg tablet twice a day</li>\r\n	<li><strong>Day 3</strong>: Aprepitant 80 mg orally, 5-HT3 antagonist (Ondansetron): 8 mg tablet twice a day.</li>\r\n</ul>\r\n\r\n<p>Aprepitant is administered orally 1 hour prior to chemotherapy treatment on Day 1 and in the morning on Days 2 and 3. Dexamethasone is administered 30 minutes prior to chemotherapy treatment on Day 1. The dose of dexamethasone accounts for drug interactions.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Aprepitant may be taken with or without food. No dosage adjustment is necessary for the elderly patients.</p>', '<p>Aprepitant is a substrate, a weak-to-moderate (dose dependent) inhibitor, and an inducer of CYP3A4. Aprepitant is also an inducer of CYP2C9. Precautions should be taken while coadministering Aprepitant with drugs that use CYP3A4 or CYP2C9, for example- Warfarin, Tolbutamide, Phenytoin, Ketoconazole, Itraconazole, Nefazodone, Troleandomycin, Clarithromycin, Ritonavir, Nelfinavir, Diltiazem, Rifampin, Carbamazepine etc. &nbsp;<br />\r\n<br />\r\nUpon coadministration with Aprepitant, the efficacy of hormonal contraceptives during and for 28 days following the last dose of Aprepitant may be reduced. Alternative or back-up methods of contraception should be used during treatment with Aprepitant and for 1 month following the last dose of Aprepitant.</p>', '<p>Aprepitant is contraindicated in patients who are hypersensitive to any component of the product. Aprepitant should not be used concurrently with Pimozide, Terfenadine, Astemizole &amp; Cisapride.</p>', '<p>Constipation, Hypotension, Pruritus, Pyrexia</p>', '<p>Pregnancy Category B. This drug should be used during pregnancy only if clearly needed. It is not known whether this drug is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug based on patient&rsquo;s importance.</p>', NULL, '<p>No specific information is available on the treatment of overdosage with Aprepitant. Single doses up to 600 mg of Aprepitant were generally well tolerated in healthy subjects. Drowsiness and headache can be seen due to overdose. In the event of overdose, Aprepitant should be discontinued. General supportive treatment and monitoring should be provided. Because of the antiemetic activity of Aprepitant, medicine-induced emesis may not be effective. Aprepitant cannot be removed by hemodialysis.</p>', '<p>Anti-emetic drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', '<p><strong>Patients with Renal Impairment</strong>: No dosage adjustment is necessary for patients with renal impairment or for patients with end-stage renal disease (ESRD) undergoing hemodialysis.<br />\r\n<br />\r\n<strong>Patients with Hepatic Impairment</strong>: No dosage adjustment is necessary for patients with mild to moderate hepatic impairment. There are no clinical data in patients with severe hepatic impairment.</p>', '2022-02-14 07:03:54', '2022-03-16 00:36:26'),
(113, 113, '<p>Arabinoxylan is able to increase NK cell activity by as much as 300% in just a couple of weeks, whilst T and B cell activity are increased by 200 and 150% respectively. Research has also shown that it can help significantly boost natural antibody production, as well as other parameters of the immune system. This is particularly important as we age as the immune system naturally declines with age.<br />\r\n<br />\r\nResearch shows that Arabinoxylan also has anti-inflammatory effects and antioxidant scavenging activity, as well as the ability to improve glucose tolerance, enhance pancreatic and liver function, reduce the adverse effects of chemotherapy, and improve general quality of life.<br />\r\n<br />\r\nThis ability to enhance the immune system and reduce inflammation means that Arabinoxylan is an important food supplement for a variety of situations. (Please note that the majority of research has been conducted in relation to cancer, and that more research needs to be done on viral infections, bacterial infections and diabetes.)<br />\r\n<br />\r\nThis product is basically used for the patients who are attacked by cancer, virus, bacteria.</p>', '<p>Arabinoxylan might work by reducing the amount of sugar and&nbsp;cholesterol&nbsp;that is absorbed in the&nbsp;stomach&nbsp;and intestines.</p>', '<p>The recommended dose of Arabinoxylan is 1 to 3 gram per day, taken orally.<br />\r\n<br />\r\nAs the body does not build up a resistance to Arabinoxylan over time, this food supplement can safely and effectively be taken over an extended period of time, and without the necessity of slowly increasing the dosage as with other immunomodulators.<br />\r\n<br />\r\nMost research into Arabinoxylan has been conducted using 30 to 45 mg/kg/day in a divided dose with meals, with maintenance doses down to 15 mg/kg/day. A dosage of at least 500 mg a day should be taken for general health maintenance (unless potentised with yeast); for more serious immune support (such as in the case of arthritis, diabetes, hepatitis B, hepatitis C and other infections) the recommended dosage should be 1000 mg a day; and for serious conditions where the immune system is severely compromised (such as with cancer or AIDS) 3 g per day is recommended for 1 month and then 1g per day thereafter.<br />\r\n<br />\r\nArabinoxylan should always be taken after food (ideally, 30 minutes after) and larger daily intakes should be divided into three portions and taken with breakfast, lunch and dinner. If the person taking the compound is very ill, they can stay on the 3 g per day intake for an extended period.<br />\r\n<br />\r\nApart from the case of general health maintenance, we always recommend that your doctor be informed that you are taking this supplement, so that he or she can integrate it into your treatment program. intake for an extended period.</p>', '<p>Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination. Arabinoxylan might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking arabinoxylan along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.</p>', NULL, '<p>Arabinoxylan compound is a natural product that has no adverse or toxic side-effects, confirmed by blood tests and examinations of liver and kidney function of people who have taken high amounts of the compound over several months. The only obvious contraindication is that, as an immunomodulator, able to boost weak immune systems, it should not be taken in conjunction with any medication specifically for suppressing the immune system.<br />\r\n<br />\r\nAnd, although mushroom enzymes are used in Arabinoxylan manufacture, there is no mushroom content in the final product, which means that nearly all those with mushroom intolerances have been able to take it without an allergic reaction. This compound has also been authorized by the Japan Health Food and Nutrition Food Association, and has passed strict evaluation standards set under the guidance of the Ministry of Health and Welfare.</p>', '<p>Not enough is known about the use of arabinoxylan during pregnancy and breast-feeding</p>', NULL, '<p>Arabinoxylan has been clinically shown to be completely non-toxic, even in extremely high doses. It is also safe for children and infants (intake scaled down by body weight).</p>', '<p>Immunomodulator</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:04:13', '2022-03-16 00:39:26'),
(114, 114, '<p>Arformoterol is indicated for long-term, twice daily (morning and evening) administration in the maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema.<br />\r\n<br />\r\nImportant limitations of use: Arformoterol nebuliser solution is not indicated to treat acute deteriorations of COPD. People with asthma, who take long-acting beta2 adrenergic agonist (LABA) medicines, such as Arformoterol, have an increased risk of death from asthma problems</p>', NULL, '<p>The recommended dose of Arformoterol nebuliser solution is one 15 mcg unit-dose ampoule administered twice daily (morning and evening) by nebulization. A total daily dose of greater than 30 mcg (15 mcg twice daily) is not recommended.<br />\r\n<br />\r\nPediatric Use: COPD does not occur in children. The safety and efficacy of Arformoterol nebuliser solution in pediatric patients have not been established</p>', '<p>Other adrenergic drugs may potentiate effect. Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. MAO inhibitors, tricyclic antidepressants and drugs that prolong the QTc interval may potentiate effect on the cardiovascular system. Beta-blockers may decrease effectiveness.</p>', NULL, '<p>Most common adverse reactions are pain, chest pain, back pain, diarrhea, sinusitis, leg cramps, dyspnea, rash, flu syndrome, peripheral edema and lung disorder. Arformoterol can cause serious side effects, including: People with asthma, who take LABA medicines, have an increased risk of death from asthma problems. Patient should get emergency medical care if:</p>\r\n\r\n<ul>\r\n	<li>Breathing problems worsen quickly</li>\r\n	<li>After the use of rescue inhaler medicine, it does not relieve breathing problems.</li>\r\n</ul>', '<p>Pregnancy Category C. Arformoterol nebuliser solution should be used during pregnancy, only if the potential benefit justifies the potential risk to the fetus. It is not known whether arformoterol is excreted in human milk.</p>', '<p>Arformoterol nebuliser should not be initiated in acutely deteriorating patients. It should be used with caution in patients with cardiovascular or convulsive disorders, thyrotoxicosis, or with sensitivity to sympathomimetic drugs. Life-threatening paradoxical bronchospasm can occur.</p>', '<p>As with all inhaled sympathomimetic medications, cardiac arrest and even death may be associated with an overdose of Arformoterol nebuliser solution.</p>', '<p>Bronchodilator</p>', '<p>Arformoterol nebuliser solution should be stored at 2-8&deg;C, protected from light and excessive heat. Do not freeze. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:04:35', '2022-03-16 00:42:34'),
(115, 115, '<p><strong>Aripiprazole is indicated for</strong>-</p>\r\n\r\n<ul>\r\n	<li>Schizophrenia</li>\r\n	<li>Schizoaffective disorder</li>\r\n	<li>Acute manic and mixed episodes associated with Bipolar I Disorder</li>\r\n	<li>Maintaining efficacy in patients with Bipolar I Disorder who are stabilized</li>\r\n</ul>', '<p>Aripiprazole is an atypical antipsychotic that has both dopamine and serotonin receptors activity. It is a partial agonist of dopamine D2 receptors that relieves the symptoms of schizophrenia. It is characterized as a dopamine system stabilizer. It is a potent partial agonist at serotonin 5-HT1A receptors and antagonist at 5-HT2A receptors. This is associated with improvement of depressive, cognitive and negative symptoms.</p>', '<p><strong>For Schizophrenia</strong>: 10 to 15 mg, once daily, without regard to food. Dose increment should not be made before 2 weeks, the time needed to achieve steady state.<br />\r\n<br />\r\n<strong>For Bipolar mania</strong>:&nbsp;30 mg, once daily, without regard to food.</p>', '<p>Caution should be exercised when aripipazole is taken in combination with other centrally acting drugs and alcohol. Carbamazepine could cause an increase in aripiprazole clearance and lower blood levels. Ketoconazole, quinidine, fluoxetine or paroxetine can inhibit aripiprazole elimination and cause increased blood levels.</p>', '<p>Aripiprazole is contraindicated in patients who are hypersensitive to it or to any component of this product.</p>', '<p>Headache, constipation, asthenia, nausea, dyspepsia, vomiting, coughing, abdominal pain.</p>', '<p>Aripiprazole should not be used in pregnancy as no human trial is performed. Patients should be advised not to breast feed an infant if they are taking aripiprazole.</p>', '<p>Aripiprazole may be associated with orthostatic hypotension (orthostatic lightheadedness).<br />\r\n<br />\r\nAripiprazole should be used with caution in patients with known cardiovascular disease (myocardial infarction or ischaemic heart disease, heart failure or conduction abnormalities), cerebrovascular disease, or conditions that would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications).<br />\r\n<br />\r\nSeizures occurred in aripiprazole-treated patients. As with other antipsychotic drugs, aripiprazole should be used cautiously in patients with Alzheimer&#39;s dementia.<br />\r\n<br />\r\nAripiprazole is not approved for the treatment of patients with dementia-related psychosis.</p>', '<p>Aripiprazole at doses up to 1080 mg causes no fatalities. The signs and symptoms observed with aripiprazole overdose included nausea, vomiting, asthenia, diarrhea, and somnolence.</p>', '<p>Atypical neuroleptic drugs</p>', NULL, NULL, '2022-02-14 07:04:55', '2022-03-16 00:45:51'),
(116, 116, '<p>Armodafinil is indicated to improve wakefulness in adult patients with-</p>\r\n\r\n<ul>\r\n	<li>Obstructive sleep apnea (OSA)</li>\r\n	<li>Narcolepsy</li>\r\n	<li>Shift work disorder (SWD)</li>\r\n</ul>', '<p>Armodafinil is an indirect dopamine receptor agonist. This is the R-enantiomer of Modafinil which is a 1:1 mixture of the R- and S-enantiomers. Armodafinil binds to the dopamine transporter and inhibits dopamine reuptake. As a result,&nbsp;increases neuronal activity in the hypothalamus, enhances activity in hypothalamic wakefulness center (TMN, tuberomammillary nucleus) within the hypothalamic sleep wake switch.</p>', '<p><strong>Adults</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Obstructive Sleep Apnea (OSA) &amp; Narcolepsy</strong>: 150 mg to 250 mg as a single dose in the morning.</li>\r\n	<li><strong>Shift Work Disorder (SWD)</strong>: 150 mg as a single dose approximately 1 hour prior to the start of work shift.</li>\r\n</ul>\r\n\r\n<p><strong>Children</strong>: Safety and effectiveness in pediatric patients less than 17 years of age have not been established.<br />\r\n<br />\r\n<strong>Elderly</strong>: In elderly patients, elimination of Armodafinil and its metabolites may be reduced as a consequence of aging. Therefore, consideration should be given to the use of lower doses and close monitoring in this population.</p>', '<p>The clearance of drugs that are substrates for CYP3A4 or CYP3A5 (e.g., steroidal contraceptives, Cyclosporine, Midazolam and Triazolam) may be increased by Armodafinil which results in lower systemic exposure. Dosage adjustment of these drugs should be considered when used concomitantly with Armodafinil.<br />\r\n<br />\r\nElimination of drugs that are substrates for CYP2C19 (e.g., Phenytoin, Diazepam, Propranolol, Omeprazole and Clomipramine) may be prolonged by Armodafinil which results in higher systemic exposure. Dosage adjustment of these drugs should be considered when used concomitantly with Armodafinil.<br />\r\n<br />\r\nMore frequent monitoring of prothrombin times/ International normalized ratio (INR) should be considered whenever Armodafinil is co-administered with Warfarin.<br />\r\n<br />\r\nCaution should be used when concomitantly administering MAO inhibitors and Armodafinil.</p>', '<p>Contraindicated in patients with known hypersensitivity to Armodafinil or any of theexcipients of this product</p>', '<p>The most common side effects of Armodafinil are serious rash, including Stevens-Johnson syndrome, angioedema and anaphylaxis reactions, multi-organ hypersensitivity reactions, persistent sleepiness, psychiatric symptoms and some cardiovascular events.</p>', '<p><strong>Pregnancy</strong>: There are no adequate and well controlled studies of Armodafinil in pregnant women. Armodafinil should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Armodafinil or its metabolites are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Armodafinil is administered to a nursing woman.</p>', '<p>Patients should be cautioned about operating an automobile or other hazardous machinery until it is reasonably certain that Armodafinil therapy will not adversely affect their ability to engage in such activities. Caution should be taken in treating patients with a history of psychosis, depression or mania. Discontinuation of treatment should be considered if psychiatric symptoms develop. Increased monitoring of heart rate and blood pressure should be exercised. Caution should be exercised when prescribing Armodafinil to patients with known cardiovascular disease.</p>', '<p>There were no overdoses reported in the Armodafinil clinical studies. Symptoms of Armodafinil overdose are likely to be similar to those of Modafinil which included excitation or agitation, insomnia and slight or moderate elevations in hemodynamic parameters. There is no specific antidote for Armodafinil overdose. However, if overdose occurs, it should be managed with primary supportive care.</p>', '<p>CNS stimulant drugs</p>', '<p>Store in a cool (below 25&deg;C) and dry place protected from light.</p>', '<p><strong>Patients with hepatic impairment</strong>: In patients with severe hepatic impairment, Armodafinil should be administered at a reduced dose.<br />\r\n<br />\r\n<strong>Patients with renal impairment</strong>:There is inadequate information to determine safety and efficacy of dosing in patients with severe renal impairment.</p>', '2022-02-14 07:05:14', '2022-03-16 00:49:22'),
(117, 117, '<p>Artemether is indicated for Malaria, Schistosomiasis.</p>', '<p>Artemether is a potent and rapidly acting blood schizontocide, which is highly efficacious in treating chloroquine-resistant falciparum malaria, and complicated falciparum malaria including cerebral malaria. Its quick onset of effect and high efficacy in bringing down the parasite load are the properties which make this drug a suitable therapeutic option against falciparum infection.</p>', '<p><strong>Adult</strong>: 80 mg twice daily for 1 day followed by 80 mg once daily for 4 days. Maximum dose: 480 mg for 5 days.<br />\r\n<br />\r\n<strong>Children</strong>: 3.2 mg/kg/day in 2 divided doses followed by 1.6 mg/kg/day once daily for 4 days. Maximum dose: 9.6 mg/kg for 5 days.</p>', '<p>Artemether causes QT prolongation in some patients. Thus concomitant use of erythromycin, terfenadine, procainamide, quinidine, disopyramide, amiodarone, bretylium, bepridil, sotalol, astemizole, probucol, tricyclic antidepressants, phenothiazines may be avoided.</p>', '<p>Contraindicated in patients with hpersensitivity to&nbsp;Artemether.</p>', '<p>Mild Gl disturbance, dizziness, tinnitus, reduction in reticulocyte and leucocyte counts, nausea, vomiting, abdominal pain, bradycardia, first degree heart block, transient increase in serum transaminases.</p>', '<p>Pregnancy Category-C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks</p>', '<p>Avoid concomitant use of drugs known to prolong QT interval or monitor such patients.</p>', NULL, '<p>Anti-malarial drugs</p>', NULL, NULL, '2022-02-14 07:05:32', '2022-03-16 01:02:54'),
(118, 118, '<p>This preparation is indicated for: Treatment and stand by emergency treatment of adults, children and infants with acute, uncomplicated infection due to Plasmodium falciparum or mixed infections including P. falciparum. Because Artemether and Lumefantrine is effective against both drug sensitive and drug resistance P. falciparum. This preparation is also recommended for malaria infections acquired in areas where the parasites may be resistant to other antimalarials. Stand by emergency treatment: Most tourists and business travelers, considered to be non-immune, will be able to obtain prompt medical attention if malaria is suspected. However a minority at risk of infection may be unable to obtain such care within 24 hours of onset of symptoms, particularly if they are in an isolated location far from medical services. In such case, prescribers are advised to issue Artemether and Lumefantrine to be carried by the traveler for self-administration (stand by emergency treatment). Consideration should be given to official guidance regarding the appropriate use of the anti-malarial agents.</p>', '<p>This preparation contains a fixed ratio of 1:6 parts of Artemether and Lumefantrine respectively. Artemether is a derivative of naturally occurring substance Artemisinin. Lumefantrine is a synthetic racemic fluorine mixture belonging to the aryl amino alcohol family like other anti-malarials (e.g. Quinine, mafloquine, halofantrine). Both components act in the food vacuoles of malarial parasites, where they are thought to interfere with the conversion of haem, a toxic intermediate formed during haemoglobin breakdown, to the non-toxic haemozin (a malaria pigment). Lumefantrine is thought to interfere with the polymerization process, while Artemether generates reactive metabolites as a result of interaction between the peroxide bridge and haem iron. Both Artemether and Lumefantrine have a secondary action involving inhibition of nucleic acid - protein synthesis within the malarial parasites. This tablet did not induce resistance. This tablet is active against blood stages of Plasmodium vivax, but it is not active against hypnozoites. Therefore, sequential treatment with premaquine should be used to achieve hypnozoite eradication.</p>', '<p>Patients with acute malaria are frequently averse to food. The dose should be taken with high fat food or drinks such as milk. In the event of vomiting within 1 hour of administration a repeat dose should be taken.<br />\r\n<br />\r\n<strong>Adults and children weighing 35 kg and above</strong>: A standard 3 days treatment schedule with a total of 6 doses is recommended dosage is 4 tablets as a single dose at the time of initial diagnosis, again 4 tablets after eight hours, and then 4 tablets twice daily (morning and evening) on each of the following two days (Total course comprises 24 tablets).<br />\r\n<br />\r\n<strong>5 to &lt;15 kg body weight</strong>: 1 tablet at the time of initial diagnosis, 1 tablet again after 8 hours and then 1 tablet twice daily (morning and evening) on each of the following two days (Total course comprises of 6 tablets).<br />\r\n<br />\r\n<strong>15 to &lt;25 kg body weight</strong>: 2 tablets as a single dose at the time of initial diagnosis , 2 tablets again after 8 hours and then 2 tablets twice daily (morning and evening) on each of the following two days (Total course comprises 12 tablets).<br />\r\n<br />\r\n<strong>25 to &lt;35 kg body weight</strong>: 3 tablets as a single dose at the time of initial diagnosis, 3 tablets again after 8 hours and then 3 tablets twice daily (morning and evening) on each of the following two days (Total courses comprises 18 tablets).</p>', '<p>No such result is available.</p>', '<p>Hypersensitivity to any of the ingredients or excipients; Patients with severe malaria according to WHO definition; First trimester of pregnancy; Patients with a family history of congenital prolongation of the QTc interval or sudden death or with any other clinical condition known to prolong the QTc interval such as patients with a history of symptomatic cardiac arrythmias with clinically relevant bradycardia or with severe cardiac disease; Patients with known disturbance of electrolyte balance e.g. hypokalaemia or hypomagnesemia; Patients taking any drug which is metabolized by the cytochrome enzyme CYP2D6 (e.g. flecainide, metoprolol, imipramine, amitriptyline, clomipramine).</p>', '<p>It is generally very well tolerated by children and adults, with most adverse effects are of mild to moderate severity and duration. Hypersensitivity, headache, dizziness, sleep disorder, somnolence, involuntary muscle contractions, paraesthesia, hypoesthesia, abnormal gait, ataxia, palpitation, cough, abdominal pain, anorexia, diarrhoea, vomiting, nausea, pruritus, rash, arthralgia, myalgia, asthenia, fatigue.</p>', '<p>Use in pregnancy &amp; lactation is contraindicated; especially in the first trimester of pregnancy. Breast feeding women should not take this preparation. Due to the long elimination half-life of Lumefantrine (4-6 days), it is recommended that breast feeding should not resume before day 28 unless potential benefits to the mother and child outweigh the risk of treatment.</p>', '<p>This has not been evaluated for prophylaxis and is therefore not indicated. This is also not evaluated for the treatment of cerebral malaria or other severe manifestations of severe malaria including pulmonary oedema or renal failure.</p>', '<p>In cases of suspected over dosage, symptomatic and supportive therapy should be given as appropriate. ECG and blood potassium level should be monitored.</p>', '<p>Anti-malarial drugs</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:05:53', '2022-03-16 02:44:40'),
(119, 119, '<p>Artesunate can quickly and reliably control the acute attack of malaria. It is suitable to salvage the patients with pernicious malaria and treat P. falciparum malaria and P. vivax malaria. It is effective against malaria caused by chloroquine resistant strain of plasmodium falciparum.</p>', '<p>Artesunate is a potent and rapidly-acting blood schizontocide derived from the leaves of the chinese herb, Armesia annua. The exact mode of action is not clear but clinical studies have confirmed the effectiveness of artesunate in P. vivax and falciparum malaria.</p>', '<p><strong>Adult</strong>: 5 days treatment: on the 1st day 2 tablets twice and 2nd day onward 1 tablet twice daily for remaining 4 days<br />\r\n<br />\r\n<strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>1-3 years</strong>: 5 days treatment: on the 1st day &frac12; tablet twice and 2nd day onward &frac14; tablet twice daily for remaining 4 days</li>\r\n	<li><strong>4-5 years</strong>: 5 days treatment: on the 1st day 1 tablet twice and 2nd day onward &frac12; tablet twice daily for remaining 4 days</li>\r\n	<li><strong>6-12 years</strong>: 5 days treatment: on the 1st day &frac12; tablet twice, 2nd day 1 tablet twice and 3rd day onward &frac12; tablet twice daily for remaining 3 days</li>\r\n</ul>\r\n\r\n<p><strong>Prophylmcis</strong>: 100 mg tablet once a week, from 1 week before entering malarial areas, to 4 weeks after leaving the area.</p>', '<p>Antimalarial potentiating action seen with mefloquine, primaquine and tetracycline. Additive effect with chloroquine. Antagonistic effect with pyrimethamine and sulphonamides.</p>', '<p>Hypersensitivity.</p>', '<p>Transient and reversible reticulocytopaenia, drug fever, rash, bradycardia, transient 1st-degree heart block and reversible elevation of serum transaminases.</p>', '<p>Pregnancy category is not classified. FDA has yet not classified the drug into a specific pregnancy catagory.</p>', '<p>Hepatic or renal insufficiency; Pregnancy and lactation.</p>', NULL, '<p>Anti-malarial drugs</p>', NULL, NULL, '2022-02-14 07:06:15', '2022-03-16 22:47:16'),
(120, 120, '<p>Articaine and Epinephrine is an amide local anesthetic containing a vasoconstrictor indicated for local, infiltrative, or conductive anesthesia in both simple and complex dental procedures.</p>', '<p>Articaine is an amide local anesthetic. Local anesthetics block the generation and conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination, and conduction velocity of the affected nerve fibers. Epinephrine is a vasoconstrictor added to articaine to slow absorption into the general circulation and thus prolong maintenance of an active tissue concentration.</p>', '<p>Below are the recommended volumes and concentrations of articaine-epinephrine for various types of anesthetic procedures. The dosages suggested below are for normal healthy adults, administered by submucosal infiltration and/or nerve block.<br />\r\n<br />\r\n<strong>Infiltration</strong>: 0.5 mL to 2.5 mL or 20 mg to 100 mg of articaine<br />\r\n<strong>Nerve block</strong>: 0.5 mL to 3.4 mL or 20 mg to 136 mg of articaine<br />\r\n<strong>Oral surgery</strong>: 1.0 mL to 5.1 mL or 40 mg to 204 mg of articaine.<br />\r\n<br />\r\nFor normal healthy adults, the maximum dose of articaine administered by submucosal infiltration and/or nerve block should not exceed 7 mg/kg of body weight.</p>', '<p>The administration of local anesthetic solutions containing epinephrine to patients receiving monoamine oxidase inhibitors, nonselective beta-adrenergic antagonists or tricyclic antidepressants may produce severe, prolonged hypertension. Phenothiazines and butyrophenones may reduce or reverse the pressor effect of epinephrine. Concurrent use of these agents should generally be avoided. In situations when concurrent therapy is necessary, careful patient monitoring is essential</p>', '<p>Articaine HCl and Epinephrine is contraindicated in patients who are hypersensitive to products containing sulfites. Products containing sulfites may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. Sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people</p>', '<p>Common side effects include Pain, headache, facial edema, gingivitis, paresthesia, infection. Other side effects include pain, headache, positive blood aspiration into syringe, swelling, face edema, infection, neck pain, abdominal pain, ear pain, taste perversion, and accidental injury have been reported<br />\r\n<br />\r\n<strong>Gastrointestinal side effects</strong>&nbsp;including nausea and emesis, gingivitis, constipation, diarrhea, dyspepsia, glossitis, gum hemorrhage, mouth ulceration, nausea, stomatitis, tongue edema, tooth disorder, and vomiting have been reported.<br />\r\n<br />\r\n<strong>Musculoskeletal side effects</strong>&nbsp;including trismus, arthralgia, myalgia, back pain, and osteomyelitis have been reported.<br />\r\n<br />\r\n<strong>General side effects</strong>&nbsp;including sleepiness, malaise, and asthenia have been reported.<br />\r\n<br />\r\n<strong>Nervous system side effects</strong>&nbsp;including paresthesia, numbness and tingling, dizziness, dry mouth, facial paralysis, hyperesthesia, increased salivation, nervousness, neuropathy, paresthesia, somnolence, and exacerbation of Kearns-Sayre syndrome have been reported.<br />\r\n<br />\r\n<strong>Cardiovascular side effects</strong>&nbsp;including palpitation, hemorrhage, migraine, syncope, tachycardia, and elevated blood pressure have been reported.<br />\r\n<br />\r\n<strong>Respiratory side effects</strong>&nbsp;including pharyngitis, rhinitis, sinus pain, and sinus congestion have been reported.</p>', '<p>Pregnancy Category C.&nbsp;There are no adequate and well-controlled studies in pregnant women with articaine with epinephrine. This&nbsp;should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\nNursing Mothers: It is not known whether Articaine and Epinephrine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when this combination&nbsp;is administered to a nursing woman.</p>', NULL, NULL, '<p>Local &amp; Surface anesthesia</p>', NULL, '<p><strong>Pediatric Use</strong>: Safety of doses greater than 7 mg/kg of articaine in pediatric patients has not been established. Dosages in pediatric patients should be reduced, commensurate with age, body weight, and physical condition.<br />\r\n<br />\r\n<strong>Renal or Hepatic Insufficiency</strong>: No studies have been performed with articaine and epinephrine in renal and hepatic impaired patient.</p>', '2022-02-14 07:06:50', '2022-03-16 22:51:10'),
(121, 121, '<p>Used as a diet supplement and sugar substitute.</p>', '<p>Aspartame is a low-calorie sweetener used to sweeten a wide variety of low- and reduced-calorie foods and beverages, including low-calorie tabletop sweeteners. Aspartame is composed of two amino acids, aspartic acid and phenylalanine, as the methyl ester. Aspartic acid and phenylalanine are also found naturally in protein containing foods, including meats, grains and dairy products. Methyl esters are also found naturally in many foods such as fruits and vegetable and their juices. Upon digestion, aspartame breaks down into three components (aspartic acid, phenylalanine and methanol), which are then absorbed into the blood and used in normal body processes. Neither aspartame nor its components accumulates in the body. These components are used in the body in the same ways as when they are derived from common foods.<br />\r\n<br />\r\nAspartame is 180 to 200 times sweeter than sucrose, it is metabolized as a protein and its subsequent amino-acids used up in there respective mechanisms.</p>', '<p>According to individual taste. 1 pellet is equivalent in sweetness to 1 tsf of sugar.</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Complete biliary obstruction, hypersensitivity.</p>', '<p>Constipation; faecal impaction; haemorrhoids; abdominal discomfort or pain; heartburn; flatulence; nausea; vomiting; diarrhoea; increased bleeding tendency (chronic use); osteoporosis; steatorrhoea (high doses); skin rashes; pruritus of the tongue, skin and perianal region; hyperchloraemic acidosis.</p>', '<p>Pregnancy Category-C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.</p>', '<p>If pregnant or breast-feeding, seek advice of a health professional before use.</p>', NULL, '<p>Oral nutritional preparations</p>', NULL, NULL, '2022-02-14 07:07:02', '2022-03-16 22:53:55'),
(122, 122, '<p>Aspirin is indicated in the following indications-</p>\r\n\r\n<ul>\r\n	<li><strong>Prophylaxis against arterial occlusive events</strong>: Myocardial infarction, myocardial re-infarction, after bypass surgery, acute ischaemic stroke/TIA.</li>\r\n	<li><strong>Mild to moderate pain</strong>: Headache, muscle pain, dysmenorrhoea and toothache etc.</li>\r\n	<li><strong>Chronic disease accompanied by pain and inflammation</strong>: Osteoarthritis.</li>\r\n	<li><strong>Antipyretic</strong>: Cold fever and influenzae.</li>\r\n</ul>', '<p>By decreasing platelet aggregation, Aspirin inhibits thrombus formation on the arterial side of the circulation, where thrombi are formed by platelet aggregation and anticoagulants have little effect. Aspirin is the analgesic of choice for headache, transient musculoskeletal pain and dysmenorrhoea. It has anti-inflammatory and antipyretic properties, which may be useful. Enteric-coated Aspirin reduces intestinal disturbance and gastrointestinal ulceration due to aspirin.</p>', '<p><strong>Pain, inflammatory diseases and as antipyretic</strong>: Aspirin 300 mg 1-3 tablets 6 hourly with a maximum daily dose of 4 gm.<br />\r\n<br />\r\n<strong>Suspected acute coronary syndrome</strong>: 150 mg-300 mg immediately unless there are clear contraindications.<br />\r\n<br />\r\n<strong>After myocardial infarction</strong>: Aspirin 150 mg daily for 1 month. Long-term use of aspirin in a dose of 75 mg daily is recommended thereafter.<br />\r\n<br />\r\n<strong>Acute ischaemic stroke/Transient ischaemic stroke (TIA)</strong>: The starting dose is 150 mg-300 mg daily and Aspirin 75 mg daily thereafter.<br />\r\n<br />\r\n<strong>Following bypass surgery</strong>: 75 mg-300 mg daily starting 6 hours post-procedure.</p>', '<p>Salicylates may enhance the effect of anticoagulants, oral hypoglycaemic agents, phenytoin and sodium valporate. They inhibit the uricosuric effect of probenecid and may increase the toxicity of sulphonamides. They may also precipitate bronchospasm or induce attacks of asthma in susceptible subjects.</p>', '<p>Aspirin is contraindicated to the children (Reye&#39;s syndrome) less than 12 years, in breast-feeding and active peptic ulcer. It is also contraindicated in bleeding due to haemophilia, intracranial haemorrhage and other ulceration.</p>', '<p>Side effects for the usual dosage of Aspirin are mild including nausea, dyspepsia, gastrointestinal ulceration and bronchospasm etc.</p>', '<p>It is especially important not to use aspirin during the last 3 months of pregnancy unless specifically directed to do so by a doctor because it may cause problems in the unborn child or complications during delivery. Aspirin penetrates into breast milk. So, it should be administered with caution to lactating mothers.</p>', '<p>It should be administered cautiously in asthma, uncontrolled blood pressure, and pregnant women. It should be administered with caution to patients with a nasal polyp and nasal allergy.</p>', '<p>Overdosage produces dizziness, tinnitus, sweating, nausea and vomiting, confusion and hyperventilation. Gross overdosage may lead to CNS depression with coma, cardiovascular collapse and respiratory depression. If the overdosage is suspected, the patient should be kept under observation for at least 24 hours, as symptoms and salicylate blood levels may not become apparent for several hours. Treatment of overdosage consists of gastric lavage and forced alkaline diuresis. Haemodialysis may be necessary in severe cases.</p>', '<p>Anti-platelet drugs</p>', '<p>Keep all medicines out of reach of children. Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-14 07:07:25', '2022-03-16 23:02:00'),
(123, 123, '<p>This capsule is a combination antiplatelet agent indicated to reduce the risk of stroke in patients who have had transient ischemia of the brain or a complete ischemic stroke due to thrombosis.</p>', '<p>This is a combination of anti-platelet agents Aspirin &amp; Dipyridamole intended for oral administration. Aspirin inhibits platelet aggregation by irreversible inhibition of platelet cyclooxygenase and thus inhibits the generation of thromboxane A2. Dipyridamole inhibits platelet aggregation by inhibiting the uptake of adenosine into platelet, which is a potent mediator of vasodilation. Dipyridamole increases local concentration of adenosine which increases cAMP (cyclic-adenosine monophosphate) level thus decreased ca++&nbsp;concentration and inhibits platelet aggregation. Dipyridamole also inhibits phosphodiesterase (PDE) especially cyclic-guanosine monophosphate-PDE (cGMP-PDE), which increases cGMP produced by EDRF (endothelium-derived relaxing factor) Nitric oxide a potent vasodilator.</p>', '<p>The recommended dose is one capsule given orally twice daily. One in the morning and one in the evening. Capsules should be swallowed whole without chewing. This can be administered with or without food.<br />\r\n<br />\r\nPediatric Use: The safety and effectiveness of this capsule in pediatric patients have not been studied. So, the use of this preparation in the pediatric population is not recommended.</p>\r\n\r\n<p>&nbsp;</p>', '<p>Co-administration with anticoagulants, antiplatelets or NSAIDS can increase risk of bleeding. Decreased renal function can occur with co-administration with NSAID, beta blockers and diuretics. Dipyridamole may counteract the anticholinesterase effect of cholinesterase inhibitors, thereby potentially aggravating myasthenia gravis.</p>', '<p><strong>Hypersensitivity</strong>: This capsule is contraindicated in patients with known hypersensitivity to any of the product components.<br />\r\n<br />\r\n<strong>Allergy</strong>: Aspirin is contraindicated in patients with known allergy to Nonsteroidal anti-inflammatory drugs and in patients with the syndrome of asthma, rhinitis and nasal polyps. Aspirin may cause severe urticaria, angioedema or bronchospasm.<br />\r\n<br />\r\n<strong>Reye Syndrome</strong>: Aspirin should not be used in children or teenagers with viral infections because of the risk of Reye syndrome.</p>', '<p>The most frequently reported adverse reactions are headache, dyspepsia, abdominal pain, nausea and diarrhea.</p>', '<p>Pregnancy Category D. Aspirin can results in excessive blood loss at delivery as well as prolonged gestation and prolonged labor. So this capsule should be avoided in the third trimester of pregnancy and during labor and delivery. Both Dipyridamole and Aspirin are excreted in human milk. This capsule not to be administered to a nursing woman.</p>', '<p>This is not interchangeable with the individual components of Aspirin and Dipyridamole tablets. This increases the risk of Intracranial Hemorrhage &amp; Gastrointestinal Bleeding. Avoid this in patient with peptic ulcer, coronary artery diseases, hypotension &amp; severe renal failure or hepatic insufficiency.</p>', '<p>Overdosage of this is likely to be dominated by signs and symptoms of Dipyridamole &amp; Aspirin overdoses. Overdose of Dipyridamole shows hemodynamic effects with various symptoms such as warm feeling, flushes, sweating, restlessness, feeling of weakness, dizziness and a drop in blood pressure and tachycardia might also be observed. The sign of Aspirin overdose includes tinnitus, hyperthermia and hypovolemia. Treatment of overdose consists primarily of supporting vital functions, increasing drug elimination, correcting acid-base disturbances and gastric emptying or lavage as soon as possible after ingestion. Maintain fluid, electrolyte balance and to control the hypoglycemic condition intravenous fluid and infusion of glucose must be administered. Administration of Xanthine derivatives (e.g. aminophylline) may reverse the hemodynamic effects of Dipyridamole overdose.</p>', '<p>Anti-platelet drugs</p>', '<p>Store at cool &amp; dry place. Protect from light. Keep away from reach of children.</p>', NULL, '2022-02-14 07:07:49', '2022-03-16 23:06:42'),
(124, 124, '<p>Astaxanthin is indicated to-</p>\r\n\r\n<ul>\r\n	<li>Strong antioxidant</li>\r\n	<li>Improves cardiovascular health (Atherosclerosis, reduce cholesterol)</li>\r\n	<li>Improves immune function</li>\r\n	<li>Improves condition of skin</li>\r\n	<li>Protects skin from damage caused by sun (Reduces wrinkles, pimples and other signs of aging)</li>\r\n	<li>Improves recovery from central nervous system injuries</li>\r\n	<li>Protects from Parkinson&rsquo;s disease, Dementia and Alzheimer&#39;s disease</li>\r\n	<li>Protects eyes from cataracts and macular degeneration</li>\r\n	<li>Reduces inflammation (Arthritis)</li>\r\n	<li>Reduces risk of infertility</li>\r\n</ul>\r\n\r\n<p>Also Astaxanthin effectively reduces oxidative damage to DNA, decreases the risk for many types<br />\r\nof cancer and stabilizes blood sugar.</p>', '<p>Astaxanthin acts as an antioxidant by dual mode of action. It suppresses singlet oxygen and also inhibits lipid peroxidation. By these actions it reduces the harmful free radicals. Therefore acts as a very strong antioxidant. Astaxanthin is absorbed by passive diffusion into the intestinal epithelium alongside fatty acids. Then it is incorporated into lipoproteins, transported to the liver, via lymph and blood and partly resecreted with lipoproteins. More than 70% of the Astaxanthin is contained in high-density lipoprotein part of plasma. Highest concentration of Astaxanthin is in the small intestine, followed by subcutaneous fat, abdominal fat, spleen, liver, heart, kidney and skin and lowest in the muscles.</p>', '<p>Adults (18 years and older): Daily dose is 4 mg. Should be taken along with or immediately prior to meals in the morning.</p>\r\n\r\n<ul>\r\n	<li><strong>4 mg</strong>: As a strong antioxidant, improves cardiovascular health (Atherosclerosis, reduce cholesterol), improves immune function.</li>\r\n	<li><strong>4-8 mg</strong>: Improves condition of skin, protects skin from sun damage (Reduce wrinkles, pimples and other signs of aging), improves recovery from central nervous systehn injuries and protects eyes from cataracts and macular degeneration.</li>\r\n	<li><strong>8-12 mg</strong>: Reduces inflammation (Arthritis)</li>\r\n	<li><strong>16 mg</strong>: Reduces risk of infertility</li>\r\n</ul>', '<p>Concomitant intake of Astaxanthin with Cholestyramine, Colestipol, Mineral oil, Orlistat may reduce the absorption rate of Astaxanthin.</p>', '<p>Contraindicated for those with known allergies to Astaxanthin.</p>', '<p>No severe side effects have been reported yet.</p>', '<p>Both pregnant women and lactating mothers should avoid Astaxanthin supplements as no data on safety has been found yet.</p>', NULL, '<p>No case of overdose has occurred with Astaxanthin.</p>', '<p>Supplements &amp; adjuvant therapy</p>', '<p>Store in cool and dry place, away from direct light. Keep out of reach of children.</p>', NULL, '2022-02-14 07:08:07', '2022-03-16 23:10:43');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(125, 125, '<p>Atenolol &amp; Chlorthalidoneis combination is indicated for the treatment of hypertension.</p>', '<p><strong>Atenolol&nbsp;</strong>is a beta1-selective (cardio selective) beta-adrenergic receptor blocking agentwithout membrane stabilizing or intrinsic sympathomimetic (partial agonist) activities.This preferential effect is not absolute, however, and at higher doses, Atenolol inhibitsbeta-2-adrenoreceptors, chiefly located in the bronchial and vascular musculature.Chlorthalidone<br />\r\n<br />\r\n<strong>Chlorthalidone&nbsp;</strong>is a monosulfonamyl double ring system which differs chemically fromthiazide diuretics in that a double ring system is incorporated in its&#39; structure. It is an oraldiuretic with prolonged action and low toxicity. The diuretic of the drug occurs within 2 hours of an oral dose. It produces diuresis with greatly increased excretion of sodium andchloride. At maximal therapeutic dosage, Chlorthalidone is approximately equal in itsdiuretic effect to comparable maximal therapeutic doses of benzothiadiazine diuretics.The site of action appears to be the cortical diluting segment of the ascending limb of Henle&#39;s loop of the nephron.</p>', '<p>Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of Atenolol is 50 mg daily. Therefore, the initial dose should be one Chlorthalidone 25 &amp; Atenolol 50 mg once a day. If an optimal response is not achieved, the dosage should be increased to one Chlorthalidone 25 &amp; Atenolol 100 mg&nbsp;once a day. Dose of two tablets once daily should not be used as initial therapy in elderly patients.</p>', '<p>Atenolol and Chlorthalidone combination may potentiate the action of other antihypertensives such as Clonidine, Diltiazem. Prostaglandin synthase inhibiting drugs e.g. Indomethacin may decrease the hypotensive effects of beta-blockers. This tablet should not be given with Lithium due to high risk of Lithium toxicity.</p>', '<p>Atenolol and Chlorthalidone combination is contraindicated in hypersensitivity to this product or to sulfonamide-derived drugs. It is also contraindicated in patients with sinus bradycardia, heart block greater than first degree, cardiogenic shock, overt cardiac failure and anuria.</p>', '<p>Atenolol and Chlorthalidone combination is usually well tolerated. Most adverse effects have been mild and transient. However dizziness, fatigue, vertigo, nausea, diarrhea and bradycardia have been reported rarely.</p>', '<p>Pregnancy Category D. Atenolol &amp; Chlorthalidone combination can cause fetal harm to the developing baby and may appear in breast milk. So it should not be taken during pregnancy &amp; lactation.</p>', '<p>Atenolol and Chlorthalidone combination should be given with caution to patients with severe renal impairment, uncontrolled heart failure, impaired hepatic function or liver disease.</p>', '<p>No specific information is available with regard to over dosage and Atenolol and Chlorthalidone in humans. Treatment should be symptomatic and supportive and directed to the removal of any unabsorbed drug by induced emesis, or administration of activated charcoal. Atenolol can be removed from the general circulation by hemodialysis. Further consideration should be given to dehydration, electrolyte imbalance and hypotension by established procedures.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Store in cool and dry place, protected from light.</p>', '<p><strong>Pediatric Uses</strong>: Safety and effectiveness in pediatric patients have not been established<br />\r\n<br />\r\n<strong>Use in elderly</strong>: Clinical studies of Atenolol &amp; Chlorthalidone combination did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.</p>', '2022-02-14 07:09:00', '2022-03-16 23:16:21'),
(126, 126, '<p>Management of hypertension where therapy with either a calcium channel blocker or a beta-blocking drug proves inadequate.<br />\r\n<br />\r\nManagement of chronic stable angina pectoris where therapy with calcium channel blocker or a &beta;-adrenoceptor blocking drug proves inadequate.</p>', '<p><strong>Atenolol</strong>&nbsp;belongs to a group of medicines called beta-blockers. It has an effect on the heart by blocking the action of chemicals called noradrenaline and adrenaline on beta receptor and control its rate and rhythm of beating. By reducing the heart rate and the force of muscle contraction, atenolol reduces the need of heart muscle for oxygen (demand). Because angina occurs when oxygen demand of the heart exceeds supply, atenolol is helpful in treating angina.<br />\r\n<br />\r\n<strong>Nifedipine</strong>&nbsp;belongs to a group of medicines called calcium-channel blockers. These medicines block the transport of calcium, via holes called channels, into the smooth muscle cells lining the heart blood vessels and other blood vessels of the body. Blocking calcium transport relaxes the muscles of the blood vessels and makes them wider.</p>', '<p><strong>Adult</strong>:</p>\r\n\r\n<ul>\r\n	<li><strong>Hypertension</strong>&nbsp;: One capsule daily swallowed with water. If necessary, the dosage may be increased to 1 capsule dosed every 12 hours.</li>\r\n	<li><strong>Angina</strong>&nbsp;: One capsule every 12 hours swallowed with water. Where additional efficacy is necessary, prophylactic nitrate therapy or additional nifedipine may be of benefit.</li>\r\n</ul>\r\n\r\n<p><strong>Elderly</strong>: Dosage should not exceed 1 capsule daily in hypertension or 1 capsule twice daily in angina.<br />\r\n<br />\r\n<strong>Pediatric</strong>: Safety and effectiveness in pediatric patients have not been established.</p>', '<p>This combination must not be used in conjunction with calcium channel blockers with negative inotropic effects. eg. verapamil, diltiazem. Concomitant therapy with additional dihydropyridines, e.g. nifedipine, may increase the risk of hypotension, and cardiac failure may occur in patients with latent cardiac insufficiency.</p>', '<p>This combination should not be used in patients with any of the following conditions: known hypersensitivity to either active component, or any other excipient or other dihydropyridines. Bradycardia; cardiogenic shock; hypotension; metabolic acidosis; severe peripheral arterial circulatory disturbances; second or third degree heart block; sick sinus syndrome; untreated phaeochromocytoma; uncontrolled heart failure; women capable of childbearing or during pregnancy or during lactation; patients with clinically significant aortic stenosis; patients with marked renal impairment. This combination should not be used for secondary prevention of myocardial infarction.</p>', '<p>The following undesired events have been reported:</p>\r\n\r\n<ul>\r\n	<li><strong>Cardiovascular</strong>: flushing, edema</li>\r\n	<li><strong>CNS</strong>: dizziness, headache</li>\r\n	<li><strong>Gastrointestinal</strong>: gastrointestinal disturbance</li>\r\n	<li><strong>Haematological</strong>: purpura</li>\r\n	<li><strong>Reproductive</strong>: impotence</li>\r\n	<li><strong>Others</strong>: fatigue</li>\r\n</ul>', '<p>Contraindicated in women capable of childbearing or during pregnancy or during lactation.</p>', '<p>Due to its beta-blocker component this combination may increase the number and duration of angina attacks in patients with Prinzmetal&#39;s angina due to unopposed alpha receptor mediated coronary artery vasoconstriction. Due to its negative effect on conduction time, caution must be exercised if it is given to patients with first degree heart block.</p>', '<p><strong>Symptoms</strong>: Bradycardia, hypoglycaemia, bronchospasm, hypotension and acute cardiac failure.<br />\r\n<br />\r\n<strong>Treatment</strong>: Unabsorbed drug may be removed by gastric lavage, activated charcoal and a laxative. Symptomatic treatment may be required.</p>', '<p>Combined antihypertensive preparations</p>', '<p>Store in a cool and dry place protected from light and moisture.</p>', '<p>Use in Children: Safety and effectiveness in pediatric patients have not been established.</p>', '2022-02-14 07:09:52', '2022-03-16 23:22:35'),
(127, 127, '<p>Atezolizumab is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (UC):</p>\r\n\r\n<ul>\r\n	<li>After prior chemotherapy, or</li>\r\n	<li>Who are considered cisplatin ineligibleand whose tumours have a PD-L1 expression &ge; 5%, or</li>\r\n	<li>Who are not eligible for any platinum-containing chemotherapy regardless of level of tumor PD-L1 expression.</li>\r\n</ul>\r\n\r\n<p>Atezolizumab is indicated for the treatment of patients with locally advanced or metastatic non-small cell lung cancer NSCLC after prior chemotherapy.</p>', '<p>Binding of PD-L1 to the PD-1 and B7.1 receptors found on T cells suppresses cytotoxic T-cell activity through the inhibition of T-cell proliferation and cytokine production. PD-L1 may be expressed on tumor cells and tumor-infiltrating immune cells, and can contribute to the inhibition of the antitumor immune response in the microenvironment.<br />\r\n<br />\r\nAtezolizumab is an Fc-engineered humanized immunoglobulin G1 (IgG1) monoclonal antibody that directly binds to PD-L1 and blocks interactions with the PD-1 and B7.1 receptors, releasing PD-L1 / PD-1 pathway-mediated inhibition of the immune response, including reactivating the antitumor immune response. Atezolizumab leaves the PD-L2/PD-1 interaction intact. In syngeneic mouse tumor models, blocking PD-L1 activity resulted in decreased tumor growth</p>', '<p><strong>General</strong>: Atezolizumab must be administered as an intravenousinfusion under the supervision of a qualified healthcare professional. Do not administer as an IV push or bolus. Substitution by any other biological medicinal product requires the consent of the prescribing physician. The initial dose of Atezolizumab must be administered over 60 minutes. If the first infusion is tolerated all subsequent infusions may be administered over 30 minutes. The recommended dose of Atezolizumab is either:</p>\r\n\r\n<ul>\r\n	<li>1200 mg administered by IV infusion every 3 weeks or</li>\r\n	<li>1680 mg administered by IV infusion every 4 weeks.</li>\r\n</ul>\r\n\r\n<p><strong>1L cisplatin-ineligible mUC</strong>: Patients should be selected for treatment based on the tumor expression of PD-L1 confirmed by a validated test</p>', NULL, '<p>Atezolizumab is contraindicated in patients with a known hypersensitivity to atezolizumab or any of the excipients.</p>', NULL, '<p>There are no clinical studies of Atezolizumab in pregnant women. Atezolizumab is not recommended during pregnancy unless the potential benefit for the mother outweighs the potential risk to the fetus<br />\r\n<br />\r\nIt is not known whether Atezolizumab is excreted in human breast milk. No studies have been conducted to assess the impact of Atezolizumab on milk production or its presence in breast milk.Asthe potential for harm to the nursing infant is unknown,a decision must be madeto either discontinue breast-feeding ordiscontinue Atezolizumabtherapy.</p>', '<p><strong>Immune-related pneumonitis</strong>: Cases of pneumonitis, including fatal cases, have been observed in clinical trials with Atezolizumab. Patients should be monitored for signs and symptoms of pneumonitis.<br />\r\n<br />\r\n<strong>Immune-related hepatitis</strong>: Cases of hepatitis, some leading to fatal outcomes, have been observed in clinical trials with Atezolizumab. Patients should be monitored for signs and symptoms of hepatitis. Monitor aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin prior to and periodically during treatment with Atezolizumab. Consider appropriate management of patients with abnormal liver function tests (LFTs) at baseline.<br />\r\n<br />\r\n<strong>Immune-related colitis</strong>: Cases of diarrhea or colitis have been observed in clinical trials with Atezolizumab. Patients should be monitored for signs and symptoms of colitis.<br />\r\n<br />\r\n<strong>Immune-related endocrinopathies</strong>: Hypothyroidism, hyperthyroidism, adrenal insufficiency, hypophysitis, and type 1 diabetes mellitus, including diabetic ketoacidosis, have been observed in clinical trials with Atezolizumab. Patients should be monitored for clinical signs and symptoms of endocrinopathies. Monitor thyroid function prior to and periodically during treatment with Atezolizumab. Consider appropriate management of patients with abnormal thyroid function tests at baseline. Patients with abnormal thyroid function tests who are asymptomatic may receive Atezolizumab.</p>', '<p>There is no information on overdose with Atezolizumab</p>', '<p>Anti neoplastic preparations, Vaccines, Anti-sera &amp; Immunoglobulin</p>', '<p>Store at 2&deg;C-8&deg;C. Atezolizumab should be protected from light. Do not freeze. Do not shake.</p>', '<p><strong>Pediatric use</strong>: The safety and efficacy of Atezolizumab in children and adolescents below 18 years of age have not been established.<br />\r\n<br />\r\n<strong>Geriatric use</strong>: Based on a population pharmacokinetic analysis, no dose adjustment of Atezolizumab is required in patients &ge; 65 years of age<br />\r\n<br />\r\n<strong>Renal impairment</strong>: Based on a population pharmacokinetic analysis, no dose adjustment is required in patients with renal impairment<br />\r\n<br />\r\n<strong>Hepatic impairment</strong>: Based on a population pharmacokinetic analysis, no dose adjustment is required for patients with mild hepatic impairment. There are no data in patients with moderate or severe hepatic impairment</p>', '2022-02-14 07:10:17', '2022-03-16 23:26:57'),
(128, 128, '<p>Attention deficit hyperactivity disorder (ADHD).</p>', '<p>The precise mechanism by which Atomoxetine produces its therapeutic effects in Attention Deficit Hyperactivity Disorder (ADHD) is unknown. But, it is thought to be related to selective inhibition of the pre-synaptic nor-epinephrine transporter. Atomoxetine is well-absorbed after oral administration and is minimally affected by food. It is eliminated primarily by oxidative metabolism through the cytochrome P450 2D6 (CYP2D6) enzymatic pathway.</p>', '<p>Adult &amp; adolescents-<br />\r\n&gt;70 kg:</p>\r\n\r\n<ul>\r\n	<li><strong>Initially</strong>: 40 mg/day for at least 7 days.</li>\r\n	<li><strong>Maintenance</strong>: 80 mg/day.</li>\r\n	<li><strong>Max</strong>: 100 mg/day.</li>\r\n</ul>\r\n\r\n<p>Children &amp; adolescents-<br />\r\nUp to 70 kg:</p>\r\n\r\n<ul>\r\n	<li><strong>Initially:</strong>&nbsp;0.5 mg/kg/day for at least 7 days.</li>\r\n	<li><strong>Maintenance</strong>: 1.2 mg/kg/day.</li>\r\n	<li><strong>Max</strong>: 1.8 mg/kg/day.</li>\r\n</ul>', '<p>Albuterol, CYP2D6 inhibitors &amp; antihypertensive agents interact with Atomoxetine.</p>', '<ul>\r\n	<li>Hypersensitivity to Atomoxetine</li>\r\n	<li>Concomitant use with Monoamine oxidase inhibitors (MAOIs).</li>\r\n	<li>Narrow-angle glaucoma.</li>\r\n	<li>Severe cardiovascular&nbsp;or cerebrovascular disorders.</li>\r\n	<li>History of pheochromocytoma.</li>\r\n</ul>', '<p>Decreased appetite; headache; nausea; increased BP &amp; heart rate; Insomnia; dry mouth in adults; Somnolence; abdominal pain; vomiting in children.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal or other) and there are no studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Atomoxetine should be used with caution in patients with a history of seizures. Atomoxetine can affect heart rate and blood pressure. It is recommended that the heart rate and blood pressure be measured before treatment is started and periodically during treatment to detect possible clinically important increases. Most patients taking Atomoxetine experience a modest increase in heart rate</p>', '<p>The most commonly reported gastrointestinal symptoms including somnolence, dizziness, tremor, and abnormal behaviour. Hyperactivity and agitation have also been reported. Signs and symptoms consistent with mild to moderate sympatheticnervous system activation (e.g. tachycardia, blood pressure increased, mydriasis, dry mouth) were also observed. Most events were mild to moderate. In some cases of overdose involving Atomoxetine, seizures and very rarely QT prolongation have been reported. There is limited clinical trial experience with Atomoxetine overdose. No fatal overdoses occurred in clinical trials.</p>', '<p>CNS stimulant drugs</p>', '<p>Store in a cool and dry place, protected from light and moisture.</p>', '<p>Pediatric use: The pharmacokinetics of Atomoxetine have not been evaluated in children under 6 years of age.</p>', '2022-02-14 07:10:38', '2022-03-16 23:31:27'),
(129, 129, '<p>Atosiban is indicated to delay imminent pre-term birth in pregnant adult women with:</p>\r\n\r\n<ul>\r\n	<li>regular uterine contractions of at least 30 seconds duration at a rate of &ge;4 per 30 minutes</li>\r\n	<li>a cervical dilation of 1 to 3 cm (0-3 for nulliparas) and effacement of &ge;50%</li>\r\n	<li>a gestational age from 24 until 33 completed weeks</li>\r\n	<li>a normal fetal heart rate</li>\r\n</ul>', '<p>It binds to membrane bound oxytocin receptors on the myometrium and prevents oxytocin-stimulated increases in inositol triphosphate production. This ultimately prevents release of stored calcium from the sarcoplasmic reticulum and subsequent opening of voltage gated calcium channels. This shutdown of cytosolic calcium increase prevents contractions of the uterine muscle, reducing the frequency of contractions and inducing uterine quiescence.<br />\r\n<br />\r\nAtosiban has more recently been found to act as a biased ligand at oxytocin receptors. It acts as an antagonist of Gq coupling, explaining the inhibition of the inositol triphosphate pathway thought to be responsible for the effect on uterine contraction, but acts as an agonist of Gi coupling. This agonism produces a pro-inflammatory effect in the human amnion, activating pro-inflammatory signal tranducer NF-&kappa;B. It is thought that this reduces atosiban&#39;s effectiveness compared to agents which do not produce inflammation as inflammatory mediators are known to play a role in the induction of labour.</p>', '<p>Atosiban is administered intravenously in three successive stages: an initial bolus dose (6.75 mg), performed with Atosiban 6.75 mg/0.9 ml solution for injection, immediately followed by a continuous high dose infusion (loading infusion 300 micrograms/min) of Atosiban 37.5 mg/5 ml concentrate for solution for infusion during three hours, followed by a lower dose of Atosiban 37.5 mg/5 ml concentrate for solution for infusion (subsequent infusion 100 micrograms/min) up to 45 hours. The duration of the treatment should not exceed 48 hours. The total dose given during a full course of Atosiban therapy should preferably not exceed 330.75 mg of atosiban.</p>', '<p>It is unlikely that atosiban is involved in cytochrome P450 mediated drug-drug interactions as in vitro investigations have shown that atosiban is not a substrate for the cytochrome P450 system, and does not inhibit the drug metabolising cytochrome P450 enzymes. Interaction studies have been performed with labetalol and betamethasone in healthy, female volunteers. No clinically relevant interaction was found between atosiban and bethamethasone or labetalol.</p>', '<p>Atosiban must not be used in the following conditions:</p>\r\n\r\n<ul>\r\n	<li>Gestational age below 24 or over 33 completed weeks</li>\r\n	<li>Premature rupture of the membranes &gt;30 weeks of gestation</li>\r\n	<li>Abnormal foetal heart rate</li>\r\n	<li>Antepartum uterine haemorrhage requiring immediate delivery</li>\r\n	<li>Eclampsia and severe pre-eclampsia requiring delivery</li>\r\n	<li>Intrauterine foetal death</li>\r\n	<li>Suspected intrauterine infection</li>\r\n	<li>Placenta praevia</li>\r\n	<li>Abruptio placenta</li>\r\n	<li>Any other conditions of the mother or foetus, in which continuation of pregnancy is hazardous</li>\r\n</ul>', '<p>Very common (affects more than 1 in 10 people): feeling sick (nausea).<br />\r\n<br />\r\nCommon (affects less than 1 in 10 people): headache, feeling dizzy, hot flushes, being sick (vomiting), fast heartbeat, Low blood pressure. Signs may include feeling dizzy or light-headed, A reaction at the site where the injection was given, high blood sugar.<br />\r\n<br />\r\nUncommon (affects less than 1 in 100 people): high temperature (fever), difficulty sleeping (insomnia), itching, rash.</p>', '<p>If you are pregnant and breast-feeding an earlier child, you should stop breast-feeding while you are given<br />\r\nAtosiban.</p>', '<ul>\r\n	<li>When Atosiban is used in patients in whom premature rupture of membranes cannot be excluded, the benefits of delaying delivery should be balanced against the potential risk of chorioamnionitis.</li>\r\n	<li>There is no experience with Atosiban treatment in patients with impaired function of the liver or kidneys. Renal impairment is not likely to warrant a dose adjustment, since only a small extent of Atosiban is excreted in the urine. In patients with impaired hepatic function, Atosiban should be used with caution</li>\r\n	<li>There is only limited clinical experience in the use of Atosiban in multiple pregnancies or the gestational age group between 24 and 27 weeks, because of the small number of patients treated. The benefit of Atosiban in these subgroups is therefore uncertain.</li>\r\n	<li>Re-treatment with Atosiban is possible, but there is only limited clinical experience available with multiple re-treatments, up to 3 re-treatments.</li>\r\n	<li>In case of intrauterine growth retardation, the decision to continue or reinitiate the administration of Atosiban&nbsp;depends on the assessment of fetal maturity.</li>\r\n	<li>Monitoring of uterine contractions and fetal heart rate during administration of Atosiban and in case of persistent uterine contractions should be considered.</li>\r\n	<li>As an antagonist of oxytocin, Atosiban may theoretically facilitate uterine relaxation and postpartum bleeding therefore blood loss after delivery should be monitored. However, inadequate uterus contraction postpartum was not observed during the clinical trials.</li>\r\n	<li>Multiple pregnancy and medicinal products with tocolytic activity like calcium channel blockers and beta- mimetics are known to be associated with increased risk of pulmonary oedema. Therefore, Atosiban should be used with caution in case of multiple pregnancy and/or concomitant administration of other medicinal products with tocolytic activity</li>\r\n</ul>', NULL, '<p>Other preparations</p>', '<p>Store in a refrigerator (2&deg;C-8&deg;C). Keep away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:11:33', '2022-03-16 23:38:51'),
(130, 130, '<p>Atracurium is indicated for endotracheal intubation, facilitate mechanical ventilation in intensive care, muscle relaxant in general anaesthesia.</p>', '<p>Atracurium antagonizes the neurotransmitter action of acetylcholine by binding competitively with cholinergic receptor sites on the motor end-plate. This antagonism is inhibited, and neuromuscular block reversed, by acetylcholinesterase inhibitors such as neostigmine, edrophonium, and pyridostigmine.</p>', '<p><strong>Adult and&nbsp;Child (&gt;1 month)</strong>: Initially, 300-600 mcg/kg as bolus IV, with subsequent doses of 100-200 mcg/kg by IV every 15-25 min or 5-10 mcg/kg/min by infusion in prolonged procedures. Higher infusion rate may be used in patients undergoing controlled ventilation in intensive care.</p>', '<p>Enhanced neuromuscular blocking effect w/ general anaesth (e.g. enflurane, isoflurane, halothane), certain antibiotics (e.g. aminoglycosides, polymyxins), lithium, Mg salts, procainamide, quinidine.</p>', '<p>Atracurium is contraindicated in patients known to be hypersensitive to atracurium, cisatracurium or benzenesulfonic acid. In common with all the other neuromuscular blocking agents, atracurium besilate paralyses the respiratory muscles as well as other skeletal muscles but has no effect on consciousness.</p>', '<p>Skin flush, erythema, pruritus, urticaria, wheezing, increased bronchial secretions, bronchospasm, cyanosis, angioedema, CV effects (e.g. bradycardia); wheals and erythema at inj site. Potentially Fatal: Anaphylaxis.</p>', '<p>Pregnancy Category C:&nbsp;Teratogenic Effects. Atracurium besylate has been shown to be potentially teratogenic in rabbits when given in doses up to approximately one-half the human dose. There are no adequate and well-controlled studies in pregnant women. Atracurium should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.</p>', '<p>Patient with CV disease, burn injury, asthma; conditions which may antagonise neuromuscular blockade (e.g. resp alkalosis, hypercalcaemia, demyelinating lesions, peripheral neuropathies, denervation, muscle trauma); conditions which may potentiate neuromuscular blockade (e.g. electrolyte abnormalities, neuromuscular diseases, metabolic acidosis, resp acidosis, Eaton-Lambert syndrome, myasthenia gravis). Pregnancy and lactation.</p>', '<p>Stimulation of histamine release, CV effects especiall hypotension</p>', '<p>Non depolarizing muscle relaxants</p>', '<p>Store between 2-8&deg; C. Do not freeze.</p>', NULL, '2022-02-14 07:11:55', '2022-03-16 23:42:11'),
(131, 131, '<p>Atropine is indicated for Non ulcer dyspepsia, Irritable bowel syndrome, Diverticular disease, Bradycardia, Organophosphorus poisoning, Premedication in anesthesia,&nbsp;Poisoning or overdosage with compound having muscarinic actions, Ophthalmic Inflammatory eye disorders, Eye refraction.</p>', '<p>Atropine binds to and inhibit muscarinic acetylcholine receptors, producing a wide range of anticholinergic effects. Atropine is an anticholinergic agent which competitively blocks the muscarinic receptors in peripheral tissues such as the heart, intestines, bronchial muscles, iris and secretory glands. Some central stimulation may occur. Atropine abolishes bradycardia and reduces heart block due to vagal activity. Smooth muscles in the bronchi and gut are relaxed while glandular secretions are reduced. It also has mydriatic and cycloplegic effect.</p>', '<p>Adult:</p>\r\n\r\n<ul>\r\n	<li><strong>IV</strong>: Bradycardia: 500 mcg every 3-5 mins. Total: 3 mg.</li>\r\n	<li><strong>IV/IM</strong>: Organophosphorus poisoning: 2 mg every 10-30 mins until muscarinic effects disappear or atropine toxicity appears.</li>\r\n	<li><strong>IM/SC</strong>: Premedication in anesthesia: 300-600 mcg 30-60 mins before anesthesia.</li>\r\n	<li><strong>IV/IM/SC</strong>: Poisoning or overdosage with compound having muscarinic actions: 0.6-1 mg, repeat 2 hrly.</li>\r\n	<li><strong>Ophthalmic</strong>: Inflammatory eye disorders: As 0.5-1% solution: 1-2 drops 4 times/day.</li>\r\n	<li><strong>Ophthalmic</strong>: refraction: 1% solution 1 drop twice daily for 1-2 days before procedure.</li>\r\n	<li><strong>Oral</strong>: Non ulcer dyspepsia, Irritable bowel syndrome, Diverticular disease: 0.6-1.2 mg as a single dose at bedtime.</li>\r\n</ul>\r\n\r\n<p>Usual Pediatric Dose for Anesthesia:</p>\r\n\r\n<ul>\r\n	<li><strong>7 to 16 pounds</strong>: 0.1 mg, IV, IM, or subcutaneously</li>\r\n	<li><strong>17 to 24 pounds</strong>: 0.15 mg, IV, IM, or subcutaneously</li>\r\n	<li><strong>24 to 40 pounds</strong>: 0.2 mg, IV, IM, or subcutaneously</li>\r\n	<li><strong>40 to 65 pounds</strong>: 0.3 mg, IV, IM, or subcutaneously</li>\r\n	<li><strong>65 to 90 pounds</strong>: 0.4 mg, IV, IM, or subcutaneously</li>\r\n	<li><strong>Over 90 pounds</strong>: 0.4 to 0.6 mg, IV, IM, or subcutaneously</li>\r\n</ul>', '<p>Additive anticholinergic effects with quinidine, antidepressants and some antihistamines.</p>', '<p>Glaucoma, chronic respiratory disease, sick sinus syndrome, thyrotoxicosis, cardiac failure, pyloric stenosis, prostatic hypertrophy.</p>', '<p><strong>Injection</strong>: Dry mouth, dysphagia, constipation, flushing and dryness of skin, tachycardia, palpitations, arrhythmias, mydriasis, photophobia, cycloplegia, raised intraocular pressure. Toxic doses cause tachycardia, hyperpyrexia, restlessness, confusion, excitement, hallucinations, delirium and may progress to circulatory failure and resp depression.<br />\r\n<br />\r\n<strong>Eye drops or ointment</strong>: Systemic toxicity esp in children, on prolonged use may lead to irritation, hyperaemia, oedema and conjunctivitis. Increased intraocular pressure.</p>', '<p>Pregnancy Category C. Animal reproduction studies have not been conducted with atropine. It also is not known whether atropine can cause fetal harm when given to a pregnant woman or can affect reproduction capacity. Atropine should be given to a pregnant woman only if clearly needed.</p>', '<p>Reflux oesophagitis; elderly; infants and children; Pregnancy.</p>', '<p>May cause hyperthermia, hypertension, increased respiratory rate, nausea and vomiting. May also lead to CNS stimulation. Severe intoxication may lead to CNS depression, coma, respiratory failure and death.</p>', '<p>Anticholinergics (antimuscarinics)/ Anti-spasmodics, Mydriatic and Cycloplegic agents</p>', '<p>Store atropine at room temperature between 20 to 25&deg; C. Store away from heat, moisture, and light. Keep atropine out of the reach of children.</p>', NULL, '2022-02-14 07:12:15', '2022-03-16 23:46:17'),
(132, 132, '<p>Avanafil is a phosphodiesterase 5 (PDE5) inhibitor indicated for the treatment of erectile dysfunction</p>', '<p>Avanafil is a selective phosphodiesterase 5 (PDE5) enzyme inhibitor used for the treatment of erectile dysfunction caused by diabetes, age induced oxidative stress or other complications. Avanafil inhibits the cGMP specific phosphodiesterase type 5 (PDE5) which is responsible for degradation of cGMP in the corpus cavernosum located around the penis. Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and corpus cavernosal smooth muscle. This response is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cGMP in smooth muscle cells. Cyclic GMP causes smooth muscle relaxation and increased blood flow into the corpus cavernosum. The inhibition of phosphodiesterase type 5 (PDE5) by avanafil enhances erectile function by increasing the amount of cGMP.</p>', '<p>For most patients, the starting dose is 100 mg taken approximately 30 minutes before sexual activity, on an as needed basis.&nbsp;Avanafil may be taken with or without food. Take Avanafil no more than once a day<br />\r\n<br />\r\nThe dose may be increased to 200 mg or decreased to 50 mg based on efficacy and/or tolerability. Use the lowest dose that provides benefit<br />\r\n<br />\r\nDo not use Avanafil with strong CYP3A4 inhibitors. If taking a moderate CYP3A4 inhibitor, the dose should be no more than 50 mg in a 24-hour period. In patients on stable alpha-blocker therapy, the recommended starting dose of Avanafil is 50 mg</p>', '<p>Avanafil can potentiate the hypotensive effect of nitrates, alphablockers, antihypertensives, and alcohol. CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, erythromycin) increase Avanafil exposure</p>', '<p>Administration of Avanafil to patients using any form of organic nitrate is contraindicated. Hypersensitivity to any component of the Avanafil tablet</p>', '<p>Most common adverse reactions (greater than or equal to 2%) include headache, flushing, nasal congestion, nasopharyngitis, and back pain</p>', '<p>Pregnancy Category C. Avanafil is not indicated for use in women. There are no adequate and well-controlled studies of Avanafil in pregnant women.</p>', '<p>Patients should not use Avanafil if sexual activity is inadvisable due to cardiovascular status or any other reason&nbsp;<br />\r\n<br />\r\nUse of Avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension<br />\r\n<br />\r\nPatients should seek emergency treatment if an erection lasts greater than 4 hours<br />\r\n<br />\r\nPatients should stop Avanafil and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of Non Arteritic Ischemic Optic Neuropathy (NAION). Discuss with patients the increased risk of NAION in patients with a history of NAION<br />\r\n<br />\r\nPatients should stop taking Avanafil and seek prompt medical attention in the event of sudden decrease or loss of hearing</p>', '<p>Single doses up to 800 mg have been given to healthy subjects, and multiple doses up to 300 mg have been given to patients. In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance because avanafil is highly bound to plasma proteins and is not significantly eliminated in the urine.</p>', '<p>Drugs for Erectile Dysfunction</p>', '<p>Store at 20-25&deg;C</p>', '<p><strong>Pediatric Use</strong>: STENDRA is not indicated for use in pediatric patients. Safety and efficacy in patients below the age of 18 years has not been established.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the total number of subjects in clinical studies of avanafil, approximately 23% were 65 and over. No overall differences in efficacy and safety were observed between subjects over 65 years of age compared to younger subjects; therefore no dose adjustment is warranted based on age alone. However, a greater sensitivity to medication in some older individuals should be considered<br />\r\n<br />\r\n<strong>Renal &amp;&nbsp;hepatic impairment patients</strong>: Do not use in patients with severe renal &amp; hepatic impairment.</p>', '2022-02-14 07:12:32', '2022-03-16 23:50:51'),
(133, 133, '<p>Axitinib is indicated for the treatment of advanced&nbsp;renal cell carcinoma&nbsp;(RCC) after failure of one prior&nbsp;systemic therapy.</p>', '<p>Axitinib has been shown to inhibit receptor&nbsp;tyrosine&nbsp;kinases including&nbsp;vascular endothelial growth factor&nbsp;receptors (VEGFR)-1, VEGFR-2, and VEGFR-3 at therapeutic plasma concentrations. These receptors are implicated in&nbsp;pathologic&nbsp;angiogenesis, tumor growth, and cancer progression.&nbsp;VEGF-mediated&nbsp;endothelial&nbsp;cell proliferation and survival were inhibited by axitinib&nbsp;in vitro&nbsp;and in mouse models. Axitinib was shown to inhibit tumor growth and&nbsp;phosphorylation&nbsp;of VEGFR-2 in tumor&nbsp;xenograft&nbsp;mouse models.</p>', '<p><strong>Recommended Dosing</strong>: The recommended starting oral dose of Axitinib is 5 mg twice daily. Administer Axitinib doses approximately 12 hours apart with or without food. Axitinib should be swallowed whole with a glass of water.<br />\r\n<br />\r\nIf the patient vomits or misses a dose, an additional dose should not be taken. The next prescribed dose should be taken at the usual time.<br />\r\n<br />\r\n<strong>Dose Modification Guidelines</strong>: Dose increase or reduction is recommended based on individual safety and tolerability.<br />\r\n<br />\r\nOver the course of treatment, patients who tolerate Axitinib for at least two consecutive weeks with no adverse reactions &gt; Grade 2 (according to the Common Toxicity Criteria for Adverse Events), are&nbsp;normotensive, and are not receiving anti-hypertension&nbsp;medication, may have their dose increased. When a dose increase from 5 mg twice daily is recommended, the Axitinib dose may be increased to 7 mg twice daily, and further to 10 mg twice daily using the same criteria.<br />\r\n<br />\r\nOver the course of treatment, management of some adverse drug reactions may require temporary interruption or permanent discontinuation and/or dose reduction of Axitinib therapy. If dose reduction from 5 mg twice daily is required, the recommended dose is 3 mg twice daily. If additional dose reduction is required, the recommended dose is 2 mg twice daily.</p>', '<p>In vitro data indicate that axitinib is metabolized primarily by CYP3A4/5 and, to a lesser extent, CYP1A2, CYP2C19, and uridine diphosphate-glucuronosyltransferase (UGT) 1A1.<br />\r\n<br />\r\n<strong>CYP3A4/5 Inhibitors</strong>: Co-administration of ketoconazole, a strong inhibitor of CYP3A4/5, increased the plasma exposure of axitinib in healthy volunteers. Co-administration of Axitinib with strong CYP3A4/5 inhibitors should be avoided. Grapefruit or grapefruit juice may also increase axitinib plasma concentrations and should be avoided. Selection of concomitant medication with no or minimal CYP3A4/5 inhibition potential is recommended. If a strong CYP3A4/5 inhibitor must be co-administered, the Axitinib dose should be reduced&nbsp;<br />\r\n<br />\r\n<strong>CYP3A4/5 Inducers</strong>: Co-administration of rifampin, a strong inducer of CYP3A4/5, reduced the plasma exposure of axitinib in healthy volunteers. Co-administration of Axitinib with strong CYP3A4/5 inducers (e.g., rifampin, dexamethasone, phenytoin, carbamazepine, rifabutin, rifapentin, phenobarbital, and St. John&#39;s wort) should be avoided. Selection of concomitant medication with no or minimal CYP3A4/5 induction potential is recommended. Moderate CYP3A4/5 inducers (e.g., bosentan, efavirenz, etravirine,&nbsp;modafinil, and nafcillin) may also reduce the plasma exposure of axitinib and should be avoided if possible.</p>', '<p>None</p>', '<p>Selected adverse reactions (all grades) that were reported in &lt; 10% of patients treated with Axitinib&nbsp;included dizziness (9%), upper abdominal pain (8%),&nbsp;myalgia&nbsp;(7%), dehydration (6%),&nbsp;epistaxis&nbsp;(6%),&nbsp;anemia&nbsp;(4%),&nbsp;hemorrhoids&nbsp;(4%),&nbsp;hematuria&nbsp;(3%),&nbsp;tinnitus&nbsp;(3%), lipase increased (3%), glossodynia (3%),&nbsp;pulmonary embolism&nbsp;(2%), rectal hemorrhage (2%),&nbsp;hemoptysis&nbsp;(2%),&nbsp;deep vein thrombosis&nbsp;(1%), retinal-veinocclusion/thrombosis&nbsp;(1%),&nbsp;polycythemia&nbsp;(1%), and&nbsp;transient ischemic attack&nbsp;(1%).</p>', '<p><strong>Pregnancy</strong>&nbsp;Category D. Axitinib can cause fetal harm when administered to a pregnant woman based on its mechanism of action. There are no adequate and well-controlled studies in pregnant women using Axitinib. In developmental toxicity studies in mice, axitinib was&nbsp;teratogenic, embryotoxic and fetotoxic at maternal exposures that were lower than human exposures at the recommended clinical dose.<br />\r\n<br />\r\nWomen of childbearing potential should be advised to avoid becoming pregnant while receiving Axitinib. If this drug is used during pregnancy, or if a patient becomes pregnant while receiving this drug, the patient should be apprised of the potential hazard to the fetus<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether axitinib is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Axitinib, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Patient with HTN, cardiac disease, history of or risk for thrombosis. Patients taking strong CYP3A4 inhibitors. Withhold treatment at least 24 hr prior to scheduled surgery. Moderate hepatic impairment (Child-Pugh Class B). Pregnancy.</p>', '<p>There is no specific treatment for Axitinib overdose.<br />\r\n<br />\r\nIn a controlled clinical study with Axitinib for the treatment of patients with RCC, 1 patient inadvertently received a dose of 20 mg twice daily for 4 days and experienced dizziness (Grade 1).<br />\r\n<br />\r\nIn a clinical dose finding study with Axitinib, subjects who received starting doses of 10 mg twice daily or 20 mg twice daily experienced adverse reactions which included hypertension, seizures associated with hypertension, and fatal hemoptysis.<br />\r\n<br />\r\nIn cases of suspected overdose, Axitinib should be withheld and supportive care instituted.</p>', '<p>Targeted Cancer Therapy</p>', '<p>Store at 20&deg;C to 25&deg;C</p>', '<p><strong>Hepatic Impairment</strong>: The systemic exposure to axitinib was higher in subjects with moderate hepatic impairment (Child-Pugh class B) compared to subjects with normal hepatic function. A dose decrease is recommended when administering Axitinib to patients with moderate hepatic impairment (Child-Pugh class B). Axitinib has not been studied in patients with severe hepatic impairment (Child-Pugh class C)&nbsp;<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dedicated renal impairment trial for axitinib has been conducted. Based on the population pharmacokinetic analyses, no significant difference in axitinib clearance was observed in patients with pre-existing mild to severe renal impairment (15 mL/min &le; ClCr &lt; 89 mL/min). No starting dose adjustment is needed for patients with pre-existing mild to severe renal impairment. Caution should be used in patients with end-stage renal disease (ClCr&lt; 15 mL/min).<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and efficacy of axitinib in pediatric patients have not been studied.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>:&nbsp;No dosage adjustment is required in elderly patients</p>', '2022-02-14 07:12:53', '2022-03-16 23:56:20'),
(134, 134, '<p>Azathioprine is indicated as an adjunct for the prevention of rejection in renal homotransplantation. It is also indicated for the management of active&nbsp;rheumatoid arthritis&nbsp;to reduce signs and symptoms.<br />\r\n<br />\r\n<strong>Renal Homotransplantation</strong>: Azathioprine is indicated as an adjunct for the prevention of rejection in renal homotransplantation. Experience with over 16,000 transplants shows a 5-year patient survival of 35% to 55%, but this is dependent on&nbsp;donor, match for&nbsp;HLA&nbsp;antigens, anti-donor or anti-B-cell alloantigen antibody, and other variables. The effect of Azathioprine on these variables has not been tested in controlled trials.<br />\r\n<br />\r\n<strong>Rheumatoid Arthritis</strong>: Azathioprine is indicated for the treatment of active rheumatoid arthritis (RA) to reduce signs and symptoms.&nbsp;Aspirin, non-steroidal anti-inflammatory drugs and/or low dose glucocorticoids may be continued during treatment with Azathioprine. The combined use of Azathioprine with disease modifying anti-rheumatic drugs (DMARDs) has not been studied for either added benefit or unexpected adverse effects. The use of Azathioprine with these agents cannot be recommended.</p>', '<p>Azathioprine antagonizes purine metabolism and may inhibit synthesis of DNA, RNA, and proteins. It may also interfere with cellular metabolism and inhibit mitosis. Its mechanism of action is likely due to incorporation of thiopurine analogues into the DNA structure, causing chain termination and cytotoxicity.</p>', '<p><strong>Renal Homotransplantation</strong>: The dose of Azathioprine required to prevent rejection and minimize toxicity will vary with individual patients; this necessitates careful management. The initial dose is usually 3 to 5 mg/kg daily, beginning at the time of transplant. Azathioprine is usually given as a single daily dose on the day of, and in a minority of cases 1 to 3 days before, transplantation. Dose reduction to maintenance levels of 1 to 3 mg/kg daily is usually possible. The dose of Azathioprine should not be increased to toxic levels because of threatened rejection. Discontinuation may be necessary for severe hematologic or other toxicity, even if rejection of the&nbsp;homograft&nbsp;may be a consequence of drug withdrawal.<br />\r\n<br />\r\n<strong>Rheumatoid Arthritis</strong>: Azathioprine is usually given on a daily basis. The initial dose should be approximately 1.0 mg/kg (50 to 100 mg) given as a single dose or on a twice-daily schedule. The dose may be increased, beginning at 6 to 8 weeks and thereafter by steps at 4-week intervals, if there are no serious toxicities and if initial response is unsatisfactory. Dose increments should be 0.5 mg/kg daily, up to a maximum dose of 2.5 mg/kg per day. Therapeutic response occurs after several weeks of treatment, usually 6 to 8; an adequate trial should be a minimum of 12 weeks. Patients not improved after 12 weeks can be considered refractory. Azathioprine may be continued long-term in patients with clinical response, but patients should be monitored carefully, and gradual dosage reduction should be attempted to reduce risk of toxicities.<br />\r\n<br />\r\nMaintenance therapy&nbsp;should be at the lowest&nbsp;effective dose, and the dose given can be lowered decrementally with changes of 0.5 mg/kg or approximately 25 mg daily every 4 weeks while other therapy is kept constant. The optimum duration of maintenance Azathioprine has not been determined. Azathioprine can be discontinued abruptly, but delayed effects are possible.</p>', '<p>Metabolism inhibited by allopurinol. Reduces the neuromuscular blockade of curare, tubocurarine but potentiates that of succinylcholine.</p>', '<p>Azathioprine should not be used for treating rheumatoid arthritis in pregnant women.Patients with rheumatoid arthritis previously treated with alkylating agents (cyclophosphamide, chlorambucil, melphalan, or others) may have a prohibitive risk of malignancy if treated with&nbsp;Azathioprine</p>', '<p>Opportunistic infections especially in transplant patients receiving concomitant other immunosuppressants. Bone marrow depression, leucopenia, thrombocytopenia, nausea. Uncommonly, anaemia, hypersensitivity reactions, cholestasis, pancreatitis.</p>', '<p>Pregnancy&nbsp;Category D. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk</p>', '<p>Monitor FBC wkly during 1st 8 wk of therapy especially with high dose or severe renal/hepatic impairment. Inherited deficiency of thiopurine methyltransferase enzyme. Avoid excessive sun/UV exposure.</p>', NULL, '<p>Cytotoxic immunosuppressants</p>', '<p>Azathioprine should be stored at 15&nbsp;to 25&deg; C in a dry place and protected from light.</p>', '<p><strong>Use In Renal Dysfunction</strong>: Relatively oliguric patients, especially those with tubular&nbsp;necrosis&nbsp;in the immediate postcadaveric transplant period, may have delayed clearance of Azathioprine&nbsp;or its metabolites, may be particularly sensitive to this drug, and are usually given lower doses. Procedures for proper handling and disposal of this immunosuppressive antimetabolite&nbsp;drug should be considered. Several guidelines on this subject have been published.25-31&nbsp;There is no general agreement that all of the procedures recommended in the guidelines are necessary or appropriate.</p>', '2022-02-14 07:13:10', '2022-03-17 00:00:32'),
(135, 135, '<p>Azelaic Acid cream is indicated for the topical treatment of mild to moderate inflammatory acne vulgaris.</p>', '<p>Azelaic acid has been shown to possess antimicrobial activity against Propionibacterium acnes and Staphylococcus epidennidis. The antimicrobial action may be attributable to the inhibition of microbial cellular protein synthesis. A normalization of keratinization leading to an anticomedonal effect of Azelaic acid may also contribute to its clinical activity.</p>', '<p>After the skin is thoroughly washed and patted dry, a thin film of Azelaic Acid should be gently but thoroughly massaged into the affected areas twice daily, in the morning and evening. The hands should be washed following application. Safety and effectiveness in pediatric patients under 12 years of age have not been established. Or as directed by the physician.</p>', NULL, '<p>Azelaic acid is contraindicated in individuals who have shown hypersensitivity to any of its components.</p>', '<p>Local skin irritation (e.g. erythema, scaling, itching or burning) occurs in occasional cases, usually at the start of treatment. However, in the majority of cases the irritation is mild and regresses as treatment continues.</p>', '<p>FDA Pregnancy Category B. This drug should be used during pregnancy only if clearly needed. Caution should be exercised when Azelaic acid is administered to a nursing mother.</p>', '<p>For external use only. If Azelaic acid comes into contact with the eyes they should immediately be thoroughly rinsed with copious amounts of water. The patients should consult a physician if eye irritation persists.</p>', NULL, '<p>Acne treatment preparations</p>', '<p>Store in a cool &amp; dry place protected from light. Keep ail medicines out of reach of children.</p>', NULL, '2022-02-14 07:13:31', '2022-03-17 00:03:35');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(136, 136, '<p>Treatment and prevention of the symptoms of seasonal allergic conjunctivitis in adults and children 4 years and older. Treatment of the symptoms of non-seasonal (perennial) allergic conjunctivitis in adults and children 12 years and older.</p>', '<p>Azelastine Eye drops contains the active substance azelastine hydrochloride, which belongs to a group of medicines called antiallergics (antihistamines). Antihistamines work by preventing the effects of substances such as histamine that the body produces as part of an allergic reaction. Azelastine has been shown to reduce inflammation of the eye.<br />\r\n<br />\r\nAzelastine, a phthalazinone derivative is classified as a potent long-acting anti-allergic compound with selective H1 antagonist properties. An additional anti-inflammatory effect could be detected after topical ocular administration. Data from in vivo (pre-clinical) and in vitro studies show that Azelastine inhibits the synthesis or release of the chemical mediators known to be involved in early and late stage allergic reactions e.g. leukotriene, histamine, PAF and serotonin.</p>', '<p><strong>Seasonal allergic conjunctivitis</strong>: The usual dosage in adults and children 4 years and older is one drop in each eye twice daily that can be increased, if necessary to four times daily. If allergen exposure is anticipated Azelastine hydrochloride Eye drops, solution should be administered prophylactically, prior to the exposure.<br />\r\n<br />\r\n<strong>Non-seasonal (perennial) allergic conjunctivitis</strong>: The usual dosage in adults and children 12 years and older is one drop in each eye twice daily that can be increased, if necessary to four times daily.<br />\r\n<br />\r\nAs safety and efficacy have been demonstrated in clinical trials for a period of up to 6 weeks, the duration of any course should be limited to a maximum of 6 weeks. Patients should be advised to contact their doctor if symptoms worsen or do not improve after 48 hours.</p>', '<p>No specific interaction studies have been performed. Interaction studies at high oral doses of Azelastine have been performed however they bear no relevance to Azelastine hydrochloride Eye drops, solution, as systemic levels, after administration of the eye drops, are in the picogram range.</p>', '<p>Hypersensitivity to the active substance or to any of the excipients of this preparation.</p>', NULL, '<p>There is insufficient information available to establish the safety of azelastine in human pregnancy. At high oral doses azelastine has shown to induce adverse effects (foetal death, growth retardation and skeletal malformation) in experimental animals. Local ocular application will result in minimal systemic exposure (picogram range). However, caution should be exercised when using Azelastine hydrochloride Eye drops, solution during pregnancy. Azelastine is excreted into the milk in low quantities. For that reason Azelastine hydrochloride Eye drops, solution is not recommended during lactation.</p>', '<p>Azelastine hydrochloride Eye drops, solution is not intended for treatment of eye infections. Azelastine hydrochloride Eye drops, solution contains the preservative benzalkonium chloride. Benzalkonium chloride may cause eye irritation, especially with dry eyes or disorders of the cornea. Contact with soft contact lenses should be avoided. Contact lenses should be removed prior to application and the patient should wait at least 15 minutes before reinsertion. Known to discolour soft contact lenses.</p>', '<p>No specific reactions after ocular overdosage are known, and with the ocular route of administration, overdosage reactions are not anticipated. There is no experience with the administration of toxic doses of azelastine hydrochloride in humans. In the case of overdose or intoxication, disturbances of the central nervous system are to be expected based on the results of animal experiments. Treatment of these disorders must be symptomatic. There is no known antidote.</p>', '<p>Anti-histamine Preparations</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:14:10', '2022-03-17 00:13:14'),
(137, 137, '<p>Azelastine Hydrochloride nasal spray is an H1-receptor antagonist indicated for the treatment of the symptoms of seasonal allergic rhinitis in adults and pediatric patients 5 years and older and for the treatment of the symptoms of vasomotor rhinitis in adults and adolescent patients 12 years and older.</p>', '<p>Azelastine, a phthalazinone derivative, exhibits histamine H1 receptor antagonist activity in isolated tissues, animal models and humans. It is administered as a racemic mixture with no difference in pharmacologic activity noted between the enantiomers in invitro studies. The major metabolite, desmethylazelastine, also possesses H1-receptor antagonist activity.</p>', '<p><strong>Seasonal Allergic Rhinitis</strong>: The recommended dosage of Azelastine Nasal Spray in adults and adolescent patients 12 years and older with seasonal allergic rhinitis is one or two sprays per nostril twice daily. The recommended dosage of Azelastine Nasal Spray in pediatric patients 5 years to 11 years of age is one spray per nostril twice daily.<br />\r\n<br />\r\n<strong>Vasomotor Rhinitis</strong>: The recommended dosage of Azelastine Nasal Spray in adults and adolescent patients 12 years and older with vasomotor rhinitis is two sprays per nostril twice daily. Administer Azelastine Nasal Spray by the intranasal route only.<br />\r\n<br />\r\n<strong>Priming</strong>: Prime Azelastine Nasal Spray before initial use by releasing 4 sprays or until a fine mist appears. When Azelastine Nasal Spray has not been used for 3 or more days, reprime with 2 sprays or until a fine mist appears. Avoid spraying Azelastine Nasal Spray into the eyes.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>It is especially important to check before combining Azelastine nasal spray with Alcohol, CNS depressants, Cimetidine &amp; Ketoconazole.</p>', '<p>Contraindicated in patients with a known hypersensitivity to Azelastine or any of its components.</p>', '<p>Headache, dizziness, sneezing, nosebleed, nausea, stinging or itching in nose, dry mouth, sore throat, bitter taste etc.</p>', '<p>Use in pregnancy: The effects of Azelastine during pregnancy have not been adequately studied. Azelastine should be administered during pregnancy, if the potential benefit justifies the potential risks to fetus.<br />\r\n<br />\r\nUse in nursing mother: It is not known whether Azelastine is excreted in human milk. However, caution should be exercised when Azelastine is administered to a nursing mother.</p>', '<p>In clinical trials, the occurrence of somnolence has been reported in some patients taking Azelastine nasal spray; due caution should therefore be exercised when driving a car or operating potentially dangerous machinery. Concurrent use of this&nbsp;nasal spray with alcohol or other CNS depressants should be avoided because additional reductions in alertness and additional impairment of CNS performance may occur.</p>', NULL, '<p>Nasal Anti-histamine preparations</p>', '<p>Keep out of reach of children. Store in a cool and dry place protected from light. Do not freeze.</p>', '<p>Use in children: The safety and effectiveness of Azelastine nasal spray in patients below 5 years of age have not been established.</p>', '2022-02-14 07:14:35', '2022-03-17 00:17:54'),
(138, 138, '<p>Azelastine and Fluticasone Nasal Spray is indicated for the relief of symptoms of seasonal allergic rhinitis in patients 6 years of age and older who require treatment with both Azelastine Hydrochloride and Fluticasone Propionate for symptomatic relief.</p>', '<p>Azelastine Hydrochloride exhibits histamine H1-receptor antagonist activity in isolated tissues. The major metabolite, desmethylazelastine, also possesses H1-receptor antagonist activity. Fluticasone Propionate is a synthetic trifluorinated corticosteroid with anti-inflammatory activity. The precise mechanism through which Fluticasone Propionate affects allergic rhinitis symptoms is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes etc.) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in inflammation.</p>', '<p><strong>Adult</strong>: The recommended dosage is one spray each nostril twice daily.<br />\r\n<br />\r\n<strong>Paediatric</strong>: The safety and effectiveness of Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray has not been established for patients less than 6 years of age.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/ other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', NULL, '<p>There is no known contraindication.</p>', '<p>The most common adverse reactions (&gt;2% incidence) are: dysgeusia, epistaxis, and headache.</p>', '<p><strong>Pregnancy</strong>&nbsp;category C. There are no adequate and well-controlled clinical trials of Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray, Azelastine Hydrochloride only or Fluticasone Propionate only in pregnant women. It should be used in pregnant women only if the potential benefit to the mother justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Nursing Mothers</strong>: It is not known whether Azelastine Hydrochloride and Fluticasone Propionate Nasal Spray is excreted in human breast milk. Because many drugs are excreted in human milk, caution should be exercised when administered to a nursing woman.</p>', '<p>Engagement in hazardous occupations requiring complete mental alertness such as driving or operating machinery should be avoided when taking Azelastine and Fluticasone&nbsp;Nasal Spray. Concurrent use of alcohol or other central nervous system (CNS) depressants with this Nasal Spray&nbsp;should also be avoided because of further decreased alertness and impairment of CNS. Hypercorticism and adrenal suppression with very high dosages or at the regular dosage in susceptible individuals may appear. If such changes occur, the spray should be discontinued slowly.</p>', '<p>There have been no reported over dosages with Azelastine Hydrochloride. Acute Azelastine Hydrochloride overdosage by adults with this dosage form is unlikely to result in clinically significant adverse events, other than increased somnolence. Chronic Fluticasone Propionate overdosage may result in symptoms of hypercorticism.</p>', '<p>Nasal Steroid Preparations</p>', '<p>Store below 25&deg; C. Protected from light. Do not store in the refrigerator. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:15:02', '2022-03-17 00:24:40'),
(139, 139, '<p>Azilsartan Medoxomil is indicated for the treatment of hypertension to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily stroke and myocardial infarction. Azilsartan Medoxomil may be used either alone or in combination with other antihypertensive agents.</p>', '<p>Azilsartan Medoxomil, a prodrug, is hydrolyzed to Azilsartan in the gastrointestinal tract during absorption. Azilsartan is a selective AT1 subtype angiotensin II receptor antagonist. Azilsartan blocks the vasoconstrictor and aldosterone secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland.</p>', '<p>The recommended dose in adults is 80 mg taken orally once daily. Consider a Starting dose of 40 mg for patients who are treated with high doses of diuretics. If blood pressure is not controlled with Azilsartan alone, additional blood pressure reduction can be achieved by taking Azilsartan with other antihypertensive agents.</p>', '<p>No drug interactions have been observed in studies of Azilsartan Medoxomil or Azilsartan given with amlodipine, antacids, chlorthalidone, digoxin, fluconazole, glyburide, ketoconazole, metformin, pioglitazone and warfarin. The antihypertensive effect of Azilsartan may be attenuated by the non-steroidal anti-inflammatory drugs including selective COX-2 inhibitors. Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors or aliskiren is associated with increased risks of hypotension, hyperkalemia and changes in renal function.</p>', '<p>It is contraindicated to co-administer Aliskiren with Azilsartan in patients with Diabetes.</p>', '<p>The most common adverse reaction in adults is diarrhea. The other side effects are nausea, asthenia, fatigue, muscle spasm, dizziness and cough.</p>', '<p>Pregnancy Category D. The risk to the fetus increases if Azilsartan Medoxomil is administered during the second or third trimesters of pregnancy. It is not known whether Azilsartan Medoxomil is excreted in human milk, as many drugs are excreted in human milk and because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.</p>', '<p>Use of Azilsartan Medoxomil during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. In patients who are intravascularly volume-depleted (e.g., those treated with high-dose diuretics), symptomatic hypotension may occur. Changes in renal function including renal failure has been reported in renal impaired patient.</p>', '<p>Limited data are available related to overdose in humans. In the event of and overdose, supportive therapy should be instituted as dictated by the patient&rsquo;s clinical status. Azilsartan is not dialyzable.</p>', '<p>Angiotensin-ll receptor blocker</p>', '<p>keep in a dry place away from light and heat. Keep out of the reach of children.</p>', '<p>Safety and effectiveness in pediatric patients under 18 years of ages have not been established.</p>', '2022-02-14 07:15:28', '2022-03-17 00:30:17'),
(140, 140, '<p>For the treatment of hypertension, to lower blood pressure:</p>\r\n\r\n<ul>\r\n	<li>In patients not adequately controlled with ARB monotherapy</li>\r\n	<li>As initial therapy in patients likely to need multiple drugs to help</li>\r\n</ul>\r\n\r\n<p>To achieve blood pressure goals and to reduce the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.</p>', '<p>Azilsartan medoxomil is an angiotensin II receptor blocker (ARB). Azilsartan helps blood vessels to dilate. It also helps to excrete of Sodium and water from body. This combination also contains a diuretic. Chlorthalidone works in the kidneys to flush excess water and salt (sodium) from the body. Together, these 2 medicines work to help lower blood pressure in people who need more than 1 medicine to treat their high blood pressure (hypertension).</p>', '<p>The recommended starting dose is 40/12.5 mg taken orally once daily. Most of the antihypertensive effect is apparent within 1 to 2 weeks. This combination may be used to provide additional blood pressure lowering for patients not adequately controlled on ARB or diuretic monotherapy treatment. Patients not controlled with azilsartan medoxomil 80 mg may have an additional systolic/diastolic clinic blood pressure reduction of 13/6 mm Hg when switched to this combination 40/12.5 mg.<br />\r\n<br />\r\nThis combination may be used as initial therapy if a patient is likely to need multiple drugs to achieve blood pressure goals. Patients titrated to the individual components (azilsartan medoxomil and chlorthalidone) may instead receive the corresponding dose of This combination.</p>', '<p>Renal clearance of lithium is reduced by diuretics, such as chlorthalidone increasing the risk of lithium toxicity. NSAIDs increase risk of renal dysfunction and interfere with antihypertensive effect</p>', '<p>This is contraindicated in patients with anuria.</p>', '<p>The following potential adverse reactions are-</p>\r\n\r\n<ul>\r\n	<li>Fetal toxicity</li>\r\n	<li>Hypotension in Volume- or Salt-Depleted Patients</li>\r\n	<li>Impaired Renal Function</li>\r\n	<li>Hypokalemia Hyperuricemia</li>\r\n</ul>', '<p>Pregnancy Category D. Use of drugs that affect the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death.</p>', '<ul>\r\n	<li>In patients with an activated renin-angiotensin-aldosterone system (RAAS), such as volume- and/or salt-depleted patients, this combination can cause excessive hypotension. Correct volume or salt depletion prior to administration of azilsartan and chlorthalidone.</li>\r\n	<li>In patients with renal artery stenosis, This combination may cause renal failure.</li>\r\n	<li>Monitor renal function in patients with renal impairment. Consider discontinuing this combination with progressive renal impairment.</li>\r\n	<li>Heart rhythm problems (e.g., bradycardia, QT prolongation, ventricular tachycardia), liver problems, certain uncorrected mineral imbalances (low potassium/magnesium levels), severe kidney problems.</li>\r\n</ul>', NULL, '<p>Combined antihypertensive preparations</p>', '<p>Store in a cool &amp; dry place, away from light and children.</p>', NULL, '2022-02-14 07:15:50', '2022-03-17 00:33:56'),
(141, 141, '<p>Azithromycin is indicated for infections (caused by susceptible organisms) in lower respiratory tract infections including bronchitis and pneumonia, in upper respiratory tract infections including sinusitis and pharyngitis/tonsillitis, in otitis media, and in skin and soft tissue infections. In sexually transmitted diseases in men and women, Azithromycin&nbsp;is indicated in the treatment of non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis.</p>', '<p>Azithromycin is acid-stable and can therefore be taken orally with no need of protection from gastric acids. It is readily absorbed; its absorption is greater on an empty stomach. Time to peak concentration in adults is 2.1 to 3.2 hours for oral dosage forms. Due to the high concentration in phagocytes, azithromycin is actively transported to the site of infection. During active phagocytosis, large concentrations of azithromycin are released. The concentration of azithromycin in the tissues can be over 50 times higher than in plasma. This is due to ion trapping and the high lipid solubility.<br />\r\n<br />\r\nAzithromycin&#39;s half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drug from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as unchanged drug in urine.<br />\r\n<br />\r\nMicrobiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:</p>\r\n\r\n<ul>\r\n	<li><strong>Aerobic and facultative gram-positive microorganisms</strong>: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes</li>\r\n	<li><strong>Aerobic and facultative gram-negative microorganisms</strong>: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae</li>\r\n	<li><strong>Other microorganisms</strong>: Chlamydia pneumoniae, Chlamydia trachomatis , Mycoplasma pneumoniae , Betalactamase production should have no effect on azithromycin activity.</li>\r\n	<li><strong>Aerobic and facultative gram-positive microorganisms</strong>: Streptococci (Groups C,F,G), Viridans group streptococci</li>\r\n	<li><strong>Aerobic and facultative gram-negative microorganisms</strong>: Bordetella pertussis, Legionella pneumophila</li>\r\n	<li><strong>Anaerobic microorganisms</strong>: Peptostreptococcus species, Prevotella bivia</li>\r\n</ul>', '<p><strong>Oral</strong>-<br />\r\n<strong>Adult</strong>: 500 mg once daily orally for 3 days or 500 mg once on day 1, then 250 mg once on days 2-5 for 4 days. For sexually transmitted diseases caused by Chlamydia trachomatis in adults, the dose is 1 gm given as a single dose or 500 mg once on day 1, followed by 250 mg once daily for next 2 days may also be given.<br />\r\n<br />\r\n<strong>Children</strong>:</p>\r\n\r\n<ul>\r\n	<li>10 mg/kg body weight once daily for 3 days for child over 6 months</li>\r\n	<li>200 mg (1 teaspoonful) for 3 days if body weight is 15-25 kg</li>\r\n	<li>300 mg (1&frac12; teaspoonfuls) for 3 days if body weight is 26-35 kg; 400 mg (2 teaspoonfuls) for 3 days if body weight is 36-45 kg.</li>\r\n	<li>In typhoid fever, 500 mg (2&frac12; teaspoonfuls) once daily for 7-10 days is given.</li>\r\n</ul>\r\n\r\n<p><br />\r\n<strong>Azithromycin Injection (For IV Infusion only)</strong>: The recommended dose of Azithromycin for injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is:</p>\r\n\r\n<ul>\r\n	<li>500 mg as a single daily dose by the intravenous route for at least two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 500 mg, administered as two 250-mg tablets to complete a 7 to 10-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response.</li>\r\n	<li>The recommended dose of Azithromycin for the treatment of adult patients with pelvic inflammatory disease due to the indicated organisms is: 500 mg as a single daily dose by the intravenous route for one or two days. Intravenous therapy should be followed by Azithromycin by the oral route at a single, daily dose of 250 mg to complete a 7-day course of therapy. The timing of the switch to oral therapy should be done at the discretion of the physician and in accordance with clinical response. If anaerobic microorganisms are suspected of contributing to the infection, an antimicrobial agent with anaerobic activity should be administered in combination with Azithromycin.</li>\r\n	<li>Safety and effectiveness of azithromycin for injection in children or adolescents under 16 years have not been established.&nbsp;\r\n	<p><strong>Administration</strong></p>\r\n\r\n	<p>Reconstitution procedure of suspension-</p>\r\n	</li>\r\n	<li>Step 01: Shake the bottle well to loosen the powder.</li>\r\n	<li>Step 02: Add boiled and cooled water up to the water mark of the bottle label.</li>\r\n	<li>Step 03: Shake until powder is completely mixed with water.</li>\r\n	<li>\r\n	<p>Azithromycin should be taken at least 1 hour before or 2 hours after meal.</p>\r\n	</li>\r\n</ul>', '<p>Azithromycin absorption is reduced in presence of food and antacid. In patients receiving ergot alkaloids Azithromycin should be avoided because of the possibility of ergotism resulting from interaction of Azithromycin with the cytochrome P-450 system. As macrolides increase the plasma concentration of digoxin and cyclosporin, caution should be exercised while co-administration. There have been no drug interactions between Azithromycin and Warfarin, Theophylline, Carbamazepine, Methylprednisolone or Cimetidine.</p>', '<p>Azithromycin is contraindicated in patients hypersensitive to Azithromycin or any other macrolide antibiotic. Co-administration of ergot derivatives and Azithromycin is contraindicated. Azithromycin is contraindicated in patients with hepatic diseases.</p>', '<p>Azithromycin is well tolerated with a low incidence of side effects. The side effects include nausea, vomiting, abdominal discomfort (pain/cramps), flatulence, diarrhoea, headache, dizziness, and skin rashes and are reversible upon discontinuation of therapy.</p>', '<p>Pregnancy Category of Azithromycin is B. Animal reproduction studies have demonstrated that Azithromycin has no evidence of harm to the fetus. There are no adequate and well controlled studies in pregnant women. Since animal reproduction studies are not always predictive of human response, Azithromycin should be used during pregnancy only if adequate alternatives are not available. It is not known whether Azithromycin is secreted in breast milk. So, caution should be exercised when Azithromycin is administered to nursing women.</p>', '<p>As with any antibiotic, observation for signs of superinfection with non-susceptible organisms, including fungi, is recommended. No dose adjustment is needed in patients with renal impairment.</p>', '<p>There is no data on overdosage with Azithromycin. Typical symptoms of overdosage with macrolide antibiotics include hearing loss, severe nausea, vomiting and diarrhoea. Gastric lavage and general supportive measures are indicated.</p>', NULL, '<p>Keep in a dry place away from light and heat. Keep out of the reach of children.</p>', NULL, '2022-02-14 07:16:29', '2022-03-17 00:40:04'),
(142, 142, '<p>Azithromycin Eye Drops is indicated for the treatment of bacterial conjunctivitis caused by CDC coryneform group G, Haemophilus influenzae, Staphylococcus aureus, Streptococcus mitis group, and Streptococcus pneumonia.</p>', '<p>Azithromycin is acid-stable and can therefore be taken orally with no need of protection from gastric acids. It is readily absorbed; its absorption is greater on an empty stomach. Time to peak concentration in adults is 2.1 to 3.2 hours for oral dosage forms. Due to the high concentration in phagocytes, azithromycin is actively transported to the site of infection. During active phagocytosis, large concentrations of azithromycin are released. The concentration of azithromycin in the tissues can be over 50 times higher than in plasma. This is due to ion trapping and the high lipid solubility.<br />\r\n<br />\r\nAzithromycin&#39;s half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drug from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as unchanged drug in urine.<br />\r\n<br />\r\nMicrobiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:</p>\r\n\r\n<ul>\r\n	<li>Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes</li>\r\n	<li>Aerobic and facultative gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae</li>\r\n	<li>Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis , Mycoplasma pneumoniae , Betalactamase production should have no effect on azithromycin activity.</li>\r\n	<li>Aerobic and facultative gram-positive microorganisms: Streptococci (Groups C,F,G), Viridans group streptococci</li>\r\n	<li>Aerobic and facultative gram-negative microorganisms: Bordetella pertussis, Legionella pneumophila</li>\r\n	<li>Anaerobic microorganisms: Peptostreptococcus species, Prevotella bivia</li>\r\n</ul>', '<p><strong>Children of one year of age and adults</strong>: Instill 1 drop in affected eye(s) twice daily for the first 2 days then once daily for the next 5 days.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Azithromycin Eye Drops in pediatric patients below 1 year of age have not been established.<br />\r\n<br />\r\n<strong>Children less than one year of age</strong>: Not recommended.</p>', '<p>Drug interaction studies have not been conducted with Azithromycin Eye Drops.</p>', '<p>Hypersensitivity to any component of the preparation.</p>', '<p>Eye irritation, contact dermatitis, corneal erosion, dry eye, punctate keratitis etc.</p>', '<p>Pregnancy Category B. In the animal studies, no evidence of harm to the fetus due to Azithromycin was found. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, Azithromycin should be used during pregnancy only if clearly needed. It is not known whether Azithromycin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Azithromycin is administered to a nursing woman.</p>', '<p>Azithromycin Eye Drops is indicated for topical ophthalmic use only and should not be administered systemically, injected subconjunctivally, or introduced directly into the anterior chamber of the eye.</p>', NULL, '<p>Macrolides</p>', '<p>Store unopened bottle under refrigeration at 2&deg;C to 8&deg;C. Once the bottle is opened, store it at 25&deg;C for up to 14 days. Discard after the 14 days of opening.</p>', NULL, '2022-02-14 07:16:49', '2022-03-17 00:43:39'),
(143, 143, '<p>Aztreonam is indicated in the treatment of the following infections caused by susceptible aerobic Gram-negative micro-organisms<br />\r\n<br />\r\n<strong>Urinary tract infections:</strong>&nbsp;Pyelonephritis, cystitis (initial and recurrent) and asymptomatic bacteriuria (including those due to pathogens resistant to the aminoglycosides, cephalosporins or penicillins).<br />\r\n<strong>Gonorrhea:</strong>&nbsp;Acute uncomplicated urogenital or anorectal infections.<br />\r\n<strong>Lower respiratory tract infections:</strong>&nbsp;Including pneumonia, bronchitis and lung infections in patients with cystic fibrosis.<br />\r\n<strong>Skin and soft tissue infections:</strong>&nbsp;Postoperative wounds, ulcers and burns.<br />\r\n<strong>Meningitis:</strong>&nbsp;Caused by Haemophilusinfluenzae or Neisseria meningitidis.<br />\r\n<strong>Gynecological infections:</strong>&nbsp;Pelvic Inflammatory Disease (PID), endometritis and pelvic cellulitis.<br />\r\n<strong>Intra-abdominal infections:</strong>&nbsp;Peritonitis.<br />\r\n<strong>Bacteremia/ septicemia:</strong>&nbsp;Septicemia caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa,Proteus mirabilis, Serratia marcescens and Enterobacter species.<br />\r\n<strong>Bone and joint infections:</strong>&nbsp;Osteomyelitis,septic arthritis.<br />\r\n<br />\r\nAztreonam is also indicated for adjunctive therapy to surgery in the management of infections caused by susceptible organisms. Patients with serious Pseudomonas infections may benefit from concurrent use of Aztreonam and an aminoglycoside because of their synergistic action.</p>', '<p>Aztreonam is a synthetic bactericidal monobactam antibiotic. It inhibits bacterial cell wall synthesis by blocking peptidoglycan crosslinking. The inhibition of bacterial cell wall synthesis occurs due to a high affinity of Aztreonam for penicillin binding protein 3 (PBP3). By binding to PBP3, Aztreonam inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins. It is possible that Aztreonam interferes with an autolysin inhibitor.</p>', '<p><strong>Adults</strong>: The usual dose of Aztreonam is 3 to 4 gm daily (maximum recommended dose is 8 gm daily). The dosage and route of administration should be determined by the susceptibility of the causative organisms, severity of infection and the condition of the patient. In case of Pseudomonas aeruginosa infections, 2 gm every 6 or 8 hours is recommended.<br />\r\n<br />\r\n<strong>Children</strong>: The usual dosage for patients older than one week is 30 mg/kg/dose every 6 or 8 hours. For severe infections in patients 2 years of age or older, 50 mg/kg/dose every 6 or 8 hours is recommended.Dosage information is not yet available for new-born less than 1 week old.<br />\r\n<br />\r\n<strong>Dosage Guideline for adult:</strong></p>\r\n\r\n<ul>\r\n	<li>Urinary tract infections: 500 mg or 1 gm; 8 or 12 hourly</li>\r\n	<li>Moderately severe systemic infections: 1 g or 2 gm; 8 or 12 hourly</li>\r\n	<li>Severe systemic or life-threatening infections: 2 gm; 6 or 8 hourly</li>\r\n	<li>Maximum recommended dose is 8 gm/ day.</li>\r\n</ul>\r\n\r\n<p><strong>Dosage Guideline or pediatric:</strong></p>\r\n\r\n<ul>\r\n	<li>Mild to moderate infections: 30 mg/kg; 8 hourly</li>\r\n	<li>Moderate to severe infections (2 years or older): 50 mg/kg; 6 or 8 hourly</li>\r\n	<li>Maximum recommended dose is 120 mg/ kg/ day.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p><strong>Intramuscular administration</strong>: The dose should be given by deep injection into a large muscle mass. Aztreonam is well tolerated and should not be administered with any local anesthetic agent. For each gram of Aztreonam add at least 3 ml water for injection BP and shake well.<br />\r\n<br />\r\n<strong>Intravenous administration</strong>: A bolus injection may be used to initiate therapy. The dose should be slowly injected directly into a vein, or the tubing of a suitable administration set, over a period of 3 to 5 minutes.<br />\r\n<br />\r\n<strong>For infusion</strong>: Each gram of Aztreonam should be initially constituted with at least 3 ml of water for injection BP. The resulting solution should be diluted with an appropriate infusion solution to a final concentration not exceeding 2% w/v (at least 50 ml solution per gram Aztreonam). The Aztreonam infusion should be administered over a 20-60 minute period. A number of intravenous solutions may be used as diluents for the administration of Aztreonam by intravenous infusion.These include sodium chloride injection, dextrose and mixed injections of sodium chloride and dextrose, Ringers and lactated Ringers injection,water for injection etc.</p>', '<p>Concomitant administration of probenecid or furosemide and Aztreonam causes clinically insignificant increases in the serum levels of Aztreonam.</p>', '<p>This preparation is contraindicated in patients with known hypersensitivity to Aztreonam or any other component in the formulation.</p>', '<p>Local reactions such as phlebitis/thrombophlebitis following IV administration and discomfort/swelling at the injection site following IM administration may occur. Systemic reactions like diarrhea, nausea and/or vomiting, and rash may occur. Other side effects include anaphylaxis, angioedema, bronchospasm, pancytopenia, neutropenia, thrombocytopenia, anemia, eosinophilia, leukocytosis, thrombocytosis, abdominal cramps, dermatitis, urticaria, pruritus, hypotension, flushing, seizure, weakness, headache, fever, malaise may occur.</p>', '<p>Pregnancy Category B. Aztreonam crosses the placenta and enters the fetal circulation. So it should be used during pregnancy only if the potential benefit justifies the potential risk.<br />\r\n<br />\r\nAztreonam is excreted in breast milk in concentrations that are less than 1% of concentrations determined in simultaneously obtained maternal serum. Temporary discontinuation of nursing is recommended.</p>', '<p>In patients with impaired hepatic or renal function, appropriate monitoring is recommended during therapy.</p>', '<p>If necessary, Aztreonam may be cleared from the serum by hemodialysis and/or peritoneal dialysis.</p>', '<p>Other beta-lactam Antibiotics</p>', '<p>Store in a cool &amp; dry place, protected from light &amp; moisture. Keep all medicines out of reach of children.</p>', '<p><strong>Renal Impairment</strong>: In patients with impaired renal function, the normal recommended initial dose should be given. This should be followed by maintenance doses as below:<br />\r\n<br />\r\nCreatinine clearance (10&ndash;30 ml/min): Maintenance dose is half of the initial dose.<br />\r\n<br />\r\nCreatinine clearance (Less than 10 ml/min): One quarter of the initial dose.<br />\r\n<br />\r\nThe normal dose interval should not be altered. In patients on haemodialysis, a supplementary one eighth of the initial dose should be given after each dialysis.<br />\r\n<br />\r\nRecommended for children of one week and older. Aztreonam for injection should be administered intravenously to pediatric patients with normal renal function. There are insufficient data regarding intramuscular administration to pediatric patients or dosing in pediatric patients with renal impairment.</p>', '2022-02-14 07:17:08', '2022-03-17 00:47:15'),
(144, 144, '<p>Bacillus clausii spores is used for managing the alterations of the intestinal bacterial flora. Bacillus clausii spores restores the equilibrium of the intestinal flora changed during diarrhoea or in the course of thera-pies with antibiotics or chemo-therapy, contributing to correct the consequent dysvitaminosis (that is the imbalance of production and assimilation of the vitamins).</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p>1 mini bottle contains-</p>\r\n\r\n<ul>\r\n	<li>Active element: 2 billion spores of polyantibiotic resistant Bacillus clausii*</li>\r\n	<li>Excipient: Purified water</li>\r\n</ul>\r\n\r\n<p>*Polyantibiotic resistant means resistant to a certain number of antibiotics. It is an extremely important characteristic of Bacillus clausii spores that allows it to be administered during antibiotic treatment with penicillin, cephalosporins, tetracycline, macrolides, aminoglycosides, novabi-ocin, chloramphenicol, tiamphenicol, Lincomycin, isoniazid, cycloserin, rifampicin, Nalidixic acid and pipernidic acid</p>', '<p>Bacillus clausii spores is a probiotic which is useful for the management of imbalance of intestinal bacterial flora due to diverse causes. The possible presence of corpuscles visible in the vials of Enterogermina is due to aggregates of Bacillus clausii spores and does not, therefore, indicate that the product has undergone any changes.</p>', '<p><strong>Adults</strong>: from 2 to 3 mini bottles a day<br />\r\n<strong>Children</strong>: from 1 to 2 mini bottles a day<br />\r\n<strong>Infants</strong>: from 1 to 2 mini bottles a day<br />\r\n<br />\r\nDo not exceed the instructed doses without the advice of the professional. Bacillus clausii spores is presented in the form of&nbsp; an oral suspension in water and is available as 5 ml mini bottles. One pack contains 10 ready-to-drink mini bottles.</p>\r\n\r\n<p><strong>Administration</strong>: Take Bacillus clausii spores at regular intervals during the day. Consult the professional if the condition recurs or if you have noticed any recent change in the nature of problems. Use only for brief periods of Management.<br />\r\n<br />\r\nIt is necessary to shake the mini bottle before use. To open the mini bottle rotate the upper part and detach it. Take the content as such or dilute it in water or other drinks (for example; Milk, Tea, Orange juice). Once open, consume it within a short period to avoid contamination of the suspension.</p>', NULL, '<p>Hypersensitivity towards the components or other closely related substances.</p>', '<p>No side effects have been reported with the use of Enterogermina. However, it is important to communicate any undesirable effects.</p>', '<p>Bacillus clausii spores can be used during pregnancy &amp; lactation</p>', '<p>During antibiotic therapy, the product should be administered in the interval between one dose of antibiotic and the next. Keep out of the reach of children. Contact your doctor if the condition worsen after 2-3 days of usage.</p>', '<p>Excessive doses of Enterogermina do not produce side effects. However, it is better to follow the recommended doses. While there are no particular problems associated with missing a dose, it is advisable to complete the daily dose for best results. Remember that the correct and careful administration increases its effectiveness.</p>', '<p>Other antibiotic</p>', '<p>The un-opened mini bottles of Enterogermina are stable for a period of 24 months. Do not use Enterogermina after the expiry date on the label. Store at a temperature not higher than 30&deg;C.</p>', NULL, '2022-02-15 05:25:00', '2022-03-10 05:08:44'),
(145, 145, '<p>This&nbsp;ophthalmic ointment is indicated in the treatment of bacterial infections of the eye and its adnexa including conjunctivitis, keratitis, corneal ulceration and ulcerative blepharitis. It may be applied to prevent ocular infection both pre and post operatively.</p>', '<p>This&nbsp;ophthalmic ointment is a sterile antimicrobial ointment for ophthalmic use, cointaining Polymixin-B sulphate and Bacitracin Zinc.<br />\r\n<br />\r\nPolymixin-B sulphate and Becitracin Zinc are both bactericidal antibiotics, The former exerts its action by binding with the cellular membrane and the later by inhibiting bacterial cell wall development.</p>', '<p>Apply the ointment every 3 to 4 hourly for 7 to 10 days, depending on the severity of the infection or as directed by the physician.</p>', NULL, '<p>Polytracin is contraindicated in those individuals who have shown hypersensitivity to Polymixin-B sulphate, Becitracin Zinc or to cross sensitizing substances.</p>', '<p>Sometimes this ointment&nbsp;may be absorbed in the blood, but shows no blood related toxicity. Moreover Allergic reaction, eye irritation, eye redness, itching, swelling may occur.</p>', '<p>Bacitracin Zinc: Pregnancy Category C<br />\r\nPolymyxin B Sulphate: Pregnancy Category B<br />\r\nLactation: Undetermined</p>', NULL, NULL, '<p>Ophthalmic antibacterial drugs</p>', NULL, NULL, '2022-02-15 05:26:01', '2022-03-17 00:55:32');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(146, 146, '<p>Baclofen is indicated in-</p>\r\n\r\n<ul>\r\n	<li>spasticity resulting from multiple sclerosis</li>\r\n	<li>flexor spasms and concomitant pain, clonus and muscular rigidity</li>\r\n	<li>skeletal muscle spasm resulting from rheumatic disorders</li>\r\n	<li>spinal cord injuries and other spinal cord diseases</li>\r\n	<li>cerebrovascular accidents or neoplastic or degenerative brain disease</li>\r\n</ul>', '<p>Baclofen inhibits both monosynaptic and polysynaptic reflexes at the spinal level by stimulating the GABAB&nbsp;receptors, which inhibits the release of glutamate and aspartate. It may also act at intraspinal sites producing CNS depression. Baclofen also exerts an antinociceptive effect.</p>', '<p><strong>Adult &amp; children over 10 years</strong>: 5 mg 3 times daily, preferably with or after food, gradually increased; max. 100 mg daily.<br />\r\n<br />\r\n<strong>Children &lt;10 years</strong>: Treatment is usually started with 2.5 mg (2.5 ml) given 4 times daily then raised according to requirement. Daily maintenance dose-</p>\r\n\r\n<ul>\r\n	<li>12 month-2 years: 10-20 mg (10-20 ml)</li>\r\n	<li>2 years-6 years: 20-30 mg (20-30 ml)</li>\r\n	<li>6 years-10 years: 30-60 mg (30-60 ml</li>\r\n</ul>', '<ul>\r\n	<li>Increased sedation may occur if Baclofen is taken with agents acting on the central nervous system, alcohol or synthetic opiates. The risk of respiratory depression is also increased.</li>\r\n	<li>Combined treatment with Baclofen and antihypertensives is likely to increase the fall in blood pressure; therefore the dosage of antihypertensive medication should be adjusted accordingly.</li>\r\n	<li>The concomitant administration of Baclofen and tricyclic antidepressants may potentiate the pharmacological effects of Baclofen resulting in pronounced muscular hypotonia.</li>\r\n	<li>In patients with Parkinsons disease receiving treatment with Baclofen and levodopa and carbidopa, there have been several reports of mental confusion, hallucinations, headaches, nausea and agitation.</li>\r\n	<li>The concurrent use of MAO inhibitors and Baclofen may result in increased CNS depressant effects. Caution is advised and the dosage of one or both agents should be adjusted accordingly.</li>\r\n	<li>Caution should be exercised when administering Baclofen and magnesium sulphate or other neuromuscular blocking agents since a synergistic effect may theoretically occur.</li>\r\n</ul>', '<p>Baclofen is contraindicated in patients with hypersensitivity to any component of this product.</p>', '<p>The most common adverse reactions associated with Baclofen are transient drowsiness, daytime sedation, dizziness, weakness and fatigue.</p>\r\n\r\n<ul>\r\n	<li><strong>Central Nervous System</strong>: Headache (&lt;10%), insomnia (&lt;10%), and rarely, euphoria, excitement, depression, confusion, hallucinations, paraesthesia, nightmares, muscle pain, tinnitus, slurred speech, co-ordination disorder, tremor, rigidity, dystonia, ataxia, blurred vision, nystagmus, strabismus, miosis, mydriasis, diplopia, dysarthria, epileptic seizures, respiratory depression.</li>\r\n	<li><strong>Cardiovascular:</strong>&nbsp;Hypotension (&lt;10%), rare instances of dyspnoea, palpitation, chest pain, syncope.</li>\r\n	<li><strong>Gastrointestinal</strong>: Nausea (approximately 10%), constipation (&lt;10%) and rarely, dry mouth, anorexia, taste disorder, abdominal pain, vomiting, diarrhoea and positive test for occult blood in stool.</li>\r\n	<li><strong>Genitourinary</strong>: Urinary frequency (&lt;10%) and rarely, enuresis, urinary retention, dysuria, impotence, inability to ejaculate, nocturia, haematuria.</li>\r\n	<li><strong>Other</strong>: Instances of rash, pruritus, ankle oedema, excessive perspiration, weight gain, nasal congestion, visual disturbances, hepatic function disorders and paradoxical increase in spasticity. Muscular hypotonia of a degree sufficient to make walking or movement difficult may occur but is usually relieved by readjusting the dosage. For this purpose, the daytime dosage may be reduced and the evening dosage increased.</li>\r\n</ul>', '<p>Pregnancy category B3. Safe use of Baclofen during pregnancy has not been established. Baclofen crosses the placental barrier. Baclofen should only be administered to pregnant women when in the judgement of the physician concludes that the potential benefits outweigh the possible hazards. Baclofen is excreted in breast milk however evidence to date suggests that the quantities are so small that no undesirable effects on the infant would be expected.</p>', '<ul>\r\n	<li>Lower doses (approximately 5 mg per day) should be used for patients with impaired renal function or those undergoing chronic haemodialysis.</li>\r\n	<li>Patients suffering not only from spasticity but also from psychotic disorders, schizophrenia, depressive or manic disorders or confusional states should be treated cautiously and closely monitored as exacerbations of these disorders may occur.</li>\r\n	<li>In patients with epilepsy and muscle spasticity, Baclofen may be used under appropriate supervision and provided that adequate anticonvulsive therapy is continued. Lowering of the convulsion threshold may occur and seizures have been reported after the cessation of Baclofen therapy or with overdose.</li>\r\n	<li>Baclofen should be used with caution in patients with or with a history of peptic ulcers, cerebrovascular diseases, or hepatic, renal or respiratory failure.</li>\r\n	<li>Careful monitoring of respiratory and cardiovascular function is essential especially in patients with cardiopulmonary disease and respiratory muscle weakness.</li>\r\n	<li>During treatment with Baclofen, neurogenic disturbances affecting emptying of the bladder may improve. However in patients with preexisting sphincter hypertonia, acute retention of urine may occur. Baclofen should be used with caution in these circumstances.</li>\r\n	<li>Baclofen has not significantly benefited patients with stroke. These patients have also shown poor tolerance to the medicine.</li>\r\n	<li>Appropriate laboratory tests should be performed periodically in patients with hepatic diseases or diabetes mellitus to ensure that no medicine induced changes in these underlying diseases have occurred.</li>\r\n</ul>', '<p>Gastric lavage is important in case of severe overdose.</p>', '<p>Centrally acting Skeletal Muscle Relaxants</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:26:32', '2022-03-17 00:58:15'),
(147, 147, '<p>This&nbsp;is an isotonic solution for use in irrigating tissues of the eyes. For irrigation during various surgical procedures of the eyes, ears, nose and/or throat.</p>', '<p>This sterile Irrigating Solution is an isotonic solution for use in irrigating tissues of the eyes.<br />\r\n<br />\r\n<strong>Calcium chloride</strong>&nbsp;is used to prevent or treat negative calcium balance. It also regulates action potential excitation threshold to facilitate nerve and muscle performance.<br />\r\n<br />\r\n<strong>Potassium chloride</strong>&nbsp;is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion. Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives.<br />\r\n<br />\r\n<strong>Magnessium Chloride</strong>:&nbsp;Acts as cofactor in numerous enzymatic reactions involving protein synthesis and carbohydrate metabolism; depresses CNS, blocks peripheral neuromuscular transmission, produces anticonvulsant effects.<br />\r\n<br />\r\n<strong>Sodium chloride</strong>&nbsp;plays an important role in controlling the total body water and its distribution. Sodium is the main cation in the extracellular fluid and comprises &gt;90% of total cations. The acetate component is an alternate source of bicarbonate by metabolic conversion in the liver.</p>', '<p>This ocular irrigating solution should be used according to standard format for each surgical procedure</p>', NULL, '<p>Contraindicated in patients with known hypersensitivity to the products.</p>', '<p>When the corneal endothelium is abnormal, irrigation or any other trauma may result in bullous keratopathy. Postoperative inflammatory reactions as well as incidents of corneal edema and corneal decompensation have been reported. Their relationship to the use of balanced salt solution has not been established.</p>', '<p>Pregnancy&nbsp;Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>This solution contains no preservative and should not be used for more than one patient. Use only if container and seal are undamaged and solution is clear. The addition of any medication to isotonic solution may result in damage to intraocular tissue. There have been rare reports of corneal clouding or edema following ocular surgery in which isotonic solution was used as an irrigating solution. As in all surgical procedures appropriate measures should be&nbsp;taken to minimize trauma to the cornea and other ocular tissues.</p>', NULL, '<p>Irrigation during various surgical procedures</p>', '<p>Protect from light and store between 2&deg; to 25&deg; C. Do not freeze. Keep out of reach of children</p>', NULL, '2022-02-15 05:26:52', '2022-03-17 01:00:44'),
(148, 148, '<p>Baloxavir Marboxil is an influenza virus polymerase acidic (PA) endonuclease inhibitor indicated for:</p>\r\n\r\n<ul>\r\n	<li>Treatment of acute uncomplicated influenza in patients 12 years of age and older who have been symptomatic for no more than 48 hours and who are: otherwise healthy, or at high risk of developing influenza-related complications.</li>\r\n	<li>Post-exposure prophylaxis of influenza in patients 12 years of age and older following contact with an individual who has influenza.</li>\r\n</ul>', '<p>Baloxavir marboxil is a selective inhibitor of influenza cap-dependent endonuclease which prevents polymerase function and therefore influenza virus mRNA replication. It has shown therapeutic activity against influenza A and B virus infections, including strains resistant to current antiviral agents. This drug inhibits an enzyme required for viral replication, thus rapidly treating flu virus infection, and alleviating the symptoms associated with infection. A single dose of this agent was shown to be superior to placebo in relieving influenza symptoms and superior to both oseltamivir and placebo drug in virologic outcomes (marked by decreased viral load). The safety profile of Baloxavir marboxil compared favorably with that of oseltamivir, making it an effective treatment option for treatment of the flu virus, in one single dose.</p>', '<p><strong>Treatment and Post-Exposure Prophylaxis of Influenza</strong>: Baloxavir Marboxil should be taken as a single dose as soon as possible and within 48 hours of influenza symptom onset for treatment of acute uncomplicated influenza or following contact with an individual who has influenza. Baloxavir Marboxil should be taken with or without food.<br />\r\n<br />\r\nRecommended Single Oral Dose in Patients 12 Years of Age and Older:</p>\r\n\r\n<ul>\r\n	<li><strong>Less than 80 kg</strong>: One 40 mg tablet</li>\r\n	<li><strong>At least 80 kg</strong>: One 80 mg tablet</li>\r\n</ul>', '<ul>\r\n	<li>Avoid coadministration of Baloxavir Marboxil with dairy products, calcium-fortified beverages, polyvalent cation-containing laxatives, antacids, or oral supplements (e.g., calcium, iron, magnesium, selenium, or zinc).</li>\r\n	<li>Live attenuated influenza vaccines may be affected by antivirals.</li>\r\n</ul>', '<p>Baloxavir Marboxil is contraindicated in patients with a history of hypersensitivity to baloxavir marboxil or any of its ingredients.</p>', '<p>Adverse events reported in at least 1% of adult and adolescent influenza subjects treated with Baloxavir Marboxil included diarrhea (3%), bronchitis (3%), nausea (2%), sinusitis (2%), and headache (1%).</p>', '<p>There are no adequate and well-controlled studies with Baloxavir Marboxil in pregnant women to inform a drug-associated risk of adverse developmental outcomes. There are risks to the mother and fetus associated with influenza virus infection in pregnancy. There are no data on the presence of baloxavir marboxil in human milk, the effects on the breastfed infant, or the effects on milk production.</p>', '<p><strong>Hypersensitivity such as anaphylaxis, angioedema, urticaria, and erythema multiforme</strong>: Initiate appropriate treatment if an allergic-like reaction occurs or is suspected.<br />\r\n<br />\r\n<strong>Risk of bacterial infection</strong>: Serious bacterial infections may begin with influenza-like symptoms or may coexist with, or occur as, a complication of influenza. Baloxavir Marboxil has not been shown to prevent such complications. Prescribers should be alert to potential secondary bacterial infections and treat them as appropriate.</p>', NULL, '<p>Respiratory viral infections (Influenza)</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:27:12', '2022-03-17 01:03:38'),
(149, 149, '<p>Bambuterol is indicated for Bronchial asthma, chronic bronchitis, emphysema &amp; other lung diseases where bronchospasm is a complicating factor.</p>', '<p>Bambuterol is an adrenergic &beta;2 receptor agonist which predominantly stimulates &beta;2 receptor, thus producing relaxation of bronchial smooth muscle, inhibition of release of endogenous spasmogens, inhibition of edema caused by endogenous mediators &amp; increased mucocilliary clearance.</p>', '<p><strong>Adult or Elderly</strong>: The recommended initial dose 10 mg. The dose may be increased to 20 mg after 1-2 weeks depending on the clinical effect.<br />\r\n<br />\r\n<strong>Children 2-5 years</strong>:&nbsp;The recommended normal dose 10 mg (10 ml syrup).<br />\r\n<br />\r\n<strong>Children 6-12 years</strong>:&nbsp;The recommended normal dose 10 mg (10 ml syrup). The dose may be increased to 20 mg.</p>', '<p>Succinylcholin, MAOIs (monoamine oxidase inhibitors), &beta;2-blockers, corticosteroids, diuretics, muscle relaxants, sympathomimetic xanthine derivatives. Bambuterol may partly or totally inhibit the effect of &beta;-blockers.</p>', '<p>Bambuterol is contraindicated in hepatic impairment, liver cirrhosis or severely impaired liver function.</p>', '<p>Common side effects are fatigue, nausea, palpitation, headache, dizziness &amp; tremor.</p>', '<p><strong>Pregnant women</strong>: There is no definite evidence of ill consequence during pregnancy. Nevertheless, the drug should not be used during the first trimester of pregnancy, unless the expected benefit is thought to outweigh any possible risk to the fetus.<br />\r\n<br />\r\n<strong>Lactating mother</strong>: It is excreted in breast milk. So, patients taking this drug should not breast-feed.</p>', '<p>Reduce the dose in renal impairment, avoid in cirrhosis and severe hepatic impairment. Caution should be observed in patients with severe cardiovascular disorder, such as ischaemic heart disease, tachyarrhythmias or severe heart failure.</p>', NULL, '<p>Short-acting selective &amp; &beta;2-adrenoceptor stimulants</p>', '<p>Keep away from light, store in a cool and dry place. Keep out of reach of children.</p>', '<p><strong>Impaired renal function (GFR 50 ml/min)</strong>:&nbsp;The recommended starting dose is 5 mg, which may be increased to 10 mg after one to two weeks, depending on the clinical effect.<br />\r\n<br />\r\n<strong>Impaired hepatic function</strong>: Not recommended because of unpredictable conversion to terbutalin</p>', '2022-02-15 05:27:38', '2022-03-17 01:14:38'),
(150, 150, '<p>Barium Suphate is used to help doctors examine the esophagus (tube that connect mouth and stomach), stomach and intestine using X-rays or computed tomography (CAT scan, CT Scan; a type of body scan that uses a computer to put together X-ray images to create cross sectional or three dimensional picture of the inside of the body). Barium sulphate is a class of medications called radiopaque contrast media. Its works by coating the esophagus, stomach or intestine with a material that is not absorbed into the body so that diseased or damaged areas can be clearly seen by X-ray examination or CT scan.</p>', '<p>Barium sulfate increases the absorption of x-rays as they pass through the body, thus delineating body structures, in which barium sulfate is localized.<br />\r\n<br />\r\nBarium sulfate is an insoluble material which, because of its density, provides a positive contrast during x-ray examination. Barium sulfate is an inert radiopaque material which is not absorbed or metabolized and is eliminated intact from the body in a manner similar to other non-absorbed inorganic materials. Excretion rate is a function of gastrointestinal transit time.</p>', '<p>Barium Sulphate comes as a powder to be mixed with water, a suspension (liquid), a paste, and a tablet. The powder and water mixture and the suspension may be taken by mouth or may be given as an enema (liquid that is instilled into the rectum), and the paste and tablet are taken by mouth. Barium Sulphate is usually taken one or more times before an X-ray examinations or CT scan. If you are using a Barium Sulphate enema, the enema will be administered by medical staff at the testing center. If you are taking Barium Sulphate by mouth, you may be given the medication after you arrive at the testing center or you may be given the medication to take at home at specific times the night before and/or the day of your test. If you are taking Barium Sulphate at home, take it exactly as directed. Do not take more or less of it or take it more often or at different times than directed. Shake the liquid well before each use to mix the medication evenly. If you are given a powder to mix with water and take at home, be sure that you are also given directions for mixing and that you understand these directions. Ask your doctor or staff at testing center if you have any questions about mixing your medications. You will be given specific directions to follow before and after your test. You may be told to drink only clear liquid after a certain time the day before your test, not to eat or drink after a specific time, and/or to use laxatives or enemas before your test. You may also be told to use laxatives to clear the Barium Sulphate from your body after your test. Be sure that your understand these directions and follow them carefully. Ask your doctor or the staff at the testing center if you are not given directions or if you have questions about.</p>', NULL, '<p>Barium sulfate products are contraindicated in patients with known or suspected obstruction of the colon, known or suspected gastrointestinal tract perforation, suspected tracheoesophageal fistula, obstructing lesions of the small intestine, pyloric stenosis or known hypersensitivity to barium sulfate formulations.</p>', '<p>Common side effects are:&nbsp;severe stomach pain, severe cramping, diarrhea, or constipation, sweating, ringing in your ears, confusion, fast heart rate, pale skin, weakness</p>', '<p>Safe use of barium sulfate during pregnancy has not been established. Barium sulfate should be used in pregnant women only if the possible benefits outweigh the potential risks. Radiation is known to cause harm to the unborn fetus exposed in utero.</p>', '<p><strong>General: &nbsp;</strong>Diagnostic procedures which involve the use of radiopaque contrast agents should be carried out under the direction of personnel with the requisite training and with a thorough knowledge of the particular procedure to be performed. A history of bronchial asthma, atopy, as evidenced by hay fever and eczema, a family history of allergy, or a previous reaction to a contrast agent warrant special attention. Caution should be exercised with the use of radiopaque media in severely debilitated patients and in those with marked hypertension or advanced cardiac disease.<br />\r\n<br />\r\nAnaphylactic and allergic reactions have been reported during double contrast examinations in which glucagon has been used.<br />\r\n<br />\r\nIngestion of barium sulfate suspension is not recommended in patients with a history of food aspiration. If barium sulfate suspension is aspirated into the larynx, further administration of the suspension should be immediately discontinued.<br />\r\n<br />\r\nPatient preparation for diagnostic gastrointestinal examinations frequently requires cathartics and a liquid diet. The various preparations can result in water loss for the patient. Patients should be rehydrated quickly following a barium sulfate suspension examination of the gastrointestinal tract.<br />\r\n<br />\r\n<strong>Pregnancy:&nbsp;</strong>Safe use of barium sulfate during pregnancy has not been established. Barium sulfate should be used in pregnant women only if the possible benefits outweigh the potential risks. Elective radiography of the abdomen is considered to be contraindicated during pregnancy due to the risk to the fetus from radiation exposure. Radiation is known to cause harm to the unborn fetus exposed in utero.</p>', '<p>In rare instances, immediate repeat oral examinations may lead to severe stomach cramps and diarrhea. Cases reported implicate a total dose in the range of 30 ounces (900 mL) of a 115% w/v barium sulfate suspension. Instances of this type have resolved spontaneously and they are not considered to be life-threatening.</p>', '<p>Contrast medium for diagnostic procedures</p>', '<p>Store at 25&deg; C</p>', '<p><strong>Pediatrics:&nbsp;</strong>Two deaths of infants from barium aspiration have been reported; however, the volume of aspirated material rather than the nature of the material was probably the responsible factor.<br />\r\n<br />\r\n<strong>Geriatrics:&nbsp;</strong>Diagnostic studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of barium sulfate in the elderly. However, colon distention has caused electrocardiographic changes, especially in geriatric patients with a history of cardiac disease.</p>', '2022-02-15 05:27:57', '2022-03-17 01:20:20'),
(151, 151, '<p>Asthma: Beclomethasone dipropionate/Formoterol fumarate dihydrate is indicated in the regular treatment of asthma where use of a combination product (inhaled corticosteroid and long-acting &beta;2-agonist) is appropriate: patients not adequately controlled with inhaled corticosteroids and &#39;as needed&#39; inhaled rapid-acting &beta;2-agonist or patients already adequately controlled on both inhaled corticosteroids and long-acting &beta;2-agonists.<br />\r\n<br />\r\nCOPD:&nbsp;Symptomatic treatment of patients with severe COPD (FEV1&nbsp;&lt;50% predicted normal) and a history of repeated exacerbations, who have significant symptoms despite regular therapy with long-acting bronchodilators.</p>', '<p>Beclomethasone dipropionate given by inhalation at recommended doses has a glucocorticoid antiinflammatory action within the lungs, resulting in reduced symptoms and exacerbations of asthma with less adverse effects than when corticosteroids are administered systemically.<br />\r\n<br />\r\nFormoterol is a selective &beta;2-adrenergic agonist that produces relaxation of bronchial smooth muscle in patients with reversible airways obstruction. The bronchodilating effect sets in rapidly, within 1-3 minutes after inhalation, and has a duration of 12 hours after a single dose.</p>', '<p><strong>Adults 18 years and above</strong>: One or two inhalations twice daily. The maximum daily dose is 4 inhalations.<br />\r\n<br />\r\n<strong>Children and adolescents under 18 years</strong>: The safety and efficacy in children and adolescents under 18 years of age have not been established yet. No data are available with the drug in children under 12 years of age. Therefore the drug is not recommended for children and adolescents under 18 years until further data become available.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Using an Inhaler seems simple, but most patients do not know how to use it in the right way. If the Inhaler is used in the wrong way, less medicine can reach the lungs. Correct and regular use of the Inhaler will prevent or lessen the severity of asthma attacks.<br />\r\n<br />\r\nFollowing simple steps can help to use Inhaler effectively (According to &quot;<strong>National Asthma Guidelines for Medical Practitioners</strong>&quot; published by Asthma Association):</p>\r\n\r\n<ol>\r\n	<li>Take off the cap.</li>\r\n	<li>Shake the inhaler (at least six times) vigorously before each use.</li>\r\n	<li>If the inhaler is new or if it has not been used for a week or more, shake it well and release one puff into the air to make sure that it works.</li>\r\n	<li>Breathe out as full as comfortably possible &amp; hold the inhaler upright.</li>\r\n	<li>Place the actuator into mouth between the teeth and close lips around the mouthpiece.</li>\r\n	<li>While breathing deeply and slowly through the mouth, press down firmly add fully on the canister to release medicine.</li>\r\n	<li>Remove the inhaler from mouth. Continue holding breath for at least for 10 seconds or as long as it is comfortable.</li>\r\n	<li>If doctor has prescribed more than one inhalation per treatment, wait 1 minute between puffs (inhalations). Shake the inhaler well and repeat steps 4 to 7.</li>\r\n	<li>After use, replace the cap on the mouthpiece. After each treatment, rinse mouth with water.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation, you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 4 carefully.</li>\r\n</ol>\r\n\r\n<p><strong>Instructions for Cleaning Inhaler</strong>: Clean your Inhaler at least once a week. Remove canister and rinse the plastic actuator and cap in warm water but do not put the metal canister into water. Dry the actuator and cap thoroughly and gently replace the metal canister into the actuator with a twisting motion. Put the cap on the mouthpiece.</p>', '<p>Beta-blockers (including eye drops) should be avoided in asthmatic patients. If beta-blockers are administered for compelling reasons, the effect of formoterol will be reduced or abolished. On the other hand, concomitant use of other beta adrenergic drugs can have potentially additive effects, therefore caution is required when theophylline or other beta adrenergic drugs are prescribed concomitantly with formoterol. Concomitant treatment with quinidine, disopyramide, procainamide, phenothiazines, antihistamines, monoamine oxidase inhibitors and tricyclic antidepressants can prolong the QTc-interval and increase the risk of ventricular arrhythmias.</p>', '<p>Contraindicated in patients with hypersensitivity to any component of this product.</p>', '<p>As the drug contains beclometasone dipropionate and formoterol fumarate dihydrate, the type and severity of adverse reactions associated with each of the compounds may be expected. Common side effects are pharyngitis, oral candidiasis, headache, dysphonia.</p>', '<p>There are no relevant clinical data on the use of the drug in pregnant women. Animal studies using beclometasone dipropionate and formoterol combination showed evidence of toxicity to reproduction after high systemic exposure. There are no relevant clinical data on the use of the drug in lactation in humans. Although no data from animal experiments are available, it is reasonable to assume that beclometasone dipropionate is secreted in milk, like other corticosteroids.</p>', '<p>The drug should be used with caution (which may include monitoring) in patients with cardiac arrhythmias, especially third degree atrioventricular block and tachyarrhythmias (accelerated and/or irregular heart beat), idiopathic subvalvular aortic stenosis, hypertrophic obstructive cardiomyopathy, severe heart disease, particularly acute myocardial infarction, ischaemic heart disease, congestive heart failure, occlusive vascular diseases, particularly arteriosclerosis, arterial hypertension and aneurysm. Caution should also be observed when treating patients with known or suspected prolongation of the QTc interval, either congenital or drug induced (QTc &gt;0.44 seconds). Formoterol itself may induce prolongation of the QTc interval.</p>', NULL, '<p>Respiratory corticosteroids</p>', '<p>Prior to dispensing to the patient: Store in a refrigerator (2-8&deg;C) (for a maximum of 15 months). After dispensing: Store at temperatures not exceeding 30&deg;C (for a maximum of 2 months).</p>', NULL, '2022-02-15 05:28:14', '2022-03-17 01:24:34'),
(152, 152, '<p>Beclometasone 50, 100 &amp; 250 HFA Inhaler is indicated in the prophylactic management of mild, moderate, or severe asthma in adults or children. Beclometasone dipropionate given by inhalation offers preventative treatment for asthma. It provides effective anti-inflammatory action in the lungs with a lower incidence and severity of adverse effects than those observed when corticosteroids are administered systemically.<br />\r\n<br />\r\n<strong>Mild asthma</strong>: Patients requiring symptomatic bronchodilator asthma medication on a regular basis.<br />\r\n<br />\r\n<strong>Moderate asthma</strong>: Patients with unstable or worsening asthma despite prophylactic therapy or bronchodilator alone.<br />\r\n<br />\r\n<strong>Severe asthma</strong>: Patients with severe chronic asthma and those who are dependent on systemic corticosteroids for adequate control of symptoms. Many patients who are dependent on systemic corticosteroids for adequate control of symptoms may be able to reduce significantly, or eliminate, their requirement for oral corticosteroids when they are transferred to high dose inhaled beclometasone dipropionate.</p>', '<p>Beclomethasone dipropionate produces anti-inflammatory and vasoconstrictor effects. The mechanisms responsible for the anti-inflammatory action of beclomethasone dipropionate are unknown. Corticosteroids have been shown to have a wide range of effects on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in inflammation. The direct relationship of these findings to the effects of beclomethasone dipropionate on allergic rhinitis symptoms is not known.<br />\r\n<br />\r\nBiopsies of nasal mucosa obtained during clinical studies showed no histopathologic changes when beclomethasone dipropionate was administered intranasally.<br />\r\n<br />\r\nBeclomethasone dipropionate is a pro-drug with weak glucocorticoid receptor binding affinity. It is hydrolyzed via esterase enzymes to its active metabolite beclomethasone-17-monopropionate (B-17-MP), which has high topical anti inflammatory activity.</p>', '<p>Beclometasone dipropionate Inhaler is for oral inhalation use only. Patients should be given a starting dose of inhaled beclometasone dipropionate&nbsp;appropriate to the severity of their disease. The dose may then be adjusted until control is achieved, or reduced to the minimum effective dose according to individual response.<br />\r\n<br />\r\n<strong>Adults (including the elderly)</strong>: The usual starting dose is 200 micrograms twice a day. In more severe cases the starting dose may need to increase to 600 to 800 micrograms per day which may then be reduced when the patient&#39;s asthma has stabilised. The total daily dose may be administered as two, three, or four divided doses<br />\r\n<br />\r\n<strong>Children</strong>: 50 to 100 micrograms should be given two, three or four times daily in accordance to the response. Alternatively, 100 micrograms or 200 micrograms twice daily should be given. The usual starting dose is 100 micrograms twice daily. Beclometasone 250 Inhaler is not recommended for children.<br />\r\n<br />\r\n<strong>Beclometasone 250 HFA Inhaler</strong>: The usual starting dose is 200 micrograms twice a day. In more severe cases the starting dose may need to increase to 600 to 800 micrograms per day which may then be reduced when the patient&#39;s asthma has stabilised. The total daily dose may be administered as two, three, or four divided doses.<br />\r\n<br />\r\nThere is no need to increase the dose in patients with hepatic or renal impairment.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Using an Inhaler seems simple, but most patients do not know how to use it in the right way. If the Inhaler is used in the wrong way, less medicine can reach the lungs. Correct and regular use of the Inhaler will prevent or lessen the severity of asthma attacks.<br />\r\n<br />\r\nFollowing simple steps can help to use Inhaler effectively (According to &quot;<strong>National Asthma Guidelines for Medical Practitioners</strong>&quot; published by Asthma Association):</p>\r\n\r\n<ol>\r\n	<li>Take off the cap.</li>\r\n	<li>Shake the inhaler (at least six times) vigorously before each use.</li>\r\n	<li>If the inhaler is new or if it has not been used for a week or more, shake it well and release one puff into the air to make sure that it works.</li>\r\n	<li>Breathe out as full as comfortably possible &amp; hold the inhaler upright.</li>\r\n	<li>Place the actuator into mouth between the teeth and close lips around the mouthpiece.</li>\r\n	<li>While breathing deeply and slowly through the mouth, press down firmly add fully on the canister to release medicine.</li>\r\n	<li>Remove the inhaler from mouth. Continue holding breath for at least for 10 seconds or as long as it is comfortable.</li>\r\n	<li>If doctor has prescribed more than one inhalation per treatment, wait 1 minute between puffs (inhalations). Shake the inhaler well and repeat steps 4 to 7.</li>\r\n	<li>After use, replace the cap on the mouthpiece. After each treatment, rinse mouth with water.</li>\r\n	<li>Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation, you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 4 carefully.</li>\r\n</ol>\r\n\r\n<p><strong>Instructions for Cleaning Inhaler</strong>: Clean your Inhaler at least once a week. Remove canister and rinse the plastic actuator and cap in warm water but do not put the metal canister into water. Dry the actuator and cap thoroughly and gently replace the metal canister into the actuator with a twisting motion. Put the cap on the mouthpiece.</p>', NULL, '<p>Hypersensitivity to any of the components. Special care is necessary in patients with active or quiescent pulmonary tuberculosis.</p>', '<p>Systemic effects of inhaled corticosteroids may occur, particularly at high doses prescribed for prolonged periods. Possible systemic effects include Cushing&#39;s syndrome, Cushingoid features, and adrenal suppression, growth retardation in children and&nbsp;adolescents, decrease in bone mineral density, cataract, and glaucoma.</p>', '<p>There is inadequate evidence of safety in human pregnancy. Administration of corticosteroids to pregnant animals can cause abnormalities of fetal development including cleft palate and intra-uterine growth retardation.<br />\r\n<br />\r\nThe use of beclometasone dipropionate in mothers breast feeding their babies requires that the therapeutic benefits of the drug be weighed against the potential hazards to the mother and baby.</p>', '<p>Patients should be instructed in the proper use of the inhaler, and their technique checked, to ensure that the drug reaches the target areas within the lungs. They should also be made aware that Beclometasone Inhaler has to be used regularly, every day, even when they are asymptomatic, for optimum benefit.</p>', NULL, '<p>Respiratory corticosteroids</p>', '<p>The Inhaler should be stored below 30&deg; C, protected from direct sunlight and heat. The canister should not be broken, punctured or burnt, even when apparently empty. Keep away from eyes. Keep out of reach of children.</p>', NULL, '2022-02-15 05:28:34', '2022-03-17 01:29:33'),
(153, 153, '<p>Prophylaxis and treatment of seasonal &amp; perennial allergic rhinitis including hay fever &amp; non-allergic (vasomotor) rhinitis. Prevention of recurrence of nasal polyps following surgical removal.</p>', '<p>Following topical administration into the nasal mucosa, Beclomethasone Dipropionate produces anti-inflammatory and vasoconstrictor effects. The exact mechanism of these actions remain unknown, but may involve reductions in the following: number of mediator cells (basophil, leukocytes and mast cells) at the epithelial level, number of eosinophils, sensitivity of sensory nerves to mechanical stimuli, secretory response to cholinergic receptor stimulation, and fibroblast activity. Other mechanisms may involve inhibition of capillary dilation and permeability, stabilization of lysosomal membranes and subsequent prevention of release of proteolytic enzymes.</p>', '<p>Dosage of intranasal Beclomethasone Dipropionate must be carefully adjusted according to individual requirements and response.<br />\r\n<br />\r\n<strong>Adults</strong>: Recommended usual dosage: 02 (two) sprays (50 &micro;gm/spray) in each nostril twice daily. For some patients, 01 (one) spray in each nostril 3 to 4 times daily may be preferred. Total daily doses of 400 &micro;gm (08 sprays) should not generally be exceeded.<br />\r\n<br />\r\n<strong>Children</strong>&nbsp;(6 to 12 years of age): Usual dose: 01 (one) spray in each nostril twice daily. Patients not adequately responding, or those with more severe symptoms may use 02 (two) sprays in each nostril twice daily.<br />\r\n<br />\r\n<strong>Children under 6 years of age</strong>: Not recommended since safety profile studies have not been conducted. After the first few days, patients may be able to reduce their dosage to 100 &micro;g (one spray in each nostril) once daily for maintenance therapy.</p>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>How to use the Nasal Spray-</p>\r\n\r\n<ul>\r\n	<li>Shake the bottle gently and remove the dust cover.</li>\r\n	<li>Hold the spray with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle. Press down until a fine spray appears. If using for the first time or if you have not used it for a week or more, press the nasal applicator several times until a fine moist comes out from the container.</li>\r\n	<li>Gently blow the nose to clear the nostrils.</li>\r\n	<li>Close one nostril and carefully insert the nasal applicator into the open nostril. Tilt your head forward slightly and keep the spray upright. Breathe in through your nose and while breathing in, press the white-collar of nasal applicator firmly down once to release a spray.</li>\r\n	<li>Breathe out through your mouth.</li>\r\n	<li>Repeat the above steps in the same/other nostril for consecutive doses.</li>\r\n</ul>\r\n\r\n<p>Cleaning: The nasal spray should be cleaned at least once a week. The procedures are as follows-</p>\r\n\r\n<ul>\r\n	<li>Remove the dust cover.</li>\r\n	<li>Gently pull off the nasal applicator.</li>\r\n	<li>Wash the applicator and dust cover in warm water.</li>\r\n	<li>Shake off the excess water and leave to dry in a normal place. Avoid to apply additional heat.</li>\r\n	<li>Gently push the applicator back on the top of the bottle and re-fix the dust cover.</li>\r\n</ul>', '<p>None is known.</p>', '<p>Contraindicated in patients with a history of hypersensitivity to any of its components. Infections of the nasal passages and paranasal sinuses should be appropriately treated but do not constitute a specific contraindication to treatment with Beclomethasone nasal spray.</p>', '<p>Rare instances of nasal septum perforation have been reported following intranasal administration. As with other nasal sprays, dryness and irritation of the nose and throat, unpleasant taste &amp; smell and epistaxis have been reported rarely. Rare instances of wheezing, cataracts, glaucoma and increased intra-ocular pressure have been reported following the intranasal use of Beclomethasone.</p>', '<p>Beclomethasone should be used during pregnancy, if the potential benefit justifies the potential risks to fetus. In addition, as there is natural increase in corticosteroid production during pregnancy, most women will require a lower exogenous corticosteroid dose and many will not need corticosteroid treatment during pregnancy. As other corticosteroids are excreted in human milk, caution should be exercised when Beclomethasone nasal spray is administered to a nursing woman.</p>', '<p>Infections of the nasal passages and paranasal sinuses should be appropriately treated but do not constitute a specific contraindication to treatment with Beclometasone nasal spray. Care must be taken while transferring patients from systemic steroid to Beclometasone Nasal spray if there is any reason to suppose that their adrenal function is impaired.</p>', '<p>Inhalation of excessive doses over a short time period may suppress hypothalamic pituitary adrenal&nbsp;(HPA) function, and no special emergency action need to be taken, rather treatment should be continued at recommended dose. HPA function recovers within one or two day</p>', '<p>Nasal Steroid Preparations</p>', '<p>Store at a temperature not exceeding 30˚ C. Protect from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:28:56', '2022-03-17 02:48:02'),
(154, 154, '<p>Formidable combination for Ear infections-</p>\r\n\r\n<ul>\r\n	<li>Safe and effective combination in otitis externa &amp; otitis media with the perforated ear.</li>\r\n	<li>Shows higher efficacy of Clotrimazole to treat Otomycosis.</li>\r\n	<li>Shows excellent pain reduction of lidocaine to treat acute otitis media.</li>\r\n</ul>', '<p>Beclometasone, Chloramphenicol, Clotrimazole &amp; Lidocaine which treats ear infections. Lidocaine is a local anesthetic which works by blocking pain signals from the nerves to brain thereby decreasing pain sensation. Beclometasone is a steroid medicine. It blocks the production of certain chemical messengers (prostaglandins) that make the ear red, swollen and itchy. Clotrimazole is an antifungal which stops the growth of fungi by preventing them from forming their own protective covering. Chloramphenicol is an antibiotic. It stops bacterial growth by preventing synthesis of essential proteins.</p>', '<p>Use 2 or 3 drops in the affected ear 2 to 3 times a day for 7 to 14 days</p>\r\n\r\n<ul>\r\n	<li>Otitis Externa: From 6 months &amp; older.</li>\r\n	<li>Otitis Media: From 12 years &amp; older.</li>\r\n</ul>', NULL, NULL, '<p>The following is a list of possible side effects that may occur from all constituting ingredients of Chloramphenicol Beclomethasone &amp; Clotrimazole Ear Drops. This is not a comprehensive list. These side effects are possible but do not always occur. Some of the side effects may be rare but serious. Consult your doctor if you observe any of the following side effects, especially if they do not go away.</p>\r\n\r\n<ul>\r\n	<li>Inflammation Of The Skin</li>\r\n	<li>Irritation</li>\r\n	<li>Itchy Rash</li>\r\n	<li>Blisters</li>\r\n	<li>Peeling Or Flaking Of The Skin</li>\r\n	<li>Discomfort.</li>\r\n</ul>', NULL, '<p>Before using this drug, inform your doctor about your current list of medications, over-the-counter products (e.g. vitamins, herbal supplements, etc.), allergies, pre-existing diseases, and current health conditions (e.g. pregnancy, upcoming surgery, etc.). Some health conditions may make you more susceptible to the side effects of the drug. Take as directed by your doctor or follow the direction printed on the product insert. Dosage is based on your condition. Tell your doctor if your condition persists or worsens. Important counseling points are listed below-</p>\r\n\r\n<ul>\r\n	<li>Apply to the affected area two or three times a day</li>\r\n	<li>Avoid repeated courses</li>\r\n	<li>Avoid situations in which bruising or injury may occur</li>\r\n	<li>Bacterial infection</li>\r\n	<li>Cataracts</li>\r\n	<li>Check blood sugar levels closely</li>\r\n</ul>', NULL, '<p>Anti-fungal or anti-bacterial ear drops</p>', '<p>Formidable combination for Ear infections-</p>\r\n\r\n<ul>\r\n	<li>Safe and effective combination in otitis externa &amp; otitis media with the perforated ear.</li>\r\n	<li>Shows higher efficacy of Clotrimazole to treat Otomycosis.</li>\r\n	<li>Shows excellent pain reduction of lidocaine to treat acute otitis media.</li>\r\n</ul>', NULL, '2022-02-15 05:29:30', '2022-03-21 01:19:56');
INSERT INTO `generic_details` (`id`, `generic_id`, `indications`, `pharmacology`, `dosage_and_administration`, `interaction`, `contraindications`, `side_effects`, `pregnancy_and_lactation`, `precautions_and_warnings`, `overdose_effects`, `therapeutic_class`, `storage_conditions`, `use_in_special_populations`, `created_at`, `updated_at`) VALUES
(155, 155, '<p>Bempedoic acid is an adenosine triphosphate-citrate lyase (ACL) inhibitor indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C.</p>', '<p>Bempedoic acid is an adenosine triphosphate-citrate lyase (ACL) inhibitor that lowers low-density lipoprotein cholesterol (LDL-C) by inhibition of cholesterol synthesis in the liver. ACL is an enzyme upstream of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase in the cholesterol biosynthesis pathway. Bempedoic acid and its active metabolite, ESP15228, require coenzyme A (CoA) activation by very long-chain acyl-CoA synthetase 1 (ACSVL1) to ETC-1002-CoA and ESP15228-CoA, respectively. ACSVL1 is expressed primarily in the liver. Inhibition of ACL by ETC-1002-CoA results in decreased cholesterol synthesis in the liver and lowers LDL-C in blood via upregulation of low-density lipoprotein receptors.</p>', '<p>The recommended dosage of Bempedoic acid, in combination with maximally tolerated statin therapy, is 180 mg administered orally once daily. Bempedoic acid can be taken with or without food. After initiation of Bempedoic acid, analyze lipid levels within 8 to 12 weeks.</p>', '<p>Simvastatin: Avoid concomitant use of Bempedoic Acid with simvastatin greater than 20 mg. Pravastatin: Avoid concomitant use of Bempedoic Acid with pravastatin greater than 40 mg.</p>', NULL, '<ul>\r\n	<li>Upper respiratory tract infection</li>\r\n	<li>Muscle spasms</li>\r\n	<li>Hyperuricemia</li>\r\n	<li>Back pain</li>\r\n	<li>Abdominal pain or discomfort</li>\r\n	<li>Bronchitis</li>\r\n	<li>Pain in extremity</li>\r\n	<li>Anemia</li>\r\n	<li>Elevated liver enzymes</li>\r\n</ul>', '<p>Discontinue Bempedoic Acid when pregnancy is recognized unless the benefits of therapy outweigh the potential risks to the fetus. There are no available data on Bempedoic Acid use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. There is no information regarding the presence of Bempedoic Acid in human or animal milk, the effects of the drug on the breastfed infant, or the effects of the drug on milk production. Breastfeeding is not recommended during treatment with Bempedoic Acid.</p>', '<p>Bempedoic acid inhibits renal tubular OAT2 and may increase blood uric acid levels. In clinical trials, 26% of Bempedoic acid-treated patients with normal baseline uric acid values (versus 9.5% placebo) experienced hyperuricemia one or more times, and 3.5% of patients experienced clinically significant hyperuricemia reported as an adverse reaction (versus 1.1% placebo). Increases in uric acid levels usually occurred within the first 4 weeks of treatment initiation and persisted throughout treatment. After 12 weeks of treatment, the mean placebo-adjusted increase in uric acid compared to baseline was 0.8 mg/dL for patients treated with Bempedoic acid.<br />\r\n<br />\r\nElevated blood uric acid may lead to the development of gout. Gout was reported in 1.5% of patients treated with Bempedoic acid and 0.4% of patients treated with placebo. The risk for gout events was higher in patients with a prior history of gout (11.2% Bempedoic acid versus 1.7% placebo), although gout also occurred more frequently than placebo in patients treated with Bempedoic acid who had no prior gout history (1.0% Bempedoic acid versus 0.3% placebo). Advise patients to contact their healthcare provider if symptoms of hyperuricemia occur. Assess serum uric acid when clinically indicated. Monitor patients for signs and symptoms of hyperuricemia, and initiate treatment with urate-lowering drugs as appropriate.<br />\r\n<br />\r\nTendon Rupture: Bempedoic acid is associated with an increased risk of tendon rupture or injury. In clinical trials, tendon rupture occurred in 0.5% of patients treated with Bempedoic acid versus 0% of placebo-treated patients and involved the rotator cuff (the shoulder), biceps tendon, or Achilles tendon. Tendon rupture occurred within weeks to months of starting Bempedoic acid. Tendon rupture may occur more frequently in patients over 60 years of age, in those taking corticosteroid or fluoroquinolone drugs, in patients with renal failure, and in patients with previous tendon disorders.<br />\r\n<br />\r\nDiscontinue Bempedoic acid immediately if the patient experiences rupture of a tendon. Consider discontinuing Bempedoic acid if the patient experiences joint pain, swelling, or inflammation. Advise patients to rest at the first sign of tendinitis or tendon rupture and to contact their healthcare provider if tendinitis or tendon rupture symptoms occur. Consider alternative therapy in patients with a history of tendon disorders or tendon rupture.</p>', NULL, NULL, '<p>Bempedoic acid is an adenosine triphosphate-citrate lyase (ACL) inhibitor indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C.</p>', '<p><strong>Pediatric Use</strong>: The safety and effectiveness of Bempedoic acid have not been established in pediatric patients.<br />\r\n<br />\r\n<strong>Geriatric Use</strong>: Of the 3009 patients in clinical trials of Bempedoic acid, 1753 (58%) were 65 years and older, while 478 (16%) were 75 years and older. No overall differences in safety or effectiveness were observed between these patients and younger patients, and other reported clinical experience has not identified differences in responses between the elderly and younger patients. However, greater sensitivity of some older individuals cannot be ruled out.<br />\r\n<br />\r\n<strong>Renal Impairment</strong>: No dosage adjustment is necessary in patients with mild or moderate renal impairment. There is limited experience with Bempedoic acid in patients with severe renal impairment (eGFR &lt; 30 mL/min/1.73 m 2 ), and Bempedoic acid has not been studied in patients with end-stage renal disease (ESRD) receiving dialysis.<br />\r\n<br />\r\n<strong>Hepatic Impairment</strong>: No dosage adjustment is necessary in patients with mild or moderate hepatic impairment (Child-Pugh A or B. Patients with severe hepatic impairment (Child-Pugh C) have not been studied.</p>', '2022-02-15 05:30:04', '2022-03-21 01:20:17'),
(156, 156, '<p>Higher concentrations of Benzalkonium chloride is used as an antiseptic and disinfectant. This is also widely used as a preservative in eye-drops.</p>', '<p>Benzalkonium chloride is a quaternary ammonium antiseptic and disinfectant. It is also used as an antimicrobial preservative for pharmaceutical products. It is also used for the disinfection of rigid contact lenses.</p>', '<ul>\r\n	<li>Tincture of benzalkonium chloride 1:750 is used for the preoperative disinfection of unbroken skin or treatment of superficial injuries.</li>\r\n	<li>For preoperative disinfection of mucous membranes and denuded skin, benzalkonium chloride solution in concentrations of 1:10000 to 1:2000 is used.</li>\r\n	<li>For irrigation of the eye, a solution of 1:10000 to 1:5000 is used.</li>\r\n	<li>For urinary bladder and urethral irrigation, a solution 1:5000 to 1:20000 is used.</li>\r\n	<li>For vaginal douche and irrigation, benzalkonium chloride solution 1:5000 to 1:20000.</li>\r\n</ul>', '<p>Disinfectants containing quaternary ammonium salts should not be used for skin preparation before injections of viscoelastic solutions. Hyaluronic acid will precipitate in the presence of these salts.</p>', '<p>Incompatible with soaps and other anionic surfactants, citrates, iodides, nitrates, permanganates, salicylates, silver salts, tartrates, and zinc oxide and sulfate.</p>', NULL, NULL, NULL, NULL, '<p>Bleaching and Disinfectants</p>\r\n\r\n<p>&nbsp;</p>', '<p>Higher concentrations of Benzalkonium chloride is used as an antiseptic and disinfectant. This is also widely used as a preservative in eye-drops.</p>', NULL, '2022-02-15 05:30:26', '2022-03-21 01:20:39'),
(157, 157, '<p>Benzathine Penicillin is indicated in-</p>\r\n\r\n<ul>\r\n	<li>The treatment of penicillin-sensitive infections where initial high blood levels are not required.</li>\r\n	<li>The prophylaxis of penicillin-sensitive secondary infections especially in children. It is particularly valuable in continuous prophylaxis against rheumatic fever and streptococcal infections.</li>\r\n	<li>Prophylaxis of streptococcal impetigo</li>\r\n	<li>Treatment of acute otitis media</li>\r\n	<li>Treatment of syphilis</li>\r\n	<li>Treatment of diphtheria carriers</li>\r\n</ul>', '<p>Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.</p>', '<p><strong>Treatment of infection</strong>: 0.3 to 1.2 million units repeated every five to seven days.<br />\r\n<br />\r\n<strong>Prophylaxis of rheumatic fever</strong>: 1.2 million units every three weeks.<br />\r\n<br />\r\n<strong>Specific dosage schedule</strong>:&nbsp;Treatment of group-A &beta;-haemolytic streptococcal infections: A single intramuscular dose of 600,000 units.<br />\r\n<br />\r\n<strong>Prevention of rheumatic fever</strong>: Monthly injection of a single dose of 1.2 million units is the most effective regimen for preventing further attacks of rheumatic fever.<br />\r\n<br />\r\n<strong>Treatment of acute otitis media</strong>: A single injection of 6 million units.</p>\r\n\r\n<ul>\r\n	<li><strong>Early syphilis</strong>- 2.4 million units as a single dose.</li>\r\n	<li><strong>Late syphilis:</strong>&nbsp;2.4 million units weekly for three successive weeks.</li>\r\n	<li><strong>Neurosyphilis:</strong>&nbsp;Benzylpenicillin, intravenously, 2 to 4 million units every 4 hours for 10 days, followed by benzathine penicillin intramuscularly, 2.4 million units weekly for three successive weeks.</li>\r\n	<li><strong>Congenital syphilis</strong>: Asymptomatic infants with normal cerebrospinal fluid, intramuscularly 50,000 units per kg in a single dose.</li>\r\n</ul>\r\n\r\n<p>Primary and secondary syphilis have been treated with single injections of 2.4 million units of long acting benzathine penicillin (Benzapen) weekly for 2 to 4 weeks with satisfactory results.</p>', '<p>No potentially hazardous interactions have been described.</p>', '<p>Hypersensitivity to penicillins</p>', '<p>The toxicity of penicillins is generally low, but in a small number of patients penicillin can cause sensitization and allergic reactions. Acute, lifethreatening anaphylactic reactions are rare, but they do occur.<br />\r\n<br />\r\nIntramuscular injection of benzathine penicillin can cause moderate burning discomfort, local pain, and deep muscle soreness and tenderness at the site of injection, lasting for one to three days in about 10% of patients. Some patients had low-grade fever (102˚F) associated with local pain and tenderness. This febrile reaction disappeared within 24 to 48 hours.</p>', '<p>Pregnancy category B. Benzathine Penicillin should not be administered during pregnancy unless in the judgment of the physician such administration is clinically justifiable. Special care should be taken in the first three months of pregnancy.<br />\r\n<br />\r\nAs penicillin appears in breast milk, it is probably best for a mother to stop breast-feeding while being given penicillin to avoid exposing the infant to the drug unnecessarily.</p>', '<p>Patient with previous hypersensitivity reactions to cephalosporins, history of allergy, asthma, seizure disorder. Not intended for IV or intra-arterial admin or inj near major peripheral nerves of blood vessels. Prolonged use may result in bacterial or fungal superinfection. Renal impairment.</p>', NULL, '<p>Long acting penicillin</p>', '<p>Store between 2-8&deg;C. Do not freeze.</p>', NULL, '2022-02-15 05:30:51', '2022-03-21 01:26:16'),
(158, 158, '<p>For the temporary relief of pain due to minor injury or irritation of the mouth and gums like Toothache, Sore gums, Canker sores, Braces, Minor dental procedures, Dentures</p>', '<p>Benzocaine, an ester local anaesthetic, blocks the initiation and conduction of nerve impulses by decreasing the neuronal membrane&rsquo;s permeability to Na ions, which results in inhibition of depolarisation with resultant blockade of conduction.</p>', '<p>Apply to the affected area up to 4 times daily or as directed by a doctor/dentist. Children under 12 years of age should be supervised during the use of this product. Children under 2 years of age should be consulted to a doctor/dentist prior to the use of this product. An easy application might be done by fixing applicator on the tube&rsquo;s nozzle. After application, supplied cap should be fixed on top of the applicator.</p>', '<p>May antagonise the therapeutic effect of sulfonamides. Anticholinesterases may inhibit the metabolism benzocaine.</p>', '<p>Epiglottis (oral spray), methaemoglobinaemia.</p>', '<p>Side effects are less common. The side effects include allergies, swelling in the mouth or throatetc.</p>', '<p>Pregnancy&nbsp;Category C. Either studies in animals have revealed adverse effects on the fetus (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 fetus.</p>', '<p>Patient with asthma, bronchitis, emphysema, heart disease; smokers. Children, Pregnancy and lactation.</p>', '<p><strong>Symptom</strong>: Methaemoglobinaemia, manifested by cyanotic (greyish) skin discolouration, unusual breathing or breathlessness.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment. IV methylene blue 1% may be administered.</p>', '<p>Local &amp; Surface anesthesia</p>', '<p>Store between 15-30&deg; C.</p>', NULL, '2022-02-15 05:31:09', '2022-03-21 01:29:40'),
(159, 159, '<p>This is a topical anesthetic indicated for the production of anesthesia of all accessible mucous membrane except the eyes. This reparation is indicated to control pain and for use for surgical or endoscopic or other procedures in the ear, nose, mouth, pharynx, larynx, trachea, bronchi and esophagus. It may also be used for vaginal or rectal procedures when feasible.</p>', '<p>The onset of this topical gel-produced anesthesia is rapid (approximately 30 seconds) and the duration of anesthesia is typically 30-60 minutes, when used as directed. This effect is due to the rapid onset, but short duration of action of Benzocaine coupled with the slow onset, but extended duration of Tetracaine HCI and bridged by the intermediate action of Butamben. It is believed that all of these agents act by reversibly blocking nerve conduction. Speed and duration of action is determined by the ability of the agent to be absorbed by the mucous membrane. It will be excreted in the urine after metabolism.</p>', '<p>Dispense and apply 200 mg of gel (a bead approximately &frac14; to &frac12; inches long) by gently squeezing the tube. Application of gel in excess of 400 mg is contraindicated. Spread thinly and evenly over the desired area using a cotton swab. An appropriate pediatric dosage has not been established for this topical gel. Dosages should be reduced in the debilitated elderly, acutely ill, and very young patients Tissue need not be dried prior to application of this topical gel. It should be applied directly to the site where pain control is required. Anesthesia is produced within one minute with an approximate duration of thirty minutes.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: Safety and effectiveness of this gel in pediatric patients have not been established.</p>', NULL, '<p>This topical gel is not suitable and should never be used for injection. Do not use on the eyes. To avoid excessive systemic absorption, this topical gel should not be applied to large areas of denuded or inflamed tissue. This topical gel should not be administered to patients who are hypersensitive to any of its ingredients or to patients known to have cholinesterase deficiencies. Tolerance may vary with the status of the patient. This topical gel should not be used under dentures or cotton rolls, as retention of the active ingredients under a denture or cotton roll could possibly cause an escharotic effect. Routine precaution for the use of any topical anesthetic should be observed when using this topical gel.</p>', '<p>Hypersensitivity Reactions: Unpredictable adverse reactions (i.e. hypersensitivity, including anaphylaxis) are extremely rare. Localized allergic reactions may occur after prolonged or repeated use of any aminobenzoate anesthetic. The most common adverse reaction caused by local anesthetics is contact dermatitis characterized by erythema and pruritus that may progress to vesiculation and oozing. This occurs most commonly in patients following prolonged self-medication, which is contraindicated. If rash, urticaria, edema, or other manifestations of allergy develop during use, the drug should be discontinued. To minimize the possibility of a serious allergic reaction, this topical gel preparations should not be applied for prolonged periods except under continual supervision. Dehydration of the epithelium or an escharotic effect may also result from prolonged contact.</p>', '<p>Safe use of this gel has not been established with respect to possible adverse effects upon fetal development. Therefore, this gel should not be used during early pregnancy, unless in the judgement of a physician, the potential benefits outweigh the unknown hazards. Routine precaution for the use of any topical anesthetic should be observed when this gel is used.</p>', '<p>On rare occasions, methemoglobinemia has been reported in connection with the use of benzocaine-containing products. Care should be used not to exceed the maximum recommended dosage. If a patient becomes cyanotic, treat appropriately to counteract (such as with methylene blue, if medically indicated).</p>', NULL, '<p>Topical Local Anesthetics</p>', '<p>Store in a cool and dry place, protect from light. Keep out of reach of children.</p>', NULL, '2022-02-15 05:31:23', '2022-03-21 01:32:24'),
(160, 160, '<p>This is indicated in sore throat, toothaches, gum pain, canker sores</p>', '<p><strong>Benzocaine</strong>&nbsp;binds to sodium channels and reversibly stabilizes the neuronal membrane which decreases its permeability to sodium ions. Depolarization of the neuronal membrane is inhibited thereby blocking the initiation and conduction of nerve impulses.<br />\r\n<br />\r\n<strong>Camphor</strong>&nbsp;is a naturally occurring compound that is used as a major active ingredient of balms and liniments supplied as topical analgesics. Despite its long history of common medical use, the underlying molecular mechanism of camphor action is not understood.<br />\r\n<br />\r\n<strong>Menthol</strong>&nbsp;is topically applied agents widely used for similar purposes, are known to excite and desensitize sensory nerves by acting on two members of transient receptor potential (TRP) channel superfamily: heat-sensitive TRP vanilloid subtype 1 (TRPV1) and cold-sensitive TRP channel M8, respectively.<br />\r\n<br />\r\n<strong>Phenol</strong>&nbsp;is a potent proteolytic agent. Concentrations in the 5% to 7% range dissolve tissue on contact via proteolysis. In high concentrations when injected next to a nerve, phenol produces a chemical neurolysis which is nonselective across nerve fiber size and most prominent on its outer aspect. Local anesthetic effects occur within 5-10 minutes.</p>', '<p><strong>Adults</strong>: apply to the affected area not more than 3 to 4 times daily<br />\r\n<br />\r\n<strong>Children 2 years of age and older</strong>: apply to the affected area not more than 3 to 4 times daily.<br />\r\n<br />\r\n<strong>Children under 12 years of age</strong>: adult supervision should be given in the use of this product</p>', '<p>There are no known drug interactions and none well documented.</p>', '<p>Do not use this product if you have a history of allergy to local anesthetics such as procaine, butacaine, benzocaine, or other &quot;caine&quot; anesthetics.</p>', '<p>Benzocaine are more likely to cause contact sensitization. Slight burning, tingling, or stinging may occur.</p>', '<p>Pregnancy Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Do not use over deep or puncture wounds, infections, or lacerations. Do not use for more than 7 days. When using this product avoid contact with the eyes, do not exceed recommended dosage. Keep out of reach of children.</p>', NULL, '<p>Topical Local Anesthetics</p>', NULL, NULL, '2022-02-15 05:31:43', '2022-03-21 01:35:06'),
(161, 161, '<p>Benzoic Acid &amp; Salicylic Acid is indicated for fungal infections, athlete&#39;s foot, barber&#39;s itch.</p>', '<p><strong>Benzoic acid:</strong>&nbsp;Elicits weak antifungal and antibacterial properties; also helps acidify urine.<br />\r\n<br />\r\n<strong>Salicylic acid:&nbsp;</strong>It has a potent keratolytic action and a slight antiseptic action when applied topically. It softens and destroys the stratum corneum by increasing endogenous hydration which causes the horny layer of the skin to swell, soften, and then desquamate. At high concentrations, salicylic acid has a caustic effect. It also possesses weak antifungal and antibacterial activity.</p>', '<p>Apply locally on the affected area 2-3 times per day.</p>', '<p>It is not known if this interacts with other topical medications applied to the treatment area. The use of this drug with other topical drugs has not been studied.</p>', '<p>Hypersensitivity.</p>', '<p>Irritation, sensitivity, excessive drying; systemic effects on prolonged use.</p>', '<p>Pregnancy Category-C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks</p>', '<p>Not for prolonged use in high concentrations and on large areas of the body. Avoid broken skin, mouth, eyes, mucous membranes and anogenital region.</p>', NULL, '<p>Other Antifungal preparations</p>', NULL, NULL, '2022-02-15 05:32:18', '2022-03-21 01:38:19'),
(162, 162, '<p>Topical therapy for the treatment of acne vulgaris.</p>', '<p>Benzoyl peroxide has mild keratolytic effect and antimicrobial activity due to release of free-radical oxygen which oxidizes bacterial protein. It is active against Staphylococcus epidermidis and Propionibacterium acnes.</p>', '<p><strong>Adult:</strong>&nbsp;As 2.5-10% preparation: Apply 1-2 times daily after cleansing, may gradually increase to tid if needed. Start with lower strength preparations. As cleanser: Wash 1-2 times daily.<br />\r\n<strong>Child:</strong>&nbsp;&ge;12 yr Same as adult dose.</p>', '<p>There is no known interaction with other medications which might be used cutaneously and concurrently with Benzoyl Peroxide; however, drugs with desquamative, irritant and drying effects should not be used concurrently with Benzoyl Peroxide gel.</p>', '<p>Benzoyl Peroxide gel is contra-indicated in patients with known hypersensitivity to Benzoyl Peroxide.</p>', '<p>The major adverse reaction reported to date with Benzoyl Peroxide cutaneous therapy is irritation of the skin including erythema, burning, peeling, dryness, itching, stinging, feeling of skin tension locally at the site of application. This is reversible when treatment is reduced in frequency or discontinued. Allergic contact dermatitis, including face oedema, may occur.</p>', '<p><strong>Pregnancy&nbsp;Category C.</strong>&nbsp;Either studies in animals have revealed adverse effects on the fetus (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 fetus.</p>', '<p>Children, Pregnancy and lactation.</p>', '<p>Benzoyl Peroxide gel is a preparation indicated for topical treatment only. If the medication is applied excessively, no more rapid or better results will be obtained and severe irritation might develop. In this event, treatment must be discontinued and appropriate symptomatic therapy should be instituted.</p>', '<p>Acne treatment preparations</p>', '<p>Store in a cool and dry place, protected from light.</p>', NULL, '2022-02-15 05:32:36', '2022-03-21 01:41:59'),
(163, 163, '<p>Benzydamine Hydrochloride mouthwash is used to treat many painful conditions affecting the throat or mouth including: Sore throat, Sore tongue or gums, Mouth ulcers, Discomfort caused by dentures, Pain after dental surgery etc.</p>', '<p>Benzydamine Hydrochloride mouthwash is a Non-Steroidal Anti-Inflammatory Drug (NSAID) with analgesic and local anesthetic properties. The clinical pharmacology of Benzydamine mouthwash is well known. Benzydamine is poorly absorbed in the blood, thereby limiting systemic exposure to the drug when applied topically but ensures high concentration at the site of injury in mouth or throat. Therefore, it provides excellent oropharyngeal pain relief with minimal side effects.<br />\r\n<br />\r\nAlthough Benzydamine is a Non-Steroidal Anti-Inflammatory agent, it possesses a different mechanism of action that distinguishes it from conventional NSAIDs. Benzydamine mouthwash shows analgesic &amp; anti-inflammatory action by inhibiting pro-inflammatory cytokines &amp; reducing vascular permeability. Moreover, Benzydamine mouthwash shows local anesthetic property which provides an immediate effect on pain.</p>', '<p>15 ml of Benzydamine mouthwash should be rinsed or gargled every 1.5-3 hours or as required, for 20-30 seconds. If stinging occurs, it can be diluted with an equal volume of water.</p>', '<p>Patients allergic (hypersensitive) to Benzydamine or other component of mouthwash should not use the preparation. Contact with eye should be avoided. If accidentally get into eyes, they should be immediately washed with cold water.</p>', '<p>Benzydamine Hydrochloride mouthwash can cause side effects, although not everybody gets them. Side effects are generally minor.</p>\r\n\r\n<ul>\r\n	<li>Severe allergic reaction which may include a red and lumpy skin rash, difficulty breathing, swelling of face, mouth, lips or eyelids, unexplained high temperature (fever) and feeling faint. If the swelling affects throat and makes breathing difficult and swallowing difficult, patients should be hospitalized</li>\r\n	<li>Itchy rash, sometimes with pale, raised areas of skin with red edges (urticaria).</li>\r\n	<li>A feeling of numbness in mouth.</li>\r\n	<li>A stinging feeling in mouth- the mouthwash may be diluted with water if you experience stinging. This should help to reduce the stinging effect.</li>\r\n</ul>', NULL, '<p>The safety of Benzydamine has not been established in pregnant patients. Risk to benefit ratio should be established if this drug is to be used in these patients.</p>', NULL, NULL, '<p>Topical anti-inflammatory preparations</p>', '<p>Keep away from light, store in cool and dry place under 30&ordm; C. Keep out of reach of children.</p>', NULL, '2022-02-15 05:33:05', '2022-03-21 01:46:17'),
(164, 164, '<p>Benzyl alcohol lotion is indicated for the topical treatment of head lice infestation in patients 6 months of age and older. Benzyl alcohol Lotion does not have ovicidal activity.</p>', '<p>Benzyl alcohol inhibits lice from closing their respiratory spiracles, allowing the vehicle to obstruct the spiracles and causing the lice to asphyxiate.</p>', '<p><strong>Adult</strong>:&nbsp;<br />\r\nApply lotion to dry hair, using enough to completely saturate hair &amp; scalp, rinse off with water after 10 minutes. Repeat treatment in 7 days<br />\r\n<br />\r\nAmount of Lotion Needed to Cover Scalp and Hair Completely</p>\r\n\r\n<ul>\r\n	<li><strong>Hair length 0-2 inches</strong>: 4-6 ounces</li>\r\n	<li><strong>Hair length 2-4 inches</strong>: 6-8 ounces</li>\r\n	<li><strong>Hair length 4-8 inches</strong>: 8-12 ounces</li>\r\n	<li><strong>Hair length 8-16 inches</strong>: 12-24 ounces</li>\r\n	<li><strong>Hair length 16-22 inches</strong>: 24-32 ounces</li>\r\n	<li><strong>Hair length &gt;22 inches</strong>: 32-48 ounces</li>\r\n</ul>\r\n\r\n<p><strong>Child</strong>:&nbsp;</p>\r\n\r\n<ul>\r\n	<li><strong>&lt;6 months</strong>: Do not use</li>\r\n	<li><strong>&gt;6 months</strong>: Apply lotion to dry hair, using enough to completely saturate hair &amp; scalp, rinse off with water after 10 minutes; repeat treatment in 7 days</li>\r\n</ul>', '<p>No formal drug interaction studies to date.</p>', '<p>Hypersensitivity to any of the active ingredients.</p>', '<p>Generally well tolerated. However, a few allergic reactions may be seen. Irritation, itching, redness, tingling, or numbness at the application site may occur. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.</p>', '<p><strong>Pregnancy</strong>&nbsp;Category B. Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.<br />\r\n<br />\r\n<strong>Lactation</strong>: Excretion in milk unknown; use with caution</p>', '<p>Constant or forceful scratching of the skin/scalp may lead to a bacterial skin infection.</p>', NULL, '<p>Other scalp preparations</p>', NULL, NULL, '2022-02-15 05:33:22', '2022-03-21 01:49:08'),
(165, 165, '<p>Benzyl Benzoate is indicated for scabies</p>', '<p>Benzyl benzoate is an acaricide that is used in the treatment of scabies.&nbsp;Benzyl benzoate exerts toxic effects on the nervous system of the parasite, resulting in its death. It is also toxic to mite ova, though its exact mechanism of action is unknown. In vitro, benzyl benzoate has been found to kill the Sarcoptes mite within 5 minutes.</p>', '<p><strong>Adult:</strong>&nbsp;Apply 3 times at 12 hourly intervals over the whole body, wash-off 12 hr after the last application.</p>', '<p>Irritant to eyes and mucous membranes, allergic dermatitis reactions, drying effects in the elderly.</p>', '<p>Broken or irritated skin; neonates; pregnancy.</p>', '<p>Irritant to eyes and mucous membranes, allergic dermatitis reactions, drying effects in the elderly.</p>', '<p>Pregnancy Category: Not Classified. FDA has not yet classified the drug into a specified pregnancy category.</p>', '<p>Prevent drug from entering the eyes, elderly (drying effects).</p>', NULL, '<p>Parasiticidal preparations, Topical Antifungal preparations</p>', '<p>Store below 25&deg;C.</p>', NULL, '2022-02-15 05:33:45', '2022-03-21 01:52:14'),
(166, 166, '<p>For use in the treatment of severe infections caused by penicillin G-susceptible microorganisms when rapid and high penicillin levels are required such as in the treatment of septicemia, meningitis, pericarditis, endocarditis and severe pneumonia.</p>', '<p>Benzylpenicillin has a bactericidal action against gram positive&nbsp;bacteria, gram negative&nbsp;cocci, some other gram negative cross-linking stage of peptidoglycan production through binding and inactivation of transpeptidases on the inner surface of the bacterial cell membrane thus inhibiting bacterial cell wall synthesis. It is inhibited by penicillinase and other &beta;-lactamases.</p>', '<p><strong>Adult:</strong><br />\r\n<br />\r\n<strong>Oral</strong>: Susceptible infections: 125-312 mg 4-6 hrly.<br />\r\n<strong>IM/IV</strong>: Susceptible infections: 0.6-3.6 g/day in 4-6 divided doses.<br />\r\n<strong>IV</strong>:</p>\r\n\r\n<ul>\r\n	<li>Bacterial endocarditis: 7.2-12 g/day in divided doses.</li>\r\n	<li>Intrapartum prophylaxis against group B Streptoccocal infection in neonates Initial: 3 g, followed by 1.5 g 4 hrly until delivery.</li>\r\n	<li>Meningococcal meningitis; Pneumococcal meningitis: 2.4 g 4 hrly. Max: 18 g/day in meningococcal meningitis.</li>\r\n</ul>\r\n\r\n<p><br />\r\n<strong>Child:</strong><br />\r\n<br />\r\n<strong>IV</strong>: Meningococcal meningitis, Pneumococcal meningitis:&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Newborn infants: 100 mg/kg daily in 2 divided doses;</li>\r\n	<li>1-4 wk: 150 mg/kg daily in 3 divided doses;</li>\r\n	<li>&gt;1 mth to 12 yr: 180-300 mg/kg daily in 4-6 divided doses.</li>\r\n</ul>\r\n\r\n<p><strong>Parenteral</strong>: susceptible infections:&nbsp;</p>\r\n\r\n<ul>\r\n	<li>Newborn infants: 50 mg/kg daily in 2 divided doses;</li>\r\n	<li>1-4 wk: 75 mg/kg daily in 3 divided doses;</li>\r\n	<li>&gt;1 mth to 12 yr: 100 mg/kg daily in divided doses, not exceeding 4 g/day.</li>\r\n</ul>\r\n\r\n<p>&nbsp;</p>\r\n\r\n<p><strong>Administration</strong></p>\r\n\r\n<p>Should be taken on an empty stomach. Take with a full glass of water on an empty stomach 1 hr before or 2 hr after meals. Do not take acidic beverages within 1 hr of a dose.</p>', '<p>May increase the risk of methotrexate toxicity. Increased plasma concentration with probenecid. Antagonism of bactericidal effect with bacteriostatic antibacterials (e.g. erythromycin, tetracyclines).</p>', '<p>Hypersensitivity to benzylpenicillin and other penicillins.</p>', '<p>Nausea, vomiting, stomatitis, black or hairy tongue, rash, fever, serum-like sickness, convulsions, interstitial nephritis, haemolytic anaemia, granulocytopenia, agranulocytosis, leucopenia, thrombocytopenia</p>', '<p><strong>Pregnancy</strong>&nbsp;category B. Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect that was not confirmed in controlled studies in women in the 1st trimester.<br />\r\n<br />\r\n<strong>Lactation</strong>: Monitor electrolyte, hepatic, renal, cardiac and haematologic function; signs and symptoms of anaphylaxis during 1st dose.</p>', '<p>Patient with history of allergy esp &beta;-lactam allergy and/or asthma, seizure disorder. Diabetic patients. Renal impairment. Pregnancy and lactation.</p>', '<p><strong>Symptoms</strong>: Agitation, confusion, asterixis, hallucinations, stupor, coma, multifocal myoclonus, seizures and encephalopathy, hyperkalaemia.<br />\r\n<br />\r\n<strong>Management</strong>: Symptomatic and supportive treatment.</p>', '<p>Benzylpenicillin &amp; Phenoxymethyl penicillin</p>', '<p>Store between 20-25&deg;C. Reconstituted soln: Store between 2-8&deg;C.</p>', NULL, '2022-02-15 05:34:06', '2022-03-21 01:55:58'),
(167, 167, '<p>Bepotastine Besilate is indicated for the treatment of itching associated with signs and symptoms of allergic conjunctivitis.</p>', '<p>Bepotastine is direct H1-receptor antagonist and an inhibitor of the release of histamine from mast cells.</p>', '<p>The recommended dose is 1 drop into the affected eye(s) twice a day. Safety and effectiveness in children below the age of 2 years have not been established.</p>', '<p>No drug interactions observed but patients who are sensitive to this product molecule should be used with caution.</p>', '<p>Contraindicated in patients with a history of hypersensitivity reactions to Bepotastine Besilate or any of the other ingredients of this product.</p>', '<p>The most common reported side effect occurring in approximately 25% of subjects was a mild taste following instillation. Other side effects occurring in 2-5% of subjects were eye irritation, headache, and nasopharyngitis.</p>', '<p>Pregnancy&nbsp;Category C. There are no adequate and well controlled studies in pregnant women. It should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the fetus.<br />\r\n<br />\r\nLactation: It is not known if Bepotastine Besilate is excreted in human milk. Caution should be exercised when it is administered to a nursing woman.</p>', '<p>To minimize the risk of contamination, do not touch dropper tip to any surface. It should not be used to treat contact lens-related irritation. Patients should be advised not to wear contact lens when using this drop.</p>', '<p>If you use more Bepotastine Besilate eye drops than you should, rinse your eye with warm water. Do not put in any more drops until it is time for your next regular dose. Pharmaceutical Precautions</p>', '<p>Ophthalmic Anti-allergic preparations</p>', '<p>Store in a cool, dry place &amp; protected from light. Keep out of reach of children. Do not use more than 4 weeks after opening.</p>', NULL, '2022-02-15 05:34:25', '2022-03-21 01:58:56'),
(168, 168, '<p>Besifloxacin ophthalmic suspension is indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of the following bacteria:</p>\r\n\r\n<ul>\r\n	<li>Corynebacterium pseudodiphtheriticum</li>\r\n	<li>Corynebacterium striatum</li>\r\n	<li>Haemophilus influenzae</li>\r\n	<li>Moraxella lacunata</li>\r\n	<li>Staphylococcus aureus</li>\r\n	<li>Staphylococcus epidermidis</li>\r\n	<li>Staphylococcus hominis</li>\r\n	<li>Staphylococcus lugdunensis</li>\r\n	<li>Streptococcus mitis group</li>\r\n	<li>Streptococcus oralis</li>\r\n	<li>Streptococcus pneumoniae</li>\r\n	<li>Streptococcus salivarius</li>\r\n</ul>\r\n\r\n<p>Efficacy for this organism was studied in fewer than 10 infections.</p>', '<p>Besifloxacin acts against Gram positive and Gram negative bacteria due to the inhibition of both bacterial DNA gyrase and topoisomerase IV. DNA gyrase is an essential enzyme required for replication, transcription and repair of bacterial DNA. Topoisomerase IV is an essential enzyme required for partitioning of the chromosomal DNA during bacterial cell division.</p>', '<p><strong>Adults and children (1 year of age and older)</strong>: Instill one drop in the affected eye(s) 3 times a day for 7 days.<br />\r\n<br />\r\n<strong>Pediatric Use</strong>: The safety and effectiveness of Besifloxacin in infants below one year of age have not been established.</p>', '<p>No such information found. Topical ophthalmic use only</p>', '<p>Hypersensitivity to the active ingredient or any component of this formulation.</p>', '<p>The most frequently reported ocular adverse event was conjunctival redness, reported in approximately 2% of patients. Other adverse events reported in patients receiving Besifloxacin occurring in approximately 1-2% of patients included: blurred vision, eye pain, eye irritation, eye pruritus and headache.</p>', '<p><strong>Pregnancy&nbsp;</strong>Category C. No adequate and well-controlled studies are established in pregnant women. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.<br />\r\n<br />\r\n<strong>Lactation</strong>: It is not known whether Besifloxacin is secreted in human milk or not. Caution should be exercised when Besifloxacin is administered to a nursing mother.</p>', '<p>This drug is for topical ophthalmic use only and should not be injected subconjunctivally, nor should it be introduced directly into the anterior chamber of the eye. As with other anti-infectives, prolonged use may result in overgrowth of non-susceptible organisms, including fungi. If superinfection occurs, discontinue use and institute alternative therapy. To prevent contamination do not touch the tip of the dropper to eye, eyelid or any surface of the affected eye. Patients should not wear contact lenses during the course of therapy with this drug. Shake well before use.</p>', '<p>No data are available regarding the over dose of Besifloxacin.</p>', '<p>Ophthalmic antibacterial drugs</p>', '<p>Store in a cool, dry place and protected from light. Keep out of the reach of children. Discard the container 4 weeks after opening.</p>', NULL, '2022-02-15 05:34:51', '2022-03-21 02:10:02'),
(169, 169, '<p>Antioxidant vitamins are used in a wide range of conditions where free radical damage is playing a role. Antioxidant vitamin combination is used in the prevention of coronary heart diseases, certain types of cancer, aging as well as free radical damage caused by excessive exercise, illness, certain medications, air pollution, smoke, radiation and pesticides. The main role of the antioxidant vitamins is as follows:<br />\r\n<br />\r\n&beta; carotene prevents free radical formation by quenching singlet oxygen, a highly reactive form of oxygen. Vitamin C is another free radical scavenger which deactivates free radicals. It works specially in the plasma, lung fluid, aqueous humour and interstitial fluid. It can increase white blood cell activity; play important roles in the biochemistry of antibodies, prostaglandin E 1 , B and T lymphocytes, and interferon. Vitamin E also scavenges free radicals in the blood along with &beta; carotene and vitamin C. Moreover, vitamin E is essential to protect against some of the ill effects of smog and smoke. In relation to other nutrients vitamin E protects vitamin A from being destroyed in the body.</p>', '<p><strong>Beta carotene</strong>&nbsp;of this&nbsp;tablet is converted to vitamin A (Retinol) when required. Retinol has several biochemical functions e.g. on retina, growth, tissue differentiation, immunological response. It has also some anti-cancer activity.<br />\r\n<br />\r\n<strong>Vitamin C</strong>&nbsp;is the most powerful reducing agent known to be present in living tissues. Vitamin C deficiency produces scurvy. It is a cofactor in numerous biological processes. Vitamin C and molecular oxygen are essential for the conversion of proline to hydroxyproline, dopamine to noradrenaline . Vitamin C is also essential for the synthesis of adrenal steroid hormones. Vitamin C is important in the defense against infection and studies shown that vitamin C is important for the normal functioning of T-lymphocyte and leukocyte. Ascorbic acid has some antiinflammatory activity and protects cells against oxidation of essential molecules. In high doses, (1-2 g daily) ascorbic acid increases iron absorption.<br />\r\n<br />\r\n<strong>vitamin E</strong>&nbsp;seems to be as a defense against oxidative stress and lipid peroxidation. In most cell membranes there is one molecule of tocopherol for every 1000 lipid molecules. Tocopherol mops up peroxide radicals and then needs a supply of reduced hydrogen to restore the steady-state situation. This is usually supplied by ascorbic acid or reduced glutathione.</p>', '<p>This tablet is administered orally. The adult dose of this combination of antioxidant vitamin tablet is 1 tablet daily or as prescribed by the physician.</p>', '<p>Cholestyramine, Colestipol, Neomycin cause decreased absorption of &beta; carotene. Circulating vitamin C levels have been shown to be reduced during prolonged administration of oral contraceptives containing Oestrogen, Tetracycline and Aspirin. The decrease in vitamin C level may be due to drug induced impaired absorption or increased utilization of the vitamin for drug metabolism. Vitamin E may enhance the anticoagulant activity of anticoagulant drugs. High doses of vitamin E can impair intestinal absorption of vitamins A and K.</p>', '<p>Carocet is contraindicated in patients with hypersensitivity to any of its components.</p>', '<p><strong>&beta; carotene</strong>&nbsp;is comparatively safe even at high and prolonged exposure. Individuals who routinely ingest large amounts of carotenoids can develop hypercarotenosis, which is characterised by a yellowish colouration of the skin and a very high concentration of carotenoids in the plasma. This benign condition, although resembling jaundice, gradually disappears upon correcting the excessive intake of carotenoids.<br />\r\n<br />\r\n<strong>Vitamin C</strong>&nbsp;is generally a safe drug for human use in normal doses. Larger doses may lead to gastrointestinal tract upset and renal stone formation.<br />\r\n<br />\r\n<strong>Vitamin E</strong>&nbsp;is considered safe even in large doses. Doses over 800 mg may cause diarrhoea, abdominal pain or cramps, fatigue and reduced resistance to bacterial infection and transiently raised blood pressure.</p>', '<p>&beta; carotene, vitamin C and vitamin E have no teratogenic effects in humans. However, like any other drugs caution should be taken in prescribing to pregnant women.</p>', '<p>There are some evidences that &beta; carotene may cause harm to heavy smokers and alcoholics. Therefore, caution should be exercised in these cases. Vitamin C should be given with caution to patients with hyperoxaluria. Vitamin E should be used with caution in patients taking anticoagulant drugs, because vitamin E may enhance the anticoagulant activity of these drugs.</p>', NULL, '<p>Anti-oxidant Multivitamin preparations</p>', '<p>Antioxidant vitamins are used in a wide range of conditions where free radical damage is playing a role. Antioxidant vitamin combination is used in the prevention of coronary heart diseases, certain types of cancer, aging as well as free radical damage caused by excessive exercise, illness, certain medications, air pollution, smoke, radiation and pesticides. The main role of the antioxidant vitamins is as follows:<br />\r\n<br />\r\n&beta; carotene prevents free radical formation by quenching singlet oxygen, a highly reactive form of oxygen. Vitamin C is another free radical scavenger which deactivates free radicals. It works specially in the plasma, lung fluid, aqueous humour and interstitial fluid. It can increase white blood cell activity; play important roles in the biochemistry of antibodies, prostaglandin E 1 , B and T lymphocytes, and interferon. Vitamin E also scavenges free radicals in the blood along with &beta; carotene and vitamin C. Moreover, vitamin E is essential to protect against some of the ill effects of smog and smoke. In relation to other nutrients vitamin E protects vitamin A from being destroyed in the body.</p>', NULL, '2022-02-15 05:35:11', '2022-06-09 17:35:44'),
(170, 170, '<p>Meniere&#39;s disease and Meniere-like syndromes are characterized by attacks of vertigo, tinnitus and/or progressive loss of hearing, usually accompanied by nausea and vomiting.</p>', '<p>The mechanism of action of betahistine is multifactorial. Meniere&#39;s disease is thought to result from a disruption of endolymphatic fluid homeostasis in the ear. Betahistine mainly acts as a histamine H1-receptor agonist. The stimulation of H1-receptors in the inner ear causes a vasodilatory effect leading to increased permeability of blood vessels and a reduction in endolymphatic pressure; this action prevents the rupture of the labyrinth, which can contribute to the hearing loss associated with M&eacute;ni&egrave;re&#39;s disease. Betahistine is also purported to act by reducing the asymmetrical functioning of sensory vestibular organs and increasing vestibulocochlear blood flow, relieving symptoms of vertigo.<br />\r\n<br />\r\nIn addition to the above mechanisms, betahistine also acts as a histamine H3-receptor antagonist, increasing the turnover of histamine from postsynaptic histaminergic nerve receptors, subsequently leading to an increase in H1-agonist activity. H3-receptor antagonism elevates levels of neurotransmitters including serotonin in the brainstem, inhibiting the activity of vestibular nuclei, thus restoring proper balance and decreasing vertigo symptoms.</p>', '<p><strong>The usual initial dose</strong>: 8 mg to 16 mg three times daily taken preferably with meals.<br />\r\n<br />\r\n<strong>Maintenance dose</strong>: Up to 48 mg daily has been recommended. Betahistine is not recommended for use in children.</p>', '<p>There are no proven cases of hazardous interactions. Though an antagonism between Betahistine and antihistamines could be expected on a theoretical basis, no such interactions have been reported.</p>', '<p>Betahistine is contraindicated in pheochromocytoma.</p>', '<p>Betahistine is generally well tolerated and there is no known serious adverse effects. In some circumstances gastrointestinal disturbances, headache, rashes and pruritus have been reported.</p>', '<p><strong>In Pregnancy</strong>: The safety of Betahistine in human pregnancy has not been completely established, although there is no known teratogenic effect in animals. A careful assessment of potential benefits should be made before prescribing Betahistine in pregnancy.<br />\r\n<br />\r\n<strong>In Lactation</strong>: Betahistine is excreted in the breast milk of nursing mothers in concentrations similar to those found in plasma. Toxicity to the neonate at these concentrations is not known.</p>', '<p>Caution should be exercised in patients with bronchial asthma and peptic ulceration.</p>', NULL, '<p>Drugs used in meniere&#39;s diseases</p>', '<p>Keep below 30&deg;C temperature, away from light &amp; moisture. Keep out of the reach of children.</p>', NULL, '2022-02-15 05:35:51', '2022-03-21 02:15:21');
