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c c

?     


c
 
  :
c cytidine, diphosphate choline ’   
 Ôobuject, Ôobutrex, Hospira
dobutamine in 5% Ôextrose Injection, Hospira
’  c 
 : Lupram
Ôobutamine Injection, Inocard
c enhance serotogenic activity in the CNS by
 :
 directly stimulates beta 1 receptors to
inhibiting
c neuronal uptake of serotonin but not of
increase myocardial contractility and stroke volume.
norepinephrine. Weak inhibitor of CYP450 enzyme
c Ôecreases peripheral vascular resistance, reduces
system which makes it more appealing than other
ventricular filling pressure and facilitate AV node
drugs.c
conduction.
c
   treatment of depression; obsessive-
c
    Ôobutamine is used to increase the
compulsive disorder. Prevention of relapse and
contractility of the heart in acute heart failure, as
recurrence
c of depression. Panic disorder with or
occurs in cardiogenic shock and myocardial
without agoraphobia.
c infarction; it is also used in septic shock. Other
?
c    concomitant monoamine oxidase circumstances on which inotropic activity maybe
inhibitor (MAOI) therapy. Hypersensitivity. useful are during cardiac surgery and positive end-
c
expiration pressure ventilation (PEEP).

 
c dry mouth, nausea, somnolence,
increased sweating and tremor. ?
    Ôobutamine hydrochloride should
c
be avoided or used only with great caution in


  monoamine oxidase inhibitors
c patients with marked obstruction of cardiac
(MAOI), sumatripan, cimetidine
c ejection, such as idiopathic hyperthropic subaortic
stenosis.
c
c c
c
(Ôobutamine cont) ’      !
c

  dose-related increases in heart ’   
 Ñonakion MM/Ñonakion MM
c
rate and blood pressure, ectopic beats, angina or Paed.
c
chest pain, and palpitations; dosage should be
c
reduced or temporarily stopped if they occur.   synthethic analog of vitamin Ñ which is
c
Ventricular tachycardia may occur rarely. Other essential for hepatic synthesis of blood clotting

adverse
c effects that have occurred occasionally factors II,VII, IX, and X.

includec hypotension, dyspnea, paraesthesias,     Vitamin Ñ compounds are used in the
headache,
c nausea and vomiting, and leg cramps. treatment and prevention of hemorrhage associated
c


 extreme caution during with vitamin Ñ deficiency.

anaesthesia
c with cyclopropane, halothane, and other ?
   pronounced allergic diathesis,
volatile
c anaesthetics. Beta-blockers. Infants <1yr
c

  
discontinue drug, support 
  hypotension, cyanosis, headache,
circulation.
c dizziness,pruritic erythmatous plaques at IM
c c injection site, rash, uticaria. Hyperbilirubinemia,
c c including kernicterus, in newborns. Anaphylactoid

c reactions; pain, swelling and tenderness at injection


c
site; death after intravenous injection.
c c



 Ôicumarol and derivatives.


c c
c
  
 (Ôipenhydramide cont)
c
?
    hypersensitivity to anti-
c 
  Ôrugmaker·s Biotech
’  
Ôiphephydramine, Nebrecon histamines; narrow-angled glaucoma; stenosing
c
peptic ulcer; symptomatic prostatic hyperthrophy;
 
c acts on blood vessels, GI, respiratory asthmatic attack; bladder neck obstruction
system
c by antagonizing the effects of histamine for
H1-receptor site; decreases allergic response by 
   Orthostatic hypotension;
c
blocking histamine; causes increased heart rate, palpitations; bradycardia; tachycardia;
c
vasodilation, secretions; Significant CNS depressant extrasystoles; faintness; drowsiness; sedation;
c dizziness; disturbed coordination. Nasal stuffiness;
and anti-cholinergic properties.
c dry mouth; nose and throat; sore throat.
   it is used for the symptomatic relief of
c
allergic conditions including uticaria and angioedema, 

 Central Nervous System (CNS)
c depressants including alcohol, bartiburates,
rhinitis and conjunctivitis, and in pruritic skin
c hypotonics, oploid analgesics, anxiolytic sedatives,
disorders. It is also used for its antiemetic
c
properties in the properties in the treatment of and antipsychotics.
c and vomiting, particularly in the prevention
nausea
and treatment
c of motion sickness when it should be
givenc at least 30 mins before travelling, and in the
treatment of vertigo of various causes c
c
c
c
c
c
c

c (Epinephrine cont)
^ 

c 
  cardiac arrhythmias, excessive
 
   adrenaline
c hypertension, palpitations, dysrythmias, anginal pain
’  c 
  Hizon Epinephrine in predisposed patients, flushing. Nervousness,
c tremors, vertigo, pain, headache, dizziness,
 stimulates both alpha and beta-receptors
weakness, stroke, cerebral hemorrhage, drowsiness,
within csympathetic nervous system that relaxes
confusion, hallucination, agitation, altered state of
bronchial
c smooth muscle.
perception and thought, psychosis. Nausea, vomiting,
c
    treatment and prophylaxis of transitory anorexia. Bronchial and pulmonary edema, dyspnea.
c
atrioventicular block, treatment of Adam-Stokes


  may increase risk of ventricular
c
syndrome, treatment of hay fever, relief of
arrhythmias with cardiac glycosides and general
bronchial
c asthma, treatment of syncope caused by
anesthetics.
heart block
c of carotid sinus hypersensitivity.
c
?
c    Angleclosure glaucoma, shock
c
(other c than anaphylactic), organic heart and brain
c
disease,
c cardiac dilations, arrhythmias,coronary
c
insufficiency,
c
or cerebral arteriosclerosis. For local
anaesthesia of fingers, nose, ears, genitalia.
c
Hypersensitive to sympathomimetic amines.
c
c

c
c c

¦ c  (Hyoscine cont)

c 
  Xerostomia, tachycardia, urinary
 
  scolopomine
c retention. When administered IV, visual
’   
 Ascopen,
c
Buscopan accommodation disturbances, dizziness,
 inhibits
c acethylcoline at receptor sites in agranulocytosis, pancytopenia, and bronchospasm.
autonomic
c nervous system, which controls 

 TCAÔ·s, antihistamines,
secretions
c free acids in stomach; blocks central quinidine, amantadine, and disopyramide, beta-
muscarinic receptors, which decreases involuntary adregenic agents. Ôopamine antagonists.
c
movements.
c
  c Acute GI, biliary and genitourinary
c
spasms, include biliary and renal colic,
c
c
dysmenorrheal. Parenterally also as an aid in
c
diagnostic and therapeutic procedures, e.g. c
c
gastroduodenal endoscopy, radiology. c
c
?
   Myasthenia gravis, megacolon
c
hypersensitivity. Parenteral glaucoma, hypertrophy
c
of the prostate with urinary retention, mechanical
c
stenosis of GIT, tachycardia.
c
c

c
c c
c

[

c  (Furosemide cont)

c 

 Aminoglycosides, cisplatin,
’   
 Lasix, Pharmix, Piplen
c digitalis glycosides, lithium, NSAIÔS, phenytoin,
 inhibits sodium and chloride reabsorption at salicylates, thiazides diuretics.
c
the proximal tubules, distal tubules, and ascending
c c
loop of Henley leading to excretion of water
c c
together with sodium, chloride and potassium.
c
Ôiuretics, antihypersensitive. c

c c
   treatment of edema associated with
c
congestive heart failure (CHF), hepatic cirrhosis,
c
and renal disease, hypertension.
c
?
    hypersensitivity to sulfonylureas;
c
anuria.
c

  orthostatic hypotension,
c
thrombphlebitis, chronic aortitis, vertigo, headache,
c
dizziness, paresthesia, restlessness, fever,
c
photosensitivity, urticaria, pruritis, necrotizing
c erythema.
angitis,
c

c
c c
c
M   ’
 
c

’  c 
 Nubain  
   acetaminophen
c
 binds with opiate receptors in the CNS: £
  Paracetamol, Biogesic, Tempra
c
ascending pain pathways in limbic system, thalamus,
 decreases fever by inhibiting the effects
midbrain,
c hypothalamus, altering perception of and
of pyrogens on the hypothalamic action leading to
emorional
c response to pain. Relieves to pain.
sweating and vasodilation. Relieves pain by inhibiting
c Relief of moderate to severe pain; for
   prostraglandin
c
pre-operatively analgesia, supplement to balanced
   relief of mild-to-moderate pain;
anesthesia,
c surgical anesthesia, obstetrical
treatment of fever.
analgesia.
c
?
   hypersensitivity; intolerance to
?
c    hypersensitivity,
tartrazine (yellow dye #5), alcohol, table sugar,
pregnancy(Category
c Ô only if used prolonged periods
saccharin.
or in high
c doses)

  stimulation, drowsiness, nausea,
c

   sedation, drowsiness, sweating,
vomiting, abdominal pain, hepatotoxicity, hepatic
nausea,c dry mouth, and dizziness, headache,
seizure (overdose), renal failure(high prolonged
vomiting.
c
doses), leucopenia, neutropenia, jaundice.
c


 Narcotic analgesic, general


 hepatoxic drugs, cholestyramine
anesthesia, sedatives, hypotonics, alcohol.
c
c
c c


"
c   (Tranexamic cont)

c 

 drugs with action in hemostasis
’   
 Ôostan, Hemostan
c should be given with caution to patients on
 inhibits breakdown of fibrin clots. It acts antifibronolytic therapy. The potential for thrombus
c
primarily blocking the binding of plasminogen and formation maybe increased by estrogens, for
c
plasmin to fibrin; direct inhibition example, or the action of the antifibronolytic
c
    treatment and prophylaxis of antagonized by the compounds such as the
c
hemorrhage associated with excessive fibrinolysis. thrombolytics.
c
Prophylaxis of hereditary angioedema. c
c
c
?
c     hypersensitivity.Patients with
active intravascular clotting because of the risk of c
c
thrombosis. Severe renal sufficiency. Patients with c
c
microscopic hematuria. c
c

  GI disturbances. Hypotension
c
particularly after rapid IV administration.
c
Thrombotic complications complications have been
c
reported. Instances of transient disturbance of
colour cvision associated with its use.
c
c

c
c c

? 
 
c
 (Chlorpheniramine cont.)

c ?
   lower respiratory tract
 
  chlorphenamine
c symptoms. Herpes simplex of the eye. Newborn or
’   
 Antamine, Ôrugmaker·s Biotech premature infants, patients receiving monoamine
c
Chlorphenamine oxidase inhibitor (MAOI) therapy. Hyperthyroidism,
c
  competes with histamine for H1-receptor hypertension, coronary disease,phaeochromocytoma,
c
site on effector cells; decreases allergic response close-angle glaucoma. Acute asthma attack. Patients
c
by blocking histamine with osteoporosis, active peptic ulcer, psychoses, or
c
severe psychoneuroses; systemic fungal infection;
c treatment of allergic disorders of
  
acute infections.
allergic rhinitis, bronchial asthma, uticaria,
c
vasomotor rhinitis, contact dermatoses, food and 
  dry mouth, constipation,
c
drug allergy, insect bites. Sneezing, nasal difficulty with micturition, blurred vision. Ôelirium,
c agitation, insomnia. Jaundice, postural hypotension.
congestion, watery eyes accompanying common cold
c
and viral infections. Measles, asthma, tuberculosis, Cardiac arrhythmia, AV-block, ventricular
c
pneumonia, pharangytis, bronchial irritation. Body tachycardia, and fibrillation during neurologic
aches c and pains, runny nose, anaphylactic shock. therapy. Respiratory depression.

c 

 effect intensified by alcohol,
.
c bartiburates and other sedatives. Prolongs action of

c CNS depressants e.g. anesthetics.
c
c
c c

¦

  (Hydrocotisone cont)
c
?
   systemic fungal infections; IM
c 
  Cortizan, Ôrugmaker·s Biotech
’  
Hydrocotisone, Efficort, Hydrotropic, Hydrotropic use in idiopathic thrombocytopenic purpura;
c
Injection, Lacticare-HC Lotion, Pharex administration of live virus vaccines in patients
c
Hydrocortisone, Pharmacort, Phoenix receiving immunosuppressive corticoid doses;
c psychosis; acute glomerulonephritis; amebiasis; non-
Hydrocortisone, Solu-Cortef
c asthmatic bronchial disease; children <2yrs, AIÔS,
 Glucocorticoid with anti-inflammatory TB.
c
effect because of its ability to inhibit prostaglandin
c 
  depression, flushing, sweating
synthesis, inhibit migration of microphages,
c headache, mood changes, hypertension, circulatory
leucocytes, and fibroblasts at sites of inflammation,
c
phagocytosis and lysosomal enzyme release. It can collapse, thrombophlebitis, embolism, tachycardia,
c
also cause the reversal of increased capillary edema, fungal infections, increased intraocular

permeability. pressure, blurred vision, diarrhea, nausea, abdominal


c
distention, hemorrhage, increase appetite.
c
   treatment of primary or secondary
c
adrenal cortex insufficiency, rheumatic disorders, 

 corticosteroid decreases

collagen
c diseases, dermatologic disease, allergic expected effects.

states,
c allergic and ophthalmic processes, c

respiratory
c
disease, hematologic disorders, c
neoplastic diseases, edematous states,GI disease.
c
c
c
M 
  
c 
 
’   
 Cardepine
c
 inhibits calcium ion influx across cell ’   
 Euro-Med Atropine Sulfate,
c Hizon Atropine Sulfate, Isopto Atropine
membrane during cardiac depolarization, produces
c
relaxation of coronary vascular smooth muscle and  inhibits acetylcholine at parasympathetic
c
peripheral vascular smooth muscles, dilates coronary neuro effector junction, blocking vagal effect on
c
arteries, and increases myocardial oxygen delivery the heart (SA node), exocrine glands, smooth
in patients
c with vasopastic angina. muscles and urinary bladder. Ôrug increases heart
c rate, dries secretions, decreases sweating and
   management of: hypertension, angina
c salivation in low doses. Mydriasis (dilation of the
pectoris, vasopastic angina. Unlabeled use:
c
pupil) and cycloplegia occur at moderate doses.
management of congestive heart failure.
Motility of GI and GU systems are affected at high
c
?
   patients who do not have doses.
c
complete hemostasis following intracranial
c    administration prior to anesthesia to
hemorrhage.Increased intracranial pressure during
reduce or prevent secretions of respiratory tract;
acutec phase of a stroke.
to control rhinorrhea; treatment of Parkinsonism;
c

  peripheral restoration of cardiac rate and arterial pressure in
c
edema,headache,tachycardia, palpitations,localized some situations. Antidote for cardiovascular
thrombophlebitis
c and hypotension. collapse in certain overdoses or poisoning.
c


 oral may increase plasma digoxin
c
c c

(Atropine cont) 


   

c

c    hypersensitivity to
?
 
  isosorbide dinitrate, ISÔ/ISÔN
anticholinergics; narrow-angle glaucoma; adhesions
c
between iris and lens; prostatic hypertrophy; ’   
 Isoket, Isoket
c IV, Isoket spray, Isomonit, Isordil
obstructive uropathy; myocardial ischemia; unstable
c
cardiac status caused by hemorrhage; tachycardia;  increases supply of oxygen to the heart by
c
myasthenia gravis; pyloric or intestinal obstruction; dilating both the arteries and vein which supply the
c
asthma; hyperthyroidism; renal disease; hepatic heart itself.
disease;
c toxic megacolon; intestinal atony or
   preventive and long-term treatment of
paralytic
c ileus.
angina pectoris/post myocardial infarction (MI)
c

  palpitations, tachycardia, angina. Treatment of severe congestive heart
bradycardia,
c orthostatic hypotension, headache, failure (CHF) in combination with cardiac glycosides,
nervousness,
c drowsiness, weakness, dizziness, diuretics, angiotensin-converting enzyme (ACE)
confusion,
c
insomnia, fever, excitability, restlessness inhibitors, arterial vasodilators; pulmonary
c


 Haloperidol; Penothiazines; and hypertension.

otherc anticholinergic agents. ?


   acute myocardial infarction (MI)
c c with low filling pressures, very low BP, not as
c c treatment for sudden cardiac pain.

c c c

c
c c
c
(Isosorbide cont) x

c

  transient hypoxemia; headache;
c ’   
 Cardo Peten, Euro-Med
fall in BP; reflex rise in pulse rate, dizziness and
c Metoclopramide, Plasil
weakness. Nausea, vomiting, transient skin,
c  Ôopamine antagonist that acts by increasing
disorders and allergic skin reactions may sometimes
occur.c Rare: paradoxical nitrate effect or receptor sensitivity and response of upper GIT
c
bradycardia. tissues to acetylcholine. This causes contraction of

c gastric smooth muscles, relaxation of the pyloric




 other hypersensitive agents, e.g.
sphincter and duodenal bulb and increases
c
beta-blockers, Calcium-antagonists; vasodilators;
peristalsis without stimulating gastric, biliary, and
c
neuroleptics or Tricyclitic antidepressants (TCAÔs),
pancreatic secretions. It also produces sedation and
alcohol;
c dihydroergotamine;, non-steroidal anti-
induces release of prolactin.
rheumatic
c drugs, sildefanil, narcotics,
antihistamines, anticholinergics.    GI motility disturbances. Nausea and
c
vomiting of central and peripheral origin associated/
c c
surgery, metabolic diseases, malignant disease,
c c
infectious disease and drug induced. Radiological
c c procedures of GIT. Control of post-operative
c vomiting and to assist in intestinal intubation.
c

c
c c

c
(Metoclopramide cont) ’  
c
?
   Phaechromocytoma. Patients in  
  Phenytoin sodium,
c
whom increase in GI might be dangerous e.g. diphenylhydantoin, ÔPH
c
presence of GI hemorrhage, mechanical obstruction
or perforation.
c Hypersensitivity or intolerance to ’   
 Ôilantin

the drugs.
c Lactation. Children. Patients with breast  limits seizure activity by stabilizes neuronal
cancer.
c membranes of hyper excitable cells through
c

  sedation, restlessness, decreasing influx of sodium during action potential,

lassitude, fatigue, diarrhea, insomnia, headache, influx of calcium is also decreased. It also delays
c
dizziness, nausea, extrapyramidal effects,tardive outward potassium current leading to increased
c
dyskinesia, parkinsonism, drowsiness and bowel refractory period.
c
upset.    tonic-clonic and psychomotos seizure,
c


 anticholinergics, narcotic seizures occurring during or following neurosurgery.
c
analgesics,
c
alcohol, sedatives, hypnotics, narcotics, ?
   sinus bradycardia, SA block, AV
tranquilizer, phenothiazines, paracetamol, digoxin, blocks II and III, Adam-Stokes syndrome
c
tetracycline, levodopa.
c 
  GI disturbances, ataxia, slurred
c
c speech, diplopia, nystagmus and mental confusion
c


 antibiotics, carbamazepine,
acetaminophen, corticosteroids, doxycycline.
c c
c
c
 #
c


  blurred vision,; paradoxical
c 
 Valium
’  
reactions; dependence, withdrawal symptoms.
c
 facilitates the inhibitory activity of GABA
c 

 other centrally active drugs;
at the limbic system and the reticular formation to
c
alcohol.
reduce anxiety and promote calmness and sleep. The
inhibition
c also suppresses the spread of seizure c

activity
c produced by epileptogenic foci in the c

cortex,
c
thalamus and limbic system. Enhancement of
GABA-mediated pre-sympathetic inhibition at the
c
spinal level and brain stem reticular formation
c
results to skeletal muscle relaxation.
c
   relief of anxiety, agitation, tension due
c
to psychoneurotic states. Basal sedation before
c
stressful therapeutic measures or interventions.
c
Treatment of excitation.
c
?
   pregnancy (Category Ô),
c
hypersensitivity. Ôependence in other substances
c
including alcohol, except in management of acute
withdrawal reactions. Severe chronic hypercapnia.
c c



c     
c
’   
 Ôototral, Euro-Med Tramadol ’   
 Ceranid. Cygran, Ôrugmaker·s
c
HCI, Gesidol, Milador, Tradonal,Tramal Biotech Ranitidine, Entac, Incid, Ramadazine, Zantac
c
 centrally acting analgesic not chemically  inhibits histamine at H2 receptor site in the
c
related to opioids but binds to mu-opioid receptors gastric acid secretion.
c
and inhibits reuptake of norepinephrine and
   used in the management of various GI
c
serotonin.
disorders: dyspepsia, gastro-esophageal reflux
c
   moderate to severe pain disease (GERÔ), peptic ulcer and Zollinger-Ellison
c
syndrome. Prophylaxis of GI hemorrhage from
?
   hypersensitivity. Acute
c stress ulceration.
intoxication with alcohol, hypnotics, centrally acting
c
analgesics, oploids or psychotropic agents. ?
   Hypersensitivity. History of acute
c
porphyria. Long-term therapy.

  vasodilation, dizziness/vertigo,
c
headache 
^Cardiac arrhythmias,
c
bradycardia. Headache, somnolence fatigue,



c  Carbamezapine; may reduce
dizziness, hallucinations, depression, insomnia.
serum ctramadol levels, leading to decreased
effectiveness. Monoamine oxidase (MAO) inhibitors: 

 Coumarin anticoagulants,
c
Risk seizures may be increased. theophylline, diapezam, metroprolol, propranalol,
c
c lignocaine, phenytoin. Antacidsm, alcohol, glipizide.
cc
c
ë  £ 
 
c
ë  
 
  baking
c
soda/sodium acid carbonate
(HCO3)  
   albuterol
c

c 
 B. Braun 8.4% sodium
’   £
  Ventolin
bicarbonate
c
 stimulates beta-2 receptors of bronchioles
c
 increases plasma bicarbonate, which excess by increasing level of cAMP which relaxes smooth
buffers
c H ion concentrations; reverses metabolic muscles to produce bronchodilation. Also cause CNS
acidosis;
c neutralize gastric acid, which forms water, stimulation, cardiac stimulation, increased diuresis,
NaCl, CO2, raises blood pH. skeletal muscle tremors, and increased gastric acid
c
secretions. Longer acting than isoproterenol.
  
c treatment of metabolic acidosis;
promotion
c of systemic , gastric, and urine    relief of bronchospasm in bronchial
alkalinization,
c asthma, chronic bronchitis, emphysema and other

c    hypoventilation, hypocalcaemia,
reversible, obstructive pulmonary diseases.
?

increased
c serum osmolarity, cardiac insufficiency, c

edema,
c hypertension, eclampsia, severe kidney c
insufficiency.
c


 
c hyperanatraemia, serum
hyperosmolarity
c



 Aspirin, androgens, and diuretics.
c c

 "c  (Ôigoxin cont)


c
’   
  Lanoxin ?
   intermittent complete heart block
c
or second degree AV-block especially with history
c inhibits sodium-potassium activated ATP,
  of Adam-Stokes attack; Wolff-Parkinson-White
thereby
c following influx of calcium into the syndrome; hyperthropic obstructive
intracellular space (cytoplasm), more available cardiomyopathy; hypersensitivity.
c
calcium promotes increased force of myocardial
c 
  anorexia, GI disturbances, CNS
contraction (positive inotropic effect) resulting to
c effects. Atrial tachycardia. Gynecomastia.
increased cardiac output. It also acts on the CNS to
c vagal tone, causing the decrease of
enhance 

 diuretics, lithium salts,
c
conduction speed between the SA and AV nodes. corticosteroids, carbenoxolone, calcium antagonists,
This vagal
c stimulation decreases the cardiac rate nifedipine, and diltiazem.
(negative
c chronotropic effect) to prevent
c
arrhythmia.
c c
c chronic cardiac failure with atrial
   c
fibrillation,
c ventricular dilatation, supraventricular
c
arrhythmias.
c c
c c c
c c c
c
c
c c
c
(Salbutamol cont) 
  
c
?
   hypersensitivity, pregnancy, ’   
 Combivent, Ôuavent
c
cardiac arrhythmia, and thyrotoxicosis.
c · management of reversible bronchospasms

^fine
c skeletal muscle tremor, leg associated with obstructive airway diseases.
cramps,
c
palpitations, tachycardia, hypertension
c
headache, nausea, vomiting, dizziness.
c




c beta-adgernic blockers.
Concomitant
c
use of theophylline and other xanthine
derivatives, steroids and diuretics. Sedatives, TCAs,
c
emic drugs.
c
c
c
c
c
c
c
c
c
c
c
c
c
c
c
c

c
c
   
c
x  
c ’   
 Aminophylline, Phyllocontin,
c 
 Ôolfenal, Ponstan
’   Truphylline

c
 aspirin-like drug that has analgesic, anti-  inhibits phosphodiesterase (PÔE), which
c
pyretic, and anti-inflammatory activities. These increases intracellular cyclic adenine monophosphate
activities
c appear to be due to its ability to inhibit (cAMP). This leads to a release of epinephrine from
cyclogenase
c and also antagonize certain effects of the adrenal medulla cells. Aminophylline also blocks
prostaglandins. adenosine receptors that mediate the constriction
c
of airways. These actions cause bronchodilation,
c relief of pain
  
diuresis and stimulation of the central nervous and
c
?
   pregnancy, and lactation. cardiac systems, and also increase gastric acid
c
Hypersensitivity. Active ulceration or chronic secretion.
c
inflammation of either the upper or lower GIT.
    To prevent and relieve symptoms of
Bloodc disorders, poor platelet function. Ñidney or
acute bronchial asthma and treatment of
liver impairment.
c bronchospasm associated with chronic bronchitis
c

^GIT discomfort, diarrhea, and and emphysema.
constipation,visual
c disturbances, skin rash.
6c ?
   hypersens. to
c drug/class/compon.caution if PUÔ, active, caution if


 oral coumarin anticoagulants,
highlyc protein-bound drugs. seizure disorder,caution if arrhythmias
6c caution if CHF,caution if pulmonary edema,
c
acute,caution if shock.
c c
c
(Aminophylline cont)
c 
  ë 

^: Nausea, vomiting, abdominal pain,
c ’   
 Bricanyl Expectorant
diarrhoea, headache, insomnia, dizziness, anxiety,
c
restlessness; tremor, palpitations.Convulsions, · anti- asthma
c
cardiac arrhythmias, hypotension and sudden death
c rapid IV injection
after too
c


 Other xanthines. Clearance
c
reduced by allopurinol, some antiarrhythmics
c
,cimetidine, disulfiram, fluvoxamine, interferon-Ĵ,
c antibiotics, quinolones,oral
macrolide
contraceptives,
c thiabendazole and viloxazine.
Clearance
c increased byphenytoin,
anticonvulsants,
c
ritonavir, rifampicin,
sulfinpyrazone, cigarette smoking. Corticosteroids,
c
diuretics, ǀ2-agonists.
c
 c

c c

c
c

c
’
  #  (Promethazine cont)
c

c
’   
 cPhenergan, Phenadoz, ?
   Phenergan Tablets and
Promethegan
c Suppositories may impair the mental and/or physical
c abilities required for the performance of potentially
  used as an anti-histamine, sedative,
and antiemetic (anti-nausea). The body releases hazardous tasks, such as driving a vehicle or
c
histamine during several types of allergic reactions. operating machinery. The impairment may be
c
When histamine binds to its receptors on cells, it amplified by concomitant use of other central-
c
stimulates changes within the cells that lead to nervous-system depressants such as alcohol,
sneezing,
c itching, and increased mucus production.
sedatives/hypnotics (including barbiturates),
Antihistamines
c
such as promethazine compete with
narcotics, narcotic analgesics, general anesthetics,
histamine for one of the receptors for histamine
c tricyclic antidepressants, and tranquilizers;
(the H1 receptor) on cells. However, when the
c
antihistamines bind to the receptors they do not therefore such agents should either be eliminated
stimulate
c the cells. Instead, they prevent histamine
or given in reduced dosage in the presence of
from binding and stimulating the cells. Promethazine promethazine HCl
c
also blocks the action of acetylcholine
c
(anticholinergic effect), and this may explain its 

 Promethazine should not be
benefit cin reducing thenausea of motion sickness taken with any of the MAO (mono-amine oxidase)
inhibitor-class of antidepressants, for example,
   c
isocarboxazid (Marplan), phenelzine (Nardil),
c
tranylcypromine and procarbazine (Matulane),
because of the increased risk of extrapyramidal
symptoms (EPS)--uncontrollable movement
c

c
c

c
c

c
c

c
c

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