Suxamethonium chloride Indication Side Effect Precautions and Dosage

Pharmacologicalaction
Suxamethonium chloride is a deplorising neuromuscular blocking agent.the initial effect is to depolarize the membrane in the same manner as acetylcholine,but more peristently,ehich results in a brief period of firing manifested by transient muscular fasciculation.This phase is succeeded shortly by neuromuscular paralysis
the mechanism and even the primary site of which are still uncertain and controversial.

Indication
Suxamethonium (Cl) is primarily indicated in conditions like Muscle relaxation (rapid onset, short duration), Muscular spasm, Neuromuscular blockade, and can also be given in adjunctive therapy as an alternative drug of choice in Anesthesia, Insomnia, Surgery.

Side Effect of suxamethonium chloride

• Increased saliva levels or mucous
• production
• Rash
• Muscle twitching or pain
• Flushing
• Itching
• More bowel movements than
• normal
• Change in heart beat or
• palpitations
• Eye pain
• Muscle stiffness
• Fever
• Breathing difficulties, rash or
• Irritation
• Headache
• Feeling faint

Warnings / Precautions
Avoid suxamethazone in patients with burns, massive trauma, renal impairment, severe long lasting sepsis and severe hyperkalaemia, sensitivity to drug, eye injury or glaucoma. It should be used with caution in patients with bone fractures, cardiac or respiratory disease. Dose of neuromuscular blocking agent need to be clearly titrated for individual patients according to their response; monitoring of the degree of block is recommended in order to reduce the risk of overdosage. Patients who have received neuromuscular blocker should always have their respiration assisted or controlled until the drug has been inactivated or antagonized.

Dosage of suxamethonium chloride
Determined by the physician according to patient's needs.
Usual dose: 20 to 80 mg intravenously maximum up to 100mg.2.5mg to 4mg per kg body weight intramuscularly maximum up to 150mg

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Unknown dosage, indication, Precautions, Side Effects, Suxamethonium chloride

Verapamil Clinical Pharmacology and Mechanism of action

Clinical Pharmacology
Verapamil has a pronounecd antiarrhythmic action particularly in supraventricular cardiac arrhythmias.it prolongs impulse condition in the AV node and thereby depending on the type of arrhythmia restores the sinus rhythm and/or normalises the ventricular rate.

The calcium antagonist verapamil reduces myocardial oxygen consumption directly by intervening in the energy consuming metabolic processes of the myocardial cell and indirectly by diminishing the peripheral resistance (afterload).

The decrease of the vascular smooth muscle tone moreover prevents coronary spasms and lowers raised blood pressure.

Indication for Used
For the treatment of hypertension, angina, and cluster headache prophylaxis.

Mechanism of action
Verapamil inhibits voltage-dependent calcium channels. Specifically, its effect on L-type calcium channels in the heart causes a reduction in ionotropy and chronotropy, thuis reducing heart rate and blood pressure. Verapamil's mechanism of effect in cluster headache is thought to be linked to its calcium-channel blocker effect, but which channel subtypes are involved is presently not known.

Used in Pregnancy ( Category C )

verapamil carries the potential to produce hypocia associated with maternal hypotnsion.

Verapamil side effects

serious side effects:

•     fast or slow heartbeats;
•     feeling like you might pass out;
•     fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
•     feeling short of breath, even with mild exertion;
•     swelling, rapid weight gain; or
•     nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious verapamil side effects may include:

•     constipation, nausea;
•     skin rash or itching;
•     dizziness, headache, tired feeling; or
•     warmth, itching, redness, or tingly feeling under your skin.

Half life
2.8-7.4 hours
Dosage of Verapamil

Adult (usual):
Angina: (extended-release) initial: 180 mg po qd at bedtime. Titrate up to 480 mg at bedtime- maximum 540 mg at bedtime. (immediate release) initial: 80 mg po tid - may titrate at daily or weekly intervals to 360 mg daily.
Arrhythmias, supraventricular: (immediate-release) initial: 240-320 mg po daily in 3-4 divided doses. Non-digitalized patients may require up to 480 mg daily in 3-4 divided doses. Arrhythmias, supraventricular: 5-10 mg IV (0.075-0.15 mg/kg) IV bolus over 2 min. May give additional 10 mg after 30 minutes if no response.
Hypertension: (extended-release) initial, 180 mg tablet po qd at bedtime OR 200 mg capsule po qd at bedtime. Maintenance: titrate up to 480 mg TAB qd at hs or 400 mg capsule po qd at hs.
Hypertension: (immediate-release) initial- 80 mg po tid. May titrate at daily or weekly intervals to 360-480 mg daily. Hypertension: (sustained-release) initial: 240 mg orally once daily in the morning. Maintenance (based on response): titrate up to 240 mg bid (tablet) or 480 mg (capsule) once a day in the morning.
Migraine headache, prophylaxis: 80 mg po 3-4 times daily.

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Unknown Action, Clinical Pharmacology, dosage, Mechanisms, pharmacology, Side Effects, verapamil

Clindamycin Side Effects Indication and Usage

Clindamycin, an antibiotic, is prescribed to treat infections of the respiratory tract, skin, pelvis, vagina, and abdomen. Antibiotics will not work for colds, flu, or other viral infections.

An antibacterial agent that is a semisynthetic analog of lincomycin.

Indication and Usage

Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (eg, erythromycin).

Anaerobes: Serious respiratory tract infections such as empyema, anaerobic pneumonitis and lung abscess; serious skin and soft tissue infections; septicemia; intra-abdominal infections such as peritonitis and intra-abdominal abscess (typically resulting from anaerobic organisms resident in the normal gastrointestinal tract); infections of the female pelvis and genital tract such as endometritis, nongonococcal tuboovarian abscess, pelvic cellulitis and postsurgical vaginal cuff infection.

Streptococci: Serious respiratory tract infections; serious skin and soft tissue infections.

Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections.

Pneumococci: Serious respiratory tract infections.

Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Clindamycin HCl and other antibacterial drugs, Clindamycin HCl should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Clindamycin side effects.

Mild Diarrhea;
- Nausea;
- Upset Stomach;
- Vomitin
Skin Dryness;
- Reddened Skin;
- Peeling Skin;
- Itching;
- Burning;



DOSAGE AND ADMINISTRATION

If significant diarrhea occurs during therapy, this antibiotic should be discontinued (see WARNING box).

Adults:   Serious infections —150 to 300 mg every 6 hours.

More severe infections —300 to 450 mg every 6 hours.

Pediatric Patients:   Serious infections —8 to 16 mg/kg/day (4 to 8 mg/lb/day) divided into three or four equal doses. More severe infections —16 to 20 mg/kg/day (8 to 10 mg/lb/day) divided into three or four equal doses.

To avoid the possibility of esophageal irritation, Clindamycin HCl Capsules should be taken with a full glass of water.

Serious infections due to anaerobic bacteria are usually treated with Clindamycin Phosphate Sterile Solution. However, in clinically appropriate circumstances, the physician may elect to initiate treatment or continue treatment with Clindamycin HCl Capsules.

In cases of ß-hemolytic streptococcal infections, treatment should continue for at least 10 days.

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Unknown administration, Clindamycin, dosage, indication, Side Effects

Imipenem Precautions Dosage and Administration

Imipenem and cilastatin combination is used to treat infections in many different parts of the body. nfections caused by bacteria. It is sometimes given with other antibiotics.

PRECAUTIONS: Before using imipenem with cilastatin, tell your doctor or pharmacist if you are allergic to either of its ingredients; or to penicillins or cephalosporins; or if you have any other allergies.Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders (e.g., seizures, head injury, tumor), kidney disease, liver disease, stomach/intestinal diseases (e.g., colitis).Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be at greater risk for side effects while using this drug.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Though there have been no reports of harm to nursing infants, consult your doctor before breast-feeding.


Dosage and Administration
Adults

IV 125, 250, or 500 mg dose over 20 to 30 min. Infuse a 750 mg or 1 g dose over 40 to 60 min. If nausea develops, slow the infusion rate. Max: 50 mg/kg/day or 4 g/day, whichever is lower.
Adults

IM 500 to 750 mg every 12 h. Max: 1,500 mg/day.
Children less than 40 kg

IM 60 mg/kg/day.
Children at least 40 kg

IM Adult dose.
Premature Infants (at least 36 wk Gestational Age)

IM 20 mg/kg every 12 h.
General Advice

    For IV administration, reconstitute with 100 mL of compatible diluent. Shake until suspension is clear; add suspension to 100 mL of appropriate infusion solution. Then add 10 mL of infusion to vial; shake well to ensure that all medication is used and transfer resulting suspension to infusion solution. Color of solution may range from colorless to yellow. Solution is stable for 4 h at room temperature and for 24 h when refrigerated. Do not administer if solution is cloudy.
    Do not mix with or physically add to antibiotics. However, it may be administered concomitantly with other antibiotics (eg, aminoglycosides).
    Do not use IM preparation for IV administration.
    For IM administration, prepare with 1% lidocaine HCl solution (without epinephrine). Prepare 500 mg vial with 2 mL and 750 mg vial with 3 mL of lidocaine. Agitate to form suspension. Color of solution may range from white to light tan. Withdraw and inject entire contents of vial IM. Use within 1 h of preparation.

Storage/Stability

Store unreconstituted powder at or below 77°F.

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Unknown administration, dosage, Imipenem, Precautions