Ampicillin

Ampicillin

Indication

PRINCIPEN Capsules (Ampicillin Capsules) and PRINCIPEN for Oral Suspension (Ampicillin for Oral Suspension) are indicated in the treatment of infections caused by susceptible strains of the designated organism listed below;
Infections of the Genitourinary Tract Including Gonorrhea: E. coli, P. mirabilis, enterococci, Shigella, S. typhosa and other Salmonella, and nonpenicillinase-producing N. gononhoeae.
Infections of the Respiratory Tract: Nonpenicillinase-producing H. influenzae and staphylococci, and streptococci including streptococcus pneumoniae.
Infections of the Gastrointestinal Tract: Shigella, S. typhosa and other Salmonella, E. coli, P. mirabilis, and enterococci.
Meningitis: O. Meningitides.
Bacteriology studies to determine the causative organisms and their sensetivity to ampicillin should be performed. Therapy may be instituted prior to the results of susceptibility testing.

Description
Ampicillin trihydrate is a semisynthetic penicillin derived from the basic penicillin nucleus, 6-aminopenicillanic acid. Ampicillin is designated chemically as (2S, 5R, 6R)-6-[(8)-2-Amino-2-phenylacetamido]-3,3-dimethyl-t-oxo-4-thia-1- azabicyclo[3.2.0] heptane-2-carboxylic acid. The chemical formula is C₁₆H₁₉N₃O₄S·3H₂O and its molecular weight is 403.45.

This is the anhydrous form of ampicillin. It is prepared as the trihydrate form attached to 3 water (H2O) molecules.

 

PRINCIPEN Capsules (Ampicillin Capsules USP) for oral administration provide ampicillin trihydrate equivalent to 250 mg and 500 mg ampicillin.

Inactive ingredients: black iron oxide, gelatin, FD&C Blue #1, FD&C Red #3, FD&C Red #40, lactose monohydrate, silica gel, and titanium dioxide.

 

PRINCIPEN for Oral Suspension (Ampicillin for oral suspension USP) provide, after constitution, ampicillin trihydrate equivalent to 125 mg and 250 mg ampicillin per 5 mL.

 

Inactive ingredients: antifoam AF emulsion, Atmos 300, colloidal silicon dioxide, FD&C Red #40, lecithin, natural and artificial flavors, sucrose, sodium citrate, sodium benzoate, and vanillin. 

 

Side Effect

As with other penicillins, it may be expected that untoward reactions will be essentially limited to sensitivity phenomena. They are more likely to occur in individuals who have previously demonstrated hypersensitivity to penicillin and in those with a history of allergy, asthma, hay fever, or urticaria.
The following adverse reactions have been reported as associated with the use of ampicillin:

Gastrointestinal: glositis, stamatitis, nausea, vomiting, enterocolitis, pseudomembranous colitis, and diarrhea. These reactions are usually associated with oral dosage forms of the drugs.

Hypersensitivity Reactions: An erythematous, mildly pruritic, maculopapular skin rash has been reported fairly frequently. The rash, which usually does not develop within the first week of therapy, may cover the entire body including the soles, palms, and oral mucosa. The eruption usually disappears in three to seven days.
Other hypersensitivity reactions that have been reported are: skin rash, pruritus, urticaria, erythema multiforme, and an occasional case of exfoliative dermatitis. Anaphylaxis is the most serious reaction experienced and has usually been associated with the parenteral dosage form of the drug

Note: Urticaria, other skin rashes, and serum sickness-like reactions may be controlled by antihistamines, and if necessary, systemic corticosteroids. Whenever such reactions occur, ampicillin should be discontinued unless, in the opinion of the physician, the condition being treated is life-threatening, and amenable only to ampicillin therapy. Serious anaphylactoid reactions require emergency measure.

Liver: Moderate elevation in serum glutamic oxalaacetic transaminase (SGOT) has been noted, but the significance of this finding is unknown.

Hemic and Lymphatic Systems: Anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukapenia, and agranulacytosis have been reported during therapy with penicillins. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena.
Other: Other adverse reactions that have been reported with the use at ampicillin are laryngeal stride and high fever. An occasional patient may complain of sore mouth or tongue as with any oral penicillin preparation.

 

Dosage

Adults and Children Weight Over 20 kg.
For genitourinary or gastrointestinal tract infections other than gonorrhea in men and women, the usual dose is 500 mg qid in equally spaced doses; severe or chronic infections may require larger doses.
For the treatment of gonerrhea in both men and women, a single oral dose of 3.5 grams of ampicillin administered simultaneously with 1 gram of probenecid is recommended. Physicians are cautioned to use no less than the above recommended dosage for the treatment of gonorrhea. Follow-up cultures should be obtained from the original site(s) of infection 7 to 14 days after therapy. In women, it is also desirable to obtain culture test-of-cure from both the endo-cervical and anal canals. Prolonged intensive therapy is needed for complications such as proshtitis and epididymitis. For respiratory tract infections, the usual dose is 250 mg qid in equally spaced doses.

Children Weighing 20 kg or Less
For genitourinary or gastrointestinal tract infections, the usual dose is 100 mg/kg/day total, qid in equally divided and spaced doses. For respiratory infections, the usual dose is 50 mg/kg/day total, in equally divided and spaced doses three to four times daily. Doses for children should not exceed doses recommended for adults,

All Patients, Irrespective of Age and Weight
Larger doses may be required for severe or chronic infections. Although ampicillin is resistant to degradation by gastric acid, it should be administered at least one half-hour before or two hours after meals for maximal absorption. Except for the single dose regimen for gonorrhea referred to above, therapy should be continued for a minimum of 48 to 72 hours after the patient becomes asymptomatic or evidence at bacterial eradication has been obtained. In infections caused by hemolytic strains of streptococci, a minimum of 10 days treatment is recommended to guard against the risk of rheumatic fever of glomerulonephritis (see PRECAUTIONS —  
Laboratory Tests). In the treatment of chronic urinary or gastrointestinal infections, frequent bacteriologic and clinical appraisal is necessary during therapy and may be necessary for several months afterwards. Stubborn infections may require treatment for several weeks. Smaller doses than those indicated above should not be used.

 

Amoxicillin

Amoxicillin

Indication

Infections Of The Ear, Nose, And Throat

AMOXIL® is indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Streptococcus species. (α-and β-hemolytic isolates only),Streptococcus pneumoniae, Staphylococcus spp.or Haemophilus influenzae.

Infections Of The Genitourinary Tract

AMOXIL® is indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Escherichia coli, Proteus mirabilis,or Enterococcus faecalis.

Infections Of The Skin And Skin Structure

AMOXIL® is indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Streptococcus spp. (α-and β-hemolytic isolates only), Staphylococcus spp., or E. coli.

Infections Of The Lower Respiratory Tract

AMOXIL® is indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Streptococcus spp. (α-and β-hemolytic isolates only), S. pneumoniae, Staphylococcus spp., or H. influenzae.

Helicobacter Pylori Infection

Triple Therapy for Helicobacter Pylori with Clarithromycin and Lansoprazole

AMOXIL, in combination with clarithromycin plus lansoprazole as triple therapy, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or 1-year history of a duodenal ulcer) to eradicate H. pylori. Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

Dual Therapy for H. Pylori with Lansoprazole

AMOXIL, in combination with lansoprazole delayed-release capsules as dual therapy, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or 1-year history of a duodenal ulcer) who are either allergic or intolerant to clarithromycin or in whom resistance to clarithromycin is known or suspected. (See the clarithromycin package insert, Microbiology.) Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

Usage

To reduce the development of drug-resistant bacteria and maintain the effectiveness of AMOXIL (amoxicillin) and other antibacterial drugs, AMOXIL should be used only to treat infections that are proven or strongly suspected to be caused by 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.

Dosage & Administration

Dosing For Adult And Pediatric Patients > 3 Months Of Age

Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic or evidence of bacterial eradication has been obtained. It is recommended that there be at least 10 days' treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. In some infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy.

Dosing In Neonates And Infants Aged ≤ 12 Weeks ( ≤ 3 Months)

Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic or evidence of bacterial eradication has been obtained. It is recommended that there be at least 10 days' treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. Due to incompletely developed renal function affecting elimination of amoxicillin in this age group, the recommended upper dose of AMOXIL is 30 mg/kg/day divided every 12 hours. There are currently no dosing recommendations for pediatric patients with impaired renal function.

Dosing For H. Pylori Infection

Triple therapy

The recommended adult oral dose is 1 gram AMOXIL, 500 mg clarithromycin, and 30 mg lansoprazole, all given twice daily (every 12 hours) for 14 days.

Dual therapy

The recommended adult oral dose is 1 gram AMOXIL and 30 mg lansoprazole, each given three times daily (every 8 hours) for 14 days. Please refer to clarithromycin and lansoprazole full prescribing information.

Dosing In Renal Impairment

• Patients with impaired renal function do not generally require a reduction in dose unless the impairment is severe.
• Severely impaired patients with a glomerular filtration rate of < 30 mL/min. should not receive a 875-mg dose.
• Patients with a glomerular filtration rate of 10 to 30 mL/min should receive 500 mg or 250 mg every 12 hours, depending on the severity of the infection.
• Patients with a glomerular filtration rate less than 10 mL/min should receive 500 mg or 250 mg every 24 hours, depending on severity of the infection.
• Hemodialysis patients should receive 500 mg or 250 mg every 24 hours, depending on severity of the infection. They should receive an additional dose both during and at the end of dialysis.

Directions For Mixing Oral Suspension

Tap bottle until all powder flows freely. Add approximately 1/3 of the total amount of water for reconstitution (see Table 2) and shake vigorously to wet powder. Add remainder of the water and again shake vigorously.

After reconstitution, the required amount of suspension should be placed directly on the child's tongue for swallowing. Alternate means of administration are to add the required amount of suspension to formula, milk, fruit juice, water, ginger ale, or cold drinks. These preparations should then be taken immediately.
NOTE: SHAKE ORAL SUSPENSION WELL BEFORE USING. Keep bottle tightly closed. Any unused portion of the reconstituted suspension must be discarded after 14 days. Refrigeration is preferable, but not required.

Ambrox

Ambroxol

 

Indication:

This medication is a mucolytic agent, prescribed for various respiratory diseases such as emphysema with bronchitis pneumoconiosis, chronic inflammatory pulmonary conditions, tracheobronchitis (respiratory tract inflammation), bronchiectasis, bronchitis with bronchospasm asthma.

 Dosage & When it is to be taken : 

Adult: PO-The recommended dose is 30-120mg/day in 2-3 divided doses. 

How it should be taken : 

It comes as a tablet to take by mouth, with food. 
Warnings and Precautions :  Caution needed for pregnant and breastfeeding women.

Side Effects : 

Mild gastrointestinal effects, runny nose and allergic reactions.

Other Precautions : 

Avoid excess dosage.

Storage Conditions : 

Store it at room temperature, away from children.

Cefaclor

Cefaclor 

Indication

Ceclor (cefaclor) is indicated in the treatment of the following infections when caused by susceptible strains of the designated microorganisms:

Otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, staphylococci, and Streptococcus pyogenes

Note: (β-lactamase-negative, ampicillin-resistant (BLNAR) strains of Haemophilus influenzae should be considered resistant to cefaclor despite apparent in vitro susceptibility of some BLNAR strains.

Lower respiratory tract infections, including pneumonia, caused by Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus pyogenes

Note: β-lactamase-negative, ampicillin-resistant (BLNAR) strains of Haemophilus influenzae should be considered resistant to cefaclor despite apparent in vitro susceptibility of some BLNAR strains.

Pharyngitis and Tonsillitis, caused by Streptococcus pyogenes

Note: Penicillin is the usual drug of choice in the treatment and prevention of streptococcal infections, including the prophylaxis of rheumatic fever. Ceclor (cefaclor) is generally effective in the eradication of streptococci from the nasopharynx; however, substantial data establishing the efficacy of Ceclor (cefaclor) in the subsequent prevention of rheumatic fever are not available at present.

Urinary tract infections, including pyelonephritis and cystitis, caused by Escherichia coli, Proteus mirabilis, Klebsiella spp., and coagulase-negative staphylococci

Skin and skin structure infections caused by Staphylococcus aureus and Streptococcus pyogenes

Appropriate culture and susceptibility studies should be performed to determine susceptibility of the causative organism to cefaclor.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ceclor (cefaclor) and other antibacterial drugs, Ceclor (cefaclor) 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.

Dosage:

Ceclor (cefaclor) is administered orally.

Adults - The usual adult dosage is 250 mg every 8 hours. For more severe infections (such as pneumonia) or those caused by less susceptible organisms, doses may be doubled.

Pediatric patients - The usual recommended daily dosage for pediatric patients is 20 mg/kg/day in divided doses every 8 hours. In more serious infections, otitis media, and infections caused by less susceptible organisms, 40 mg/kg/day are recommended, with a maximum dosage of 1 g/day.

B.I.D. Treatment Option - For the treatment of otitis media and pharyngitis, the total daily dosage may be divided and administered every 12 hours.

Ceclor (cefaclor) may be administered in the presence of impaired renal function. Under such a condition, the dosage usually is unchanged (see PRECAUTIONS).

In the treatment of p-hemolytic streptococcal infections, a therapeutic dosage of Ceclor (cefaclor) should be administered for at least 10 days.

Beuflox

Beuflox (Ciprofloxacin)

Therapeutic Group: Anti Bacterial

Description

Ciprofloxacin is a synthetic 4-quinolone derivative with bactericidal activity against a wide range of gram-positive and gram-negative organism. It is active against most gram-negative aerobic bacteria including Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin is also active against gram-positive aerobic bacteria including penicillinase producing, non-penicillinase producing and methicillin resistant Staphylococci. However many strains of Streptococci are relatively resistant to the drug. The bactericidal activity of Ciprofloxacin results from interference with the enzyme DNA gyrase needed for the synthesis of bacterial DNA. The mode of action of Ciprofloxacin is different from other antibiotics like penicillins, cephalosporins, aminoglycosides, tetracyclines and for this reason it is observed that organisms resistant to these antibiotics are susceptible to Ciprofloxacin. Ciprofloxacin is well absorbed from the GIT after oral administration and it is widely distributed into the body tissues and fluid. The half-life of Ciprofloxacin is 3.5 - 4.5 hours. About 30-50% of an oral dose of Ciprofloxacin is excreted in the urine within 24 hours as unchanged drug and active metabolites.

Indication

Ciprofloxacin is indicated for the treatment of the following infections caused by sensitive bacteria:
Severe systemic infections: e.g; septicemia, bacteremia, peritonitis, infections in immunosuppressed patients with haematological or solid tumors and in patients in intensive care unit with specific problems such as infected burns.
Respiratory tract infections: Lobar and broncho pneumonia, acute and chronic bronchitis and empyema.
Urinary tract infections: Uncomplicated and complicated urethritis, cystitis, pyelonephritis, prostatitis and epididymitis.
Skin and soft tissue infections: Infected ulcers, wound infections, abscesses, cellulitis, otitis externa, erysipelas and infected burns.
Gastrointestinal infections: Enteric fever, infective diarrhea.
Infections of the biliary tract: Cholangitis, cholecystitis, empyema of the gall bladder.
Intra-abdominal infections: Peritonitis, intra abdominal abscesses.
Bone and joint infections: Osteomyelitis, septic arthritis.
Pelvic infections: Salpingitis, endometritis, pelvic inflammatory diseases.
Eye, ear, nose and throat infections: Otitis media, sinusitis, mastoiditis, tonsillitis.
Gonorrhoea: Urethral, rectal and pharyngeal gonorrhoea caused by beta-lactamase producing organism or organisms moderately sensitive to penicillin.

Dosages & Administration

Adult Dose:
For oral dosage &suspension:
Urinary Tract infection: Acute uncomplicated: 250 mg twice daily for 3 days; Mild/Moderate: 250 mg twice daily for 7 to 14 days; Severe/Complicated: 500 mg twice daily for 7 to 14 days; Chronic Bacterial Prostitis : 500 mg twice daily for 28 days; Lower Respiratory Tract infection: Mild/Moderate: 500 mg twice daily for 7 to 14 days, Severe/Complicated : 750 mg twice daily for 7 to 14 days; Acute Sinusitis : 500 mg twice daily for 10 days; Skin and Skin Structure infection: Mild/Moderate : 500 mg twice daily for 7 to 14 days, Severe/Complicated : 750 mg twice daily for 7 to 14 days, Bone and joint infection: Mild/Moderate 500 mg twice daily for 4 to 6 weeks, Severe/Complicated : 750 mg twice daily for 4 to 6 weeks, Intra Abdominal Infection: 500 mg twice daily for 7 to 14 days, Infectious Diarrhea: Mild/Moderate/Severe: 500 mg twice daily for 5 to 7 days, Typhoid Fever : 500 mg twice daily for 10 days, Urethral & Cervical Gonococcal Infections: Uncomplicated: 250 mg Single dose.

For IV infusion :
Urinary Tract Infection: Mild to Moderate: 200 mg 12 hourly for 7-14 days;Severe or Complicated: 400 mg 12 hourly for 7-14 days; Lower Respiratory Tract infection: Mild to Moderate: 400 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 8 hourly for 7-14 days; Nosocomial Pneumonia: Mild/Moderate/Severe: 400 mg 8 hourly for 10-14 days; Skin and Skin Structure: Mild to Moderate: 400 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 8 hourly for 7-14 days; Bone and Joint Infection: Mild to Moderate: 400 mg 12 hourly for more than 4-6 weeks; Severe/Comlicated: 400 mg 8 hourly for more than 4-6weeks; Intra abdominal (Acute abdomen): Complicated: 400 mg 12 hourly for 7-14 days; Acute Sinusitis: Mild/Moderate: 400 mg 12 hourly for10 days: Chronic Bacterial Prostatitis: Mild/Moderate: 400 mg 12 hourly for 28 Days.

Children and adolescents:
RTI & GI infections: Neonate-15mg/kg twice daily, Child (1 month -18 years)-20mg/kg (max 750 mg) twice daily; UTI: Neonate-10 mg/kg twice daily, Child (1 month -18 years)-10mg/kg (max 750 mg) twice daily; Pseudomonal lower respiratory tract infection in cystic fibrosis: Child (1 month -18 years) - 20mg/kg (max 750 mg) twice daily; Anthrax (treatment & post exposure prophylaxis): Child (1 month -18 years) - 20mg/kg (max 750 mg) twice daily.
Use in Pregnancy and Lactation
Reproduction studies performed in rats and rabbits using parenteral and oral administration did not reveal any evidence of teratogenicity, impairment of fertility or impairment of pre or postnatal development. However, as with other quinolones, Ciprofloxacin has been shown to cause arthropathy in immature animals and therefore, its use during pregnancy is not recommended. Studies in rats have indicated that Ciprofloxacin is secreted in milk, administration to nursing mothers is thus not recommended.

Side Effect:

Ciprofloxacin is generally well tolerated. Frequent adverse reactions are- Gastrointestinal disturbance: e.g. nausea diarrhea, vomiting, dyspepsia, abdominal pain. Disturbance of the CNS: e.g. dizziness, headache, tiredness, confusion, convulsions. Hypersensitivity reactions: e.g. skin rashes, pruritus, and possible systemic reactions. Other possible side effects are - joint pain, light sensitivity, transient increase in liver enzyme (especially in patients with history of liver damage), serum bilirubin, urea or serum creatinine. Arthralgia and myalgia may also occur.

Indication and reaction of kefim

Kefim

cefixme

Description

Kefim(Cefixime) is a third generation orally active cephalosporin.It is a broad spectrum antibiotic: bactericidal in action & stable to hydrolysis by many betalactamases.Kefim kills bacteria by interfering with cell wall synthesis.Kefim is highly effectiv against a wide range of pathogens including N.gonorroease,H.influenzae,moraxella catarrhalis including beta-lactamase producing ones:most of the entero bactriaceae,beta-laemolytic Streptococcus (group A& B)&Streptococcus pneumoniae.Kefim(cefixime)is more active than other oral cephalosporins against e. coli,klebsiella spp.Proteus mirabilis 7serratia marcescens.Kefim is also active against streptcoccus pyogenes 40-50% of an oral dose is absored from gastro-intestinal tract regardless of presence of meal.the plasma half life is usually about 3-4hrs.& may be prolonged in patients with renal disfunctions. about 65% of the absorbed drug is bound to plasma proteins.

Indications:

Indication and reaction of Amodis

Amodis

Metronidazole BP

Pharmacology:

Amodis (Metronidazole) a nitroimidazole has an extermely broad spectrum antiprotazoal and antimicrobial activities, with high activity against anaerobic bacteria and protozoa.Amodis(Metronidazole) is usually completely and rapidly absorbed after oral administration.The half-lic=fe in plasma is about 8 hours.About 10% of the drug is bound to plasma proteins.Amodis (Metronidazole)penetrates well into body tissues and fluids.The liver is the main site of metabolism.Both unchanged Metronidazole and metabolites are excreted in various proportions in the urine after oral administration.

Indication

All forms of amoebiasis(intestinl and extra-intestinal disease including liver abscess and that of symptomless cyst passers)*Trichomoniasis*Giardiasis*Bacterial vaginosis*Acute ulcerative*ginvitis*Anaerobic infections including septicaemia,bacteraemia,peritonitisbrain abscess,necrotising pneumonia,ostemyelitis,puerperal sepsis,pelvic absess,pelvic cellultis etc.

*Anaerobically-infected leg ulcers and pressure sores*Acute dental infections9e.g.acute pericoronitis and acute apical infections)*Surgical prophylxix(prevention of postoperative infections due to anaerobic bacteria,particulary species of bacteroides and anaerobic streptococci.*Chronic symptomatic peptic ulcer disease(as an agent of triple therapy to eradicate H.pylori-the most important aetiological factor of peptic ulcer)

Adverse Reaction

Metalic taste,furred tongue,nausea,vomition,diarrhoea,drowsiness,rashes and milt reversible leucopenia may be observed during treatment.

Drug Interaction

Metronidazole interacts with warfarin,nicoumalone,phenytoin,phenobarbitonefluorouracil,disulfiram,lithium,cimetidine etc,

Pregnancy & Lactation

Not recommended during first & later trimesters.breast feeding should be delayed until 48 hours after discontinuing. metronidazole in the mother.

Loactolax

Lactolax

Oral Solution

Composition

Lactolax oral solution : Each 5ml oral solution contains Lactulose concentrate USP equivalent to Lactulose 3.35mg.

Properties and effectiveness

Lactulose, which is not broken down in the stomach and small intestine,begins its action in the large intestine where it is broken down primarily by intestinal bacteria.In this degradation process,lactic acid is produced,this in turn supports the growth of intestinal bcteri important for humns and hinders the growth of putrefactive bacteria.Thus normalization of intestinal flora(eubiosis) results.In addition,the increase in metabolic degradation products in the blood which cannot be sufficiently  detoxified by the liver is reduced.

Lactulose improves the transter of calcium Salts and Phosphates from the intestines,stimulates intestianal peristalsis and leads to a softening of the stool.It also leads to healing and improvement n gum disease through normalization of metabolic process in theperiodontal region.

Even long-term use of Lactolax does not lead to habituation and thus there is no loss of efficacy.

Indication

Constipation(chronic constipation): In every case of chronic constipation,initial treatment should consist of a diet rich in fiber(vegatables,salads,fruits,suppliments of linseeds, whet germ,etc) a generous amount of liquids and much physical exercise.

Lactolx is only to be taken when these measures prove insufficient. 

Intestinal flora disturbances : in

• Damage to intestinal flora,following therapy with broad spectrum antibiotics
• infants
• gall bladder diseases
• intestinal diseases(coltis,diverticulosis,megacolon)

 Increased blood ammonia levels(hyperammoniemia in hepatopathy,portal systemic encphalopathy,precom,coma)
Diseases of the gums and the parodontic apparatus(paradontosis,bleeding frm the gums,inflammation,dystrophy)

Dosage & Administration
1.In constipation(chronic constipation): due to the tact that every organism responds differently to Lactoiax,each patient must determine his/her own optimal dos in the course of time.

Patient group                           initially                                   in long term therapy
Adults                                    3 to 6 tea-spoons daily        1.5 to 6  tea-spoon daily.
children up to 14 years           3 tea-spoon daily                 1 to 2 tea-spoon daily.
Infants and toddlers                1 to 2 tea-spoon daily          1 tea-spoon daily.

Contraindications
Hypersensitivity to either galactose and or lactose, galactose-free diet,Gastro-cardial symptom complex(heart prolems stemming from the gastrointestinal tract),suspected intestinal obstruction.

Pregnancy&lactation
studies show that lactulose has no adverse effects,Decisions regarding use during pregnancy and lactation must be made by a registered physican.

Side Effects
Occasionally flatulence can occur at the beginning of treatment,this is rapidly eliminated by reducing the dose and or taking the daily dose in several smaller individual portions spread over the course of the day.Overdoses can result in dirrhoea.In abuse; loss of electrolytes(primarily Potassium)

Nalgram

NAlIGRAM

(Nalidixic Acid)

Composition
Tablet: Each tablet contains Nalidixic acid BP 500mg.
Suspension: Each 5ml suspension contains Nalidixic acid BP 300 mg.

Description
Naligram (Nalidixic Acid) is a bactericidal antimicrobial agent used mainly in the treatment and prophylaxis of urinary tract infection caused by gram negative pathogen specially E coli. Naligram (Nalidixic acid)exerts its antibacterial activity inhibiting DNA replication in the bacterial cell by inhbition of the enzyme DNa gyrase.It is effective against most gram- negative bacilli with the notable exception of pseudomonas species.
Naligram(nalidixic Acid) is considered as the first-line treatment in cases of multiresistant shigella infections.Naligram shows high clinical and bacteriological cure rates in patients with bloody diarrhoea caused by multiresistant shigella and proved to be an efficacious antibacterial in bacillary dysentry.Naligram proved to be a childhood safe antimicrobial in the therapeutic dosage range.

Indication
Acute and chronic urinary tract infections,bacillary dysentry due to salmonella and shigella.Naligram provides and effective alternative to ampicillin in the treatment of childhood shigellosis.Naligram is also indicated in the treatment of chronic shigellosis caused by multiresistant shigella organism.

Dosage and Administration
Adults : 1g(2tablets) every 6 hours for 7 days,reduced in chronic infections to 500mg every 6 hours.
Children : For infants and children over 03 months of age,initial therapy is 55mg/kg/day administered in 04 equally divided does.For prolonged therapy,the total daily dose may be reduced to 33 mg/kg/day.

Contraindication
Nalidixic acid is not indicated in children below 3 month of age.It is contraindicated in epileptic patients and in patients with known hypersensitivity to Nalidixic acid.

Side Effect
Nalidixic Acid is genarally well tolerated & absorbed.Occasionally gastrointestiral hypersensitivity,fevereosinophilia,photosensitvity&neurological disturbances like malais,drowsiness,dizziness may occur.Mild leukopenia,htombocytopenia,hemolytic anemia may also be observd.Nalidixic Acid may also produce false elevations of 17-ketogenic steroids in urine.
Drug Interactions
Anticoagulant effect of nicoumalone and warfarin and toxicity of melphalan is enhanced by Nalidixic Acid.Probenecid reduces excretion of Nalidixic Acid.

Ambronil

AMBRONIL

Ambroxol Hydrochloride BP

Presentation :-

Ambronil syrup - Each 5ml syrup contains Ambroxol Hydrochloride BP 15mg

Ambronil Pedeatric Drops -Each ml of drop contains Ambroxxol hydrocloride BP 6mg.

Pharmcology : Ambroxol is the active metabolite of bromhexine and it has been proven that this metaolite possesses a greater bronchosecretolytic effect than bromhexineAbbroxl is shown to exert 3 activitis;1.Secretolytic activity, 2. Anti inflammatory and antioxidant activity, 3. Local anaestheric effect.

Indications :-Productive cough,Acute and chronic inflammatory disorders of upper and lower respiratory tracts associated with viscid mucus, Asthmtic bronchitis, bronchil asthma with thick expectoration, Bronchiectasis and chronic pneumonia.

Dosage and administration : Average daily dose ( preferably after meal )

2-5  years old               1/2 teaspoonful(2.5ml)2-3 time a day

5-10 years old               1 teaspoonful(5ml) 2-3 time a day

10years and adults         2teaspoonfuls(10ml) 3 time a day

Side Effect : Gastrointestinal side effects like epigastric pain,stomach overfill feeling may sccur occasonally. Rarely allergic responses such as eruption,urticaria or angioneurotic edem have been reported. 

Contraindications: contraindicated in known hyersensitivity to ambroxol or bromhexine.

 Precaution: Ambroxol should be given cautiosly to patients with gastric and duodenal ukceration or convulsive disorders.Patients with hepatic and renal insufficiency shoul take it with caution.

Drug interaction : Abroxol should not be taken simultaneously with antitussives because phlegm,which has been liquefied by ambroxol might not be expectorated.

Use in pregnancy and Lactation : Teratogenic and foetal toxicity studies have shown no harmful effect of ambroxolHowever,it is advised not to use it in pregnancy,especially during the 1st trimester,Safety during lactation has not been established yet.

Antibiotic

ANTIBIOTIC

What is an antibiotic?

Antibiotics, also known as antimicrobial drugs, are drugs that fight infections caused by bacteria. Alexander Fleming discovered the first antibiotic, penicillin, in 1927. After the first use of antibiotics in the 1940s, they transformed medical care and dramatically reduced illness and death from infectious diseases.
The term "antibiotic" originally referred to a natural compound produced by a fungus or another microorganism that kills bacteria which cause disease in humans or animals. Some antibiotics may be synthetic compounds (not produced by microorganisms) that can also kill or inhibit the growth of microbes. Technically, the term "antimicrobial agent" refers to both natural and synthetic compounds; however, many people use the word "antibiotic" to refer to both. Although antibiotics have many beneficial effects, their use has contributed to the problem of antibiotic resistance.

What is antibiotic resistance?

Antibiotic resistance is the ability of bacteria or other microbes to resist the effects of an antibiotic. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm.

Why should I be concerned about antibiotic resistance?

Antibiotic resistance has been called one of the world's most pressing public health problems. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment when it is really needed. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates, and co-workers - threatening the community with a new strain of infectious disease that is more difficult to cure and more expensive to treat. For this reason, antibiotic resistance is among CDC's top concerns.
Antibiotic resistance can cause significant danger and suffering for children and adults who have common infections, once easily treatable with antibiotics. Microbes can develop resistance to specific medicines. A common misconception is that a person's body becomes resistant to specific drugs. However, it is microbes, not people, that become resistant to the drugs.
If a microbe is resistant to many drugs, treating the infections it causes can become difficult or even impossible. Someone with an infection that is resistant to a certain medicine can pass that resistant infection to another person. In this way, a hard-to-treat illness can be spread from person to person. In some cases, the illness can lead to serious disability or even death.