Learn about the essential drugs list, their indication, adverse effects, and contraindications.

1. ESSENTIAL DRUGS LIST
TAHIR, ALBASHIR (BSc. Pharm.)
albashirtahir@gmail.com
+2348068440615
APRIL, 2023.
1

2. • According to World Health Organisation (WHO), essential drugs
are those drugs that satisfy the health care needs of the majority
of the population, they should therefore be available at all times
in adequate amounts and in appropriate dosage forms, at a price
the community can afford.
• The Essential Drug Programme of the Federal Republic of Nigeria
came on stream in 1988 and received legal backing in 1989 when
Decree 43 was promulgated.
• That same year, the first Essential Drug List was published.
2

3. Objectives of the National Essential Drug Programme (NEDP)
• To continuously ensure that drugs that are needed to the entire
population are available
• To reduce the cost of drugs by purchasing drugs with generic names
instead of brand names
• To impact management skills to health workers
• To prevent production, distribution and use of fake and sub-standard
drugs at all levels
• To encourage the use of only safe and effective drugs at all levels.
3

4. Criteria for the Selection of Essential Drugs
• The drug should meet the health care needs of the majority of the people
• Evidence on safety and efficacy
• Disease prevalence
• Stability in various conditions
• Single drug formulations are mostly preferable
• Genetic and environmental factors
• Demographic factors with respect to that community
• Should be in dosage forms, acceptable to the people and should have a reliable
shelf life
4

5. • It is economical in terms of cost
• It is affordable and accessible since majority of the population can
afford to buy
• It enables agencies related to drug control perform effectively
• Drug usage in health facilities can easily be managed
• It makes prescription easy since the drugs are available
• The reduction in the number of drugs used in the healthcare system
makes purchasing, storage and distribution easier
5
Advantages of Essential Drugs

6. Steps for the Management of Essential Drugs and
Supply
• Selecting from the essential drugs list those drugs needed
• Ordering the drugs
• Receiving and storing the drugs
• Issuing and using the drugs
6

7. ANAESTHETICS
General Anaesthetics and Oxygen
General Anaesthetics are drugs that produce reversible loss of all sensation
and consciousness.
Inhalational
1. Halothane
2. Isoflurane
3. Nitrous oxide
4. Oxygen
5. Sevoflurane
Injectable
1. Ketamine
2. Propofol
7

8. Ketamine
Indications
 Induction and maintenance of anaesthesia
 Anaesthesia for short-term diagnostic and surgical procedures
Adverse effects
 Raised intracranial pressure
 Postoperative nausea, vomiting and salivation
 Hallucinationsa
Contra-indications
 Increased intracranial pressure
 Psychiatric disturbance
 Hypertension
 Thyrotoxicosisb
8

9. Local Anaesthetics
Local anaesthetics are drugs which upon topical
application or local injection cause reversible loss of
sensory perception, especially of pain, in a restricted area
of the body.
1. Bupivacaine
2. Lidocaine
3. Lidocaine + Epinephrine (Adrenaline)
9

10. Lidocaine
Indications
 Nerve block anaesthesia
 Infiltration anaesthesia
 Epidural anaesthesia
 Spinal anaesthesia
Adverse effects
 Drowsiness
 Dysphoria
 Altered taste
 Tinnitus
 Blurred vision
 Light-headedness
Contra-indications
 Adjacent skin infection
 Inflamed skin
 Concomitant anticoagulant
therapy
10

11. Bupivacaine
Indications
 Infiltration anaesthesia
 Peripheral and sympathetic nerve
block
 Spinal anaesthesia
 Postoperative pain relief
Adverse effects
 Light-headedness
 Blurred vision
 Hypotension
 Restlessness
Contra-indications
 Adjacent skin infection
 Inflamed skin
 Concomitant anticoagulant
therapy
 Severe anaemia or heart
disease
11

12. MEDICINES FOR PAIN AND PALLIATIVE
CARE
Narcotic Analgesics
1. Dihydrocodeine
2. Fentanyl
3. Morphine
4. Pentazocine
5. Pethidine
6. Tramadol
Non-narcotic Analgesics and
Antipyretics
1. Acetylsalicylic acid
2. Paracetamol
NSAIDs, Gout and Rheumatoid
Medicines
1. Allopurinol
2. Colchicine
3. Diclofenac
4. Febuxostat
5. Ibuprofen
6. Ketoprofen
7. Naproxen
12

13. Pentazocine
Indications
 Moderate to severe pain
Adverse effects
 Sedation
 Dizziness
 Occasional euphoria
 Nausea and vomiting
 Light headedness
 Constipation
 Respiratory disturbances
 Visual disturbances
Contra-indications
 Respiratory depression
 Renal or hepatic impairment
 Pregnancy
 Myocardial infarction
13

14. Acetylsalicylic Acid
Indications
 Dysmenorrhea
 Headache
 Pyrexia
 Acute migraine attack
 Antiplatelet
Adverse effects
 Nausea
 Ulceration with occult bleeding
 Tinnitus
 Vertigo
 Confusion
 Increase bleeding time
Contra-indications
 Hypersensitivity
 Reye syndrome
 Previous or active peptic ulceration
 Haemophilia
14

15. Paracetamol
Indications
 Headache
 Dysmenorrhea
 Pyrexia
 Acute migraine attack
 Pain relief in osteoarthritis and soft tissue lesions
Adverse effects
 Hepatic damage
 Renal damage (rare)
Contra-indications
 Hypersensitivity
 Severe hepatic disease
15

16. Diclofenac
Indications
 Inflammation and degenerative
forms of rheumatism
 Post-traumatic inflammation
 Dysmenorrhea
 Adjuvant in severe painful
inflammatory infections of the
ENT
Adverse effects
 GI upset
 Upper abdominal pain
 Nausea
 Diarrhoea
 Hypersensitivity reactions such as
skin rash and pruritus
Contra-indications
 Peptic ulcers
 Pregnancy
 Lactation
 Hypersensitivity
 Severe disorders of liver function
16

17. Ibuprofen
Indications
 Mild to moderate pain and inflammation
 Headache
 Dysmenorrhea
 Pyrexia
 Acute migraine attack
Adverse effects
 GI disturbance including nausea, diarrhoea
 GI ulceration and haemorrhage
 Vertigo
 Tinnitus
 Hepatic damage (rare)
Contra-indications
 Hypersensitivity including asthma, urticarial, rhinitis
 Active peptic ulceration
17

18. Allopurinol
Indications
 Pr0phylaxis of gout
 Prophylaxis of hyperuricaemia associated with cancer chemotherapy
Adverse effects
 Rash
 Fever
 Hepatitis
 Renal impairment
Contra-indications
 Hypersensitivity
18

19. ANTI-ALLERGICS AND MEDICINES USED IN
ANAPHYLAXIS
Allergy is a reaction to foreign substances by the immune system- the
body system of defence against foreign invaders, particularly pathogens.
Anti-anaphylactics
1. Dexamethasone
2. Epinephrine (Adrenaline)
3. Hydrocortisone
Antihistamines
1. Chlorpheniramine (Chlorphenamine)
2. Loratadine
3. Predisolone
4. Promethazine
19

20. Chlorpheniramine
Indications
 Nasal allergies
 Allergic dermatoses
 Management of severe allergic or hypersensitivity reactions
Adverse effects
 Drowsiness
 Drowsiness
 Arrythmias
 Constipation
 Dry mouth
Contra-indications
 Hypersensitivity
 Lactation
 Children <4 years
20

21. Promethazine
Indications
 Prevention and treatment of N and V especially motion sickness
 Premedication prior to surgery
 Anaphylactic reactions
 Symptomatic treatment of allergic conditions of the respiratory track and skin
Adverse effects
 Sedation
 Headache
 Nightmares
 Psychomotor impairment
 Photosensitivity reactions
 Dry mouth, blurred vision, urinary retention
Contra-indications
 Hypersensitivity
 Narrow-angle glaucoma
 Children <2 years due to the potential for fatal respiratory depression
 Porphyria
21

22. Loratadine
Indications
 Relief of symptoms of seasonal allergies
 Management of chronic idiopathic urticaria
 Management of hives
Adverse effects
 Confusion
 Drowsiness (rare)
 Blurred vision
 Dry mouth
Contra-indications
 Hypersensitivity
22

23. ANTIDOTES
Non-specific (General) Antidotes
1. Charcoal (activated)
Specific Antidotes
1. Acetylcysteine
2. Atropine
3. Calcium gluconate
4. Methionine
5. Methylammonium chloride
(methylene blue)
6. Naloxone
7. Phytomenadione (vit. K1)
8. Potassium ferric
hexacyanoferrate (II) (Prussian
blue)
9. Protamine sulphate
Complementary List
1. Deferoxamine
2. Dimercaprol
3. Fomepizole
4. Sodium calcium edetate
5. Pralidoxime
23

24. Atropine
Indication
1. To inhibit salivary secretions
2. To inhibit arrhythmias resulting from excessive vagal stimulation
3. To block the parasympathomimetic effects of anticholinestrases and carbamate
poisoning
Adverse effects
1. Dry mouth
2. Blurred vision
3. Photophobia
4. Difficulty in micturition
5. Flushing
Contra-indication
1. Angle-closure glaucoma
2. Myasthenia gravis
24

25. POISONING ANTIDOTE
Organophosphates, nerve gases Atropine
Heparin Protamine sulphate
Naloxone Opiates
Heparin Protamine sulphate
Warfarin Phytonadione
Iron Deferoxamine
Paracetamol Acetylcysteine, Methionine
25

26. ANTIMIGRAINE DRUGS
Migraine is a periodic attack of headache on one or both sides of
the head. These may be accompanied by nausea, vomiting,
increased sensitivity of the eyes to light (photophobia), increased
sensitivity to sound (phonophobia), dizziness, blurred vision,
cognitive disturbances, and other symptoms.
1. Ergotamine
2. Ibuprofen
3. Paracetamol
4. Sumatriptan
26

27. ANTISEPTICS AND DISINFECTANTS
1. Benzoin
2. Cetrimide + Chlorhexidine
3. Chlorhexidine
4. Coal tar
5. Dichloroxylenol +
Chlorophenol
6. Formaldehyde
7. Glutaraldehyde
8. Iodine
9. Methylated spirit
10. Povidone-iodine
11. Potassium permanganate
12. Sodium hypochloride
13. Trichlorophenol
27

28. CARDIOVASCULAR DRUGS
Anti-anginal Medicines
1. Bisoprolol
2. Diltiazem
3. Glyceryl trinitrate
4. Isosorbide dinitrate
Anti-arrhythmic Drugs
1. Amiodarone
2. Bisoprolol
3. Lidocaine
4. Procainamide
5. Propranolol
6. Verapamil
Medicines Used in Heart Failure
1. Captopril
2. Carvedilol
3. Digoxin
4. Dobutamine
5. Dopamine
6. Enalapril
7. Furosemide
8. Metoprolol
9. Spironolactone
10. Torsemide
28

29. CARDIOVASCULAR DRUGS…
Antihypertensive Drugs
1. Amiloride +
Hydrochlorothiazide
2. Amlodipine
3. Atenolol
4. Bendrofuazide
5. Captopril
6. Enalapril
7. Hydrochlorothiazide
8. Hydralazine
9. Indapamide
10. Labetalol
11. Lisinopril
12. Lorsatan
13. Methyldopa
14. Nifedipine
15. Nimodipine
16. Propranolol
17. Telmisartan
Lipid-lowering Agents
1. Artovastatin
2. Simvastatin
29

30. Amlodipine
Indications
 Hypertension
 Angina
Adverse effects
 Abdominal pain
 Nausea
 Headache
 Dizziness
 Sleep disturbances
 Fatigue
Contra-indications
 Hypersensitivity
 Severe hepatic impairment
(dosage reduction recommended)
30

31. Propranolol
Indication
 Angina pectoris
 Cardiac arrhythmias
 Hypertension
 Prophylaxis of migraine
Adverse effects
 Bradycardia
 Hypotension
 Heart failure
 Fatigue
 Bronchospasm
Contra-indications
 Asthma or history of obstructive
airways disease
 Marked bradycardia
 Hypotension
31

32. DIURETICS
1. Amiloride + Hydrochlorothiazide
2. Furosemide
3. Hydrochlorothiazide
4. Mannitol
5. Spironolactone
6. Torsemide
32

33. Furosemide
Indication
 Oedema
 Oliguria due to renal failure
 Hypertension
Adverse effects
 Blurred vision
 Dizziness
 Vertigo
 Headache
 Itching or rash
Contra-indications
 Pregnancy
 Lactation
 Infants and children less than 4
years
33

34. ORAL ANTIDIABETIC MEDICINES
1. Glibenclamide
2. Gliclazide
3. Glimeperide
4. Metformin
5. Vidagliptin
6. Sitagliptin
34

35. Metformin
Indications
 Type 2 diabetes mellitus
Adverse effects
 Anorexia
 Nausea
 Vomiting
 Abdominal pain
 Pruritus (itching)
 Urticaria (hives)
Contra-indications
 Renal impairment
35

36. MEDICINES ACTING ON THE
RESPIRATORY TRACT
Anti-asthmatic Medicines
1. Budesonide
2. Epinephrine (Adrenaline)
3. Ipratropium bromide
4. Salbutamol
5. Salmeterol + Fluticasone
36

37. Salbutamol
Indications
 Prophylaxis and treatment of asthma
Adverse effects
 Arrythmias
 Tachycardia
 Headache
 Insomnia
 Fine tremor
Contra-indications
 Hypersensitivity
 Use cautiously in: Cardiac disease, Hypertension, Diabetes
37

38. GASTRO-INTESTINAL DRUGS
Anti-emetic Medicines
1. Dexamethasone
2. Metoclopramide
3. Ondansetron
4. Promethazine
Antacids
1. Aluminium hydroxide +
Magnesium trisilicate
2. Magnesium trisilicate
Anti-ulcer Medicines
1. Omeprazole
2. Rabeprazole
3. Ranitidine
Laxatives
1. Bisacodyl
2. Lactulose
3. Liquid Paraffin
4. Senna
Medicines Used in Diarrhoea
1. Loperamide
2. Diphenoxylate + Atropine
38

39. Metoclopramide
Indication
 Nausea and vomiting associated with migraine
 Nausea and vomiting in GI disorders and cytotoxic therapy
Adverse effects
 Extrapyramidal effects (especially in children and young adults)
 Drowsiness
 restlessness
Contra-indications
 GI obstruction
 Haemorrhage or perforation
 Within 3-4 days of GI surgery
39

40. Omeprazole
Indication
 Treatment of pyrosis (heartburns)
 Gastroesophageal reflux disease (GERD)
 Stress ulceration
 Gastric and duodenal ulcers
 Prophylaxis in long-term NSAID therapy
Adverse effects
 Nausea
 Headache
 Diarrhoea
 Constipation
Contra-indications
 Pregnancy and lactation
40

41. Bisacodyl
Indication
 Treatment of constipation
 Bowel clearance before surgery,
labour or radiological
examination
Adverse effects
 Mild abdominal cramps
 Nausea and vomiting
 Rectal burning
 Vertigo
Contra-indications
 Abdominal pain
 Nausea, vomiting
 Rectal fissures
 Ulcerated haemorrhoids
 Intestinal obstruction
41

42. Loperamide
Indication
 Symptomatic control of acute and chronic diarrhoea
Adverse effects
 Hypersensitivity reactions (skin rash)
 Abdominal pain, distention or discomfort
 Nausea and vomiting
 Constipation
 Tiredness
Contra-indications
 Hypersensitivity
 Child < 2 yrs due to risk of respiratory depression
 Abdominal pain in the absence of diarrhoea
42

43. ANTICONVULSANTS (ANTI-EPILEPTICS)
1. Carbamazepine
2. Clonazepam
3. Diazepam
4. Ethosuximide
5. Magnesium sulphate
6. Midazolam
7. Phenobarbital
8. Phenytoin sodium
9. Pregabalin
10. Sodium valproate (Valproic acid)
11. Topiramate
43

44. Diazepam
Indications
 Drug of choice in the emergency control of convulsions
 Pre-operative sedation
 Skeletal muscle relaxant
Adverse effects
 Drowsiness
 Amnesia
 Dependence
 Hypotension
Contra-indications
 Respiratory depression
 Acute pulmonary insufficiency
 Sleep apnea
 Severe hepatic impairment
 Myasthenia gravis
44

45. Carbamazepine
Indication
 Prophylaxis of bipolar disorder
 Diabetic neuropathy
Adverse effects
 Dizziness
 Headache
 Ataxia
 Blurred vision
 GI intolerance
Contra-indications
 Hypersensitivity
 History of bone marrow depression
 Porphyria 45

46. OXYTOCIC
1. Ergometrine
2. Misoprostol
3. Oxytocin
46

47. Misoprostol
Indication
1. Duodenal and gastric ulcer
2. Prophylaxis of NSAID-induced
ulcers
3. Induction of labour
Adverse effects
1. Diarrhoea
2. Abdominal pain
3. Headache
4. Nausea
5. Flatulence
6. Dysmenorrhoea
7. Foetal distress
Contra-indication
1. Pregnancy
2. Hypersensitivity to
prostaglandin medications
47

48. Oxytocin
Indication
1. Induction of labour for medical reasons
2. Prevention and treatment of postpartum uterine atony and haemorrhage
Adverse effects
1. Uterine spasm
2. Foetal distress, asphyxia and death (excessive doses)
3. Nausea
4. Vomiting
5. Arrhythmias
Contra-indication
1. Mechanical obstruction of labour
2. Foetal distress
3. Any condition where spontaneous labour or vaginal delivery is inadvisable
48

49. ANTI-INFECTIVE DRUGS
Anti-amoebic and Antigiardiasis
Medicines
1. Metronidazole
2. Tinidazole
Anthelminthics
 Antifilarials
1. Albendazole
2. Diethylcarbamazine
3. Ivermectin
 Antischistosomal and Other
Antitrematode Medicines
1. Praziquantel
Intestinal Anthelminthics
1. Albendazole
2. Mebendazole
3. Pyrantel pamoate
4. Praziquantel
49

50. ANTI-INFECTIVE DRUGS…
Antibacterial Drugs
1. Ampicillin
2. Amoxicillin
3. Amoxicillin + clavulanic acid
4. Benzathine benzylpenicillin
5. Benzylpenicillin
6. Cefixime
7. Ceftriaxone
8. Cefuroxime
9. Cefpodoxime
10. Chloramphenicol
11. Ciprofloxacin
12. Clarithromycin
13. Clindamycin
14. Cloxacillin
15. Doxycycline
16. Erythromycin
17. Flucloxacillin
18. Gentamicin
19. Levofloxacin
20. Metronidazole
21. Ofloxacin
22. Nitrofurantoin
23. Phenoxymethyl penicillin
24. Piperallin + Tazobactam
25. Sulfamethoxazole +
Trimethoprim (C0-trimaxazole)
26. Tetracycline
50

51. ANTI-INFECTIVE DRUGS…
Antifungal Medicines (Systemic)
1. Amphotericin B
2. Clotrimazole
3. Fluconazole
4. Miconazole
5. Nystatin
Antileprosy Drugs
1. Clofazimine
2. Dapsone
3. Rifampicin
Antimalarial Medicines
 For treatment
1. Artemeter
2. Artemeter + Lumefantrine
3. Artesunate
4. Artesunate + Amodiaquine
5. Artesunate + Pyronaridine +
tetraphosphate
6. Dihydroartemisinin + Piperaquine
phosphate
7. Doxycycline
8. Quinine
 Prophylaxis
1. Atovaquone + Proguanil
2. Proguanil
3. Mefloquine
4. Sulfadoxine + Pyrimethamine
51

52. ANTI-INFECTIVE DRUGS…
Antituberculosis Drugs
1. Ethambutol
2. Ethambutol + Isoniazid
3. Isoniazid
4. Isoniazid + Pyrazinamide +
Rifampicin
5. Isoniazid + Rifampicin
6. Isoniazid + Rifampicin +
Ethambutol + Pyrazinamide
7. Pyrazinamide
8. Rifampicin
Antiretroviral (ARV) Drugs
 Non-nucleoside Reverse
Transcriptase Inhibitors
1. Nevirapine
2. Efavirenz
 Nucleoside Reverse Transcriptase
Inhibitors
1. Abacavir
2. Didanosine
3. Lamivudine
4. Zidovudine
 Protease Inhibitors
1. Indinavir
2. Lopinavir + Ritonavir
52

53. ANTI-INFECTIVE DRUGS…
Antihepatitis Medines
 Medicines for Hepatitis B
1. Entecavir
2. Lamivudine
3. Tenofovir
 Medicines for Hepatitis C
1. Daclatasvir
2. Sofosbuvir
53

54. Metronidazole
Indications
 Tetanus
 Septicaemia
 Skin and soft tissue infections
 Helicobacter pylori eradication
 Amoebic dysentery
 Bacterial vaginosis
Adverse effects
 Nausea
 Vomiting
 Unpleasant metallic taste
 Furred tongue
 Anorexia
Contra-indications
 Hypersensitivity
 Chronic alcohol dependence
 First trimester of pregnancy

55. Ampicillin
Indications
 Gynaecological infections
 Septicaemia
 Meningitis
 Osteomyelitis
Adverse effects
 Nausea
 Vomiting
 Diarrhoea
 Hypersensitivity reactions (urticarial, rashes)
Contra-indications
 Hypersensitivity to penicillins

56. Ciprofoxacin
Indications
 Typhoid fever
 Gastroenteritis
 Gonorrhoea
 Meningitis
 RTIs
 Skin infections
Adverse effects
 Nausea
 Vomiting
 Abdominal pain
 Hyperglycaemia
Contra-indications
 Hypersensitivity
 History of myasthenia gravis (may
worsen muscle weakness and
breathing)
 History of tendon disorders
related to quinolone use

57. Tetracycline
Indications
 ENT infections
 Respiratory tract infections
 GI tract infections
 Liver infections
 Genitourinary infections
Adverse effects
 GI disturbances
 Photosensitivity
 Dermatological reactions
Contra-indications
 Hypersensitivity to tetracyclines
 Pregnancy
 Lactation
 Children < 12 yrs (permanent
teeth stain)
 Kidney disease

58. Isoniazid
Indications
 Treatment of tuberculosis (in combination with other drugs)
 Prophylaxis of tuberculosis
Adverse effects
 GI disorders (N, V, D pain, constipation, dry mouth)
 Hypersensitivity (fever, rashes, joint pain, usually during 1st week of tx)
 Blood disorders
 Hepatitis (>35 yrs and regular alcoholism)
Contra-indications
 Hypersensitivity
 Acute liver disease
 Drug-induced hepatic disease

59. Artemeter
Indications
 Management of severe malaria (injection)
 In combination with other drugs in the treatment of uncomplicated malaria
caused by P. falciparum (oral).
Adverse effects
 N, V, D
 Headache
 Tinnitus
 Elevated liver enzyme values
 ECG abnormalities
Contra-indications
 First trimester of pregnancy

60. Quinine
Indications
 Multi-drug resistant P. falciparum malaria
 Orally in the treatment of uncomplicated P. falciparum malaria in first trimester
of pregnancy in combination with Clindamycin
Adverse effects
 Cinchonism
 Hypersensitivity reactions
Contra-indications
 Haemoglobinuria
 Optic neuritis
 Tinnitus
 Myasthenia gravis

61. Lamivudine
Indications
 Treatment of chronic HBV in
adult and children > 16 yrs
 HIV infection in combination
with at least two other ARV drugs
 Prevention of mother-to-child
transmission of HIV
Adverse effects
 N, V, D
 Abdominal pain
 Cough
 Headache
 Fatigue
 Insomnia
 Malaise
 Fever
 Rash
 Alopecia
Contra-indications
 Hypersensitivity
 Paediatric patients with a history
of or sig. risk factors for
pancreatitis (use only if no
alternative)

62. ANTINEOPLASTIC, IMMUNOSUPPRESSIVE
MEDICINES AND ADJUVANTS
1. Actinomycin-D
2. Azathioprine
3. Bleomycin
4. Busulphan
5. Chlorambucil
6. Cisplastin
7. Cyclophosphamide
8. Cytarabine
9. Dexamethasone
10. Doxorubicin
11. Fluorouracil
12. Mercaptopurine
13. Methotrexate
14. Prednisolone
15. Procarbazine
16. Stilboesterol
17. Tamoxifem
18. Vincristine
62

63. Dexamethasone
Indications
 Adjunct in the emergency
treatment of anaphylaxis
 Suppression of inflammatory and
allergic disorders
 Shock
 Skin diseases
 Cerebral oedema
Adverse effects
 Nausea
 Vomiting
 Stomach upset
 Heartburn
 Headache
 Endocrine effects including
adrenal suppression, menstrual
irregularities and amenorrhea,
hirsutism, increased appetite
Contra-indications
 Systemic infection
 Avoid chronic use in lactating
mothers
63

64. Methotrexate
Indications
 Rheumatoid arthritis
 Carcinoma of the breast, head
and neck, and lung
 Non-Hodgkin lymphomas
Adverse effects
 Liver damage
 Pulmonary toxicity
 Renal failure
 Skin reactions
 Alopecia
 Osteoporosis
Contra-indications
 Pregnancy and lactation
 Immunodeficiency syndromes
64

65. MEDICINES FOR PARKINSONISM AND
OTHER NEUROLOGICAL DISORDERS
Antiparkinsonism drugs
1. Benzhexol
2. Biperiden
3. Levodopa + Carbidopa
Drugs for Myasthenia gravis
1. Neostigmine
2. Pyridostigmine
65

66. Benzhexol
Indications
 Adjunctive treatment of Parkinson’s disease
 Extrapyramidal syndrome induced by phenothiazines and reserpine
Adverse effects
 Constipation
 Dry mouth
 Decreased sweating
 Dry mouth, throat and skin
 Difficult urination
Contra-indications
 Hypersensitivity
 Narrow-angle glaucoma
 Myasthenia gravis

67. Neostigmine
Indications
 Myasthenia gravis
 Postoperative urinary retention
Adverse effects
 Increased salivation
 Nausea, vomiting, diarrhoea
 Abdominal cramps
Contra-indications
 Recent intestinal or bladder surgery
 Mechanical intestinal or urinary tract obstruction
 Pneumonia

68. MEDICINES AFFECTING THE BLOOD
Anti-anaemic Medicines (Haematinics)
1. Ferrous salt
2. Folic acid
3. Hydroxocobalamin (Vitamin B12)
Medicines Affecting Coagulation
1. Desmopressin
2. Phytomenadione (Vitamin K1)
3. Heparin sodium
4. Warfarin
68

69. Folic acid
Indications
 Treatment of folate-deficiency megaloblastic anemia
 Prevention of neural tube defect in pregnancy
Adverse effects
 Folate dependent malignant disease
 Rash
 Irritability
 Difficulty sleeping
 Malaise
Contra-indications
 Used cautiously in undiagnosed anemias

70. Desmopressin
Indications
 Treatment of diabetes insipidus
 Controlling of bleeding in mild to moderate haemophilia
 Nocturnal enuresis
Adverse effects
 Nausea
 Abdominal cramps
 Headache
 Dizziness
 Increase in BP
 Pain at injection site
Contra-indications
 Hypersensitivity
 Cardiac insufficiency

71. Warfarin
Indications
 Prophylaxis of embolization in rheumatic heart disease and atrial fibrillation
 Prophylaxis and treatment of venous thrombosis and pulmonary embolism
 Transient ischemic attack
Adverse effects
 Hypersensitivity (rash)
 Haemorrhage
 Alopecia
 N, V
 Pancreatitis
Contra-indications
 Pregnancy
 Peptic ulcer
 Severe hypertension

72. THANK YOU!

73. 73