AnticholinergicsContraindications:Contraindicated in patients hypersensitive to drug.Special Precautions:Contraindicated in patients who have angle-closure glaucoma, renal or GI obstructive disease,reflux esophagitis or myasthenia gravis.Adverse Drug Reaction:Therapeutic doses commonly cause dry mouth, decrease sweating or anhidrosis, headache,mydriasis, blurred vision, cycloplegia, urinary hesitancy, urine retention, constipation, palpitationand tachycardia. These reactions usually disappear when therapy stops. Toxicity can cause signsand symptoms resembling psychosis (disorientation, confusion, hallucinations, delusions, anxiety,agitation and restlessness); dilated non-reactive pupils; blurred visions; hot dry flushed skin; drymucous membranes; dysphagia; decreased or absent bowel sounds; urine retention; hyperthermia;tachycardia; hypertension and increased respirations.Drug Interaction:AcetylcysteineContraindications:Contraindicated in patients hypersensitive to drug. Use cautiously in debilitated patients withsevere respiratory insufficiency. Use I.V. form cautiously in patients with asthma or a history ofbronchospasm. In pregnant women and breast-feeding and elderly patients with severe respiratoryinsufficiency, use cautiously.Special Precautions:Asthmatic patients, history of bronchospasm, peptic ulceration. Pregnancy, lactation.Adverse Drug Reaction:Flushing, fever, stomatitis, nausea, vomiting, rhinorrhoea, bronchospasm, anaphylactoid reactions,rashes. Rarely, blurred vision, bradycardia, syncope, thrombocytopenia, convulsions.Potentially Fatal: Rarely, respiratory or cardiac arrest.Drug Interaction:Activated charcoal: Limits acetylcysteine’s effectiveness.
AlbuterolContraindications:Contraindicated in patients hypersensitive to drug or its components. Use cautiously in patientswith CV disorders (coronary insufficiency, cardiac arrhythmias and hypertension),hyperthyroidism or diabetes mellitus; or unusual responsiveness to adrenergics. Use extended-release tablets cautiously in patients with GI narrowing. Use cautiously in pregnant women andbreast-feeding women.Special Precautions:Monitor patient response clinically & by lung function tests. Inhaled salbutamol prep are notappropriate for managing premature labor. Thyrotoxicosis; serious hypokalemia; acute severeasthma. Concomitant use w/ xanthine derivatives, steroids, diuretics & by hypoxia. Monitor serumK levels, fluid balance, cardioresp function & ECG. Consider starting or increasing corticosteroidtherapy in sudden & progressive deterioration of asthma control. Discontinue use if pulmonaryedema or myocardial ischemia develop. Pregnancy & lactation. Syr: Increased risk of dental cariesin long-term treatment. Nebules: Patients known to receive large doses of other sympathomimetics.Concomitant use w/ nebulized anticholinergics. Avoid contact w/ eyes. Increased blood sugarlevels, ketoacidosis. Monitor for the development of elevated serum lactate & consequent metabolicacidosis. Infant <18 mth.Adverse Drug Reaction:Tremor, headache; tachycardia. Tab/syr: Palpitations, muscle cramps.Drug Interaction:Nonselective β-blockers eg propranolol: mutual antagonism. CNS stimulants; increased CNSstimulation. MAO inhibitors, tricyclic antidepressants; Increased adverse CV effects.Amlodipine besylateContraindications :Known sensitivity to dihydropyridines.Special Precautions:Use cautiously in patients receiving other peripheral vasodilators (especially those with severeaortic stenosis) and in those with heart failure. In patients with severe hepatic disease, usecautiously and in reduced dosage because drug is metabolized by liver. Impaired liver function.Pregnancy & lactation.Adverse Drug Reaction:Headache, edema, fatigue, somnolence, nausea, abdominal pain, flushing, palpitations, dizziness.Asthenia, vasodilation & epistaxis.Drug Interaction:None reported.
CaptoprilContraindications :Hypersensitivity to the drug or other ACE inhibitors. Aortic stenosis, outflow tract obstruction, &renovascular disease. Pregnancy & lactation.Special Precautions:Peripheral vascular diseases, general artherosclerosis. Renal function should be checked prior to &during the treatment. Patients taking large doses should be monitored for proteinuria and theirWBC counts.Adverse Drug Reaction:Nausea, headache, dizziness, taste disturbances, skin reactions (uticaria, pruritus) cough,pneumonitis & cholestatic jaundice. CV: Tachycardia, hypotension, angina pectoris, heart failure,pericarditis. MI: palpitations, Raynaud syndrome. GI: anorexia, disgeusia. GU: proteinuria,membranous glomerulopathy, renal impairment. Hematologic: leucopenia, agranulocytosis,neutropenia.Drug Interaction:Allopurinol, antacids, antidiabetics, azathioprine, digoxin.IbuprofenContraindications :Hypersensitivity to the drug. Hypersensitivity to aspirin or other NSAIDs. Concurrent or previoushistory of GI ulcer or bleeding. Pregnancy (last trimester).Special Precautions:Do not take >10 days for pain or >3 days for fever or when severe allergic reaction including skinreddening, rash or blisters develops. Discontinue use if pain or fever persists or gets worse, painfularea is red or swollen, bloody vomit or stool. Asthma, heart or kidney disease, liver cirrhosis, HTN.Concomitant use w/ other NSAIDs (eg aspirin, acetaminophen). Pregnancy & lactation. Elderly.Adverse Drug Reaction:Abdominal pain, diarrhea, nausea w/ or w/o vomiting, GI bleeding & ulceration.Drug Interaction:Anticoagulants; diuretics, other antihypertensive drugs; corticosteroids, SSRIs; cyclosporine,tacrolimus; lithium, methotrexate.
FluconazoleContraindications:Hypersensitivity. Co-administration w/ terfenadine, cisapride, astemizole, pimozide, quinidine,erythromycin.Special Precautions:Monitor liver function, discontinue treatment if clinical signs & symptoms consistent w/development of liver disease. Pregnancy & lactation.Adverse Drug Reaction:Nausea, abdominal pain, diarrhea, flatulence; skin rash, headache. Dizziness, seizures, tasteperversion, QT prolongation, leukopenia including neutropenia & agranulocytosis,thrombocytopenia, angioedema, face edema, pruritus. Hepatic failure, hypertriglyceridemia &hypokalemia.Drug Interaction:Warfarin, oral sulfonylureas, phenytoin, rifampicin, cyclosporin, theophylline, terfenadine,zidovudine, OC, anticoagulants, losartan. Short-acting benzodiazepines, cisapride,hydrochlorothiazide, rifabutin, tacrolimus & astemizole. Erythromycin. Quinidine. Voriconazole.LactuloseContraindication:Galactosemia, bowel obstruction, hypersensitivity.Special Precautions:Use cautiously in patients with diabetes mellitus. Use cautiously in pregnancy & lactating women.Elderly.Adverse Drug Reaction:Flatulence, diarrhea.Drug Interactions:Drug-Drug: Antacids, antibiotics, oral neomycin: May decrease effectiveness of lactulose so avoidusing together. Drugs that have a colon pH-dependent release may be inactivated.MeropenemContraindication:Contraindicated in patients hypersensitive to drug or its components. Hypersensitivity. Pregnancy& lactation. Infant <3 mth.
Special Precautions:Hypersensitivity to carbapenems, penicillins or other β-lactam antibiotics. Considerpseudomembranous colitis in patients who develop diarrhea. Monitor liver function in patients w/preexisting liver disorders. +ve direct/indirect Coombs test.Adverse Drug Reaction:Thrombocythemia. Nausea, vomiting, diarrhea. Increases in serum transaminases, bilirubin,alkaline phosphatase, lactic dehydrogenase. Inflammation, thrombophlebitis, pain.Drug Interactions:Probenecid: Inhibits renal excretion of meropenem. Don’t give together. May reduce serumvalproic acid levelsOmeprazoleContraindication:Contraindicated in patients hypersensitive to drug or its components.Special Precautions:Rule out gastric malignancy when gastric ulcer is suspected before treatment w/ omeprazole.In pregnant women and breast-feeding women, use cautiously.Adverse Drug Reaction:Reversible confusional state, agitation, depression & hallucination. Arthralgia, paresthesia,aggression, blurred vision, taste disturbances, peripheral edema, hyponatremia, agranulocytosis,leukopenia, thrombocytopenia, interstitial nephritis & hepatotoxicity.Drug Interactions:Diazepam, phenytoin & warfarin.SimvastatinContraindication:Contraindicated in patients hypersensitive to drug or its components or those with active liverdisease or conditions that have unexplained persistent elevations of transaminase levels.Special Precautions:Use cautiously in patients who consume substantial quantities of alcohols or have history of liverdisease. Also, in pregnant women and breast-feeding women, use cautiously.Adverse Drug Reaction:CNS: Headache, asthenia. GI: abdominal pain, constipation, diarrhea, dyspepsia, flatulence, nausea.Respiratory: upper respiratory tract infection.
Drug Interactions:Drug-drug. Amiodarone, verapamil: Increases risk of myopathy and rhabdomyolosis. Don’t exceed20 mg simvastatin daily.TheophyllineContraindication:Contraindicated in patients with peptic ulcer, seizure disorders and hypersensitivity to xanthinecompounds.Special Precautions:Use cautiously in patients with COPD, corpulmonale, renal or hepatic disease, peptic ulcer,hyperthyroidism, diabetes, glaucoma, severe hypoxemia, hypertension, compromised cardiac orcirculatory function, angina, acute MI or sulfite sensitivity. In pregnant women, breast-feedingwomen and elders, use this drug cautiously.Adverse Drug Reaction:CNS: restlessness, dizziness, headache, insomnia, irritability, seizures, muscle twitching. CV:palpitations, sinus tachycardia, extrasystoles, flushing, marked hypotension, arrhythmias. GI:nausea, vomiting, diarrhea, epigastric pain. Respiratory: increased resp. rate, respiratory arrest.Drug Interactions:Drug-Drug. Adenosine: Decreases anti-arrhythmic effectiveness. Barbiturates, carbamazepine,phenytoin, rifampin: decreases theophylline level. Beta-blockers: Antagonizes drug; may causebronchospasm. Cimetidine, fluoroquinolones, hormonal contraceptives, influenza virus vaccine,macrolides: increases theophylline level.Drug-food. Any food: accelerates absorptions. Caffeine: increases theophylline level.Drug-Lifestyle. Smoking: Increases drug elimination and dosage requirement.