The document discusses critical care injectables used in intensive care units. It describes conditions that may require critical care like problems with organs and major trauma. It also lists different types of intensive care units and provides examples of preferred critical care molecules used in two hospitals, identifying the brand name, company, molecule, class, and indications. The most consumed critical care molecule in one hospital was hydrocortisone.

1. CRITICAL CARE
INJECTABLES
PRESENTED
BY
SUDIPTO HALDAR

2. WHY CRITICAL CARE
 Problems with the heart and blood vessels - such as very high blood
pressure, very low blood pressure (called shock), abnormal heart
beats, or a heart attack.
 Problems with the lungs - such as asthma, severe pneumonia, or
pulmonary embolism (blood clots in the lung).
 Problems with salts, chemicals, or minerals in the bloodstream -
The body's cells require a number of substances that must be
present in the correct balance for the body to work properly.

3. WHY CRITICAL CARE
 Brain injuries - Severe brain injuries including bleeding, stroke and
head trauma, may cause loss of consciousness, also called coma.
 Severe trauma - such as auto accidents, gunshot wounds and burns.
 Major surgery - Patients undergoing major surgery, who need
special monitoring or who are at high risk of having problems after
the operation.

4. CLASSIFICATION OF CRITICAL CARE
 Neonatal Intensive Care Unit (NICU)
 Pediatric Intensive Care Unit (PICU)
 Psychiatric Intensive Care Unit (PICU)
 Coronary Care Unit (CCU)
 Post Anesthesia Care Unit (PACU)
 High Dependency Unit (HDU) or Post-Operative Critical Care Unit
(POCCU)
 High Dependency Unit (HDU)
 SVU Ward
 PSDU Ward

5. INSIGHT FOR CRITICAL CARE INJECTABLES IN
RTIICS/DEVI SHETTY MUKUNDAPUR

6. Preferred CC Molecule In RTIICS
BRAND NAME COMPANY MOLECULE CLASS INDICATIONS
RANTAC J.B. Ranitidine H2 Critical condition & acid
50mg / 2ml Chemicals Antagonist(Reduction aspiration syndrome
Of gastric Acid
Secretion)
ZIN TAC GSK Zantac H2 Duodenal ulcer, benign
Injection 50 mg/2ml Antagonist(Reduction gastric ulcer, post -
Of gastric Acid operative ulcer, reflux
Secretion) oesophagitis, Zollinger -
Ellison Syndrome
TAZACT CIPLA Piperacillin Extended Spectrum Noscomial pneumonia,
piperacillin 4 g, +Tazobactum Penicillins(Ureidopenici various infections for
tazobactam sodium llins)+ β- lactame antibacterial agent,
500 mg, piperacillin Inhibitors diabetes related foot
2 g, tazobactam 250 infections, peritonitis,,
mg, piperacillin 1 g, febrile neutropenia
tazobactam 125 mg.

7. Preferred CC Molecule In RTIICS
BRAND COMPANY MOLECULE CLASS INDICATIONS
NAME
PANTAC Pantoprazole Proton Pump Gastroesophageal
Inhibitors reflux disease (GERD),
ulcers, Zollinger-
Ellison Syndrome, and
erosive esophagitis
STECORT RANBAXY Hydrocortisone Corticosteroids relative corticosteroid
(100mg IV, IM) insufficiency in
patients with severe
septic shock,
adrenal insufficiency,
steroid responsive
inflammatory
conditions
LASIX SANOFI- Furosemide Diuretics For Adult& paed
(10mg/ml) AVENTIS Edema associate with
CHF, Renal failure,
acute pulmonary
edema

8. Preferred CC Molecule In RTIICS
BRAND NAME COMPANY MOLECULE CLASS INDICATIONS
ARIXTRA GSK (fondaparinux Anticoagulant Prophylaxix of
Na) (factor XA DVT, acute
inhibitor) pulmonary
embolism, Knee
replacement,
abdominal surgery
NITROCIN inj NA 10 mg Unresponsive
(proprietary) Nitroglycerin in systolic Left
10 ml sterile ventricular failure
isotonic sol, 50
mg in 50 ml
ONDET Intas Ondansteron Antiemetic Nausea &
2mgx1mlx10ml, vomiting
2mgx 1mlx2ml,
2mgx 1mlx4ml
BEPARIN BIO E Heparin Anticoagulant Atrial fibrillation
with embolization
LOX Neon Labs Lignocaine Antiarrhythmic Itching, burning,
skin inflammation

9. Maximum Number of CC Molecule consumption in
RTIICS (in a Week)
Weekly Consumption (Vial)
Analysis:
Maximum No. of
60 consumption:
50
Hydrocortisone
mol. In RTIICS
40
30 53
40
20
25
10 15 18
0
Total Vial Consumption: 600-800 approx.

10. INSIGHT FOR CRITICAL CARE INJECTABLES IN
APOLLO HOSPITAL

11. Preferred CC Molecule In APOLLO,KOLKATA
Brand Name Company Molecule Class Indication
Metrogyl Inj J.B. Chemicals Metronidazole Nitroimidazole In prophylaxis &
500mg/100ml treatment of
Anaerobic
infections
Augmentin GSK AmoxicillinNa+ Upper
Clavulanic acid respiratory tract
IV 0,6 500 mg of infection:
IV 1,2 Amoxicillin & 100 sinustis, otitis
mg Cl. Acid media, tonsilitis.
Or 1000 Lower respiratory
mg/200mg tract Infection:
Bronchitis,
Urinary Tract
Infections:
Cystitis, Urethritis

12. Preferred CC Molecule In APOLLO,KOLKATA
Brand Company Molecule Class Indication
Name
Zobactin, GSK, CIPLA Piperacillin+ Extended Same
Tazact Tazobactum Spectrum (mentioned in
Penicillins(Ureid RTIICS)
openicillins)+ β-
lactame
Inhibitors
AMIKIN Health& Bio Amikacin Aminoglycoside In serious kidney
antibiotic problem treat
bacterial
infection
ESBLANEM, GSK, Astrazeneca Meropenam Febrile
MERONEM neutropenia, he
matological
malignacies, Bon
e marrow
suppression

13. Preferred CC Molecule In APOLLO,KOLKATA
Brand Name Company Molecule Class Indication
DORIBAX Janseen Doripenem Carbapenem Complicated intra
Pharmaceuticals Monohydrate antibiotics abdominal
infections,
Complicated
urinary tract
infections
Total Consumption: Approximately 3000 vial in a week

14. Maximum No.Of CC Molecule consumption in
Apollo,Kolkata
Weekly consumption(Vial)
200
180 Analysis:
160 Nitroimidazole
140 & Antibiotic
120 consumption is
200 200
100 more.
80
60 110
40
20
40 30
0
Metronidazole Piperacillin+ Amoxicillin Doripenem Acyclovir
Tazobactum Na+ Clavunate

15. MARKET SURVEY ON CRITICAL CARE
INJECTABLES IN AMRI(SALTLAKE)

16. MARKET SURVEY OF AMRI(SALTLAKE)
 No. of General wards: 10-12 (no. of beds 1oo
& above)
 ICU: 1 (no. of beds 10-12)
 NICU:1 (no. of beds 15-20)
 PICU: 1 (no. of beds 10-12)

17. Target Patients for Critical Care
On basis of the survey of AMRI:
 NICU Patients(age group): 3-9 months
 PICU Patients (age group): 1-10 years
 ICU Patients(age group): 15-80 years

18. Molecule Preferred Most In AMRI,SALTLAKE
BRAND NAME COMPANY MOLECULE
MERONEM ASTRAZENECA Meropenam
NA NA Itraconazole, Fluconazole,
LiposomalAMP B
NA NA Capsofungin
Total Vial Consumption: 1000 approx.

19. Insight for CRITICAL CARE BELLE VUE
CLINIC

20. PREFERRED MOLECULE IN BELLE VUE CLINIC
BRAND NAME COMPANY MOLECULE
3 CEF NOVO 1.5, 3 CEF NOVO ALKEM Cefoperazone Na, Sulbactam
375
Pigewest NA Pigecycline(tetracycline-
antibacterial
Tazact CIPLA Piperacillin +Tazobactum
Cancidas Merck & CO Capsofangin(antifungal)
Total Consumption: 1500-2000 vial in weekly basis(approx)

21. Most Common Critical Care Diseases
according to Doctor’s feedback
 Asthma
 Renal Failure
 Diabetic Coma
 Cerebrovascular Hameorrhage
 Acute Coronary syndrome

22. Maximum Number of Critical Care Disease
Percentage of Disease(%)
20 30
10 Acute Coronary Syndrome 35-50 yrs
Brain stroke 50 & above yrs
Pregnancy 20-30 yrs
Others 10-80 yrs
40
Analysis: Elderly
patients suffer much
more in critical care
condition

23. Present Trend in Molecule Level
 According to survey in antibiotic the present trend is moving to the
Uripenam/ Indipenam
 80% cases antibiotic is preferred molecule.
 Hydrocortisone is also useful for critical care treatment.
 Adrenaline, Morphine widely used in Critical care for Govt. Hospital
as well as Non Govt. Hospitals, Nursing homes.