Incompatibilities in prescription, prescription Incompatibilities, important ...RajkumarKumawat11
Incompatibilities in prescription, prescription Incompatibilities, pharmaceutics, prescription errors, important topic for pharmacist, how to remove error in the dispense and compound prescription
Incompatibilities in prescription, prescription Incompatibilities, important ...RajkumarKumawat11
Incompatibilities in prescription, prescription Incompatibilities, pharmaceutics, prescription errors, important topic for pharmacist, how to remove error in the dispense and compound prescription
Incompatibility occurs as a result of mixing of two or more antagonistic substance and an undesirable product is formed which may affect the safety, efficacy and appearance of the pharmaceutical preparation.
The change may be detected by change in physical, chemical and therapeutic qualities of the medicines.
Types : 1 Physical 2 Therapeutic 3 Chemical
An excipient is generally a pharmacologically inactive substance used as a carrier for the active ingredients of a medication
EXCIPIENTS USED IN LIQUID DOSAGE FORMS:
Solvents/co-solvents ,
Buffering agents,
Preservatives,
Anti-oxidants,
Humectants,
Wetting agents,
Anti-foaming agents,
Thickening agents,
Sweetening agents,
Flavouring agents,
EXCIPIENTS USED IN TABLETS:
Binders
Coatings
Disintegrants
Fillers
Flavours
Colours
Lubricants
Glidants
Preservatives
Sweeteners
Incompatibility occurs as a result of mixing of two or more antagonistic substance and an undesirable product is formed which may affect the safety, efficacy and appearance of the pharmaceutical preparation.
The change may be detected by change in physical, chemical and therapeutic qualities of the medicines.
Types : 1 Physical 2 Therapeutic 3 Chemical
An excipient is generally a pharmacologically inactive substance used as a carrier for the active ingredients of a medication
EXCIPIENTS USED IN LIQUID DOSAGE FORMS:
Solvents/co-solvents ,
Buffering agents,
Preservatives,
Anti-oxidants,
Humectants,
Wetting agents,
Anti-foaming agents,
Thickening agents,
Sweetening agents,
Flavouring agents,
EXCIPIENTS USED IN TABLETS:
Binders
Coatings
Disintegrants
Fillers
Flavours
Colours
Lubricants
Glidants
Preservatives
Sweeteners
" Stability testing is an essential part of the process of ensuring that the patient receives a product that meets established standards of safety, efficacy and quality."
Content :
* USP Definition of Stability.
* The Five Types of Stability.
* Factors affecting stability.
* Stability studies in manufacturing.
* Observing products for evidence of instability.
* Responsibility of the pharmacist.
Reference : USP – United States Pharmacopeia, 2008.
{1191} Stability consideration in dispensing practice/ General information, page 2414.
Introduction,Drug- Excipient Compatibility Experimental Design ,Excipient role in drug destabilization,DRUG EXCIPIENT COMPATIBILTY IN PARENTERAL PRODUCTS.This topic are described.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
1. RATNAM INSTITUTE OF PHARMACY
INCOMPATIBILITIES IN PRESCRIPTIONS
By,
MR. CH.PRAVEEN KUMAR M.Pharm., (Ph.D)
ASSOCIATE PROFESSOR
DEPARTMENT OF PHARMACEUTICS
2. 2
INTRODUCTION
Incompatibility -
Incompatibility occurs as a result of mixing of two or more antagonistic substances and an
undesirable product is formed, which may affect the safety, efficacy, appearance and stability of the
pharmaceutical product.
It is of three types.
Physical,
Chemical and
Therapeutic incompatibilities.
3. 3
INTRODUCTION
Incompatibility -
Incompatibilities occur during:
Compounding
Formulation
Manufacturing
Packaging
Dispensing
Storage
Administration of drugs
The incompatibilities may be detected by changes in the physical, chemical, and therapeutic
qualities of the medicine.
4. 4
Incompatibility
Physical Incompatibility -
When two or more than two substances are combined together, a physical change takes place and an
unacceptable product is formed.
Manifestations of physical incompatibility –
Insolubility:-insolubility of prescribed agents in vehicle
Immiscibility:-Immiscibility of two or more liquids
Precipitation:-It occurs due to solvent is insoluble when it is added to solution
Liquefaction:-Liquefaction of solids mixed in a dry state (called eutexia)
5. 5
Incompatibility
Physical Incompatibility - Insolubility
It means the inability of material to dissolve in a particular solvent system. The majority of
incompatibilities is due to insolubility of the inorganic as well as organic compounds in particular
solvents.
The following factors affect the solubility of prescribed agent in vehicle and may render it less
soluble.
Change in pH
Milling
Surfactant
Chemical reaction
Complex formation
Co-solvent
6. 6
Incompatibility
Physical Incompatibility - Insolubility
Insolubility of inorganic compounds –
1. Metals and their salts:
Alkali metals – These cations are listed in decreasing order of solubility
Alkaline earth metals – Water soluble salts with univalent anions, insoluble salts with divalent and
trivalent anions .
Boron compounds are water soluble, Mercurous salts are insoluble and mercuric salts are soluble in water.
2. Non metals:
Sulphur and Iodine are commonly used. Sulphur is insoluble in water and common solvents. Iodine is
made soluble in water in the presence of potassium iodide.
7. 7
Incompatibility
Physical Incompatibility - Insolubility
Insolubility of organic compounds –
Organic compound contain polar and non polar parts except hydrocarbons.
- Hydrocarbons are completely nonpolar and does not dissolves in water
-Solubility of other organic compounds depend on polar and non-polar parts.
Organic compound soluble in water by forming
-Hydrogen bond or
- Ionisation.
8. 8
Incompatibility
Physical Incompatibility - Insolubility
Insolubility of organic compounds –
Solubility of organic compounds was based on functional groups to carbon atoms
Term Functional group Carbon atom
Soluble 1, 2 3, 6
Slightly soluble 1,2 5, 10
Insoluble 1 6 and >6
E.g.:-
Phenol Resorcinol
Phenol is less soluble when
compared to resorcinol due to
presence of less functional groups
compared to phenol.
9. 9
Incompatibility
Physical Incompatibility - Immiscibility
When two such ingredients are combined resulting in a non- homogenous product, such ingredients
are called immiscible to each other and the phenomenon is called immiscibility. This manifestation
appears clearly in emulsions, creams, lotions, some types of ointments. Separation in two phases is
noticed in this pharmaceutical dosage form .
The following factors lead to immiscibility
Incomplete mixing
Addition of surfactant with unsuitable concentration
False time of addition - Unsuitable for the type of emulsion
Presence of micro – organisms - Some bacteria grow on constituents of mixture.
10. 10
Incompatibility Physical Incompatibility - Immiscibility
E.g.:- Castor oil emulsion
Rx
Castor oil – 15ml
Water – 60ml
Causes: -In this prescription castor oil is immiscible with water due to high interfacial tensions,
which is a sign of incompatibility.
Remedy:-To overcome this type of incompatibility emulsification is necessary with the help of an
emulsifying agent. The corrected prescription is
Rx
Castor oil – 15ml
Acacia – 2% W/V
Water– upto 60ml
11. 11
Incompatibility
Physical Incompatibility - Liquefaction
When certain low melting point solids are mixed together, a liquid or soft mass know as eutectic
mixture is produced. This occurs due to the lowering of the melting point of the mixture to below
room temperature and liberation of hydrates.
The medicaments showing this type of behavior are camphor, menthol, phenol, thymol, chloral
hydrate, aspirin, sodium salicylates, etc……
12. 12
Incompatibility Physical Incompatibility - Liquefaction
E.g.:-Insufflations
Rx
Menthol – 5g
Camphor – 5g
Water – 60ml
Rx
Menthol – 5g
Camphor – 5g
Light kaolin– 0.2g
Triturate together to form liquid and mixed with an absorbent (light kaolin, magnesium carbonate)
to produce the following powder. The individual medicaments is powdered separately and mixed
with an adsorbent and then combined together.
13. 13
Incompatibility Physical Incompatibility - Precipitation
Solubilized substances may precipitate in solution if a non-solvent for the substances is added to the
solution.
E.g.:- Resins are insoluble in water
Alcoholic solution of resins + water =precipitated resins.
Polysaccharide mucilage + high concentration of alcohol or salts =precipitated colloids.
E.g.:- Lotion of compound tincture of benzoin
Rx
Tincture benzoin compound – 5g
Glycerin – 10ml
Rose water upto 100ml
Cause – Unavoidable precipitate, Remedy – Rapid mixing
14. 14
Incompatibility
Chemical Incompatibility -
Reaction between two or more substances which lead to change in chemical properties of
pharmaceutical dosage form. As a result of this a toxic or inactive or product may be formed.
Occurrence:-
Chemical incompatibilities occur, due to the
chemical properties of drugs and additives like,
pH change
Oxidation-reduction reactions
Acid-base hydrolysis
Double decomposition
Complex formation
These reactions may be noticed by
Precipitation
Effervescence
Decomposition
Color change
Explosion
15. 15
Incompatibility Chemical Incompatibility - Types
Based on chemical interactions -
Tolerated incompatibility: - In this type incompatibility, the chemical interactions can be changing the
order of mixing the solutions in dilute forms, without or by changing the order of mixing.
Adjusted incompatibilities: - In adjusted incompatibility change in the formulation is needed with a
compound having equal therapeutic value.
Based on nature of chemical reaction -
Immediate incompatibilities: - If the chemical reaction takes place, immediately after combining the
prescription ingredients, they are called immediate incompatibilities. Hence, they should be dispensed
only after correction.
Delayed incompatibility: - When the chemical reaction proceeds at a very slow rate and no appreciable
visible change occurs which may develop on keeping the product for along time are called delayed
incompatibility.
16. 16
Incompatibility
Chemical Incompatibility - Types
Based on the prescriber -
Intentional:- When the prescriber knowingly prescribes the incompatible drugs.
Unidirectional:- When the prescriber prescribes the drugs without knowing that there is incompatibility
between the prescribed drugs.
Generally reaction between strong solution proceed at a faster rate and the precipitates are formed are
thick and do not diffuse readily. Reaction between the dilute solutions proceeds at a slow rate and the
precipitates formed are light and diffuse readily in the solution.
17. 17
Incompatibility
Chemical Incompatibility -
Precipitate yielding interactions
The precipitates so formed may be diffusible or in-diffusible. The method A or B is followed in dispensing
the prescription yielding diffusible and in-diffusible precipitates respectively. The preparation should
contain a thickening agent if the precipitate is non-diffusible .
Method A: (For diffusible precipitates)
Method B: (For in-diffusible precipitates)
A secondary label ―SHAKE WELL BEFORE USE‖ should be fixed on the container whenever method A or
method B is followed in dispensing the prescription.
18. 18
Incompatibility Chemical Incompatibility -
E.g.:-
Alkaloid incompatibility:-
1. Alkaloidal salts with alkaloid substances
2. Alkaloidal salts with soluble iodides
3. Alkaloidal salts with tannins
4. Alkaloid salts with salicylates
5. Alkaloid with soluble iodides and bromides.
E.g.:-
Soluble salicylates incompatibility:-
1.Soluble salicylates with ferric salts
2.Soluble salicylates with alkali bicarbonates
3.Soluble salicylates and benzoates with acids.
E.g.:-
Soluble iodides incompatibility:-
1.Oxidation of iodides with potassium chlorate
2.Oxidation of iodides with quinine sulphate.
19. 19
Incompatibility Chemical Incompatibility -
E.g.:- Alkaloidal incompatibility
Rx
Quinine hydrochloride– 0.12g
Sodium salicylate – 4g
water upto -100ml
Cause – in-diffusible precipitates of quinine
salicylate, Remedy – Method -B
E.g.:- Salicylate incompatibility
Rx
Ferric chloride solution– 2 ml
Sodium salicylate – 3g
water upto -90ml
Cause – in-diffusible precipitates of quinine
salicylate, Remedy – Method -B
E.g.:- Iodide incompatibility
Rx
Quinine sulfate – 1.5g
Dil Sulfuric acid- 4 ml
Potassium iodide – 8 g
water up to -200ml
Cause – Iodosulphite of quinine (Herapathite) – Herapath reaction – olive green crystals,
Remedy – Prepare the mixture for 3 days only.
20. 20
Incompatibility Chemical Incompatibility -
E.g.:-
Chemical incompatibility causing evolution of carbon dioxide gas:-
Miscellaneous incompatibilities:-
1.Potassium chlorate with oxdisable substances
2. Incompatibility of emulsifying agent
3. Color stability of dyes
4. Incompatibilities of liquorices liquid extract
21. 21
Incompatibility Therapeutic Incompatibility -
It may occur as a result of prescribing certain drugs to a patient with the intention to produce a
specific degree of pharmacological action, but the intensity of action produced is different from that
intended by the prescriber.
It is divided into two groups. They are
Pharmacokinetics: It involves the effect of a drug on another from the point of view that includes
absorption, distribution, metabolism and excretion.
Pharmacodynamics: These are related to the pharmacological activity of the drugs.
E.g., Synergism, antagonism, altered cellular transport, effect on the receptor site.
22. 22
Incompatibility
Therapeutic Incompatibility -
Therapeutic incompatibilities occurs due to following reasons
a. Error in dosage
b. Wrong dose or dosage form
c. Contra-indicated drugs
d. Synergistic and antagonistic drugs
e. Drug interactions
23. 23
Incompatibility
Therapeutic Incompatibility - ERROR IN DOSAGE
Many therapeutic incompatibilities result from errors in writing or interpreting the prescription order.
The most serious type of the dosage error in the dispensing is overdose of a medication
E.g., Atropine sulphate capsules
Rx
Atropine sulphate - 0.005g
Phenobarbitone - 0.015g
Aspirin - 0.300g
Cause: Over Dose, Remedy: (referred back to the prescriber)
The recommended dose of atropine for a single capsule is 0.25 to 2mg .
24. 24
Incompatibility
Therapeutic Incompatibility – WRONG DOSE OR DOSAGE FORM
There are certain drugs which have quite similar names and there is always a danger of dispensing the
wrong drug.
E.g.,
Prednisone and Prednisolone
Digoxin and Digitoxin
25. 25
Incompatibility
Therapeutic Incompatibility – CONTRAINDICATED DRUGS
There are certain drugs which may be contra-indicated in a particular disease or a particular patient
who is allergic to it.
E.g.,
Corticosteroids are contra-indicated in the patients having peptic ulcers.
The penicillin and sulphur drugs are contra-indicated in the patients who are allergic.
Vasoconstrictors are contra-indicated in hypertensive patients.
Barbiturates and morphine should not be given to the asthmatic patients.
26. 26
Incompatibility
Therapeutic Incompatibility – SYNERGISTIC & ANTAGONISTIC DRUGS
When two drugs are prescribed together, they tend to increase the activity of each other which is
known as SYNERGISM. When two drugs are prescribed together, they tend to decrease the activity of
each other which is known as ANTAGONISM.
E.g.,
A combination of aspirin and paracetamol increases the analgesic activity.
A combination of penicillin and streptomycin increases the antibacterial activity.
Amphetamines show its antagonists effect with the barbiturates.
27. 27
Incompatibility
Therapeutic Incompatibility – DRUG INTERACTIONS
The effect of one drug is altered by the prior or simultaneous administration of another drug. The
drug interaction can usually be corrected by the proper adjustment of dosage if the suspected
interaction is detected.
E.g., Tetracycline capsules - 250mg capsules
Direction: Take one capsule every 6 hours with milk.
Causes:-Tetracycline is inactivated by calcium present in milk. So, it should not be taken with milk.
Remedy: In this prescription, the therapeutic incompatibility is unintentional. So, the prescription is referred
back to the prescriber to change the direction.