Don A

Domperidone

Description

Don A is a dopamine antagonist that principally blocks the dopamine receptors located in the chemoreceptor trigger zone and stomach its gastro prokinetic action is based on its blocking effect of dopamine receptors that have an influence on the motility of gastro intestinal tract due to its weak penetration across the blood brain barrier Don A has almost no effect on the dopaminergic receptors in the brain therefore excluding psychotropic and neurologic side effects Don A restores normal motility and tone of the upper gastro intestinal tract facilitates gastric emptying enhances antral and duodenal peristalsis and regulates contraction of the pylorus Don A also increases esophageal peristalisis and lower esophageal sphincter pressure and thus prevents regurgitation of gastric content

Indications

Don A is indicated for

Stimulation of gut mobility

a)     Non ulcer dyspepsia

b)    Esophageal reflux, reflux esophagitis and gastritis

c)     Diabetic gastro paresis

d)    Functional dyspepsia

e)     Speeding barium transit in follow through radiological studies.

Dosage and administration

Dose and frequency of administration should be adjusted according to severity and duration of symptoms Don A tablet suspension and paediatric drops should be taken minutes before meal.

Contraindications

Domperidone is contraindicated to the patients with known hypersensitivity to this drug and in case of neonates

Precautions

Domperidone should be used with absolute caution in case of children because there may be increased risk of extra pyramidal reactions in young children because of an incompletely developed blood brain barrier since Domperidone is highly metabolized in liver it should be used with caution in patients with hepatic impairment

Side effect

The common side effect of Domperidone is hyperprolactinemia which may result in galactorrhea breast enlargement soreness and reduced libido other side effects are dry mouth thirst headache nervoudness drowsiness diarrhea skin rash and itching which may occur during treatment with Domperidone extra pyramidal reactions are seen in 0.05% of patients in clinical studies.

Flexi

Aceclofenac BP

Composition

Flexi tablet ach film coated tablet contains aceclofenac BP 100mg

Pharmacology

Flexi aceclofenac is a non steroidal agent with market anti inflammatory and analgesic oroperties it is a pitent inhibitor of the enzyme cyclooxigenase which is involved in the oroduction of prostaglandin after oral administration  aceclofenac is rapidly and completely absorbed as unchanged drug peak plasma concentrations are reached approxi mately 1.25 to 3.00 hours following ungestion aceclofenac penetrates into the synovial fluid where the concentrations reach approximately 57% of those in plasma the mean oplasma elimination half life is around 4 hours aceclofenac is highly portion bound aceclofenac circulates mainly as unchanged drug 4 hydroxy aceclofenac is the main metabolite detected in plasma approximately two thirds of the administered dose is excreted via the urine mainly as hydroxyme tabolites

Indication

For the relief of pain and inflammation in osteoarthists rheumatoid arthritis and ankylosing spondylitis  

Dosage and administration

Adult the recommended dose is 100mg twice daily

children there are no clinical data on the use of aceclofenac in children

elderly the pharmacokinetics of aceclofenac is not altered in elderly patients therefore it is not considered necessary to modify the dose or dose frequency

Contraindication and precaution

Aceclofenac should not be administered to patients with active or suspected peptic ulcer or gastric intestinal bleeding it should not be given to patients with moderate to severe renal impairment close medical surveillance is also imperative in patients suffering from severe impairment of hepatic function ir should not be prescribed during pregnancy unless there are compelling reasons for doing so the lowest effective dosage should be used aceclofenac should not be administered to patients previously sensitive to aceclofenac or in whom aspirin or NSAIDs precipitate arracks of asthma acute rhinitis or urticaria or who are hypertensive to these drugs

Side effects

The majority of side effects observed have been reversible and of a minor mature and include gastro intestinal disorders dyspepsia abdominal pain nausea and diarrhea and occasional occurrence of dizziness dermatological complaints including pruritus and rash and abnormal hepatic enxyme levels and raised serum creatinine have occasionally been reported.

Drug interaction

Lithuma and digoxim aceclofenac like many NSAIDs may increase plasma concentrations of  lithium and digoxin.

Rolac

Kerorolac tromethamine

Description

Rolac contains ketorolac tromethamine which is a member of the pyrrolopyrrole group of no steroidal anti-inflammatory drugs that exhibits analgesic anti inflammatory and antipyretic activity it has more pronounced amalgesic activity than ost nsaids ketorolac inhibits synthesis of prostaglandins any may be considered a peripherally acting analgesic ketorolac tromethamine 3 mg intramuscularly appears to be similar in efficacy to morphine 12 mg intramuscularly appears to be similar in efficacy to motphine 12 mg and superior to pethidine 100 mg it has no opioid activity and thus does not present a problem of addiction

Composition

Rolac tablet each film coated tablet contains ketorolac tromethamine usp 10 mg

Indication

Rolac ampoules are indicated for the short term management of moderate to severe acute postoperative pain

Rolac tablet are indicated for the short term management of moderate postoperative pain

Dosage and administration

Rolac ampoules ara for administration by intramuscular or bolus intravenous injection bolus intravenous doses should be given over no less than 15 seconds rolac ampoules should not be used for epidural or spinal administration the time to onset of analgesic effect following both i.v and i.m administration is similar and is approximately 30 minutes with maximum analgesia occurring within 1 to 2 hours the median duration of analgesia is generally 4 to 6 hours dosage should be adjusted according to the severity of the pain and the patient response duration of treatment the administration of continuous multiple daily doses of rolac intramuscularly or intravenously should not exceed 2 days because adverse event may increase with prolonged usage threw has been limited experience with dosing for longer periods since the vast majority of patients have transferred to oral medication or no longer require analgesic therapy after this time rolac tablets are recommended for short term use only up to 7 days and are not recommended for chronic use adults ampoules the recommended initial dose of rolac is 10 mg followed by 10-30 mg every 4to 60 hours as requited in the initial postoperative period rolac may be given as often

Contraindication

A history of poetic ulcer of gastrointestinal bleeding suspected or confirmed cerebrovascular bleeding hemorrhagic diatheses including coagulation disorders patients with hypersensitivity to kerolac tromethazine or other naiads and patients in whom aspirin or other prostaglandin synthesis inhibitors induce allergic reactions

Side effects

Gastro intestinal nausea dyspepsia gastro intestinal pain abdominal discomfort bowel changes gastritis diarrhea   

Precautions

Physicians should carefully weigh the potential risks and benefits of its use on a long term basis patients should be instructed to watch for signs of serious GL adverse events and they should monitored more closely than if they were on another NSAID.