All the Therapeutic System Drugs
Anticholinergic agent. Atropine Sulphate 1 mg/ml. AMP. (sol. for IM, IV inj.): 5×1ml. Pre-anesthet. med.: Adults: 0.3-0.6 mg by IV inj. immed. before the anesthes. induct. or by IM inj. 30-60 min. before the induc.
Child.: 0.02 mg/kg (max. dose 0.6 mg).
Tmt. of sinus bradycard.: 0.3 and 1.0 mg IV.
Antidote in poison. by organophosphorus:
Adult.: 2 mg (IM or IV, taking into account the sever. of the poison.) every 5-10 min., until the skin becomes red and dry, the pupils dilate and tachycard. appears.
Child.: The 0.02 mg/kg.
Preanesthetic medication to decrease excessive salivation and secretions of the respiratory tract. Treatment of sinus bradycardia, particularly if complicated by hypotension.
Antidote in poisoning by organophosphorus.
C/I: Hypersens. Clos. ang. glauc., esophag. reflux, pyloric stenosis, GI obstruct., ulcerat. colit., prostat. hypertrophy, paralytic ileus, intest. atony.
Acetylcholinesterase Inhibitor. Pyridostigmine (Bromide) 60 mg. DRAGEES: 20. See lit.
Myasthen. gravis.
C/I: Hypersens., mechan. obstruct. GI/
urinary tract., inflamm. peritoneum,
disords. accomp. incr. tonus bronch.
muscles (spastic bronchit./bronch.
asthma), lact.
Anticholinesterase. Neostigmine Methylsulphate 2.5 mg/ml. AMPOUL.: 10×1ml. Should be given very slowly by the IV route. A syr. of Atropine Sulphate should always be available to counteract severe cholinergic react. should they occur.
Myasthen. Gr..: 1 – 2.5 mg by IM or SC inj. at interv. throughout the day, when max. strength is needed. The usual durat. of act. of a dose is 2- 4 hrs. The total dly. dose is usually 5 – 20 mg by inject. but higher doses may be needed by some pts.
Neonatal Myasthen. Gr. may be treated with 0.1 mg Neostigmine intramuscul. initial. Thereafter, the dose must be titrated individ. But is usually 0.05 – 0.25 mg IM or 0.03 mg/kg IM, every 2 –4 hrs. Because of the self-limiting nature of the dis. in neonates, the dly. dosage should be reduced until the drug can be withdrawn.
Older Child.: (Under 12 yrs. of age) May be given 0.2 – 0.5 mg by inj. as required. Dosage require. should be adjusted accord. to the response of the pt.
Antagon.to Non-depolariz. Neuromusc. Blockade: Reversal of Neuromusc. blockade with Neostigmine should not be attempted unless there is spontan. recovery from paralysis.
Adult. & Child.: A single dose of Neostigmine 0.05 – 0.07 mg/kg bdy.-wt. and Atropine 0.02 – 0.03 mg/kg bdy. wt., by slow IV inj. over one min. is usually adequate for complete reversal of Non-depolariz. Muscle Relax. within 5 – 15 min. The max. recomm. dose of Neostigmine in adult. is 5 mg and in child. 2.5 mg.
Atropine & Neostigmine may be given simultan., but in pts with Bradycardia, the pulse rate should be incr. to 80 per min. with Atropine before admin. Neostigmine.
Paralytic Ileus: Adult.: 0.5 – 2.5 mg Neostigmine Methylsulphate by SC or IM injection.
Child.: 0.125 – 1 mg by inj. Doses may be varied accord. to the individ. needs of the pt.
Myasthen. Grav., antagon. to non- epolarizing neuromusc. blockade, Paralytic Ileus.
C/I: Hypersens. Pts. with mechan. obstruct. of GI or urin. tracts, peritonitis or doubtful bowel viability. Concom. use with depolaris. muscle relaxants such as suxamethonium as neuromuscul. blockade may be potentiated.
Acetylcholinesterase Inhibitor. Pyridostigmine (as Bromide) 30 mg, 60 mg. TABS: 21X 30 mg, 30 X 60 mg. See lit.
Myasthen. gravis.
Monoclonal Antibody. Eculizumab 10 mg/ml. VIAL (concentrate for sol. for infus.): 1×300mg. Adult. (≥18 years of age): (PNH)-consists of a 4-week initial phase follow. by a mainten. phase: Initial phase: 600 mg admin. via a 25–45 min. IV infus. every wk. for the first 4 wks.
Mainten. phase: 900 mg admin. via a 25-45 min. IV infus. for the 5TH week, follow. by 900 mg admin. via a 25–45 min. IV infus. every 14±2 d.
In atyp. Haemolytic Uremic Synd. (aHUS) and refract. general. Myasthenia Gravis (gMG): The aHUS and refract. gMG dosing regimen for adult pts. (≥18 yrs. of age) consists of a 4 wk. init. phase follow. by a mainten. phase: Init. phase: 900 mg admin. via a 25–45 min. IV infus. every wk. for the first 4 wks.
Mainten. phase: 1,200 mg admin. via a 25–45 min. IV infus. for the fifth wk., follow. by 1,200 mg admin. via a 25–45 min. IV infus. every 14±2 d.
Paed. pts. in PNH and aHUS: Paed. pts PNH, above 11 yrs. old, and aHUS pts. with bdy. wt.≥40 kg are treated with the adult dosing recommend. respectively.
Pts. bdy. wt. 30 to<40 kg init. phase 600 mg wkly.×2, mainten. phase 900 mg at wk. 3; then 900 mg every 2 wks.
Pts. bdy. wt. 20 to<30 kg, init. phase 600 mg wkly.×2, mainten. phase 600 mg at wk. 3; then 600 mg every 2 wks.
Pts. bdy. wt. 10 to<20 kg, init. phase 600 mg wkly.×1, mainten. phase 300 mg at wk. 2; then 300 mg every 2 wks.
Pts. bdy. wt. 5 to<10 kg, init. phase 300 mg wkly.×1 mainten. phase 300 mg at wk. 2; then 300 mg every 3 wks. See lit.
Paroxysmal nocturnal haemoglobinuria (PNH).
Evidence of clinical benefit is demonstrat. in pts. with haemolysis with clinical sympt. indicative of high dis. activity, regardless of transfus. history.
Eculizumab has not been studied in clinic. trials in pts. with PNH below 11 yrs. of age.
Atypical haemolytic uremic syndr. (aHUS).
Soliris is indicated in adult. for the tmt. of: Refract. generalized myasthenia gravis (gMG) in pts. who are anti-acetylcholine receptor (AChR) antibody-positive.
C/I: Hypersens. Therapy must not be init. in pts.: with unresolved Neisseria meningitidis infect, pts. that are not current. vaccine. against Neisseria meningitidis unless they receive prophylact. tmt. with appropr. antibiot. until 2 wks. after vaccinat.
NSAID. Diclofenac Sodium 1%, 2%. EMULGEL: 20 g, 50 g, 100 g, 150 g. Adult. & adolesc. aged 12 yrs. and over: Should be applied over the affect. area 3/4 times dly. The amount need. depend. on the size of the painf. area: 2 g-4 g (a quant. rang. in size from a cherry to a walnut) is suffic. to treat an area of about 400-800 cm².
The durat. of tmt. depend. on the indic. and clinic. response. The gel should not to be used for more than 14 d. for soft-tissue injur. or soft tissue rheumat. unless recomm. by a doctor, or 21 d. for arthrit. pain.
When used without med. prescript., pts. should consult their doctor if the condit. does not improve within 7 d, or if it gets worse.
Child.: not recomm. for use in child.<12 yrs. of age.
Self medicat. the follow. indicat.:
Local tmt. of pain, inflamm. and swell. due to: Pain & inflamm. and swell. in trauma of the tendon., ligament., muscl. & joint., e.g. due to sprains, strains and/or bruises and/or backache (e.g. sports injur.);
Localiz. forms of soft tissue rheumatis. such as tendonit. (e.g. tennis elbow), bursitis.
By Physicians order:
Pain caused by osteoarthrit. of the peripher. joints, as of the knee or finger.
C/I: Pts. with/without chron. asthma in whom attacks of asthma, urticar. or acute rhinit. are precipit. by aspirin or other NSAIDs. Hypersens. to diclofenac, aspirin or NSAIDs. 3rd trim. of preg. Concom. use of oral NSAID's. Co-admin. with other products contain. diclofenac. Child. & adolesc. aged less than 12yrs.
