Drug Study 1) Na Cl ( Sodium Chloride) Mechanism of Action: Sodium chloride is the major extracellular cation.

It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives. Absorption: Well-absorbed from the GI tract. Excretion: Mainly in the urine, with small amounts excreted in the sweat, faeces, tears and saliva. Indication: Oral Chronic salt-losing conditions Adult: As modified-release preparation: 2.4-4.8 g (40-80 mmol sodium) daily accompanied by suitable fluid intake. Up to 12 g daily may be necessary in severe cases. Renal impairment: Dosage adjustment may be necessary. Oral Prophylaxis of muscle cramps during routine haemodialysis Adult: As modified-release preparation: 6-10 g every dialysis session. Oral Oral hygiene Adult: Used as mouthwash. Nasal Nasal congestion Adult: 0.9% used as nasal drops or spray. Child: 0.9% used as nasal drops. Intravenous Replacement of fluid and electrolytes Adult: As 0.9%, 3% or 5% solution: Dosage depends on age, wt, clinical condition and laboratory determinations of the patient. Dose to be administered via a large vein, with care taken to prevent infiltration. Intravenous Hypernatraemia Adult: As 0.9% solution: Dosage depends on age, wt, clinical condition and laboratory determinations of the patient. Dose to be administered via a large vein, with care taken to prevent infiltration. Irrigation Irrigation of the bladder, eye, general skin and wound cleansing Adult: 0.9% solution is used. Adverse Effect: Hypernatraemia; thirst, reduced salivation and lachrymation, fever, tachycardia, hypertension, headache, dizziness, restlessness, irritability and weakness. Potentially Fatal: Intra-amniotic inj of hypertonic solutions: Disseminated intravascular

coagulation, renal necrosis, cervical and uterine lesions, pulmonary embolism, pneumonia and death.

2) Human albumin Mechanism of Action: Albumin is responsible for 75-80% of the colloid osmotic pressure of normal plasma. Albumin stabilizes circulating blood volume and is a carrier of hormones, enzymes, medicinal products and toxins. Albumin is a protein with a total extravascular mass of approximately 160 g and an intravascular mass of about 120 g. Indication: Hypovolemia Albumin (Human) 20% is indicated in the emergency treatment of hypovolemia with or without shock. Its effectiveness in reversing hypovolemia depends largely upon its ability to draw interstitial fluid into the circulation. It is most effective in patients who are well hydrated. When blood volume deficit is the result of hemorrhage, compatible red blood cells or whole blood should be administered as quickly as possible. [1, 2] When hypovolemia is long standing and hypoalbuminemia exists accompanied by adequate hydration or edema, 20% - 25% albumin solutions should be used. Hypoalbuminemia For subjects with hypoalbuminemia who are critically ill and/or are bleeding actively, Albumin (Human) 20% infusions may be indicated. When albumin deficit is the result of excessive protein loss, the effect of administration of Albumin (Human) 20% will be temporary unless the underlying disorder is reversed. Prevention of Central Volume Depletion after Paracentesis due to Cirrhotic Ascites (Treatment Adjunct) Albumin (Human) 20% may be used to maintain cardiovascular function following the removal of large volumes of ascitic fluid after paracentesis due to cirrhotic ascites. Ovarian Hyperstimulation Syndrome (OHSS) Albumin (Human) 20% may be used as a plasma expander in fluid management relating to severe forms of ovarian hyperstimulation syndrome (OHSS). Adult Respiratory Distress Syndrome (ARDS) (Treatment Adjunct) Albumin (Human) 20% infusions may be indicated in conjunction with diuretics to correct the fluid volume overload associated with ARDS. Acute Nephrosis (Treatment Adjunct) Albumin (Human) 20% may be used to treat edema in patients with acute nephrosis who are refractory to cyclophosphamide and corticosteroid therapy.

Hemolytic Disease of the Newborn (HDN) Albumin (Human) 20% is indicated in the treatment of hyperbilirubinemia. It may be used prior to or during an exchange procedure in an attempt to bind free and to enhance its removal. Adverse Effect: anaphylactic shock cardiac failure loss of consciousness circulatory failure hypersensitivity congestive heart failure pulmonary edema dyspnea hypotension hypertension tachycardia bradycardia vomiting urticaria angioneurotic edema rash erythematous confusional state headache chills pyrexia flushing nausea pruritus hyperhidrosis

3) Iberet Folic Acid Mechanism of Action: Pharmacology: Pharmacodynamics: Iron, an essential mineral, is a component of hemoglobin, myoglobin and a number of enzymes. The total body content of iron is approximately 50 mg/kg in man and 35 mg/kg in women. Iron is primarily stored in the body as hemosiderin or ferritin, found in the reticuloendothelial cells of the liver, spleen and bone marrow. Approximately 2/3 of total body iron is in the circulatory red blood cell mass in hemoglobin, the major factor in oxygen transport. Concentration of plasma iron and the total iron-binding capacity of plasma vary greatly in different physiological conditions and disease states. Approximately 2/3 of folic acid is bound to plasma proteins. Half of the folic acid stored in the body is found in the liver. Folic acid is also concentrated in the spinal fluid. Indication: Treatment & prevention of Fe-deficiency & concomitant folic acid deficiency w/ associated deficient intake or increased need for vit B-complex in non-pregnant adults. Administration: should be taken on an empty stomach (Best taken between meals. May be taken w/ meals to reduce GI discomfort.) Adverse Effect: Allergic reactions GI effects hyperbilirubinemia, acne form vulgaris deterioration or acne form exanthema eruption bright yellow urine discoloration flushing dizziness or faintness, peripheral sensoryneuropathies, stone formation, crystalluria & oxalosis Black discoloration of stool.

4) Sucrofer Indication: Sucrofer is indicated in the treatment of iron deficiency anemia in patients undergoing chronic hemodialysis who are receiving supplemental erythropoietin therapy. Adverse Effect:

chest pain; feeling like you might pass out; swelling in your hands, ankles, or feet; trouble breathing; or Dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats. 5) Insulin (Rapid Acting Insulin/ Lantus Solostar) Mechanism of action: Insulin is a hormone secreted by beta cells of the pancreas that, by receptor-mediated effects, promotes the storage of the bodys fuels, facilitating the transport of metabolites and ions (potassium) through cell membranes and stimulating the synthesis of glycogen from glucose, of fats from lipids, and proteins from amino acids.

Adverse Reaction: Severe Hypoglycemia

6) Multidex Classification: Nutritional, Fluid, & Electrolyte Products/ Nutritional Products, Parenteral, Nutritional, Fluid, & Electrolyte Products/ Fluids & Electrolytes, Parenteral. Indication: Treatment and prevention of vitamin deficiency.

7) Moriamin Forte Indication: Malnutrition, protein and vitamin deficiencies, anemia, convalescence, restoration and maintenance of body resistance, pregnancy and lactation, adjuvant in the therapy of peptic ulcer and TB. Adverse Reaction: Hypervitaminosis

8) Co-Amoxiclav Indication: Infections due to -lactamase-producing strains (where amoxicillin alone is not appropriate) including resp tract, genitourinary & abdominal infections; cellulitis, animal bites, severe dental infection w/ spreading cellulitis. Adverse Reaction: Hypersensitivity reactions & GI disturbances. Reversible leukopenia & thrombocytopenia, thrombocytopenic purpura, agranulocytosis, anemia, slight thrombocytosis, eosinophilia, abnormal platelet aggregation, prolonged bleeding & prothrombin time. Dizziness, headache, reversible hyperactivity & convulsions, agitation, anxiety, behavioral changes, confusion, insomnia. Increased AST & ALT, serum bilirubin & alkaline phosphatase; hepatitis, cholestatic jaundice, acute hepatic dysfunction. Acute interstitial nephritis, crystalluria, vag itching, soreness & discharge. Superficial tooth discoloration. 9) Tazobactam Indication: Amiodarone hydrochloride injection is a class III antiarrhythmic drug. Amiodarone HCl injection is indicated for initiation of treatment and prophylaxis of frequently recurring ventricular fibrillation and hemodynamically unstable ventricular tachycardia in patients refractory to other therapy. Amiodarone injection also can be used to treat patients with VT/VF for whom oral amiodarone is indicated, but who are unable to take oral medication. During or after treatment with intravenous amiodarone injection patients may be transferred to oral amiodarone therapy. Amiodarone injection should be used for acute treatment until the patient's ventricular arrhythmias are stabilized. Most patients will require this therapy for 48 to 96 hours, but amiodarone injection may be safely administered for longer periods if necessary.

Adverse Reaction: Autonomic nervous system hypotension, ileus, syncope Body as a whole rigors, back pain, malaise Cardiovascular tachycardia, including supraventricular and ventricular; bradycardia; arrhythmia, including atrial fibrillation, ventricular fibrillation, cardiac arrest, cardiac failure, circulatory failure, myocardial infarction Central nervous system tremor, convulsions, vertigo Gastrointestinal melena, flatulence, hemorrhage, gastritis, hiccough, ulcerative stomatitis Pseudomembranous colitis was reported in one patient during the clinical trials. The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment. Hearing and Vestibular System tinnitus

Hypersensitivity anaphylaxis Metabolic and Nutritional symptomatic hypoglycemia, thirst Musculoskeletal myalgia, arthralgia Platelets, Bleeding, Clotting mesenteric embolism, purpura, epistaxis, pulmonary embolism

10) Fluimucil

Indication: Acute & chronic resp tract infections w/ abundant mucus secretions due to acute bronchitis, chronic bronchitis & its exacerbations, pulmonary emphysema, mucoviscidosis & bronchiectasis. Adverse Reaction: Rarely, urticaria, bronchospasm, nausea, vomiting. Inhalant: Rhinitis, stomatitis.