CLASSES Generic name: PREGABALIN Brand name: LYRICA Analgesic Antiepileptic Calcium channel modulator

ACTION Binds to alpha-delta sites on the nerve in the CNS, which reduces the calcium influx in to the cell and decreases the release of neurotransmitters into the synaptic cleft, resulting in less stimulation of the nerve; it is also increases the transport and density of GABA, which known to supress nerve activity.

INDICATION Management of acute pain assoc. with diabetic peripheral neuropathy. Management of postherpetic neuralgia. Adjunct therapy of adult patients with partial onset of seizures.

CONTRAINDICATION Contraindicated with known hypersensitivity to pregabalin or any component of the drug, lactation. Use cautiously with diabetes, HF, pregnancy.

ADVERSE EFFECT CNS: Dizziness, somnolence, neuropathy, ataxia, vertigo, confusion, euphoria, incoordination, vision abnormalities, suicidal ideation. GI: Dry mouth, constipation, flatulence. Other: Peripheral edema, weight gain, hypoglycaemia, back pain, chest pain, infection, creatinine kinase elevation, loss of fertility (male), angioedema.

CONSIDERATION Hx: lactation, pregnancy, diabetes, heart failure, allergy to pregabalin. Px: Weight; orientation, reflexes, affect, vision,; renal function tests, blood glucose level.

CLASSES Generic name: METRONIDAZO LE Brand name: FLAGYL, FLAGYL 375,FLAGYL ER, PROSTAT, VANDAZOLE ANTIBACTERI AL ANTIBIOTIC ANTIPROTOZ OAL

ACTION Bactericidal and inhibits dna synthesis in specific (obligate)anaerobes, causing cell death, antiprotozoaltrichomonacidal, amebicidal; biochemical mechanism of action is not known.

INDICATION Acute infection w/susceptible analerobic bacteria Acute intestinal amebiasis Amebic liver abscess Trichomoniasis (acute and partners of patients with acute infection Bacterial vaginosis

CONTRAINDICATION Contraindicated with hypersensitivity to metronidazole; prenacy (do not use for trichomoniasis in first trisemester). Use cautiously with CNS diseases, hepatic disease, candidiasis, lactation.

ADVERSE EFFECT CNS: Headache dizziness, ataxia, vertigo, incoordination, insomnia, seizures, peripheral neuropathy, fatigue. GI: unpleasant metallic taste, anorexia, nausea, vomiting, diarrhea, GI upset, cramps. Other: Severe, disulfiram-like interaction with alcohol,candidiasis(s uprinfection)

CONSIDERATION Hx: CNS or hepatic diseases, candidiasis (moniliasis), blood dyscrasis, pregnancy, lactation. Px: Reflexes, affects; skin, color (with topical application); abdominal examination, liver palpation; urinalysis, CBC, LFTs.

CLASSES Generic name: CELECOXIB Brand name: CELEBREX Analgesic NSAID

ACTION Analgesic and antiflammatory activities related to inhibition of the COX-2 enzyme, which is activated inflammation to cause the signs and symptoms associated with inflammation: does not effect the COX-1 enzyme, which protects the lining of the GI tract and has blood clotting and renal function.

INDICATION Acute and longterm treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis. Reduction of the number of colorectal polyps in familial adenomatous polyposis(FAP) Management of acute pain Relief of signs and symptoms of ankylosing spondylitis. Relief of signs and symptoms of juvenile rheumatoid arthritis.

CONTRAINDICATION Contraindicated with allergies to sulphonamides, celecoxib, NSAIDs or aspirin; significant renal impairment; perioperative pain post CABG surgery; pregnancy (third trisemester); lactation. Use cautiously with impaired hearing, hepatic and CV condition.

ADVERSE EFFECT CNS: Headache, dizziness, somnolence, insomnia, fatigue, tiredness, tinitus, ophthalmologic effect. GI: Nausea, abdominal pain, dyspepsia, flatulence, GI bleeding. Other: Peripheral edema, anaphylactoid reaction to anaphylactic shocks.

CONSIDERATION Hx: Renal impairment, impaired hearing allergies, hepatic and CV conditions, lactation and pregnancy. Px: Skin color lessions; orientation, reflexes, ophthalmologic and audiometric evaluation; peripheral sensation; P edema; R, adventitious sounds; liver evaluation; CBC, LFTs, renal function test; serum electrolytes.

CLASSES Generic name: METOPROLOL Brand name: APO-METOPR OL GEN-METOPRO LOL Antihyperten sive
Beta-selective

ACTION Competitive blocks betaadregenic receptors in th e heart and juxtaglomeru lar apparatus, drecreasin g the influence of the sy mphathetic nervous syste m on these tissues and th e excitability of the heart, decreasing cardiac outpu t and the release of renin , and lowering BP; acts in the CNS to reduce symph athetic outflow and vasoc onstrictor tone.

INDICATION Hypertension, alo ne or with other drugs, especially diuretics. Immediate-releas e tablets and inje ction: Preventilat ion of reinfarctio n in MI patients who are hemody namically stable.

CONTRAINDICATION Contraindicated with si nus bradycardia (HR less than 45 beats/min), sec ond- or third-degree heart block (PR interval more than 0.24 sec), car diogenic shocks, HF, sec ond and third trimesters if pregnancy.

ADVERSE EFFECT CNS: Diziness, ver tigo, tinnitus, fatigu e, emotional depre ssion, paresthesias, sleep disturbances, hallucinations, diso rientation, memory loss. GI: Gastric pain, fl atulence, constipati on, diarrhea, nause a, vomiting. Other: Decreased exercise tolerance, development of ANA,hyperglycemia or hypoglycemia, and elevated seru m transaminase, al kaline phosphate.

CONSIDERATION Hx: Sinus bradycardia (HR less than 45 beats/min), s econd- or third-degree h eart block (PR interval gr eater than 0.24 sec), card iogenic shock, geart failur e, systolic BP less than 10 0 mmHg; diabetes or thyr otoxicosis; asthma or CO PD; lactation, pregnancy. Px: Weight, skin conditio n, neurologic status, P, BP, ECG, respiratory status, renal and thyroid function test, blood and urine glucose.

adregenic blocker

CLASSES Generic name: CEFUROXIME Brand name: CEFLIN ZINACEF Antibiotic

Cephalosporin

ACTION Bactericidal: inhibits synt hesis of bacterial cell wal, causing cell death.

INDICATION UTI's caused by escherichia coli, k lebsiella pneumo niae. Uncomplicated and disseminated gonorrhea cause d by N. gonorrhe a.

CONTRAINDICATION Contraindicated with al lergy to cephalosporins or penicilins. Use cautiously with re nal failure, lactation, pre gnancy.

ADVERSE EFFECT CNS: Headache, d izziness, lethargy, p aresthiasis. GI: nausea, vomit ting, diarrhea, anor exia Other: superinfec tions, disulfram-lik e reaction with alco hol.

CONSIDERATION Hx: Hepatic and renal im pairment, lactation, preg nancy. Px: Skin status, LFTs, rena l function test, culture of affected area, sensitivity test.

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