..

2005

 802935 (075.8) 81.2 . 73 72 - - 14.12.2004 ., 4 . . .. : . . .. ; . . ..

72

, . . : .-. / . . . . : , 2005. 74 . ISBN 9854624072.

2 . 4 : , , , . . , , . 2- , . 802935 (075.8) 81.2 . 73

ISBN 9854624072

. , 2005

PART I
GETTING INFORMATION UNIT I. PHARMACOLOGY AND DRUG NAMES Introduction
1. Think about your associations with the word pharmacology. Take down into your exercise-book as many of them as you can. 2. Do the crossword puzzle: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. P H A R M A C O L O G Y

1. a person who is receiving medical treatment; 2. a place, where drugs are prepared and sold; 3. a particular kind of body or mind illness caused by infection or internal disorder with special symptoms and name; 4. a well-known drug used to reduce high temperature; 5. a scientist working in the field of pharmacology; 6. a process of fighting against a disease using different drugs and therapeutic procedures; 7. a method of introducing a drug into a muscle or a vein; 8. any substance, either taken internally or applied externally, that impairs the health or is dangerous to life; 9. a hard solid dosage form, containing medicinal substances; with or without suitable diluents; it may vary in shape, size and weight; 10. a chemical substance, produced by a plant or microorganism, that is able to inhibit or kill foreign organism in the body; 11. any chemical or biological substance used in the prevention or treatment of disease; 12. an instrument (tube) for introducing fluid drug into the body; giving injections.

3. 1) Study the schemes. These are the subdivisions of Pharmacology and their subjects of study. A. Medicinal chemistry Molecular pharmacology Pharmacokinetics Pharmacodynamics Chemotherapy Toxicology

.
1______..._______ the study of new drug synthesis

PHARMACOLOGY
2_______..._______ the study of drug effects in the body 3_______..._______ drug concentration in tissues and blood measured over a period of time 4_______..._______ the study of interaction of drugs and components inside the cell or on the cell surface

5_______..._______ use of drugs in treatment of diseases

6_______..._______ studies of harmful chemicals and their effects on the body

2) Copy scheme B into your exercise-book and try to fill it in with the words from table A. 3) Make sure that you can pronounce all the words correctly: medicinal chemistry [medisnl kemistri] molecular pharmacology [mulekjul fa:mkldi] pharmacokinetics [fa:mkkainetiks] pharmacodynamics [fa:mkdainmiks] chemotherapy [ki:muerpi] toxicology [tksikldi] 4) Listen to the text about Pharmacology and correct yourself. 4. Answer the questions: 1) Do you often fall ill? 2) What kind of treatment do you use: drug or popular methods of treatment (herbs, diet, applications, massage)? Why? 5. Give your pros and cons for using drugs or alternative forms of treatment.

LANGUAGE WORK
6. Memorize the vocabulary: alter [:lt], v beneficial [benifil], a brand [brnd], n capitalize [kpitlaiz], v derivative [dirivtiv], a dispense [dispens], v formula
[f:mjul], n

(), (), , , ; ~ name , , ( ) (pl. formulas [- z], formulae [-i:]) 1) ; 2)

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generic hormone legal mood pharmacy property proprietary

[dnerik], a [h:mun], n [li:gl], a [mu:d], n [fa:msi], n [prpti], n [prpraitri], a [p:ps], n [sikri:t], v [sbstitju:t], 1) n; 2) v [sinsaiz], v [treid], n

purpose secrete substitute synthesize trade

1) ; ; 2) ; . ~ name . , , 1) ; 2) 1) , ; 2) , ; 3) 1) , - ; 2) ; ~ medicine ; , , . , 1) ; 2) , attr. ; ~ name ,

7. Practise the pronunciation: antibiotic [ntibaitik] behaviour [biheivj] beneficial [benifil] biological [bailikl] chemical [kemikl] competitor [kmpetit] erythromycin [iri:rumaisin] identify [aidentifai] isolate [aisleit]

manufacturer [mnjufktr] mould [muld] pharmacist [fa:msist] recognize [rekgnaiz] register [reist] secretion [sikri:n] source [s:s] superscript [sjupskript] synthesize [sinsaiz]

8. Read and translate the following words and word-combinations: 1) drug [drg]: an obtained drug; to isolate a drug; drug name; to produce a drug; the chemical formula for the drug; a laboratory-synthesized drug. 2) name [neim]: to have three different names; the chemical name; the generic name; the brand name; to order a specific trade name. 3) dispense [dispens]: to dispense a drug; to dispense drugs through a drugstore; a drug dispensed by the pharmacist. 4) obtain [btein]: to obtain a drug; to obtain from parts of plants; to be obtained from animals. 9. 1) 2) 3) 4) Translate the groups of the words with the same root: drug, druggist, drugstore; biology, biological, antibiotic; to alter, alteration, alterative, alterable, alterant; chemical, a chemical, chemistry, a chemists (= chemist shop), a chemist; a chemist a specialist or expert in Chemistry Attention! a chemist a pharmacist ,
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5) pharmacology, pharmacological, pharmacologist, pharmacy, pharmacist, pharmaceutical; Attention! a pharmacologist a person (often a a pharmacist a person who prepares and medical doctor) who specializes in the dispenses drugs from a (drug) store study of the action of drugs , 6) 7) 8) 9) generic, generation, general; a body, bodily; to perform, performed, performing, performance; to secrete, secretion, secretory.

10. Read the definitions of the words and write the number of the meaning of the words drug and medicine for each sentence. DRUG 1. Therapeutic agent used in the prevention, diagnosis, treatment or cure of disease. 2. General term for any substance, stimulating or depressing, that can be habituated or addictive (produce dependence), especially a narcotic. MEDICINE 1. A drug. 2. The science concerned with disease in all its relations. 3. The art of preventing or curing general diseases, or those affecting the internal parts of the body.

The doctor prescribed him some drugs. Alcohol and nicotine are legal drugs.
11. Match the synonyms: a drug to alter beneficial to obtain to isolate to make to prepare a drugstore

He studies Medicine at the University. I need some medicine for headache. Dr. Parsons practised medicine in a small
village. to produce, to manufacture to get, to synthesize to dispense to extract a pharmacy, a chemists a medicine to change, to modify good, healthy

12. Take down into your exercise-book the word which doesnt belong to each group. Consult a dictionary if necessary. 1) beneficial, good, harmful, healthy, healing; 2) to give, to obtain, to get, to receive; 3) to make, to produce, to synthesize, to manufacture, to dispose; 4) a pharmacist, a patient, a chemist, a dispenser; 5) complicated, intricate, complex, simple; 6) trade, commercial, brand, private, generic. 13. Now make up a sentence with each of the words you have just put down. 14. Match the words with their definitions: 1) generic name a) commercial name for a drug; trade name; 2) prescription b) chemical formula for a drug; 3) antibiotic c) the legal non-commercial name for a drug; 4) brand name d) substance found in food and very important in small quantities for
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5) chemical name 6) vitamin

growth and good health; e) chemical substance, produced by a plant or microorganism, that can inhibit or kill foreign organisms in the body; f) written order for a drug from a physician or other medical specialist.

15. Read the text Drugs and Drug Names.

TEXT 1
Drugs and Drug Names Drugs are chemical or biological substances used in the prevention or treatment of disease or to alter bodily functions, such as mood, behaviour, or performance, in a beneficial way. Drugs can come from many different sources. Some drugs are obtained from parts of plants, such as the roots, leaves, and fruit. Examples of such drugs are digitalis (from the foxglove plant) and antibiotics such as penicillin and erythromycin (from lower plants called moulds). Drugs can also be obtained from animals; for example, certain hormones are secretions from the glands of animals. Drugs can be made as chemical substances that are synthesized in the laboratory. Anticancer drugs may be examples of laboratory-synthesized drugs. Some drugs are isolated from plant or animal sources and are contained in food substances. These drugs are called vitamins. Drugs are prepared and dispensed by a pharmacist through a drugstore or pharmacy on written order from a physician or dentist. A drug can have three different names. The chemical name is the chemical formula for the drug. This name, often long and complicated, is useful for the chemist because it shows the structure of the drug. The generic, or official, name is a shorter, less complicated name that is recognized as identifying the drug for legal and scientific purposes. The generic name becomes public property after 17 years of use by original manufacturer, and any drug manufacturer may use it thereafter. There is only one generic name for each drug. The brand (trade or proprietary) name is the private property of the individual drug manufacturer, and no competitor () may use it. A brand name often has the superscript after or before the name, indicating that it is a registered trade name. Drugs may have several brand names because each manufacturer producing a drug gives it a different name. When a specific brand name is ordered on a prescription by a physician, it must be dispensed by the pharmacist; no other brand name may be substituted. It is usual practice to capitalize the first letter or a brand name. The following list shows the chemical, generic, and brand names of the antibiotic drug ampicillin; note that the drug can have several names but only one generic, or official, name: Chemical Name derivative of 6aminopenicillanic acid Generic Name ampicillin Brand Name Omnipen Polycillin Principen Totacillin

LANGUAGE WORK
16. Give the English equivalents: ; , ; ; ; ; ; ; ; ; ; ; ; ; -.
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17. 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11)

Fill in the gaps with the missing words. You have the first letter of the word: D___ are chemical or biological substances used in the p___ or treatment of disease. Properly chosen drugs a___ persons condition in a beneficial way. Some drugs are o___ from parts of p___: roots, leaves or fruit. A___ come from molds. Glands of humans and animals secrete h___. Pharmacologists also s___ drugs in the laboratories. The c___ name is the chemical f___ for the drug. The g___ or o___ name is a shorter, less complicated name than the chemical name. The brand name is the private p___ of the individual drug manufacturer. Drugs may have several t___ names. When a specific brand name is ordered on a prescription, a pharmacist must d___ it.

18. Write a possible question for each response: 1) What __________? Drugs can be obtained from plants and animals. 2) __________? No, drugs can also be made as chemical laboratory-synthesized substances. 3) What __________? Drugs are used in prevention or treatment of disease or to alter beneficially body functions, mood, behaviour. 4) Where __________? Vitamins are contained in food substances. 5) What __________? Pharmacies or drugstores dispense drugs. 6) __________, isnt it? Yes, the chemical name is the chemical formula for the drug. 7) How many __________? There is only one generic name for each drug. 8) Why __________? Because each manufacturer producing a drug gives a different name to it. 9) How __________? The brand name and generic name are differentiated by the first letter, and the brand name usually has a superscript.

COMPREHENSION
19. Define the sentences as True, False or The text doesnt mention it. Begin your statement with: Its absolutely right ... I differ from you ... I quite agree that ... It is not true to the fact... There is no doubt ... In my opinion ... 1) There are many different sources of drugs. 2) The only function of a drug is to prevent or treat diseases. 3) The drugs are dispensed on written order from a physician and over-the-counter ( ). 4) A pharmacist must complete a Pharm. D. (Doctor of Pharmacy) after 6 or 7 years of study. 5) The chemical name is the chemical formula for the drug and shows its structure. 6) Each drug may have several generic names. 7) The brand name is the private property of the individual drug manufacturer. 8) Toxicological studies in animals are required by law before new drugs can be tested in humans.
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20. 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12)

Answer the questions: What are drugs? What are they used for? What are the sources of drugs? Are antibiotics obtained from plants? What drugs are called vitamins? Where and by whom are drugs prepared and dispensed? What names can a drug have? What name shows the structure of the drug? Which one is the only name for each drug? What is the brand name? Which name may be used by competitors and which one may not? Why may drugs have several brand names? What is special about brand names?

DISCUSSION
21. Revise the section Introduction. 22. 1) 2) 3) Prepare short summaries on the topics: Pharmacology, its subdivisions and their tasks. Drugs, their sources and, probably, examples of drugs of different nature. Drug names.

23. Try to answer or discuss with your group-mates the following questions: 1) What can you say about pharmaceutical industry in your country? Are there any pharmaceutical enterprises? 2) What can you say about the proportion of the home-made and imported drugs? How can you explain it? 3) Can you give any opinion about the quality of drugs produced in your country? 4) Have there been any important pharmaceutical achievements in your country? Give any examples, if you can.

SELF CHECK
24. Distribute the following to the adequate columns: dodecamethylendimethacrylate; Procardia; nifedinipe; 3, 5 pyridinedicarboxylic acid; Argosulfan; Mucomyst; argentum sulfathiazolum; sulfonamide; acetylcysteine; N-acetyl derivative of cysteine amino acid; Charisma; acrylate; Tylenol; Imodium; loperamide; acetaminophen. Chemical Name Generic Name Brand Name

25. Read the text Pharmacology. Complete it with the following sentences or parts of them that are taken out of the text. a) Pharmacodynamics involves the study of drug effects in the body. b) (changes that drugs undergo within the body); c) These studies provide important information about the mechanism of action of drugs. d) A toxicologist is also interested in finding proper antidotes to any harmful effects of drugs. e) (how drugs pass into the bloodstream); f) the relationship between chemical structure and biological effects. g) treatment of infections diseases and cancer. h) (removal of the drug from the body).
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TEXT 2
Pharmacology The field of medicine that studies drugs their nature, origin, and effect on the body is called pharmacology. Pharmacology is a broad medical specialty and contains many subdivisions of study: medicinal chemistry, pharmacodynamics, pharmacokinetics, molecular pharmacology, chemotherapy, and toxicology. Medicinal chemistry is the study of new drug synthesis and 1 ___. 2___. Scientists may also study the processes of drug absorption 3 ___, metabolism 4___, and excretion 5___. Molecular pharmacology concerns the study of the interaction of drugs and subcellular entities, such as DNA, RNA, and enzymes. 6 ___. Chemotherapy is the study of drugs that destroy microorganisms, parasites, or malignant cells within the body. Chemotherapy includes 7___. Toxicology is the study of the harmful effects of drugs and chemicals on the body. 8___. Antidotes are substances given to neutralize unwanted effects of drugs. Toxicological studies in animals are required by law before new drugs can be tested in humans.

UNIT 2. DRUG ADMINISTRATION Introduction

1. Find the following words in the puzzle. Remember that the words can be read in any direction: Word list

tablet pill suppository aerosol powder capsule solution mixture patch plaster lotion cream ointment drops syrup

a p x l s c m o h j t e n a c

b c d e f s q t a b o y z a b l o s o r u l t u v t d i e f i s u p p o p q r o n z a b w c k l m d u t v w e f m a e r o p q p r b c d e f a p s u l

g l c e w g o s c n x c s g e

h i j k l e t r s r d e f o g a m p n o x s y u z h i g j r s i t o r i t u v w d n e f g o o t p q y i z m a g t h i e t o u v w h l i j k o p q r s

d m n o t u v w h i j k p q r m a r b i k e l x y t n t x s y u h a i r r l s e b p c d j k l m n x y z l t m n t u v w

2. Read the extract from the text At the Chemists: There are two departments in the chemists shop: at the chemists department one can have some medicine right away, other drugs have to be ordered at the prescription department. At the chemists they keep all drugs in drug cabinets. Every small bottle or box has a label with the name of the medicine stuck on it. There are labels of three colours

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3. Finish the paragraph. Give the colours of the labels and explain what these colours indicate. 4. Read the instructions for nurses at their work-place: 10 Golden Rules for Administering Drugs Safely To protect your patients and your licence, follow these guidelines for avoiding medication errors.

1. Administer the right drug. 2. Administer the drug to the right patient. 3. Administer the right dose. 4. Administer the drug by the right route. 5. Administer the drug at the right time. 6. Teach your patient about the drug hes receiving. 7. Take a complete patient drug history. 8. Find out if the patient has any drug allergies. 9. Be aware of possible drug / drug or drug / food interactions. 10. Document each drug you administer.
5. Try to comment each rule. Why is it important to follow it? 6. Tick () the rule or rules you havent been able to comment and proceed to the next task. 7. Try to translate the following words without consulting the dictionary: absorption, oral, enteral, parenteral, sublingual, intestinal, subcutaneous, intradermal, intrathecal, intravenous, intramuscular, inhalation, intraosseous, endotracheal, topical, ocular, nasal, transdermal, aerosol. LANGUAGE WORK 8. Memorize the vocabulary: administer [dminist], v buttocks [btks], n pl dissolve enteral epidural infusion inhalation intradermal intraosseous intrathecal parenteral route sublingual
[dizlv], v [entrl], a [epidjurl], a [infju:n], n [inhlein], n [intrd:ml], a [intrsis], a [intri:kl], a [prentrl], a [ru:t], n [sbligwl], a

, () (); ; (); () ( ) 1) 2) () 1) 2) e., , , , , , , ,

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via

[vai], prep

subcutaneous [sbkju(:)teinjs] ocular [kjul] endotracheal [endtrkil] nasal [neizl] aural [:rl] aerosol [erusl] suppository [spzitri]

9. Practise the pronunciation: dermatomucosal [d:mtmjukusl] absorption [bs:pn] duration [djurein] oral [:rl] tongue [t] saliva [slaiv] disadvantage [disdva:ntid]

10. Read and translate the following words and word-combinations: 1) administer [dminist]: to administer some drugs, drugs may be administered, to administer by different routes. 2) route [ru:t]: the route of drug administration; enteral or parenteral route; by oral route. 3) injection [indekn]: to give an injection, the technique of injection, the site for injection, injection location. 4) inhalation [inhlein]: to prescribe inhalation procedures; various substances for inhalation; aerosols are administered by inhalation. 5) deliver [diliv]: to deliver drugs into the organism; to deliver drugs by different routes; continuous delivery. 11. Translate the groups of the words with the same root: 1) administer, administration, administering; 2) to absorb, absorption, absorptive; 3) to digest, digestive, digestion, indigestion; 4) to inject, injection, injected; 5) to advise, an advise, advisable; 6) to deliver, delivery, deliverer, delivering, delivered. 12. A. Study the meaning of the prefixes: epi above; on extra out; out of hypo under; beneath; less, than intra in; within par(a) other, than; apart from sub under; beneath B. Form new words with the above mentioned prefixes and translate them: epi: dural extra: corporal hypo: dermic, tensive, sensitive intra: muscular, venous, cavitary, osseous, thecal par(a): enteral, psychological, medical sub: cutaneous, lingual, mucosal 13. Match the synonyms: enteral route subcutaneous location to administer to introduce hypodermic side to insert intestinal local to deliver
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topical method, technique, way 14. Complete each pair with the word meaning the opposite. Consult a dictionary if necessary. ineffective, inner, deep, lower, inadvisable, immediate effective treatment ... treatment shallow injection ... injection advisable administration ... administration upper layer ... layer slow effect ... effect outer surface ... surface 15. Find the term corresponding to the definition: 1) Particles of drug suspended in air. 2) Administration of drug in gaseous or vapour form through the nose or mouth. 3) Drugs are given by mouth. 4) Drugs are given by injection into the skin, muscles or vein (any route other than through the digestive tract). 5) Drugs are inserted through the anus into the rectum. 6) Drugs are given by placement under the tongue. 7) Drugs are applied locally on the skin or mucous membranes of the body: ointments, creams and lotions. 16. Read the text Administration of Drugs:

1) oral administration 2) topical administration 3) sublingual administration 4) aerosol 5) rectal administration 6) parenteral administration 7) inhalation

TEXT 1
Administration of Drugs Drugs may be administered by many routes. The route of administration of a drug is very important in determining the rate and completeness of its absorption into the bloodstream and the speed and duration of the drugs action in the body. The enteral route, the most commonly used one, involves drug absorption through the gastrointestinal tract. There are two ways to administer drugs orally: oral and sublingual administration. In oral route drugs are given by mouth, swallowed and are slowly absorbed into the blood stream through the stomach or intestinal wall. Sublingual administration means that drugs are not swallowed but are placed under the tongue and allowed to dissolve in the saliva. This method sometimes has several disadvantages. If the drug is destroyed in the digestive tract by digestive juices, or if the drug is unable to pass through the intestinal mucosa, it will be ineffective. Oral administration is also disadvantageous if time is a factor in therapy. The parenteral route means any route other than through the digestive tract. It is usually an injection or infusion. There are several types of parenteral injections: 1. Subcutaneous injection (SC). This is also called a hypodermic injection and it is given just under the skin. The outer surface of the thigh is a usual location for this injection. 2. Intradermal injection is shallow and made into the upper layers of the skin and is used chiefly in skin testing for allergic reactions. 3. Intramuscular injection (IM). The buttock or upper arm is usually the site for this injection into muscle. 4. Intravenous injection (IV). This injection is given directly into a vein. It is used when an immediate effect from the drug is desired or when the drug cannot be safely introduced into other tissues. Good technical skill is needed to administer this injection because leakage of a drug into surrounding tissues may result in irritation and inflammation. 5. Intrathecal injection. This injection is made into the space underlying the membranes (meninges) that surround the spinal cord and brain.
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6. Intracavitary injection. This injection is made into a body cavity, such as the peritoneal or pleural cavity (intrapleural injection through the chest wall). 7. Intraosseous infusion. When rapid venous infusion is difficult or impossible, intraosseous infusion allows delivery of fluids, medications or whole blood into the bone marrow. Performed on infants and children, this technique is used in emergencies. Inhalation. Vapours, or gases, are taken into the nose or mouth and are absorbed into the bloodstream through the thin walls of the air sacs in the lungs. Aerosols (particles of drug suspended in air) are administered by inhalation, as are many anaesthetics, and various aerosolized medicines used to treat asthma. The endotracheal route involves administering a drug into the respiratory system through an endotracheal tube. The epidural route involves giving a drug (usually an aesthetic or narcotic analgesic) through a catheter inserted near the spinal cord by a lumbar puncture. The topical or dermatomucosal route includes aural, ocular, nasal and vaginal administration (ointments, creams, lotions). Drugs can also be delivered by oropharingeal inhalation or transdermal absorption (for continuous drug delivery through the skin, for example, patches or plasters). Rectal administration is used when oral administration presents difficulties, such as in case of nausea or vomiting. Suppositories (cone-shaped objects containing drugs) and aqueous solutions are inserted into the rectum. LANGUAGE WORK 17. Give the English equivalents: ; () ; ; ; ; ; ; ; ; ; . 18. Pick up the adjectives to the nouns they can be combined with: oral; enteral; subcutaneous; rectal; intradermal; intramuscular; parenteral; intravenous; sublingual; intracavitary; painful; epidural; intraosseous. Administration ... Injection ...

19. Name the route of drug administration based on its description: 1) Drug is administered via suppository or fluid into the anus. ____________ 2) Drug is administered via vapour or gas into the nose or mouth. ____________ 3) Drug is administered under the tongue. ____________ 4) Drug is applied locally on skin or mucous membrane. ____________ 5) Drug is injected via syringe under the skin or into a vein, muscle, or body cavity. ____________ 6) Drug is given by mouth and absorbed through the stomach or intestinal wall. ____________ 20. Give the meaning of the following terms: 1) intravenous ________________________ 2) intrathecal _________________________ 3) aerosol ____________________________ 4) intramuscular _______________________ 5) subcutaneous _______________________ 6) intracavitary ________________________ 21. Look through the text again. How can you explain the following abbreviations: SC; IM; IV?
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Study some other examples: ac before meals (ante cibum) pc after meals (post cibum) bid two times a day (bis in die) caps capsule gr, gm gram gt, gtt drops (gutta) h hour (hora) i.c. intracutaneously id intradermally IU International unit (of hormone activity) mg milligram NPO nothing by mouth (nil per os) po by mouth (per os) Q (q) every (quaque) qd every day (quaque die) qh every hour (quaque hora) qhs at bedtime (quaque hora somni) qid four times a day (quater in die) subcu, subq, SC, SQ subcutaneous injection tab tablet tid tree times a day (ter in die) 22. Try to read the following prescriptions: 1) Fluoxetine (Prozac) 20 mg po bid 2) Dimenhydrinate (Dramamine) 10 mg 2 tab q 4-6 h 3) Ranitidine (Zantac) 300 mg 1 tab pc qd 4) Pseudoephedrine (Sudafed) 60 mg 1 cap qid for 15 days

Comprehension
23. Match the routes of drug administration in column I with the medication or procedures in column II. Write the letter of the answer in the given space. I II 1) intravenous _____________________ a) lotions, creams, ointments 2) rectal _____________________ b) tablets and capsules 3) oral _____________________ c) skin testing for allergy 4) topical _____________________ d) lumbar puncture 5) inhalation _____________________ e) deep injection, usually in buttock 6) intrathecal _____________________ f) suppositories 7) intramuscular _____________________ g) blood transfusions 8) intradermal _____________________ h) aerosol medications 24. Define the sentences as True or False. Correct the false statements. Use introductory phrases: Its absolutely right I differ from you I quite agree that It is not true to the fact There is no doubt In my opinion 1) 2) 3) 4) 5) Treatment plan depends a lot on routes of drug administration. There are two main routes of drug administration: enteral and parenteral. Oral and sublingual administrations are examples of parenteral route. Oral administration is the most effective route. There are several types of parenteral injections.
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6) Vapours or gases are administered by injections. 7) Topical applications are locally applied on the skin or mucous membranes of the body. 25. Answer the questions: 1) What determines the rate, completeness, speed and duration of the drug action in the body? 2) How can you explain the enteral route of drug administration? 3) How many routes of enteral administration do you know? What are they? 4) What route do different injections belong to? 5) Enumerate types of injection. 6) Give examples of deep and shallow injections. 7) What types of drug administration are connected with respiratory system? 8) What route is considered to be external route of drug administration? 26. Look through Text 2. Remember, you dont have to understand every word.

TEXT 2
Drug Action and Drug Toxicity After the drugs have been absorbed into the blood-stream they may show some action and interaction in the organism. The following phenomena may be observed: Additive Action. The combination of two similar drugs is equal to the sum of the effect of each. Idiosyncrasy. This is unexpected effect that may appear in the patient following administration of a drug. Idiosyncratic reactions are produced in very few patients but may be lifethreatening in those few instances. A combination of two drugs can sometimes cause an effect that is greater than the sum of the individual effects of each drug given alone. This phenomenon is called synergism or potentiation. Tolerance. The effect of a given dose diminishes as treatment goes on, and increasing amounts are needed to produce the same effect. Tolerance is the feature of addiction to drugs. Addiction is the physical and psychological dependence on and craving for a drug and the presence of clear effects when that drug or other agent is withdrawn. Drug toxicity is the poisonous and potentially dangerous effects of some drugs. Some types of drug toxicity are more or less predictable and are based on the dosage of the given drug. Side effects are toxic effects that routinely result from the use of a drug. They often occur with the usual therapeutic dosage of a drug and are generally tolerable. Contraindications are factors in a patients condition that make the use of a drug dangerous and ill advised. Notes: addiction , ; additive action , ; contraindication ; idiosyncrasy , ; side effect ; synergism ; ; tolerance , . 27. Paraphrase the words in bold type using the expressions from the text: 1) After the drugs have been absorbed into the bloodstream they may show some effect and mutual effect in the organism. 2) Idiosyncrasy is a sudden unpredictable effect that may appear in the patient. 3) Idiosyncratic reactions may be dangerous to life.
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4) In case of tolerance the effect of a given dose decreases as the treatment continues, and elevated amounts are needed to achieve the same effect. 5) Side effects are poisonous effects that usually result from the use of a drug. 6) Contraindications make the use of a drug life-threatening and irrecomended. 28. Answer the questions: 1) What phenomena may be observed in the patients condition after the drugs have been absorbed into the bloodstream? 2) What is additive action? 3) How is unexpected effect of the drug appeared in the patient called? 4) Is potentiation (or synergism) equal to the sum of the individual effects of each drug given alone? 5) What does the term tolerance mean? 6) What is the difference between the side effects and contraindication factors? 29. Give definition for: Additive action _________________________ Idiosyncrasy ___________________________ Synergism or potentiation ________________ Tolerance _____________________________ Addiction _____________________________ Side effect ____________________________ Contraindication ________________________

DISCUSSION
30. Go back to the section Introduction and revise exercises 4, 5, 6. Basing on Text 2 try to comment or discuss with your partner those rules you ticked. 31. Revise the routes of drug administration and classify them as invasive and non-invasive, painful and non-painful; stressful and stressless for the patients. Work out your recommendations and comment them.

SELF CHECK
32. Try to code the following: Model: Britapen 1 gr intramuscular injection every 6 hours . . . Britapen 1 gr IM q 6 h 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) Clamoxil 500 mg 1 tablet by mouth every 8 hours . . . Ampicillin 15 mg intramuscular injection at bedtime . . . Tosein 28 gr by mouth after meals . . . Buscapin compositum 26 drops every hour . . . Febrectal 4 ml subcutaneous injection every day . . . Seguril 37 mm intravenous injection 2 times a day . . . Paracetamol 1 tablet by mouth three times a day . . . Nolotil 2 capsules before meals . . . Insulin 150 international units subcutaneous injection . . . Valium 5 mg intravenous injection at bedtime . . .

33. Choose the correct answer: 1) The drug for injections are labelled with: a) white labels; b) blue labels; c) yellow labels. 2) If the drug is absorbed through the gastrointestinal tract, the route of administration is: a) injection; b) endotracheal; c) enteral.
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3) There are ... classes of injections: a) 5; b) 6; c) 7. 4) The injection made into the space surrounding the brain or the spinal cord is called a) intrathecal; b) intraosseous; c) epidural. 5) Subcutaneous injection is deeper than intradermal one a) yes; b) no. 6) The route for administration of such drugs as lotions, creams and ointments is a) oral; b) topical; c) endotracheal. 7) Abbreviation for four times a day is a) qid; b) tid; c) bid. 8) What is true about side effect: a) It is an unexpected effect produced in a particularly sensitive individual but not seen in most patients; b) It is a toxic effect that routinely results from the use of a drug; c) It is a factor in the patient condition that prevents the use of a particular drug or treatment? 9) What is not true about the tolerance (2 answers): a) It is a drug action in which the combination of two similar drugs is equal to the sum of the effects of each; b) It is a drug action in which larger and larger doses must be given to achieve the desired effect; c) It is a drug action in which the combination of two drugs causes an effect that is greater than the sum of the individual effects of each drug alone? 10) Physical and psychological dependence on and craving for a drug is: a) additive action; b) addiction; c) potentiation. 34. Translate in written form: A Contraindications: Ciprobay must not be used in cases of hypersensitivity to ciprofloxacin or other quinole chemotherapeutics. Ciprobay must not be prescribed to growing children or juveniles, or to pregnant women or nursing mothers, since there is no information on the drug safety in these patient groups and since animal studies indicate that damage to articular cartilage in the immature organism cannot be fully excluded. Animal studies have not yielded any evidence of teratogenic effects (malformations). B : (chloramphenicol) / . , - . , (hydantoin), (phenylbutazone) .

UNIT 3. CLASSES OF DRUGS Introduction

1. Think and put down into your exercise-book as many classes of drugs as you can. 2. Using the prefix anti- and the suffixes -ant (ent), -al, -ic form the words which name classes of drugs. Try to explain the meaning of the words you have obtained. Model: biology antibiotic Virus; coagulate; depress; diabetes; nausea; convulse; diarrhoea; platelet.
18

3. A) Copy the following form into your exercise-book: I know what these drugs are for I can guess what these drugs are for I have never heard what these drugs are for

B) Distribute the following classes of drugs according to the columns: Analgesics; anaesthetics; antibiotics; antivirals; anticoagulants; antiplatelet drugs; anticonvulsants; antidepressants; antidiabetics; antihistamines; cardiovascular drugs; endocrine drugs; respiratory drugs; sedatives; gastrointestinal drugs; hypnotics; stimulants; tranquillizers; diuretics; antacids; antinauseants; antiemetics; laxatives. 4. Match the term with its meaning: 1) a chemical substance produced by a plant or microorganism, that has the ability to inhibit or kill foreign organisms in the body; 2) a drug used to relieve symptoms of depression; 3) a drug that blocks the action of histamine and helps prevent symptoms of allergy; 4) a drug that relieves pain; 5) a drug that prevents blood clotting; 6) a drug that reduces or eliminates sensation; 7) a drug used to prevent diabetes mellitus; 8) a mild drug that relaxes without necessarily producing sleep; 9) an agent that excites and promotes activity; 10) a drug used to control anxiety and severe disorders of behaviour. 1) analgesic 2) tranquillizer 3) antibiotic 4) 5) 6) 7) 8) 9) 10) stimulant sedative antidepressant antihistamine antidiabetic anaesthetic anticoagulant

5. Solve the anagrams, that is: obtain the word combining the given letters in different ways. All the words are drug classes. 1) stnalumits 6) arthrianladeas 2) ssidevate 7) ancersilut 3) incatdas 8) tqlruzainseril 4) hactesiantes 9) nasivtilar 5) ricisuted 10) aaannttcgilosu LANGUAGE WORK 6. Memorize the vocabulary: Alertness [l:tnis], n Anaesthetic* [nsetik], 1) n; 2) a Analgesic (analgetic) * , 1) a , ; 2) 1) , [,nli:zik], 1) n; 2) a , ; 2) , 1) a ; [,ntsid], 1) n; 2) a 2) [niutensin knv:ti ()
enzaim] [ntgnist], n [,ntibaitik], 1) n; 2) a [,ntikugjulnt], 1) n; 2) a 19

Antacid (antiacid) * Angiotensin converting Enzyme (ACE) Antagonist Antibiotic* Anticoagulant*

, , Calcium antagonist 1) ; 2) 1) ,

Anticonvulsant*

[,ntiknvlsnt], 1) n; 2) a [,ntidipresnt], 1) n; 2) a [,ntidaibetik], 1) n; 2) a [nti,dairil], 1) n; 2) a [,ntiimetik], 1) n; 2) a [,ntihistmi:n], n [,ntin:sint], 1) n; 2) a [,ntipleitlit], n [,ntils], 1) n; 2) a [ntivairl], a [zaiti], n [bi:tblk], n [bl:], v [brkdaileit], n [ka:tik], 1) n; 2) a [k:n], n [,daijuretik], 1) n; 2) a [drauzins], n [emb,lizm], n [fgs], n [hei fi:v] [haivz], n [hipntik], 1) n; 2) a [,indiskrimint], a [indju:s], v [lkstiv], 1) n; 2) a [mun sikns] [mail], n [putnt], a [prmut], v 20

Antidepressant*

Antidiabetic* Antidiarrheal*

1) () ; 2) 1) , ; 2) 1) ; 2) 1) , ; 2) , 1) ; 2) , () 1) ; 2) , , , - , ; blurred vision , , , 1) ; 2) , , , 1) , ; 2) , , , , 1) ; 2) , , 1) ; 2) , , , , , ,

Antiemetic* Antihistamine* Antinauseant* Antiplatelet* Antiulcer* Antiviral* Anxiety Beta-blocker Blur

Bronchodilator Cathartic* Caution Diuretic* Drowsiness Embolism Fungus (pl. fungi) Hay fever Hives Hypnotic* Indiscriminate Induce Laxative* Motion sickness Myalgia Potent Promote

Purgative* Sedative*

[p:gtiv], 1) n; 2) a [sedtiv], 1) n; 2) a [sensein], n [sterid], 1) n; 2) a [stimjulnt ], 1) n; 2) a [trkwlaiz], n [ji:st], n

Sensation Steroid* Stimulant* Tranquillizer Yeast

1) ; 2) , 1) () ; 2) , , , 1) ; 2) , ,

* 1: , , : : an analgesic action (?) , (.. ) : to take a hypnotic (?) . 2: . , : British English: American English: anaemia anemia anaesthesia anesthesia diarrhoea diarrhea dispnoea dispnea foetus fetus gynaecology gynecology haemorrhage hemorrhage oedema edema oesophagus esophagus orthopaedic orthopedic paediatric pediatric . -e-, -ae-, -oe-.

7. Practice the pronunciation: aerosol [erusl] arrhythmia [a:rimi] bactericidal [bktirisaidl] convulsion [knvln] dyspnoea [dispni:] endogenous [endns] epilepsy [epilepsi] glucocorticoid [glu:kk:tikid]

hydrochloric acid [haidruklriksid] immunodeficiency [imju:ndifinsi] insulin [insjulin] opioid [upiid] rheumatic [rumtik] tolerance [tlrns] unconsciousness [nknsns] vertigo [v:tigu]

8. Read and translate the following words and word-combinations: 1) anaesthetic [nsetik]: general anaesthetic; local anaesthetic; to inject or apply anaesthetics; anaesthetics reduce or eliminate sensation. 2) anticoagulant [,ntikugjulnt]: to administer anticoagulants; to show anticoagulant action; heparin is a natural anticoagulant. 3) anticonvulsant [,ntiknvlsnt]: to take anticonvulsants; anticonvulsants prevent or reduce convulsions; anticonvulsants are prescribed in case of epilepsy.
21

4) antacid [,ntsid]: an antacid preparation; to take antacids after meal; antacids relieve symptoms of epigastric discomfort. 5) cathartic [ka:tik]: a mild cathartic; a strong cathartic; cathartics should be taken for some diagnostic or operative procedures. 6) stimulant [stimjulnt]: caffeine is a stimulant; stimulants improve appetite; alertness produced by a stimulant; this drug contains a stimulant substance. 9. Distribute the following words of the same root into columns according to the parts of speech they are, translate them. Class of drugs Antiviral Anticoagulant Anticonvulsant Antidepressant Antacid Antinauseant Sedative Stimulant Tranquillizer Hypnotic Anaesthetic Nouns Verbs Adjectives or participles

Viral, virulent, virology, virulence; anaesthetist, anaesthesiologist, anaesthetize; coagulate, coagulation, coagulum, coagulant; convulse, convulsion, convulsive; depress, depression, depressant, depressed, depressor; acidity, acidic, acidify, acidulous, acidly; nausea, nauseate, nauseated, nauseous; sedate, sedation, sedated; stimulate, stimulus, stimuli, stimulation; tranquil, tranquillity, tranquillize; hypnotism, hypnotist, hypnotize. Which word doesnt belong to any column? Make up a sentence with it. 10. Fill in the gaps with the necessary part of speech obtaining it from the word given to the right of the sentence. Put it into a correct grammar form. Model: The scientists study human immunodeficiency _____. ANTIVIRAL The scientists study human immunodeficiency VIRUS. 1) An _____ is a drug that relieves pain. 2) Unstabilized blood _____ quickly. 3) It took the patient two hours to recover his consciousness after general _____. 4) Psychiatry and Psychotherapy sometimes use _____ in the treatment of their patients. 5) Hydrochloric _____ helps the stomach to digest food. 6) _____ may be a symptom of many gastrointestinal disorders, some infectious diseases, also it may result from excessive nervousness. 7) These drugs block the action of _____, which is normally released in the body in allergic reaction. 8) _____ and cooperation of the patient are very important in all types of treatment. 9) _____ is a process of bowel cleansing, natural or artificial bowel evacuation. 10) There are two types of _____: insulin-dependent and non-insulindependent. MYALGIA ANTICOAGULANT ANAESTHETIC HYPNOTIC ANTACID ANTIDIARRHEAL ANTIHISTAMINE SEDATIVE CATHARTIC ANTIDIABETIC

22

11. Read the Text Classes of Drugs:

TEXT 1
Classes of Drugs The following are the major classes of drugs and explanation of their uses in the body. An analgesic (alges/o means sensitivity to pain) is a drug that relieves pain. Mild analgesics are used for mild to moderate pains, such as that caused by myalgias, headaches, and toothaches. More potent analgesics are narcotics or opioids, so called because they contain or are derived from opium. They induce stupor (a condition of near unconsciousness and reduced mental and physical activity). They are used only to relieve severe pain because they may produce dependence (habit formation) and tolerance. Some non-narcotic analgesics relieve fever, pain, and inflammation and are used in rheumatic (joint) disorders. These agents are not steroid hormones (such as cortisone) and are known as non-steroidal anti-inflammatory drugs (NSAIDs). An anaesthetic is an agent that reduces or eliminates sensation. This can affect the whole body (general anaesthetic) or a particular region (local anaesthetic). General anaesthetics are used for surgical procedures; they depress the activity of the central nervous system, producing loss of consciousness. Local anaesthetics inhibit the conduction of impulses in sensory nerves in the region in which they are injected or applied. An antibiotic is a chemical substance produced by a microorganism (bacterium, yeast, or mold) that inhibits (bacteriostatic) or kills (bactericidal) bacteria, fungi, and parasites. The use of antibiotics has largely controlled many diseases such as pneumonia and rheumatic fever. Caution about the use of antibiotics is necessary because they are powerful agents. With indiscriminate use, pathogenic organisms can develop resistance to the antibiotic and thus destroy the antibio tics disease-fighting capability. Antiviral drugs are used against viruses, such as herpes virus, cytomegalovirus (CMV), and human immunodeficiency virus (HIV). Anticoagulants prevent the clotting (coagulation) of blood. They prevent the formation of clots or break up clots in blood vessels in conditions such as thrombosis and embolism. They are also used to prevent coagulation in preserved blood used for transfusions. Antiplatelet drugs reduce the tendency of platelets to stick together. Aspirin is an example of an antiplatelet drug; it is recommended for patients with coronary artery disease and for those who have had heart attack. An anticonvulsant prevents or reduces the frequency of convulsions in various types of epilepsy. Ideally, anticonvulsants depress abnormal spontaneous activity of the brain arising from areas of scar or tumour, without affecting normal brain function. Antidepressants treat symptoms of depression. They can elevate mood, increase physical activity and mental alertness, and improve appetite and sleep patterns. Many antidepressants are also mild sedatives and treat mild forms of depression associated with anxiety. Antidiabetics are used to treat diabetes mellitus (a condition in which the hormone insulin is either not produced by the pancreas or is not effective in the body). Patients with type 1 (insulindependent) diabetes must receive daily injection of insulin. Patients with type 2 (non-insulindependent) diabetes are given oral antidiabetic drugs. Antihistamines block the action of histamine, which is normally released in the body in allergic reactions. Histamine causes allergic symptoms such as hives, bronchial asthma, hay fever, and in severe cases anaphylactic shock (dyspnoea, hypotension, and loss of consciousness). Antihistamines cannot cure the allergic reaction, but they can relieve its symptoms. Many antihistamines have strong antiemetic (prevention of nausea) activity and are used to prevent motion sickness. The most common side effects of antihistamines are drowsiness, blurred vision, tremors, digestive upset, and lack of motor coordination. Cardiovascular drugs act on the heart or the blood vessels to treat hypertension, angina (pain due to decrease of oxygen delivery to heart muscle), heart attack, congestive heart failure, and arrhythmias. Often, before other drugs are used, daily aspirin therapy (to prevent clots in blood
23

vessels) and sublingual nitroglycerine (to dilate coronary blood vessels) are prescribed. Angiotensin-Converting Enzyme (ACE) Inhibitors keep blood vessels dilated to lower blood pressure, improve the performance of the heart, and reduce its workload. ACE inhibitors are used in treating hypertension, congestive heart failure, and heart attack (myocardial infarction), especially if the patients show evidence of a weakened heart. Beta-Blockers decrease the muscular tone in blood vessels (vasodilatation), decrease the output of heart, and reduce blood pressure by blocking the action of epinephrine at receptor sites in the heart muscle and in blood vessels. They are used to treat angina, hypertension, and arrhythmias and to treat patients after heart attacks. Calcium Antagonists or Calcium Channel Blockers, as with beta-blockers, they dilate blood vessels and lower blood pressure; they are used to treat angina and arrhythmias. They inhibit the entry of calcium (necessary for blood vessel contraction) into muscles of the heart and blood vessels. Cholesterol-Lowering Drugs reduce hypercholesterolemia (high level of cholesterol in the blood), which is a major factor in the development of heart disease. Diuretics are drugs that reduce the volume of blood in the body by promoting the kidneys to remove water and salt through urine. They are used to treat hypertension and congestive heart failure. Endocrine drugs act in much the same manner as the naturally occurring (endogenous) hormones. Different classes of these drugs are used for male hormone replacement and to treat endometriosis and breast cancer in women, prostate cancer. Some are used for symptoms associated with menopause and to prevent postmenopausal osteoporosis; as chemotherapy for some types of cancer, in hormone replacement therapy and as oral contraceptives. Thyroid hormone is administered when there is a low output of hormone from the thyroid gland. Glucocorticoids (adrenal corticosteroids) are prescribed for reduction of inflammation and a wide range of other disorders, including arthritis, severe skin and allergic conditions, respiratory and blood disorders, gastrointestinal ailments, and malignant conditions. Gastrointestinal drugs are often used to relieve uncomfortable and potentially dangerous symptoms, rather than as cures for specific diseases. Antacids neutralize the hydrochloric acid in the stomach to relieve symptoms of peptic ulcer, esophagitis, and epigastric discomfort. Antiulcer drugs block secretion of acid by cells in the lining of the stomach and are prescribed for patients with gastric and duodenal ulcers and gastroesophageal reflux disease (GERD). Antidiarrheal drugs relieve diarrhoea and decrease the rapid movement of the walls of the colon. Cathartics relieve constipation and promote defecation for diagnostic and operative procedures and are used in the treatment of disorders of gastrointestinal tract. Laxatives are mild cathartics, and purgatives are strong cathartics. Antinauseants (antiemetics) relieve nausea and vomiting and also overcome vertigo, dizziness, motion sickness, and labyrinthitis (inflammation of the inner ear). Respiratory drugs are prescribed for the treatment of emphysema, asthma, respiratory infections, such as pneumonia and bronchitis. Bronchodilators are used to open the air passages (bronchial tubes) and can be administered by injection or aerosol inhalers. Also there may be administered steroid drugs that are used as inhalants or intranasal products to reduce inflammation in nasal passages. Sedatives and hypnotics are medications that depress the central nervous system and promote drowsiness and sleep. They are prescribed for insomnia and sleep disorders. These products have a very high abuse potential and should be used only for short periods of time and under close supervision. Stimulants act on the brain and are used to speed up vital processes (heart and respiration) in cases of shock and collapse. They also increase alertness and inhibit hyperactive behaviour in children. High doses can produce restlessness, insomnia, and hypertension. Tranquillizers are useful for controlling anxiety. Minor tranquillizers control minor symptoms of anxiety. Major tranquillizers control more severe disturbances of behaviour.

24

LANGUAGE WORK 12. Give the English equivalents: () ; (); ; ; ; ; (); ; ; ; ; ; . 13. With what classes of drugs can you combine the following adjectives: Mild; potent; powerful; local; general; minor; major; strong-effective? Find synonym and antonym groups among them. Which words do not belong to any group? Make up a sentence (or sentences) with them. 14. 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) Fill in the gaps with prepositions where it is necessary: As you bad condition is caused myalgia, you may use a mild analgesic it. Narcotics are called opioids because they are derived opium. Stupor is a condition near unconsciousness Local anaesthetics inhibit the conduction impulses sensory nerves the region which they are injected or applied. indiscriminate use, pathogenic organisms can develop resistance the antibiotic. Anticoagulants prevent the formation clots or break clots blood vessels conditions such as thrombosis and embolism. Aspirin is recommended patients coronary artery disease. Mild sedatives treat mild forms depression associated anxiety. Cardiovascular drugs act the heart or the blood vessels treat hypertension, angina, heart attack, and arrhythmias. ACE inhibitors are used treating hypertension. Diuretics reduce the volume blood the body promoting the kidneys remove water and salt urine. Gastrointestinal drugs are often used relieve discomfort, rather than as cures specific diseases.

15. Write questions for the answers: 1) For what ________________? For mild to moderate pains, such as myalgias, headaches, and toothaches. 2) Why _______________? Because they contain or are derived from opium. 3) _______________? Yes, they may produce dependence. 4) How many _______________? There are two classes: general and local. 5) _______________? No, because the grippe is of viral origin and not bacterial. 6) What _______________? They treat symptoms of depression. 7) _______________? No, they cant, but they can relieve allergic symptoms. 8) What _______________? They are ACE inhibitors, beta-blockers, calcium antagonists, cholesterol-lowering drugs, and diuretics. 9) What _______________? Laxatives are mild cathartics, and purgatives are strong cathartics.
25

10) How _______________? Patients with insulin-dependent diabetes receive daily injections and patients with non-insulindependent diabetes are given oral antidiabetics. 11) What _______________? In case of these diseases respiratory drugs are prescribed. 12) _______________? No, tranquillizers are more powerful than sedatives.

Comprehension
16. 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) Find in the text the adequate word to complete the sentences: _____ reduces or eliminates sensation. _____ are used to regulate the level of insulin in the body. _____ relieves pain. _____ prevent the formation of clots or break up clots in blood vessels and are added in preserved blood. _____ cannot cure the allergic reaction, but they can relieve its symptoms. _____ depress the central nervous system and promote drowsiness and sleep. _____ are taken if something is wrong with the organs of the digestive tract. _____ elevate mood, increase physical activity and mental alertness, and improve appetite and sleep. _____ act on the heart and blood vessels. _____ inhibit or kill bacteria, fungi, and parasites.

17. Define the sentences as True or False. Correct the false statements. Begin your statement with: Its absolutely right I differ from you I quite agree that It is not true to the fact There is no doubt that In my opinion 1) Analgesics are used for pains of different intensity or even induce stupor. 2) Analgesics are used in surgical procedures and can affect the whole body or a particular region. 3) The antibiotics disease-fighting capability is destroyed if pathogenic microorganisms developed resistance to this antibiotic. 4) Antiviral drugs produce the same effect as antibiotics do. 5) Antiplatelet drugs increase the tendency of platelets to stick together. 6) Anticonvulsants are prescribed in various types of epilepsy. 7) Antihistamines cause allergic symptoms such as hives, asthma, hay fever, and, in severe cases, anaphylactic shock. 8) Cardiovascular drugs are divided into various subclasses. 9) Endocrine drugs act in much the same manner as the endogenous hormones. 10) Different classes of gastrointestinal drugs cure for specific diseases. 11) It is necessary to administer some tranquillizers to control anxiety and severe disturbances of behaviour. 18. 1) 2) 3) Answer the following questions: What is the action of an analgesic? What kind of pains are they used for? Do anaesthetics eliminate sensation? What classes of anaesthetics do you know? What kinds of pathogens may be inhibited or killed by antibiotics? Why is caution about their use necessary? 4) What drugs prevent blood clotting? 5) What medication is administered in case of epilepsy? 6) What are the action and the most common side effects of antihistamines?
26

7) What classes of drugs show antiemetic action? 8) What classes of drugs may produce dependence (addiction)? 9) What class of drugs is mainly administered as an inhalant? 19. Distribute the following subclasses to the adequate drug classes. Explain their uses in the body. Diuretics; bronchodilators; antacids; antinauseants; ACE inhibitors; steroid drugs; beta-blockers; calcium antagonists; antiulcer drugs; cholesterol-lowering drugs; antidiarrheals; cathartics. 1) Respiratory drugs: , ,. 2) Cardiovascular drugs: , , . 3) Gastrointestinal drugs: , , . 20. What is the difference between: mild and potent analgesics; general and local anaesthetics; laxatives and purgatives; sedatives and tranquillizers? 21. Give the meaning of the following terms that describe classes of drugs: Antibiotic ________________________ Antidepressant ____________________ Antihistamine _____________________ Analgesic ________________________ Anticoagulant _____________________ Anaesthetic _______________________ Antidiabetic ______________________ Sedative _________________________ Stimulant ________________________ Tranquillizer ______________________ Beta-blocker ___________________________ Calcium antagonist______________________ Antacid _______________________________ Cathartic ______________________________ Antiemetic ____________________________ Bronchodilator _________________________ Hypnotic ______________________________ Diuretic ______________________________ Cholesterol-lowering drug ________________

22. Administer the proper class of drug according to the situation given in the dialogue. Choose from the words given below: Anticonvulsant; anticoagulant; antacid; antibiotic; ACE inhibitor; bronchodilator; antihistamine; tranquillizer; analgesic 1. A: This patient has the history of severe behaviour disturbances and anxiety. B: He needs a (an) . 2. A: Doctor, this patient has a convulsion attack. I think, its epilepsy. B: We shall give him a (an) . 3. A: The cardiologist made the diagnosis of congestive heart failure and hypertension. B: Im sure he administered a (an) . 4. A: Doctor, I often feel some epigastric discomfort after meal. B: You may take some . 5. A: Can you recommend me anything for myalgia and neuralgia? B: I can advise you a mild . 6. A (in the operating room): This patient is developing the anaphylactic shock. B: We must prevent it with a (an) . 7. A: What should I administer in case of thrombosis or embolism? B: s are in that drug cabinet. 8. A: The diagnosis of the patient admitted to the ward 617 is bacterial pneumonia. B: Give him injections of this every 6 hours. 9. A: Can I help you? B: My daughter suffers from asthma attacks. I need a new prescription for her .
27

Discussion
23. Go around the classroom and ask each of your group-mates what classes of drugs he or she takes. Ask in what situations they do it. Prepare a statistic chart and report about the results of your questioning. 24. What drugs do you take? Here is the list of some classes of drugs. Tick those you take with or add the missing ones. How often do you take them? Mark them 1 for the most frequently taken to 10 for the least frequently taken. You neednt give numbers to the drug classes you never take. Give your comments.

(please, specify) (please, specify) (please, specify) (please, specify) (please, specify)

Self Check
25. Choose a correct answer: 1) After his heart attack, Bernie was supposed to take many drugs including diuretics and a (an) (antibiotic; laxative; anticoagulant) to prevent blood clots. 2) Estelle was always anxious and had a hard time sleeping. Dr. Max felt that a mild (tranquillizer; antacid; anticonvulsant) would help her relax and concentrate on her work. 3) During chemotherapy Helen was very nauseated. Her doctor prescribed a (an) (antihypertensive; antiemetic; antianginal) to relieve her symptoms. 4) The label said that the drug might impair fine motor skills. It listed () (side effects; dosage; antidote) on taking the sedative. 5) If you have an allergy the doctor may administer a (an) (sedative; antihistamine; anticonvulsant). 6) Penicillin is an example of a (an) (respiratory drug; stimulant; antibiotic). 7) (Antacids; anaesthetics; nauseants) are used in case of epigastric discomfort. 8) Mary has been experiencing asthma attacks since her childhood so she always has a (an) (sedative; bronchodilator; antibiotic) on her. 9) Harry had a very bad toothache so he couldnt sleep. He had taken two tablets of a (an) (analgesic; antidepressant, anaesthetic) before he could come to his dentist in the morning. 10) Taking a (an) (sedative; antidiabetic; anticonvulsant) in time may help to prevent the onset of seizures. 11) Having eaten a bad food one may get food poisoning. In this case a (an) (antiviral; antacid; antidiarrheal) should be taken. 12) Going to the dentist we expect a local (analgesic; tranquillizer; anaesthetic) to have been injected or applied before the dental work begins. 13) Johnny has been stung by a bee and theres quite a lot of swelling and itching. He needs a (an) (bronchodilator; sedative; antihistamine) as soon as possible. 14) Falling down Alan cut his forehead badly. In the surgery where his mother brought him a nurse cleaned the wound with a (an) (antiseptic; antiviral; anticoagulant). 15) Rose suffering from exhaustion was recommended to have total bed rest for a week and to take a (an) (sedative; tranquillizer, stimulant) thereafter to regain her full strength.
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UNIT 4. STUDYING PHARMACEUTICAL REFERENCES Introduction

1. Translate the following words without consulting a dictionary: Description; indication; application; composition; presentation; dosage; effect; action; interaction; instruction; toxicity; administration; synergism; pharmacodynamics; pharmacokinetics. Now consult a dictionary and specify the words which have more meanings in Russian than you have given.

2. Answer the questions: Do you often take medicines? Do you get them with the doctors prescription or over-the-counter sale? Are you used to reading pharmaceutical references when you have to take medicines? What sections of a pharmacology reference do you pay special attention to?

3. Draw in your exercise-book the following dosage forms and packs: a tablet an ampoule a film-coated tablet a bottle a softgel a tube a capsule a parcel / a pack a dragee a blister strip / a contour cellular packing a suppository a tube / eye dropper a vial Add more words to each list, if you know any.

4. Make up word-combinations according to the model: Model: a bottle of ... a bottle of mixture, a bottle of solution, etc Use the words given in the second column of Exercise 3 to continue. 5. People sometimes ask advice about some medical problem at the chemists. Look at the three medical problems below. Do you know what they are? Headache Sunburn Diarrhoea

All the words in the box below relate to these problems. Write them in the diagram as in the examples. Use each word or phrase only once. vomiting medicine an aspirin fair skin see a doctor tablets burn paracetamol a spoonful of medicine sunscreen lotion cream keep it covered up

29

Headache

Paracetamol

Sunburn

Diarrhea

6. Make sure that you can pronounce all the word and phrases correctly. 7. Listen to three conversations about the problems from Exercise 5. Check that you have written the words in the box under the correct problem. Number the words (1, 2, 3, etc.) in the order you hear them in the conversation. 8. Now listen to each conversation separately. Each time, listen for the answers to these three questions: 1) Who is the medicine for? 2) What does the customer buy at the end of the conversation? 3) Does the pharmacist give any advice? LANGUAGE WORK 9. Memorize the vocabulary: Administration [dministrein], n Composition [kmpzin] , n Contraindication [kntrindikein] , n Description [diskripn] , n Dosage [dusi] , n Expire [ikspai] , v expiry date [ikspairi deit] , n Indication [indikein] , n Interaction [intrkn] , n Overdosage [uvdusi] , n pharmacology reference [fa:mkli refrns] , n Precaution [prik:n] , n Presentation
[prezntein] , n 30

, , ,

Side effect Storage strain

[said ifekt] , n [st:ri] , n [strein] , n

, . eczema [eksim] leucopenia [lju:kpi:ni] diathesis [daisis] concurrently [knkrntli] exceed [iksi:d] capsule [kpsju:l] agranulocytosis [grnjulsaitusis]

10. Practise the pronunciation: antiexudative [ntieksjudeitiv] exhibit [igzibit] enhance [inha:ns] susceptible [sseptbl] psoriasis [sraisis] resorption [riz:pn] ointment [intmnt]

11. Read and translate the following words and word-combinations: 1) administration [dministrein]: indications for administration; methods of administration; correct administration; administration and dosage. 2) dosage [dusi]: oral dosage; a starting dosage; a dosage range; the total daily dosage; individually determined dosage; do not exceed the daily dosage of 10-40 mg. 3) side effect [said ifekt]: minor side effects; to report some side effects; to withdraw the drug in case of some side effects. 4) precaution [prik:n]: precaution should be exercised; general and special precautions; precautions for use. 5) interaction [intrkn]: drug/drug interaction; drug/food interaction; incompatibilities and interactions; to avoid drug interactions. 6) storage [st:ri]: storage temperature; rules of storage; instructions for handling and storage; storage container. 12. Match the term with its meaning: 1) The basis for initiation of a treatment for a disease or of a diagnostic test; 2) The branch of pharmacology and therapeutics concerned with a determination of the doses of remedies; the science of dosage; 3) Any special symptom or circumstance that renders the use of a remedy or carrying out the procedure inadvisable, usually because of risk; 4) The kinds and numbers of atoms constituting a molecule; or list of components in a complex substance; 5) Giving of medicine or other therapeutic agent in prescribed amount; the determination of the proper dose of a remedy.

1) composition 2) dosage 3) indication 4) contraindication 5) posology

13. Study and remember the following synonymous groups: 1) Description: features; properties; effects 2) Indications: uses; common uses; applications; therapeutic activity 3) Composition: actives; inactives; (list of) excipients 4) Presentation: packaging; delivery units; dosage forms and packs; pharmaceutical form; how supplied. 5) Dosage: posology, directions for use; dosage instructions 6) Contraindications: restrictions on use 6) Side effects: adverse effects; undesirable effects 7) Interactions: incompatibilities 8) Overdosage: overdose; toxic effects (and their treatment)
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9) Precautions: caution; warnings 10) Storage: special notes; safety data 11) Expiry date: expire; best before 14. Read the abstracts and give them an appropriate title from the previous exercise: 1) Each ampoule of 15 ml contains: Pentoxifylline 300 mg. Water for injection I.P. q.s. 2) Store at room temperature in a dry place. Do not use Kreon after the expiry date. Keep out of reach of children. 3) Treatment of insomnia. 4) There is a possibility of local allergic reaction, especially in case of prolonged treatment. 5) TRENTAL must not be employed in patients with hypersensitivity to pentoxifylline, in the presence of severe haemorrhage or acute myocardial infarction. TRENTAL should not be administered during pregnancy. 6) Adults: 1 to 2 tablets Children 8 to 13 years: 1 tablet Children 3 to 8 years: tablet Up to 3 doses may be taken in 24 hours. 7) It has been reported that STAN may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with purpura has been reported. 8) 50 cartridges of 1.7 ml each 9) An overdose may produce convulsions and/or hallucinatory delirium. Rapid-action anticonvulsants should be administered by intramuscular or intravenous injection and a stomach wash effectuated even if a time interval has elapsed. 15. 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) Change the infinitives for positive or negative forms of the Imperative: (To keep) drugs out of the reach of children. (Not to lie) down for at least 30 minutes after taking this drug. (To store) at room temperature away from light and moisture. (Not to share) this medication with others. If you miss a dose of this medicine, (to take) it as soon as possible, but (not to take) 2 doses at once. (Not to drive), operate machinery, or do anything else that could be dangerous until you know how you react to this medicine. If any of these effects persists or worsens, (to notify) your doctor. While taking Cytotec (to avoid) antacids containing magnesium. (To shake) well before each use. In case of apparent allergy to one of the constituents (not to carry) out the application of the drug.

16. Fill in the gaps with the most suitable modal verb: must, can, could, should, may: 1) Patients recently withdrawn from beta-blockers develop a withdrawal syndrome with increased angina. 2) If you are a woman of childbearing age, you talk with your doctor about the most effective form of contraception that you follow during therapy. 3) The physician be aware of potential problems and, if the patients condition permits, sufficient time (at least 36 hours) be allowed for PROCARDIA to be washed out of the body. 4) Daily use of alcohol and this medicine increase your risk for stomach bleeding. 5) This medication be used only when clearly needed during pregnancy. 6) If you have diabetes, this medicine affect your blood sugar.
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7) Ciprobay not be used after the expiry date. 8) If concurrent use of the two products not be avoided, the serum concentration of theophylline be checked. 9) Acute uncomplicated cystitis be treated with a single dose of 250 mg. 10) Older patients receive as low dose as possible, depending on the severity of the disease. 11) In streptococcal infections the treatment last at least 10 days because of the risk of late complications. 17. Look quickly through Pharmacology Reference 1:

REFERENCE 1
Indomethacin Composition: Indomethacinum 10 g in ointment base up to 100 g. Properties: The ointment exhibits anti-inflammatory and antiexudative properties. Being a prostaglandin synthesis inhibitor it exercises both keratolytic and antiseptic effect. The excellent resorption of this ointment ensures its therapeutic effect creating high tissue concentrations at the application areas. Indications: Acute and chronic rheumatic polyarthritis, osteoarthrosis, Behterevs disease, degenerative articular diseases, discopathies, neuritis, plexitis, radiculitis, post-operative edema, contusions, thrombophlebitis, hyperkeratolytic eczemas, herpes zoster, arthropathic psoriasis, climacteric keratosis, etc. Contraindications: Drug allergy, peptic and duodenal ulcer, bronchial asthma, epilepsy, Parkinsonism, during pregnancy and breast feeding, leucopenia, haemorrhagic diathesis (thrombocytopenia and coagulopathy). Side-effects: Allergic reactions, thrombocytopenia, agranulocytosis. Following long term treatment, however rarely, headache, drowsiness, depressive states, hepatitis and pancreatitis can be observed especially in more susceptible patients. Drug interactions: Therapeutic effect of Indomethacin decreases, if applied concurrently with salycilates. Probenecid suppresses renal excretion of indomethacin. The effect of Indomethacin is enhanced if applied in combination with glucocorticoids and pyrazolon derivatives. Precautions: If treatment lasts longer than ten days, follow carefully the patients blood picture (leucocytes, thrombocytes). If applied in combination with antibiotics, anticoagulants or antidiabetic drugs ensure control of proper clinical and laboratory parameters. Dosage and application: Rub the affected joints or skin areas a few-centimetre-long tube squeeze of Indomethacin ointment, 23 times a day. Total daily amount should not exceed 15 cm for adults and 7.5 cm for children. Package: Ointment in aluminium tubes of 40 g. Storage: At moderate temperature (1530oC) in light-protected areas. Exp.term: 2 years (two years). Produced by: TROYAPHARM Co
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18. Give short answers yes or no if you have found information on: generic name; drug interactions; brand name; side effects; composition; storage; indications; expiry date; dosage and administration; package or presentation; warnings or precautions; manufacturer and series number. 19. Study the reference attentively. 20. What grammar forms of the verbs are most frequently used? 21. Find the English equivalents: ; , ; ; ; ; ; ; ; . 22. Define the following statements as True or False. Correct the false statements. Use introductory phrases: Its absolutely right I differ from you I quite agree that It is not true to the fact There is no doubt that In my opinion 1) 2) 3) 4) 5) 6) This drug is for cold or flu. It may be used by both adults and children. It should be rubbed in 2-3 times a day. There are no contraindications for this drug administration. Some drug interactions have been reported. The ointment may be applied without any precautions as long as the symptoms persist.

23. Answer the questions: 1) What is the pharmaceutical form of Indomethacin? 2) What are the properties of this drug? 3) What conditions may be relieved by this ointment? 4) Give dosage for adults and children. 5) Is this drug recommended for infants? 6) How long may the course of treatment last for? 7) What health conditions may limit or prevent using this drug? 8) What are the rules of storage and expiry term of this ointment? 24. Give a brief summary of this reference.

Studying Reference 2
Some over-the-counter drugs have indications for administration on the boxes or bottles. DayQuil is an example of them. 25. Study the information given on the box; compare it with the main principles of a pharmacology reference (see Fig. 1). - What sections are the same? - What is new in the arrangement of Reference 2? - What elements of advertisement have you found in this reference?
34

35

26. Translate into Russian sections Uses, Directions, Dosing Duration and Ask a Doctor.

Self Check
27. Translate into English: (GENTAMYCINI SULFAS) . , . (o, , , , .); , , ; , . , , .

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PART II. READING SKILLS

Additional Text 1
1. Read the text. 2. Divide this text into logical parts. 3. Answer the question offered as the title of the text. Why Does My Medication Give Me Side Effects? The cold remedy you take makes you sleepy. The antidepressant gives you a headache. The sinus decongestant makes your heart race. Why are side effects so common? To understand this you need to realize that your body is an immensely complex structure built from chemicals that must be regulated in order to function smoothly. Chemicals such as hormones and other molecular messengers usually make these adjustments. Medicines often work by taking the place of one of the bodys regulating chemicals to readjust the balance. When this restores functioning it is seen as helpful. However, two things complicate the picture. First, the body often uses the same chemical to regulate more than one process. This means that a medicine may retune not only the desired target but also others that dont need readjustment. An example of this is that the drug prednisone turns off inflammation, but also causes thinning of bones. Secondly, medicines are not always as selective as we would wish. This means the medicine may alter a number of unrelated processes at the same time. For example, the antidepressant drug amitriptyline can help depression (by acting on serotonin receptors), can also lower blood pressure (by affecting norepinephrine receptors), cause blurred vision, dry mouth and constipation (by blocking acetylcholine receptors) and produce sleepiness and weight gain (by binding to histamine receptors). One of the more surprising aspects of medications is how two people taking the same medicine can have such different experiences. One person may have severe or troublesome side effects that make the medicine intolerable, while another person finds that the medicine does only the good that is intended to do. In fact when many thousands or millions of people use medicines, the list of observed side effects can become long indeed. Side effects may be rare or common, serious or merely annoying. A medicine with frequent mild side effects may be tolerated by the majority of people and be regarded as relatively safe. On the other hand if a medicine has a less common but more serious side effect it can mean that the medicine should only be used when there is no alternative, and then with close monitoring. These considerations require doctors to assess the risk of side effects versus the expected benefit of any medication. In a life-threatening disease, even serious side effects may be worth the risk; but for a mild, transient illness, little risk or even discomfort should not be tolerated. As we learn more about the way our bodies are regulated, more medications are developed that allow us to intercede when diseases disrupt our functioning. It has been a prominent goal in the development of new medications to avoid more serious side effects. But it is likely that until we can foretell who is especially susceptible, at least some people may experience side effects from otherwise beneficial medication. Many of us may have to keep going back to our doctors to try a second or even a third medication before we find one with the strongest therapeutic effect and the fewest side effects.

Additional Text 2
Using the prescribing information which follows, choose the most appropriate antibiotic for these patients: 1 A 4-year-old boy with meningitis due to pneumococcus. He is allergic to penicillin. 2 A 67-year-old man with a history of chronic bronchitis now suffering from pneumonia. The causative organism is resistant to tetracycline. 3 A 27-year-old woman with urinary tract infection in early pregnancy.
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4 A 4-year-old girl with septic arthritis due to haemophilus influenzae. 5 An 18-year-old man with left leg amputation above the knee following a road traffic accident. 6 A 50-year-old woman with endocarditis caused by strep. viridans. 7 A 13-year-old girl with disfiguring acne. 8 An 8-year-old boy with tonsillitis due to -haemolytic streptococcus. 9 A 43-year-old dairyman with brucellosis. 10 A 4-year-old unimmunised sibling of a 2-year-old boy with whooping cough.
CEFUROXIME Indications: see under Cefaclor; surgical prophylaxis; more active against Haemophilus influenzae and Neisseria gonorrhoeae Cautions; Contra-indications; Side effects: see under Cefaclor Dose: by mouth (as cefuroxime axetil), 250 mg twice daily in most infections including mild to moderate lower respiratory tract infections or if pneumonia suspected. Urinary tract infection, 125 mg twice daily, doubled in pyelonephritis. Gonorrhoea, 1 g as a single dose. CHILD over 3 months, 125 mg twice daily, if infection doubled in child over two years with otitis media. By intramuscular injection or intravenous injection or infusion, 750 mg every 68 hours; 1.5 g every 68 hours in severe infections; single doses of 750 mg intravenous route only. CHILD usual dose 60 mg/kg (range 30100 mg/kg daily) in 34 divided doses (23 divided doses in neonates). Gonorrhoea, 1.5 g as a single dose by intramuscular injection (divided between 2 sites). Surgical prophylaxis, 1.5 g by intravenous injection as induction; may be supplemented with 750 mg intramuscularly 8 an 16 hours later (abdominal, pelvic, and orthopaedic operations) or followed by 750 mg intramuscularly every 8 hours for further 2448 hours (cardiac, pulmonary, oesophageal, and vascular operations). Meningitis, 3 g intravenously every 8 hours; CHILD, 200400 mg/kg daily (in 34 divided doses) reduced to 100 mg/kg daily after 3 days or on clinical improvement; NEONATE, 100 mg/kg daily reduced to 50 mg/kg daily. BENZYLPENICILLIN (Penicillin G) Indications: throat infections, otitis media, streptococcal endocarditis, meningococcal meningitis, pneumonia (see table 1); prophylaxis in limb amputation. Cautions: history of allergy; renal impairment; Interactions: Appendix 1 (penicillins) Contra-indications: penicillin hypersensitivity. Side effects: sensitivity reactions including urticaria, fever, joint pains; angioedema; transient leucopoenia and thrombocytopenia; anaphylactic shock in hypersensitive patients; diarrhoea after administration by mouth Dose: by intramuscular or by slow intravenous injection or by infusion, 1.2 g daily in 4 divided doses, increased if necessary to 2.4 g daily or more (see also below); PREMATURE INFANT and NEONATE, 50 mg/kg in 2 divided doses; INFANT 14 weeks, 75 mg/kg daily in 3 divided doses; CHILD 1 month-12 years, 100 mg/kg daily in 4 divided doses (higher doses may be required, see also below). Bacterial endocarditis, by slow intravenous injection or by infusion, 7.2 g daily in 46 divided doses. Meningococcal meningitis, by slow intravenous injection or by infusion, 2.4 g every 4-6 hours; PREMATURE INFANT and NEONATE, 100 mg/kg daily in 2 divided doses; INFANT 14 weeks, 150 mg/kg daily in 3 divided doses; CHILD 1 month 12 years, 180 300 mg/kg daily in 4 divided doses. Important. If meningococcal disease is suspected general practitioners are advised to give a single injection of benzylpenicillin by intramuscular or by intravenous injection before transporting the patient urgently to hospital. Suitable doses are: ADULT: 1.2 g; INFANT: 300 mg; CHILD 19 years 600 mg, 10 year and over as for adult Prophylaxis in limb amputation, section 5.1, table 2 By intrathecal injection, not recommended. ERYTHROMYCIN Indications: alternative to penicillin in hypersensitive patients; campylobacter enteritis, pneumonia, legionnaires disease, syphilis, non-gonococcal urethritis, chronic prostatitis, acne vulgaris (see section 13.6); diphtheria and whooping cough prophylaxis. Cautions: hepatic and renal impairment; prolongation of QT interval (ventricular tachycardia reported); porphyria (see section 9.8.2); pregnancy (not known to be harmful) and breast-feeding (only small amounts in milk); interactions: Appendix 1 (erythromycin and other macrolides). Arrhythmias. Avoid concomitant administration with astemizole or terfenadine, see pp. 13940 also avoid with cisapride [other interactions, Appendix 1]. Contra-indications: estolate contraindicated in liver disease. Side effects: nausea, vomiting, abdominal discomfort, diarrhoea (antibiotic-associated colitis reported); urticaria, rashes and other allergic reactions; reversible hearing loss reported after large doses; cholestatic jaundice and cardiac effects (including chest pain and arrhythmias) also reported. Dose: by mouth, ADULT and CHILD over 8 years, 250500 mg every 6 hours or 0.51 g every 12 hours (see notes above); up to 4 g daily in severe infections; CHILD up to 2 years, 125 mg every 6 hours, 28 years 250 mg every 6 hours, doses doubled for severe infections. Acne, see section 13.6 Early syphilis, 500 mg 4 times daily for 14 days. By intravenous infusion, ADULT and CHILD severe infections, 50 mg/kg daily by continuous infusion or in divided doses every 6 hours; mild infections (oral treatment not possible), 25 mg/kg daily.

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TETRACYCLINE Indications: exacerbation of chronic bronchitis; brucellosis (see also notes above), chlamydia, mycoplasma, and rickettsia; pleural effusions due to malignancy or cirrhosis; acne vulgaris (see section 13.6). Cautions: hepatic impairment (avoid intravenous administration); renal impairment (see Appendix 3); rarely causes photosensitivity; interactions: Appendix 1 (tetracyclines). Contra-indications: renal impairment (see Appendix 3), pregnancy and breast-feeding (see also Appendixes 4 and 5), children under 12 years of age, systemic lupus erythematosus. Side effects: nausea, vomiting, diarrhoea; erythema (discontinue treatment); headache and visual disturbances may indicate benign intracranial hypertension; hepatoxicity, antibiotic-associated pancreatitis and colitis reported. Dose: by mouth, 250 mg every 6 hours, increased in severe infections to 500 mg every 68 hours. Acne, see section 13.6. Primary, secondary, or latent syphilis, 500 mg every 6 hours for 15 days. Non-gonococcal urethritis, 500 mg every 6 hours for 714 days (21 days if failure or relapse following the first course). Counselling: Tablets or capsules should be swallowed whole with plenty of fluid while sitting or standing. By intravenous infusion, 500 mg every 12 hours; max. 2 g daily.

GENTAMICIN Indications: septicaemia and neonatal sepsis; meningitis and other CNS infections; biliary tract infection, acute pyelonephritis or prostatitis, endocarditis causes by Strep. viridans or Strep. faecalis (with penicillin); pneumonia in hospital patients, adjunct in listerial meningitis (section 5.1, table 1). Cautions: renal impairment, infants and elderly (adjust dose and monitor renal, auditory and vestibular function together with plasma gentamicin concentrations); avoid prolonged use; see also notes above; interactions: Appendix 1 (amino glycosides). Contra-indications: pregnancy, myasthenia gravis. Side effects: vestibular and auditory damage, nephrotoxicity; rarely, hypomagnesaemia on prolonged therapy, antibiotic-associated colitis; see also notes above. Dose: by intramuscular or by slow intravenous injection over at least 3 minutes or by intravenous infusion, 25 mg/kg daily (in divided doses every 8 hours), see also notes above; reduce dose and measure plasma concentrations in renal impairment. CHILD up to 2 weeks, 3 mg/kg every 12 hours, 2 weeks 12 years, 2 mg/kg every 8 hours. By intrathecal injection, 1 mg daily (increases if necessary to 5 mg daily), with 2 4 mg/kg daily by intramuscular injection (in divided doses every 8 hours).

AMPICILLIN Indications: urinary tract infections, otitis media, sinusitis, chronic bronchitis, invasive salmonellosis, gonorrhoea. Cautions: history of allergy; renal impairment; erythematous rashes common in glandular fever, chronic lymphatic leukaemia, and possibly HIV infection; interactions: Appendix 1 (penicillins). Contra-indications: penicillin hypersensitivity. Side effects: nausea; diarrhoea; rashes (discontinue treatment); rarely, antibioticassociated colitis; see also under Benzylpenicillin (section 5.1.1.1). Dose: by mouth, 0.251 g every 6 hours, at least 30 minutes before food. Gonorrhoea, 23.5 g as a single dose with probenecid 1g. Urinary tract infections, 500 mg every 8 hours. By intramuscular injection or intravenous injection or infusion, 500 mg every 46 hours; higher doses in meningitis. CHILD under 10 years, any route, half adult dose. PHENOLXYMETHYLPENICILLIN (Penicillin V) Indications: tonsillitis, otitis media, erysipelas; rheumatic fever and pneumococcal infection prophylaxis (see table 2). Cautions; Contra-indications; Side effects: see under Benzylpenicillin; interactions: Appendix 1 (penicillins). Dose: 500 mg every 6 hours increased to 750 mg every 6 hours in severe infections; CHILD, every 6 hours, up to 1 year 62.5 mg, 15 years 125 mg, 612 years 250 mg. Rheumatic fever and pneumococcal infection prophylaxis, section 5.1, table 2

Reference 1
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the reference in written form. 5. Find additional information about this drug and expand the reference.

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SARIDON
effective pain relief Each tablet contains: Paracetamol Propyphenazon Caffeine 250 mg 150 mg 50 mg

Headaches, migraines, toothache and other forms of pain can severely disrupt your life. For fast and effective relief of serious pain take Saridon. Its well balanced combination of ingredients (paracetamol and propyphenazone plus caffeine) not only kills pain fast and effectively but provides long and lasting relief. Dosage Adults: 1 or 2 tablets per dose with glass of water. Do not exceed 6 tablets in 24 hours. Children from 12 to 16 years: 1 tablet per dose with glass of water. Do not exceed 3 tablets within 24 hours. Do not give to children under 12 years unless advised by doctor. Analgesics should not be taken for more than ten days or in high doses without consulting your doctor. If your symptoms persist or return, you must consult your doctor. For further information about this product ask your doctor or pharmacist. Roche F. Hoffmann-La Roche Ltd, Basel, Switzerland

Reference 2
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the reference in written form. 5. Find additional information about this drug and expand the reference.

POLYGYNAX
Vaginal capsules

POLYGYNAX vaginal capsules are designed for local treatment of gynaecological disorders. COMPOSITION: Neomycin (sulphate): 35 000 IU Polymyxin B (sulphate): 35 000 IU Nystatin: 100 000 IU Dimethylpolysiloxane about 2,2 g Potassium sorbate about 0,3% Excipient q.s.f. one capsule. INDICATIONS: On a curative basis, POLYGYNAX is indicated for the treatment of vaginal discharges, regardless of the origin: ordinary organisms Candida albicans associated germs
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On a preventive basis: before any surgical procedure involving the lower genital tract before delivery before and after coagulation diathermy of the cervix before endo-uterine investigations (hysterography) CONTRA-INDICATIONS: allergy to one of the components. PRECAUTIONS OF USE: the duration of treatment should be limited because of the risk of resistant germs selection and because of the risk of surinfection by these germs. SIDE EFFECTS: possibility of local allergic reaction, especially in case of prolonged treatment. DOSAGE: 1 vaginal capsule at night for 12 days. WAY OF USE: vaginal route. The capsule should be inserted deeply into the vaginal cavity at bedtime. PRESENTATIONS: box of 6 vaginal capsules or box of 12 vaginal capsules. Authorized drug n 308.502.0 RESPECT PRESCRIBED DOSES KEEP OUT OF REACH OF CHILDREN LABORATOIRE INNOTHERA distributed by INNOTECH INTERNATIONAL 7-9, avenue Franois-Vincent Raspail 94110 ARCUEL - FRANCE

Reference 3
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the reference in written form. 5. Find additional information about this drug and expand the reference.

DOKTOR* MOM

HERBAL COUGH SYRUP

Doktor Mom* Herbal Cough Syrup is a pure herbal cough formulation that is soothing and cooling. It is useful in all types of cough irrespective of its origin and stage. Each 10 ml. contains extracts derived from: Ocium sanctum Main characteristics: 100 mg Effective in whooping cough, colds, lung inflammation, bronchial antiseptic, expectorant, provides relief from breathlessness. Demulcent, soothing, cooling, anti-inflammatory, expectorant. Useful in various types of cough, cold. Anti-allergic, antiinflammatory, antibacterial. Useful in cold, cough, sore throat, digestive. Expectorant, antispasmodic, antihistaminic, exerts special effect on bronchial system. Effective in dry cough, chronic febrile conditions.
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Glycerrhiza glabra Curcuma longa Zingiber officinale Adhatoda vasika Solanum indicum

60 mg 50 mg 10 mg 60 mg 20 mg

Inula Racemosa

Antispasmodic, antipyretic, expectorant, antibacterial, antifungal & antihistaminic. Piper cubeba 10 mg Stimulates mucous membrane, expectorant, effective in febrile conditions. Terminalia belerica 20 mg Antiphlegmatic, expectorant, effective in cough, sore throat. Aloe barbadensis 50 mg Effective in cough, purgative. Menthol 6 mg Liquefies phlegm, clears respiratory tract. General cough, whooping cough in early stages, irritating Indications and allergic cough, smokers cough, laryngitis, pharyngitis, tonsillitis and seasonal cough. Adults: Dosage 1 to 2 teaspoonfuls three times daily. Children: to 1 teaspoonful three times daily. This herbal remedy is safe and effective as it is derived from natural ingredients prescribed in Ayurvedic System of Medicine. It gives long lasting relief from all kinds of cough. It is free from alcohol, sedatives and addictive drugs. Hence it is completely safe for children. Presentation: Pack of 100 ml. Manufactured in India by: Unique Pharmaceutical Laboratories (A Divn. of J.B. Chemicals & Pharmaceuticals Ltd.) 128/1, GIDC Ankleshwar 393 002. Regd. Office: Neelam Centre, B Wing, 4th Floor, HIND CYCLE ROAD, WORLY, BOMBAY 400 025. * Trademark of J.B. Chemicals & Pharmaceuticals Ltd.

20 mg

Reference 4
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the reference in written form. 5. Find 5 names of other preparations of the same action.

CINFAMAR CAFFEINE
Dimenhydrinate + Caffeine COMPOSITION PER TABLET: Dimenhydrinate (INN) ................... 50 mg Caffeine .......................................... 50 mg Excipients: Maize starch, Microcrystalline cellulose, Dibasic calcium phosphate, Hydroxypropyl methylcellulose 606, Hydroxypropyl methylcellulose 615, Magnesium stearate, Sodium starch glycolate, Polyethylene glycol 6000, Polyvinylpirrolydone, Talc.
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PROPERTIES: Apart from its antihistaminic action, Dimenhydrinate prevents and relieves kinetosis, the symptomatic condition caused by movement, which frequently appears during travel and is generally characterised by dizziness, paleness, cold sweating, increased watering of the mouth, gastric upsets, nauseas, vomiting, etc. Caffeine as stimulant counteracts the effect of drowsiness which may be produced by Dimenhydrinate. INDICATIONS: CINFAMAR CAFEINA is indicated in the prevention and treatment of travel sickness produced during journeys by car, train, plane, ship, etc. DOSAGE: The doses indicated should be taken approximately half an hour before initiating the journey. If necessary, the dosis may be repeated during the journey at intervals of not less than four hours. Adults: l to 2 tablets Children 8 to 12 years: 1/21 tablet Children 3 to 8 years: 1/41/2 tablet Up to 3 doses may be taken in 24 hours. The tablets may be swallowed with little water or sweet drink. CONTRAINDICATIONS: Glaucoma and urethral-prostatic problems. PRECAUTIONS: The drowsiness caused by Dimenhydrinate, which is desirable in many cases, should be taken into account by drivers and those who use machines. WARNING: IMPORTANT FOR WOMEN: As with any drug, if you are pregnant or nursing baby, seek the advice of health professional before using this product. Sportmen-women should know this medicament keeps component which can give positive result in the analytic control in doping. INCOMPATIBILITIES AND INTERACTIONS: Dimenhydrinate may enhance the effects of other CNS depressants such as alcohol and barbiturates. If dimenhydrinate is used concomitantly with other CNS depressants, caution should be used to avoid overdosage. Because dimenhydrinate also has anticholinergic activity, it may potentiate the effects of other drugs with anticholinergic activity including tricyclic antidepressants, inhibitors, etc. SIDE EFFECTS: Drowsiness, dryness of mouth, constipation. TOXIC EFFECTS AND THEIR TREATMENT: The recommended dosage and total content of the package make poisoning unlikely. An overdose may produce convulsions and/or hallucinatory delirium. Rapid-action anticonvulsants should be administered by intramuscular or intravenous injection and stomach wash effectuated even if an interval of time has elapsed. If overdose or accidental ingestion, consult the Toxicology Information Service. Phone: (91) 562 04 20 PRESENTATION: Packages of 4 and 10 tablets.

laboratorios cinfa, s.a. Olaz - Chipi,10 HUARTE-PAMPLONA Navarra SPAIN

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NONPRESCRIPTION MEDICATION

MEDICINES SHOULD BE KEPT OUT OF CHILDREN'S REACH

Reference 5
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What are the contraindications, side effects or warnings? 3. Give the main information about this drug. 4. Translate the reference in written form. 5. Find 5 names of other preparations of the same action. COMMON NAME: ISONIAZID COMMON USES: This medicine is an antibacterial used to treat or prevent tuberculosis () infection. It may also be used to treat other conditions as determined by your doctor. BEFORE USING THIS MEDICINE: WARNING: This medicine has caused severe, even fatal, liver problems (e.g., hepatitis). Liver problems increase with age and with daily use of alcohol. Hepatitis can develop with use of this drug at any time during treatment. Stop using this medicine and notify your doctor immediately if you develop unusual fatigue, weakness, loss of appetite, nausea, vomiting, dark urine, yellowing of the eyes or skin, or stomach or abdominal pain. Your doctor may decide to slowly restart Isoniazid after these symptoms disappear and lab tests return to normal. People with active (acute) liver problems should not use this medicine for preventative treatment until after the liver problems have stopped. Your doctor will monitor your liver function tests at least every month to discuss your progress. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking rifampin or medicine for seizures. Inform your doctor of any other medical conditions, allergies, pregnancy, or breast-feeding. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine. HOW TO USE THIS MEDICINE: Follow the directions for using this medicine provided by your doctor. TAKE THIS MEDICINE ON AN EMPTY STOMACH at least 1 hour before or 2 hours after a meal. THIS MEDICINE MAY BE TAKEN WITH FOOD if it upsets your stomach. DO NOT TAKE ANTACIDS CONTAINING ALUMINUM within 1 hour of taking this medicine. STORE THIS MEDICINE at room temperature in a tightly-closed container, away from heat and light. TO CLEAR UP YOUR INFECTION COMPLETELY, continue taking this medicine for the full course of treatment. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. CAUTIONS: DO NOT STOP TAKING THIS MEDICINE without first checking with your doctor. KEEP ALL DOCTOR AND LABORATORY APPOINTMENTS while you are taking this medicine. Periodic eye exams may be done while you are taking this medicine. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. This includes acetaminophen and medicines containing acetaminophen. CHECK WITH YOUR DOCTOR before drinking alcohol while you are taking this medicine. DO NOT DRIVE, operate machinery, or do anything else that could be dangerous until you know how you react to this medicine. WHILE YOU ARE TAKING THIS MEDICINE, EATING FOODS THAT CONTAIN HISTAMINE, such as fish, tuna, sauerkraut, and yeast extract, OR TYRAMINE, such as Chianti wines, pickled herring, fermented meats, and some cheeses, may cause flushing, chills, and headaches. Obtain a complete list of these foods from your doctor, nurse, or pharmacist. IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. IF YOU HAVE DIABETES, this medicine may affect your blood sugar. Check blood glucose levels closely and ask your doctor before adjusting the dose of your diabetes medicine.
44

POSSIBLE SIDE EFFECTS: SIDE EFFECTS that may go away during treatment include upset stomach or indigestion. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience tiredness, weakness, loss of appetite, nausea, vomiting, skin rash, tingling or numbness of hands or feet, muscle or joint pain, or fever. CONTACT YOUR DOCTOR IMMEDIATELY if you experience yellow skin or eyes, or dark urine. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. OVERDOSE: If overdose is suspected, contact your local poison control centre or emergency room immediately. Symptoms of overdose may include nausea; vomiting; dizziness; slurring of speech; blurred vision; numbness, tingling, or burning of your arms, hands, legs, or feet; joint pain; hallucinations; and loss of consciousness. ADDITIONAL INFORMATION: If your symptoms do not improve within 2 to 3 weeks, or if they become worse, check with your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out. The information in this monograph is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This information is generalized and is not intended as specific medical advice. If you have questions about the medicines you are taking or would like more information, check with your doctor, pharmacist, or nurse.

Reference 6
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the reference in written form. 5. Find 5 names of other preparations of the same action.

BAUSCH & LOMB

RENU MultiPlus Multi-Purpose Solution

No Rub formula
This insert contains important information. Please read it carefully and retain for future reference. Cleans, Disinfects, Lubricates, Rinses, Stores and Removes Protein. CONTENTS: sterile, isotonic solution that contains boric acid, edetate disodium, sodium borate and sodium chloride; active ingredients: DYMED (polyaminopropyl biguanide) 0.0001%, HYDRANATE (hydroxyalkylphosphonate) 0.03%, poloxamine 1%. ACTIONS: Cleans, loosens and removes accumulations of film, protein and other deposits from soft contact lenses. Destroys harmful microorganisms on the surface of the lens. Rinses, stores and lubricates. INDICATIONS: BAUSCH & LOMB ReNu MultiPlus Multi-Purpose Solution is indicated for use in chemical (not heat) disinfection, daily cleaning, daily protein removal, lubricating, rinsing and storage of all soft contact lenses as recommended by your eye care practitioner.
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DIRECONS: Always wash and rinse your hands before you handle your lenses. Lenses must be thoroughly cleaned, rinsed and soaked each time they are removed to achieve disinfection. To clean, disinfect and remove protein without rubbing: Step 1: Thoroughly rinse each side of the lens for 5 seconds. Step 2: Place cleaned contact lens in the lens storage case and fill with fresh ReNu MultiPlus MultiPurpose Solution. Soak for at least four hours. No rinsing is required prior to lens placement in your eyes. If any debris remains on your lenses you may rinse with ReNu MultiPlus ulti-Purpose Solution. Pour the BAUSCH & LOMB ReNu MultiPlus Multi-Purpose Solution out of the lens case and rinse the case with fresh ReNu MultiPlus ulti-Purpose Solution. Leave the case with the caps off to dry in the air. Replace the caps. Your case is now ready for use. Your practitioner may recommend that you rub and rinse your lenses prior to storage. In this case, after removing from your eye, place the lens in the palm of your hand and apply few drops of BAUSCH & LOMB ReNu MultiPlus ulti-Purpose Solution to the lens. Rub the lens gently for 20 seconds using your forefinger. Rinse the lens completely free from debris with fresh BAUSCH & LOMB ReNu MultiPlus ulti-Purpose Solution. Then place in the storage case as indicated above. Lenses may be stored in the unopened case until ready to wear, up to maximum of 30 days. If you store your lenses for longer periods of time, they must be cleaned and disinfected with fresh ReNu MultiPlus ulti-Purpose Solution every 30 days and prior to wearing. WEEKLY CARE No separate protein remover is required to remove protein deposits from the lenses. Daily use of BAUSCH & LOMB ReNu MultiPlus ulti-Purpose Solution as directed removes protein. WARNINGS & PRECAUTIONS: Lens care procedures recommended by your practitioner must be followed. Failure to follow these procedures may result in the development of serious eye infections. Always wash your hands before handling your lenses. Discard the BAUSCH & LOMB ReNu MultiPlus ulti-Purpose Solution from the lens case after each use. If u are allergic to any ingredient in this product, d not use. Store solution at room temperature (1530). Discard solution six months after opening. Use before expiration date marked on the carton and bottle. Do not touch the bottle tip to any surface or your eye since this may contaminate the solution or cause injury to the eye. Replace the cap after use. Never re-use this solution. Do not use any eye medication in conjunction with this solution unless under medical supervision. Do not use BAUSCH & LOMB ReNu MultiPlus ulti-Purpose Solution with heat disinfection method. Keep out of the reach of children. IMPORTANT: If irritation or excessive tearing occurs, persists or increases, or if vision is impaired, discontinue use and promptly consult your eye r practitioner.

CE 0050
Manufactured by: Bausch & Lomb - IOM S.p.A. 20050 Macherio (Milan) Italy. Distributed by: BAUSCH & LOMB, Rochester, New York, U.S.A.14603-0743 Bausch & Lomb, ReNu MultiPlus, DYMED and HYDRANATE are registered trademarks of Bausch & Lomb Incorporated. Bausch & Lomb Incorporated I81081327-02
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Reference 7
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate in written form the sections Indications, Administration and dosage and Contraindications. 5. Find 5 names of other preparations of the same action.
For the use only of Registered Medical Practitioner or Laboratory or Hospital.

CHLORAMPHENICOL CAPSULES BP
COMPOSITION Each capsule contains: Chloramphenicol BP 250 mg. DESCRIPTION Chloramphenicol is broad-spectrum antibacterial effective against large number of gram positive and gram-negative cocci and bacilli as well as rickettsia, chlamydia and mycoplasma. It is rapidly and completely absorbed from the gastrointestinal tract. High concentrations are achieved in blood and tissue fluids including the cerebrospinal fluid, aqueous and vitreous humor and bile. Development of resistant strains from initially sensitive ones or replacement of sensitive organisms by sensitive ones has not been problem with Chloramphenicol. INDICATIONS Gastrointestinal Disorders: infantile gastroenteritis, food poisoning (salmonellosis), bacillary dysentery, ulcerative colitis, cholera, typhoid and paratyphoid. Respiratory Infections: bacterial pneumonia, bronchiectasis, viral pneumonias, Q fever, laryngotracheo-bronchitis, whooping cough (pertussis). Genito-Urinary Infections: bacillary and l urinary infections, non specific urethritis, prostatitis and epididymitis. Venereal Diseases: gonorrhoea, syphilis, lymphogranuloma, venereum, granuloma inguinale, gnl urethritis. Infectious Diseases: infectious mononucleosis, meningitis, brucellosis, anthrax. In Surgery: abdominal surgery and peritonitis, skin grafting, burns, surgical infections. Gynaecology and Obstetrics: vaginitis, salpingitis, uerril sepsis. Ophthalmology: conjunctivitis, keratitis, trachoma and intra or extra-ocular infections. Dermatology: drm, staphylococcal infection of the skin and erysipelas. ADMINISTRATION AND DOSAGE Adults: The usual dosage is 13 g. daily in equally divided and spaced doses at 4, 6 or 8 hourly intervals. In severe infections, the total daily dose of 4 g. can be given at equally divided and spaced intervals. In such cases, high initial dose may be used but this must be reduced as soon as the desired clinical response is seen. The total dose for a complete course of treatment should not exceed 25 g. in case of reinfection within short period after the previous therapy; Chloramphenicol should be used with great caution.
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Children: In children 312 years of age, the dosage is 3040 mg/kg body weight in divided and spaced doses and the total dose for complete course of treatment should not exceed that mentioned below: Upto 3 years 10 g. Upto 5 years 13 g. Upto 7 years 16 g. Upto 10 years 21 g. Upto 15 years 25 g. SIDE-EFFECTS Blood dyscrasias: The most serious adverse affect is bone marrow depression. Serious and fatal blood dyscrasias (aplastic anaemia, hypoplastic anaemia, thrombocytopenia and granulocytopenia) occur. An irreversible type of marrow depression leading to aplastic anaemia with high rate of mortality is characterised by appearance of bone marrow aplasia or hypoplasia weeks or months after therapy. GI: Nausea; vomiting; glossitis; stomatitis; diarrhoea; enterocolitis (low incidence). CNS: Headache; mild depression; mental confusion; delirium; optic and peripheral neuritis have been reported, usually following long-term therapy, if this occurs, promptly withdraw the drug. Hypersensitivity: Fever; mulr and vesicular rashes; angiodema; urticaria; anaphylaxis. Grey syndrome: Toxic reactions including fatalities have occurred in the premature infant and newborn; the signs and symptoms associated with these reactions have been referred to as the "grey syndrome". CONTRAINDICATIONS Chloramphenicol is contraindicated in individuals with history of previous hypersensitivity and/or toxic reaction to the drug. Since the drug reaches foetal circulation, women before delivery or neonates must not be given Chloramphenicol because of the risk of grey syndrome in the foetus. Chloramphenicol should not be simultaneously administered with sulphonamides, hydantoin derivatives, phenylbutazone and other bone-marrow depressing agents. PRECAUTIONS AND WARNING Blood dyscrasias including aplastic anaemia may be associated with the administration of Chloramphenicol. If facilities are available, it is better to determine the routine blood profile before therapy, and blood studies should be repeated at appropriate intervals especially during prolonged or intermittent therapy. Consideration should be given to discontinuing the drug if evidence of depression of any of the blood elements appears attributable to Chloramphenicol. Repeated courses of Chloramphenicol and concurrent therapy with other drugs known to cause bone marrow depression or even aplastic anaemia should be avoided. Chloramphenicol should be administered according to the direction of medical practitioner, and it should not be used for the treatment of trivial infections. Chloramphenicol should not be administered during pregnancy. The medical practitioner should also remember that Chloramphenicol is excreted in the milk of the lactating mother. Chloramphenicol is not alone in the phenomenon of drug interaction and when patients are concurrently receiving anticoagulants or anticonvulsants, dosage adjustment of these agents may be necessary. PRESENTATION Strip if 10 capsules, Pack of 1000's. I PC A Made in India by I LABORATORIES LTD Regd. Off : 48, Kandivli Ind: Estate, Bombay 400 067.

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Reference 8
1. Read the reference. 2. Answer the questions: Is it a drug? What is this material for? What are the actions? Is there a strict dosage? How is this material supplied? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate in written form the actions Description, Warnings and Adverse reactions. 5. Find names of other preparations of the same action. 25416 DM16A DEXON "S" POLYGLYCOLIC ACID SUTURE SYNTHETIC, ABSORBABLE USP DEXON PLUS POLYGLYCOLIC ACID SUTURE COATED WITH POLOXAMER 188 SYNTHETIC, ABSORBABLE USP DESCRIPTION Braided DEXON "S" polyglycolic acid Suture Synthetic Absorbable, USP and DEXON PLUS polyglycolic acid Suture Synthetic Absorbble, USP are homopolymers of glycolic acid, constructed of filaments finer than in an original DEXON Suture to provide optimal handling rrties. DEXON "S" Suture, monofilament, Synthetic Absorbable, USP is also homopolymer of glycolic acid. DEXON PLUS Suture in addition is coated with lmer 188, surfactant. The coating material is inert, non-collagenous, non-antigenic and non-rgeni. 8097% of the coating was excreted in the urine during the first 3 days following implantation (rabbits). The remainder was excreted within 40 days. The sutures are sterile, inert, non-collagenous, non-antigenic, non-pyrogenic and flexible. The braided and monofilament sutures are coloured green to enhance visibility in tissue. DEXON "S" and DEXON PLUS Braided Suture are also available undyed with natural beige colour. They are uniform in size and tensile strength but are smaller in diameter than other Absorbable Surgical Sutures of equivalent tensile strength. ACTIONS When DEXON "S" Sutures or DXON PLUS Sutures are placed in tissues, minimal tissue reaction occurs which is followed by microscopic layer of fibrous connective tissue which grows into the suture material. Absorption studies in animals show DEXON "S" Sutures and DEXON PLUS Sutures to be equivalent to original DEXON Sutures. Studies in rabbits revealed minimal absorption at 17 to 15 days, significant absorption at 30 days and maximum resorption after 60 to 90 days. Tensile strength, not being function of the absorption rate, may vary from tissue to tissue depending in part on the rate of hydrolysis. The early tensile strength of DEXON "S" Sutures and DXON PLUS Sutures is reported to be greater than that of comparable chromic catgut. In animal studies (subcutaneous tissue in rats) it has been shown that at two weeks post-implantation approximately 65% of the original tensile strength f DEXON "S" and DEXON PLUS Suture remains, while at three weeks approximately 35% of its original tensile strength is retained for sizes 6/0 or greater.
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INDICATIONS DEXON "S" Sutures and DEXON PLUS Sutures are indicated whenever absorbable sutures and ligatures are employed. CONTRAINDICATIONS DEXON "S" Sutures and DEXON PLUS Sutures are contraindicated where extended approximation of tissue under strain must be maintained. WARNINGS The safe use of these sutures in cardiac and major vessels has not been established. Under certain circumstances, notably orthopaedic procedures, immobilization by external support may be employed at the discretion of the surgeon. Do not resterilize. Discard ned, unused sutures. PRECAUTIONS Acceptable surgical practice should be followed with respect to drainage and closure of infected wounds. The knot with DEXON "S" lyglycolic acid Suture must be properly placed to be secure. Therefore, place the first throw in precise position for the final knot using double loop; tie the second throw square using horizontal tension; additional throws may be used as desired. DEXON PLUS Sutures, which are treated to enhance handling characteristics, require the standard surgical technique of flat and square ties with additional throws if indicated by surgical circumstances and the experience of the surgeon. Skin sutures which remain in place for periods of longer than seven days may cause localized topical irritation and the extended portion of the suture may be snipped off after five to seven days, as indicated. ADVERSE REACTIONS Those reactions that have been reported included tissue reaction or inflammation, fibrous or granulation tissue, wound separation and bleeding, and accumulation of fluid around subcuticular stitches. DOSAGE AND ADMINISTRATION Use as required. HOW SUPPLIED DEXON "S" and DEXON PLUS Sutures braided sizes 6-0 through 2 (metric size 0.7 through 5) dyed green or natural beige. Supplied in cut lengths or ligating reels, non-needled or affixed to the various DAVIS+GECK RUI needles or D-TACH removable needles USP in one, two and three dozen boxes.

DG
DAVIS+GECK DAVIS+GECK, Inc. nti, PR 00701 U.S.A. 25416 REV. 4/88 Reference 9 1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the section Posology in written form. 5. Find 5 names of other preparations of the same action.
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Kreon
Composition Each rn capsule (hard gelatine capsule, size 0) contains 300 mg pancreatin in entericcoated microspheres equivalent to 8000 Ph. Eur. units lipase, 9000 Ph. ur. units amylase, 450 Ph. Eur. units protease. Pharmaceutical Form Capsules containing enteric-coated microspheres for oral administration. Indication Kreon is indicated for the treatment of pancreatic exocrine insufficiency, caused by cystic fibrosis, chronic pancreatitis, pancreatectomy, total gastrectomy, gastric partial resections (Billroth I/II), ductal obstruction from neoplasm (e.g. of the pancreas or common bile duct). Posology and Method of Administration The posology aims at individual needs and depends on the severity of the disease and the composition of food. General recommendation: Initially one or two capsules with each main meal and one capsule with each snack. Clinical experience indicates that the effective dose may lie between 515 capsules per day. rn capsules should be swallowed whole with enough fluid (e.g. approximately 100 ml) during meals or snacks. It is recommended to take half or one third of the total dose at the beginning of the meal and the rest during it. The capsules and the microspheres should be swallowed whole, without crushing or chewing. Where swallowing of capsules is difficult (e.g. small children and elderly patients), the capsules may be carefully opened and the microspheres added to soft food that does not require chewing or taken with liquid. Any mixture of the microspheres with food or liquids should be used immediately and should not be stored. Crushing or chewing of the microspheres, as well as adding microspheres to food with pH of more than 5.5 destroys the protective enteric coating. Contra-indications Pancreatic enzymes should not be administered during the early stages of acute pancreatitis and in those patients with known hypersensitivity of pancreatin of porcine origin. Special Warnings and Special Precautions for Use: None Interaction with other Medicaments and other Forms of Interaction There have been no reports of interaction with other drugs or other forms of interaction. Pregnancy and Lactation There is inadequate evidence of safety in human pregnancy and lactation. Panreatic enzymes should therefore be used during pregnancy and by nursing mothers only if the potential benefits outweigh the potential risks. Effects on Ability to Drive and Use Machines rn has no effect on the ability to drive or operate machines. Undesirable Effects The incidence of drug-related adverse effects is very low (<1%). Diarrhoea, constipation, gastric discomfort, nausea and skin reactions have been reported occasionly in patients receiving enzyme replacement therapy. However, due to the normal symptoms of pancreatic exocrine insufficiency and, frequently, concurrent medication it is not clearly demonstrated that these are drug-related effects of pancreatin. Overdose Excessive doses of pancreatin may actuate hyperuricosuria and hyperuricaemia. Pharmacodynamic Properties Absent or reduced (less than 10% of normal) enzyme secretion by the pancreas needs replacement therapy. Orally ingested pancreatic enzymes are necessary to break down nutrients into absorbable constituents for adequate digestion. Lipase digests fat, amylase digests carbohydrates and protease digests protein. The capsule disolves within minutes in the stomach and releases hundreds of microspheres. All microspheres are enteric-coated to protect the acidinstable enzymes, especially lipase, from degradation and denaturation by gastric juice. With
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this multi-unit dose principle an extensive mixing of the microspheres with the chyme is obtained. The size of the microspheres is important to ensure passage through the pylorus during the postprandial (digestive) phase. Pharmacokinetic Properties The dissolution characteristics of an enzyme preparation also determine the availability of active enzymes in the proximal duod enum. At pH5.5 the enteric coating disintegrates very rapidly and releases the now activated enzymes at rate of more than 80% within 30 minutes (at pH 6) to ensure proper digestion and timely absorption of nutrients. Preclinical Safety Data There is no proof of any relevant acute toxicity, chronic toxicity, mutagenic or carcinogenic potential or reproductive toxicity. List of Excipients Inactive ingredients include polyethylene glycol 4000, methylhydroxypropyl cellulose pthalate, dibutyl pthalate, liquid paraffin, dimethicone. The capsule contains gelatine, red iron oxide 172, yellow iron oxide 172, tita nium dioxid e 171. Special Precautions for Storage Store at room temperature in a dry place. Instruction for Use/Handling Do not use rn after the expiry date. Keep out of reach of children. Additional Information rn is allowed for Jewish and Muslim patients when taken as medicine. Solvay Pharma Product and trademark of KALI-I PHARMA GmbH, HANNOVER, Germany, Member of the Solvay Pharmaceutical Group. Distributed by Beaufour Ipsen International, Paris, France.

Reference 10
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What other presentation forms are available? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the section Dosage and Administration in written form. 5. Find names of other preparations of the same action.

STAN
"For The Use of Registered Medical Practitioner or a Laboratory and Hospital only" COTRIMOXAZOLE FORMULATIONS STAN; STAN DS; STAN-KID DESCRIPTION: Cotrimoxazole is combination of trimethoprim and sulphamethoxazole which together block two sequential steps in the bacterial synthesis of folic acid.
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COMPOSITION: 1. Stan Tablet Each Tablet contains Trimethoprim B.P. ..................................................... 80 mg Sulphamethoxazole B.P. ............................................ 400 mg 2. Stan DS Tablet Each Tablet contains Trimethoprim .. ..................................................... 160 mg Sulphamethoxazole B.P. ............................................ 800 mg 3. Stan-Kid Dispersible Tablet Each Uncoated Tablet contains Trimethoprim B.P. ..................................................... 40 mg Sulphamethoxazole B.P. ............................................ 200 mg CLINICAL PHARMACOLOGY: Indications & Usage: URINARY TRACT INFECTIONS (UTI): For the treatment of urinary tract infections due to susceptible strains of the following organisms: . co1i, Klebsiella species, Enterobacter species, Morganella morganii, Proteus mirabilis, and Proteus vulgaris. ACUTE OTITIS MEDIA: For the treatment of acute otitis media in children due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when in the judgement of the physician STAN offers some advantage over the use of other antimicrobial agents. To date, there are limited data on the safety of repeated use of STAN in children under 2 years of age. STAN is not indicated for prophylactic or prolonged administration in otitis media at any age. ACUTE EXACERBATIONS OF CHRONIC BRONCHITIS IN ADULTS: For the treatment of acute exacerbations of chronic bronchitis due to susceptible strains of Streptococcus pneumoniae or Haemophilus influenzae when in the judgement of the physician, STAN offers some advantage over the use ot single antimicrobial agent. SHIGELLOSIS: For the treatment of enteritis caused by susceptible strains of Shigella flexneri and Shigella sonnei when antibacterial therapy is indicated. PNEUMOCYSTIS CARINII PNEUMONITIS: CONTRAINDICATIONS: Hypersensitivity to trimethoprim or sulfonamides. Patients with documented megalobastic anaemia due to folate deficiency. Marked liver parenchymal damage, blood dyscrasias and severe renal insufficiency. WARNINGS: Fatalities associated with the administration of Sulfonamides, although rare, have occurred due to severe reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant anaemia and other blood dyscrasias. PRECAUTIONS: General: STAN should be given with caution to patients with impaired renal or hepatic function, to those with possible folate deficiency eg. the elderly, chronic alcoholics, patients receiving anticoconvulsant therapy, patients with malabsorption syndrome, and patients in malnutrition states, and to those with severe allergy or bronchial asthma. In glucose-6-phosphage dehydrogenasedeficient individuals, hemolysis may occur. This reaction is frequently dose-related. DRUG INTERACTIONS: In elderly patients concurrently receiving certain diuretics, primarily thiazides, an increased incidence of thrombocytopenia with urur has been reported. It has been reported that STAN may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin. STAN may inhibit the hepatic metabolism of phenytoin.
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Usage during pregnancy Not to be used during Pregnancy at term and during the nursing period, because sulfonamides pass the placenta and are excreted in the milk and may cause kernicterus in infants less than two months of age. SIDE-EFFECTS: The most common adverse effects are gastrointestinal disturbances (nausea, vomiting, anorexia) and allergic skin reactions (such as rash and urticaria). Severe reactions, including Stevens Johnson syndrome, Toxic Epidermal Necrolysis, fulminant hepatic necrosis, agranulocytosis, and other anaemia and other blood dyscrasias have been reported. Hematologic: Agranulocytosis, aplastic anaemia, thrombocytopenia, leukopenia, neutropenia, haemolytic anaemia, hypoprothrombinemia, methemoglobinemia, eosinophilia. DOSAGE & ADMINISTRATION: Not recommended for use in infants less than two months of age. Adults: The usual adult dosage in the treatment of Urinary tract infections is one STAN DS (Double Strength) tablet, two STAN tablets or four teaspoonfuls (20 ml) STAN Suspension every 12 hours for 10 to 14 days. An identical daily dose is used for 5 days in the treatment of Shigellosis. Children: The usual adult dosage in the treatment of urinary tract infections or acute otitis media is 8 mg/kg m and 40 mg/kg Sutfamethoxazole per 24 hours, given in two divided doses every 12 hours for 10 days. An identical daily dose is used for 5 days in the treatment of shigellosis. Presentation: STAN Tablets: 10 Tablets per blister strip. STAN DS Tablets: 10 Tablets per blister strip. STAN-KID Dispersible Tablets: 10 Tablets per blister strip. Manufactured by: SOL PHARMACEUTICALS LTD., Road No. 5, I.D.A., Nacharam, HYDERABAD-501 507, INDIA.

Reference 11
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? Does it cause any dependence? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate the portion in the frame and the section Directions for use in written form. 5. Find 5 names of other preparations of the same action.

FLUNITRAZEPAM-TEVA
TABLETS COMPOSITION Each tablet contains: Flunitrazepam 2 mg THERAPEUTIC ACTIVITY Treatment of insomnia.
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INTRODUCTION This medicine belongs to the benzodiazepine group, which has special characteristics which mandate great caution in its use. Medicines of this class cause impairment in the quality of sleep; they depress deep refreshing sleep, therefore causing inefficient superficial sleep. It is especially important that close medical monitoring be effectuated when using this medicine; therefore, if you are taking this medicine, you must ensure to refer to your doctor after 7 to 10 day treatment, since the treatment is intended for short period of time only. Prolonged use of this medicine may lead to diminution of the efficacy of the medication. It may also cause severe dependence and the patient will experience difficulty to discontinue the intake of this medicine. Occasionally, prolonged use of this medicine may cause behavioural changes and paranoid symptoms. Uncontrolled discontinuation of the treatment may be accompanied by withdrawal symptoms, such as irritability, nervousness, confusion, trembling, recurrence of insomnia, abdominal pain, nausea, vomiting, sweating, convulsions. Elderly patients: Great caution should be exercised when getting up from lying or sitting position, since the medicine impairs alertness and coordination of body movements, leading to possible falling. WHEN SHOULD THE PREPARATION NOT BE USED? Do not use this medicine if you are pregnant or breastfeeding. Do not use this medicine if you are sensitive to any of its ingredients. Do not use this medicine in patients suffering from psychiatric disturbances. Do not take this medicine without consulting doctor before starting treatment. If you are suffering, or have suffered in the past, from impaired function of the respiratory system (e.g. asthma), the liver, the kidney/urinary tract, severe myasthenia gravis or if you have suffered in the past from medicine, drug or alcohol dependence. HOW WILL THIS MEDICINE AFFECT YOUR DAILY LIFE? Use of this medicine may impair alertness, and therefore caution should be exercised when engaging in activities such as driving r, operating dangerous machinery, and in any other activity which requires alertness. Smoking is prohibited during treatment with this medicine. If you are smoker, inform your doctor before commencing treatment with this medicine. WARNINGS Prolonged use may cause dependence (see the above introduction). During prolonged treatment with this medicine, (if it was approved by the doctor), the following tests should be performed: blood, urine and liver function. If you are sensitive to any type of food or medicine, inform your doctor before commencing treatment with this medicine. DRUG INTERACTIONS If you are taking another drug concomitantly or if you have just finished treatment with another medicine, inform the attending doctor, in order to prevent hazards or lack of efficacy arising from drug interactions. This is especially important for medicines belonging to the following groups: drug affecting the central nervous system (e.g., sedatives, hypnotics, drugs for parkinsonism, epilepsy, anaesthetics, narcotic analgesics and antiallergics), antidepressants, cimetidine, or oral contraceptives. SIDE EFFECTS In addition to the desired effect of the medicine, adverse reactions may occur during the course of taking this medicine, such as, drowsiness during the day, dizziness or confusion. These side effects usually disappear within short time following the period of adaptation to the medicine. If they are bothersome, consult your doctor. Effects that require special attention: Paranoid symptoms or behavioural changes (rare): stop treatment and refer to your doctor immediately.
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Rare effects that require medical attention, if persist: Change in mood, contusion, amnesia, uncontrolled body movement, visual disturbances, gastrointestinal upset, fatigue, weakness, changes in libido, tremor. After the treatment is discontinued: The side effects may continue for few days after discontinuation of the treatment. In addition, there are few cases of withdrawal symptoms especially after prolonged treatment (prescribed by doctor) and also during gradual discontinuation instructed by the doctor. Therefore, if you feel withdrawal symptoms as specified in the introduction, or any new effect, consult doctor. These ffects usually appear only after few days after the end of the treatment. DOSAGE Dosage is according to doctor's instructions only. Do not exceed the recommended dosage by no means. Do not take more than one tablet at bedtime. This medicine is not usually intended for administration to children. DIRECTIONS FOR USE Do not retain this medicine in the mouth for period longer than that required for swallowing. Avoid Poisoning! This medicine, and all other medicines, must be stored in safe place out of the reach of children and/or infants, in order to avoid poisoning. If you have taken an overdose, or if child has accidentally swallowed the medicine, proceed immediately to hospital emergency room and bring the package of the medicine with you. Do not induce vomiting unless explicity instructed to do so by doctor! This medicine has been prescribed for the treatment of your ailment; in another patient it may cause harm. Do not give this medicine to your relatives, neighbours or acquaintances. Do not take medicines in the dark! Check the label and the dose each time you take your medicine. Wear glasses if you need them. STORAGE Store this medicine in a cool and dry place. Even if kept in their original container and stored as recommended, medicines may be kept for limited period only. Please note the expiry date of the medicine! In case of doubt consult the pharmacist who dispensed the medicine to you. Do not store different medications in the same package. Teva Pharmaceutical Industries Ltd., Israel -22041230595

Reference 12
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate in written form the sections Indications and Special Notes. 5. Find 5 names of other preparations of the same action. For the use nly of registered medical practitioners or hospital or a laboratory.
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DIP/JSN 140990

TRENTAL

Injetin for infusion for the treatment of arterial and arteriovenous circulatory disorders COMPOSITION Each ampoule of 15 ml. contains: Pentoxifylline 300 mg. Water for Injection I.. q.s. TRENTAL improves altered blood flow properties by its influenc on pathologically impaired red cell flexibility by inhibiting platelet aggregation and by reducing increased blood viscosity. Consequently, TRENTAL enhances the nutritive microcirculalion in areas with impaired blood flow. The success of treatment is shown by a regression of severe symptoms of peripheral occlusive arterial disease. Improvement of circulatory disorders of the eye and in the symptoms of cerebrovascul disease has also been demonstrated. INDICATIONS Peripheral occlusive arterial disease resulting in intermittent claudication, rest pain, ulceration or threatened gangrene due to arteriosclrtic, diabetic or inflammatory causes (including thromboangiitis obliterans). Also venous leg ulcers of varicose or post-thrombotic origin. Circulatory disorders of the eye, due to acute or chronic impairment of retinal perfusion, e.g., central retinal artery or vein thrombosis. Acute or chronic cerebrovascular disorders such as ischaemic (non-haemorrhagic) strokes and vascular dementia. DOSAGE AND ADMINISTRATION TRENTAL is available in 15 ml infusion ampoules containing 300 mg pentoxifylline. The oral formulation of TRENTAL can be prescribed to supplement treatment. Depending on the severity of vascular disease, the patient's body weight and tolerability factors, intravenous infusion therapy may be implemented using the following schedule. One intravenous infusion in the morning and evening, each of 300 mg pentoxifylline (one 15 ml ampoule containing 300 mg pentoxifylline) in 250500 ml infusion fluid over period of 120 to 180 minutes. It is important to adhere to the stipulated infusion time. Additionally, oral administration of 2 x 1 TRENTAL 400 tablet may be indicated after the evening infusion. Alternatively, one TRENTAL 400 tablet may be given at around lunch time and the second tablet after the evening infusion. Where practical nursing considerations or tolerability factors permit only one intravenous infusion daily, additional oral administration of TRENTAL 400 is recommended in dose of 3(2+1) or 4 (2+2) tablets spread throughout the day (morning and evening) after i.v. infusion. 24-hour parenferal i.v. drip infusion may be indicated in more advanced cases, especially in patients with severe rest pain and gangrene or ulceration (Fontaine Stage IV). In general, the 24-hour dose of TRENTAL, for parenteral administration should not exceed 1200 mg entoxifylline and the individual dose may be based on the formula 0.6 mg pentoxifylline/kg body-weight/hour. The daily dose calculated in this way would be about 750 mg pentoxifylline for patient weighing 50 kg and 860 mg pentoxifylline for patient weighing 60 kg. The infusion volume should be established on the basis of underlying disease and generally will be between 1000 and 1500 ml./24 hours. CONTRAINDICATIONS AND PRECAUTIONS TRENTAL must not be employed in patients with hypersensitivity to pentoxifylline, in the presence of severe haemorrhage or acute myocardial infarction. TRENTAL should not be administered during pregnancy. Severe coronary and cerebral sclerosis with hrtnsion, and severe cardiac arrhythmias are relative contraindications.
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FOLLOW-UP TREATMENT After the onset of improvement, treatment may continue with oral medication alone, with one TRETAL 400 tablet 23 times daily. SIDE-EFFECTS Gastrointestinal side-effects (e.g., nausea, vomiting, diarrhoea), headache or dizziness may occur which, in individual cases, could necessitate discontinuation of the treatment However, these side-effects can generally be avoided by reducing the infusion drip rate. Agitation and sleep disorders may occur in individual cases. Flushing, rapid heart rate (tachycardia), angina pectoris or hypotensin have been very rarely reported, particularly if using high doses of pentoxifylline. In such cases discontinuation of the medication or a reduction of the daily dosage is required. Hypersensitivity reactions such as pruritus, rash, urticaria or angioneurotic oedema are rare and usually disappear rapidly aftr discontinuation of the drug treatment. In occasional instances, hypersensitivity reactions, sometimes progressing to shock have been reported. few very rare events of bleeding (e.g., skin, mucosa, gastrointestinl tract) have been reported in patients treated with TRENTAL, with and without anticoagulants or platelet aggregation inhibitors. causal relationship between TRENTAL therapy and bleeding has not been established, but cannot be excluded completely. Thrombocytopenia occurred in few cases. INTERACTIONS WITH OTHER DRUGS Individual adjustment of dosage is required if TRENTAL is administered concomitantly with antihypertensive agents. High-dose parenteral administration of TRENTAL to diabetic patients stbilizd on insulin or rl hypoglycaemic agents (glibenclamide) may intensify th hypoglemi action of these preparations. In such cases it is necessary to reduce the dose of insulin or the oral hypoglycaemic agent for the duration of TRENTAL administration. SPECIAL NOTES The infusion times should not fall below those stated above. Physiological saline solution or other conventional blood substitutes such as Hml are suitable for use as infusion fluids. mtibility with the solution to be used should be tested in each case before administration. In patients with hypotension and circulatory instability, infusion therapy should be introduced gradually because all agents which promote blood flow may produce transient hypotension coupled with tendency to collapse and in isolated cases may result in anginal discomfort. Dosage adjustment is necessary in patients with impaired renal function. STORAGE Keep medicines out of reach of children PRESENTATION Box of 5 x 15 ml ampoules ALSO AVAILABLE TRENTAL 400 tablets Registered rdemark of Hoechst G, Frankfurt am Main, Germany HOECHST INDIA LIMITED (CASSELLA MED DIVISION) Hoechst House, Nariman-Point, Bomba-400 021.

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Reference 13
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate in written form the sections Properties and Overdosage. 5. Reduce the reference up to a size of a medical exhibition advertisement. 6. Find 5 names of other preparations of the same action. INDERAL Trade Mark Issued to the dical Profession only PRESENTATION INDERAL is presented as tablets containing 10 mg, 40 mg, Propranolol Hydrochloride Ph Eur. PROPERTIES Propranolol is competitive antagonist at both the beta 1 and beta 2-adrenoceptors. It has no agonist activity at the beta-adrenoceptor, but has membrane stabilising activity at concentrations exceeding 13 mg/litre, though such concentrations are rarely achieved during oral therapy. Competitive betablockade has been demonstrated in man by parallel shift to the right in the dose-heart rate response curve to beta-agonists such as isoprenaline. Propranolol is completely absorbed after oral administration and peak plasma concentrations occur 12 hours after dosing in fasting patients. The liver removes up to 90% of an oral dose with an elimination half-life of 3 to 6 hours. Propranolol is widely and rapidly distributed throughout the body with highest levels occurring in the lungs, liver, kidney, brain and heart. Propranolol is highly protein bound (8095%). INDICATIONS INDERAL, beta-blocker, is indicated in the following: ) Control of essential and renal hypertension. b) Management of angina pectoris. ) Long term prophylaxis after recovery from acute myocardial infarction. d) Control of most forms of cardiac arrhythmias. ) Prophylaxis of migraine. f) Management of essential tremor. g) Control of anxiety and anxiety tachycardia. h) Adjunctive management of thyrotoxicosis and thyrotoxic crisis. i) Management of hypertrophic obstructive cardio-myopathy. l) Management of phaeochromocytoma (with an alpha-blocker). DOSAGE AND ADMINISTRATION Adults Oral Dosage Hypertension: starting dose of 80 mg twice a day may be increased at weekly intervals according to response. The usual dose range is 160320 mg per day. With concurrent diuretic or other antihypertensive drugs further reduction of blood pressure is obtained. Angina, anxiety, migraine and eessential tremor: starting dose of 40 mg two or three times daily may be increased by the same amount at weekly intervals according to patient response. An

59

adequate response in anxiety, migraine and essential tremor is usually seen in the range 80160 mg/day and in angina in the range 120240 mg/day. Arrhythmias, anxiety tachycardia, hypertrophic obstructive cardiomyopathy and thyrotoxicosis: dosage range of 1040 mg three or four times day usually achieves the required response. Post myocardial infarction: Treatment should start between days 5 and 21 after myocardial infarction, with an initial dose of 40 mg four times day far 2 or 3 days. In or der to improve compliance the total daily dosage may thereafter be given as 80 mg twice day. Phaeochromocytoma: (Used only with an alpha-blocker). Pre-operative: 60 mg daily for three days is recommended. Non-operable malignant cases: 30 mg daily. Children Arrhythmias, phaeochromocytoma, thyrotoxicosis: Dosage should be individually determined and the following is only guide: 0.250.5 mg/kg three or four times daily as required. Migraine: Under the age of 12: 20 mg two or three times daily. Over the age of 12: the adult dose. Elderly Patients Evidence concerning the relation between blood level and age is conflicting. With regard to the elderly, the optimum dose should be individually determined according to clinical response. CONTRA-INDICATIONS INDERAL should not be used in the presence of second or third degree heart block. INDERAL should not be used in patients with cardiogenic shock. INDERAL should not be used if there is history of bronchospasm or after prolonged fasting or in patients with metabolic acidosis. PRECAUTIONS Special r should be taken with patients whose cardiac reserve is poor. Beta-blockers should be avoided in overt heart failure. However, they may be used in patients whose signs of failure have been controlled. Heart failure due to thyrotoxicosis often responds to INDERAL alone, but if other adverse factors co-exist myocardial contractility must be maintained and signs of failure controlled with digitalis and diuretics. One of the pharmacological actions of beta-blockers is to reduce heart rate. In the rare instance when symptoms may be attributable to the slow heart rate, the dose may be reduced. Since the half-life may be increased in patients with significant hepatic or renal impairment, care should be taken when starting treatment and selecting the initial dose. INDERAL should be used with caution in patients with decompensated cirrhosis. INDERAL modifies the tachycardia of hypoglycaemia. Caution should be exercised in the concurrent use of INDERAL and hypoglycaemic therapy in diabetic patients. Propranolol may prolong the hypoglycaemic response to insulin. In patients suffering from ischaemic heart disease, as with other beta-blockers, treatment should not be discontinued abruptly. Either the equivalent dosage of another beta-blocker may be substituted or the withdrawal of INDERAL should be gradual. INDERAL may aggravate peripheral arterial circulatory disorders. While taking beta-blockers, patients with history of anaphylactic reaction to variety of allergens may have more severe reaction on repeated challenge. Such patients may be unresponsive to the usual doses of adrenaline used to treat the allergic reactions. Care should be taken in prescribing beta-blocker with Class 1 antiarrhythmic agents such as disopyramide. Beta-blockers should be used with caution in combination with verapamil in patients with impaired ventricular function. The combination should not be given to patients with conduction abnormalities. Neither drug should be administered intravenously within 48 hours of discontinuing the other.
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Care should be taken in the parenteral administration of preparations containing adrenaline to patients taking beta-blockers as, in rare cases, vasoconstriction, hypertension and bradycardia may result. Administration of propranolol during infusion of lignocaine may increase the plasma concentration of lignocaine by approximately 30%. Patients already receiving propranolol tend to have higher lignocaine levels than controls. The combination should be avoided. Beta-blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine. If the two drugs are co-administered, the beta-blocker should be withdrawn several days before discontinuing clonidine. If replacing lonidin by beta-blocker therapy, the introduction of beta-blockers should be delayed for several days after lonidine administration has stopped (see also prescribing information for clonidine). Anaesthesia: Care should be taken when using anaesthetic agents with INDERAL. The anaesthetist should be informed and the choice of anaesthetic should be the agent with as little negative inotropic activity as possible. Pregnancy: As with all other drugs. INDERAL should not be given in pregnancy unless its use is essential. There is no evidence of teratogenicity with INDERAL. Lactation: There is some accumulation of propranolol in breast milk. However, breast-feeding child receives only small amounts of drug so that adverse effects are unlikely. SIDE EFFECTS INDERAL is usually well tolerated. Minor side effects such as cold extremities, gastrointestinal disturbance, sleep disturbances, lassitude and fatigue are often transient. Deterioration in heart failure and mood changes may occasionally occur and, rarely, heart block may be precipitated in susceptible patients. Isolated cases of paraesthesia of the hands have been reported. Rare cases of alopecia, bradycardia, thrombocytopenia, purpura, psoriasiform skin reactions, exacerbation of psoriasis and CNS symptoms, including hallucinations, have been recorded. There have been reports of skin rashes and/or dry eyes associated with the use of beta-blockers. The reported incidence is small and in most cases the symptoms have cleared when treatment was withdrawn. Discontinuance of the drug should be considered if any such reaction is not otherwise explicable. Cessation of therapy with beta-blocker should be gradual. In the rare event of intolerance, manifested as bradycardia and hypotension, the drug should be withdrawn and, if necessary, treatment for overdosage instituted. OVERDOSAGE Excessive bradycardia can be countered with atropine 12 mg intravenously. If necessary, this may be followed by bolus dose of glucagon 10 mg intravenously. If required this may be repeated or followed by an intravenous infusion of glucagon 110 mg/hr i.v. depending on response. If no response to glucagon occurs or if glucagon is unavailable, beta-adrenoceptor stimulant such as dobutamine 2.5 to 10 micrograms/kg/minute by intravenous infusion or isoprenaline 10 to 25 micrograms given as an infusion at rate not exceeding 5 micrograms/minute may be given. It is likely that these doses would be inadequate to reverse the cardiac effects of beta-blockade if large overdose has been taken. The dose of dobutamine or isoprenaline should therefore be increased if necessary to achieve the required response according to the clinical condition of the patient. PHARMACEUTICAL PRECAUTIONS INDERAL tablets should be stored at room temperature, protected from light and moisture. FURTHER INFORMATION Effects on bilit to drive r operate machinery: Propranolol has no overall effect on car driving and machinery operation. This is a medicament A medicament is product which affects your health, and their nsumtin ntrr t instruction is dangerous for you.
61

Follow strictly the doctor's prescription, the method of use and the instructions of the pharmacist who sold the medicament. The doctor and the pharmacist are experts in medicine, its benefits and risks. Do not interrupt by yourself the rid of treatment prescribed for you. Do nt ret the same rprtin withut nsulting ur dotr. Keep medicaments out of reach of children Produced by: MPI Modern pharmaceutical Industries Damascus Syria Licenced by: ICI pharmaceuticals Alderley Park, Macclesfield, Cheshire, England

Reference 14
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate in written form the sections Therapeutic indications and Therapy of overdose. 5. Reduce the reference up to a size of a medical exhibition advertisement. 6. Find 5 names of other preparations of the same action.

Ubistesin forte
Information for use COMPOSITION 1 ml solution for injection contains: Active ingredients: Articaine hydrochloride 40 mg (R)-epinephrine hydrochloride 0.012 mg (equivalent to 0.01 mg base) Other ingredients: Anhydrous sodium sulphite m 0.6 mg (equivalent to m 0.31 mg S02) Sodium chloride Water for injections PHARMACEUTICAL FORM AND CONTENT Solution for injection in 1.7 m1 cartridges Local anaesthetic of the amide type and of thiophene structure with vasoconstrictive component for administration in dentistry THERAPEUTIC INDICATIONS Infiltration anaesthesia and nerve-block in dentistry. UBISTESIN forte is especially indicated for interventions requiring deep anaesthesia and pronounced restriction of blood flow, such as gingival and bone surgery
62

pulp surgery (amputation and extirpation) extraction and trepanation of desmotic teeth and extraction of fractured teeth (osteotomy) protracted surgical procedures, i.e. Caldwell-Luc operation, percutaneous osteosynthesis, cystectomy, mucogingival operations, apicectomy. CONTRAINDICATIONS Due to the local anaesthetic ingredient articaine, UBISTESIN forte cannot be used in the event of known allergy r hypersensitivity to local anaesthetics of the amide type severe impairment of the nervous impulses and conduction system of the heart (e.g. grade II and III AV block, pronounced brdrdi) acutely decompensated cardiac insufficiency (acute failure of cardiac output) severe hypotension (very low blood pressure) Due to the content of epinephrine as vasoconstrictor admixture, UBISTESIN forte also cannot be used in the event of paroxysmal tachycardia or high-frequency continuous arrhythmia-pronounced coronary insufficiency severe hypertension (high blood pressure) thyrotoxicosis (hyperactivity of the thyroid) narrow-angle glaucoma decompensated diabetic metabolic condition pheochromocytoma UBISTESIN forte must be used with particular caution in the event of severe impairment to the renal or hepatic function angina pectoris (tightness in the chest) arteriosclerosis (vascular sclerosis) injection into an inflamed (infected) area considerable impaired blood coagulation WARNING UBISTESIN forte must not be used in persons who are allergic or hypersensitive to sulphite, as well as in persons with severe bronchial asthma. In these persons, UBISTESIN forte can provoke acute allergic reactions with anaphylactic symptoms (e.g. bronchospasm). ADMINISTRATION DURING PREGNANCY AND LACTATION No sufficient studies of the use of UBISTESIN forte during pregnancy are available for evaluating the safety of its application. Above all during the early stages of pregnancy UBISTESIN forte should be used only after careful consideration of the benefit-risk ratio. relevant transfer of the active ingredients to the breastmilk is not to be anticipated, as they are rapidly decomposed and eliminated. SPECIAL WARNINGS AND PRECAUTIONS FOR USE Erroneous intravascular application must be avoided (see section: Posology and method of administration). Although several tests in probands could not establish any deviations in their normal ability to drive, the physician must decide in the individual case whether the patient can actively participate in driving or operating machinery. INTERACTIONS The sympathomimetic effect of epinephrine can be intensified by the simultaneous intake of inhibitors or tricyclic antidepressants. Epinephrine can inhibit insulin release in the pancreas and thus diminish the effect of oral antidiabetics. The concomitant administration of non-cardioselective (beta-blockers can lead to an increase in blood pressure due to the epinephrine in UBISTESIN forte. Certain inhalational narcotics, such as halothane, can sensitize the heart to catecholamines and therefore induce arrhythmias following administration of UBISTESIN forte. It should be taken into consideration that during treatment with blood clotting inhibitors (e.g. heparin or acetylsalicylic acid), an inadvertent vasopuncture when administering the local anaesthetic can lead to serious bleedlng, and that in general the hemorrhagic tendency is increased.
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POSOLOGY AND METHOD OF ADMINISTRATION The following dosage guidelines apply: The smallest possible volume of solution which will lead to effective anaesthesia should be used. For extraction of maxillary teeth, 1.7 ml UBISTESIN forte suffices per tooth in most cases; painful palatal injections can thus be avoided. In the case of serial extractions of neighbouring teeth, reduction in the quantity of injection is often possible. If cut or suture is required in the gum, palatal injection of r. 0.1 ml per puncture is indicated. For smooth extractions of mandibular premolar teeth, infiltration anaesthesia of 1.7 ml UBISTESIN forte per tooth is mostly sufficient; in isolated cases bul post-injection of 1 to 1.7 ml is required. An injection into the mandibular foramen can be indicated in rare cases. Vestibular injections of 0.5 to 1.7 ml UBISTESIN forte per tooth enable cavity preparations and smoothing of rnl stumps. Conduction anaesthesia should be used in the treatment of mandibular premolar teeth. In all surgical procedures UBISTESIN forte should be dosed individually depending on the extent and duration of the operation and the factors relating to the patient. Generally, in children weighing about 2030 kg, doses of 0.251 ml are sufficient; in children weighing 3045 kg, 0.52 ml. Increased plasma levels of UBISTESIN forte can occur in older patients due to diminished metabolic processes and lower distribution volume. The risk of accumulation of UBISTESIN forte increases in particular due to repeated application (e.g. post-injection). similar effect can ensue from the reduced general condition of the patient, as well as severely impaired hepatic and renal function. lower dosage range is thus recommended in all such cases (minimum quantity for sufficient anaesthetic depth). The UBISTESIN forte dose is to be likewise reduced in patients with certain pre-existing diseases (angina pectoris, arteriosclerosis). The maximum dose for healthy adult is 500 mg articaine (7 mg/kg body weight) equivalent to 12.5 ml UBISTESIN forte, respectively 7 cartridges. In children weighing 2030 kg no more than 1.5 ml should be given during treatment and no more than 2.5 ml within 24 hours; in children weighing 3045 kg no more than 2 ml and 5 ml should be given during treatment and within 24 hours, respectively. For injection (local anaesthetic in dentistry) To avoid intravascular injection, aspiration control in two planes (rotation of the needle by 180) must always be carefully undertaken, although negative aspiration result does not safely rule out an unintentional and unnoticed intravascular injection. The injection rate should not exceed 0.5 ml in 15 seconds, i..1 cartridge per minute. Opened cartridges must not be used in other patients. Residues must be discarded. THERAPY OF OVERDOSE GENERAL BASIC MEASURES: Diagnostics (respiration, circulation, consciousness), maintenance/restoration of the vital functions of respiration and circulation, oxygen administration, intravenous access. SPECIAL MEASURES: Hypertension: Elevation of the upper body, if necessary sublingual nifedipine. Convulsions: Protect patients from concomitant injuries, if necessary diazepam i.v. Hypotension: Horizontal position, if necessary intravascular infusion of an electrolyte solution, vasopressors (e. g. etilefrine i.v.). Bradycardia: Atropine i.v. Anaphylactic shock: Contact emergency physician, in the meantime shock positioning, generous infusion of an electrolyte solution, if necessary epinephrine i.v., cortisone i.v. Cardiac shock: Elevation of the upper body, contact emergency physician. Cardiovascular arrest: Immediate cardiopulmonary resuscitation, contact emergency physician.
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UNDESIRABLE EFFECTS PRECAUTIONARY NOTE If you notice side effects, especially those that are not described in the following paragraphs, please report this to your dentist or physician. Undesirable effects can arise from overdose, particularly as result of inadvertent intravascular injection or abnormal absorption conditions, e.g. in the inflamed or severely vascularised tissue, and manifest themselves as central nervous and/or vascular symptoms. The measures which should be taken in the event of the occurrence of the following symptoms are described in the section Therapy of overdose. Due to the local anaesthetic ingredient articaine, the following side effects can occur from the use of UBISTESIN forte: Milder central nervous symptoms involve metallic taste, tinnitus, dizziness, nausea, vomiting, restlessness, anxiety, initial increase in respiratory rate. More severe symptoms are drowsiness, confusion, tremor, muscle twitching, tonoclonic spasms, coma and respiratory paralysis. Severe cardiovascular episodes are seen in the form of a drop in blood pressure, asequence, bradycardia, cardiovascular arrest. Allergic reactions to articaine are extremely rare. Undesirable effects which can occur due to the admixture of epinephrine as vasoconstrictor: Despite the low concentration of epinephrine in UBISTESIN forte of 1/100000, symptoms such as heat sensation, sweating, heart racing, headache, blood pressure increase, anginal disorders, tachycardias, tachyarrhythmias, and cardiovascular arrest cannot be ruled out. disguising of the clinical picture can result from the simultaneous occurrence of various complications and side effects. SPECIAL PRECAUTIONS Due to the content of anhydrous sodium sulphite, allergic reactions or hypersensitivity reactions can ensue in isolated cases, particularly in bronchial asthmatics, which are manifested as vomiting, diarrhoea, wheezing, acute asthma attack, disturbance of consciousness or shock. STORAGE INFORMATION Do not use the preparation ftr the expiry date. Store protected from light and not above 25. DATE OF REVISION OF THE TEXT 03/99 PACKAGE SIZE 50 cartridges of 1.7 ml each Keep out of the reach of children!

Reference 15
1. Read the reference. 2. Answer the questions: What class of drugs does this medicine belong to? What is this drug for? What is the presentation? What is the dosage? What are the contraindications, side effects or warnings? Give the name of the manufacturer. 3. Give the main information about this drug. 4. Translate in written form the sections Microbiology, Interactions and Duration of use. 5. Reduce the reference up to a size of a medical exhibition advertisement. 6. Find 5 names of other preparations of the same action.
65

Ciprobay

Ciprofloxacin Broad-spectrum antibiotic Film-coated tablets Composition Ciprobay 250: 1 film-coated tablet contains 291 mg cipofloxacin hydrochloride 20, corresponding to 250 mg ciprofloxacin. Ciprobay 500: 1 film-coated tablet contains 582 mg ciprofloxacin hydrochloride 20, corresponding to 500 mg ciprofloxacin. Ciprobay 750: 1 film-coated tablet contains 873 mg ciprofloxacin hydrochloride 20, corresponding to 750 mg ciprofloxacin. Properties Ciprofloxacin is new active substance from the quinolone group developed by Bayer AG. These substances are also referred to as gyrase inhibitors. Microbiology Ciprobay has strong antibacterial activity again st broad spectrum of bacteria. It prevents the information necessary for the normal metabolism of the bacteria being read from the chromosome (genetic material). This lead s to rapid decrease in the ability of bacteria to reproduce. Ciprobay is also characterised by the fact th at, as result of its particular mode of action, it does not generally exhibit parallel resistance to any other antibiotic outside the gyrase inhibitor group. Therefore, Ciprobay is highly effective against bacteria which are resistant, for example, to aminoglycosides, penicillins, cephalosporins, tetracyclines and other antibiotics. Clinical pharmacology The absolute bioavailability of Ciprobay is 7080%. The maximum blood concentration is already reached 6090 minutes after ingestion. Ciprobay is present in high concentrations at the sites of infection, i.e. in the body fluids and tissues. It only needs to be taken twice daily, in the morning and evening. Indications Uncomplicated and complicated infections caused by organisms sensitive to ciprofloxacin. Infections of the respiratory tract. In neuml pneumonia in out-patients Ciprobay is not the drug of first choice. The use of Ciprobay may, however, be indicated with so-called problem organisms (e.g. Klebsiella, Enterobacter, Proteus, Pseudomonas, Legionella, Staphylococcus, Escherichia coli). middle ear (otitis media) and paranasal sinuses (sinusitis), particularly where they are caused by gram-negative organisms, including Pseudomonas or Staphylococcus. eyes. kidneys and/or the efferent urinary tract. genital organs, including gonorrhoea. abdominal cavity (e.g. bacterial infections of the gastrointestinal tract or of the biliary tract, peritonitis). skin and soft tissues. bones and joints. Septicaemia Infections or imminent risk of infection (prophylaxis) in patients whose immune system has been weakened (e.g. patients on immunosuppressants or in state of neutropenia). Administration for selective intestinal decontamination in immunosuppressed patients. Ciprobay acts bactericidally. According to in-vitro investigations, the following organisms can be regarded as sensitive:
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. co1i, Shigella, Salmonella, Citrobacter, Klebsiella, Enterobacter, Serratia, Hafnia, Edwardsiella, Proteus (indole-positive and indole-negative), Providencia, Morganella, Yersinia; Vibrio, Aeromonas, Plesiomonas, Pasteurella, Haemophilus, Campylobacter, Pseudomonas, Legionella, Neisseria, rll, Branhamella, Acinetobacter, rull; Staphylococcus, Streptococcus agalactiae, Listeria, Corynebacterium, Chlamydia. The following organisms show varying degrees of sensitivity: Gardnerella, Flavobacterium, Alcaligenes, Streptococcus faecalis, Streptococcus pyogenes, Streptococcus neumoniae, Streptococcus viridans, Mycoplasma hominis, Mycobacterium tuberculosis and Mycobacterium fortuitum. The following organisms are usually resistant: Streptococcus faecium, Ureaplasma urealyticum, Nocardia asteroides. With few exceptions anaerobes are moderately sensitive (e.g. Peptococcus, Peptostreptococcus) to resistant (e.g. Bacteroides). Ciprobay is ineffective against rnm pallidum. Contraindications Ciprobay must not be used in cases of hypersensitivity to ciprofloxacin or other quinolone chemotherapeutics. Ciprobay must not be prescribed to growing children or juveniles, or to pregnant women or nursing mothers, since there is no information on the drug's safety in these patient groups and since animal studies indicate that damage to articular cartilage in the immature organism cannot be fully excluded. Animal studies have not yielded any evidence of teratogenic effects (malformations). Restrictions on use Ciprobay must be used with caution in elderly patients. In epileptics and patients with other existing damage to the central nervous system (e.g. reduced convulsion threshold, history of convulsions, reduced cerebral blood flow, change in brain structure, or stroke) Ciprobay should only be used after careful consideration of the risks and the benefits, as these patients may be at risk from CNS side effects. Side effects The following side effects have been observed: Effects on the gastrointestinal tract Nausea, diarrhoea, vomiting, digestive disturbances, abdominal pain, flatulence, loss of appetite. If severe and persistent diarrhoea occurs during or after treatment, the doctor must be consulted since this symptom can hide serious underlying intestinal disorder (pseudomembranous colitis) which requires immediate treatment. In such cases Ciprobay must be discontinued and suitable therapy initiated (e.g. 4 250 mg vancomycin/d ..). Antiperistaltics are contraindicated. Effects on the nervous system Dizziness, headache, tiredness, sleeplessness, agitation, tremor; very rarely: peripheral paralgia, sweating, unsteady gait, convulsions, anxiety states, nightmares, confusion, depression, hallucinations, taste and smell impairment, visual disturbances (e.g. double vision, seeing colours). These reactions sometimes occurred after only one dose. In such cases Ciprobay must be discontinued immediately and the physician must be informed. Hypersensitivity reactions Skin reactions such as rashes. Very rarely: Pruritus, drug fever. Anaphylactic/anaphylactoid reactions (e.g. facial, vascular, and laryngeal oedema; dyspnoea right through to life-threatening shock), sometimes after only one dose. In such cases Ciprobay must be discontinued immediately; medical treatment (e.g. shock therapy) is necessary. Pinpoint haemorrhages (petechiae), haemorrhagic vesicles (haemorrhagic bullae), and small nodules (papules) with incrustation indicative of vascular involvement (vasculitis), StevensJohnson syndrome, interstitial nephritis, hepatitis, liver cell necrosis right through to lifethreatening liver failure.
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Effects on the cardiovascular system Very rarely: tachycardia, hot flushes, migraine, syncope. Others Very rarely: articular complaints, general feeling of weakness, muscular pains, tendovaginitis, slight photosensitivity, transient impairment of kidney function right through to temporary kidney failure, tinnitus, temporary loss of hearing, particularly at high frequencies. Effects on the blood and blood constituents Eosinophilia, leucocytopenia, leucocytosis, anaemia; very rarely: thrombocytopenia, thrombocytosis, altered prothrombin values. Influence on laboratory parameters/urinary sediment Transient increases in transaminases and alkaline phosphatase can occur, as well as cholestatic jaundice, especially in patients with existing liver damage; transient increases in serum urea, creatinine, and bilirubin, hyperglycaemia; in isolated cases crystalluria and haematuria. Note for drivers Even when used in accordance with the instructions, this product may affect the speed of reaction to such degree that the ability to drive or to operate machinery is impaired. The effect is intensified by combination with alcohol. Interactions Antacids containing aluminium hydroxide or magnesium hydroxide reduce the uptake (absorption) of Ciprobay. Ciprobay should therefore be taken either 12 h before the antacid r at least 4 h after the antacid. This restriction does not apply to antacids not containing aluminium hydroxide or magnesium hydroxide (e.g. 2 receptor blockers). Concurrent administration of Ciprobay and theophylline can cause an undesirable rise in the serum concentration of theophylline. This can lead to theophylline-induced side effects. If concurrent use of the two products cannot be avoided, the serum concentration of theophylline should be checked and the theophylline dose appropriately reduced. It is known from animal experiments that the combination of very high doses of quinolones (gyrase inhibitors) and some nonsteroidal anti-inflammatory drugs (e.g. fenbufen, but not acetylsalicylic acid) can provoke convulsions. No such interactions in combinations with Ciprobay have been observed in patients. After concurrent administration of Ciprobay and cyclosporin transient rise in serum creatinine has been observed in isolated cases. For this reason very frequent monitoring of the serum creatinine level (twice weekly) is necessary in these patients. Dosage Unless otherwise prescribed, the following guideline doses are recommended: Uncomplicated upper and lower urinary tract infections .............................. 2 100 or 125 mg/day Complicated urinary tract infections (according to severity) ........................ 2 250500 mg/day Respiratory tract infections (e.g. bronchitis) ................................................. 2 250500 mg/day Other infections (cf. Indications) .................................................................. 2 500 mg/day In particularly serious infections (e.g. recurrent infective episodes in patients with mucoviscidosis, pneumonia, infections of the abdominal cavity, bones, and joints) caused by Pseudomonas or staphylococci and in acute pneumonia due to Streptococcus pneumoniae, the daily dose must be increased to 2 750 mg (oral; film-coated tablets) if treatment is not administered parenterally. Acute gonorrhoea and acute uncomplicated cystitis in women can be treated with single dose of 250 mg (film-coated tablet). Older patients should receive as low dose as possible, depending on the severity of the disease and on the creatinine clearance. If, because of the severity of the illness or for other reasons, the patient is unable to take the filmcoated tablets, it is recommended to begin treatment with the intravenous form of ciprofloxacin. Impaired renal and liver function 1. Impaired renal function Creatinine clearance <20 ml/min or serum creatinine >3 mg/100 ml: 2 half the normal unit dose/day or 1 1 normal unit dose/day.
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2. Impaired renal function + haemodialysis Dosage as in 1; on dialysis days after dialysis. 3. Impaired liver function. No dosage adjustment is required. 4. Impaired renal and liver function Dosage adjustment as in 1, possibly determinations of Ciprobay concentrations in serum. Administration The film-coated tablets are swallowed whole with little liquid. They can be taken independently of mealtimes. If the tablets are taken on an empty stomach, the active substance is absorbed more quickly. Duration of use The duration of treatment depends on the severity of the illness and on the clinical and bacteriological course. The treatment should in principle be continued systematically for at least 3 days after disappearance of the fever or of the clinical symptoms. Mean durations of treatment: l day for acute gonorrhoea, up to 7 days for infections of the kidneys, urinary tract, and abdominal cavity, over the entire period of the neutropenic phase in patients with weakened body defences, maximum of 2 months in osteomyelitis, and 714 days in all other infections. In streptococcal infections the treatment must last at least 10 days because of the risk of late complications. Note Ciprobay must not be used after the expiry date. Keep drugs out of reach of children! Presentation Packs containing 10 and 20 film-coated tablets.

Bayer Leverkusen, Germany

748493/5202/0/8/SU/2/859/

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APPENDIX 1
TAPE SCRIPT TO UNIT 1
Subdivisions of Pharmacology Medicinal chemistry is the study of new drug synthesis and the relationship between chemical structure and biological effects. Pharmacodynamics involves the study of drug effects in the body. Scientists may also study the processes of drug absorption (how drugs pass into the bloodstream), metabolism (changes that drugs undergo within the body), and excretion (removal of the drug from the body). The mathematical description of drug disposition (appearance and disappearance) in the body over the time is called pharmacokinetics. Molecular pharmacology concerns the study of the interaction of drugs and subcellular entities, such as DNA, RNA, and enzymes. These studies provide important information about the mechanism of action of drugs. Chemotherapy is the study of drugs that destroy microorganisms, parasites, or malignant cells within the body. Chemotherapy includes treatment of infectious diseases and cancer. Toxicology is the study of harmful effects of drugs and chemicals on the body. Toxicological studies in animals are required by law before new drug can be tested in humans. A toxicologist is also interested in finding proper antidotes to any harmful effects of drugs.

TAPE SCRIPT TO UNIT 4

1 P: Pharmacist; M: Man

P: Can I help you? M: Yes. Have you got anything for a headache? P: Weve got aspirin or paracetamol. M: Er paracetamol, please. P: A large or a small bottle? M: How big are they? P: 50 tablets or 100 tablets. M: A small bottle then. And how many can I take? P: You can take two every four hours, if you need to. Its on the side of the bottle. M: Fine. Do I pay here? P: No. If you could take it to the cash desk over there, please 2 P: Pharmacist

W: Woman

D: Her daughter

W: Do you have anything for sunburn something to put on the skin? My daughters burnt her arms and back quite badly. P: I see. Could I have a look at her arms? W: Yes, show the lady, Sophie. P: Um, yes, it is quite bad, isnt it? D: Mm. P: Well, I can give you some cream for burns, but theres not really much we can do now. The most important thing is to keep it covered up if you go out into the sun again. W: Yes, of course. P: And in future, remember to use a good sunscreen lotion. Shes got very fair skin. W: Yes, she was very silly. And which cream do you recommend? P: This ones very good. You can use it as often as you want. W: Right, well take that one then. Thank you very much.
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3 P: Pharmacist

W: Woman

W: Erm Excuse me. P: Yes? W: Er Do you have anything for, er diarrhoea? P: Is it for an adult? W: Er, yes. For my husband, actually. P: I see. And how bad is it? W: Well, quite bad, actually. Yes all night. P: Any vomiting? W: No, no, just the er you know P: I see. Well, I can give you this. A spoonful of this medicine three times a day should help to stop the diarrhoea. W: Thanks. P: But if its very bad I think he should see a doctor. W: Oh, we dont know a doctor here. P: Well, theres a phone number up there by the door, can you see? Really I think thats the best thing. W: Yes, I see. Well, where can I pay for the medicine?

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APPENDIX 2
KEYS TO EXERCISES
Unit 1 Ex. 2. 1. patient; 2. pharmacy; 3. disease; 4. aspirin; 5. pharmacologist; 6. treatment; 7. injection; 8. poison; 9. tablet; 10. antibiotic; 11. drug; 12. syringe. Ex. 3.2. 1. medicinal chemistry; 2. pharmacodynamics; 3. pharmacokinetics; 4. molecular pharmacology; 5. chemotherapy; 6. toxicology. Ex. 10 Drug: 1; 2. Medicine: 2; 1; 3. Ex. 14. 1/c; 2/f; 3/e; 4/a; 5/b; 6/d. Ex. 17. 1. drug, prevention; 2. alters; 3. obtained, plants; 4. antibiotics; 5. hormones; 6. synthesize; 7. chemical, formula; 8. generic, official; 9. property; 10. trade; 11. dispense. Ex. 24 Chemical names: dodecamethylendimethacrylate; 3, 5-pyridinedicarboxylic acid; N-acetyl derivate of cysteine amino acid. Generic names: nifedipine; argentums silfathiazolum; sulfonamide; acetylcysteine; acrylate; loperamide; acetaminophen. Brand names: Procardia; Argosulfan; Mucomist; Charisma; Tylenol; Imodium. Ex. 25. 1/f; 2/a; 3/e 4/b; 5/h; 6/c; 7/g; 8/d.

Unit 2 Ex. 1

a p x l s c m o h j t e n a c

b c d e f s q t a b o y z a b l o s o r u l t u v t d i e f i s u p p o p q r o n z a b w c k l m d u t v w e f m a e r o p q p r b c d e f a p s u l

g l c e w g o s c n x c s g e

h i j k l e t r s r d e f o g a m p n o x s y u z h i g j r s i t o r i t u v w d n e f g o o t p q y i z m a g t h i e t o u v w h l i j k o p q r s

d m n o t u v w h i j k p q r m a r b i k e l x y t n t x s y u h a i r r l s e b p c d j k l m n x y z l t m n t u v w

Ex. 15 1/4; 2/7; 3/1; 4/6; 5/5; 6/3; 7/2. Ex. 19. 1. rectal; 2. aerosol/inhalation; 3. sublingual; 4. local/topical; 5. injection; 6. enteral/oral. Ex. 25. 1/g; 2/f; 3/b; 4/a; 5/h; 6/d; 7/e; 8/c. Ex. 27. 1. additive action; 2. unexpected; 3. life-threatening; 4. diminishes, goes on, increasing, produce; 5. toxic; 6. dangerous and ill advised.

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Ex. 32. 1. Clamoxil 500 mg 1 tab po q 8 h. 6. Seguril 73 mm IV (i.v.) bid. 2. Ampicillin 15 mg IM (i.m.) qhs. 7. Paracetamol 1 tab po tid. 3. Tosein 28 gr po pc. 8. Nolotil 2 caps ac. 4. Buscapin compositum 26 gt qh. 9. Insulin 150 IU sc. 5. Febrectal 4 ml sc qd. 10. Valium 5 mg IV (i.v.) qhs. Ex. 33. 1/b; 2/c; 3/c; 4/a; 5/a; 6/b; 7/a; 8/b; 9/a, c; 10/b. Unit 3 Ex. 4. 1/3; 2/6; 3/7; 4/1; 5/10; 6/9; 7/8; 8/5; 9/4; 10/2. Ex. 5. 1. stimulants; 2. sedatives; 3. antacids; 4. anaesthetics; 5. diuretics; 6. antidiarrheal drugs; 7. antiulcer drugs; 8. tranquillizers; 9. antivirals; 10. anticoagulants. Ex. 10. 1. analgesic; 2. coagulates; 3. anaesthesia; 4. hypnosis; 5. acid; 6. diarrhoea; 7. histamine; 8. sedation; 9. catharsis; 10. diabetes. Ex. 14. 1. by, for; 2. from; 3. of; 4. of, in, in, in; 5. with, to; 6. of, up, in, in; 7. for, with; 8. of, with; 9. on, to; 10. in; 11. of, in, by, to, with/through; 12. to, for. Ex. 16. 1. anaesthetic; 2. antidiabetics; 3. analgesic; 4. anticoagulants; 5. antihistamines; 6. sedatives; 7. gastrointestinal drugs; 8. stimulants; 9. cardiovascular drugs; 10. antibiotics. Ex. 19. Respiratory drugs: bronchodilators, steroid drugs. Cardiovascular drugs: diuretics, ACE inhibitors, beta-blockers, calcium antagonists, cholesterol-lowering drugs. Gastrointestinal drugs: antacids, antinauseants, antiulcer drugs, antidiarrheal drugs, cathartics. Ex. 22. 1. tranquillizer; 2. anticonvulsant; 3. ACE inhibitor; 4. antacid; 5. analgesic; 6. antihistamine; 7. anticoagulants; 8. antibiotic; 9. bronchodilator. Ex. 25. 1. anticoagulants; 2. tranquillizer; 3. antiemetic; 4. side effects; 5. antihistamine; 6. antibiotic; 7. antacids; 8. bronchodilator; 9. analgesic; 10. anticonvulsant; 11. antidiarrheal; 12. anaesthetic; 13. antihistamine; 14. antiseptic; 15. stimulant. Unit 4 Ex. 7. Headache: 1. aspirin; 2. paracetamol; 3. tablets. Sunburn: 1. cream; 2. burns; 3. to keep it covered; 4. sunscreen lotion; 5. fair skin. Diarrhoea: 1. vomiting; 2. a spoonful of medicine; 3. see a doctor; 4. medicine. Ex. 12. 1/3; 2/5; 3/4; 4/1; 5/2. Ex. 14. 1. composition; 2. storage; 3. indication; 4. side effects; 5. contraindications; 6. dosage; 7. interaction; 8. presentation; 9. overdose. Ex. 16. 1. may; 2. must, should; 3. should, should; 4. may; 5. should; 6. may; 7. must; 8. can, should; 9. can; 10. should; 11. must.

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.. .. ..

___________. 6084/8. . . Times. . . . _____. .-. . _____. ____ . ________. . 02330/0133420 14.10.2004; 02330/0131503 27.08.2004. 220050, . , , 6.
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