DRUGMECHANISM OF

ACTIONDOSAGE INDICATIONS

CONTRAINDICATION

ADVERSE EFFECTS

DRUG INTERACTIONS

Acetylcysteine Exerts mucolytic action through its free sulfhydryl group which opens up the disulfide bonds in the mucoproteins thus lowering mucous viscosity.

600mg/tab 1 tab in 1 glass H2O BID

Acute and chronic resp tract infections with abundant mucus secretions

Asthmatic patients and those with history of peptic ulceration

Urticaria, bronchospasm, nausea, vomiting

Exerts mucolytic action through its free sulfhydryl group which opens up the disulfide bonds in the mucoproteins thus lowering mucous viscosity.

Acrivastine H1 receptor antagonists block the actions of histamine by reversible competitive antagonism at the H1 receptor. They have negligible potency at the H2 receptor and little at the H3 receptor.

1. Allergic hay fever conditions2. Allergic rhinitis including hay fever

Hypersensitivity to acrivastine or tripolidine. Avoid driving or operating machineries. Pregnancy & Lactation. Reduced renal function.

Mild drowsiness & headache

Alfusozine Alpha 1 selective quinazoline derivative

10mg/tab 1 tab OD

BPH GI disturbances, lipothymic events and headache. Less frequently-dry mouth, tachycardia, chest pain, asthenia, drowsiness, rash pruritis and flushes

Orthostatic hypotension, heatic insufficiency, severe renal insufficiency, intestinal occulsion

Allopurinol Acts on purine catabolism, reducing the production of uric acid without disrupting the biosynthesis of vital purines

300mg/tab 1 tab OD

Primary or secondary hyperuricemia associated with chronic gout, uric acid nephropathy, recurrent uric acid stone formation, enzyme disorders and cancer therapy

Acute attack of gout, skin reactions, renal or hepatic impairment, pregnancy, lactation, idiopathic hemochromatosis

Azathioprine, mercaptopurine, thiazide diuretics, captopril, theophylline, vidarabine

Ambroxol 2cc Tx of acute & chronic d/o of the respi tract assoc w/ abnormal bronchial secretions, asthmatic bronchitis & bronchial asthma

Gastric ulceration, 1st trimester of pregnancy

GI discomfort

Amiodarone Inhibits adrenergic stimulation; prolongs action potential and refractory period in myocardial tissue; decrease AV conduction and sinus node function

150mg/IV

Amlodipine Calcium ion influx inhibitor and inhibits the transmembrane influx of calcium ions into the cardiac and vascular smooth smooth muscle causing dilation of peripheral arterioles thus reducing the afterload

10 mg / tab OD

Hypertension and Angina

Known sensitivity to dihydropyridines

Headache, edema, fatigue, somnolence, nausea, abdominal pain, flushing, palpitations, dizziness

Ampicillin Sulbactam

Combines ampicillin with beta-lactamase inhibitor sulbactam, extending spectrum to include oxacillin sensitive staph aureus, anaerobes, and many enterobacters

750 mg/tab, 1 tab BID

Upper and lower respiratory tract, genitourinary tract, abdominal, pelvic, polymicrobial soft tissue infections. IV antibiotic of choice for serious cellulites.

Penicillin or cephalosporin allergy.

Anaphylaxis, interstitial nephritis, anemia, leucopenia.

ASA Blocks thromboxane A2 synthesis arachidonic acid in platelets by irreversible acetylation and inhibition of cyclooxygenase ,a key enzyme in prostaglandin & thromboxane A2 synthesis.

80 mg/tab OD

Prevention and treatment of occlusive cardiovascular diseases, maintenance of vascular grafts and arterial patency and adjunct to thrombolytic therapy in MI Antiplatelet agent, for prevention of major CV level esp MI

Gastric & duodenal ulcers Children < 12 years and 3rd trimester of pregnancy, patients with bleeding tendencies

Gastric bleeding, hypersensitivity, thrombocytopenia Prolonged bleeding time, increased incidence of hemorrhagic stroke, GI bleeding

Atenolol Preferentially block B1 receptors(cardioselective beta blocker)

50mg/tab OD

Hypertensive patients with impaired pulmonary function

AV block I and II, uncompensated cardiac failure, cardiogenic shock, marked bradycardia

Hypotension, bradycardia, fatigue, drowsiness

Atorvastatin Inhibition of HMG-CoA reductase , rate-limiting step in the prod’n of cholesterol; Dec LDL receptors;

40mg/tab ODHS

Reduction of elevated cholesterol & LDL chole, APo B & trigly, in px w/ primary hypercholesterolemia,

Active liver disease or elevated serum transaminases > 3x the upper limit of normal. Pregnancy & lactation

GI disturbances, headache myalgia, asthenia, insomnia

Azithromycin Inhibits RNA dependent protein synthesis at the chain elongation step, binds to the 50s ribosomal unit resulting in blockage of transpeptidation

500mg/tab OD x 3 days

Respiratory tract infections, skin and soft tissue infections, otitis media, STD due to N.gonnorhea, prophylaxis for MAC in HIV,

hypersensitivity GI disturbances, hypersensitivity, angioedema, anaphylaxis, hearing impairment, abnormal liver function, dizziness, vertigo, reduced cell counts

Buscopan Antispasmodic 10mg/IVq8 Acute GI, biliary and genitourinary spasm, ncluding biliary and renal colic

Myasthenia gravis, megacolon. Untreated narrow-angle glaucoma, prostate hypertrophy with urinary retention, mechanical stenosis of GIT, tachycardia

Xerostomia, tachycardia, urinary retention, allergic reactions, skn reactions, rarely dyspnea.

Calcium carbonate

Neutralize gastric acid. Thus, mucosal irritation is reduced. Pain relief precedes healing.

500mg/tab I tab TID

Symptomatic relief of gastric acid irritation.Calcium supplementation.

Osteomalacia, obstructive bowel disease, constipation

Constipation, hypercalcemia, metabolic alkalosis, hemorrhoids, bleeding anal fissures, Rarely, milk alkali syndrome (if taken chronically with milk or bicarbonate)

Captopril Inhibits ACE in the lung which reduces synthesis of the vasoconstrictor angiotensin II. Suppresses aldosterone resulting in natriuresis. Potentialtes other vasodilators

25 mg/tab ¼ tab TID

Management of hypertension and congestive heart failure

Angioneuritic edema, renal artery stenosis, post kidney transplant, hemodynamically relevant aortal or mitral valve stenosis of hypertrophic cardiomyopathy

Headache, tiredness, depression, disturbed sleep, tinnitus, blurred vision, rash pruritus, flushing, angioedema, GI irritation, abdominal pain

Captopril

Carvedilol Administered as a racemic mixture; Beta-adrenoceptor blocking agent; S(-) isomer is a nonselectivebeta-adrenoceptor blocker, but both S(-) and R(+) isomers have approximately equal alpha-blocking potency

6.25 mg/tab OD

BP lowering Bronchial asthma, chronic bronchitis, pulmonary emphysema, allergic rhinitis, swelling of laryngeal mucosa, sinus node syndrome, SA block, 2nd and 3rd degree AV block, too slow a heart rate (<55), shock, MI with complications, severe liver dysfunctions, metabolic acidosis or simultaneous use of MAOIs

Dizziness, headaches and tiredness, slowed pulse rate or GI upset or flu-like symptoms, breathing problems

Cefepime bacteriacidal action by inhibiting cell wall synthesis. It’s usually active against gram-positive microorganisms such as S. pneumoniae, S. aureus, and S. pyogenes and gram-negative microorganisms such as nterobacter species, E. coli, K. pneumoniae, P. mirabilis, and P. aueruginosa.

1. Mild to moderate urinary tract infections caused by Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis, including cases related to concurrent bacteremia with these microorganisms.2. Severe urinary tract

Contraindicated in patients hypersensitive to drug, other cephalosporins, penicillins, or other beta-lactam antibiotics. Use cautiously in patients with history of GI disease (especially colitis), impaired renal function, or poor nutritional status and in those

CNS: headache, pain, fever

CV: phlebitis

GI: colitis, diarrhea, nausea, vomiting, oral candidiasis

GU: vaginitis

Skin: rash, pruritus, urticaria

Other: inflammation

infections including pyelonephritis caused by E. coli or K. pneumoniae.3.

Moderate to severe pneumonia caused by Streptococcus pneumoniae, Pseudomonas aeruginosa, K. pneumoniae, or Enterobacter species.4.

Moderate to severe uncomplicated skin and skin-structure infections caused bu Staphylococcus aureus (methicillin-susceptible strains) or Streptococcus pyogenes.5. Empiric therapy in febrile neutropenia6.

Uncomplicated and complicated urinary tract infections, uncomplicated skin and skin-structure infections, pneumonia.

receiving a protracted course of antimicrobial therapy.

Ceftazidime Interferes w/ the last step of bacterial wall synthesis, exposing a less stable membrane. Cell lysis occurs, thus bactericidal

2g/hr Infections of respi tract

Hypersensitivity to Cephalosporin

GI upsets, CNS & genitor-urinary effects, phlebitis or thrombophlebitis at IV inj site

Ceftriaxone Cephalosporins bind to PBPs on bacterial cell membranes to inhibit bacterial cell wall synthesis by mechanisms similar to those of the penicillins

3gms/IV OD

Infection of the lower respi tract, intra-abdominal infections, PID, UTI, uncomplicated gonorrhea, bacterial septicemia

Hypersensitivity to cephalosporins, hypersensitivity to lidocaine.

GI disturbances, pseudomembranous colitis, elevated liver enzymes, headache, dizziness, diaphoresis, flushing, thrombocytopenia

Cefuroxime 2nd generation cephalosporin. Inhibits peptidoglycan formation in bacterial cell wall

500 mg BID Complicated UTI, otitis, sinusitis, lower respiratory tract infections

Hypersensitivity to cephalosporins, severe renal disease.

Hypersensitivity reactions, renal toxicity, hypoprothrombinemia

Celecoxib COX-2 inhibitor 200 mg/tab 1 tab OD

Acute pain, osteoarthritis, RA, post-surgical pain, dental pain

Asthma, urticaria, allergic type reaction to sulfonamides, aspirin, NSAIDs

GI effects, anaphylactic reaction, advanced renal disease

Ciprofloxacin Blocks bacterial DNA synthesis by inhibiting bacterial topoisomerase II (DNA gyrase) and topoisomerase IV

500mg/tab q12 x 7 days

For gram-negative bacterial infections Intra-abdominal infections. Respiratory tract, middle ear, sinus, eyes, kidneys, Urinary Tract genital abdomen, skin & soft tissue infections, bone & joints, septicemia; infections in patients with reduced host

HypersensitivityPregnancy and lactation

Nausea, vomiting, diarrhea, headache, restlessness ,rash

defense & selective intestinal decontamination inmmunocompromised patients

Cisplatin Cisplatin modifies cell cycle by interfering with DNA structure and function. Effects are most prominent during the S phase but cells are killed at all stages. Cisplatin synergises with other anticancer drugs e.g. fluorouracil. It has a narrow therapeutic margin and is highly toxic.

As monotherapy: 100 mg/m2 per cycle, given as a single dose infused in 0.9% sodium chloride or glucose once every 4 wk. For combination therapy with cyclophosphamide: 75-100 mg/m2 on day 1 of every 4-wk cycle.

Metastatic testicular and ovarian cancer, renal impairment, advanced

Patients with severe renal or auditory disorder, known hypersensitivity, severe bone marrow suppression, peripheral neuropathy, pregnancy, lactation

Severe nausea and vomiting. Serious toxic effects on the kidneys, bone marrows and ears. Hypomagnesaemia, hypocalcaemia, hyperuricaemia. Peripheral neuropathies, papilloedema, optic neuritis, seizures. Ototoxicity (children) manifested as tinnitus, loss of hearing, deafness or vestibular toxicity.Potentially Fatal: Rarely, renal damage due to inadequate hydration during therapy. Very rarely life-threatening myelosuppression. Anaphylactoid reactions (rare) and cardiac abnormalities.

Citicholine Interneuronal communication enhancer; increases the neurotransmission levels because it favors the synthesis and production speed of dopamine in the striatum, acting then as a dopaminergic agonist through the inhibition of tyrosine hydroxylase; makes the neurons more active, causing the astrocytes to loosen their grip on the capillaries, thus improving microcirculation; also increases glucose incorporation aside from metabolism while at the same time decreasing lactate accumulation in the brain

1g/IV q2 Disturbances of consciousness due to head injury or brain surgery, in acute stage of cerebral infarction, hemiplegia after cerebral apoplexy, Parkinson’s disease, Pancreatitis

Parasympathetic hypertonia

Hypotension, insomnia, excitement

Clopidogrel Blocks ADP receptors which prevent fibrinogen binding at that site and thereby decreasing platelet adhesion/aggregation

75mg/tab OD

For the reduction of atherosclerotic events (MI, stroke and vascular death) in patients with atherosclerosis documented by recent stroke, MI, or established peripheral arterial disease; for the tx of pxs suffering from nonST elevation ACS (unstable angina or non-Q wave MI), in combi w/ ASA

Severe liver impairment; PUD and ICH, lactation

GI bleeding, purpura, bruising, hematoma, epistaxis, hematuria, ocular hemorrhage, intracranial bleed, abd pain, dyspepsia, gastritis, constipation, rash, pruritus

Co-amoxyclavInhibits bactrial growth by interfering with cell wall synthesis. Clavulanic acid inhibits bacterial ß-lactamases and protects hydrolyzable penicillins from inactivation.

500mg/tab q12 x 7 days

For gram-positive and ß-lactamase- producing gram-negative bacterial infections.For systemic infections.

Hypersensitivity Diarrhea, nausea, skin rashes & urticaria, vaginitis, abdominal discomfort, flatulence, headache

Combivent + ambroxol neb

Ipratropium bromide – blocks the action of Ach at parasympathetic sites

Q6

in bronchial smooth muscle causing bronchodilationSalbutamol – relaxes bronchial smooth muscle by acting on B2-receptors with little effect on heart rateAmbroxol – secretolytic; causes the formation of a qualitatively different mucus of lower viscosity by the mucus-secreting cells and thus leads to liquefaction of the mucus in the lumen of the respiratory tract; expectoration of mucus is facilitated and breathing is eased considerably

Cotrimoxazole Trimethoprim-inhibits bacterial dihydrofolic acid reductaseSulfonamides- competitively inhibit dihydropteroate synthetase

400/80mg amp, 2 amp/IV,160/800mg q12h

Moderately severe to severe pneumocystis pneumonia; gm (-) bacterial sepsis including enterobacter & serratia; shigellosis, typhoid fever, UTI

Trimethoprim-megalsoblastic anemia, leucopenia, granulocytopeniaTMP-SMX-nausea & vomiting, vasculitis, renal damage

Marked liver parenchymal damage, renal impairment, pregnancy hypersensitivity

Coumadin Block the gamma-carboxylation of several glutamate residues in prothrombin and factors VII, IX and X as well as the endogenous anticoagulant protein C and S

2.5 mg/tab OD every other day

Cardioembolic stroke

Crosses placenta readily and can cause hemorrhagic disorder in the fetus, serious birth defect characterized by abnormal bone formation, cutaneous necrosis with reduced activity of protein C

Cytarabine S-phase specific antimetabolite which competitively inhibits DNA polymerase

acute myelogenous leukemia

hypersensitivity; drug-induced bone marrow suppression; pregnancy & lactation

nausea, severe myelosuppression, varying degrees of stomatitis or alopecia

Daflon Micronized purified flavonoid fraction: reduces venous distensibility and venous stasis; in the microcirculation, it normalizes capillary permeability and reinforces capillary resistance

500mg/tab 1 tab TID

Treatment of organic and idiopathic chronic venous disease of the lower limbs with the following symptoms: heavy legs, pain, nocturnal cramps, edema. Treatment of hemorrhoids and acute hemorrhoidal attacks

None Minor gastrointestinal and autonomic disorders

Dexamethasone Decreases inflammation by suppression of PMNs migration and reversal of increased capillary permeability

0.5mg/tab q8

Cerebral edema, severe anaphylaxis, severe COPD, RA, gout, acute exacerbations of asthma

Systemic infections GI ulcerations, adrenal suppressions, Cushing’s syndrome, electrolyte imbalance, glaucoma, exacerbation of infections, hyperglycemia, impaired wound healing

Diazepam Benzodiazepine, anxiolytic, sedative, muscle relaxant, anticonvulsant by facilitating action of GABA

5mg/IV prn Symptomatic relief of anxiety, agitation & tension due to psychoneurotic states & transient situational disturbances; adjunct in major mental & organic disorders and relief of reflex muscle spasm due to local

Dependence on other substances including alcohol except in management of acute withdrawal reactions. Severe chronic hypercapnia

Blurred vision, urinary retention, paradoxical reactions, dependence, withdrawal symptoms

traumaDigoxin Inhibition of the Na K

ATPase pumps which acts to increase Na-Ca exchange to increase intracellular Ca leading to increased contractility

0.25mg/tab OD

Cardiac failure, atrial flutter and atrial fibrillations

Heart blocks Nausea and vomiting, anorexia, diarrhea, gynecomastia, headache, psychosis, arrhythmia

Diltiazam preventive treatment of angina attacks, arterial hypertension

sinusoidal dysfunction, 2nd & 3rd degree AV block without pacemaker. Left ventricular failure with pulmonary congestion. Severe bradycardia. Pregnancy. Lactation and fertile women. Use of dantrolene.

ankle edema, headache, malaise, hot flushes, GI disturbances. Symptomatic bradycardia, AV block, SA block. Rashes. Severe vascular skin reactions. Moderate & transient elevation of liver transaminases.

Diphenhydramine

H1 receptor antagonist 50mg/cap ODHS

Treat allergic reactions, to induce sleep

Anticholinergic activity may aggravate bronchial asthma, urinary retention, glaucoma

Sedative, GI upset, orthostatic postural hypotention,

Dopamine Myocardial inotropic agent which may incrase mesenteric and renal blood flow and urinary output.

Hemodynamic imbalances like shock due to MI, trauma, sepsis, surgery, renal failure, CHF

Pheochromocytoma, tachyarrythmias and ventricular fibrillations

Ectopic beats, nausea and vomiting, tachycardia, anginal paibn, palpitations, dyspnea, headache, hypotension

Doxophylline Relaxes bronchial smooth muscle

400/tab ½ tab

Doxorubicin high-affinity binding to DNA through intercalation and DNA strand scission through effects on

to membranes to alter fluidity and ion transport; generation of the semiquinone

radicals through an enzyme-mediated reductive process

leukemia, CA of breast, endometrium, ovary, testes, thyroid, lung, sarcoma, multiple myeloma Hodgkin’s disease, diffuse non-Hodgkin’s lymphoma

hypersensitivity; severe bone marrow depression; impaired cardiac function; previous treatment with

complete cumulative doses of anthracyclines; severe liver/renal impairments; uncontrolled infections;

increased hemorrhagic tendency; pregnancy and lactation

nausea, red urine, cardiotoxicity, bone marrow suppression, alopecia

Enoxaparine Either directly or indirectly convert plasminogen to plasmin w/c in turn cleaves fibrin, thus lysing thrombi.

0.4ml/SC BID

Prophylaxis of venous thromboembolic disease, esp those assoc. w/ orthopedic or general surgery. Prophylaxis of venous thromboembolism in bedridden px including cardiac insufficiency, respi failure, severe infections

Conditions w/ a high risk of uncontrolled hemorrhage including major bleeding disorders

Hemorrhage, thrombocytopenia

Eperisone HCl Skeletal muscle relaxant; reduces muscle spindle sensitivity via the γ-motor neurons

50 mg/tab, 1 tab OD

Spastic paralysis in Cerebrovascular diseases, spastic spinal paralysis, cervical spondylosis, post-operative sequelae, sequelae to trauma, ALS, CP, spinocerebellar degeneration, spinal vascular diseases, other encephalomyopathies

hypersensitivity Shock, anaphylactoid reactions, elevation of SGOT, SGPT and ALP, proteinuria, elevation of BUN, anemia, hypersensitivity, insomnia, sleepiness, headache, numbness of extremities, nausea, vomiting, anorexia, abdominal pain,

diarrhea, constipation, stomatitis, urinary retention, incontinence, weekness, lightheadedness, diaphoresis, edema

Esomeprazole Proton pump inhibitor which suppresses gastric acid secretion by inhibition of the H+/K+ ATPase in the gastric parietal cell

40 mg/tab 50 cc H20

Felodipine Dihydropiridine derivative, calcium antagonist; interfere with voltage- dependent L-type calcium channels in membranes of smooth muscle cells

10 mg/tab, 1 tab OD

Treatment of hypertension and angina pectoris

Cardiogenic shock, severe aortic or mitral stenosis, obstructive hypertrophic cardiomyopathy; unstable angina pectoris, acute MI within 4-8 weeks, decompensated heart failure. Severe hepatic impairment

Flushing, headache, tinnitus, peripheral edema

Ferrous Sulfate Repletes iron stores over approximately 6 months.

1 tab BID Iron deficiency anemia

Constipation, cramping, diarrhea, nausea

Fluconazole reduction of ergosterol synthesis by inhibition of fungal cytochrome P450

candidemia, disseminated candidiasis & other invasive candidal infections; vaginal candidiasis; oropharyngeal candidiasis; other candidal infections of mucosa; prevention of candidiasis based on risk of developing fungal infection; deep endemic mycoses; cryptococcal meningitis

hypersensitivity to the drug or related azole

nausea, abdominal pain, diarrhea, flatulence; rash

Folic Acid participation in one carbon transfer reactions, especially important for DNA synthesis

megaloblastic anemia, malabsorption syndromes

Furosemide 20mg/IV Edema of CHF, liver cirrhosis, renal disease and pulmonary edema

Hepatic cirrhosis and & ascites, hepatic coma, severe electrolyte depletion

Hypersensitivity reactions, hyperuricemia, hyperglycemia, dyslipedemia, fluid and electrolyte imbalance, ototoxicity

Glargine stimulates peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin inhibits lipolysis in the adipocyte, inhibits proteolysis, and enhances protein synthesis.

14 “U” reduces the risk of severe nocturnal hypoglycaemia

hypersensitivity Hypoglycemia, Worsening of diabetic retinopathy, Lipodystrophy, Allergic reactions, Sodium retention, Edema

Glimepiride Decreases blood glucose concentration mainly by stimulation insulin release from pancreatic B-cells

5mg/tab

Hexetedine TID General oral hygiene, minor sore throat, improves appearance of mouth tissues

Hydrocortisone Dose-related effects on CHO, protein and fat metabolism. Stimulate protein and RNA synthesis in the liver, catabolic effects on bone,

100mg/IV q8

Adrenocortical insufficiency, acute hypersensitivity reactions, conditions

Systemic fungal infection, lactation

Fluid and electrolyte disturbances, decreased carbohydrate tolerance, growth

reduces manifestations to inflammation

amenable to systemic glucocorticoid injection therapy

retardation, protein catabolism

Hydroxyurea Ribonucleotide reductase inhibitor which induces rapid disease control in cancer

500mg/tab ODInitial dose: 1-4g/day; halved with each 50% reduction of WBC count

Myeloproliferative disorders, acute leukemia, solid tumors, radiosensitizer, psoriasis, sickle cell disease, B-thalassemia

Bone marrow depression, severe anemia, pregnancy, lactation

Cytarabine, fluorouracil, live virus vaccines, CNS depressants

Imidapril Block ACE that cleaves angiotensin I to form angiotensin IILower BP by reducing peripheral vascular resistance without reflexly increasing cardiac output, rate, contractilityDiminish rate of bradykinin formationDecreases GFR indirectly by blocking the vasoconstriction of the efferent arterioles by Angiotensin II

5mg/tab OD Effective in the management of patients with chronic CHF, standard in the care following MI (started 24 hours after the end of the infarction)

Angioneurotic edema, bilateral or unilateral renal artery stenosis, relevant left ventricular inflow or outflow obstructionPregnancy and lactation

Dry cough, rashes, fever

Imipenem Binds to penicillin binding proteins. Hence itdisrupts cell wall synethesis and is bactericidal

500mg/IV TID

It is abroad-spectrum antibiotic with excellent activity against a variety of gram positive and gram negativeorganism (both aerobic and anaerobic). Susceptible organisms include: Streptococci, Enterococci. Staphylococci, Lister,Enterobacteriaceae, Pseudomonas, Bacteroides, and Clostridium

Hypersensitivity to carbapanems, hypersensitivity to local anesthetics of the amide type and in patients with severe shock or heart block

Demonstrate cross-reactivity withimipenem. Imipemem may produce nausea and vomiting. Seizures have been reported with high doses

Ipratropium bromide

competitive inhibition of acetylcholine at muscarinic receptors, effectively blocking contraction of airway smooth muscle and increase in mucus secretion

acute prevention & treatment of symptoms in chronic airway disorders with reversible bronchospasm

hypersensitivity to atropine-like substances

dryness of mouth; throat irritation or cough

Irbesartan OD An angiotensin receptor antagonist; angiotensin II acts as a vasoconstrictor and it also stimulates the release of aldosterone; once aldosterone is released, Na as well water are reabsorbed; the end result is an elevation in blood pressure; it binds to the AT1 angiotensin II receptor; this binding prevents angiotensin II from binding to the receptor thereby blocking the vasoconstriction and the aldosterone secreting effects of angiotensin II

150mg/tab For the tx of hpn and tx of renal disease in pxs with hpn and type II DM

Pregnancy and lactation

Musculoskeletal trauma and flushing

Insulin Anabolic hormone. Increased glycolysis and glycogenesis, decreased gluconeogenesis and glycogenolysis. Increased lipogenesis and protein synthesis

20 u prebreakfast10 u predinner

Hyperglycemia in DM type 1 or refractory DM type II, gestational diabetes mellitus, hyperglycemic crises, hyperkalemia

Hypoglycemia, hypersensitivity. No absolute contraindications to its use

Hypoglycemia, hypokalemia, insulin-induced hyperglycemia (“Somogyi effect”), insulin antagonism/resistance, rapid insulin metabolism, and local reactions to the “foreign” proteins

ISDN Dilates large myocardial 5mg/tab SL Most commonly Hypotension &

arteries to increase blood supply to the heart. Reduces cardiac preload by reducing venous tone. This allows blood pooling in the periphery.

used antianginal agent.

rebound tachycardia, bradycardia, cerebral ischemia, aggravation of peripheral edema

ISMN Organic compd such as nitroglycerin are thought to relax vascular smooth mx by intracellular conversion to nitrite ions and to NO, w/c in turn activates guanylate cyclase & inc\ the cells cGMP. Elevated cGMP leads to dephosphorylation of the myosin light chain resulting vascular smooth muscle relaxation.

30mg/tab OD

Anti-anginal agent, vasodilator, Long term treatment of ischemic heart disease, prevention of angina attacks, treatment of chronic cardiac failure incombination with cardiac glycosides and or diuretics

Hypersensitivity to nitrates, acute MI with low filling pressures, shock, very low BP, aortic stenosis, closed angle glaucoma

Nitrate headache , manifest of collapse may arise after 1st dose in pts w/ circ liability.

Kalium Durule Potassium replacement (equivalent to approximately 10 mEq)

2 durule TID (0.75g)

Hypokalemia. As prophylaxis during treatment with diuretics.

Renal insufficiency, hyperkalemia

Hyperkalemia

Lactulose Increases water content and softens the stoolLowers the pH of the colon which inhibits the diffusion of ammonia from the colon to the blood

30cc ODHS Chronic constipation in adults and geriatric patientsAdjunct in management of PSE

Patients on low-galactose diets

Belching, cramps, distention, flatulence, diarrhea

Levofloxacin 500 ng/IV OD Block bacterial DNA synthesis by inhibiting topoisomerase II and IV

Adults >18 y/o with mild mod and severe infection caused by susceptible strains of microorganism in the ff: CAP, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, complicated and uncomplicated skin infections, acute pyelonephritis, complicated and uncomplicated UTI, nosocomial pneumonia

Hypersensitivity to quinolones, IV epilepsy, hx of tendon d/o related to fluoroquinolone therapy, children, pregnancy, lactation

Antacids, sucralfate, metal cations, MVP with Zn, concominatant administration of theophyline, fenbufen or similar NSAIDs can increase the risk of CNS stimulation and convulsive seizures

Levophed 8 mg in 250 cc D5W to start at 2 cc/hr

Inotropic and chronotropic action on the heart and vasoconstriction; more effect in ß1 receptors, hence increases peripheral resistance and both diastolic and systolic BP

BP control in certain acute hypotensive states; adjunct in the treatment of cardiac arrest and profound hypotension

Hypotension from blood volume deficits; concomitant cyclopropane and halothane anesthesia; with mesenteric and peripheral vascular thrombosis unless lifesaving

MAOI, TCA, cycloproprane, halothane

Mannitol Adult: 50-100 g in a 24-hr period by IV infusion of a 5-25% solution. Adjust rate of administration to maintain a urine flow of at least 30-50 mL/hr. Child: 0.25-2 g/kg.

Oliguric phase of renal failure, cerebral edema, increased IOP

Pulmonary congestion or oedema; intracranial bleeding; CHF; metabolic oedema with abnormal capillary fragility; anuria due to severe renal disease; severe dehydration.

Fluid and electrolyte imbalance; acidosis (with high doses). Nausea, vomiting, thirst; headache, dizziness, convulsions, chills, fever; tachycardia, chest pain; blurred vision; urticaria and hypotension or hypertension; acute renal failure; skin necrosis; thrombophloebitis.

Metformin unknown but the following are postulated

insulin resistance syndrome with

renal impairment, cardiac failure,

GI disturbances; nausea, vomiting,

MOA’s:1. direct stimulation of glycolysis in tissues with increased glucose removal from blood2. reduced hepatic gluconeogenesis3. slowing of glucose absorption from the GI tract with increased glucose to lactate conversion by enterocytes4. reduction of plasma glucagons levels

refractory obesity; inadequacy of exclusive sulfonylurea therapy

diabetic coma, sever liver disorder, pancreatitis, severe feverish ailments, alcoholism, slimming diet, hypersensitivity to the drug, shock, severe lung disorders, vascular insufficiency, necrosis, conditions likely to predispose to lactic acidosis

diarrhea, metallic taste in the mouth; lactic acidosis

Metoclopromide blocking of dopamine receptors in chemoreceptor trigger zone

prevention and treatment of nausea and vomiting

GI hemorrhage, mechanical obstruction or perforation; pheochromocytoma; hypersensitivity; epilepsy;

breast CA

: restlessness, drowsiness, fatigue, lassitude; insomnia, headache,dizziness, nausea, galactorrhea,

gynecomastia, bowel disturbances

Metoprolol Competitive B1 specific blocker

50mg/tab ½ tab OD

Management of hypertension and angina pectoris

Untreated myocardial failure, shock, AV block grades II and III, SA block, bradycardia, bronchial asthma, hypotension, advanced stages of peripheral circulatory disturbance, pheochromocytoma

Bradycardia, ventricular arrhythmias, dizziness, fatigue, hyperglycemia, hypoglycemia, impotence

Moxifloxacin Inhibit the replication of bacterial DNA by interfering w/ the action of DNA gyrase (topoisomerase II)nduring bacterial growth & reproduction

400mg/IV OD

Upper & lower RTI, acute exacerbations of chronic bronchitis, CAP

hypersensitivity GI disturbances, headache, dizziness, taste perversion

Myrin P forte Combination chemotherapy for Mycobacterium tuberculosis

3 tabs/day pre-breakfast

Initial phase treatment and re-treatment of all forms of TB in category I and II patients caused by susceptible strains of mycobacteria

Alcoholism, optic neuritis, impaired hepatic function, severe renal insuffieciency, hyperuricemia, gouty arthritis, jaundice, retrobulbar neuritis, pregnancy, lactation

Disorders of blood and lymphatic system, immune system, metabolism and nutrition, CNS, eye, GI, hepatobiliary, skin and SC tissues, musculoskeletal, connective tissue and bone and renal conditions

Nimodipine Calcium channel blocker 30mg/tab, 2 tabs q8

Prophylaxis and treatment of ischemic neurological deficits due to cerebral vasospasm after SAH

Hypersensitivity to nimodipine

Hypotension, deterioration of renal function, arrhythmia, increased liver enzymes, GI disturbances

Nitroglycerin Patch

denitration in the smooth muscle cells, releasing free nitrite ion via glutathione S-transferase. Unknown enzymatic action releases nitric oxide, causing activation of guanylyl cyclase and an increase in cGMP, leading to smooth muscle relaxation

prevention of attacks of angina pectoris. Supplementary treatment of CHF. Prevention of phlebitis and extravasation

hypersensitivity, acute circulatory failure, increased ICP, myocardial insufficiency due to obstruction

headache; application site reactions; dizziness; reflex tachycardia

Omeprazole proton pump inhibitors (PPI) which block the production of acid by the stomach

40mg/tab 1 tab OD

short-term treatment (up to 16 weeks) of erosive esophagitis associated with GERD;maintenance treatment of erosive esophagitis, acute or maintenance

known hypersensitivity to any component of the formulation

diarrhea, nausea, vomiting, constipation, rash and headaches, dizziness, nervousness, abnormal heartbeat, muscle pain, weakness, leg cramps and water retention

treatment of duodenal or gastric ulcers, treatment of pathological hypersecretory conditions, and adjunct treatment with antibiotics for Helicobacter pylori

rarely occur

Paracetamol weak prostaglandin inhibitor in peripheral tissues with no significant anti-inflammatory effects

fever & pain nephropathy skin rashes and other allergic reactions; hematological anaphylaxis

Ondansetron Ondansetron antagonises 5-HT3 receptor, blocking serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone

Adult: 24 mg, as a single dose, 30 minutes before the start of single-day chemotherapy.

Prophylaxis of post-operative pain, nausea and vomiting

Use with apomorphine (profound hypotension).

Headache, malaise/fatigue, constipation; drowsiness, fever, dizziness, anxiety, cold sensation; pruritus, rash; diarrhoea; gynaecological disorder, urinary retention; elevated transaminase; local inj site reaction (pain, redness, burning); paresthesia; hypoxia. Rarely: Anaphylaxis, angina, bronchospasm, ECG changes, extrapyramidal symptoms, grand mal seizure, hypokalaemia, tachycardia, vascular occlusive events.

Pantoprazole Inhibits fasting and meal-stimulated secretion by blocking the final common pathway of acid secretion

40mg/IV q12 Duodenal and

gastric ulcerModerate to severe renal or hepatic dysfunctionPregnancy and lactation

Headache, diarrhea, abdominal pain

Paracetamol Weak inhibitor of prostaglandin synthesis. Analgesic and antipyretic effect.

500mg/tab q4

Pain and fever Renal and hepatic failure

Hematological, skin , and other allergic reactions

Piptazo Piperacillin- inhibits bacterial wall synthesis by binding to one or more of the penicillin binding proteins which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesisTazobactam- potent inhibitor of B- lactamases.The combination enhances and extends the antibiotic spectrum of piperacillin to include many B- lactamase- producing bacteria normally resistant to it and other B- lactam antibiotics

4.5 g/vial ½ vial

Treatment of systemic or local bacterial infection; UTI, LRTI, bacterial septicemia

Hypersensitivity to penicillins, cephlosporins or B-lactamase

Diarrhea, constipation, nausea, headache, insomia, rash, erythema, pruritus, vomiting, allergic reactions, urticaria, and superinfections

Piracetam unknown Treatment of CVA & cerebral circulatory insufficiency. Post-traumatic syndromes. Severe obnubilation & vascular coma of traumatic or toxic origin. Chronic alcoholism & addiction.

severe renal insufficiency with creatinine clearance <20mL/min.

somnolence; asthenia; dizziness; agitation; anxety

Involutional syndromes related to aging. Treatment of cortical myoclonus.

Prednisone Suppression of inflammatory and immune response by binding to specific cellular receptor proteins; profound effects on concentration, distribution and function of leukocytes and suppressive effects on inflammatory cytokines and chemokines

20 mg/tab 1 tab OD

Adrenocortical insufficiency, adjunctive short term therapy for rheumatic disorders. Collagen and inflammatory ophtha diseases. Allergic forms of bronchial asthma and rhinitis. Resp and hematological disorders. Organ transplant. GI, dermatologic neoplastic and nervous disorders

Peptic ulcer, osteoporosis, pychosis or severe psychoneuroses, active or quiescent TB, acute infection, live vaccines

Fluid and salt retention, edema, HPN, amenorrhea, hyperhidrosis, mental disturbances, acute pancreatitis, aseptic osteonecrosis, muscle weakness, cushingoid state, raised IOC, visual disturbances, local atrophy, increased appetite, growth retardation

Propranoplol Non-selective β blocker, blocks response to β1 & 2 adrenergic stimulation w/c ↓ HR, BP, myocardial contractility and O2 demand

10mg/tab TID

Hypertension, angina, anxiety, migraine, essential tremors, arrythmias, thyrotoxicosis, pheochromocytoma, tachycardia

Asthma or bronchospasm, bradycardia, cardiogenic shock, hypotension, metabolic acidosis

Cold extremities, GI and sleep disturbances, fatigue, deterioration in heart failure, bradycardia, postural hypotension

PTU Inhibits the release of pre-formed thyroid hormones and blocks the peripheral conversion of T4 T3 (DOC for thyroid storm)

50mg/tab 6 tabs q8

Hyperthyroidism, Thyroid Storm

GI disorders, exopthalmos, leucopenia, thrombocytopenia, agranulocytosis and thyrotoxic crisis after discontinuation

Ramipril Block ACE that cleaves angiotensin I to form angiotensin IILower BP by reducing peripheral vascular resistance without reflexly increasing cardiac output, rate, contractilityDiminish rate of bradykinin formation

5mg/tab OD Effective in the management of patients with chronic CHF, standard in the care following MI (started 24 hours after the end of the infarction)

Angioneurotic edema, bilateral or unilateral renal artery stenosis, relevant left ventricular inflow or outflow obstructionPregnancy and lactation

Dry cough, rashes, fever

Ranitidine Antiulcerative action: Competitively inhibits histamine;s action at H2 receptors in gastric parietal cells. This reduces basal and nocturnal gastric acid secretion as well as that caused by histamine, food, amino acids, insulin, and pentagastrin.

150 mg/tab ½ tab q 12

Duodenal ulcer, benign gastric ulcer, post-op ulcer, reflux esophagitis and Z-E syndrome

Contraindicated in patients with hypersensiticity to drug and in those with history of acute porphyria. Use cautiously in patients with impaired renal or hepatic function.

Reversible hepatitis, hypersensitivity, headache, dizziness

Salmeterol xinafoate + Fluticasone propionate (Seretide), 250 diskus, 1 puff BID

Salmeterol:Bronchodilator

action: Selectively stimulates beta2-adrenergic receptors, resulting in bronchodilation. Also blocks the release of histamine from mast cells lining the respiratory tract, which produces vasodilation and increases ciliary motility.Fluticasone:

Antiinflammatory action: Stimulates synthesis of enzymes needed to decrease inflammation

Salmeterol: 1) Long-term maintenance treatment of asthma;prevention of bronchospasm in patients with nocturnal asthma or reversible obstructive airway disease who need regular treatment with short acting beta agonists2)

Prevention of exercise-induced bronchospasm3) COPD or emphysemaFluticasone1) Relief of inflammation and pruritus of corticosteroid-

Salmeterol: Contraindicated in patients with hypersensitivity to drug or its components. Use cautiously in patients with coronary insufficiency, arrhythmias, hypertension, other CV disorders, thyrotoxicosis, or seizure disorders and in those unusually responsive to sympathomimetics.

Fluticasone: Contraindicated in patients with hypersensitivity to drug or its components and in those with viral,

Salmeterol:CNS: headache, sinus headache, tremor, nervousness, giddinessCV: tachycardia, palpitations, ventricular arrhythmiasEENT: nasopharyngitis, nasal cavity or sinus disorderGI: nausea, vomiting, diarrhea, heartburnMuskuloskeletal: joint and back pain, myalgiaResp: cough, lower repiratory infection, upper respiratory infection, bronchospasmOther: hypersensitivity

responsice dermatoses2) Allergic rhinitis3)

Management of nasal symptoms of seasonal and perennial allergic rhinitis in children4)

Maintenance therapy of asthma as prophylactic therapy

fungal, herpetic, or tubercular skin lesions. Flovent inhalation aerosol and powder are contraindicated as the primary treatment in status asthmaticus or other acute episodes of asthma in which intensive measures are required. Use care when transferring patients from systemically active corticosteroids to Flovent inhalation aerosol or powder because deaths have occurred in asthmatic patients during and after transfer from systemic corticosteroids to less systemically available inhalation cortico steroids. During periods of stress or severe asthma attack, patients who have been withdrawn from systemic corticosteroids should be instructed to resume oral corticosteroids in large doses immediately and to call for further medical assistance.

reactions (rash, urticaria)Fluticasone:CNS: dizziness, giddinessGU: dysmennorrheaMetabolic: hypothalamic-pituitary-adrenal axis suppression, hyperglycemia, glycosuria, Cushing’s syndromeMuskuloskeletal: pain in joints, sprain or strain aches and pain, pain in limbsResp: bronchitis, chest congestionSkin: stinging, burning, pruritus, irritation, dryness, erythema, folliculitis, skin atrophy, leukoderma, vesicles, numbness of fingers, rash, hypertrichosis, anceiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, striae, miliariaOther: fever

Salbutamol relaxation of airway smooth muscle and inhibition of release of bronchoconstricting substances from mast cells; inhibition of microvascular leakage; increase in mucociliary transport

relief of bronchospasm in patients with reversible obstructive airway diseases

hypersensitivity; cardiac arrhythmia associated with tachycardia caused by digitalis intoxication

nausea, dizziness, skin rash, increased heart rate & restlessness

Simvastatin A methylated derivative of lovastatin that acts by competitively inhibiting HMG-CoA reductase, the enzyme that catalyzes the rate-limiting step in cholesterol biosynthesis

40mg/tab 1 tab OD

Reduction of elevated total cholesterol, LDL-C and TG levels; increase HDL-C levels in the treatment of dyslipid- emia, including hyper- cholesterolemia and combined hyperlipidemia

Liver disease or unexplained persistent rise of serum transaminases; pregnancy and lactation

Abdominal discomfort, fatigue, rash, myopathy, asthenia, headache, dyspepsia, pruritus, anemia, alopecia, dizziness, muscle cramps, myalgia, pancreatitis, paresthesia, vomiting

Cyclosporine and other lipid-lowering agents; amiodarone and verapamil; itraconazole; ketoconazole; macrolides; HIV – protease inhibitors and nefazodone; digoxin

NaHCO3 Dissociates to provide bicarbonate ion which neutralizes hydrogen ion concentration and raises blood and urinary pH

gr X tab TID

Spirinolactone Competes with aldosterone for receptor sites at distal renal tubule increasing NaCl and water excretion, conserving K and H

25 mg/tab OD

Essential hypertension, edematous disorder, CHF, nephritic syndrome, malignant hypertension, hypoK, hypoMg

Acute renal insufficiency, anuria, hyperK, pregnancy

Gynecomastia, GI symptoms, drowsiness, lethargy, menstrual irregularities

SSKI Goiter prophylaxis for I deficiency and treatment of I deficiency

5 gtts 1 hr after PTU TID

Iodine deficiency Thyroid overactivity

Tamoxifin citrate

Antineoplastic action: Exact mechanism unclear. May exert cytotoxic action by blocking estrogen receptors within tumor cells that need estrogen to thrive. The estrogen

Advanced breast cancer, adjunct treatment to breast cancer, prevention of breast cancer in high risk women, mastalgia,

Hypersensitivity to drug and during pregnancy. In patients taking coumarin-type anticoagulants and in women with history of DVT or

GI: nausea, vomiting, diarrheaGU: vaginal discharge and bleeding, irregular menses, increased BUNHema: leucopenia,

receptor tamoxifen citrate complex may be translocated into the nucleus of the tumor cell where it inhibits DNA synthesis

stimulation of ovulation

pulmonary edema. Use cautiously in patients with existing leucopenia and thrombocytopenia.

thrombocytopeniaHepatic: elevated liver enzymesMetabolic: hypercalcemia, increased serum triglyceridea and cholesterol levels, increased thyroxine levels; weight loss or gainMuskuloskeletal: temporary bone or tumor pain, brief exacerbation of pain from osseous metastasesOther: hot flashes, fluid retention

Theophylline Bronchodilator action: May act by inhibiting phosphodiesterase, elevating cellular cAMP levels, or antagonizing adenosine receptors in the bronchi, resulting in the relaxation of the smooth muscle.

Increases sensitivity of the medullary respiratory center to carbon dioxide to reduce apneic episodes. Prevents muscle fatigue, especially that of the diaphragm. Also causes diuresis and cardiac and CNS stimulation

1)

Symptomatic relief of bronchospasm in patients not currently receiving theophylline who require rapid relief of acute symptoms2)

Parenteral theophylline for patients not currently receiving theophylline3)

Symptomatic relief of bronchospasm in patients currently receiving theophylline4)

Prophylaxis of bronchial asthma, bronchospasm of chronic bronchitis, and emphysema5) Cystic fibrosis6)

Promotion of diuresis7)

Treatment of Cheyne-Stokes respirations8)

Paroxysmal nocturnal dyspnea

Contraindicated in patients with hypersensitivity to xanthine compounds (caffeine, theobromine) and in those with active peptic ulcer and seizure disorders.

Use cautiously in elderly patients; in neonates, infants under age 1, and young children; and in patients with COPD, cardiac failure, cor pulmonale, renal or hepatic disease, peptic ulcer, hyperthyroidism, diabetes mellitus, glaucoma, severe hypoxemia, hypertension, compromised cardiac or circulatory function, angina, acute MI, or sulfite sensitivity

CNS: restlessness, dizziness, insomnia, headache, irritability, seizures, muscle twitchingCV: palpitations, sinus tachycardia, extrasystoles, flushing, marked hypotension, arryhtmiasGI: nausea, vomiting, diarrhea, epigastric painResp: tachypnea, respiratory arrest

Ticarcillin-Clavulanate

Ticarcillin – inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesisClavulanate – binds and inhibits B-lactamases thus giving an expanded spectrum of activity

3.2g/IV

Tramadol Non-opiate synthetic analgesic.Bind to u-opioid receptors, but is only partially antagonized by naloxone.

50mg/tab q8

Moderate to severe pain.

Acute intoxication with alcohol, sedatives, analgesics, sedatives, psychotropic

Constipation, dizziness, nausea, vomiting, headache, pruritus.

Antidepressants, MAOI, ritonavir

Reduces uptake of norepinephrine and serotonin.

drugsa

Tramadol+ Paracetamol (Dolcet)

Tramadol- non-opiate synthetic analgesic.Bind to u-opioid receptors, but is only partially antagonized by naloxone.Reduces uptake of norepinephrine and serotonin.Paracetamol- Weak inhibitor of prostaglandin synthesis. Analgesic and antipyretic effect

50mg/tab q6 prn

Moderate to severe pain.

Constipation, dizziness, nausea, vomiting, headache, pruritus.

Tranexamic acid An analog of aminocaproic acid (EACA), synthetic inhibitor of fibrinolysis by competitively inhibiting plasminogen activation

15mg/kg loading dose, followed by 30mg/kg q6

Adjunctive therapy in hemophilia, therapy for bleeding from fibrinolytic therapy, and as prophylxis for rebleeding from intracranial aneurysms

DIC, genitourinary bleeding of the upper tract, eg. kidney and ureters

Intravascular thrombosis, hypotension, myopathy, abdominal discomfort, diarrhea, and nasal stuffiness

Trimetazidine(Vastarel)

Metabolic anti ischemic agentInhibitor of 3-KAT which allows recoupling of glycolysis and increase in glucose oxidation for better energy production under ischemic conditions

35 mg/tab BID

Long-term treatment of coronary insufficiency and angina pectoris

Lactation GI upset

Vancomycin Bactericidal action resulting from inhibition of cell wall biosynthesis; alters bacterial cell membrane permeability and RNA synthesis

750mg/IV in 250cc D5W

Serious infections caused by susceptible strains of methicillin-resistant Staph.; Penicillin-allergic patients; staph endocarditis, septicemia, bone, lower respi tract, skin infections; diphtheroid endocarditis

Rapid infusion-related reactions, hearing loss, renal impairment, pregnancy and lactation

Thrombophlebitis, febrile reactions with rigor during administration, nephrotoxicity, ototoxicity

Increased risk of ototoxicity with loop diuretics, aminoglycosides; increased risk of nephrotoxicity with with aminoglycosides and cephalosporins

Vitamin K Confers biologic activity upon prothrombin and factors VII, IX, and X by participating in their postribosomal modification

10 mg/IV Prolonged PT

Zafirlukast (Accolate)

Antasthmatic action: Selectively competes for leukotriene receptor (LTD4 and LTE4) sites, blocking inflammatory action.

Prophylaxis and long-term treatment of asthma

Contraindicated in patients with hypersensitivity to drug or its components. Use cautiously in elderly patients and in patients with hepatic impairment.

CNS: asthenia, dizziness, headacheGI: abdominal pain, diarrhea, dyspepsia, nausea, vomitingHepatic: elevated liver enzyme levelsMusculoskeletal: back pain, myalgiaOther: accidental injury, fever, infection, pain