GPOvir Z250

GPOvir Z250
(Antivirals)

Dosage form	Brand	Strength
Tablet	GPOvir Z250®	Zidovudine 250 mg,Lamivudine 150 mg, Nevirapine 200 mg

Indication : treatment of HIV infections

Mechanism of action : Zidovudine and  lamivudine are NRTI , nevirapine  is NNRTI

Pregnancy Category Lamivudine : cat C , Zidovudine : cat C , Nevirapine : cat B

Contraindication : Life-threatening allergy to the drug or its components.

Precaution : Pregnancy; lactation. Use with caution in liver disease or hepatomegaly, especially in obese women.

Drug Interaction : Nevirapine CYP3A4 inducer

Side Effect : -Zidovudine Bone marrow suppression,anemia,nausea,abdominal pain, evaluted hepatic enzymes,headache, malaise,elevated CPK, myopathy

                       -Lamivudine Nausea, headache,fatigue, rash,anorexia

                       -Nevirapine Rash, hepatitis ,fatigue ,headache.

Monitoring parameters : ALT, AST, CBC,CD4⁺

Usual Dose : GPOvir 1 tab in morning and d4T+3TC in evening for14 day after that use GPOvir 2x2

Patient Education : This drug is not a cure for HIV disease. Opportunistic infections and other complications associated with HIV infection can continue to develop. This drug may be taken with food to decrease abdominal discomfort or nausea. It is important to have blood counts followed

closely during therapy to monitor for decreases in blood cell counts.

Theophylline anhydrous

Theophylline anhydrous
(Antiasthmatic & COPD Preparations)

Dosage form	Brand	Strength
tablet	Almarion®	125 mg

Indication : Tx of symptoms and reversible airway obstruction due to chronic asthma, or other chronic lung diseases

Mechanism of action : blocking phosphodiesterase which increases tissue concentrations of cAMP

Pregnancy Category C

Contraindication : Hypersensitivity to theophylline, patients with allergy to corn-related products                                                                      

Precaution : Cardiovascular disease, Hyperthyroidism, Peptic ulcer diseases

Drug Interaction : Adenosine, Benzodiazepines, Beta blocking

Side Effect : Flutter, tachycardia Headache, hyperactivity (children), insomnia, restlessness, seizures, Anxiety, N/V

Monitoring parameters : arterial or capillary blood gases, Serum theophylline levels

Usual Dose : 300 mg/day in divided doses every 6-8 hours for 3 days then increase to 400 mg/day in divided doses every 6-8 hours for 3 days

Patient Education : Caution in eating or drinking large amounts of caffeine-containing foods or beverages during therapy with this medication

Missed Dose : Taking as soon as possible not taking if almost time for next dose not doubling doses

Auxiliary labels  : May cause drowsiness, Avoid alcoholic beverages, Keep container tightly closed

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Simvastatin

Simvastatin
(Dyslipidaemic Agents)

Dosage form	Brand	Strength
Tablet	Zocor	5 mg , 10 mg  20 mg ,40 mg, 80 mg

Indication : reduce the risk of heart attack,prevent stroke and other heart disease

Mechanism of action : competitively inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase .

Pregnancy Category X

Contraindication : Hypersensitivity  to simvastatin or any component ,active liver disease ,unexplained persistent elevations of serum transaminases ,pregnancy; breast-feeding

Precaution  : increases in serum transaminases have occurred; liver function must be monitored by laboratory assessment

Drug Interaction : Protease Inhibitors: May increase the serum concentration of Simvastatin

Side Effect : Headache,insomnia, vertigo,muscle cramps, myalgia,myopathy. Serieous: rhabdomyolysis

Monitoring parameters : Creatine phosphokinase levels

Usual Dose : 20-40mg administered orally in evening without regard to meals

Patient Education : Avoid excessive concurrent use of alcohol, but abstinence is not required. Do not take these drugs during pregnancy because of possible harm to the fetus. Inform your physician if you become or intend to become pregnant.

Missed Dose : Take a missed dose as soon as you think about it. If it is close to time for the next dose, skip the missed dose and return to your normal time. Do not take two doses or extra doses. Do not change dose or stop drug. Talk with healthcare provider.

Auxiliary labels  : Avoid excessive concurrent use of alcohol.    

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Repaglinide

Repaglinide
(Antidiabetic Agents)

Dosage form	Brand	Strength
Tablet	Novonorm®	0.5,1,2 mg

Indication : Management of type2 diabetes mellitus (noninsulin dependent, NIDDM) as an adjunct to diet and exercise; may be used in combination with metformin or thiazolidinediones

Mechanism of action : Nonsulfonylurea hypoglycemic agent  which blocks  ATP-dependent potassium channels, depolarizing the membrane and facilitating calcium entry through calcium channels. Increased intracellular calcium stimulates insulin release from the pancreatic beta cells. Repaglinide-induced insulin release is glucose-dependent.

Pregnancy Category  C

Contraindication : Diabetic ketoacidosis; severe hepatic impairment, type1 diabetes; hypersensitivity,Lactation

 Precaution : Myocardial infarction, coma, trauma during surgery, elderly, malnourished and debilitated patients. Hepatic or severe renal impairment. Pregnancy.

Drug Interaction :  MAOIs, nonselective β-blockers, ACE inhibitors, NSAIDs, salicylates, octreotide, alcohol & anabolic steroids. thiazides, corticosteroids, danazol, thyroid hormones & sympathomimetics, sulphonylurea.

Side Effect : Common : Diarrhea; headache; joint or back pain; nasal or chest congestion; sinus inflammation.

Severe : Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest

Monitoring parameters : Monitor fasting blood glucose (periodically) and glycosylated hemoglobin (Hb A1c) levels (every 3 months) with a goal of decreasing these levels towards the normal range. During dose adjustment, fasting glucose can be used to determine response.

Usual Dose : Initial : 0.5 mg PO ac (Hb A1c<8%) 1 or 2 mg PO ac (Hb A1c≥8%)

Dose adjustment : Usually fasting blood glucose.Double the preprandial dose up to 4 mg until satisfactory blood glucose response is achieved

Patient Education : Educate patient or caregiver regarding diabetes and its management, including target ranges for blood sugar control. Instruct patient or caregiver that this medication is not a substitute for diet and exercise, and to continue to follow prescribed regimens.

Missed Dose : if meal is missed, to skip the dose for that meal to reduce risk of hypoglycemia.

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