Brand Name Zegen

Generic Name Cefuroxime

Classification Cephalosporins

Indications Treatment of skin infection; Surgical infection; Sinusitis; Meningitis; UTI Treatment and prevention of post-op pain

Side Effects Diarrhea; Nausea; Pseudomembr anous colitis

Available Forms Tab 250mg; 500mg; Powd for inj (vial) 750mg

Nursing Responsibility Ask for history of allergy; Give the meds after meals; Check the IV site

Voltaren

Diclofenac Na

Non-Steroidal Antiinflammatory Drugs (NSAIDs)

Tramal

Tramadol

Analgesics; Supportive care therapy

Moderate to severe and acute pain; Diagnostic procedure and surgery

GI disorder; Headache; Dizziness; Vertigo rash; Elevation of serum transaminases Sweating; Dizziness; Muzziness; Vomiting; Dry mouth

Nubain

Nalbuphine HCL

Analgesics (Opioid)

Relief of moderate to severe pain

Diflosid

Diclofenac Na

NSAIDs

Post-op pain

Sedation; Infrequently sweating; GI upset; Vertigo; Dizziness Fluid retention; Edema

Gastroresistant Tab 25mg; 50mg; SR Tab 100mg; Inj (amp) 25mg Cap 50mg; Retard Tab 100mg; Dispersible Tab 50mg; Inj(amp) 50mg; 100mg Inj (amp) 10mg

Monitor BP for HTN; Monitor diabetic slowly; Monitor for signs & symproms of GI irritations and ulcerations Assess onset, type, location, duration of pain; Assess drug history; Assess renal or hepatic function; Monitor pulse and BP; Assist ambulation if dizziness occur Warn patient of getting out of bed or walking; Warn out patient to avoid driving Check IV site; Report signs of bleeding; Monitor BP for HTN; Monitor daibetics closely for diabetic control Ask for history of allegry; Advise patient that drug is only for short term; Warn patient high doses can cause liver damage Monitor v/s; Determine allergies; Should be taken after meals Instruct pt to swallow 1hr before or after

Inj (amp) 25mg

Biogesic

Paracetamol

Analgesics (Non-Opioid); Antipyretic

Relief of fever, minor aches and pain

Allergic skin reaction; GI disturbances

Tab 500mg; Oral susp 120mg; Oral drops 100mg Chewable Tab 40mg

Disflatyl

Simethicone

Antiflatulents; Antiinflammatories Laxatives

Accumulation of gas in the GIT Constipation

Dulcolax

Bisacodyl

Skin irritation; redness; difficulty in breathing Diarrhea

Tab 5mg; Supp 10mg;

ingesting antacids

Pharmacokinetics of cefuroxime in normal and impaired renal function: comparison of high-pressure liquid chromatography and microbiological assays.
The pharmacokinetics of cefuroxime were studied after a single dose of 750 mg was given intravenously to each of 21 male volunteers grouped according to their creatinine clearances; these clearances were 60 to 120, 20 to 59, and less than 20 ml/min per 1.73 m,2 respectively, for groups 1 (12 subjects), 2 (4 subjects), and 3 (5 subjects). Cefuroxime obeyed two-compartment model kinetics in all three groups. Initial serum levels of cefuroxime were approximately 130 microgram/ml in group 1 and 2 and 80 microgram/ml in group 3. the levels then declined rapidly for 0.5 to 1 h after injection. After that time, cefuroxime levels declined more slowly, and the elimination rate became monoexponential. The mean serum half-lives for cefuroxime in groups 2, 2, and 3 were 1.7, 2.4, and 17.6 h, respectively. Mean cefuroxime levels in serum were greater than 8 microgram/ml for 3 h in group 1, for 6 h in group 2, and for 30 h in group 3. Cumulative 24-h urinary excretion accounted for essentially 100% of the dose in group 1 and 2, and for 40% in group 3. Urine levels exceeded the minimal inhibitory concentration for susceptible organisms for more than 12 h in all groups. Cefuroxime distribution characteristics were independent of renal function. In patients with creatinine clearances less than 20 ml/min per 1.73 m2, doses of cefuroxime needs to be reduced. A microbiological disk diffusion assay and a high-pressure liquid chromatography assay for cefuroxime yielded statistically identical results, except for serum levels in uremic patients (group 3).

PHARMACOKINETICS OF DICLOFENAC SODIUM IN NORMAL MAN Diclofenac sodium was administered as 50 mg tablets to four healthy male volunteers in a two-way randomized crossover study in which volunteers were either fasted or were given a standard breakfast immediately prior to dosing. Blood samples were obtained upto 9 hours period and drug concentration were determined by HPLC method. Besides a significantly delayed (at p>0.1) peak in fed state; an increase in absorption rate constant was observed as the only significant (at p>0.05) effect of food on biopharmaceutic characteristic of diclofenac sodium. However, the intrinsic absorption of diclofenac sodium is also fast and it is not being the rate limiting factor in the bioavailability of diclofenac sodium, its decrease upto about 18 minutes (0.31 0.05 hr) from 11 minutes (0.19 0.02 hr) produces a null difference as the net effect on bioavailability, particularly when the drug is to be used in multiple dosage Regimen

(+)-O-Desmethyltramadol and (-)-O-Desmethyltramadol, in Rats

The pharmacokinetics and pharmacodynamics of the two main metabolites of tramadol, (+)-Odesmethyltramadol and (-)-O-desmethyltramadol, were studied in rats. Pharmacodynamic endpoints evaluated were respiratory depression, measured as the change in arterial blood pCO(2), pO(2), and pH levels; and antinociception, measured by the tail-flick technique. The administration of 10 mg/kg (+)-Odesmethyltramadol in a 10-min i.v. infusion significantly altered pCO(2), pO(2), and pH values in comparison with baseline and lower-dose groups (P <.05). However, 2 mg/kg administered in a 10-min

i.v. infusion was enough to achieve 100% antinociception without respiratory depression. Moreover, the beta-funaltrexamine pretreatment completely eliminated the antinociception of the 2-mg/kg dose, suggesting that such an effect is due to mu-opioid receptor activation. To describe and adequately characterize the in vivo antinociceptive effect of the drug, (+)-O-desmethyltramadol was given at different infusion rates of varying lengths (10-300 min). Pharmacokinetics was best described by a twocompartmental model. The time course of response was described using an effect compartment associated with a linear pharmacodynamic model. The estimates of the slope of the effect versus concentration relationship were significantly decreased (P <.05) as the length of infusion was increased, suggesting the development of tolerance. Doses of up to 8 mg/kg (-)-O-desmethyltramadol given in 10min i.v. infusion did not elicit either antinociception in the tail-flick test or respiratory effects. These in vivo results are in accordance with the opiate and nonopiate properties reported for these compounds in several in vitro studies. DISPOSITION OF NALBUPHINE IN PATIENTS UNDERGOING GENERAL ANAESTHESIA The pharmacokinetics of nalbuphine 20 mg i.v. were studied in 10 patients undergoing lower abdominal or body surface surgery. Blood sampling was carried out for 600 min after injection and drug concentrations were measured by HPLC using electrochemical detection. Disposition was best described as a triexponential function, with a mean elimination half-life of 135.5 min. Mean residence time, clearance, and volumes of distribution, Vss and V, were determined by a model independent method, and gave mean values of 1497 min (MRT), 1095 ml min1 (Cl), 1599 litre (Vss) and 207.1 litre(V).

Pharmacokinetics of rectal paracetamol after repeated dosing in children

Twentythree children(aged between 9 weeks and 11 yr) were given paracetamol suppositories 25 mgkg
1

every 6 h (maximum 5 days) after major surgery andserum and saliva concentrations were measured.

There was a good correlation(r=0.91, P<0.05) between saliva andserum concentrations. A onecompartment linear model withfirstorder elimination and absorption and lagtime was fitted tothe data (ADAPT II). At steady state, the mean (SD)concentration was 15.2 (6.8) mg litre1. Mean (SD) time to reach 90% of the steady state concentrationwas 11.4 (8.6) h. Body weight, age and body surface area were wellcorrelated (P<0.05) with clearance and apparent volume ofdistribution. There was no evidence of accumulation leading tosupratherapeutic concentrations during this dosing schedule for a mean ofapproximately 23 days.

A scintigraphic study to investigate the potential for altered gut distribution of loperamide from a loperamidesimethicone formulation in man.

A loperamide simethicone combination formulation has recently been demonstrated to have significant clinical advantages compared to loperamide alone in the relief of diarrhoea and related symptoms. The product visualisation technique of gamma scintigraphy has been used to investigate the interaction of the formulation with the heterogenous environment of the human gut in a group of 12 healthy volunteers. The results suggest that changes in the intestinal kinetics of loperamide from the combination product, e.g. jejunal coating, could be contributing to the improved efficacy. [Pharmacokinetics and laxative effect of bisacodyl following administration of various dosage forms].
Since its introduction into the market in 1952, bisacodyl has been successfully used worldwide as a laxative. In discussions on the kinetics and the laxative effect, it is often neglected that results obtained after the administration of the

pure compound bisacodyl cannot be transferred to distinctive bisacodyl formulations. The aim of the present investigation is therefore to study the absorption and the plasma level profile and to correlate plasma level profile and laxative effect after the administration of various dosage forms. 12 healthy volunteers were administered with 10 mg bisacodyl as an experimental solution, with an acid resistant, commercially available Dulcolax Dragees (2 x 5 mg) and with a 10 mg Dulcolax suppository. Following glucuronidase cleavage, mean maximum plasma levels of 236.5 +/- 59.2 ng/ml of bis-(phydroxyphenyl)-pyridyl-2-methane (BHPM) were reached after the administration of the solution 1.7 h post administration (p.a.), however, the laxative effect did not occur until 5.7 h +/- 0.7 h p.a. The dominant biological half-life of deconjugated BHPM, the diphenol of bisacodyl which circulated as BHPM-glucuronide, was about 16.5 +/- 4.2 h. The dragee yielded the desired low plasma levels which were between 7 and 47 ng/ml at 4-10 h p.a. In comparison to the solution only 16% were absorbed after the administration of the dragee. The laxative effect started 7.7 h +/- 1.7 h p.a. with no apparent relationship between effect and plasma level. The administration of the suppository resulted 20 +/- 10 min p.a. in a prompt laxative effect, although in 6 out 12 subjects, the plasma levels were below the detection limit.(ABSTRACT TRUNCATED AT 250 WORDS)