clopidogrel bisulfate, Plavix

GENERIC NAME: clopidogrel bisulfate BRAND NAME: Plavix DRUG CLASS AND MECHANISM: Clopidogrel bisulfate is an anti-platelet drug, that is, a drug that inhibits the ability of platelets to clump together as part of a blood clot. It is similar to ticlopidine (Ticlid) in chemical structure and in the way it works. Unlike ticlopidine, clopidogrel bisulfate does not cause serious reductions of white cells in the blood and, therefore, routine blood testing to determine if the white blood cell count is low is not necessary during treatment. The risk of heart attacks and strokes (which usually are caused by blood clots) is increased in patients with a recent history of stroke or heart attackand patients with peripheral vascular disease. (Peripheral vascular disease is the same as atherosclerotic arterial disease or "hardening" of the arteries in which the arteries become narrowed. It frequently occurs in the legs and often causes claudication or pain in the legs upon walking). Clopidogrel bisulfate is used to reduce the risk of heart attacks and strokes in these patients. Clopidogrel bisulfate was approved by the FDA in 1997. PREPARATIONS: Tablets: 75mg. STORAGE: Tablets should be stored at room temperature, 15-30 C (59-86 F). PRESCRIBED FOR: Clopidogrel is used to prevent strokes and heart attacks in persons who are at high risk. In one large study, clopidogrel bisulfate was more effective than aspirin in reducing heart attacks. The frequency of side effects of clopidogrel bisulfate was similar to aspirin; however, stomach and intestinal bleeding probably occurs less often with clopidogrel bisulfate than with aspirin. DOSING: Clopidogrel bisulfate usually is taken once daily. It can be taken with or without food. Clopidogrel is activated by enzymes in the liver. Individuals who have reduced activity of liver enzymes that activate clopidogrel may not adequately respond to clopidogrel. Alternative treatments should be used for these patients. SIDE EFFECTS: The tolerability of clopidogrel is similar to that of aspirin.Diarrhea, rash, or itching occurs in approximately 1 in 20 persons taking clopidogrel. Abdominal pain also occurs in about 1 in 20 persons, but it is less frequent than with aspirin. Ticlopidine (Ticlid) is an antiplatelet medication quite similar to clopidogrel. It has been associated with a severe reduction in white blood cell count in between 0.8% and 1% of persons. The risk of this dangerous side effect with clopidogrel is about 0.04%, much less than with ticlopidine but twice that of aspirin. Clopidogrel rarely causes a condition called thrombotic thrombocytopenic purpura (TTP) in one out of every 250,000 people. TTP is a serious condition in which blood clots form throughout the body. Blood platelets, which participate in clotting, are consumed, and the result can be bleeding because enough platelets are no longer left to allow blood to clot normally. For comparison, the related drug, ticlodipine (Ticlid), causes TTP 17-50 times more frequently than clopidogrel.

Disflatyl

- tablets amass the gas bubble formed in the stomach and intestine, helping easier routing of gas. It is

prescribed for relief from pressure created by excessive formation of gas bubbles in the stomach and intestine. Disflatyl tablets may be prescribed for ailments not listed above.
Dosage

Adults For functional gastric disorder, postoperative Gas Pains and Flatulence: 40 to 125 Mg of Simethicone to be administered orally after meal and at bedtime. Adults for Endoscopy: 67 Mg of Simethicone as an oral suspension administered just before Endoscopy.
Disflatyl tablets side effects

Rare cases of side effects associated to Disflatyl tablets have been reported. In case any of these side effects occur, seek for immediate medical help. Symptoms include extreme allergic reaction; skin irritation, hives skin rashes, redness, difficulty in breathing, swelling, and chest pain, chest congestion, swelling of the face, lips tongue or throat. Common side effects include headache, nausea, vomiting, constipation, diarrhea and abdominal cramps. Consult a doctor if any of these side effects of Disflatyl tablets become persistent and troublesome.
Important information on Disflatyl tablets

Avoid the medication if you are allergic to Simethicone. Use the medication after taking your meal at bedtime or follow the instructions prescribed by your doctor. It is important to maintain your diet prescribed by your doctor along with using the medication for effective results. Consult with your doctor the list of food you need to avoid for controlling the ailments. Simethicone may interact with other drugs and cause severe side effects, inform your doctor if you are using any other drug, vitamin supplement or herbal remedies for prevailing ailments. Avoid using over the counter medication without consulting with your doctor. Consult with your doctor before using Disflatyl tablets in case of pregnancy or breast-feeding. Avoid overdose; strictly follow the instruction prescribed to you by your doctor. In case of overdose, seek for immediate medical help. Store Disflatyl tablets at room temperature away from direct sunlight, hear and moisture. Keep it safely out of reach of children. Disflatyl tablets may cause drowsiness, avoid using it while driving or operating heavy machinery.

Ansimar
Generic Name : Ansimar

Brand Name: Zuellig Dosage Tab Adult 1 tab bid-tid. Syr Childn >12 yr 10 mL once-tid, <12 yr 6-9 mg/kg FREQUENCY: bid. Mechanism of Action Bronchodilator. Indications Bronchial asthma & pulmonary disease w/ spastic bronchial component. Contraindications Acute MI, hypotension, lactation. Adverse Drug Reactions Nausea, vomiting, epigastric pain, cephalalgia, irritability, insomnia, tachycardia, extrasystole, tachypnea, hyperglycemia, albuminuria. NURSING RESPONSIBILITIES: > Use with caution in patients with hypoxemia, hyperthyroidism, liver disease, renal disease, in those with history of peptic ulcer and in elderly. Frequently, patients with CHF have markedly prolonged drug serum levels following discontinuation of Ansimar. > assess for allergic reaction > assess for breath sounds >should be given to a pregnant woman only if clearly needed.

Losartan, Cozaar
GENERIC NAME: losartan BRAND NAME: Cozaar

DRUG CLASS AND MECHANISM: Losartan is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARBs). Other ARBs include irbesartan (Avapro), valsartan (Diovan), andcandesartan (Atacand). Angiotensin, formed in the blood by the action ofangiotensin converting enzyme (ACE), is a powerful chemical that attaches to angiotensin receptors found in many tissues but primarily on smooth muscle cells of blood vessels. Angiotensin's attachment to the receptors causes the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure (hypertension). Losartan (more specifically, the chemical formed when the liver converts the inactive losartan into an active chemical) blocks the angiotensin receptor. By blocking the action of angiotensin, losartan dilates blood vessels and thereby reduces blood pressure. Losartan was approved by the FDA in April 1995. PREPARATIONS: Tablets: 25, 50 and 100 mg STORAGE: Tablets should be stored at room temperature in a tightly closed, light resistant container. PRESCRIBED FOR: Losartan is used for treating hypertension, left ventricular hypertrophy (increase in muscle) and diabetic nephropathy (kidney disease). It may be used alone or in combination with other drugs. DOSING: The usual starting dose of losartan for adults is 50 mg daily. The maximum dose is 100 mg daily. The total daily dose may be divided and administered twice daily. Losartan may be given with or without food. The starting dose of losartan for pediatric patients 6 years of age or older is 0.7 mg/kg up to 50 mg once daily. Doses more than 1.4 mg/kg or 100 mg daily have not been evaluated in pediatric patients. SIDE EFFECTS: diarrhea, muscle cramps,dizziness, insomnia, and nasal congestion. Losartan also may cause a persistent cough, increase serum potassium, and angioedema. Losartan may reduce kidney function in some patients and should not be used by patients who have bilateral renal artery stenosis (narrowing of both arteries going to the kidneys). Rare cases of rhabdomyolysis (muscle breakdown) have been reported.

Janumet
-a combination of sitagliptin and metformin which are the oral diabetes medicine to control the levels of blood sugar. Metformin helps reduce the production of glucose (sugar) in liver and also minimizes the glucose absorption by the intestines. Sitagliptin (Junavia) helps in regulating the insulin levels which the body produces after eating something. Janumet can be used along with exercise and diet to lower down the blood sugar levels in adults having type 2 diabetes. Be aware that Janumet cannot be used to treat type 1 diabetes.

Try to avoid drinking the alcohol while taking this drug as the alcohol can lower the blood sugar level and may increase the chances of lactic acidosis. Side Effects of Janumet Janumet may lead to lactic acidosis which can slowly become worse over time. Seek emergency help when you experience mild signs of lactic acidosis like weakness, muscle pain, cold or numb feeling in the legs and arms, breathing trouble, nausea with vomiting, stomach pain, irregular or slow heart rate, feeling very tired or weak and dizziness. Some of the other symptoms of an allergic reaction to Janumet include hives, swelling on face, throat, tongue, lips and breathing difficulty. Just call your physician if you feel some serious side effects, such as: pancreatitis i.e. excruciating pain in the upper abdomen, loss of appetite, vomiting and fast nausea, heart rate; mild exertion, short of breath; or rapid weight gain or swelling Less serious side effects of Janumet may include: mild nausea, diarrhea, upset stomach; weakness, headache; or cold symptoms like stuffy or runny nose, sore throat, sneezing.

Diltiazem Generic Name: diltiazem (dil TYE a zem)

Brand names: Cardizem, Cardizem CD, Cardizem LA, Cartia XT, Dilacor XR, Dilt-CD, Dilt-XR, Diltia XT, Diltiazem Hydrochloride CD, Diltiazem Hydrochloride SR, Diltiazem Hydrochloride XR, Diltiazem Hydrochloride XT, Diltzac, Taztia XT, Tiazac, Cardizem SR, Cardizem Monovial, Matzim LA Diltiazem is in a group of drugs called calcium channel blockers. It works by relaxing the muscles of your heart and blood vessels. Diltiazem is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders. Before taking Diltiazem You should not use this medication if you are allergic to diltiazem, or if you have: certain heart conditions, especially "sick sinus syndrome" or "AV block" (unless you have a pacemaker); low blood pressure; or if you have recently had a heart attack. To make sure you can safely take diltiazem, tell your doctor if you have any of these other conditions: kidney disease; liver disease; congestive heart failure; or if you are also taking clonidine (Catapres). FDA pregnancy category C. What should I avoid while taking diltiazem? Diltiazem may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid drinking alcohol while taking diltiazem. Grapefruit and grapefruit juice may interact with diltiazem and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Avoid exposure to sunlight or tanning beds. Diltiazem can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Diltiazem side effects Get emergency medical help if you have any of these signs of an allergic reaction to diltiazem: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as: a red, blistering skin rash; swelling in your hands or feet; trouble breathing; slow heartbeats; dizziness, fainting, fast or pounding heartbeat; upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. Less serious diltiazem side effects may include: headache; dizziness, weakness, tired feeling; upset stomach, nausea; sore throat, cough, stuffy nose; or flushing (warmth, redness, or tingly feeling).

Coralan
(ivabradine) The first selective and specific If inhibitor Mode of action Ivabradine is a heart rate lowering agent. It acts by selective and specific inhibition of the cardiac pacemaker If current, an important ionic current that usually controls spontaneous diastolic depolarisation in the sinus node and thereby regulates heart rate. The cardiac effects of ivabradine are specific to the sinus node and ivabradine has no effect on intra-atrial, atrioventricular or intraventricular conduction times, myocardial contractility or ventricular repolarisation. An elevated heart rate increases myocardial oxygen demand and limits tissue perfusion, the latter by reducing the duration of diastole, during which most myocardial perfusion occurs. Therefore, a pure reduction in heart rate can reduce myocardial ischaemia and prevent angina pectoris. Approved indication Ivabradine is indicated for the symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm who are intolerant to beta-blockers or in whom these agents are contraindicated. Precautions o General Ivabradine is contraindicated in patients with cardiac dysrhythmias, unstable angina pectoris, acute coronary syndrome, class lll to lV heart failure, 3 rd degree AV block, cardiogenic shock, those with a pacemaker, a resting heart rate below 60 bpm or severe hypotension (< 90/50 mm Hg). Ivabradine is not recommended for use in patients with liver dysfunction and is contraindicated in patients with severe liver dysfunction. o Pregnancy and lactation Ivabradine is contraindicated for use during pregnancy and lactation. Major adverse effects Luminous phenomena (phosphenes) i.e. enhanced brightness in the visual field, have been reported in 14.5% of patients. These effects usually resolve spontaneously during treatment. Other common side effects include bradycardia, AV 1 st degree heart block, ventricular extrasystoles, headache and dizziness. Patient information Ivabradine should be taken twice daily in the morning and in the evening. The tablets should be swallowed with a little water and taken with some food. Changes in vision may occur, but usually resolve with continued treatment.