DRUGS

Presented by Dr.(prof) Suresh Babu

 PARACETAMOL
INDICATIONS
• Acetaminophen or paracetamol, is an nonopioid analgesic and
antipyretic drug indicated for temporary relief of fever and
pain.

• ADVERSE EFFECTS
• Skin rash, Nephrotoxicity( with chronic overdose), Incresed
serum ALP level and incresed serum bilirubin level, nausea,
vomiting , agitation, anaemia, dyspnoea, edema, tachycardia
 Acetylcysteine
INDICATION
• Acetylcysteine is a mucolytic agent used to prevent or lessen
hepatic injury after ingestion of a potentially hepatotoxic
quantity of acetaminophen in patients with acute ingestion or
from repeated supratherapeutic ingestion. It is also used as an
adjunct therapy in patients with abnormal, viscid or
inspissated mucous secretions in conditions such as chronic
bronchopulomonary disease; tracheostomy care, pulmonary
complications associated with surgery; use during anesthesia;
post traumatic chest conditions; atelectasis due to mucous
obstruction.

ADVERSE EFFECTS
• Drowsiness, hypotension, bronchospam, rash, pruritis,
Anaphylactoid reaction, flushing.
 DICLOFENAC
INDICATIONS
• It is a Nonsteroidal anti-inflammatory drug (NSAID) used for
the releif of signs and symptoms of Rheumatoid arthritis,
osteoarthritis, ankylosing spondylitis, dysmenorrhoea, acute
pain, acute migraine.

ADVERSE EFFECTS
• Dyspepsia ,Edema, nausea, headache, abdominal pain,
constipation, flatulence, dizziness, GI ulcers, Renal
insufficency and Incresed liver enzymes
 Noradrenaline
INDICATIONS
• It is an organic chemical in the catecholamine family that
functions in the brain and body as a hormone an
neurotransmitter. Noradrenaline function as a peripheral
vasoconstrictor and is indicated for use as an emergancy
measure in the restoration of blood pressure in cases of acute
hypotension.

ADVERSE EFFECTS
• Anxiety, transient headache, Bradycardia, cardiac
arrhythemia, cardiomyopathy, peripheral vascular
insufficiency and dyspnea.
 DOBUTAMINE
INDICATIONS
• It is beta 1- agonist catecholamine indicated when parenteral
therapy is necessary for inotropic support in the short term
management of patients with cardiac decompensation due to
depressed contractility, resulting either from organic heart
disease or from cardiac surgical precodures.

ADVERSE EFFECTS
• Headache, tachycardia,Increased systolic blood pressure,
ventricular premature contractions, angina pectoris,
palpitations, cardiomyopathy, eosiniophilia, hypokalemia.
 Adenosine
INDICATION
• It is a ribonucleoside comprised of adenine bound to ribose,
with vasodilatory, antiarrhythmic, and analgesic activites.
• Is exerts its antiarryhthmic actions by reducing conduction
time throgh AV node, interrupting re-entry pathways through
AV node and restoring normal sinus rhythm.
• It also used in myocardial perfusion scintigraphy and narrow
complex supraventricular tachycardia(SVT).

ADVERSE EFFECTS
• Headache, dizziness,cardiac arrthyhmia, facial flushing,
cardiac arrythmia, dyspnea, gastro intestinal distress.
 Diltiazem
INDICATIONS
• It is a nondihydropyridine calcium channel blocker indicated
for the treatment of hypertension, chronic stable angina,
vasospastic angina, atrial fibrillation,or atrial flutter ( for acute
ventricular rate control) and also for the conversion of
supraventricular tachycardia.

ADVERSE EFFECTS
• Peripheral edema, Dizziness, headache, fatigue, nervouness,
abnormal dreams, drowsiness, Constipation and reversible
hepatotoxicity, bradycardia, hypotension, palpitation,
Dyspepsia.
 Hydrocortisone
INDICATION
• It is a glucocorticoid that exhibits mild mineralocorticoid
acitivity and moderate anti-inflammatory effects; it also
control or prevents inflammatory effects; it also controls or
prevents inflammation by controlling rate of protein synthesis
and suppressing migration of polymorphonuclear leukocyted.
• It is indicated for relief of rheumatic disease, respiratory
disease, as well as immune and allergic disorders.

ADVERSE EFFECTS
• Sodium retention, Congstive heart failure, hypokalemic
alkalosis, hypetension, convulsions, headache, potassium loss,
abdominal distention and loss of muscle mass.
 HEPARIN
INDICATIONS
• It is an anticoagulant indicated for the prophylaxis and
treatment of thromboembolic disorders and thromboembolic
complications associated with atrail fibrillation. It is also used
for prevention of clotting in arterial and cardiac surgery and as
an anticoagulant for blood transfusions, extracorporeal
circulation and dialysis procedures.

ADVERSE EFFECTS
• Bleeding, Dysesthesia, peripheral neuropathy, chills,
headache, chest pain, shock(including hemorrhagic shock),
Adrenal hemorrhage, Hematemesis, melena, skin necrosis,
dermal ulcers, hyperkalemia, erectile dysfunction.
 Furosemide
INDICATION
• It is a sulfamolanthranilic acid derivative, is a potent loop
diuretic used in the management of edema associated with
heart failure, cirrhosis of liver ( ascites), or renal disease. It is
also indicated for the management of hypertension and acute
pulmonary edema.

ADVERSE EFFECTS
• Ototoxicity, hyperuricemia, Acute hypovolemia, potassium
depletion, hypomagnesemia, Dehydration, hyponatremia,
Dizziness, hypokalemia.
 Spironolactone
INDICATION
• It is a potassium sparing diuretic, it compete with aldosterone
for receptor sites in the distal renal tubules, increasing sodium
chloride and water excretion, while conserving potassium and
hydrogen ions. It is indicated for the management of edema
for cirrhosis of liver and nephrotic syndrome, heart failure,
hypertension unresponsive to other therapies, and primary
hyperaldosteronism.

ADVERSE EFFECTS
• Hyperkalemia, Hyponatremia, Weakness, Dehydration,
Hyperglycemia, Gynecomastia, Impotenece
 ESCITALOPRAM

INDICATION
• It is a selective serotonin reuptake inhibitor indicated for the
acute and maintenance treatment of major depressive
disorder in adults and in adolescents for the acute treatment
of generalised anxiety disorder, alcoholism, binge eating
disorder, hot flushes, panic disorder.

ADVERSE EFFECTS
• Drowsiness,Headcahe and insomnia, Ejaculatory disorder,
Diaphoresis, nausea, xerostomia, confusion, bradycardia,
pruritus, abdominal pain
 LIGNOCAINE

INDICATIONS
• It is a local anesthetic administered via infiltration, nerve
block, epidural injection, or intraspinal injection for local and
regional anesthesia. It is also used for acute treatment of
ventricular arrhythmias, post herpetic neuralgia.

Adverse effects
• Headache, Shivering, Radiculopathy, Eryhthema, petechae,
edema, confusion, bradycardia, dysgusea, dermatitis,
respiratory depression.
 RAMIPRIL

INDICATION
• It is a angiotensin converting enzyme (ACE) inhibitor. It is used
for Hypertension, reduce the risk of Myocardial infarction,
stroke or death from cardiovascular causes, also indicated in
stable patients who have clinical signs of congestive heart
failure following myocardial infarction.

ADVERSE EFFECTS
• Hyotension, Dry Cough, angioedema, angina pectoris,
orthostatic hypotension, hyperkalemia, renal insufficiency,
agranulocytosis, Dizziness.
 SALBUTAMOL

INDICATIONS
• It is a short acting, selective beta 2 adrenergic receptor
agonist indicated for the treatment or prevention in
obstructive airway disease, Bronchospasm, asthama,
hyperkalemia, exercise induced bronchospasm.

• ADVERSE EFFECTS
• Excitement, nervousness, tremors, Upper respiratory tract
infection, rhinitis, shakiness, headache, ataxia, tachycardia,
hypertension.
 Ciprofloxacin
INDICATION
• It is a synthetic, broad-spectrum, second generation
fluroquinolone antibiotic. It inhibit enzymes topoisomerase 2
(DNA gyrase) and topoisomerase 4, which are required for
bacterial DNA replication, transcription and repair.
• It indicated for treatment of skin infections, bone and joint
infections, infectious diarrhea, typhoid fever, uncontrolled
gonorrhea, inhalational anthrax, chronic bacterial prostatitis,
acute exacerbation of chronic bronchitis, acute uncomplicated
cystitis, complicated UTI and acute sinositis.
ADVERSE EFFECTS
• Dizziness, drowsiness, musculoskeletal signs and symptoms,
skin rash, vaginal discharge, heartburn.
 RIFAMPICIN
INDICATION
• It inhibits RNA synthesis by binding to DNA dependant RNA
polymerase and blocking RNA transcription. Used in
Tuberculosis, prophylaxis of meningococcal, leprosy, brain
abscess, brucellosis

ADVERSE EFFECTS
• Hepatoroxicity(deranged LFT), myopathy, Dyspnea , flu like
symptoms, conjuctivitis, Orange color urination, ataxia,
confusion, drowsiness, hypotension, abdominal cramps,
erythema multiforme.
 Cefuroxime
INDICATION
• It is a broad spectrum second generation bactericidal agent that
inhibit cell wall synthesis by binding to one or more of penicillin
binding proteins(PBPs), which in term inhibit the final
transpeptidation step of peptidoglycan synthesis in bacterial cell
walls,thereby inhibiting cell wall synthesis.
• It is used in treatment of bone and joint infections,copd (acute
exacerbation), lower respiratory tract infections,lymes disease,
acute otitis media, pharyngitis, tonsillitis, septicemia, sinusitis,
impetigo, UTI

ADVERSE EFFECTS
• Diarrhea,diaper rash,vaginitis,local thrombophlebitis,increased
lactate dehydrogenase, decresed hematocrit,decresed
hemoglobin level.
 Itraconazole
INDICATION
• It is a broad antifungal agent which interferes with
cytochrome 450 activity,decreasing ergosterol synthesis
(principal sterol in fungal cell membrane) and inhibiting cell
membrane formation.
• It is used in treatment of histoplasmosis, blastomycosis,
aspergillosis,dermatophytosis.

ADVERSE EFFECTS
• Diarrhea,edema, chest pain,dizziness,fatigue, malaise,
pruritis, hypertriglyceridemia, hypokalemia,gastritis,
hepatotoxicity,cystitis, myalgia, bursitis, rhinitis
 Metronidazole
INDICATION
• It is a DNA synthesis inhibitor, and used to treat
gastrointestinal infections, trichomoniasis and giardiasis and
amebiasis which are parasitic infections.

ADVERSE EFFECTS
• Headache,dizziness,xerostomia,mettalic taste,disulfiram like
reaction, upper respiratory tract infection,pruritis,candidiasis,
dry mouth,stomatitis, vaginal dryness
 Metformin
INDICATION
• It is a biguanide anti hyperglycemic agent that improves
glucose tolerance in patients with type 2 diabetes mellitus,
lowering both basal and postprandial plasma glucose.
• It also decreases hepatic glucose production and decreases
intestinal absorption of glucose and improve insulin
sensitivity by increasing peripheral glucose uptake and
utilization.

ADVERSE EFFECTS
• lactic acidosis, cholestasis, Diarrhea, flatulence, asthenia ,
myalgia, cyanocobalmin defeciency , abdominal distension.
 METOCLOPRAMIDE
INDICATION
• It is a dopamine D2 antagonist indicated for treatment of
documented, symptomatic, Gastroesophgeal reflux in adults
who fail to respond to conventional therapy; also used for
acute and recuurent diabetic gastroparesis and prophylaxis of
chemotherapy induced nausea vomitting.

ADVERSE EFFECTS
• Drowsiness, Drug induced parkinson disease, Dystonic
reactions, Dysgeusia, restlessness, fatigue, bradycardia,
cardiac failure, diarrhoea, skin rash.
 Montelukast
INDICATION
• It is a selective leukotriene receptor antagonist that inhibits
the cysteinyl leukotriene receptor.
• It is indicated for prophylaxis and chronic treatment of asthma
in adults and pediatric patients and also indicated for the
prevention of exercise induced bronchoconstriction.
• It is also indicated for the relief of symptoms of seasonal
allergic rhinitis in patients.

ADVERSE EFFECTS
• Agitation, aggression, feeling restless or irritable, anxiety,
depression, hallucinations, sleep problems, confusion.
 Levosulpride
INDICATION
• It is a selective peripheral dopamine 2 receptor antagonist. It
increases gastric motility and peristalsis. It is used for relief of
symptoms associated with functional(non-ulcer) dyspepsia,
including feeling of abdominal fullness, epigastric discomfort
heartburn, belching, nausea and vomiting.

ADVERSE EFFECTS
• Dizziness, insomnia, Cardiac arrhythmia, Drowsiness, fatigue,
Gynecomastia, constipation, Abdominal pain ad cramps,
weight gain, skin rash, Amenorrhea, tremor
 ROSUVASTATIN
INDICATIONS;
• It is a HMG-CoA reductase inhibitor indicated for the primary
prevention of atherosclerosis, cardio vascular diasease, for
reduction of elevated blood cholesterol levels, LDL levels and
trigyceride levels ,familial hyperlipoproteinemia.

ADVERSE EVENTS
• Myalgia, athralgia, pharyngitis, headache,nausea, dizziness,
constipation, abdominal pain and cystitis