Anastrozole

Generic Name : Anastrozole

Pronunciation : an as' troe zole

Trade Name(s): 
India- Altraz Tab, Altrol Tab, Anabrez Tab, Arimidex Tab, Armotraz Tab, Redest Tab, Stazonex Tab.
International-Arimidex.

Why it is prescribed (Indications) : 
This medication is prescribed for early breast cancer in women who have experienced menopause including women with disease progression after tamoxifen therapy. It is a non-steroidal aromatase inhibitor. It decreases the amount of estrogen the body makes.

When it is not to be taken (Contraindications): 

Contraindicated to pregnancy, premenopausal women, patients who are experienced with hypersensitivity to any components.

Pregnancy Category :

A B C D X

Category D : There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

When it is to be taken : 
Adjuvant treatment in early breast cancer; Advanced or locally advanced breast cancer in postmenopausal women: 1 mg/day.

How it should be taken : 
This medication available in the form of tablets to take by mouth once a day, with or without food.

Special Instruction : 
*Caution should be exercised in patients with history of moderate or severe liver impairment, excess fat.


*It may cause dizziness. Do not drive a car or operate machinery while driving this medication.


* Avoid alcohol consumption.




*Do the lab test for menopause if status is doubtful.


*Bone mass density (bone mineral density) test should be conducted at the start of the therapy and at regular intervals thereafter.

Side Effects : 
Heart-

Widening of blood vessels, hypertension, sudden cardiac death, blood clot in veins and insufficient blood supply to brain.

Central Nervous System-

Lack of energy, mood disturbances, headache, depression, sleeplessness, dizziness, abnormal sensations, anxiety, increased tightness of muscle and fatigue.

Skin-
Rash, sweating, redness of the skin, mucous membrane infection.

Eye and ENT-
Inflammation of pharynx and clouding of eye lenses.

Gastrointestinal-

Stomach disturbances, nausea, vomiting, abdominal pain, constipation, diarrhea, loss of appetite, indigestion, gastrointestinal disorder and dry mouth.

Genitourinary-
Breast pain, urinary tract infection, inflammation of vagina, breast neoplasm, vaginal bleeding, whitish or yellowish vaginal discharge and vaginal dryness.

Blood-Lymphatic-
Lymph nodes swelling, decrease in hemoglobin, and white blood cells.

Liver-
Increased level of liver enzymes and jaundice.

Hypersensitivity-
Allergic reactions including hypersensitivity reaction, rapid swelling of the dermis and skin rash.

Metabolic-Nutritional-
Edema, high blood cholesterol and weight gain.

Musculoskeletal-
Inflammation of joints, joint pain, back pain, bone pain, an increased risk of fracture, pelvic pain and muscle pain.

Respiratory-Difficulty in breathing, increased cough, sinus or sinusitis and inflammation of bronchus.

Miscellaneous-
Hot flashes, pain, accidental injury, infection, chest pain, flu syndrome, cyst, neoplasm and tumor flare.

Other Precautions : 
* Monitor cholesterol levels and bone mineral density periodically.

Storage Conditions : 
Oral: Store at 20-25�C. Store it in airtight container.

Lorazepam

Generic Name : Lorazepam

Pronunciation : lor a' ze pam

Trade Name(s): 
India- Almazine Tab, Anxipose Tab, Atipam Tab, Ativan Inj, Ativan Tab, Calmese Amp, Calmese Tab, C-Van Tab, Larpose Tab, Lopez Amp, Lopez Tab, Lora Amp, Loracalm Tab, Loraz Inj, Loraz Tab, Lorcin Tab, Lorel Tab, Loripam Inj, Loripam Sublingual Tab, Loripam Tab, Lorivan Tab, Lorpik Tab, Lorvan Tab, L-Pam Tab, L-Zepam Tab, Orazep Tab, Psycopan Tab, Trapex Tab, Zepatrac Tab, Zepnap Tab.
International- Ativan, Lorazepam Intensol.

Why it is prescribed (Indications) : This medication is a benzodiazepine, prescribed for anxiety.

When it is not to be taken (Contraindications): 

Contraindicated in patients with narrow-angle glaucoma and hypersensitivity.

Pregnancy Category :

A B C D X

Category D : There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

When it is to be taken : PO- The recommended dose is 2-3 mg/day given in two or three divided doses.

How it should be taken : It comes as a tablet to take by mouth, with or without food.

Special Instruction : 
* Caution should be exercised in patients with history of increased eye pressure, seizures, lung, heart or liver disease, any allergy, who are taking other medications, elderly, during pregnancy and breastfeeding.


* It may cause drowsiness or dizziness, do not drive a car or operate machinery while taking this medication.



* Avoid alcohol consumption.



* Monitor liver function and complete blood counts regularly while taking this medication.

Side Effects : 
Most Common -

Dizziness, weakness and unsteadiness.
Central Nervous System -


Drowsiness, memory loss, confusion, disorientation, depression, emotional state, suicidal thought/attempt, incoordination, weakness, convulsions/seizures, tremor, fainting, visual disturbances, slurred speech, change in libido, impotence, headache and coma.
Respiratory -


Respiratory depression and worsening of obstructive pulmonary disease.
Gastrointestinal -


Nausea, change in appetite, constipation and jaundice.
Hypersensitivity reactions -


Shock.
Skin -


Hair loss.

Other Precautions : 
*Avoid excess dosage.

Storage Conditions : 
Store it at room temperature and in an airtight container. Keep away from children.

Estradiol

Generic Name : Estradiol

Pronunciation : ES-tra-DYE-ol

Trade Name(s): 
India- Evalon, Progynova, Evalon Forte, Espauz, Conjugase, Ed Val, Premarin, Estrofem, Progynon Depot, E-2 Gel, Sandrena, Estraderm MX, ETS Patch, Systen-50.
International- Divigel Gel, E 2 Vaginal Tab Tab, E2 Gel Gel, Estraderm Mx Patch, Estrofem Tab, Ets Patch Patch, Evalon Crm Cream, Evalon Tab, Oestrogel Gel, Progynon Depot Inj, Progynova Tab, Sandrena Gel.

Why it is prescribed (Indications) : 
This medication is a sex hormone, prescribed for treating conditions due to menopause, treating vulval or vaginal atrophy, prostate cancer, and preventing osteoporosis (brittle bones). It is also used for estrogen replacement therapy after failure of the ovaries and to relieve the symptoms of breast cancer.

When it is not to be taken (Contraindications): 

Contraindicated in patients with hypersensitivity; undiagnosed vaginal bleeding; clot in blood vessels; breast cancer, estrogen-dependent tumor; disorders of certain enzymes; pregnancy.

Pregnancy Category :

A B C D X

Category X : Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

When it is to be taken : 
Estradiol dosage varies according to indication and route of administration.

How it should be taken : 
It may be administered orally, as an intramuscular injection or applied to the skin or mucous membranes.

Special Instruction : 
*Conditions that become more severe with estrogen include fluid retention; increase in calcium level, poor blood flow to the brain, coronary artery disease, gall bladder diseases; lipid effects; familial defects of lipoprotein metabolism.


*May increase blood pressure, risk of blood clot in the vein, breast cancer, benign tumor of the liver, endometrial cancer and size of preexisting uterine fibroid.


*Dosage should be reduced in liver problem and during breastfeeding.


*It should not be used in children.

Side Effects : 
Central Nervous System-
Headache, dizziness, sleeplessness, depression, anxiety, nervousness, migraine.

Gastrointestinal-
Abdominal distension, abdominal pain, flatulence, nausea, constipation, upset stomach , diarrhea, bleeding, toothache, tooth disorder.

Skin-
Rash, itching, inflammation of the skin, skin scar.

Heart-
Temporary loss of consciousness and posture, vein inflammation.

Genitourinary-
Abnormal bleeding during menstrual cycles, breast pain, breast tenderness, vaginal bleeding, vaginal discomfort, blood in urine, urinary incontinence.

Other Precautions : 
*Monitor blood sugar level regularly, in case if you have diabetes.

Storage Conditions : 
Store it at room temperature.

Aztreonam

Generic Name : Aztreonam

Pronunciation : az-TREE-oh-nam

Trade Name(s): 
India- Azactam Vial, Azenam Vial, Azom Inj Vial, Azotum Vial, Aztreo Vial, Treonam Vial, Trezam Vial.
International- Azactam.

Why it is prescribed (Indications) : 
This medication is monobactam antibiotic, prescribed for serious infections caused by susceptible gram negative bacteria like urinary tract infection, lower respiratory tract infection. It works by killing sensitive bacteria that cause infection.

When it is not to be taken (Contraindications): 

Hypersensitivity; lactation

Pregnancy Category :

A B C D X

Category B : Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

When it is to be taken : 
IV/IM -Gram negative infections- 1 to 8 g/day in divided doses depending on severity. Max: 8 g/day.
Urinary tract infection- 0.5 to1 g 8 to12 hours.
IM Cystitis; Gonorrhoea -1 g as a single dose.

Inhalation- 75 mg 3 times daily (at least 4 h apart) for 28 days.

How it should be taken : 
It is usually administered as an injection at your doctor's office, hospital, or clinic.
Inhalation: Do not administer with any other nebulizer.

Special Instruction : 
*Do not use this medication if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.


*Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials.


*Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudo membranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away.


*Hypersensitivity to other β-lactams.


*Harmful to liver or kidney functions, and pregnancy.

Side Effects : 
Central Nervous System-
Injection-
Seizures, confusion, vertigo, tingling, dizziness.

Skin-
Inhalation-
Rash.


Injection-
Rash.

Eye and ENT-
Inhalation -
Nasal congestion, pharyngolaryngeal pain.

Gastrointestinal-
Inhalation -
Abdominal pain, vomiting.


Injection -
Diarrhea, nausea, pseudomembranous colitis, vomiting.

Local-
Inflammation of vein after IV administration, pain/swelling at IM injection site.

Respiratory-
Inhalation -
Cough, wheezing, asthma.


Injection-
Difficulty in breathing.

Miscellaneous-
Inhalation
Chest discomfort, fever.
Injection -
Fever.

Other Precautions : 
*Avoid long-term use, otherwise it will cause secondary infection.

Storage Conditions : 
Injection: Once reconstituted, it should be used within 48 hr if stored at 15-30°C or 7 days if stored at 2-8°C. Do not freeze it.

Loxapine

Generic Name : Loxapine

Pronunciation : lox' a peen

Trade Name(s): 
India- Enipaxol Cap, Loxapac Cap, Loxapac Liqd.
International- Loxitane.

Why it is prescribed (Indications) : This medication is a tranquilizer, prescribed for emotional and mental conditions.

When it is not to be taken (Contraindications): 

Contraindicated in patients with coma, severe central nervous system depression, and hypersensitivity.

Pregnancy Category :

A B C D X

Category C : Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

When it is to be taken : PO- The recommended dose range is 10 – 250 mg/day in divided doses.

How it should be taken : It comes as a capsule and liquid to take by mouth, with food.

Special Instruction : 
* Caution should be exercised in patients with history of seizures, difficulty in urinating, increased eye pressure, breast cancer, brain tumor, heart disease, any allergy, who are taking other medications, during pregnancy and breastfeeding.


* It may cause dizziness or drowsiness, do not drive a car or operate machinery and get up slowly from bed while taking this medication.



* Avoid alcohol consumption.



* Do not become overheated; otherwise it may cause heat stroke.




* Patient may develop with increased risk of Neuroleptic Malignant Syndrome (NMS) with the following symptoms: increased body heat, muscle rigidity, altered mental abilities. If it so consult with your doctor.

Side Effects : 
Central Nervous System -


Dizziness, faintness, staggering gait, muscle twitching, weakness, sleeplessness, agitation, tension, seizures, slurred speech, numbness and confusion.
Heart -

Fast heart rate, low/high blood pressure, lightheadedness and fainting.
Blood -

Decrease in white blood cells and platelets.
Skin -

Skin inflammation, swelling, itching, rash, hair loss and scaling.
Anticholinergic -

Dry mouth, nose congestion, constipation, blurred vision, urinary retention and intestinal obstruction.
Gastrointestinal -

Nausea, jaundice and/liver inflammation.
Others -
Weight gain, weight loss, difficulty in breathing, fever, flushing, headache, tingling, increased thirst, absence of menstrual period, breast enlargement in male and menstrual irregularity.

Other Precautions : 
* Some patients may develop with involuntary movements; if it so consult with your doctor.



* Avoid excess dosage.

Storage Conditions : 
Store it at controlled room temperature (15-30°C).

Acenocoumarol

Generic Name : Acenocoumarol

Trade Name(s): 
India- Acitrom Tab, Nistrom Tab.
International- Acenox, Acitrom, Antitrom, Azecar, Cumarol, Mini-Sintrom.

Why it is prescribed (Indications) : 
This medication is an anticoagulant, prescribed for thromboembolic disorders.

When it is not to be taken (Contraindications): 

This medication is not advisable in patients with active bleeding or risk of serious bleeding, severe high blood pressure and pregnancy.

Pregnancy Category :

A B C D X

Category X : Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

When it is to be taken : 
Adult: PO- 4-12 mg on the 1st day and 4-8 mg on the 2nd day. Maintenance: 1-8 mg/day as a single dose.

How it should be taken : 
It comes as a tablet to take by mouth, with food.

Special Instruction : 
* Caution should be exercised in patients with history of bleeding disorders, peptic ulcer, severe wounds, allergies, stroke, stomach infections, liver or kidney impairment, elderly, children and breastfeeding.


* Avoid alcohol consumption while taking this medication.

Side Effects : 
Skin-

Hair loss, rash, hives and itching.
Gastrointestinal-



Nausea, vomiting and diarrhea.
Liver -



Liver damage.
Potentially Fatal- Severe bleeding.

Other Precautions : 
*Avoid excess dosage.

Storage Conditions : 
Oral: Store it at room temperature (20-25°C) and in an airtight container.

Ribavirin

Generic Name : Ribavirin

Pronunciation : RYE-ba-VIR-in

Trade Name(s): 
India- Rebetol Cap, Ribamac Cap, Ribavin Cap, Ribavin Syr, Rivirin Cap, Virazide Syr, Virazide Tab.
International- Copegus, Rebetol, Virazole.

Why it is prescribed (Indications) : 
This medication is an antiviral agent, prescribed for severe Respiratory Syncytial Viral infection in infants and children, especially those with other risk factors such heart disease. It is also used in chronic hepatitis C infection combined with Peginterferon.

When it is not to be taken (Contraindications): 

Contraindicated to pregnant women, men whose female partners are pregnant, patients with a history of allergy to this drug or any component of the product; patients with abnormal hemoglobin and anemia, autoimmune liver disease, liver failure, creatinine clearance

Pregnancy Category :

A B C D X

Category X : Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

When it is to be taken : 
Adult: PO- 400 – 600 mg two times per day. Dosage depends on the product used and patient's body weight. It is administered via inhalation in infants.

How it should be taken : 
It comes as a tablet, a capsule, an oral solution to take by mouth and an aerosol solution. Take oral preparations two times per day with food.

Special Instruction : 
*Caution needed for patients with history of extensive liver fibrosis, kidney impairment, and anemia.
*Monitor complete blood count regularly during treatment.
*Use at least 2 reliable contraceptives during treatment and for at least 6 month after treatment.
*Increased risk of heart attack in patients with anemia.
*It may make you drowsy, dizzy, or confused. Do not drive a car or operate machinery while taking this medication.

Side Effects : 
Most common-
Injection site reaction, fatigue, weakness, headache, rigors, fevers, nausea, muscle pain and anxiety, anger, mood swings.
Most Serious -
Hemolytic anemia (Anemia due to breakdown of red blood cells).
Central Nervous System-
Fatigue, weakness, headache, depression, psychosis, aggressive behavior, hallucinations, or violent behavior.
Gastrointestinal-
Nausea, vomiting, loss of appetite.
Metabolic-
Abnormality in thyroid hormone.
Heart-
Abnormal rate or rhythm may occur in patients taking inhaled ribavirin with underlying heart disease.
Miscellaneous-
Fever, decrease in white blood cell, injection site redness, loss of hair, allergic reactions.

Other Precautions : 
*Do not change the dosage.

Storage Conditions : 
Store it at room temperature (25°C).