DRUG CHART 8 – 10 years 360 – 375 mg

TABLE OF CONTENTS: 10 – 12 years 480 – 500 mg

Analgesics (Non-Opiod) 12 – 16 years 480 – 750
o Paracetamol mg
o  Note: When calculating the maximum daily dose, consider all sources of
Anti-Dementia Drugs acetaminophen (prescription and OTC) and all routes of administration. Do not
o Memantine exceed the maximum recommended daily dose.
 Weight-based dosing: Infants, Children, and Adolescents: 10 to 15 mg/kg/dose
Drugs for Bladder & Prostate Disorders every 4 to 6 hours as needed; do not exceed 5 doses in 24 hours; maximum daily
o Finasteride dose: 75 mg/kg/day not to exceed 4 g daily.
 Fixed dosing: Oral suspension, chewable tablets: Infants and Children <12 years:
Cough and cold preparations Consult specific product formulations for appropriate age groups; doses may be
o Ambroxol repeated every 4 hours; maximum: 5 doses daily.

Anti Asthmatic and COPD Preparations o Oral: Post-immunisation pyrexia

o Salbutamol  Child: 2-3 mth 60 mg. If necessary, a 2nd dose may be given after 4-6 hr.
o Rectal: Mild to moderate pain and fever
Penicillins  Adult: As supp: 0.5-1 g 4-6 hrly. Max: 4 g daily.
o Amoxicillin  Child: 3 mth to <1 yr 60-125 mg; 1 to <5 yr 125-250 mg; 5-12 yr 250-500 mg.
Metformin Given 4-6 hrly if necessary, up to 4 times daily.
o Rectal: Post-immunisation pyrexia
ANALGESICS (NON-OPIOID) & ANTIPYRETICS  Child: 2-3 mth 60 mg. If necessary, a 2nd dose may be given after 4-6 hr.
PARACETAMOL  For Renal Impairment: IV: Creatinine Clearance <30 – Increase dosing interval to 6
 Indication: Mild to moderate pain and fever. hourly
 Dosage:  For Hepatic Impairment: IV: Max dose of 3 g / day
o Adult : PO 0.5-1 g 4-6 hrly. Max: 4 g/day.  Administration: May be taken with or without food
o Rectal As supp: 0.5-1 g 4-6 hrly. Max: 4 g/day.
o IV 33-50 kg: 15 mg/kg as a single dose, at least 4 hrly. Max: 60 mg/kg/day up to  Special Precaution:
3 g/day; >50 kg: 1 g as a single dose, at least 4 hrly. Max: 4 g/day. Admin by o Patient w/ chronic alcoholism
infusion over 15 min. o known G6PD deficiency
o Intravenous via infusion for 15 minutes :For Mild to moderate pain and fever o Severe hypovolaemia
Kg Single Dose Hours Max Dose o Chronic malnutrition
(mg/kg daily) o Renal and hepatic impairment
Adult 33 - 50 kg 15 mg/kg 60 mg/kg (up o Pregnancy and lactation
to 3 g) daily
>50 kg 1g 4g  Adverse Drug Interaction:
Child <10 kg 7.5 mg/kg 30 mg/kg o Thrombocytopenia, leucopenia, pancytopenia, neutropenia,
Least 4 hours agranulocytosis, pain and burning sensation at inj site. Rarely, hypotension
10 – 33 kg 15 mg/kg 60 mg/kg (up
to 2 g) and tachycardia.
>33 – 50 kg 15 mg/kg 60 mg/kg (uo o Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis,
to 3 g) acute generalised exanthematous pustulosis, acute renal tubular necrosis
*Dilute soln to a minimum strength of 1 mg/mL in NaCl 0.9% or glucose 5%; diluted soln and hepatotoxicity
should be used w/in 1 hr of preparation.
 Pregnancy Category: PO: B; IV: C
o Oral: Mild to moderate pain and fever  Monitoring Parameters: Monitor serum paracetamol levels esp when acute
overdosage is suspected and w/ long-term use
Age Single Dose Hours Max Dose
Adult 0.5 – 1 g 4 g daily
 Drug Interactions:
Child 3 – 6 months 60 mg 4 doses daily
o May reduce serum levels w/ anticonvulsants (e.g. phenytoin, barbiturates,
6 months – 2 120 mg carbamazepine).
years 4 -6 hours o May enhance the anticoagulant effect of warfarin and other coumarins w/
2 – 4 years 180 mg prolonged use
4 – 6 years 240 mg o Accelerated absorption w/ metoclopramide and domperidone
6 – 8 years 240 – 250 mg o May increase serum levels w/ probenecid
 o May increase serum levels of chloramphenicol
o May reduce absorption w/ colestyramine w/in 1 hr of admin
o May cause severe hypothermia w/ phenothiazine.
 Food Interaction: Alcohol may increase risk of hepatotoxicity.
 Lab Interference: May produce false-positive test results for urinary 5
hydroxyindoleacetic acid.
 Mechanism of Action
o Description: Paracetamol exhibits analgesic action by peripheral blockage of
pain impulse generation. It produces antipyresis by inhibiting the hypothalamic
heat-regulating centre. Its weak anti-inflammatory activity is related to
inhibition of prostaglandin synthesis in the CNS.
o Onset: Oral: <1 hr. IV: 5-10 min (analgesia); w/in 30 min (antipyretic).
o Duration: 4-6 hr (analgesia). IV: ≥6 hr (antipyretic).
o Pharmacokinetics:
 Absorption: Readily absorbed from the GI tract. Time to peak plasma
concentration: Approx 10-60 min (oral).
 Distribution: Distributed into most body tissues; crosses the placenta and
enters breast milk. Plasma protein binding: Approx 25%.
 Metabolism: Hepatic via glucuronic and sulfuric acid conjugation. N-
acetyl-p-benzoquinoneimine (minor hydroxylated metabolite), is usually
produced in very small amounts by CYP2E1 and CYP3A4 isoenzymes in
the liver and kidneys.
 Excretion: Mainly via urine (as glucuronide and sulfate conjugates, <5%
as unchanged drug). Elimination half-life: Approx 1-3 hr.
 Storage: Store between 15-30°C. Avoid freezing.
ANTI-DEMENTIA DRUGS
MEMANTINE
 Classification: Neurodegenerative Disease Drugs / Anti-dementia Drugs
 Indication: Moderate to severe dementia in Alzheimer's disease.
 Dosage:
o Adult : PO Initial: 5 mg once daily for the 1st wk, increased in wkly increments of
5 mg. Max: 20 mg/day.
o Oral: Moderate to severe dementia in Alzheimer's disease
 Adult: Initially, 5 mg once daily for the 1st wk, increased in wkly
increments of 5 mg. Max: 20 mg daily.
 For Renal Impairment:
CrCl
Dosage
(mL/min)
5-29 Max: 10 mg daily.
10 mg daily (after initial dose of 5 mg daily), if well tolerated for at
30-49
least 7 days, may increase to 20 mg daily.
 Administration: May be taken with or without food
 Special Precaution:
o Patient w/ CV disease
o Epilepsy
o History of convulsions or those w/ predisposing factors for epilepsy
o Conditions that may increase urinary pH (e.g. drastic dietary changes)
o Moderate to severe renal and severe hepatic impairment
o Pregnancy and lactation.
 Adverse Drug Interaction:
o Headache, dizziness, constipation, HTN, somnolence, anxiety, confusion,
hallucinations, fatigue, abnormal gait, hypertonia, vomiting, fungal infections,
cystitis, thromboembolism, increased libido, psychotic reactions, pancreatitis;
agranulocytosis, leucopenia (including neutropenia), thrombocytopenia,
pancytopenia, thrombotic thrombocytopenic purpura, CHF, hepatitis, suicidal
ideation, acute renal failure (including increased creatinine and renal
impairment), Stevens-Johnson syndrome.
 Pregnancy Category: Category B: Either animal-reproduction studies have not
demonstrated a foetal risk but there are no controlled studies in pregnant women
or animal-reproduction studies have shown an adverse effect (other than a
decrease in fertility) that was not confirmed in controlled studies in women in the
1st trimester (and there is no evidence of a risk in later trimesters).
 Patient Counselling: May impair ability to drive or operate machinery.
 Monitoring Parameters: Monitor cognitive function; periodic ophtha examination.
 Overdosage: Symptoms: Agitation, asthenia, bradycardia, vomiting, dizziness,
vertigo, ECG changes, increased BP, visual hallucinations, confusion, lethargy,
restlessness, slowed movement, somnolence, stupor, unsteady gait, weakness, loss of
consciousness, psychosis, coma. Management: Symptomatic and supportive
treatment. May increase elimination by urinary acidification.
 Drug Interactions:
o Increased risk of adverse effects w/ amantadine, ketamine or
dextromethorphan. May decrease the effects of barbiturates and
neuroleptics. May increase the effects of L-dopa, dopaminergic agonists and
anticholinergics. May alter the effect of antispasmodics (e.g. dantrolene, or
baclofen). Decreased clearance w/ carbonic anhydrase inhibitors and Na
bicarbonate. May potentially increase plasma levels of cimetidine,
procainamide, ranitidine, quinidine, quinine, nicotine. May decrease serum
level of hydrochlorothiazide.
 Mechanism of Action
o Description: Memantine, a derivative of amantadine, is a noncompetitive N-
methyl-D-aspartate (NMDA)-receptor antagonist which binds preferentially to
NMDA-receptor-operated cation channels. It blocks the action of glutamate,
the principal excitatory neurotransmitter in the CNS. Glutamate may
contribute to the pathogenesis of Alzheimer's disease by overstimulating
various glutamate receptors resulting in excitotoxicity and neuronal cell death.
o Onset:
o Duration:
o Pharmacokinetics:
 Absorption: Well absorbed. Absolute bioavailability: Approx 100%. Time
to peak plasma concentration: Approx 3-8 hr.
 Distribution: Volume of distribution: 9-11 L/kg. Plasma protein binding:
Approx 45%.
 Metabolism: Undergoes partial hepatic metabolism to main metabolites
including N-3,5-dimethyl-gludantan and 1-nitroso-3,5-dimethyl-
adamantane.
 Excretion: Mainly via urine (approx 57-82% as unchanged drug). Terminal
half-life: 60-100 hr.
 Storage: Store between 20-25°C.
DRUGS FOR BLADDER AND PROSTATE DISORDERS
FINASTERIDE
 Classification: Other Dermatologicals / Drugs for bladder and Prostate Disorders  Storage: Store at 20-25°C. Protect from light.
 Indication: Benign Prostatic Hyperplasia / Male pattern baldness
 Dosage: COUGH AND COLD PREPARATION
o Adult : PO Initial: 5 mg once daily for the 1st wk, increased in wkly increments of AMBROXOL
5 mg. Max: 20 mg/day.  Classification: Cough and cold preparation / Mucolytics
o Oral: Benign Prostatic Hyperplasia  Indication: As a mucolytic
 Adult: 5 mg once daily for at least 6 mth.  Dosage:
o Oral: Male pattern Baldness o Oral: Adult : 60-120 mg daily, in 2-3 divided doses.
 Adult: 1 mg once daily for at least 3 mth. o Child: <2 yr: 7.5 mg bid; 2-5 yr: 7.5 mg bid/tid; 6-12 yr: 15 mg bid/tid.

 Administration: May be taken with or without food  Administration: Should be taken with food
 Contraindications: Women, children and adolescents. Pregnancy and lactation.
 Special Precaution:  Adverse Drug Interaction:
o Men at risk of obstructive uropathy o Mild GI effects and allergic reactions.
o Hepatic impairment.
 Adverse Drug Interaction:  Mechanism of Action
o Sexual dysfunction (e.g. decreased libido, erectile dysfunction, ejaculation o Description: Ambroxol is a metabolite of bromhexine and is used similarly as a
disorders including reduced vol of ejaculate) mucolytic.
o Gynaecomastia
o Testicular pain ANTIASTHMATIC AND COPD PREPARATIONS
o Hypersensitivity reactions (e.g. swelling of lips and face, pruritus, urticaria, SALBUTAMOL
rashes, angioedema)
 Classification: Drugs Acting on the Uterus / Antiasthmatic & COPD Preparations
o Decreased prostate-specific antigen (PSA) levels
o Belongs to the class of adrenergic inhalants, selective beta-2-adrenoreceptor
o Depression
agonists. Used in the treatment of obstructive airway diseases.
o Male breast cancer
o Belongs to the class of adrenergics for systemic use, selective beta-2-
o Orgasm disorders
adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
 Indication: Benign Prostatic Hyperplasia / Male pattern baldness
 Pregnancy Category: Category X: Studies in animals or human beings have
 Dosage Details:
demonstrated foetal abnormalities or there is evidence of foetal risk based on
o Inhalation/Respiratory:
human experience or both, and the risk of the use of the drug in pregnant women
a. For Severe bronchospasm
clearly outweighs any possible benefit. The drug is contraindicated in women who
 Adult: Via nebuliser: 2.5-5 mg, up to 4 times daily, alternatively, may
are or may become pregnant.
be given continuously at a rate of 1-2 mg/hr.
 Patient Counselling: Women who are or may become pregnant should avoid
 Child: ≥4 yr Same as adult dose.
contact w/ crushed or broken tablets.
b. For Acute bronchospasm
 Monitoring Parameters: Monitor prostate-specific antigen (PSA) levels.
 Adult: As metered-dose aerosol or dry powd inhaler (90 or 100
 Lab Interference: Monitor prostate-specific antigen (PSA) levels.
mcg/actuation): 1 or 2 inhalations up to 4 times daily. Max: 800 mcg
daily.
 Mechanism of Action
 Child: 6-12 yr 1 inhalation, may be increased to 2 inhalations as
o Description: Finasteride is a synthetic 4-azasteroid compound and a
necessary. Max: 400 mcg daily.
competitive inhibitor of both tissue and hepatic 5α-reductase. This results in
c. For Acute severe asthma
inhibition of the conversion of testosterone to dihydrotestosterone and
 Adult: As metered-dose inhaler (100 mcg/actuation) via spacer
markedly suppresses serum dihydrotestosterone (DHT) levels. In male pattern
device: Initially, 4 inhalations, then a further 2 inhalations every 2 min
baldness, finasteride decreases scalp DHT levels to levels found in hairy scalp.
according to response. Max: 10 inhalations.
Reduced serum DHT, increases hair regrowth and slows hair loss.
d. For Prophylaxis of exercise-induced bronchospasm
o Onset:
 Adult: As metered-dose aerosol or dry powd inhaler (90 or 100
o Duration:
mcg/actuation): 2 inhalations 10-15 min prior to exercise.
o Pharmacokinetics:
 Child: 6-12 yr 1 inhalation 10-15 min prior to exercise.
 Absorption: Absorbed from the GI tract. Bioavailability: Approx 80%. Time
o Intravenous
to peak plasma concentration: 1-2 hr.
a. For Uncomplicated premature labour
 Distribution: Crosses the blood-brain barrier and distributed into seminal
 Adult: For arrest of preterm labour between 22 and 37 wk of
fluid. Volume of distribution: 76 L. Plasma protein binding: Approx 90%.
gestation: Initially, 10 mcg/min, increasing gradually at 10-min
 Metabolism: Undergoes hepatic metabolism primarily by CYP3A4
intervals until there is response; increase infusion rate slowly thereafter
isoenzyme.
until contractions cease. Maintain rate for 1 hr after contractions
 Excretion: Via urine (39%) and faeces (57%) as metabolites. Terminal half-
have stopped, then gradually reduce rate by 50% at intervals of 6 hr.
life: Approx 6 hr.
 Usual dose: 10-45 mcg/min. Max duration: 48 hr. Doses are given
preferably w/ the aid of a syringe pump.
b. For Severe bronchospasm
 Adult: As 50 mcg/mL soln: 250 mcg (4 mcg/kg) injected slowly. May
be repeated if necessary. As 10 mcg/mL soln: Usual rate of 3-20
mcg/min (0.3-2 mL/min), adjusted according to patient needs. Higher
doses may be used in resp failure.
 Child: ≥12 yr Same as adult dose.
o Oral
a. For Acute bronchospasm
 Adult: 2-4 mg 3 or 4 times daily, up to 8 mg 3 or 4 times daily as
required in some patients. As modified-release tab: 8 mg bid.
 Child: 2-6 yr 1-2 mg; >6-12 yr 2 mg; >12 yr Same as adult dose. Doses
to be given 3 or 4 times daily.
 Elderly: 2 mg 3 or 4 times daily.
o Parenteral
a. For Severe bronchospasm
 Adult: IM/SC: 500 mcg (8 mcg/kg) and repeated 4 hrly as required.
 Child: ≥12 yr Same as adult dose.
 Administration: Should be taken on an empty stomach. Take 1 hr before or 2 hr
after meals.
 Reconstitution:
o Intravenous
 Bronchospasm: Dilute 5 mL of soln w/ 500 mL NaCl or dextrose inj or other
suitable diluents to provide a 10 mcg/mL soln
 Premature labour: Dilute 10 mL of soln w/ 40 mL of dextrose 5% to provide
a 200 mcg/mL soln for use in syringe pump, alternatively, dilute 10 mL of
soln w/ 490 mL of dextrose 5% for use in other infusion methods.
o Inhalation: Dilute 0.5 mL of soln to a total of 3 mL w/ NaCl 0.9% to prepare a 2.5
mg dose.
 Contraindications: IV (in the treatment of premature labour): Pre-existing or risk
factors for ischaemic heart disease, gestational age <22 wk, conditions in which
prolongation of pregnancy is hazardous (e.g. severe toxaemia, intrauterine
infection, vag bleeding resulting from placenta praevia, eclampsia or severe
preeclampsia, placental abruption, cord compression; use in threatened abortion.
 Special Precaution:
o Hyperthyroidism, myocardial insufficiency, arrhythmias, susceptibility to QT-
interval prolongation, HTN, DM, glaucoma, hypokalaemia, seizure disorder.
Renal impairment. Elderly. Pregnancy and lactation.
 Adverse Drug Interaction:
o Tremor, nervousness, nausea and vomiting, tachycardia, palpitations, chest
pain, shakiness, dizziness, headache, insomnia, inhalation site sensation,
hyperactivity, HTN, hypotension, increased sweating, allergic reactions, DM,
muscle cramps, flu-like syndrome, conjunctivitis, UTI, hypokalaemia,. Rarely,
erythema multiforme, Stevens-Johnson syndrome.
Potentially Fatal: Paradoxical bronchospasm.
 Pregnancy Category: Category C: Either studies in animals have revealed adverse
effects on the foetus (teratogenic or embryocidal or other) and there are no
controlled studies in women or studies in women and animals are not available.
Drugs should be given only if the potential benefit justifies the potential risk to the
foetus.
 Monitoring Parameters: Monitor BP, heart rate, electrolyte and fluid balance;
glucose, lactate and K levels
 Overdosage
o Symptoms: Tachycardia, CNS stimulation, tremor, hypokalaemia,
hyperglycaemia, lactic acidosis, nausea, vomiting. Management:
Symptomatic and supportive treatment. May administer activated charcoal.
β-blocking agents (e.g. metoprolol) may be given but w/ extreme caution in
asthmatic patients.
 Drug interactions
o Increased risk of hypokalaemia w/ K depleting agents (e.g. corticosteroid,
diuretics, xanthines, digoxin). Increased uterine inertia w/ halogenated
anaesth (IV). Increased risk of pulmonary oedema w/ corticosteroids. May
antagonise the effect of anti-diabetics. Effects may be altered by
guanethidine, reserpine, methyldopa, TCAs and MAOIs. Increased risk of CV
effects w/ other sympathomimetic agents. Antagonistic effect w/ β-blockers.
 Mechanism of Action
o Description: Salbutamol activates adenyl cyclase, the enzyme that stimulates
the production of cyclic adenosine-3', 5'-monophosphate (cAMP). Increased
cAMP leads to activation of protein kinase A, which inhibits phosphorylation of
myosin and lowers intracellular ionic Ca concentrations, resulting in smooth
muscle relaxation
o Onset: W/in 5 min (inhalation); w/in 30 min (oral).
o Duration: Approx 3-6 hr (inhalation); up to 6 hr (oral).
o Pharmacokinetics:
 Absorption: Readily absorbed from the GI tract.
 Distribution:
 Metabolism: Undergoes metabolism in the liver and in the gut wall.
 Excretion: Via urine (as metabolites and unchanged drug); faeces (small
amounts).
 Storage: Store between 15-30°C. Protect from light.
PENICILLINS
AMOXICILLIN
 Classification: Drugs Acting on the Uterus / Antiasthmatic & COPD Preparations
o Belongs to the class of adrenergic inhalants, selective beta-2-adrenoreceptor
agonists. Used in the treatment of obstructive airway diseases.
o Belongs to the class of adrenergics for systemic use, selective beta-2-
adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
 Indication: Benign Prostatic Hyperplasia / Male pattern baldness
 Dosage Details:
o Inhalation/Respiratory:
e. For Severe bronchospasm
 Adult: Via nebuliser: 2.5-5 mg, up to 4 times daily, alternatively, may
be given continuously at a rate of 1-2 mg/hr.
 Child: ≥4 yr Same as adult dose.
f. For Acute bronchospasm
 Adult: As metered-dose aerosol or dry powd inhaler (90 or 100
mcg/actuation): 1 or 2 inhalations up to 4 times daily. Max: 800 mcg
daily.
 Child: 6-12 yr 1 inhalation, may be increased to 2 inhalations as
necessary. Max: 400 mcg daily.
g. For Acute severe asthma
 Adult: As metered-dose inhaler (100 mcg/actuation) via spacer
device: Initially, 4 inhalations, then a further 2 inhalations every 2 min
according to response. Max: 10 inhalations.
 h. For Prophylaxis of exercise-induced bronchospasm
 Adult: As metered-dose aerosol or dry powd inhaler (90 or 100
mcg/actuation): 2 inhalations 10-15 min prior to exercise.
 Child: 6-12 yr 1 inhalation 10-15 min prior to exercise.
o Intravenous
c. For Uncomplicated premature labour
 Adult: For arrest of preterm labour between 22 and 37 wk of
gestation: Initially, 10 mcg/min, increasing gradually at 10-min
intervals until there is response; increase infusion rate slowly thereafter
until contractions cease. Maintain rate for 1 hr after contractions
have stopped, then gradually reduce rate by 50% at intervals of 6 hr.
Usual dose: 10-45 mcg/min. Max duration: 48 hr. Doses are given
preferably w/ the aid of a syringe pump.
d. For Severe bronchospasm
 Adult: As 50 mcg/mL soln: 250 mcg (4 mcg/kg) injected slowly. May
be repeated if necessary. As 10 mcg/mL soln: Usual rate of 3-20
mcg/min (0.3-2 mL/min), adjusted according to patient needs. Higher
doses may be used in resp failure.
 Child: ≥12 yr Same as adult dose.
o Oral
b. For Acute bronchospasm
 Adult: 2-4 mg 3 or 4 times daily, up to 8 mg 3 or 4 times daily as
required in some patients. As modified-release tab: 8 mg bid.
 Child: 2-6 yr 1-2 mg; >6-12 yr 2 mg; >12 yr Same as adult dose. Doses
to be given 3 or 4 times daily.
 Elderly: 2 mg 3 or 4 times daily.
o Parenteral
b. For Severe bronchospasm
 Adult: IM/SC: 500 mcg (8 mcg/kg) and repeated 4 hrly as required.
 Child: ≥12 yr Same as adult dose.
 Administration: Should be taken on an empty stomach. Take 1 hr before or 2 hr
after meals.
 Reconstitution:
o Intravenous
 Bronchospasm: Dilute 5 mL of soln w/ 500 mL NaCl or dextrose inj or other
suitable diluents to provide a 10 mcg/mL soln
 Premature labour: Dilute 10 mL of soln w/ 40 mL of dextrose 5% to provide
a 200 mcg/mL soln for use in syringe pump, alternatively, dilute 10 mL of
soln w/ 490 mL of dextrose 5% for use in other infusion methods.
o Inhalation: Dilute 0.5 mL of soln to a total of 3 mL w/ NaCl 0.9% to prepare a 2.5
mg dose.
 Contraindications: IV (in the treatment of premature labour): Pre-existing or risk
factors for ischaemic heart disease, gestational age <22 wk, conditions in which
prolongation of pregnancy is hazardous (e.g. severe toxaemia, intrauterine
infection, vag bleeding resulting from placenta praevia, eclampsia or severe
preeclampsia, placental abruption, cord compression; use in threatened abortion.
 Special Precaution:
o Hyperthyroidism, myocardial insufficiency, arrhythmias, susceptibility to QT-
interval prolongation, HTN, DM, glaucoma, hypokalaemia, seizure disorder.
Renal impairment. Elderly. Pregnancy and lactation.
 Adverse Drug Interaction:
o Tremor, nervousness, nausea and vomiting, tachycardia, palpitations, chest
pain, shakiness, dizziness, headache, insomnia, inhalation site sensation,
hyperactivity, HTN, hypotension, increased sweating, allergic reactions, DM,
muscle cramps, flu-like syndrome, conjunctivitis, UTI, hypokalaemia,. Rarely,
erythema multiforme, Stevens-Johnson syndrome.
Potentially Fatal: Paradoxical bronchospasm.
 Pregnancy Category: Category C: Either studies in animals have revealed adverse
effects on the foetus (teratogenic or embryocidal or other) and there are no
controlled studies in women or studies in women and animals are not available.
Drugs should be given only if the potential benefit justifies the potential risk to the
foetus.
 Monitoring Parameters: Monitor BP, heart rate, electrolyte and fluid balance;
glucose, lactate and K levels
 Overdosage
o Symptoms: Tachycardia, CNS stimulation, tremor, hypokalaemia,
hyperglycaemia, lactic acidosis, nausea, vomiting. Management:
Symptomatic and supportive treatment. May administer activated charcoal.
β-blocking agents (e.g. metoprolol) may be given but w/ extreme caution in
asthmatic patients.
 Drug interactions
o Increased risk of hypokalaemia w/ K depleting agents (e.g. corticosteroid,
diuretics, xanthines, digoxin). Increased uterine inertia w/ halogenated
anaesth (IV). Increased risk of pulmonary oedema w/ corticosteroids. May
antagonise the effect of anti-diabetics. Effects may be altered by
guanethidine, reserpine, methyldopa, TCAs and MAOIs. Increased risk of CV
effects w/ other sympathomimetic agents. Antagonistic effect w/ β-blockers.
 Mechanism of Action
o Description: Salbutamol activates adenyl cyclase, the enzyme that stimulates
the production of cyclic adenosine-3', 5'-monophosphate (cAMP). Increased
cAMP leads to activation of protein kinase A, which inhibits phosphorylation of
myosin and lowers intracellular ionic Ca concentrations, resulting in smooth
muscle relaxation
o Onset: W/in 5 min (inhalation); w/in 30 min (oral).
o Duration: Approx 3-6 hr (inhalation); up to 6 hr (oral).
o Pharmacokinetics:
 Absorption: Readily absorbed from the GI tract.
 Distribution:
 Metabolism: Undergoes metabolism in the liver and in the gut wall.
 Excretion: Via urine (as metabolites and unchanged drug); faeces (small
amounts).
Storage: Store between 15-30°C. Protect from light.
AMOXICILLIN
METFORMIN
DIPHENHYDRAMINE
PHENYLEPHRINE
CO AMOXICLAV
MONTELUKAST
AMLODIPINE
LOSARTAN
CEFUROXIME AXETIL
ALPRAZOLAM
DIAZEPAM
DESMOPRESSIN