Tioconazole: Uses,Dosage,Side Effects

Generic Name

Tioconazole
Therapeutic Class: used in Vaginal and Vulval condition, Topical Antifungal preparations

Indications:

Tioconazole is indicated for the local treatment of vulvovaginal candidiasis (moniliasis).

Presentation:
Tioconazole Ointment: Each gram ointment contains Tioconazole BP 65 mg.

Description:
Tioconazole is a topical antifungal agent. It is a broad-spectrum antifungal agent that inhibits the growth of human pathogenic yeasts. It exhibits fungicidal activity in-vitro against Candida albicans, other species of the genus Candida, and against Torulopsis glabrata.

Dosage & Administration:
Tioconazole has been found to be effective as a single dose treatment for vulvovaginal candidiasis. Insert one applicator-full (about 4.6 g) intravaginally. Administration of Tioconazole just prior to bedtime may be preferred.

Side Effects:
Burning and itching were the most frequent side effects occurring in approximately 6% and 5% of the patients respectively. There were occasional reports (less than 1%) of other side effects including irritation, discharge, vulvar edema and swelling, vaginal pain, dysuria, nocturia, dyspareunia, dryness of vaginal secretions, desquamation.

Precautions:
Tioconazole is intended for intravaginal administration only. Administration of Tioconazole just prior to bedtime may be preferred. The Tioconazole ointment base may interact with rubber or latex products such as condoms; therefore, use of such products within 72 hours following treatment is not recommended.

Use in Pregnancy & Lactation:
Pregnancy: Pregnancy category C. Tioconazole should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Lactation: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, nursing should be temporarily discontinued while Tioconazole is administered.

Storage:
Do not store above 30 O C. Keep away from light and out of the reach of children.

Timolol Maleate: Uses,Dosage,Side Effects

Generic Name

Timolol Maleate
Therapeutic Class: Ophthalmic

Indications:
Timolol Maleate Ophthalmic Solution is indicated in the treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma.

Presentation:
Timolol Maleate 0.5 Sterile Eye Drops: Each ml contains Timolol Maleate BP equivalent to Timolol 5 mg.

Description:
Timolol Maleate ophthalmic solution is a non-selective beta-adrenergic receptor blocking agent. Timolol Maleate Ophthalmic Solution, when applied topically on the eye, has the action of reducing elevated as well as normal intraocular pressure, whether or not accompanied by glaucoma. The precise mechanism of the ocular hypotensive action of Timolol Maleate is not clearly established at this time. Tonography and fluorophotometry studies in man suggest that its predominant action may be related to reduced aqueous humour formation. However, in some studies, a slight increase in outflow facility was also observed.

Dosage & Administration:
The usual starting dose is one drop of Timolol Maleate 0.5 in the affected eye(s) twice a day. Since in some patients the pressure-lowering response to Timolol Maleate may require a few weeks to stabilize, evaluation should include a determination of intraocular pressure after approximately 4 weeks of treatment with Timolol Maleate.
If the intraocular pressure is maintained at satisfactory levels, the dosage schedule may be changed to one drop once a day in the affected eye(s). Because of diurnal variations in intraocular pressure, satisfactory response to the once-a-day dose is best determined by measuring the intraocular pressure at different times during the day.
Dosages above one drop of Timolol Maleate 0.5 twice a day generally have not been shown to produce further reduction in intraocular pressure. If the patient's intraocular pressure is still not at a satisfactory level on this regimen, concomitant therapy with other agents (s) for lowering intraocular pressure can be instituted. The concomitant use of two topical beta-adrenergic blocking agents is not recommended.
Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
Geriatric Use: No overall differences in safety or effectiveness have been observed between elderly and younger patients.

Side Effects:
The most frequently reported adverse experiences have been burning and stinging upon instillation.
Less frequent adverse effects with ocular administration of Timolol Maleate formulations are nausea, diarrhea, dyspepsia, anorexia, dry mouth, headache, asthenia/fatigue, chest pain, bradycardia, arrhythmia, hypotension, palpitation, cold hands and feet, systemic lupus erythematosus, dizziness, paresthesia, somnolence, insomnia, nightmares, signs, and symptoms of systemic allergic reactions, bronchospasm (predominantly in patients with pre-existing bronchospastic disease).

Precautions:
As with many topically applied ophthalmic drugs, this drug is absorbed systemically. The same adverse reactions found with systemic administration of beta-adrenergic blocking agents may occur with topical administration. For example, severe respiratory reactions and cardiac reactions have been reported following systemic or ophthalmic administration of Timolol Maleate. Precautions should be exercised in patients with cardiac failure, cerebrovascular insufficiency, obstructive pulmonary disease, major surgery, diabetes mellitus, thyrotoxicosis, bacterial keratitis, angle-closure glaucoma, anaphylaxis, and muscle weakness.

Use in Pregnancy & Lactation:
Pregnancy: There are no adequate and well-controlled studies in pregnant women. Timolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Lactation: Timolol has been detected in breast milk following oral and ophthalmic drug administration. Because of the potential for serious adverse reactions from Timolol in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Interaction:
Although Timolol used alone has little or no effect on pupil size, mydriasis resulting from concomitant therapy with Timolol Maleate and epinephrine has been reported occasionally. Drug interactions of Timolol Maleate have been noticed with concomitant administration of beta-adrenergic blocking agents (both oral and topical), calcium antagonists, catecholamine-depleting drugs, digitalis, quinidine, clonidine, injectable epinephrine.

Overdose:
There have been reports of inadvertent overdosage with Timolol Ophthalmic Solution resulting in systemic effects similar to those seen with systemic beta-adrenergic blocking agents such as dizziness, headache, shortness of breath, bradycardia, bronchospasm, and cardiac arrest.

Storage:
Store between 15-30° C. Avoid freezing and protect from light.

Tigecycline: Uses,Dosage,Side Effects

Generic Name

Tigecycline
Therapeutic Class: Anti Bacteria

Indications:
Tigecycline is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions listed below:

Complicated Skin and Skin Structure Infections:
Complicated skin and skin structure infections caused by Escherichia coli, Enterococcus faecalis (vancomycin-susceptible isolates only), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus agalactiae, Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Streptococcus pyogenes, Enterobacter cloacae, Klebsiella pneumoniae and Bacteroides fragilis.

Complicated Intra-Abdominal Infections:
Complicated intra-abdominal infections caused by Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus faecalis (vancomycin-susceptible isolates only), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatus, Clostridium perfringens, and Peptostreptococcus micros.

Community-Acquired Bacterial Pneumonia:
Community-acquired bacterial pneumonia caused by Streptococcus pneumoniae (penicillin-susceptible isolates), including cases with concurrent bacteremia, Haemophilus influenzae (beta-lactamase negative isolates), and Legionella pneumophila.

Presentation:
Tigecycline: Each vial contains Tigecycline INN 50 mg as a lyophilized powder.

Description:
Tigecycline is a glycylcycline antibacterial agent for intravenous infusion. Tigecycline inhibits protein translation in bacteria by binding to the 30S ribosomal subunit and blocking the entry of amino-acyl tRNA molecules into the A site of the ribosome. This prevents the incorporation of amino acid residues into elongating peptide chains. To date, there has been no cross-resistance observed between Tigecycline and other antibacterials. Tigecycline is not affected by the two major Tetracycline-resistance mechanisms- ribosomal protection and efflux. Additionally, Tigecycline is not affected by resistance mechanisms such as beta-lactamases (including extended-spectrum beta-lactamases), target-site modifications, macrolide efflux pumps, or enzyme target changes (e.g. gyrase/topoisomerases).

Dosage & Administration:
The duration of therapy should be guided by the severity and site of the infection and the patient's clinical and bacteriological progress. The recommended duration of treatment with Tigecycline for complicated skin and skin structure infections or for complicated intra-abdominal infections is 5 to 14 days and for community-acquired bacterial pneumonia is 7 to 14 days. The recommended daily dose is as follows:

Adults: The recommended dosage regimen for Tigecycline is an initial dose of 100 mg, followed by 50 mg every 12 hours. Intravenous (IV) infusions of Tigecycline should be administered over approximately 30 to 60 minutes every 12 hours.
Pediatric use: Safety and effectiveness in pediatric patients below the age of 18 years have not been established.
Geriatric use: No unexpected overall differences in safety or effectiveness were observed between these subjects and younger subjects.

Method of reconstitution
Each vial of Tigecycline should be reconstituted with 5.3 ml of 0.9% Sodium Chloride Injection to achieve a concentration of 10 mg/ml of Tigecycline. The vial should be gently swirled until the drug dissolves. Withdraw 5 ml of the reconstituted solution from the vial and add to a 100 ml intravenous bag of 0.9% Sodium Chloride or 5% Dextrose for infusion (for a 100 mg dose, reconstitute two vials; for a 50 mg dose, reconstitute one vial). The maximum concentration of IV solution should be 1 mg/ml. If the same intravenous line is used for sequential infusion of several drugs, the line should be flushed before and after infusion of Tigecycline with either 0.9% Sodium Chloride Injection or 5% Dextrose Injection.
Compatible Infusion fluid
Tigecycline is compatible with the following IV fluid:
0.9% Sodium Chloride Injection
5% Dextrose Injection
Lactated Ringer’s Injection.

Side Effects:
The most common treatment-emergent adverse events are nausea and vomiting which generally occurre during the first 1-2 days of therapy. The following drug-related adverse events are reported infrequently in patients receiving Tigecycline:
Injection site inflammation & pain, septic shock, allergic reaction, chills, thrombophlebitis, bradycardia, tachycardia, vasodilatation, anorexia, dry mouth, hypoglycemia, hyponatremia, prolonged prothrombin time, eosinophilia, thrombocytopenia, vaginal moniliasis, vaginitis, leukorrhea.

Precautions:
Tigecycline is structurally similar to Tetracycline-class antibiotics and should be administered with caution in patients with known hypersensitivity to Tetracycline-class antibiotics.
Pharmaceutical precaution: Prior to reconstitution, Tigecycline should be stored at 20°C to 25°C. Once reconstituted, Tigecycline may be stored at room temperature for up to 24 hours (up to 6 hours in the vial and the remaining time in the intravenous bag). Reconstituted solution may be stored refrigerated at 2 °C to 8 °C for up to 48 hours following an immediate transfer of reconstituted solution into the intravenous bag.

Use in Pregnancy & Lactation:
Pregnancy: Tigecycline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Lactation: Caution should be exercised when Tigecycline is administered to a nursing woman.

Interaction:
Drug interaction of Tigecycline with Digoxin and Warfarin is observed.

Overdose:
No specific information is available on the treatment of overdosage with Tigecycline. Intravenous administration of Tigecycline at a single dose of 300 mg over 60 minutes in healthy volunteers resulted in an increased incidence of nausea and vomiting.

Storage:
Prior to reconstitution, Tigecycline should be stored at 20°C to 25°C. Once reconstituted, Tigecycline may be stored at room temperature for up to 24 hours (up to 6 hours in the vial and the remaining time in the intravenous bag). Reconstituted solution may be stored refrigerated at 2°C to 8°C for up to 48 hours following the immediate transfer of reconstituted solution into the intravenous bag.

Tiemonium Methylsulfate: Uses,Dosage,Side Effects

Generic Name

Tiemonium Methylsulfate
Therapeutic Class: Anti Spasmodic

Indications:
Tiemonium methyl sulphate is an antispasmodic drug. It reduces muscle spasms of the intestine, biliary system, bladder and uterus. Tiemonium methyl sulphates indicated for pain in gastrointestinal and biliary diseases and in urology and gynaecology such as gastroenteritis, diarrhoea, dysentery, biliary colic, enterocolitis, cholecystitis, colonopathies, mild cystitis and spasmodic dysmenorrhoea.

Presentation:
Tiemonium methyl sulphate tablet: Each film-coated tablet contains Tiemonium Methylsulfate INN 50 mg.
Tiemonium methyl sulphate IV/IM injection: Each 2ml contains Tiemonium Methylsulfate INN 5 mg.

Description:
Tiemonium Methylsulfate is a synthetic anticholinergic-antispasmodic drug.

Dosage & Administration:
Tablet: The usual dosages of Tiemonium methyl sulphate are 2 to 6 tablets (100-300 mg) daily in divided doses as required.
Injection: 1 ampoule by slow IV/IM injection 3 times daily.

Side Effects:
Tiemonium Methylsulfate INN may have some undesirable effects in certain individuals like the risk of hypotension and tachycardia especially in the case of injection.

Precautions:
Precautions should be exercised for the treatment of patients with disorders of the prostate, serious diseases of the kidney or liver, cardiac disorders, thyroid disorders, chronic bronchitis and certain gastrointestinal diseases. The risks of visual disturbances can make it dangerous to drive or use machines.

Use in Pregnancy & Lactation:
The use of this drug is not recommended during pregnancy & lactation unless otherwise indicated by a physician.

Overdose:
In the case of overdose, seek medical attention

Storage:
Store in a cool and dry place, protected from light.

Ticagrelor: Uses,Dosage,Side Effects

Generic Name

Ticagrelor
Therapeutic Class: Cardiovascular

Indications:
Acute Coronary Syndromes

Ticagrelor is a P2Y12 platelet inhibitor indicated to reduce the rate of thrombotic cardiovascular events in patients with the acute coronary syndrome (ACS) (unstable angina, non-ST elevation myocardial infarction, or ST-elevation myocardial infarction). Ticagrelor has been shown to reduce the rate of a combined endpoint of cardiovascular death, myocardial infarction, or stroke in ACS patients. In patients treated with percutaneous coronary intervention (PCI), it also reduces the rate of stent thrombosis.

Presentation:
Ticagrelor 90: Each tablet contains Ticagrelor INN 90 mg.

Description:
Ticagrelor, a cyclopentyl-triazolopyrimidine which is a reversible platelet aggregation inhibitor. Ticagrelor reversibly binds with the platelet P2Y12 adenosine diphosphate (ADP) receptor and thereby inhibits signal transduction and platelet aggregation.

Dosage & Administration:
Initiate Ticagrelor treatment with a 180 mg (two 90 mg tablets) loading dose and continue treatment with 90 mg twice daily. After the initial loading dose of aspirin (usually 325 mg), use Ticagrelor with a daily maintenance dose of aspirin of 75-100 mg.

Side Effects:
• Bleeding
• Dyspnea
• Other side effects (Headache, Back pain, Nausea, Dizziness, Cough, Hypotension, Fatigue, Atrial fibrillation)

Precautions:
• General Risk of Bleeding
Drugs that inhibit platelet function including Ticagrelor increase the risk of bleeding.
• Concomitant Aspirin Maintenance Dose
Use of Ticagrelor with maintenance doses of aspirin above 100 mg decreased the effectiveness of Ticagrelor. Therefore, after the initial loading dose of aspirin (usually 325 mg), use Ticagrelor with a maintenance dose of aspirin of 75-100 mg.
• Moderate Hepatic Impairment
Ticagrelor has not been studied in patients with moderate hepatic impairment.
• Discontinuation of Ticagrelor
Discontinuation of Ticagrelor will increase the risk of myocardial infarction, stent thrombosis, and death.

Use in Pregnancy & Lactation:
Pregnancy Category C, There are no adequate and well-controlled studies of Ticagrelor used in pregnant women. It is not known whether ticagrelor or its active metabolites are excreted in human milk.
Pediatric Use
The safety and effectiveness of Ticagrelor in pediatric patients have not been established.
Geriatric Use
No overall differences in safety or effectiveness were observed in patients of
Hepatic Impairment
Ticagrelor has not been studied in patients with moderate or severe hepatic impairment. Ticagrelor is metabolized by the liver and impaired hepatic function can increase risks for bleeding and other adverse events. Hence,
Renal Impairment
No dosage adjustment is needed in patients with renal impairment. Patients receiving dialysis have not been studied.

Interaction:
Avoid the use of strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, and telithromycin). Use of Ticagrelor with aspirin maintenance doses above 100 mg reduced the effectiveness of Ticagrelor. Ticagrelor will result in higher serum concentrations of simvastatin or rosuvastatin because these drugs are metabolized by CYP3A.

Overdose:
Other effects of an overdose may include gastrointestinal effects (e.g- nausea, diarrhea) or ventricular pauses. Proper management should be taken through ECG monitoring in severe bleeding.

Storage:
Protect from light & moisture. Store below 25° C. Keep out of reach of children

Coronavirus (COVID-19)

Overview:

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illnesses.

The best way to prevent and slow down transmission is to be well informed about the COVID-19 virus, the disease it causes, and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol-based rub frequently and not touching your face.

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).

Stay informed:

Protect yourself: advice for the public
Myth busters
Questions and answers
Situation reports
All information on the COVID-19 outbreak

Prevention:
To prevent infection and to slow transmission of COVID-19, do the following:

Wash your hands regularly with soap and water, or clean them with an alcohol-based hand rub.
Maintain at least 1 meter distance between you and people coughing or sneezing.
Avoid touching your face.
Cover your mouth and nose when coughing or sneezing.
Stay home if you feel unwell.
Refrain from smoking and other activities that weaken the lungs.
Practice physical distancing by avoiding unnecessary travel and staying away from large groups of people.

Symptoms:
COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.

Most common symptoms:

fever.
dry cough.
tiredness.

Less common symptoms:

aches and pains.
sore throat.
diarrhea.
conjunctivitis.
headache.
loss of taste or smell.
a rash on the skin, or discoloration of fingers or toes.

Serious symptoms:

difficulty breathing or shortness of breath.
chest pain or pressure.
loss of speech or movement.

Seek immediate medical attention if you have serious symptoms. Always call before visiting your doctor or health facility.

People with mild symptoms who are otherwise healthy should manage their symptoms at home.

On average it takes 5–6 days from when someone is infected with the virus for symptoms to show, however it can take up to 14 days.

COLLECTED BY: Go- WHO

Countries : All countries which are Members of the United Nations may become members of WHO by accepting its Constitution.

All countries that area unit Members of the world organization could become members of United Nations agency by acceptive its Constitution. different countries is also admitted as members once their application has been approved by a straightforward majority vote of the globe Health Assembly. Territories that don't seem to be liable for the conduct of their diplomacy is also admitted as Associate Members upon application created on their behalf by the Member or different authority liable for their diplomacy. Members of United Nations agency area unit sorted in step with regional distribution (194 Member States).

Eastern Mediterranean Region

Tioconazole: Uses,Dosage,Side Effects

Timolol Maleate: Uses,Dosage,Side Effects

Tigecycline: Uses,Dosage,Side Effects

Tiemonium Methylsulfate: Uses,Dosage,Side Effects

Ticagrelor: Uses,Dosage,Side Effects

Coronavirus (COVID-19)

Countries : All countries which are Members of the United Nations may become members of WHO by accepting its Constitution.

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