Senario-1___আপনার কাছে একজন রোগী আসলো ,তার সমস্যা হলো,রোগীর ভাষ্যমতে__Sir ২/৩ দিন হয়ে গেছে আমার বাথরুম হয় না।আগে এমন হয়নি ,,খুব কম।সার আমারে মেডিসিন দেন। কি করবো,কি করলে আমার বাথরুম হবে!!
Senario-2_আরেক জন রুগি আসলো,তার সমস্যা ইদানীং প্রায়ই তার Constipation হচ্ছে,রেগুলার,,আপ্নি তাকে কি দিবেন?
কখন Suppository আর কখন Oral ( Avolac) mostly prescribed দিবেন!!_______________
Other 2ndary Cause exclude করে
সিনারিও_1 এর ক্ষেত্রে আমরা Suppository Glysup দিতে পারি
আর সিনারিও_2 এর জন্য যেহেতু রেগুলার সমস্যার কথা বলে হয়েছে, তাই সিরাপ Avolac দিতে পারি।
কেনো Glysup একজন কে,,আর অন্য জনকে Avolac??
আমাদের বাসায় বেসিনের পাইপের কথাই ধরা যাক,, পানির পাইপে ময়লা আটকে গেলে, আমরা কি করি? যেই দিকে আটকে গেছে,ওইদিকে খুচা দেই,,
ঠিক তেমনি Senario _1 এর ক্ষেত্রেও same অবস্থা এইখানেও External stimulus দিলেই হবে মানে খুচা দিলেই হবে!__ তাই আমরা stimulus হিসেবে Suppository Glysup দিতে পারি। কারন এইখানে Faecal Impaction হয়েছে তাই Suppository ( আরোও সহজে Acute case বা Suden ব্লক এ আমরা Suppository দিলেই পারি)______
Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
Indications of Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
Glysup suppository is used for the relief of occasional constipation.
Pharmacology of Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
Glycerin is a hyperosmotic laxative, given rectally, which usually produces a bowel movement within 15 minutes to 1 hour. Hyperosmotic laxatives encourage bowel movements by drawing water into the bowel from surrounding tissues. This produces a softer stool mass and increases bowel action. These products are used for fast, predictable relief of occasional constipation.
Dosage & Administration of Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
Children under 2 years: As directed by the physician.
Children (2 to 6 years): Only 1 Glycerin 1.15 Suppository per day or as directed by the physician.
Adults and Children (From 6 years): Only 1 Glycerin 2.30 Suppository per day or as directed by the physician
Insert suppository well up into the rectum. Suppository does not need to melt completely to produce laxative action.
Contraindications of Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
Sensitivity to the ingredients. Do not use unless the patient to be treated is, in fact, constipated.
Side Effects of Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
When Glysup used rectally may cause rectal discomfort or a burning sensation.
Pregnancy & Lactation of Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
Pregnancy category C. There are no controlled data in human pregnancy.
Therapeutic Class of Suppository 1.Glysup 4mg (AS A Glycerin AS A Osmotic purgatives).
Osmotic purgatives
আর সিনারিও ২ এ পেশেন্ট রেগুলার অথাৎ মাঝে মাঝেই তার Constipation হয় বাথরুম আটকে যায়,___আর আমাদের পানির লাইনে এরকম বার বার আটকে গেলে , অনেক অনেক সময় পানি ঢালি, অথবা খুচা দিয়ে পরেও পানি ঢালি!
তাই রেগুলার বেসিস এ আমরা Avolac syrup দিলাম_যেহেতু অনেকটা ক্রনিক কেস!________
তাহলে কি হলো,Acute case এ suppository!
Regular constipation বা লং-টার্ম সমস্যা সমাধানের জন্য Oral Avolac
আবার আমরা শুরুতে Suppository দিয়ে পরে Oral continue করবে এভাবেও বলতে পারি!
Syrup 2.Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
Indications of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Avolac is only to be taken when these measures prove insufficient.
Intestinal flora disturbances:
- In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
- Gall bladder diseases
- Intestinal diseases (Colitis, Diverticulosis, Megacolon)
Increased blood ammonia levels (hyper ammoniemia in hepatopathy, portal-systemic encephalopathy)
Description of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
Avolac is a hyperosmolar laxative which is used as an effective treatment approach for constipation. It is a non-absorbable disaccharide which draws water into the bowel; causes distention through fluid accumulation, thus promotes soft stool and accelerates bowel motion.
Pharmacology of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.
Dosage & Administration of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
In constipation ( chronic constipation):
- Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
- Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
- Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
In damaged intestinal flora:
- Adults: 1-2 tea-spoons daily
- Children: 1 tea-spoon daily
For reduction of blood ammonia level:
- Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily.
- In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
Interaction of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
There is no significant drug interactions with Avolac. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
Contraindications of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
Side Effects of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
Pregnancy & Lactation of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
Therapeutic Class of Syrup .Avolac Oral soluation 3.35gm/5ml (AS A Lactulose AS A Osmotic purgatives).
Osmotic purgatives
Advice_
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ধন্যবাদ Raiyyan Tahsan Date:21-01-2025 Tuesday Time:-3-04-45 PM
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