Pulmonology Case No 3. Asthma With Hypertension.

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Pulmonology Case No 3. Asthma With Hypertension.

Asthma এর Management দিবো আর Hypertension এর ক্ষেত্রে আমরা____

Avoid Beta Blocker…তবে Cardioselective Beta blockr দেয়া যেতে পারে….

Drug of choice হবে – Calcium Channel Blocker (CCB) or ARBS (Losartan,Valsartan)…..

ACE ইনহিবিটর Avoid করাই ভালো ,কারন এইটা Dry cough করে

Tablet 1.Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

Indications of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

Hypertension: Angilock tablet is indicated for the treatment of hypertension. It may be used alone or in combination with other antihypertensive agents (eg. thiazide diuretics).

Renal Protection in Type-2 Diabetic Patients with Proteinuria: Angilock tablet is indicated to delay the progression of renal disease in hypertensive type-2 diabetics with proteinuria, defined as urinary albumin to creatinine ratio >300 mg/g.

Pharmacology of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

Losartan Potassium is the first non-peptide orally active angiotensin II receptor blocker. It binds to the AT1 receptor found in many tissues (e.g. vascular smooth muscle, adrenal gland, kidneys and the heart) and reduces several important biological actions including vasoconstriction and the release of aldosterone responsible for hypertension.

Dosage & Administration of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

The usual starting and maintenance dose is 50 mg once daily for most patients. If the antihypertensive effect using 50 mg once daily is inadequate, 25 mg twice daily is recommended prior to increasing the dose. For patients with intravascular volume-depletion (e.g., those treated with high-dose diuretics), a starting dose of 25 mg once daily should be considered. Losartan Potassium can be administered once or twice daily. The total daily dose ranges from 25 mg to 100 mg.

Patients upto 75 years: No initial dosage adjustment is necessary for this group of patients.

Patients over 75 years: Presently there is limited clinical experience in this group; a lower starting dose of 25 mg once daily is recommended.

Interaction of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

Rifampicin and fluconazole reduce levels of active metabolite of Angilock. Concomitant use of Angilock and hydrochlorothiazide may lead to potentiation of the antihypertensive effects. Concomitant use of potassium-sparing diuretics (eg, spironolactone, triamterene, amiloride), potassium supplements or salt substitutes containing potassium may lead to increases in serum potassium. The antihypertensive effect of losartan may be attenuated by the non-steroidal anti-inflammatory drug indomethacin. The use of ACE-inhibitor, angiotensin receptor antagonist, an anti-inflammatory drug and a thiazide diuretic at the same time increases the risk of renal impairment.

Contraindications of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

Losartan Potassium is contraindicated in pregnant women and in patients who are hypersensitive to any component of this product. Losartan Potassium should not be administered with Aliskiren in patients with diabetes.

Side Effects of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

The side effects with the use of Angilock are mild and transient in nature. The most common side effects are dizziness, diarrhea, nasal congestion, cough, upper respiratory infection. Other side effects are fatigue, oedema, abdominal pain, chest pain, nausea, headache & pharyngitis.

Pregnancy & Lactation of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

Pregnancy Category D. The risk to the fetus increases if Losartan Potassium is administered during the second or third trimesters of pregnancy. It is not known whether Losartan Potassium is excreted in human milk, as many drugs are excreted in human milk and because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Therapeutic Class of Tablet:-Angilock 100 mg (AS A Losartan Potassium AS A Angiotensin-ll receptor blocker).

Angiotensin-ll receptor blocker

Valsartan

Tablet 2: Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Indications of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Disys is indicated:

For hypertension
To reduce hospitalizations in patients with congestive heart failure
To reduce death in patients who developed congestive heart failure after myocardial infarction

Pharmacology of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Valsartan is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARBs). It is orally active and specific angiotensin II antagonist acting on the AT1 subtype. Angiotensin’s attachment to the receptors cause the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure (hypertension). Valsartan blocks the angiotensin II receptor. By blocking the action of angiotensin, Valsartan dilates blood vessels and reduces blood pressure without affecting pulse rate. Valsartan has much greater affinity (about 20,000-fold) for the AT1 receptor than for the AT2 receptor. It does not bind or block other hormone receptors or ion channels known to be important in cardiovascular regulation.

Dosage of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Hypertension: The usual dose of Valsartan is 80 to 160 mg once daily. The maximum dose is 320 mg daily. Maximum blood pressure reduction occurs within 4 weeks.

Heart failure: The usual dose is 40 mg twice daily and may be increased to 80-160 mg twice daily.

Post-Myocardial Infarction: The initial dose after myocardial infarction is 20 mg twice daily. The dose should be increased with a target of 160 mg daily if tolerated without side effects.

Administration of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Administration of Valsartan with food decreases the absorption of Valsartan by about 40%, so it should be taken on an empty stomach. No initial dosage adjustment is required for elderly patients with mild to moderate renal and hepatic insufficiency.

Interaction of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

No drug interactions of clinical significance have been found. Compounds which have been studied in clinical trials include Cimetidine, Warfarin, Furosemide, Digoxin, Atenolol, Indomethacin, Hydrochlorothiazide, Amlodipine and Glibenclamide

As Disys is not metabolized to a significant extent, clinically relevant drug-drug interactions in the form of metabolic induction or inhibition of the cytochrome P450 system are not expected with Disys. Although Disys is highly bound to plasma proteins, in vitrostudies have not shown any interaction at this level with a range of molecules which are also highly protein bound, such as Diclofenac, Furosemide, and Warfarin. Concomitant use of potassium sparing diuretics (e.g., Spironolactone, Triamterene, Amiloride) potassium supplements, or salt substitutes containing potassium may lead to increase in serum potassium. If co medication is considered necessary, caution is advisable

Contraindications

Valsartan is contraindicated in patients who are hypersensitive to any component of this product.

Side Effects of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Disys is generally well tolerated and side effects are rare. The most common side effects include headache, dizziness, fatigue, abdominal pain, cough, diarrhea and nausea. Patient may also experience hyperkalemia, impotency, reduced renal function, allergic reactions, dyspnea, constipation, back pain, muscle cramps, rash, anxiety, insomnia and vertigo. Hypotension may also occur if patient have been taking diuretics along with Disys.

Pregnancy & Lactation of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Pregnancy: Valsartan should not be used in pregnancy, as in 2nd and 3rd trimester it can cause injury and even death to fetus. When pregnancy is detected, Valsartan should be stopped as soon as possible.

Nursing mothers: It is not known whether Valsartan is excreted in human milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Precautions & Warnings of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Impaired Hepatic Function: As the majority of Disys is eliminated in the bile, care should be exercised in patients with mild to moderate hepatic impairment including biliary obstructive disorder.

Impaired Renal Function: Dosage reduction or discontinuation may be required with patients having pre-existing renal impairment.

Heart Failure and Myocardial Infarction: Caution should be exercised when initiating therapy in patients with heart failure and post-myocardial infarction patients.

Use in Special Populations

Pediatric use: Safety and effectiveness in paediatric patients have not been established.

Geriatric use: No overall difference in the efficacy or safety of Disys was observed in this patient population, but greater sensitivity of some elderly persons cannot be ruled out.

Hepatic Impairment:

Mild to moderate: Max: 80 mg once daily.
Severe: Contraindicated.

Overdose Effects of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Limited data are available related to overdosage in humans. The most likely manifestations of overdosage would be hypotension and tachycardia, bradycardia could occur from parasympathetic (vagal) stimulation. If excessive hypotension occurs, the patient should be placed in the supine position and if necessary, has to be given an intravenous infusion of normal saline.

Therapeutic Class of Tablet : Disys 160 mg (AS A Valsartan AS A Angiotensin-ll receptor blocker).

Angiotensin-ll receptor blocker

_____________________

𝘼𝙨𝙩𝙝𝙢𝙖 𝙬𝙞𝙩𝙝 𝙄𝙃𝘿

Antianginal-Nitrates, CCB(Verapamil & Diltiazem) হচ্ছে ড্রাগ অফ চয়েজ…..

𝐂𝐥𝐨𝐩𝐢𝐝𝐨𝐠𝐫𝐞𝐥 প্রেফার করা হয় Aspirin থেকে — Coz Aspirin- Asthma কে Aggravate করতে পারে!!

Tablet 3.Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Indications of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Acute Coronary Syndrome (ACS): Anclog tablet is indicated to reduce the rate of myocardial infarction (MI) and stroke in patients with non-ST-segment elevation ACS [unstable angina (UA)/non-ST-elevation myocardial infarction (NSTEMI)]. It is indicated to reduce the rate of myocardial infarction and stroke in patients with acute ST-elevation myocardial infarction (STEMI).

Recent MI, recent Stroke, or established Peripheral Arterial Disease: In patients with established peripheral arterial disease or with a history of recent myocardial infarction (MI) or recent stroke Anclog tablet is indicated to reduce the rate of MI and stroke.

Pharmacology of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Clopidogrel is a prodrug. It inhibits platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. Dose-dependent inhibition of platelet aggregation can be seen 2 hours after single oral doses. Repeated doses of 75 mg per day inhibit ADP-induced platelet aggregation on the first day, and inhibition reaches steady state between Day 3 and Day 7.

Dosage & Administration of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Acute Coronary Syndrome: In patients who need an antiplatelet effect within hours, initiate clopidogrel with a single 300 mg (4 tablets) oral loading dose and then continue at 75 mg once daily. Initiating it without a loading dose will delay establishment of an antiplatelet effect by several days.

Recent MI, Recent Stroke, or Established Peripheral Arterial Disease: 75 mg once daily orally without a loading dose.

It is given orally with or without food.

Interaction of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

NSAIDs, warfarin, selective serotonin and serotonin norepinephrine reuptake inhibitors (SSRIs, SNRIs): Increases risk of bleeding
CYP2C19 inhibitors (omeprazole or esomeprazole): Avoid concomitant use of omeprazole or esomeprazole
Repaglinide (CYP2C8 substrates): Avoid concomitant use of Anclog with Repaglinide as it increases plasma concentrations of Repaglinide

Contraindications of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Clopidogrel is contraindicated in the following conditions: Hypersensitivity to the drug substance or any component of the product. Active pathological bleeding such as peptic ulcer or intracranial hemorrhage.

Side Effects of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Anclog is generally well tolerated drug.

Common side effects: Bleeding, Diarrhoea, gastrointestinal discomfort, haemorrhage, Skin reactions.
Rare side effects: Acquired haemophilia, anaemia, angioedema, arthralgia, arthritis, bone marrow disorders.

Pregnancy & Lactation of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

There are no adequate and well-controlled studies in pregnant women. It should be used during pregnancy only if clearly needed. It is unknown whether clopidogrel is excreted in human breast milk. 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.

Precautions & Warnings

As it is a prodrug, so metabolism to its active metabolite is impaired by genetic variations in CYP2C19 (poor metabolizer) and by the drugs that inhibit CYP2C19 such as Omeprazole and Esomeprazole. Concomitant use with these drugs and in CYP2C19 poor metaboliser may reduce the antiplatelet activity of Anclog.
As it inhibits platelet aggregation for the lifetime of the platelet (7-10 days), risk of bleeding may increase. To restore hemostasis, platelet transfusions within 4 hours of the loading dose or 2 hours of the maintenance dose may be less effective.
Discontinuation of Anclog increases the risk of cardiovascular events. Discontinue 5 days prior to elective surgery that has a major risk of bleeding. Resume Anclog as soon as hemostasis is achieved.
Thrombotic Thrombocytopenic Purpura (TTP) has been reported that requires urgent treatment including plasmapheresis (plasma exchange).
Hypersensitivity including rash, angioedema or hematologic reaction has been reported in patients receiving clopidogrel or history of hypersensitivity to other thienopyridines.

Use in Special Populations

Safety and effectiveness in pediatric populations have not been established. No dosage adjustment is necessary in elderly patients.

Overdose Effects of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Overdose following clopidogrel administration may lead to bleeding complications. Based on biological plausibility, platelet transfusion may restore clotting ability.

Therapeutic Class of Tablet:-Anclog 75mg (AS A Clopidogrel Bisulphate AS A Anti-platelet drugs).

Anti-platelet drugs

Beta blockr হিসেবে use এর ক্ষেত্রে Cardioselective Beta blockr (Metoprolol) দেয়া যেতে পারে…

Asthma Control এ Rakhbe.

Tablet 4.Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

Indications of Tablet:-Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

ln the management of hypertension and angina pectoris. Cardiac arrhythmias, especially supraventricular tachyarrhythmias. Adjunct to the treatment of hyperthyroidism. Early intervention with Betaloc-XR in acute myocardial infarction reduces infarct size and the incidence of ventricular fibrillation. Pain relief may also decrease the need for opiate analgesics. Betaloc-XR has been shown to reduce mortality when administered to patients with acute myocardial infarction.

Pharmacology of Tablet:-Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

Metoprolol is a selective beta1-blocker. Metoprolol reduces or inhibits the agonistic effect on the heart of catecholamines (which are released during physical and mental stress). This means that the usual increase in heart rate, cardiac output, cardiac contractility and blood pressure, produced by the acute increase in catecholamines, is reduced by Metoprolol. Metoprolol interferes less with Insulin release and carbohydrate metabolism than do non-selective beta-blockers. Metoprolol interferes much less with the cardiovascular response to hypoglycaemia than do non-selective beta-blockers.

Dosage & Administration of Tablet:-Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

Film-coated tablet–

Hypertension: Total daily dosage Metoprolol 100-400 mg to be given as a single or twice-daily dose. The starting dose is 100 mg (two Metoprolol-50 tablets) per day. This may be increased by 100 mg per day at weekly intervals. lf full control is not achieved using a single daily dose, a b.i.d. regimen should be initiated. Combination therapy with a diuretic or other antihypertensive agents may also be considered.
Angina: Usually Metoprolol 50 mg (one Metoprolol-50 tablet) to 100 mg (two Metoprolol-50 tablets) twice or three times daily.
Cardiac arrhythmias: Metoprolol 50 mg (one Metoprolol-50 tablet) b.i.d or t.i.d should usually control the condition. It is necessary the dose can be increased up to 300 mg per day in divided doses. Following the treatment of an acute arrhythmia with Metoprolol injection, continuation therapy with Metoprolol tablets should be initiated 4-6 hours later. The initial oral dose should not exceed 50 mg t.i.d.
Hyperthyroidism: Metoprolol 50 mg (one Metoprolol-50 tablet) four times a day. The dose should be reduced as the euthyroid state is achieved.
Myocardial infarction: Orally, therapy should commence 15 minutes after the last injection with 50 mg every 6 hours for 48 hours. Patients who fail to tolerate the full intravenous dose should be given half the suggested oral dose. Maintenance- The usual maintenance dose is 200 mg daily given in divided doses. Elderly’ There are no special dosage requirements in otherwise healthy elderly patients. Significant hepatic dysfunction: A reduction in dosage may be necessary.

Extended-release tablet-

Hypertension: The usual initial dosage is 25 to 100 mg daily in a single dose, whether used alone or added to a diuretic.
Angina Pectoris: The dosage of extended-release Metoprolol Succinate should be individualized. The usual initial dosage is 100 mg daily, in a single dose.
Heart Failure: The recommended starting dose of sustained-release Metoprolol Succinate is 25 mg once daily for two weeks in patients with NYHA class II heart failure and 12.5 mg once daily in patients with more severe heart failure. The dosage may be increased at weekly (or longer) intervals until optimum blood pressure reduction is achieved. If treatment is to be discontinued, the dosage should be reduced gradually over a period of 1-2 weeks.

IV Injection-

Arrhythmias: By intravenous injection, up to 5 mg at a rate of 1-2 mg/minute, repeated after 5 minutes if necessary, total dose 10-15 mg.
In surgery: By slow intravenous injection 2-4 mg at induction or to control arrhythmias developing during anaesthesia; 2 mg doses may be repeated to a maximum of 10 mg.
Myocardial Infarction: Early intervention within 12 hours of infarction, by intravenous injection 5 mg every 2 minutes to a maximum of 15 mg, followed after 15 minutes by 50 mg by mouth every 6 hours for 48 hours; maintenance 200 mg daily in divided doses.

Interaction of Tablet:-Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

Catecholamine‐depleting drugs (e.g. Reserpine, Monoamine Oxidase (MAO) inhibitors) may have an additive effect when given with beta‐blocking agents. Drugs that inhibit CYP2D6 such as quinidine, fluoxetine, paroxetine and propafenone are likely to increase Betaloc-XR concentration. These increases in plasma concentration would decrease the cardioselectivity of Betaloc-XR. Concomitant use of digitalis glycosides and beta‐blockers can increase the risk of bradycardia. Beta‐blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine.

Contraindications of Tablet:-Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

AV block, Uncontrolled heart failure, severe bradycardia, sick-sinus syndrome, cardiogenic shock and severe peripheral arterial disease. Known hypersensitivity to Metoprolol or other B-blockers. Metoprolol is also contra-indicated when myocardial infarction is complicated by significant bradycardia, first-degree heart block, systolic hypotension (<100mmHg) and/or severe heart failure.

Side Effects of Tablet:-Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

Tiredness, dizziness, depression, diarrhea, itching or rash, shortness of breath, slow heart rate, mental confusion, headache, somnolence, nightmares, insomnia, dyspnea, Nausea, dry mouth, gastric pain, constipation, flatulence, digestive tract disorders, heartburn, pruritus, musculoskeletal pain, blurred vision, decreased libido, and tinnitus have also been reported, intensification of AV block.

Pregnancy & Lactation of Tablet:-Betaloc XR 50mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

Pregnancy Category C. There are no adequate and well‐controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Metoprolol is excreted in breast milk in very small quantities. Caution should be exercised when Metoprolol is administered to a nursing woman.

If Necessery Can be used

Capsule 4.Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Indications of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Doxicap is indicated in the following infections caused by susceptible microorganisms:

Respiratory tract infections: Pneumonia, influenza, sinusitis, bronchitis, tonsillitis, tracheitis.
Gastrointestinal tract infections: Cholera, traveler’s diarrhea, shigella dysentery, acute intestinal amebiasis.
Chlamydial infections: Lympho-granuloma venereum, psittacosis, trachoma.
Sexually transmitted diseases: Non gonococcal urethritis, acute pelvic inflammatory disease, uncomplicated urethral and endocervical or rectal infections, gonorrhoea, syphilis, pyelonephritis, cystitis.
Other infections: Impetigo, furunculosis, inclusion conjunctivitis, brucellosis, tularemia, cellulitis, acne and Q-fever.

Description of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Doxicap is a highly active broad-spectrum antibiotic of tetracycline group. It is effective against a wide range of Gram-positive and Gram-negative bacteria, spirochete, mycoplasma, rickettsia and mycobacteria. Doxicap is used as an alternate to penicillin in the treatment of gonorrhoea and syphilis. Doxicap has its main mechanism of action on protein synthesis. Inside the bacterial cell, it inhibits protein synthesis.
Pharmacology
Doxycycline Hydrochloride is a semisynthetic tetracycline antibiotic with broad spectrum activity. It is primarily a bacteriostatic antibiotic. It has a similar spectrum of activity to other tetracyclines but in particular is more active against Staphylococcus aureus and Nocardia. The drug is often active against penicillin-resistant strains of Staphylococcus aureus and against strains of those organisms that are resistant to other Tetracyclines. Certain Gram-negative strains of E. coli, Proteus mirabilis and Klebsiella, which are often resistant to Tetracycline, may be sensitive to Doxycycline. In addition, 70-90% of the various anaerobes are sensitive to Doxycycline and Bacteroides fragilis is more likely to be sensitive to Doxycycline than to other tetracyclines.

Doxycycline is active against most strains of Haemophilus influenzaeand is particularly useful for infections with H. ducreyi, Actinomyces, Brucella and Vibrio cholerae. It is also active against Nocardia, Chlamydia, Mycoplasma and a wide range of Rickettsiae. Doxycycline is active against spirochetes such as Borellia recurrentis, Treponema pallidum and Treponema pertenue. It is also active against Plasmodium falciparum.

Dosage of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Usual dose: 200 mg on first day, then 100 mg daily for 7-10 days.
Severe infections (including refractory urinary tract infections): 200 mg daily for 10 days.
Acne: 100 mg daily.
Uncomplicated genital chlamydia, non-gonococcal urethritis: 100 mg twice daily for 7-21 days (14-21 days in pelvic inflammatory disease).
Administration
Capsules should be swallowed whole with plenty of fluid during meals while sitting or standing.

Interaction of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Absorption of tetracyclines is impaired by antacid containing aluminium, calcium or magnesium, and iron containing preparation. Absorption of tetracyclines is also impaired by bismuth salicylate. Barbiturates, carbamazepine and phenytoin decrease half-life of doxycycline. Concurrent use of tetracyclines may render oral contraceptive less effective. Patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosages. It is advisable to avoid giving tetracyclines in conjunction with penicillin.

Contraindications of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Doxycycline is contraindicated to the patients who have shown hypersensitivity to any of the tetracyclines. Doxycycline is contraindicated to the children under 8 years of age. It is also contraindicated to pregnant women and to the lactating mothers.

Side Effects of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Nausea, vomiting, diarrhoea, skin rashes, hemolytic anaemia, eosinophilia may be reported.

Pregnancy & Lactation of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Doxycycline should be avoided in pregnant women, because of the risk of both staining and effect on bone growth in the foetus. Doxycyclines enter breast milk, and mothers taking these drugs should not breastfeed their child.

Precautions & Warnings of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

The use of drugs of the tetracycline class during tooth development (last half of pregnancy, infancy and childhood to the age of 8 years) may cause permanent discoloration of teeth. Tetracyclines drugs, therefore should not be used in this age group.

Therapeutic Class of Capsule:-Doxicap 100 mg (AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs)

Tetracycline group of drugs

In short-

ড্রাগ shuld b avoid In Pt of Asthma ___

•NSAID

•Beta blkr

•Cholinergic agent

Raiyyan Tahsan Date:24-01-2025 Friday Time:4-45-55

Raiyyan Tahsan

Raiyyan Tahsan