Sebel Bia FS dee oe ts monitonng th3 serunt tneopnyit ze the av tinyperuricemic action of @ uncosune action of probencid, mn denvat:.2s. ornmon adverse reactions are gastric ggastnc pain, nd tramor. These are 1. However, with high doses ventricular athe frst signs '0 appear, enhanced. The spleen contracts due (o simulation of its muscuias Capsule, thereby causing leukocytosis and increased red cell count. Pilocarping causes hypertension and tachycardia through @ and release of epinaphrine from the odrenal medulla, Pilocarpine evokes cortical arousa! rasponse in cats, and produces a variety of stimulant and depressant effects on theCNS, Pilocarpine's fatal dose in humans is unknown, but 100 my is regarded as a dangerous snount. The usual systemic adult dose of pilocarpine, eithar as tha hydrochioride or nitrate, is § mg and is y Or orally. sting, epig pain, b { bleeding and reactivation of peptic , festlessness, insomnia, twitching, sxcatability. tac*ycardia, hypotension, circulatory 5. extrasysioies and flushing. rdhematuna. pnea and inappropriate ADH syndrome. fwua, restlessness, mid excitemeni or are the early symptoms, which may ah as banitus of flashes of light are a and vonuting are frequently earty overdosage. iON and extreme thirst may de seen. Systemic effects have bean reported from tha excessive use of it ophthalmic p Thirty drops of 8 2% pilocarpine HCI solution instilled in 1 patent over a1 hout pariod during treatment of angle closure glaucoma caused symptoms interpreted as pilocarping toxicity: marked sweating, retching, salivation, end muscle tremors. These signs disappeared within 7 hours after reducing the pilocarpine dosage to 2 to 3 drops every 4 hours, insisad ol every 10 minutes as had been the regimen in the 2 hours leading up tothe episode. Tha insullation af 6 drops of 2% pilccarpine solution in tha eyés of asthmatic patients has been reporisd to produce increased bronchial resistance. For g ir tar tension in narrow angle and séconcary glaucoma, and in the contro! of intraocular tension pre and postoperatively. Also usetu! in facilitating recovery from Ss. f dloody, syrup fike “cott ttensoe spasm interrupted by clonic juickaned respiration, stupor and finally fers and respiratory collapse, leading to dow gross overdosages. ] 10° ang ug Pilocarpine, 2 5105 m9, has been administered Oraily to counteract some of the common adversa effects of ganglionic blocking agents such as xerostomia, conshpation and impaired vision. Contraindications: When pupillary constriction is undesirable, as in with acula Y disezse of the anterior senval oral overdose is ang nduce vomiting. Administer a catharuic d when a sustained release preparation senvatad charcoal, LOU Che Daye ais Mery es yl re we Since codeine crosses the placental barnes, its use in pregnancy 1s not recommended. AS codaine may inhibit peristalsis, patients with chronic constipation should be given Pi Only after weighing the Potential therapeutic benefit againa! the hazards involved. Coniains codeina—may be habit- forming. Dosages: Adults, Sor 10. mt every 4 hours as required. Supplied: Each 5 mL of syrup contains: white pine bark 365 mg, wild Cherry bark 365 mg, senguinaria 45 mg; balm gitead bud 22 mg, codeine phosphate 11 mg and Nlavored syrup bese q.s. Available in 500i bottles. PIPERAZINE Anthelmintic Pharmacology: The mode of action of the drug against Enterobius vermicularis (pinworm)i is notclear, Against Ascans appears to “aflect paralysis of the neuromuscular juncton within the worm. This -,curare like effect is very weak in mammalian muscles, but foundworms appear to be much more susceptible. Thus the “stunned” worm no longer can satistsctorily “bridge” iteelt across the intestinal lumen and is Carried away with the fecal stream to be Passed out in the siool. Since muscular activity of the worns is not stimulated, there is litte danger of blockage in the inlestinas or the bile duct, even in haavily infected patients. Piperazine attects all Stages of the parasite in the gui but appears to have little or no etect On ldrvagin the tissues. The presance of food in the intestine does not intertere with the etectiveness of piperazine, and purgation i is unnecessary. The drug has ignili effactonh , Whips segment of the eye, and g gO P g after lar cataract i synechiag may where eatr occur. sezure, establisn an airway. A hiv. diazepam, 10010300 ng/kg up to 10 nactain blood pressure and provide in airway and oxygenation. if a result of above recommendations to prevent on and ‘avage will have to be periormed and the Catharnc and charcoal will need @ bore gasine lavage tube. Connue to ard) adequate hydration while warting for in gen-~ral, the drug is metabolized sOwarrs U Consideration of dialyss ish the tablets. Adults: 225 (0 337.5 mg (1 tt. Dosage adjusiments snould be based ponse and/or serum theophylline levels, tablet per dose ai 3 or 4 day intervals. fy Consederably and the physician should pabent's dose accordingly. Admunster 2 opnyiline/24 hours. if of the lids of conjunctiva orcurs, discontinue use. When lopicaily applied at frequent intervais over a Felatvaly short time, the possibility of systemic toxicity mut be conswered. Adverse Ettects: Ciliary spasm is encountered win pilocarpina usage bul is not a contraindication to continued therapy unless the induced myopia is incapacilanng {0 the patient. Imation irom pilocarpine has and may require ion of therapy, depending | on the Ohysician’s judgment. True allergis reactions 3. but req tthe drugil they occur. Dossge: Topical (locat instil int 8ac). in primary acute angle closure glaucoma, inthalty, 1 or 2. drops of a 2% solution in atfacted eye every minute for 5 minutes. Than, 1 or 2 drops placed in atfected aye every 5 minutes for 25 minutes, followed by 1 or 2 drops 3 of 4 times hourly until angle opens. Thrse drops of a 1% solution should be placer ‘n unattected eye every 8 hours to avoed bilateral attach In primary open angle gleucoma, the drug should be given in lowest ettectwe concentration and Ao more frequently than necessary (0 VIN ii tension. Initalty, 1 oF 2 fwhne, fal faced, round tadlat eng 225 mg of aminophylline USF ‘equevalent “aophyliine) in a sustained release base. & iduct Recognition Section) athomimetic— Topical Miotic drops of a 1% of 2% solution in each eye very 6 to B hours. A 0.5% solution may be used if stronger concentrations ave not loleraied. Concentration and frequency of administraton may be increased later as needed; hows. r, concentrations above 4% are of litte benefit. Its ops dunng prolanged usa, Indications: Piperazine, os the acipate, citrate, gluconate, hyarate, phosphate and tartrate saits and as the chelated compound, piperazine eaoum wae is used to tena Oxyuriasis (pinworm } ans ). In the tr _ of oxyuriasis, the citrate, dinate, and phosphate have sen reported to be tha piperazine salts of choice. Piperazine citrate anc adipate hava been reported to give better resulls than the phospnate or tartrate salisin tra; yr" Cort sitleations: Impauted renal or hepatic function, corwulsne) . 3, OF a history of hyper fo Orit sails. Preceutiona: 8 of pip in children, Bvoid prolong axcass ofthat recommended. 1 Safety of this drug for use during pregnancy has not veer) 1a H CNS. significant gastromntestinal, or hypersensitrvity reactions occur, discontinue the drug. in patents with severe mainutrtion, or enema, 620°C19¢ appropriate Caution. Eremes or are not Pr treatment in excess of that recommended should be woiosd, Cure Must be established by determining tha adsance of ove by use ol the perianal swab. Adverse Effects: The following reactions have been reported with iperazine salts, usually due to excessive dosage: nausea, cramps, di CNS: headache, verhgo, atasia, “tramors, chorerform movement, » hyporetiaxia, paresthesia, blurred vision, tesponsiveness often can be restored by s g an anticnolinesterase drug for a short time. Betore surgery fee congenital glaucoma, initially, 1 of 2 Grops ol a 2% solution in attected eye every 6 hours, then every 10minutes for 30 y belore surgery. © 13 a direct acting y Rilary consinction, stimulates the cilary s80us humor outflow faciity. In association w taciiny, there 1s a decrease in intraoculzr t6rug useful in glaucoma. Pilocarpine aiso ia which is generally more pronounced in & Can be maintained on pilocarpne to Land prevent changes in the visual held. * Fesponse relgnon cehween the maximum Ne and the concentration ol pilocarpene up “WOON, however, little lurther cnange in tne lw pressure reduction 1s usually noted. The waver, maintained longer, with the greater Carpene HCI solubon in normal human eyes, frooms alter 6 (0 10 minutes, reaching 3 260 munutes and returning to hai! maomum ‘ura. The affect lasts about 6 hours. focarpine include marked diapnoress. At Ay Droduce hiceupoing, salvation, nausea, 1S Collapse. Salary, lacrimal, gastric, glands and mucous cells of the resowatory ythe drug § SmOOIN muscies of the intestinal tract, Ta counteract mydriasis and restore accommodative power alter usa ol cycloglegics. 1 of 2 drops of higher concentraons as neaded. Suppliers: A&H (duli); Alcon (Isopto Carpine hydrochionae); Allergan (P.V. Carpine nitrate}; Alza (OCUSERT Pilo- 20 and Pito~40): Coopervision (Miocarpine hydrochlonde); Nowa (Nova-Carpine): Senuth & Nephew (Minis). PINOCODEINE® @® Frosst Pinus Strobus Compound Expectorani—Antitussive tton and control cough Sputum which does in adults, to with i mucosa and Rot respond to products of lesser potency. Contraindlestons, Precautions and Aczerse Effacts: As for codeine phosphate, Before prescnbing medication to suppress or modtly Cough, 1 ts important {0 ascertain thst the undertying causes of the Cough is identihad, that modification of the cough does not increase the nsk of clinical or phy va, and that therapy for the onmary disease is provided. In young children the y cantreis jally to th action of narcotic cough suppreasants. Baneft to nsk ty. Bronetual Is ard Ad with a reduction in vital ~ Tone of Compe ww Sox Sal fatto should be carefully consxtered, especially in ctudren with amma ceuth ision, EEG abnor sanse of paralytic str detachment, mamory defect. Hypersensitevity: urticara, erythema multiforme, purpura, fever, arunvalgia. Dosage: Orally. The dosage of the SSits of piperazine is usually expresssd in terms of piperazine hydrate; 100 mg of piperazine hydrate is y 1 to 120mg of adipate, to 214 mg of peperazine caicrum edetaie, to 125 mg of piperazine trate, and to 104 mg of piperazine phosphate. Pinworms: Tha drug should be administered for 7 days: a second course after a7 day interval is rarely required. Up to 7 kg, 250mg daily. 710 14kg, S00mg duly. 16102049, 19 daily Over 28 kg, and aduits, 2 + g daily. Some tat piperazine adipats be utilized inal day tennant with dosage aa lows: Under 2 years, 0.6 Q 3 times 4 day; 210 5 years, 1.29 J bes a day; over & years and adults, 1.8.9 I hmes a day. Dosage is given over a penod of 12 hours and may ba rapaated in 2 weeks’ hme necessary. Roundworms: Administer the drug once duly for 2 consecutve Gays. Upto 14kg, 19.; 141023, 29; 2310 45kg, 3g: over 45k9, 3.59. Suppélers: ASH (Entacy!); 8.W. Lid. (Antepar—1953); Orug Trading. ... 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