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- Pharmacology For Reserpine + Dihydralazine sulphate + Hydrochlorothiazide
Reserpine + Dihydralazine sulphate + Hydrochlorothiazide Pharmacology
Reserpine + Dihydralazine sulphate + Hydrochlorothiazide
About Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AMechanism of Action of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/APharmacokinets of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AOnset of Action for Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/ADuration of Action for Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AHalf Life of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/ASide Effects of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AContra-indications of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/ASpecial Precautions while taking Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AInteractions for Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/ATypical Dosage for Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/ASchedule of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AStorage Requirements for Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AEffects of Missed Dosage of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AEffects of Overdose of Reserpine + Dihydralazine sulphate + HydrochlorothiazideN/AReserpine
About ReserpineCentral Monoamine-Depleting Agent, Rauwolfia Alkaloid, Antihypertensive , antipsychotic.Mechanism of Action of ReserpineThe drug exerts its action by causing depletion of Catecholamine and serotonin which leads to decrease in blood pressure & bradycardia. Reserpine acts at the intraneural granular membrane which stores monoamines like Adrenaline, nor adrenaline, Serotonin, & Dopamine and irreversibly inhibits the active amine transport & storage. The mono amines are gradually depleted and degraded by MAO. It also inhibits the release of renin.Hypotensive action is primarily due to depletion of nor adrenaline from peripheral neurons.Pharmacokinets of ReserpineAbsorption: well absorbed orally and parenterally, Distribution: Widely distributed preferably in to lipid rich tissues Metabolism: Metabolized inside the bodyOnset of Action for ReserpineFew daysDuration of Action for ReserpineN/AHalf Life of ReserpineN/ASide Effects of Reserpine1.Excessive salivation
2.Nasal congestion
3.Cutaneous vasodilatation
4.Increased gut motility
5.Increased acidity
6.A-V conduction blocks
7.Orthostatic hypotension
8.Mental depression
9.Exacerbate epilepsy
10.Weight gain
11.Electrolyte imbalance
12.Parkinsonism
13.Gynecomastia
14.Impotence
15.Hypotension
16.Purpura
17.Thrombocytopenia
Contra-indications of Reserpine1.Depression
2.In patients receiving electro convulsive therapy
3.Peptic ulcer
4.Ulcerative colitis
5.Parkinsonism
6.Pheochromocytoma
7.Thyrotoxicosis
Special Precautions while taking Reserpine1.Tachycardia
2.Myocardial infarction
3.Arrhythmia
4.Bradycardia
5.Cardiac failure
6.Renal impairment
7.Hepatic impairment
6.Epilepsy
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for ReserpineHypertensionInteractions for ReserpineAntihypertensives / Diuretics: Antihypertensive effects are enhanced.
Digitialis and Quinidine: May result in cardiac arrhythmias.
Ephedrine or Mephentermine: Hypertension may occur.
General anaesthesia: Hypotension and bradycardia may occur.
Levodopa: Signs and symptoms of Parkinsonism may be exacerbated.
MAOIs: Should be avoided since it may result in hypertension.
Sympathomimetics: Reserpine prolongs sympathomimetic response of direct acting and inhibits of indirect acting sympathomimetics.
TCAs: Results in a response refractory to TCA therapy. Also hypotension, flushing, diarrhoea and manic reactions may occur.
Lab tests: Increased serum prolactin levels, decreased urinary excretion of catecholamines, 17-ketosteroids, 17-hydroxycorticosteroids (17-OCHS) and vanillyl mandelic acid (VMA).Typical Dosage for Reserpine250 to 500mcg/day, gradually reduce to maintenance dose of 250mcg/day
Maximum dose: 1mg to 1.5 mg
Schedule of ReserpineHStorage Requirements for ReserpineStore in a well closed container and protect from light. Keep out of the reach of children.Effects of Missed Dosage of ReserpineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of ReserpineTreatment is supportive & symptomatic. Dihydralazine sulphate
About Dihydralazine sulphateA pyridazine antiadrenergic agent, Nonsympatholytic vasodilatory antihypertensives.Mechanism of Action of Dihydralazine sulphateDihydralazine is an antihypertensive and its actions are similar to Hydralazine.Hydralazine exerts its pharmacological actions by direct vasodilator action on arteriolar smooth muscles with little actions on venous capacitance vessels. It produces after load reduction by dilating resistance vessels which leads to decreasing aortic impedence.So that more blood is pumped even in weaker ventricular contractions. It decreases total peripheral resistance and there is greater decrease in diastolic pressure than systolic pressure. There is a decrease in intracellular Ca2+concentration but there is no reduction in renal blood flow.Pharmacokinets of Dihydralazine sulphateAbsorption: It is well absorbed orally, but bioavailability is low in fast acetylators.Distribution: Widely distributed in a highly plasma protein bound form.Metabolism: It is metabolized in liver,plasma and gastrointestinal mucosa. Excretion: Excreted mainly through urine and the rest of dose is excreted through bile and faeces.
Onset of Action for Dihydralazine sulphateN/ADuration of Action for Dihydralazine sulphateN/AHalf Life of Dihydralazine sulphateN/ASide Effects of Dihydralazine sulphate1. Tachycardia
2. Tachyphylaxis
3. Edema
4. Palpitation
5. Dizziness
6. Dryness of mouth
7. Nasal congestion
8. Headache
9. Palpitation
10. Weakness
11. Orthostatic hypotension
12. Angina
13. Anxiety
14. Sleep disturbances
15. Reversible lupus erythmatosis
16. Paraeshesia
17. Tremor
18. Muscle cramps
Contra-indications of Dihydralazine sulphate1. Hypersensitivity to the drug
2. Ischaemic heart disease
3. Coronary artery diseases
4. Valvular stenosis
5. Pericarditis
6. Aortic aneurism
Special Precautions while taking Dihydralazine sulphate1. Renal impairment
2. Hepatic impairment
3. Cardiovascular disorders
4. Cerebro vascular disorders
5. Use with caution along with other antihypertensive drugs
6. Slowly withdraw the drug with caution
Pregnancy Related InformationUse with cautionOld Age Related InformationContraindicatedBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Dihydralazine sulphate1. Hypertension
2. Congestive heart failure
Interactions for Dihydralazine sulphateN/ATypical Dosage for Dihydralazine sulphateAs directed by the physicianSchedule of Dihydralazine sulphateHStorage Requirements for Dihydralazine sulphateStore at controlled room temperature at a temperature range of 15 to 30 degree C in a light resistant tightly closed container.Effects of Missed Dosage of Dihydralazine sulphateTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.Effects of Overdose of Dihydralazine sulphateTreatment is supportive and symptomatic. After ingestion empty the stomach by induced emesis and gastric lavage. Administer activated charcoal to reduce absorption. Hydrochlorothiazide
About HydrochlorothiazideThiazide derivatibve, Diuretic.Mechanism of Action of HydrochlorothiazideIt is thiazide diuretic which exerts its action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It has additional carbonic anhydrase inhibitory actions in proximal tubules. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.
Vertigo: Diuretics are used in vertigo in assumption that vertigo is due to endolymphatic hydrops. They reduce labyrinthine fluid pressure
Pharmacokinets of HydrochlorothiazideAbsorption: It is absorbed after oral administration.
Metabolism: It is not metabolized in the body.
Excretion: Excreted unchanged in urine.
Onset of Action for Hydrochlorothiazide1 to 3 hoursDuration of Action for Hydrochlorothiazide12 to 16 hoursHalf Life of Hydrochlorothiazide5 to 15 hoursSide Effects of Hydrochlorothiazide1. Dizziness
2. Blurred vision
3. Confusion
4. Tingling fingers
5. Dry mouth
6. Nausea
7. Diarrhoea
8. Constipation
9. Vomiting
10. Weakness
11. Hypokalaemia
12. Hyponatraemia
13. Hyperuricaemia
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
16. Polyuria
17. Electrolyte imbalance
18. Jaundice
19. Rashes
20. Photosensitivity
21. Fever
22. Itching
23. Myalgia
24. Muscle cramps
25. Arthralgia
26. Blood dyscrasias
27. Ototoxicity
Contra-indications of Hydrochlorothiazide1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
5. Anuria
6. Hypersensitivity to the drug
7. Hyper sensitivity to sulfonamides
8. Fluid and electrolyte imbalance
Special Precautions while taking Hydrochlorothiazide1. Gout
2. Diabetes mellitus
3. Renal impairment
4. Hepatic impairment
5. Monitor and correct Fluid and electrolyte imbalance
6. Hyper parathyroidism
7. Cirrhosis
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationMay be usedIndications for Hydrochlorothiazide1. Hypertension
2. Oedema associated with heart failure
3. Oedema due to renal and hepatic diseases
4. Diabetes insipidus
5. Idiopathic hypercalciurea.
6. Vertigo
Interactions for HydrochlorothiazideCholestyramine & Colestipol: decrease absorption of hydrochlorothiazide.
Diazoxide: Additive action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretics induced hypokalaemia may precipitate digitalis toxicity.
Lithium: Hydrochlorothiazide potentiates therapeutic and toxic effects by increasing its renal excretion.
Frusemide: Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants: Diuretics induced hypokalaemia enhances efficacy.
Sulfonylureas: Efficacy decreased due to hydrochlorothiazide induced glucose intolerance.
Chlorpropamide: Hypokalaemia.
Propantheline: Bioavailability of hydrochlorothiazide increased.
Metoclopramide: Bioavailability of hydrochlorothiazide decreased.
NSAIDs: Natriuretic effect of hydrochlorothiazide decreased.
Typical Dosage for HydrochlorothiazideAdults:
Hypertension: 25mg once daily or in divided doses. Increased to 50mg if required; depending up on the patient`s response.
Children: 1mg/kg single daily dose.
Oedema:
Adults:
Starts with 25 to 50mg. Increased the dose until desired response is obtained.
Maximum dose: 200mg/day
Maintenance dosage: 25 to 100mg daily or on alternate days.
Children: 1mg/kg single daily dose or 1 to 3mg/kg/day in two divided doses
Schedule of HydrochlorothiazideGStorage Requirements for HydrochlorothiazideStore at room temperature in a well closed container and protected from light.Effects of Missed Dosage of HydrochlorothiazideTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.Effects of Overdose of HydrochlorothiazideTreatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.Home Delivery for Reserpine + Dihydralazine sulphate + Hydrochlorothiazide in Your City
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