Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine Pharmacology

Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine

About Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Mechanism of Action of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Pharmacokinets of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Onset of Action for Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Duration of Action for Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Half Life of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Side Effects of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Contra-indications of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Special Precautions while taking Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Interactions for Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Typical Dosage for Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Schedule of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Storage Requirements for Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Effects of Missed Dosage of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Effects of Overdose of Sodium citrate + Ammonium chloride + Pseudoephedrine + Diphenhydramine
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Sodium citrate

About Sodium citrate
Sodium compound,citrates, Urinary alkalinizing agent, a directly acing expectorant.
Mechanism of Action of Sodium citrate
Sodium citrate is an alkalinizing agent which is used to make the urine more alkaline (less acidic).It prevents certain kinds of kidney stones and also relieve discomfort in mild urinary tract infections such as cystitis. Sodium citrate also makes the blood more alkaline in certain conditions. Sodium citrate is a directly acing expectorant which increases bronchial secretion by salt action.
Pharmacokinets of Sodium citrate
Absorption: Administered orally, Metabolism: Metabolized in to sodium bicarbonate, Excretion: Excreted through urine.
Onset of Action for Sodium citrate
N/A
Duration of Action for Sodium citrate
N/A
Half Life of Sodium citrate
N/A
Side Effects of Sodium citrate
1. Polyuria
2. Hypernatremia
3. Metabolic alkalosis
4. Diarrhea
5. Loose bowel movements
6. Allergic reactions (rare)
7. Chest pain (rare)
8. Shortness of breath (rare)
Contra-indications of Sodium citrate
Hypersensitivity to the drug
Special Precautions while taking Sodium citrate
1. Renal impairment
2. Edema
3. Hypertension
4. Patients on a sodium restricted diet
5. Along with other medication
6. Addison`s disease
7. Type 2 diabetes mellitus
8. Chronic Diarrhea
9. Cardiac diseases
10. Toxemia of pregnancy
11. Urinary tract infections
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Sodium citrate
1. Expectorant
2. Kidney stones
3. Cystitis
4. Gout
5. Urine and blood alkaliniser
6. Symptomatic treatment of nausea and vomiting
Interactions for Sodium citrate
N/A
Typical Dosage for Sodium citrate
Oral:
Expectorant: 0.3 to 1g
As alkaliniser: Dosage individualized and varies in different combinations Symptomatic treatment of nausea and vomiting: Use 5%Sodium citrate in the following doses:
Adults: 2 to3 g; 3 to 4 times daily.
Children (up to 3 months): 0.05 g;
Children (3 to 6 months): 0.1 g;
Children (6 to 12 months): 0.25 g;
Children (2 to 3 years): 0.30 g;
Children (4 to 7 years): 0.50 g;
Children (8 to 14 years): 1 to 2 g; 3 to 4 times daily
Schedule of Sodium citrate
N/A
Storage Requirements for Sodium citrate
Store in a cool dry area in a tightly closed container. Protect from direct light, heat, and moisture
Effects of Missed Dosage of Sodium citrate
Take 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 Sodium citrate
Provide symptomatic treatment and supportive measures.

Ammonium chloride

About Ammonium chloride
Ammonium compound, Acidifier,Expectorant.
Mechanism of Action of Ammonium chloride
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Pharmacokinets of Ammonium chloride
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Onset of Action for Ammonium chloride
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Duration of Action for Ammonium chloride
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Half Life of Ammonium chloride
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Side Effects of Ammonium chloride
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Contra-indications of Ammonium chloride
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Special Precautions while taking Ammonium chloride
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Ammonium chloride
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Interactions for Ammonium chloride
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Typical Dosage for Ammonium chloride
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Schedule of Ammonium chloride
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Storage Requirements for Ammonium chloride
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Effects of Missed Dosage of Ammonium chloride
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Effects of Overdose of Ammonium chloride
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Pseudoephedrine

About Pseudoephedrine
Alpha/Beta Adrenergic Agonist, a phenethylamine derivative, A nasal decongestant.
Mechanism of Action of Pseudoephedrine
It is a nasal decongestant with alpha-2 agonistic action. It produces local vasoconstriction, reduces blood flow, and causes shrinkage of mucosa which provides relief of nasal congestion. It reduces oedema of the nasal mucosa, thus improving ventilation, drainage and nasal stuffiness.
Pharmacokinets of Pseudoephedrine
Absorption: Well absorbed orally, Distribution: Widely distributed throughout the body, Metabolism: Partially metabolized in liver by N-demethylation, Excretion: Excreted through urine mainly as unchanged drug and also as metabolites.
Onset of Action for Pseudoephedrine
30 minutes
Duration of Action for Pseudoephedrine
4 to 8 hours
Half Life of Pseudoephedrine
N/A
Side Effects of Pseudoephedrine
1. Rise in blood pressure
2. Tachycardia
3. Arrhythmias
4. CNS stimulation
5. Restlessness
6. Insomnia
7. Anxiety
8. Tremors
9. Skin rashes
10. Urinary retention
11. Respiratory difficulties
Contra-indications of Pseudoephedrine
1. Hypersensitivity to the drug
2. Severe hypertension
3. Coronary artery disease
4. Patients taking monoamine oxidase inhibitors (MAOIs) or who have taken MAOIs within the previous 14 days
5. Extended release preparations are contraindicated in children below 12 years
Special Precautions while taking Pseudoephedrine
1. Hypertension
2. Cardiac diseases
3. Diabetes
4. Glaucoma
5. Prostatic hyperplasia
6. Hyperthyroidism

Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Pseudoephedrine
1. Nasal and Eustachian tube congestion
2.Upper respiratory tract congestion
3.Adjunctive therapy in symptomatic relief of common cold, allergic rhinitis, blocked Eustachian tube, and upper respiratory tract infections
Interactions for Pseudoephedrine
N/A
Typical Dosage for Pseudoephedrine
Oral:
Adults and children over 12 years: 60mg 3 to 4 times daily
Maximum dose: 240mg/day
Children (age 6 to 12): 30mg 3 to 4 times daily
Maximum dose: 120mg/day
Children (age 2 to 6): 15mg 3 to 4 times daily
Maximum dose: 60mg/day or 4mg/kg.

Schedule of Pseudoephedrine
N/A
Storage Requirements for Pseudoephedrine
Store at controlled room temperature at a range of 15 to 30 degree C. Keep out of reach of children
Effects of Missed Dosage of Pseudoephedrine
Take the missed dose as soon as noticed and if it is the time for next dose
Effects of Overdose of Pseudoephedrine
Continue the regular schedule. Do not double the dose.
Over dosage and poisoning: Provide symptomatic treatment and supportive measures. Perform emesis and gastric lavage within 4 hours of ingestion. If renal function is adequate forced diuresis will increase elimination of the drug. (Do not force diuresis in severe poisoning). Monitor and assist vital signs, cardiac state and electrolyte balance. Treat cardiac toxicity with Propranolol or other effective drugs. Treat seizures with Diazepam (I.V.) and give dilute Potassium chloride solution for hypokalaemia.

Diphenhydramine

About Diphenhydramine
First Generation H1 Antagonist ,Ethanolamine derivative, Antihistamine, antiemetic, antivertigo,sedative, and hypnotic.
Mechanism of Action of Diphenhydramine
Antiallergic action: It produces its antihistamine action by competitively blocking H1 receptors. It binds to the H1 receptors present in the smooth muscles of the gastrointestinal tract, bronchi, large blood vessels and uterus and inhibit Histamine induced allergic symptoms. They do not inhibit the release of Histamine.
Antivertigo and antiemetic actions: Central antimuscarinic actions of antihistamines are responsible for these effects of Diphenhydramine.
Parkinsonism: Acetyl choline receptor antagonists are used for the treatment of Parkinsonism. Diphenhydramine reduces the unbalanced cholinergic activity in striatum of parkinsonian patients.
Antitussive action: Diphenhydramine suppresses the cough reflex by a direct effect on the cough centre.
Migraine: Diphenhydramine is used in migraine due to its sedative as well as antiemetic actions.
Pharmacokinets of Diphenhydramine
Absorption: It is well absorbed after oral administration. Distribution: Diphenhydramine is widely distributed in the body including CNS in protein bound form. Metabolism: It is extensively metabolised in the liver. Excretion: Excreted primarily in urine
Onset of Action for Diphenhydramine
15 minutes
Duration of Action for Diphenhydramine
6 - 8 hours
Half Life of Diphenhydramine
2.5 - 9 hours
Side Effects of Diphenhydramine
1.Headache
2.Dry mouth
3.Rash
4.Thrombocytopenia
5.Anaemia
6.Anorexia
7.Insomnia
8.Confusion
9.Dizziness
10.Fatigue
11.Nausea
12.Abdominal pain
13.Urine retention
14.Thickening of bronchial secretions.
Contra-indications of Diphenhydramine
1.Hypersensitivity to Diphenhydramine
2.Porphyria.
Special Precautions while taking Diphenhydramine
1.Hypertension
2.Asthma
3.Hyperthyroidism
4.Angle closure glaucoma
5.Prostatic hyperplasia
6.Urinary tract obstruction
7.Use with caution while operating machine, driving vehicle or activities requiring mental alertness
Pregnancy Related Information
Use with caution.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Contraindicated.
Children Related Information
Use with caution
NEONATES: contraindicated
Indications for Diphenhydramine
1.Parkinson`s disease
2.Motion sickness
3.Rhinitis
4.Allergy disorders
5.Insomnia
6.Productive cough
7.Vertigo
8.Migraine
Interactions for Diphenhydramine
Incompatibility reported with amphotericin, cephalothine sodium, hydrocortisone, sodium succinate, some soluble barbiturates, some contrast media.
Typical Dosage for Diphenhydramine
Adult: 25 - 50 mg 3 - 4 times daily. Dosage should be individualised according to the needs and the response of the patient
Nonproductive cough: 100 mg / day in 4-6 times daily.
Insomnia: 50 mg at bed time
Children above 12 years: 25 - 50 mg 3 - 4 times daily. Dosage should be individualised according to the needs and the response of the patient
Nonproductive cough: 100 mg / day in 4-6 divided dose
Insomnia: 50 mg at bed time
Children age 2 -12 years: 12.5 - 25 mg 3 - 4 times daily. Dosage should be individualised according to the needs and the response of the patient.
Maximum dose: 300mg / day
Nonproductive cough: 6.25 - 12.5 mg in 4-6 times daily. Dosage should be individualised according to the needs and the response of the patient
Schedule of Diphenhydramine
G
Storage Requirements for Diphenhydramine
Store at 15 - 30 degree C. Protect from heat, light and moisture. Keep out of the reach of children.
Effects of Missed Dosage of Diphenhydramine
Take 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 Diphenhydramine
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal. Hypotension can be counteracted by administration of vasopressors and seizure with Phenytoin or Diazepam.

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