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- Pharmacology For Moxonidine + Hydrochlorothiazide
Moxonidine + Hydrochlorothiazide Pharmacology
Moxonidine + HydrochlorothiazideAbout Moxonidine + HydrochlorothiazideN/AMechanism of Action of Moxonidine + HydrochlorothiazideN/APharmacokinets of Moxonidine + HydrochlorothiazideN/AOnset of Action for Moxonidine + HydrochlorothiazideN/ADuration of Action for Moxonidine + HydrochlorothiazideN/AHalf Life of Moxonidine + HydrochlorothiazideN/ASide Effects of Moxonidine + HydrochlorothiazideN/AContra-indications of Moxonidine + HydrochlorothiazideN/ASpecial Precautions while taking Moxonidine + HydrochlorothiazideN/APregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for Moxonidine + HydrochlorothiazideHypertensionInteractions for Moxonidine + HydrochlorothiazideN/ATypical Dosage for Moxonidine + HydrochlorothiazideN/ASchedule of Moxonidine + HydrochlorothiazideN/AStorage Requirements for Moxonidine + HydrochlorothiazideN/AEffects of Missed Dosage of Moxonidine + HydrochlorothiazideN/AEffects of Overdose of Moxonidine + HydrochlorothiazideN/A
MoxonidineAbout MoxonidineCentrally-acting antihypertensive.Mechanism of Action of MoxonidineMoxonidine is a centrally-acting antihypertensive. It acts in the brainstem through stimulation of central imidazoline receptors to reduce sympathetic tone. Moxonidine also has a low affinity for ?2-adrenoceptors.Pharmacokinets of MoxonidineAbsorption: Absorbed rapidly from the GI tract
Distribution: Plasma protein binding around 7%; present in breast milk
Excretion: Excreted in the urine (78% as unchanged drug)
Onset of Action for MoxonidineN/ADuration of Action for MoxonidineN/AHalf Life of MoxonidineN/ASide Effects of Moxonidine1.Dry mouth
16.Impotence and loss of libido
17.Urinary retention or incontinence
18.Slight orthostastic hypotension
Contra-indications of Moxonidine1.Conduction disorders
4.Severe heart failure
5.Severe ischaemic heart disease
6.History of angioedema
7.Severe liver or renal impairment
Special Precautions while taking Moxonidine1.Renal impairment
2.Avoid abrupt withdrawal (if concomitant treatment with ?-blocker has to be stopped, discontinue ?-blocker first, then moxonidine after few days)
Pregnancy Related InformationContraindicatedOld Age Related InformationN/ABreast Feeding Related InformationContraindicatedChildren Related InformationContra indicatedaged under 18 years.Indications for MoxonidineHypertensionInteractions for Moxonidine1.Additive effects with other antihypertensives
2.May increase sedative effects of benzodiazepines
3.Effects may be antagonised by TCAS
Typical Dosage for MoxonidineHypertension:Oral:Adult: 200 mcg once daily, increase if necessary after 3 wk to 400 mcg daily as single or in 2 divided doses. If necessary, after a further 3 wk, increase to 600 mcg daily in 2 divided doses. Max: 600 mcg daily.Schedule of MoxonidineN/AStorage Requirements for MoxonidineDo not store above 25?C. Effects of Missed Dosage of MoxonidineIf you miss a dose ignore it and take the next dose at the normal time. Do not take two doses together to make up for the one you have missed. Effects of Overdose of Moxonidine1.Taking too much moxonidine may cause the following: sedation (confusion and sleepiness), low or high blood pressure, dizziness, fainting, sickness, dry mouth, slowing of heart rate, shortness of breath, narrowing of the pupil of the eye (miosis) and coma.
2.People who have taken too much moxonidine should call a doctor or go to the nearest hospital casualty department immediately.
HydrochlorothiazideAbout 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
4. Tingling fingers
5. Dry mouth
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
17. Electrolyte imbalance
24. Muscle cramps
26. Blood dyscrasias
Contra-indications of Hydrochlorothiazide1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
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
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.
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.
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.
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.
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