tag:blogger.com,1999:blog-70297556245267959432024-03-05T17:44:40.466-08:00Health is wealth unlimitedHealth is wealth is About your health and medicinal uses.Unknownnoreply@blogger.comBlogger28125tag:blogger.com,1999:blog-7029755624526795943.post-62473934419860280412014-08-23T00:58:00.001-07:002014-08-23T00:58:20.456-07:00INSULIN AND ITS DOSAGE FORMS<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="MsoNormal">
<b><span style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">INSULIN AND
ITS DOSAGE FORMS<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></b></div>
<div class="MsoNormal">
1-Rate of insulin infusion:<br />
i-If blood glucose level is less than 4mmol/lit. than give 0.5 units of insulin
per hour.<br />
ii-If blood glucose level is less than 4-15mmol/lit. than give 2 units per
hour.<br />
iii- If blood glucose level is less than 15-20mmol/lit. than give 4 units per
hour<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://encrypted-tbn2.gstatic.com/images?q=tbn:ANd9GcRkYpmsxr29nQ4Bb_DPTa-KC8rCattIRj5_C9TZ73M8DW8sG1vhdTHUy3c" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://encrypted-tbn2.gstatic.com/images?q=tbn:ANd9GcRkYpmsxr29nQ4Bb_DPTa-KC8rCattIRj5_C9TZ73M8DW8sG1vhdTHUy3c" /></a></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
2-TYPES OF INSULINS</div>
<div class="MsoNormal">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">All insulin is not the same. Insulin actually
comes in several forms. Each of these forms are designed to work at different
rate. The following are seven of the common forms of insulin that are commonly
administered to a diabetic:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1. Lispro<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Lispro is a very rapid acting form of insulin. Within five
minutes of administering Lispro blood glucose levels begin to drop. It remains
active in lowering blood glucose levels for about 2.5 hours, though it is most
effective when it has been in the blood about 1 hour. Because it does not
remain active very long, Lispro has less chance of inducing a hypoglycemic
reaction several hours later.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2. Normal insulin<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Normal insulin starts working in about thirty minutes. It works
most effectively after it has been in the body for about three hours, but it
can continue working in the bloodstream for nearly seven hours.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">3. NPH<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">This form of insulin has been designed to mimic the insulin
produced inside the human body. It lowers blood glucose levels at a more
consistent rate. It reaches its peak when it has been in the bloodstream about
2 hours, but remains at peak for up to 12 hours. It continues working for about
24 hours total, though not as vigorously in the last 10 hours<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">4. Lente<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Lente is another insulin that is designed to work like the
insulin that naturally occurs inside the human body. It works over long periods
of time, but takes about two hours to reach its peak effectiveness in lowering
blood sugar. It will continue at its peak for about half of the day and then
function more moderately the second half of the day.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">5. Ultralente<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Ultralente was designed with the idea of providing a once per
day insulin option. It takes nearly six hours after taking Ultralente before it
starts lowering blood glucose levels. However, it continues functioning
effectively all day long.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">6. Glargine<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Glargine is a popular insulin that is used mainly with type 1
diabetes. This is a long acting form of insulin that is injected just once per
twenty four hours. Great care must be taken not to contaminate this insulin
with the other forms of insulin by using the same syringe or storage equipment.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">7. Pre-Mixed Insulin<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Pre-mixed insulins are popular because they help take patient
dosage and administration errors out of the diabetic treatment equation. e.g
HUMULIN 70/30</span></div>
<a name='more'></a><o:p></o:p><br />
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<b><span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Dosage
forms of insulin<o:p></o:p></span></b></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">1-Standard mode of therapy:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Standard mode of insulin therapy is subcutaneous injection using
conventional disposable needle and syringes.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">2-Portable pen injection:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">To facilitate subcutaneous injection of insulin, particularly
during intensive insulin therapy. portable pen sized injections have been
developed.It inject measureable quantity of insulin.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">3-Disposable insulin pens:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">disposable insulin pens are also available for selected
formulations e.g regular insulin ,insulin lispro, insulin aspart, insulin
glulisine, glargine etc<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">4-Continuous insulin infusion devices(insulin pumps):<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">These are external open loop pumps for insulin delivery. it has
user programmable pump that delivers individualized basal and bolas insulin
replacement doses based on blood glucose self monitoring results. these are
implanted subcutaneously always.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">5-Buccal dosage forms :<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">As insulin is degraded in acidic pH. buccal
film of insulin may be very useful for the treatment of diabetes more
efficiently. the release mechanism is diffusion controlled and rate of
diffusion was by first order kinetics. a significant reduction of blood sugar
was observed at 2 hr<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">6-Inhalation:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">A new ultra rapid acting mealtime insulin that is orally inhaled
for absorption via the lung ,that closely mimics the normal early insulin
response seen in healthy individuals. a thumb size device is used and patient
inhales a small amount of the powder, this drug is rapidly absorbed ultra rapid
so it become effective much more quickly than an injection of same drug(matches
the body’s natural responses in processes like secretion).</span> <v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f">
<v:stroke joinstyle="miter">
<v:formulas>
<v:f eqn="if lineDrawn pixelLineWidth 0">
<v:f eqn="sum @0 1 0">
<v:f eqn="sum 0 0 @1">
<v:f eqn="prod @2 1 2">
<v:f eqn="prod @3 21600 pixelWidth">
<v:f eqn="prod @3 21600 pixelHeight">
<v:f eqn="sum @0 0 1">
<v:f eqn="prod @6 1 2">
<v:f eqn="prod @7 21600 pixelWidth">
<v:f eqn="sum @8 21600 0">
<v:f eqn="prod @7 21600 pixelHeight">
<v:f eqn="sum @10 21600 0">
</v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas>
<v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f">
<o:lock aspectratio="t" v:ext="edit">
</o:lock></v:path></v:stroke></v:shapetype><v:shape alt="http://www.sedico.net/english/images/InhaledInsulin/spacer1.JPG" id="Picture_x0020_1" o:spid="_x0000_i1025" style="height: 150.75pt; mso-wrap-style: square; visibility: visible; width: 269.25pt;" type="#_x0000_t75">
<v:imagedata o:title="spacer1" src="file:///C:\Users\SIDRAT~1\AppData\Local\Temp\msohtmlclip1\01\clip_image001.jpg">
</v:imagedata></v:shape><br />
Fig: Insulin inhalation device<span style="color: #4b4b4b; font-family: "Verdana","sans-serif"; font-size: 10.0pt; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhayAZpsvjqT1Wm0TD4T71_Y0yvssa3zcdLqsNr2H-eKLB9QgXHL-vDl4FCrc5CZf8lRtZXrZAFXQmkIe2qIMu7ikgLFZhf2zN2qMv0YACz4TKaJ0kSZovLvy54Vbmg9bFY2vQIxIqaY7q7/s1600/Untitled.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhayAZpsvjqT1Wm0TD4T71_Y0yvssa3zcdLqsNr2H-eKLB9QgXHL-vDl4FCrc5CZf8lRtZXrZAFXQmkIe2qIMu7ikgLFZhf2zN2qMv0YACz4TKaJ0kSZovLvy54Vbmg9bFY2vQIxIqaY7q7/s1600/Untitled.png" height="640" width="593" /></a></div>
<br />
<div class="MsoNormal">
<br /></div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-74975347114462310972014-08-08T03:40:00.001-07:002014-08-08T03:40:39.883-07:00ABUSED DRUGS MECHANISMS AND WITHDRAWAL SYMPTOMS<div dir="ltr" style="text-align: left;" trbidi="on">
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; letter-spacing: .45pt;">Before
describing the various drugs of abuse and the possible mechanisms of action, it
is important to define terms</span><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: Times-Roman;">. The
management of drug abuse and addiction must be individualized according to the
drugs involved and the associated psychosocial problems of the individual
patient. An understanding of the pharmacology of the drug or combination of
drugs ingested by the patient is essential to rational and effective treatment.<br />
</span><b><i><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt;"> <o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><i><span style="color: #231f20; font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">Addiction:</span></i></b><i><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt;"> </span></i><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt;">A
primary chronic neurobiological disease, with genetic, psychosocial, and
environmental factors influencing its development and manifestations. It is
characterized by behaviors that include one or more of the following 5Cs:
chronicity, impaired control over drug use, compulsive use, continued use
despite harm, and craving.</span><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: Times-Roman;"><o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: center;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<b><i><span style="color: #231f20; font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">Physical
dependence</span></i></b><i><span style="color: #231f20; font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">:</span></i><i><span style="color: #231f20; font-family: "Times New Roman","serif"; mso-bidi-font-size: 10.0pt;"> </span></i><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt;">A state of adaptation that is manifested by a drug class–specific
withdrawal syndrome that can be produced by abrupt cessation, rapid dose
reduction, decreasing blood level of the drug, and/or administration of an
antagonist.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; line-height: 115%;">Drug
dependence</span></i></b><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; line-height: 115%;"> and the older term <b><i>drug addiction</i></b> describe the human condition in which drug
taking becomes compulsive, taking precedence over other needs, often with
serious adverse consequences. This generally implies a state of physical, as
well as psychological, dependence. Drug dependence (physical dependence) can be
viewed as a reversible pharmacological phenomenon, readily induced in animals,
whereas addiction<i>(</i>psychological
dependence)is a chronic, relapsing human condition, as distinct from an acute
illness that can be cured by abstinence. <b><i>Drug
abuse</i></b> and <b><i>substance abuse</i></b>
are more general terms, meaning any recurrent use of substances that are
illegal or that cause harm to the individual, including drugs in sports.<i> <b>Tolerance</b></i>-the decrease in
pharmacological effect on repeated administration of the drug-often accompanies
the state of dependence, and it is possible that related mechanisms account for
both phenomena. <b><i>Withdrawal syndrome</i></b>
or <b><i>abstinence syndrome</i></b>
describes the adverse effects, both physical and psychological and lasting for
a few days or weeks, of stopping taking a drug. Several psychotropic drugs,
including antidepressant and antipsychotic agents, produce withdrawal symptoms
but are not addictive, so it is important to distinguish this type of commonly
observed 'rebound' phenomenon from true dependence<a href="https://www.blogger.com/null" name="HC043003"></a><a href="https://www.blogger.com/null" name="P043008"></a>.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1.5in; text-align: justify;">
<b><u><span style="font-family: "Cambria","serif"; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">Neurobiological
basis of drug addiction<o:p></o:p></span></u></b></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Reward pathways:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; line-height: 115%;">Virtually all
dependence-producing drugs so far tested, including opioids, nicotine, amphetamines,
ethanol and cocaine; activate the reward
pathway-the mesolimbic dopaminergic pathway, which runs, via the medial
forebrain bundle, from the ventral tegmental area of the midbrain to the
nucleus accumbens and limbic region. Even though their primary sites of action
are generally elsewhere in the brain, all these drugs increase the release of
dopamine in the nucleus accumbens, as shown by microdialysis and other
techniques.<o:p></o:p></span></div>
<div class="contenthead9">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Synaptic Plasticity &
Addiction</span></b><b><span style="font-size: 10.0pt;">:<o:p></o:p></span></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519859"></a><span style="font-size: 10.0pt;">Long-term
potentiation (LTP) is a form of experience-dependent synaptic plasticity that
is induced by activating glutamate receptors of the <i>N-</i> methyl-D-aspartate
(NMDA) type. Since NMDA receptors are blocked by magnesium at negative
potentials, their activation requires the concomitant release of glutamate
(presynaptic activity) onto a receiving neuron that is depolarized
(post-synaptic activity). Correlated pre- and postsynaptic activity durably
enhances synaptic efficacy and triggers the formation of new connections.
Because associativity is a critical component, LTP has become a leading
candidate mechanism underlying learning and memory. LTP can be elicited at
glutamatergic synapses of the mesolimbic reward system and is modulated by
dopamine. Drugs of abuse could therefore interfere with LTP at sites of
convergence of dopamine and glutamate projections (e.g. ventral tegmental area
[VTA], nucleus accumbens, or prefrontal cortex). Interestingly, exposure to an
addictive drug triggers LTP at excitatory afferents and reduces GABA<sub>A</sub>
receptor-mediated inhibition of the VTA, thus increasing the excitability of
dopamine neurons<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Role of DOPAMINE in addiction:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; line-height: 115%;">To understand the
long-term changes induced by drugs of abuse, their initial molecular and
cellular targets must be identified. A combination of approaches in animals and
humans, including functional imaging, has revealed the mesolimbic dopamine
system as the prime target of addictive drugs. This system originates in the <b>ventral
tegmental area (VTA),</b> a tiny structure at the tip of the brain stem, which
projects to the <b>nucleus accumbens,</b> the amygdala, the hippocampus, and
the prefrontal cortex. Most projection neurons of the VTA are
dopamine-producing neurons. When the dopamine neurons of the VTA begin to fire
in bursts, large quantities of dopamine are released in the nucleus accumbens
and the prefrontal cortex. Direct application of drugs into the VTA also acts
as a strong reinforcer, and systemic administration of drugs of abuse causes
release of dopamine. As a general
rule, all addictive drugs activate the mesolimbic dopamine system.<a href="https://www.blogger.com/null" name="4519833"></a> Since each addictive drug has a specific molecular target
that engages distinct cellular mechanisms to activate the mesolimbic system,
three classes can be distinguished. A first group binds to <b>G</b><sub>io</sub><b>
protein-coupled receptors</b>, a second group interacts with <b>ionotropic
receptors or ion channels</b>, and a third group targets the <b>dopamine
transporter.</b><o:p></o:p></span></div>
<div class="contentbody" style="text-align: justify;">
<span style="font-size: 10.0pt;">In
the VTA, the action of these drugs is preferentially on the </span><span style="font-family: Symbol; font-size: 10.0pt; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">g</span><span style="font-size: 10.0pt;">-aminobutyric acid (GABA) neurons that act as local
inhibitory interneurons. Addictive drugs that bind to ionotropic receptors and
ion channels can have combined effects on dopamine neurons and GABA neurons,
eventually leading to enhanced release of dopamine. Finally, addictive drugs
that interfere with monoamine transporters block reuptake or stimulate
nonvesicular release of dopamine, causing an accumulation of extracellular
dopamine in target structures. Since neurons of the VTA also express
somatodendritic transporters, which normally clear dopamine released by the
dendrites. This is consistent with the observations that antidepressants that
block serotonin and norepinephrine uptake, but not dopamine uptake, do not
cause addiction even after prolonged use.<o:p></o:p></span></div>
<div class="contentbody" style="text-align: justify;">
<b><span style="font-size: 10.0pt;">Drug dependence:<o:p></o:p></span></b></div>
<div class="contentbody" style="text-align: justify;">
<span style="font-size: 10.0pt;">With
chronic exposure to addictive drugs, the brain shows signs of adaptation. For
example if morphine is used for pain at regular intervals, the dose has to be
progressively increased to maintain the analgesic effect.<o:p></o:p></span></div>
<div class="contentbody" style="text-align: justify;">
<span style="font-size: 10.0pt;">Many
variables or factors operate simultaneously to influence that a given person
would become drug addict. These variables are classified in to three
categories:<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l1 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Drug dependent<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l1 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">User dependent<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l1 level1 lfo1; text-align: justify; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Environment
dependent<o:p></o:p></span></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184; width: 565px;">
<tbody>
<tr style="height: 12.3pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid black 1.0pt; height: 12.3pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 99.85pt;" valign="top" width="133"><div class="contentbody" style="text-align: justify;">
<b><span style="font-size: 10.0pt;"> </span></b><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Drug
dependent<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid black 1.0pt; height: 12.3pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 132.75pt;" valign="top" width="177"><div class="contentbody" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">User
dependent<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid black 1.0pt; height: 12.3pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 190.9pt;" valign="top" width="255"><div class="contentbody" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Environment
dependent<o:p></o:p></span></b></div>
</td>
</tr>
<tr style="height: 84.8pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid black 1.0pt; height: 84.8pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 99.85pt;" valign="top" width="133"><div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Availability<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Cost<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Purity/potency<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Mode of
administration<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 84.8pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 132.75pt;" valign="top" width="177"><div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="color: #231f20; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Heredity </span><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: Times-Roman;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="color: #231f20; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Innate tolerance</span><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: Times-Roman;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="color: #231f20; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: Times-Roman;">Psychiatric
symptoms<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="color: #231f20; font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: Times-Roman;">Prior
experience <br />
propensity toward drug<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 84.8pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 190.9pt;" valign="top" width="255"><div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Social settings<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Community
attitude<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Peer influences<o:p></o:p></span></div>
<div class="contentbody" style="margin-left: .5in; mso-list: l2 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Employment and
educational opportunities<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<div class="contentbody" style="text-align: justify;">
<br /></div>
<div class="contentbody" style="margin-left: 1.5in; text-align: justify;">
<br /></div>
<div class="contentbody" style="margin-left: 1.5in; text-align: justify;">
<b><u><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">Pharmacological basis of Drug Abuse<o:p></o:p></span></u></b></div>
<div class="contentbody">
<span style="font-size: 10.0pt;">Since all addictive drugs
increase dopamine concentrations in target structures of the mesolimbic
projections, we classify them on the basis of their molecular targets and the
underlying mechanisms.<br />
</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">I-Drugs that activate G<sub>10 </sub>–coupled receptors: <br />
</span></b><span style="font-size: 10.0pt;">The first group contains the <b>Opioids,
cannabinoids, </b></span><span style="font-family: Symbol; font-size: 10.0pt; mso-ascii-font-family: "Times New Roman"; mso-char-type: symbol; mso-hansi-font-family: "Times New Roman"; mso-symbol-font-family: Symbol;">g</span><b><span style="font-size: 10.0pt;">-hydroxybutyric acid (GHB)</span></b><span style="font-size: 10.0pt;">,
and the <b>hallucinogens</b>, which all exert their action through G<sub>io</sub>
protein-coupled receptors.<br />
<br />
</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">II-Inotropic receptors activators: </span></b><span style="font-size: 10.0pt;"><br />
Second group includes <b>nicotine, alcohol, the benzodiazepines, dissociative
anesthetics</b>, and some <b>inhalants</b>, which interact with ionotropic
receptors or ion channels.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contentbody">
<b><span style="font-size: 10.0pt;">III-Drugs act through biogenic amine transporters:<br />
</span></b><span style="font-size: 10.0pt;">The last group comprises <b>cocaine, amphetamines</b>,
and <b>ecstasy</b>, which all bind to monoamine transporters. The non-addictive
drugs are classified using the same criteria.<b><o:p></o:p></b></span></div>
<div class="contenthead1" style="tab-stops: 256.7pt; text-align: justify;">
<b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">I-Drugs That Activate G</span></u></b><b><sub><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">io</span></sub></b><b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">-Coupled Receptors:<o:p></o:p></span></u></b></div>
<div class="MsoNormal" style="text-align: justify;">
<a href="https://www.blogger.com/null" name="4519869"></a><b><u><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">a-Opioids<a href="https://www.blogger.com/null" name="4519870"></a>:</span></u></b><b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;"> <br />
</span></b><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Although Opioids may have been the
first drugs to be abused (preceding stimulants), they are still among the most
commonly used for nonmedical purposes.</span><b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/null" name="4519871"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Mechanism of addiction:<a href="https://www.blogger.com/null" name="4519872"></a><br />
</span></b><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Opioids comprise a large family of
endogenous and exogenous agonists at three G protein-coupled receptors: the μ-,
Ҡ-, and δ-Opioids receptors. Although all three receptors couple to inhibitory
G proteins (i.e. they all inhibit adenylyl cyclase), they have distinct,
sometimes even opposing effects, mainly because of the cell type-specific
expression throughout the brain. In the VTA, for example, μ-Opioid receptors
are selectively expressed on GABA neurons (which they inhibit), whereas Ҡ-Opioids
receptors are expressed on and inhibit dopamine neurons. This may explain why μ-Opioids
agonists cause euphoria, whereas Ҡ-agonists induce dysphoria.</span><a href="https://www.blogger.com/null" name="4519873"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="MsoNormal">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Opioid drugs<a href="https://www.blogger.com/null" name="4519874"></a>: <br />
</span></b><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">The most commonly abused μ-Opioids
include <b>morphine, heroin</b> (diacetylmorphine, which is rapidly metabolized
to morphine), <b>codeine</b>, and <b>oxycodone</b>. <b>Meperidine</b> abuse is common among health
professionals. All of these drugs induce strong tolerance and dependence.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="MsoNormal">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Withdrawal syndrome</span></b><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">:<br />
May be very severe (except for codeine)
and includes intense dysphoria, nausea or vomiting, muscle aches, lacrimation,
rhinorrhea, mydriasis, piloerection, sweating, diarrhea, yawning, and fever.
Beyond the withdrawal syndrome, which usually last no longer than a few days,
individuals who have received Opioids as analgesics, only rarely develop
addiction. In contrast, when taken for recreational purposes, Opioids are
highly addictive.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<a href="https://www.blogger.com/null" name="4519875"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;">Treatment:<a href="https://www.blogger.com/null" name="4519876"></a><br />
</span></b><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">The Opioids antagonist <b>naloxone</b>
reverses the effects of a dose of morphine or heroin within minutes. This may
be life-saving in the case of a massive overdose. Naloxone administration also
provokes an acute withdrawal (precipitated abstinence) syndrome in a dependent
person who has recently taken an Opioids.<a href="https://www.blogger.com/null" name="4519877"></a> </span><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">In the treatment
of Opioids addiction, a long-acting Opioids (eg, <b>methadone</b>, <b>buprenorphine</b>)
is often substituted for the shorter-acting, more rewarding, Opioids (e.g.,
heroin). Using a partial agonist (buprenorphine) and the much longer half-life
(methadone and buprenorphine) may also have some beneficial effects (e.g.
weaker drug sensitization, which typically requires intermittent exposures),
but it is important to realize that abrupt termination of methadone
administration invariably precipitates a withdrawal syndrome; that is, the
subject on substitution therapy remains dependent.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman"; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead3">
<br /></div>
<div class="contenthead3">
<b><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">b-<u>Cannabinoids</u>:<o:p></o:p></span></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519879"></a><span style="font-size: 10.0pt;">Endogenous
cannabinoids that act as neurotransmitters include 2-arachidonyl glycerol
(2-AG) and anandamide, both of which bind to CB1 receptors. Exogenous
cannabinoids, e.g. in <b>marijuana</b>, include several pharmacologically
active substances including <b>9-tetrahydrocannabinol (THC)</b>, a
powerful psychoactive substance.<o:p></o:p></span></div>
<div class="contentbody">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 11.0pt; mso-hansi-theme-font: major-latin;">Mechanism of
addiction:<br />
</span></b><span style="font-size: 10.0pt;">These very lipid-soluble compounds
are released at the postsynaptic somatodendritic membrane, and diffuse through
the extracellular space to bind at presynaptic CB1 receptors, where they
inhibit the release of either glutamate or GABA. Because of such backward
signaling, endocannabinoids are called retrograde messengers. In the
hippocampus, release of endocannabinoids from pyramidal neurons selectively
affects inhibitory transmission and may contribute to the induction of synaptic
plasticity during learning and memory formation. Like Opioids, THC causes
disinhibition of dopamine neurons, mainly by presynaptic inhibition of GABA
neurons in the VTA. </span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 11.0pt; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contentbody">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Pharmacological effects:<br />
</span></b><span style="font-size: 10.0pt;">The most prominent effects are
euphoria and relaxation. Users also report feelings of well-being, grandiosity,
and altered perception of passage of time. Dose-dependent perceptual changes
(e.g., visual distortions), drowsiness, diminished coordination, and memory
impairment may occur. Cannabinoids can also create a dysphoric state and, in rare
cases following the use of very high doses, may result in visual
hallucinations, depersonalization, and frank psychotic episodes. Additional
effects of THC, e.g. increased appetite, attenuation of nausea, decreased
intraocular pressure, and relief of chronic pain, have led to the use of
cannabinoids in medical therapeutics.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519881"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Withdrawal syndrome:</span></b><span style="font-size: 10.0pt;"> that includes restlessness, irritability, mild
agitation, insomnia, nausea, and cramping,</span><span style="color: #231f20; font-size: 10.0pt; mso-fareast-font-family: Times-Roman;"> Sleep EEG disturbance.</span><a href="https://www.blogger.com/null" name="4519882"></a><span style="font-size: 10.0pt;"><o:p></o:p></span></div>
<div class="contenthead3">
<b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">C-Gamma-Hydroxybutyric
Acid:<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519884"></a><span style="font-size: 10.0pt;">Gamma-hydroxybutyric
acid (GHB) is produced during the metabolism of GABA, but the function of this
endogenous agent is unknown at present. The pharmacology of GHB is complex
because there are two distinct binding sites. The low-affinity binding site has
been identified as the GABA<sub>B</sub> receptor.<a href="https://www.blogger.com/null" name="4519885"></a><o:p></o:p></span></div>
<div class="contentbody">
<span style="font-size: 10.0pt;">GHB causes euphoria,
enhanced sensory perceptions, a feeling of social closeness, and amnesia. These
properties have made it a popular "club drug" that goes by colorful
street names such as "liquid ecstasy," "grievous bodily
harm," or "date rape drug." As the latter name suggests, GHB has
been used in date rapes because it is odorless and can be readily dissolved in
beverages.<o:p></o:p></span></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519886"></a><span style="font-size: 10.0pt;">Although
GABA<sub>B</sub> receptors are expressed on all neurons of the VTA, GABA
neurons are much more sensitive to GHB than dopamine neurons. Because GHB is a
weak agonist, only GABA neurons are inhibited at the concentrations typically
obtained with recreational use. At higher doses, however, GHB also
hyperpolarizes dopamine neurons, eventually completely inhibiting dopamine
release. Such an inhibition of the VTA may in turn preclude its activation by
other addictive drugs and may explain why GHB might have some usefulness as an
"anticraving" compound.<o:p></o:p></span></div>
<div class="contenthead2">
<b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 12.0pt; mso-hansi-theme-font: major-latin;">II-Drugs
that Mediate Their Effects via Ionotropic Receptors:<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519894"></a><b><u><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">a-</span></u></b><b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">Nicotine</span></u></b><b><u><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">:</span></u></b><b><span style="font-size: 10.0pt;"> <br />
</span></b><span style="font-size: 10.0pt;">In terms of numbers affected,
addiction to nicotine exceeds all other forms of addiction, touching more than
50% of all adults in some countries. Nicotine exposure occurs primarily through
smoking of tobacco, which causes associated diseases that are responsible for
many preventable deaths. The chronic use of chewing tobacco and snuff tobacco
is also addictive.<a href="https://www.blogger.com/null" name="4519896"></a><o:p></o:p></span></div>
<div class="contentbody">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mechanism of addiction:</span></b><span style="font-size: 10.0pt;"><br />
Nicotine is a selective agonist of the nicotinic acetylcholine receptor (nAChR)
that is normally activated by acetylcholine. The rewarding effect of nicotine
requires involvement of the VTA in which nAChRs are expressed on dopamine
neurons. When nicotine excites projection neurons, dopamine is released in the
nucleus accumbens and the prefrontal cortex, thus fulfilling the dopamine
requirement of addictive drugs.<o:p></o:p></span></div>
<div class="contentbody">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Withdrawal symptoms:</span></b><a href="https://www.blogger.com/null" name="4519897"></a><b><span style="font-size: 10.0pt;"><br />
</span></b><span style="font-size: 10.0pt;">Nicotine withdrawal is mild compared
with Opioids withdrawal and involves irritability and sleep problems. However,
nicotine is among the most addictive drugs and relapse after attempted
cessation is very common.<b><o:p></o:p></b></span></div>
<div class="contenthead5">
<a href="https://www.blogger.com/null" name="4519898"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Treatment:</span></b><a href="https://www.blogger.com/null" name="4519899"></a><b><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;"><br />
</span></b><span style="font-size: 10.0pt;">Treatments for nicotine addiction
include nicotine itself in forms that are slowly absorbed and several other
drugs. Nicotine that is chewed, inhaled, or transdermally delivered can be
substituted for the nicotine in cigarettes, thus slowing the pharmacokinetics
and eliminating the many complications associated with the toxic substances
found in tobacco smoke. The antidepressant <b>bupropion</b> is approved for
nicotine cessation therapy. It is most effective when combined with behavioral
therapies<a href="https://www.blogger.com/null" name="4519900"></a>.</span><b><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead3">
<b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">b-Benzodiazepines:<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519902"></a><span style="font-size: 10.0pt;">Benzodiazepines
are commonly prescribed as anxiolytics and sleep medications. They represent a
moderate risk for abuse, which has to be weighed against their beneficial
effects. Benzodiazepines are abused by some persons for their euphoriant
effects, but most often abuse occurs concomitant with other drugs, e.g. to
attenuate anxiety during withdrawal from Opioids.<o:p></o:p></span></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519903"></a><b><span style="font-size: 10.0pt;">Barbiturates,</span></b><span style="font-size: 10.0pt;"> which preceded benzodiazepines as the most commonly
abused sedative hypnotics (after ethanol), are now rarely prescribed to
outpatients.<a href="https://www.blogger.com/null" name="4519904"></a><o:p></o:p></span></div>
<div class="contentbody">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Withdrawal Symptoms:<br />
</span></b><span style="font-size: 10.0pt;">Include irritability, insomnia,
phono- and photophobia, depression, muscle cramps, and even seizures.
Typically, these symptoms taper off within 1–2 weeks.<a href="https://www.blogger.com/null" name="4519905"></a>Benzodiazepines
are positive modulators of the GABA<sub>A </sub>receptor, increasing both
single-channel conductance and open-channel probability. GABA receptors on
dopamine neurons of the VTA lack α<sub>1</sub>, a subunit that is typically
present in GABA neurons. In addition, GABA<sub>A</sub> receptors are expressed
in much higher density on interneurons, so that a disinhibition of the
mesolimbic dopamine system may explain the rewarding effects of
benzodiazepines.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead3">
<b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">c-Alcohol:<a href="https://www.blogger.com/null" name="4519907"></a><a href="https://www.blogger.com/null" name="4519908"></a><o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519909"></a><span style="font-size: 10.0pt;">Alcohol’s
mechanism of action is complex, and no single receptor mediates all of its
effects. On the contrary, alcohol alters the function of several receptors and
cellular functions, including GABA<sub>A</sub> receptors, adenosine reuptake
(through the equilibrative nucleoside transporter, ENT1), glycine receptor,
NMDA receptor, and 5-HT<sub>3</sub> receptor. They are all, with the exception
of ENT1, either ionotropic receptors or ion channels. It is not clear which of
these targets is responsible for the increase of dopamine release from the
mesolimbic reward system.<o:p></o:p></span></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519910"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Withdrawal syndrome:<br />
</span></b><span style="font-size: 10.0pt;">That may include tremor (mainly of
the hands), nausea and vomiting, excessive sweating, agitation, and anxiety. In
some individuals, this is followed by visual, tactile, and auditory
hallucinations 12–24 hours after cessation. Generalized seizures may manifest
after 24–48 hours. Finally, 48–72 hours after cessation, an alcohol withdrawal
delirium (delirium tremens) may become apparent in which the person
hallucinates, is disoriented, and shows evidence of autonomic instability.
Delirium tremens is associated with 5–15% mortality.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead5">
<a href="https://www.blogger.com/null" name="4519911"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Treatment:<a href="https://www.blogger.com/null" name="4519912"></a><br />
</span></b><span style="font-size: 10.0pt;">Treatment of ethanol withdrawal is
supportive and relies on <b>benzodiazepines</b>.<a href="https://www.blogger.com/null" name="4519913"></a> As in the
treatment of all chronic drug abuse problems, heavy reliance is placed on psychosocial
approaches to alcohol addiction.<a href="https://www.blogger.com/null" name="4519914"></a> The pharmacologic
treatment of alcohol addiction is limited, although several compounds, with
different goals, have been used.</span><a href="https://www.blogger.com/null" name="4519915"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead3">
<a href="https://www.blogger.com/null" name="4519917"></a><b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">d-Inhalants:<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519918"></a><span style="font-size: 10.0pt;">Inhalant
abuse is defined as recreational exposure to chemical vapors, such as <b>nitrates</b>,
<b>ketones</b>, and aliphatic and aromatic <b>hydrocarbons</b>. These
substances are present in a variety of household and industrial products that
are inhaled by "sniffing," "huffing," or
"bagging." Sniffing refers to inhalation from an open container,
huffing to the soaking of a cloth in the volatile substance before inhalation,
and bagging to breathing in and out of a paper or plastic bag filled with
fumes. It is common for novices to start with sniffing and progress to huffing
and bagging as addiction develops. Inhalant abuse is particularly prevalent in
children and young adults.<o:p></o:p></span></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519919"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mechanism of addiction:<br />
</span></b><span style="font-size: 10.0pt;">The exact mechanism of action of most
volatile substances remains unknown. Altered function of ionotropic receptors
and ion channels throughout the central nervous system has been demonstrated
for a few. Nitrous oxide, for example, binds to NMDA receptors and fuel
additives enhance GABA<sub>A</sub> receptor function. Most inhalants produce euphoria;
increased excitability of the VTA has been documented for toluene and may
underlie its addiction risk. Other substances, such as amyl nitrite
("poppers"), primarily produce smooth muscle relaxation and enhance
erection, but are not addictive. With chronic exposure to the aromatic
hydrocarbons (e.g. benzene, toluene), toxic effects can be observed in many
organs, including white matter lesions in the central nervous system.
Management of overdose remains supportive.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead2">
<b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">III-Drugs
That Bind to Transporters of Biogenic Amines:<o:p></o:p></span></u></b></div>
<div class="contenthead3">
<a href="https://www.blogger.com/null" name="4519921"></a><b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">a-Cocaine<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519922"></a><a href="https://www.blogger.com/null" name="4519923"></a><span style="font-size: 10.0pt;">Cocaine is an alkaloid found in the leaves of <i>Erythroxylon
coca,</i> a shrub indigenous to the Andes. For more than 100 years, it has been
extracted and used in clinical medicine, mainly as a local anesthetic and to dilate
pupils in ophthalmology. Sigmund Freud famously proposed its use to treat
depression and alcohol dependence, but addiction quickly brought an end to this
idea.<o:p></o:p></span></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519926"></a><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> Mechanism of addiction:<a href="https://www.blogger.com/null" name="4519927"></a><br />
</span></b><span style="font-size: 10.0pt;">In the peripheral nervous system,
cocaine inhibits voltage-gated sodium channels, thus blocking initiation and
conduction of action potentials. This effect, however, seems responsible for
neither the acute rewarding nor the addictive effects. In the central nervous
system, cocaine blocks the uptake of dopamine, noradrenalin, and serotonin
through their respective transporters. The block of the <b>dopamine transporter
(DAT)</b>, by increasing dopamine concentrations in the nucleus accumbens, has
been implicated in the rewarding effects of cocaine. The activation of the
sympathetic nervous system results mainly from blockage of the norepinephrine
transporter (NET) and leads to an acute increase in arterial pressure,
tachycardia, and often, ventricular arrhythmias. Users typically lose their
appetite, are hyperactive, and sleep little. Cocaine exposure increases the
risk for intracranial hemorrhage, ischemic stroke, myocardial infarction, and
seizures. Cocaine overdose may lead to hyperthermia, coma, and death.
Susceptible individuals may become dependent and addicted after only a few
exposures to cocaine. Although a withdrawal syndrome is reported, it is not as
strong as that observed with Opioids.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead3">
<b><u><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">b-Amphetamines<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519932"></a><span style="font-size: 10.0pt;">Amphetamines
are a group of synthetic, indirect-acting sympathomimetic drugs that cause the
release of endogenous biogenic amines, such as dopamine and noradrenaline. <o:p></o:p></span></div>
<div class="contentbody">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mechanism of action:<br />
</span></b><span style="font-size: 10.0pt;">Amphetamine, methamphetamine, and
their many derivatives exert their effects by reversing the action of biogenic
amine transporters at the plasma membrane. Amphetamines are substrates of these
transporters and are taken up into the cell. Once in the cell, amphetamines
interfere with the vesicular monoamine transporter (VMAT) depleting synaptic
vesicles of their neurotransmitter content. As a consequence, levels of
dopamine (or other transmitter amine) in the cytoplasm increase and quickly
become sufficient to cause release into the synapse by reversal of the plasma
membrane DAT. Normal vesicular release of dopamine consequently decreases
(because synaptic vesicles contain less transmitter), whereas nonvesicular
release increases. Similar mechanisms apply for other biogenic amines
(serotonin and norepinephrine).</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519933"></a><span style="font-size: 10.0pt;"> In general, amphetamines lead to elevated
catecholamine levels that increase arousal and reduce sleep, whereas the
effects on the dopamine system mediate euphoria but may also cause abnormal
movements and precipitate psychotic episodes. Effects on serotonin transmission
may play a role in the hallucinogenic and anorexigenic functions as well as in
the hyperthermia often caused by amphetamines.<a href="https://www.blogger.com/null" name="4519934"></a> Unlike many
other abused drugs, amphetamines are neurotoxic. The exact mechanism is not
known, but neurotoxicity depends on the NMDA receptor and affects mainly
serotonin and dopamine neurons.<a href="https://www.blogger.com/null" name="4519935"></a> Hypertensive crisis and
vasoconstriction may lead to stroke. <o:p></o:p></span></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519936"></a><span style="font-size: 10.0pt;"> </span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Withdrawal symptoms: <br />
</span></b><span style="font-size: 10.0pt;">Withdrawal consists of dysphoria,
drowsiness (in some cases, insomnia), and general irritability.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contenthead3">
<a href="https://www.blogger.com/null" name="4519937"></a><b><u><span style="font-family: "Cambria","serif"; font-size: 11.0pt; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">c-Ecstasy
(MDMA)<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519938"></a><span style="font-size: 10.0pt;">Ecstasy
is the name of a class of drugs that includes a large variety of derivatives of
the amphetamine-related compound methylene-dioxymethamphetamine (MDMA). MDMA
was originally used in some forms of psychotherapy but no medically useful effects
were documented.<o:p></o:p></span></div>
<div class="contentbody">
<b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Mechanism of action:<a href="https://www.blogger.com/null" name="4519939"></a><br />
</span></b><span style="font-size: 10.0pt;">Similar to the amphetamines, MDMA
causes release of biogenic amines by reversing the action of their respective
transporters. It has a preferential affinity for the <b>serotonin transporter
(SERT)</b> and therefore most strongly increases the extracellular
concentration of serotonin. This release is so profound that there is a marked
intracellular depletion for 24 hours after a single dose. With repetitive
administration, serotonin depletion may become permanent, which has triggered a
debate on its neurotoxicity. Although direct proof from animal models for
neurotoxicity remains weak, several studies report long-term cognitive
impairment in heavy users of MDMA.</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><o:p></o:p></span></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519940"></a><span style="font-size: 10.0pt;">In
contrast, there is a wide consensus that MDMA has several acute toxic effects,
in particular hyperthermia, which along with dehydration (e.g., caused by an
all-night dance party) may be fatal. Other complications include serotonin
syndrome (mental status change, autonomic hyperactivity, and neuromuscular
abnormalities) and seizures.<a href="https://www.blogger.com/null" name="4519941"></a><br />
</span><b><span style="font-family: "Cambria","serif"; font-size: 10.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Withdrawal symptoms:<br />
</span></b><span style="font-size: 10.0pt;">Withdrawal is marked by a mood
"offset" characterized by depression lasting up to several weeks.
There have also been reports of increased aggression during periods of
abstinence in chronic MDMA users<a href="https://www.blogger.com/null" name="4519942"></a>.<o:p></o:p></span></div>
<div class="contenthead3" style="margin-left: 1.5in;">
<b><u><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-bidi-font-size: 10.0pt; mso-hansi-theme-font: major-latin;">Non-addictive
Drugs of Abuse<o:p></o:p></span></u></b></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519863"></a><span style="font-size: 10.0pt;">Some
drugs of abuse do not lead to addiction. This is the case for substances that
alter perception without causing sensations of reward and euphoria, such as the
hallucinogens and the dissociative anesthetics. Unlike addictive drugs, which
primarily target the mesolimbic dopamine system, these agents primarily target
cortical and thalamic circuits. Lysergic acid diethylamide (LSD), for example,
activates the serotonin5-HT<sub>2A</sub> receptor in the prefrontal cortex,
enhancing glutamatergic transmission onto pyramidal neurons. These excitatory
afferents mainly come from the thalamus and carry sensory information of
different modalities, which may constitute a link to enhanced perception.
Phencyclidine (PCP) and Ketamine produce a feeling of separation of mind and
body (which is why they are called dissociative anesthetics) and, at higher
doses, stupor and coma. The principal mechanism of action is a use-dependent
inhibition of glutamate receptors of the <i>N</i> -methyl-D-aspartate
(NMDA) type.<o:p></o:p></span></div>
<div class="contentbody">
<a href="https://www.blogger.com/null" name="4519864"></a><span style="font-size: 10.0pt;">Concurrent
effects on both thalamocortical and mesolimbic systems also exist for other
addictive drugs. Psychosis-like symptoms can be observed with cannabinoids,
amphetamines, and cocaine, which may reflect their effects on thalamocortical
structures. For example, cannabinoids, in addition to their documented effects
on the mesolimbic dopamine system, also enhance excitation in cortical circuits
through presynaptic inhibition of GABA release.<a href="https://www.blogger.com/null" name="4519865"></a>Hallucinogens
and NMDA antagonists, even if they do not produce dependence or addiction, can
still have long-term effects. Flashbacks of altered perception can occur years
after LSD use. Moreover, chronic use of PCP may lead to an irreversible
schizophrenia-like psychosis.<o:p></o:p></span></div>
<div class="contentbody">
<b><span style="font-size: 14.0pt; mso-bidi-font-size: 10.0pt;">References <o:p></o:p></span></b></div>
<div class="MsoListParagraph" style="line-height: 11.25pt; mso-list: l0 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Bertram
G. katzung,<span style="color: #333333;"> </span></span><span style="color: #333333; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-fareast-font-family: "Times New Roman";">Susan B. Masters, Anthony J. Trevor,</span><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;"> Basic and
clinical pharmacology, 11<sup>th</sup> edition.<o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 2.35pt; mso-list: l0 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: #333333; font-family: Wingdings; font-size: 10.0pt; letter-spacing: .45pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 10.0pt;">Principles of
Pharmacology, The Pathophysiologic Basis of Drug Therapy 2<sup>nd</sup>
Edition.<b><span style="color: #333333; letter-spacing: .45pt;"> </span></b><span style="color: #333333; letter-spacing: .45pt; mso-bidi-font-weight: bold;">David E.
Golan MD, PhD</span>, <span style="color: #333333; letter-spacing: .45pt; mso-bidi-font-weight: bold;">Armen H. Tashjian Jr. MD.<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></span></div>
<div style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 2.35pt; mso-list: l0 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="color: #333333; font-family: Wingdings; font-size: 10.0pt; letter-spacing: .45pt; mso-bidi-font-family: Wingdings; mso-bidi-font-weight: bold; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 10.0pt; letter-spacing: .45pt; mso-bidi-font-weight: bold;">Applied therapeutics,The
clinical use of drugs(9<sup>th</sup> edition).koda kimble.<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 10.0pt; mso-bidi-font-family: Wingdings; mso-bidi-font-style: italic; mso-fareast-font-family: Wingdings;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-style: italic;">Goodman & Gilman’s<i> </i></span><span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">The<i> </i>Pharmacological<i> </i>Basis
of<i> </i>THERAPEUTICS<i> </i>eleventh
edition.<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 10pt;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Pharmacotherapy
Handbook </span><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt;">Seventh Edition</span><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">.</span><span style="color: #231f20; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-weight: bold;">Barbara
G. Wells, PharmD, FASHP, FCCP, BCPP.</span><span style="font-family: 'Times New Roman', serif; font-size: 10pt;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoListParagraphCxSpLast" style="margin-bottom: 0.0001pt; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: Wingdings; font-size: 10pt;">Ø<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Pharmacology
4<sup>th</sup> Edition Lippincott Illustrated Reviews.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 11.25pt;">
<br /></div>
<br />
<div class="MsoNormal" style="line-height: 11.25pt;">
<br /></div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-49063477893261569522014-08-08T03:35:00.000-07:002014-08-08T03:35:08.953-07:00Management of acute asthma<div dir="ltr" style="text-align: left;" trbidi="on">
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;">
<tbody>
<tr>
<td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 158.7pt;" valign="top" width="212">
<div class="MsoNormal">
<b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;">Moderate acute asthma<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 160.05pt;" valign="top" width="213">
<div class="MsoNormal">
<b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;">Severe acute asthma<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 160.05pt;" valign="top" width="213">
<div class="MsoNormal">
<b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;">Life-threatening acute asthma<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 158.7pt;" valign="top" width="212">
<div class="MsoListParagraphCxSpFirst" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Able
to talk<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Respiration(breaths/min)<25;<br />
<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span>
2-5years≤40,5-12years<br />
≤30<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Pulse(beats/min)<110;
<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span><br />
2-5years≤140, 5-12years≤125<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Arterial
oxygen saturation ≥92%.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Peak
flow>50% of predicted or best; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> 5-12years≥50%<o:p></o:p></span></div>
<div class="MsoNormal">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Treat at home
or in surgery and assess response to treatment.<br />
</span></i><b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;">Treatment </span></b><i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"><o:p></o:p></span></i></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo5; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Inhaled
<b>short acting ß2 agonist</b> via a
large-volume spacer or oxygen-driven nebulizer(if available); give 2-10 puffs
of <b>Salbutamole</b> 100mcg/metered
inhalation each inhaled separately, and repeat at 10-20 min. intervals if
necessary or give nebulised <b>Salbutamol</b>
5mg (<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> under
5years 2.5 mg, 5-12 years,2.5-5mg) or <b>Terbutaline</b>
10mg (<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> under 5
years 5mg, 5-12years 5-10mg), and repeat at 20-30min. intervals if necessary.<i><o:p></o:p></i></span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Prednisolone</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"> 40-50 mg by
mouth for at least 5 days; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span>
1-2mg/kg my mouth for 3-5 days, if the child has been taking an oral
corticosteroid for more than a few days, give <b>Prednisolone</b> 2mg/kg (<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> under 2 years max. 40mg, over 2 years max. 50mg)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Monitor
response for 15-30min, if response is poor or a relapse occurs in 3-4hr, send
immediately to hospital for assessment
and future treatment<o:p></o:p></span></i></div>
<div class="MsoNormal">
<br /></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 160.05pt;" valign="top" width="213">
<div class="MsoListParagraphCxSpFirst" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Cannot
complete sentences in one breath; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> too breathless to talk or feed<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Respiration(breaths/min)≥25;<br />
<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> 2-5 years
>40;5-12years >30<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Pulse(beats/min)≥110;<span style="color: #1f497d; mso-themecolor: text2;">CHILD </span><br />
2-5years>140;5-12years>125<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Arterial
oxygen saturation≥92%; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span>
under 12years<92%<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Peak
flow 33-50% of predicted or best; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> 5-12years 33-50%.<br />
<i>Send immediately to hospital.<br />
</i></span><b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;">Treatment </span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l2 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">High-flow
<b>oxygen</b>(if available)<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo2; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Inhaled
<b>short acting ß2 agonist </b>via a
large-volume spacer or oxygen-driven nebulizer(if available); give 2-10 puffs
of <b>Salbutamole</b> 100mcg/metered
inhalation each inhaled separately, and repeat at 10-20 min. intervals if
necessary or give nebulised <b>Salbutamol</b>
5mg (<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> under
5years 2.5 mg, 5-12 years,2.5-5mg) or <b>Terbutaline</b>
10mg (<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> under 5
yearrs 5mg, 5-12years 5-10mg), and repeat at 20-30min. intervals if
necessary.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l2 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Prednisolone</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"> by mouth as
for moderate acute asthma or <b>Hydrocortisone</b>
intravenous (preferably as sodium succinate) 100mg every 6 hr until
conversion to oral prednisolone is possible; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> 4mg/kg(under 2 years max. 25mg, 2- 5 years
50 mg, 6- 12years 100mg).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Monitor
response for 15-30min, if response is poor:</span></i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l2 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Inhaled
<b>Ipratropium bromide</b> via
oxygen-driven nebulliser(if available) 500mcg(<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> under 12 years 250mcg)repeated every
20-30min. for the first 2hr, then every 4-6hr as necessary.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Refer those who fail to respond and
require ventilatory support to an
intensive care or high-dependency unit</span></i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l2 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Consider
IV <b>ß2 agonist</b>, <b>Aminophylline</b> or <b>Magnesium sulphate</b>(unlicensed indication), only after
consultation with senior medical staff.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 160.05pt;" valign="top" width="213">
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Silent
chest, feeble respiratory effort, cyanosis<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Hypotension,
Bradycardia, arrhythmia, exhaustion, agitation (in children), or reduced
level of consciousness.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Arterial
oxygen saturation<92%<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="margin-left: .25in; mso-add-space: auto; mso-list: l4 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Peak
flow<33% of predicted or best; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> 5-12years<33%.<br />
<!--[if !supportLineBreakNewLine]--><br />
<!--[endif]--><o:p></o:p></span></div>
<div class="MsoNormal">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Send
immediately to hospital; consult with senior medical staff and refer to
intensive care.<br />
</span></i><b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;">Treatment</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l3 level1 lfo4; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">High
flow <b>oxygen</b> (if available).<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l3 level1 lfo4; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Short acting ß2
agonist</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">
via oxygen-driven nebulizer(if available);give <b>Salbutamol </b>5mg(<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span>
under 5 years 2.5mg, 5-12 years 2.5-5mg) or <b>Terbutaline </b>10 mg(<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span>
under 5years 5mg, 5-12years 5-12mg), and repeat at 20 30 min intervals or as
necessary; reserve intravenous <b>ß2
agonists</b> for those in whom inhaled therapy can’t be used reliably.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l3 level1 lfo4; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Prednisolone</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"> by mouth as
for moderate acute asthma or intravenous <b>Hydrocortisone
</b>(preferably as sodium succinate) 100mg every 6 hr until conversion to
oral prednisolone is possible; <span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> 4mg/kg(under 2 years max. 25mg, 2- 5 years 50 mg, 6-
12years 100mg).<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l2 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Inhaled
<b>Ipratropium bromide</b> via
oxygen-driven nebulliser(if available) 500mcg (<span style="color: #1f497d; mso-themecolor: text2;">CHILD</span> under 12 years 250mcg)repeated every
20-30min. for the first 2hr, then every 4-6hr as necessary.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .25in;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Monitor
response for 15-30min. if response is poor:<o:p></o:p></span></i></div>
<div class="MsoListParagraph" style="mso-list: l2 level1 lfo3; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 8.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Consider
IV <b>Aminophylline</b> or <b>Magnesium sulphate</b>(unlicensed
indication), only after consultation with senior medical staff.<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td colspan="3" style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 6.65in;" valign="top" width="638">
<div class="MsoNormal">
<b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 9.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;">Follow up in all cases: </span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Monitor
symptoms and peak flow. Setup asthma action plan and check inhaler technique review
by general practitioner or appropriate primary care health professional with
in 48hr.</span><b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 9.0pt; mso-bidi-font-size: 8.0pt; mso-themecolor: text2;"><o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td colspan="3" style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 6.65in;" valign="top" width="638">
<div class="MsoNormal">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Advice
on the management of acute asthma is based on the recommendations of the
British thoracic society and Scottish intercollegiate guidelines
network(updated on June 2012),<span style="color: #1f497d; mso-themecolor: text2;">www.britt-thoracic.org.uk</span><o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<br />
<div class="MsoNormal">
<br /></div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-39540830530890448752014-08-08T03:33:00.000-07:002014-08-08T03:33:52.537-07:00Management of chronic asthma in childrens<div dir="ltr" style="text-align: left;" trbidi="on">
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;">
<tbody>
<tr>
<td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="margin-right: 3.65pt;">
<b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-themecolor: accent1;">Adult and child over 5 years<o:p></o:p></span></b></div>
</td>
<td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="margin-right: 3.65pt;">
<b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-themecolor: accent1;">Child under 5 years<o:p></o:p></span></b></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-outline-level: 3;">
<b><span style="color: #e36c0a; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6; mso-themeshade: 191;">Step 1: occasional
relief broncodilator<span style="background: #3399FF;"><o:p></o:p></span></span></b></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-outline-level: 3;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;">Inhaled
short-acting beta<sub>2</sub> agonist as required (up to once daily)</span><b><span style="background: #3399FF; color: white; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in;">
<b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">Note:</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Move to step 2 if needed more than twice a week, or if
night-time symptoms more than once a week, or if exacerbation in the last 2
years requiring systemic corticosteroid or nebulised bronchodilator.<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-outline-level: 3;">
<b><span style="color: #e36c0a; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6; mso-themeshade: 191;">Step 1: occasional relief bronchodilator<o:p></o:p></span></b></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Short-acting beta<sub>2</sub> agonist as required (not
more than once daily)<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-outline-level: 3;">
<b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">Note<o:p></o:p></span></b></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Preferably by inhalation (less effective and more
side-effects when given by mouth)<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Move to step 2 if needed more than twice a week, or if
night-time symptoms more than once a week, or if exacerbation in the last 2
years<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 3.65pt; margin-top: 0in; mso-add-space: auto;">
<br /></div>
</td>
</tr>
<tr>
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><table border="0" cellpadding="0" class="MsoNormalTable" style="mso-cellspacing: 1.5pt; mso-yfti-tbllook: 1184; width: 270px;">
<tbody>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"><div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; mso-outline-level: 3;">
<b><span style="color: #e36c0a; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6; mso-themeshade: 191;">Step 2: regular
inhaled preventer therapy<o:p></o:p></span></b></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Inhaled short-acting beta<sub>2</sub>
agonist as required<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Regular standard-dose inhaled
corticosteroid (alternative are considerably less effective)<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"></td>
</tr>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.65pt; margin-top: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"><o:p></o:p></span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><h3 style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; mso-outline-level: 3;">
<span style="color: #e36c0a; font-size: 8.0pt; mso-themecolor: accent6; mso-themeshade: 191;">Step 2: regular preventer therapy<o:p></o:p></span></h3>
<div style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="font-size: 8.0pt;">Inhaled short-acting beta<sub>2</sub> agonist as
required<o:p></o:p></span></div>
<div class="cbd" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">Either</span></i></b><span style="font-size: 8.0pt;"> regular standard-dose<sup> </sup> inhaled corticosteroid <br />
<b><i><span style="color: #4f81bd; mso-themecolor: accent1;">Or</span></i></b><span style="color: #4f81bd; mso-themecolor: accent1;"> </span>(if inhaled
corticosteroid cannot be used) leukotriene receptor antagonist<o:p></o:p></span></div>
<div class="MsoNormalCxSpFirst" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.65pt; margin-top: 0in; mso-add-space: auto;">
<br /></div>
</td>
</tr>
<tr style="height: 59.6pt; mso-yfti-irow: 3;">
<td rowspan="2" style="border-top: none; border: solid black 1.0pt; height: 59.6pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; mso-outline-level: 3;">
<b><span style="color: #e36c0a; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6; mso-themeshade: 191;">Step 3: inhaled
corticosteroid + long-acting inhaled beta<sub>2</sub> agonist<o:p></o:p></span></b></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Inhaled short-acting beta<sub>2</sub> agonist as required<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Regular standard-dose inhaled corticosteroid<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Regular inhaled long-acting beta<sub>2</sub> agonist
(salmeterol <i>or</i> formoterol)<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">If asthma not controlled</span></i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Increase dose of inhaled corticosteroid to upper end of standard dose range<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">and</span></i></b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">Either</span></i></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"> stop long-acting beta<sub>2</sub> agonist if of no
benefit<br />
<b><i><span style="color: #4f81bd; mso-themecolor: accent1;">Or</span></i></b>
continue long-acting beta<sub>2</sub> agonist if of some benefit<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">If asthma still not controlled and long-acting beta<sub>2</sub>
agonist stopped, add one of</span></i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div>
<ul type="disc">
<li class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Leukotriene receptor antagonist<o:p></o:p></span></li>
<li class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Modified-release oral theophylline<o:p></o:p></span></li>
<li class="MsoNormalCxSpLast" style="margin-bottom: 12.0pt; mso-add-space: auto; mso-list: l1 level1 lfo1; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Modified-release oral beta<sub>2</sub> agonist<o:p></o:p></span></li>
</ul>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 59.6pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><table border="0" cellpadding="0" class="MsoNormalTable" style="mso-cellspacing: 1.5pt; mso-yfti-tbllook: 1184; width: 270px;">
<tbody>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"><h3 style="margin-bottom: .0001pt; margin: 0in;">
<span style="color: #e36c0a; font-size: 8.0pt; mso-themecolor: accent6; mso-themeshade: 191;">Step 3: add-on
therapy<o:p></o:p></span></h3>
<div style="margin-bottom: .0001pt; margin: 0in;">
<b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">Child under 2 years:</span></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">Refer
to respiratory paediatrician<o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">Child 2–5 years:</span></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">Inhaled
short-acting beta<sub>2</sub> agonist as required<o:p></o:p></span></div>
<div class="cbd" style="margin-bottom: .0001pt; margin: 0in;">
<b><i><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">Regular
inhaled corticosteroid in standard dose<o:p></o:p></span></div>
<div class="cbd" style="margin-bottom: .0001pt; margin: 0in;">
<b><i><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">Leukotriene
receptor antagonist<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"></td>
</tr>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"></td>
</tr>
</tbody></table>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.65pt; margin-top: 0in;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt;"><o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 72.4pt; mso-yfti-irow: 4;">
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 72.4pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><table border="0" cellpadding="0" class="MsoNormalTable" style="mso-cellspacing: 1.5pt; mso-yfti-tbllook: 1184; width: 270px;">
<tbody>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"><h3 style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="color: #e36c0a; font-size: 8.0pt; mso-themecolor: accent6; mso-themeshade: 191;">Step 4: persistent poor control<o:p></o:p></span></h3>
<div style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="font-size: 8.0pt;">Refer to respiratory paediatrician<o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="padding: .75pt .75pt .75pt .75pt;"><h3 style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="color: #e36c0a; font-size: 8.0pt; mso-themecolor: accent6; mso-themeshade: 191;">Stepping down<o:p></o:p></span></h3>
<div style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="font-size: 8.0pt;">Regularly review need for treatment<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
<h3 style="margin-bottom: .0001pt; margin: 0in; mso-outline-level: 3;">
<span style="font-size: 8.0pt;"><o:p></o:p></span></h3>
</td>
</tr>
<tr style="height: 240.7pt; mso-yfti-irow: 5; mso-yfti-lastrow: yes; page-break-inside: avoid;">
<td style="border-top: none; border: solid black 1.0pt; height: 240.7pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><h3 style="margin-bottom: .0001pt; margin: 0in; mso-outline-level: 3;">
<span style="color: #e36c0a; font-size: 8.0pt; mso-themecolor: accent6; mso-themeshade: 191;">Step 4: high-dose inhaled corticosteroid + regular bronchodilators<o:p></o:p></span></h3>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">Inhaled
short-acting beta<sub>2</sub> agonist as required<o:p></o:p></span></div>
<div class="cbd" style="margin-bottom: .0001pt; margin: 0in;">
<b><i><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">with</span></i></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">Regular
high-dose<sup> </sup>inhaled corticosteroid<o:p></o:p></span></div>
<div class="cbd" style="margin-bottom: .0001pt; margin: 0in;">
<b><i><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">Inhaled
long-acting beta<sub>2</sub> agonist<o:p></o:p></span></div>
<div class="cbd" style="margin-bottom: .0001pt; margin: 0in;">
<b><i><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;">plus</span></i></b><span style="color: #4f81bd; font-size: 8.0pt; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div style="margin-bottom: .0001pt; margin: 0in;">
<span style="font-size: 8.0pt;">In
adults 6-week sequential therapeutic trial of one or more of <o:p></o:p></span></div>
<div class="item-para" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 8.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 8.0pt;">Leukotriene
receptor antagonist<o:p></o:p></span></div>
<div class="item-para" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 8.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 8.0pt;">Modified-release
oral theophylline<o:p></o:p></span></div>
<div class="item-para" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 10.0pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 8.0pt; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 8.0pt;">Modified-release
oral beta<sub>2</sub> agonist<b> </b><o:p></o:p></span></div>
<div class="MsoNormalCxSpFirst" style="margin-bottom: 12.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-outline-level: 3;">
<b><span style="color: #e36c0a; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6; mso-themeshade: 191;">Step 5: regular corticosteroid tablets<o:p></o:p></span></b></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Inhaled short-acting beta<sub>2</sub> agonist as required<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">with</span></i></b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Regular high-dose inhaled corticosteroid<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<b><i><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;">and</span></i></b><span style="color: #4f81bd; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent1;"><o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">One or more long-acting bronchodilators (see step 4)<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<b><i><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">plus</span></i></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto; mso-outline-level: 3;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Regular prednisolone tablets (as single
daily dose)<b> <o:p></o:p></b></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto; mso-outline-level: 3;">
<br /></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: 12.0pt; mso-add-space: auto; mso-outline-level: 3;">
<b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text2;">Note:</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">In addition to regular prednisolone, continue high-dose
inhaled corticosteroid (in exceptional cases may exceed licensed doses);
these patients should normally be referred to an asthma clinic.<o:p></o:p></span></div>
<div class="MsoNormalCxSpLast" style="margin-bottom: 12.0pt; mso-add-space: auto;">
<br /></div>
<div class="item-para" style="margin-bottom: .0001pt; margin: 0in;">
<br /></div>
<div class="MsoNormalCxSpFirst" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; mso-outline-level: 3;">
<br /></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 240.7pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 239.4pt;" valign="top" width="319"><div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: red; font-family: "Times New Roman","serif"; font-size: 9.0pt; mso-bidi-font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Standard-dose inhaled
corticosteroids (given through a metered-dose inhaler and in children a
large-volume spacer): <o:p></o:p></span></b></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: #f79646; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6;">Beclometasone
dipropionate</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"> or <b><span style="color: #f79646; mso-themecolor: accent6;">budesonide</span></b> 100–400 micrograms twice
daily; child under 12 years 100–200 micrograms twice daily<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: #f79646; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6;">Fluticasone
propionate</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"> 50–200 micrograms twice
daily; child 4–12 years 50–100 micrograms twice daily<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: #f79646; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6;">Mometasone
furoate</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"> (given through a dry-powder
inhaler) 200 micrograms twice daily, Alternatives to inhaled
corticosteroid are leukotriene receptor antagonists, theophylline, inhaled
cromoglicate, or inhaled nedocromil. High-dose inhaled corticosteroids (given
through a metered-dose inhaler and a large-volume spacer): <o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: #f79646; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6;">Beclometasone
dipropionate or budesonide</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">
0.4–1 mg twice daily; child 5–12 years 200–400 micrograms twice
daily<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: #f79646; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6;">Fluticasone
propionate</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"> 200–500 micrograms twice
daily; child 5–12 years 100–200 micrograms twice daily.<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: #f79646; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: accent6;">Mometasone
furoate</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";"> (given through a dry powder
inhaler) 200–400 micrograms twice daily.<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<b><span style="color: #1f497d; font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman"; mso-themecolor: text2;">Note</span></b><span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">. Doses of inhaled corticosteroids here are for
CFC-containing metered-dose inhalers; dose adjustments may be required for
other inhaler devices.<o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin: 0in; mso-add-space: auto;">
<span style="font-family: "Times New Roman","serif"; font-size: 8.0pt; mso-fareast-font-family: "Times New Roman";">Failure to achieve control with
these doses is unusual.Lung-function measurements cannot be used to guide
management in those under 5 years <o:p></o:p></span></div>
<div class="MsoNormalCxSpMiddle" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 0in; margin-right: 3.65pt; margin-top: 0in; mso-add-space: auto;">
<br /></div>
</td>
</tr>
</tbody></table>
<br />
<div class="MsoNormal">
<br /></div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-79612734644737152362011-10-31T02:45:00.000-07:002011-10-31T02:45:40.491-07:00Health and computers<div dir="ltr" style="text-align: left;" trbidi="on"><br />
<div class="MsoNormal"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjtxx8Cwtn11RyWkCPjB4jxAC9-5LEGMp3d4FFwzfobcHQm0qafQssh-jejRelneUY8Bzz5U85QITaIZwmcJwvbnyAkWb2J48xRkoPsryJ6Ax4W4cDkNri7YmNup22LaaGkT_fR-1wE6r3X/s1600/brain-computer-interfaces-241207.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="161" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjtxx8Cwtn11RyWkCPjB4jxAC9-5LEGMp3d4FFwzfobcHQm0qafQssh-jejRelneUY8Bzz5U85QITaIZwmcJwvbnyAkWb2J48xRkoPsryJ6Ax4W4cDkNri7YmNup22LaaGkT_fR-1wE6r3X/s200/brain-computer-interfaces-241207.jpg" width="200" /></a>Computer has revolutionized the human’s life and they are used as bio part of the body i.e to control and synchronize body part and their movements through thoughts.</div><div class="MsoNormal">Scientist has discovered a new technique that use a skullcap fitted with sensors that recognized the brain commands and send them through computers to the machines, this technique is further refined by the scientist of Maryland that allow the person to allow the 3D movements of hands, arms, knees and hip joints to be produced.</div><a name='more'></a><br />
<div class="MsoNormal">This technique will be particularly use full for the persons who are paralyzed after a accident or a stroke and cannot move their limbs.</div><div class="MsoNormal">The brain activities used to move body parts have been analyzed much by the scientist and correlated with the limb movements, the information from this study is being used to designed a prosthetic devices that allow the movements of body parts by thoughts.</div><div class="MsoNormal">So once thoughts are decoded, it is possible to teach the paralyzed to use their minds in a way that allow the device to perform certain functions.</div><span style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The rapid advance in BRAIN COMPUTER INTERFACE (BCI) technology is creating new hopes </span></div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-7029755624526795943.post-27178781596743180792011-07-28T12:14:00.000-07:002011-07-28T12:14:01.654-07:00Sweating and weight loss<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYL-3DxMteXepthPQXsVCuPRs1VGTn9xUVtUKr0KcbyKrWEpH_iLY4ZlWkdmZu6k5RxxNze6nZlmmcb0IsB1u0sqCFaueIiH6lExzGYqfD99V5of6vvPclOZo2imTnQZ6_KvE9v2fUor4Y/s1600/water-impacts-weight-loss.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYL-3DxMteXepthPQXsVCuPRs1VGTn9xUVtUKr0KcbyKrWEpH_iLY4ZlWkdmZu6k5RxxNze6nZlmmcb0IsB1u0sqCFaueIiH6lExzGYqfD99V5of6vvPclOZo2imTnQZ6_KvE9v2fUor4Y/s1600/water-impacts-weight-loss.jpg" /></a></div>Many people think that with increasing perspiration they are losing weight......Yes it is true that when you perspire you lose weight.<br />
<br />
It is actually the water that you are losing through perspiration, but remember that your body in healthy state is very good at balancing the amount of water you hold.<br />
<br />
When you sweat, you lose a lot of water in the form of perspiration, next time you drink water to compensate this lost water. so the water lost through sweating is recovered.<br />
<br />
This is not to say that you should not sweat if you are sweating it means that you are exercising, and if you are exercising it means that you are burning calories, and this burning of calories unlike sweating would cause permanent weight loss.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-86940641316716120112011-07-26T12:59:00.000-07:002011-07-26T12:59:53.738-07:00Coffee and blood pressure<div dir="ltr" style="text-align: left;" trbidi="on"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3zEhJ_zsyEzLC9SZtsX7girxb-XA7jheJSE1kmZuZnltBBgLe7Bzj5-oZu9FU2VxOxRcPezmUAHAM8Q7F2F2UTYF2Q9FlXMJ1yg0csVqIisw2iKo0D9GcCl4NuhCynr1MollvibP4aeYA/s1600/bloodpressure277.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3zEhJ_zsyEzLC9SZtsX7girxb-XA7jheJSE1kmZuZnltBBgLe7Bzj5-oZu9FU2VxOxRcPezmUAHAM8Q7F2F2UTYF2Q9FlXMJ1yg0csVqIisw2iKo0D9GcCl4NuhCynr1MollvibP4aeYA/s200/bloodpressure277.jpg" width="200" /></a>Many of us would be unaware of the effect that <b>coffee</b> may be dangerous in hypertensive people. It is fact that coffee can increase your systolic and diastolic blood pressure even if you don't have high blood pressure. Actually coffee contains <b>caffeine</b> that is the main constituent that increase the blood pressure.<br />
<br />
<b>Mechanism</b>:<br />
there are many possible mechanisms for this increase in blood pressure, one is that caffeine block the hormone that keeps your arteries dilated.Other thinks that is causes release of epinephrine and nor epinephrine from adrenal glands that cause elevation in blood pressure.<br />
<a name='more'></a><br />
<br />
<b>Tolerance to coffee:</b><br />
It has been observed that some people who drink coffee regularly have high blood pressure than those who drink none, and some people develop tolerance to it with regular intake as a result coffee has no effect on their blood pressure.<br />
<br />
<b>Caution:</b><br />
So, the best advise to people who drink coffee regularly and have high blood pressure is that they should limit the use of their coffee intake, or should stop drinking caffeine containing beverages<br />
Also avoid coffee intake during activities that increase your blood pressure or systemic vascular resistance, e.g. physical work,strenuous exercise, weight lifting or physical labor.<br />
<br />
<b>Examine yourself:</b><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJQ96Ez31RszxaiOM1yS999mFsX5ZeMRF7lO41g5BQaQCawHC9Velc5JZOloZ8zuOUi4baOxcFOfxNT-2vDP0SMVEjBlb5iRFNPgjnoGHcPSYrPTLo9kgkbcg5KRvvMRIquhvLheOZZtpG/s1600/bp.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="178" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJQ96Ez31RszxaiOM1yS999mFsX5ZeMRF7lO41g5BQaQCawHC9Velc5JZOloZ8zuOUi4baOxcFOfxNT-2vDP0SMVEjBlb5iRFNPgjnoGHcPSYrPTLo9kgkbcg5KRvvMRIquhvLheOZZtpG/s200/bp.jpg" width="200" /></a></div>To see that caffeine is actually raising your blood pressure start checking your blood pressure after 30 min of drinking a cup of coffee or any other beverage containing caffeine, if blood pressure raises 5-8 points you may be sensitive to the blood elevating effect of caffeine.<br />
<br />
<b>Withdrawl symptoms of coffee:</b><br />
If you plan to reduce your coffee intake than do it gradually over days to weeks to avoid with drawl head ache.</div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-7029755624526795943.post-42007240931398801082011-07-25T12:41:00.000-07:002011-07-25T12:48:35.408-07:00Treatment of gout<div dir="ltr" style="text-align: left;" trbidi="on"><br />
<div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhx-Kwu2JRpZuZPZQ2-C0nCRRWaIa29pfuNWZh9cmOeoPyVJ4jU1-B7ewNWs0EX5vQDBPe3kvnlZ8o0mMiFiVWVRozp2zEbe4zcOF11dc-v2IRccxMAwscaG7vJmbspgEW2qROY7pycFpmE/s1600/gout.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="269" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhx-Kwu2JRpZuZPZQ2-C0nCRRWaIa29pfuNWZh9cmOeoPyVJ4jU1-B7ewNWs0EX5vQDBPe3kvnlZ8o0mMiFiVWVRozp2zEbe4zcOF11dc-v2IRccxMAwscaG7vJmbspgEW2qROY7pycFpmE/s320/gout.jpeg" width="320" /></a></div><br />
<b><span class="Apple-style-span" style="font-size: large;">Treatment of Gout</span></b><br />
<br />
<ul style="text-align: left;"><li><i>Drug mostly Used are:</i></li>
</ul><br />
1. NSAIDs (Asprin should be avoided as it can increase plasma urate at some conc.)<br />
2. Colchicine<br />
3. Allopurinol<br />
4. Uricosuric Agents<br />
<i>For Acute inflamation</i><br />
1. Indomethacin<br />
2. Colchicine<br />
3. Cortiosteroid for resistant episodes of gouts<br />
<i>Prophylactic Treatment</i><br />
1. Allopurinol<br />
2. Uricosuric Agents<br />
Colchicine<br />
Colchicine is an anti-inflamatory drug without anelgesic properties.<br />
<a name='more'></a><br />
<br />
<div style="text-align: left;"></div><ul style="text-align: left;"><li><i>Mechanism of Action</i></li>
</ul><br />
It interferes with the functions of mitotic spindles & causes de-polymerization. As the result, inhibition of migration of granulocytes into the inflammed area and decreased metabolic and phagocytic activity occurs. These changes lead to reduction of lactic acid release and pro inflammatory enzyme that occurs during phagocytosis and breaks the cycle that leads to the inflammatory response. Colchicine prevents spindle formation in metaphase in cell division. High conc. may prevent cells to start mitosis. Other effects are, it inhibits the release of histamine containing granules from blast cells & insulin from pancreatic islets. All these processes may involve the translocation of granules by the micro-tubular system. It lowers the body temperature, depress respiratory centers, constrict blood vessels and induce hypertension by central vasomotor stimulation. It enhances gastrointestinal activity & alters neuromuscular functions.<br />
<br />
<ul style="text-align: left;"><li><i>Pharmacokinetics</i></li>
</ul><br />
Colchicine is rapidly absorbed after oral administration. Peak conc. in plasma reaches in 0.5-2 hrs. It is metabolized to a number of compounds. Large amount of metabolites enter the intestinal tract, in the bile and spleen.<br />
<br />
<ul style="text-align: left;"><li><i>Dose</i></li>
</ul><br />
Colchicine can be used prophylactically. Prophylactic dose is 0.5mg 2-4 times in a week. Prophylactic medication depends upon the frequency & severity of attack. A single dose of 2 mg is used to relieve acute attack of gout.<br />
<br />
<ul style="text-align: left;"><li><i>Adverse Effects</i></li>
</ul><br />
Nausea, vomitting, diarrhoea and abdominal pain by inhibition of mucosal cell division.<br />
In acute poisoning of colchicine, symptoms are nephrotoxicity, ascending paralysis of CNS, gastroenteritis, and vascular damage.<br />
<div style="text-align: left;"><b>DRUGS</b></div><b>Allopurinol</b><br />
Alopurinol is an analogue of hypoxanthine and completely inhibits the enzyme xanthine oxidase.<br />
Allopurinol and its metabolite oxipurinol inhibit the biosynthesis of uric acid. Uric Acid is formed by xanthine oxidase catalyzed oxidation of hypoxanthine and xanthine. At low conc. allopurinol is a substrate for, and competitive inhibitor of, the enzyme. At high conc. it is non-competitive inhibitor. Oxipurinol , the metabolite of allopurinol formed by the action of xanthine oxidase is a non-competitive inhibitor of the enzyme. Inhibition of Uric Acid biosynthesis reduces its plasma conc. and renal excretion of the more soluble oxipurine precursors. During treatment urinary purines are divided among hypoxnthine, xanthine and uric acid. Each has independent solubility. The plasma conc. of Uric acid is reduced below its limit of solubility. Alopurinol facilitates the dissolution of monosodium crystals and prevents the formation uric acid stones and nephropathy.<br />
<br />
<ul style="text-align: left;"><li><i>Pharmacokinetics</i></li>
</ul><br />
It is rapidly absorbed after oral administration and peak plasma conc. within 60-90 min. Half-life is 1-2 hrs. Allopurinol and its metabolites oxipurinol are distributed in total tissue fluid with exception of brain. Drug is excreted in urine.<br />
<br />
<ul style="text-align: left;"><li><i>Therapeutic Uses</i></li>
</ul><br />
Allopurinol is used for the treatment of primary hyperuricemia of gout and polycythemia vera, myeloid metaphasia, gouty nephropathy, renal urate stone and impaired renal function. It is also used prophylactically to reduce hyperuricemia and to prevent urate deposition or renal clearance in patients with leukemias, lymphomas or malignancies.<br />
<br />
<ul style="text-align: left;"><li><i>Adverse effects</i></li>
</ul><br />
Hypersensitivity reactions, Fever and muscular pain are among the adverse effects<br />
<br />
<ul style="text-align: left;"><li><i>Contraindications</i></li>
</ul><br />
It inhibits enzymatic inactivation of mercaptopurines by xanthine oxidase, so dose of anti-neoplastic agents must be reduced to 1/4th – 1/3rd of usual dose.<br />
<br />
<br />
</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-80711406500466976612011-07-25T12:15:00.000-07:002011-07-25T12:19:48.569-07:00Prescription symbol<div dir="ltr" style="text-align: left;" trbidi="on"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjveNiIDOh_OGsbNemp1IJoU6zL-1kkUO8isVKEDIe1UbKHaYKmi6te1y-8x74ZYlQK6Fl9lLTANQJgHMnXlp20Q3TVITuVYAE8DQgtT73xgu64M3-Zd5Gt28wjtrcUef9rkErfP5jsUGnW/s1600/phar.bmp" imageanchor="1" style="clear: left; display: inline !important; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjveNiIDOh_OGsbNemp1IJoU6zL-1kkUO8isVKEDIe1UbKHaYKmi6te1y-8x74ZYlQK6Fl9lLTANQJgHMnXlp20Q3TVITuVYAE8DQgtT73xgu64M3-Zd5Gt28wjtrcUef9rkErfP5jsUGnW/s320/phar.bmp" width="320" /></a><br />
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; mso-yfti-tbllook: 1184; width: 100.0%;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;"><td style="padding: .75pt .75pt .75pt .75pt;"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">"The symbol "Rx" meaning "prescription" is a transliteration of a symbol resembling a capital R with a cross on the diagonal.</span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><br />
<br />
There are various theories about the origin of this symbol - some note its similarity to the Eye of Horus. <o:p></o:p></span></div><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><v:shape alt="http://g-ecx.images-amazon.com/images/G/01/askville/3801502_7924502_mywrite/untitled.jpg" id="Picture_x0020_1" o:spid="_x0000_i1025" style="height: 105.75pt; mso-wrap-style: square; visibility: visible; width: 120pt;" type="#_x0000_t75"> <v:imagedata o:title="untitled" src="file:///C:\DOCUME~1\USMANI~1\LOCALS~1\Temp\msohtmlclip1\01\clip_image002.jpg"> </v:imagedata></v:shape></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><br />
</div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0sCkyMRPoUNsE7qUtIBXrd047jPrgnuxq7Q1qKSGXjH87zuGgFjxktygxzuPGZYtG4Bs0jLvkpPbgXJaYRoqyUn8MVAMWITlcoaYvcTRj8ZbhxAl8_7OiFlfkzFbUmhtUtvWLVZ39RFOX/s1600/New+Picture.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="176" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0sCkyMRPoUNsE7qUtIBXrd047jPrgnuxq7Q1qKSGXjH87zuGgFjxktygxzuPGZYtG4Bs0jLvkpPbgXJaYRoqyUn8MVAMWITlcoaYvcTRj8ZbhxAl8_7OiFlfkzFbUmhtUtvWLVZ39RFOX/s200/New+Picture.png" width="200" /></a></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><br />
</span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><br />
</span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><br />
</span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><br />
</span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><br />
</span></div>Others to the ancient symbol for Jupiter, both gods whose protection may have been sought in medical contexts. Alternatively, it may be intended as an abbreviation of the Latin "recipe", the imperative form of "recipere", "to take", and it is quite possible that more than one of these factors influenced its form. Literally, "Recipe" means simply "Take...." and when a doctor writes a prescription beginning with "Rx", he or she is completing the command. This was probably originally directed at the pharmacist who needed to take a certain amount of each ingredient to compound the medicine, rather than at the patient who must "take" the medicine, in the sense of consuming it.<br />
The word "prescription" can be decomposed into "pre" and "script" and literally means, "to write before" a drug can be prepared. Those within the industry will often call prescriptions simply "scripts"." <o:p></o:p></td> </tr>
</tbody></table><div class="MsoNormal"><br />
</div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-43828188548490407292011-07-25T11:48:00.000-07:002011-07-25T11:55:49.866-07:00NATIONAL ESSENTIAL DRUGS LIST OF PAKISTAN<div dir="ltr" style="text-align: left;" trbidi="on"><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkstbiPkOv1HVpbq1SQPDPC-Pc0z4Hog_A9dtZfp2bgwGG1-dwj-KSpasDzw84yY7X6capqj1MyqC3fSgvOW-9cHOk-qDISHYnp-3o8c2ty4V6jnrMT_TX-XHpIIyX9ZHPhk6L7j81Rhyphenhyphenk/s1600/untitled.bmp" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkstbiPkOv1HVpbq1SQPDPC-Pc0z4Hog_A9dtZfp2bgwGG1-dwj-KSpasDzw84yY7X6capqj1MyqC3fSgvOW-9cHOk-qDISHYnp-3o8c2ty4V6jnrMT_TX-XHpIIyX9ZHPhk6L7j81Rhyphenhyphenk/s320/untitled.bmp" width="320" /></a>i<br />
<b><span class="Apple-style-span" style="font-size: large;">NATIONAL ESSENTIAL DRUGS LIST OF PAKISTAN</span></b><br />
<i> Ministry of Health</i><br />
<i> Government of Pakistan</i><br />
<i> Islamabad</i><br />
<i> 2003</i><br />
ii<br />
<br />
NATIONAL<br />
ESSENTIAL DRUGS<br />
LIST<br />
iii<br />
CONTENTS<br />
PREFACE…………………………………….……………… vii<br />
NATIONAL ESSENTIAL DRUGS LIST<br />
THIRD REVISION<br />
<br />
<a name='more'></a><br />
<br />
<br />
<br />
Explanatory Notes .........................................................viii<br />
1: ANAESTHETICS ............................................................1<br />
1.1 General Anaesthetics and Oxygen ..................... 1<br />
1.2 Local Anaesthetics .............................................1<br />
1.3 Neuromuscular Blocking Agents .......................2<br />
1.4 Miscellaneous.....................................................2<br />
2: ANALGESICS, ANTIPYRETICS, NONSTEROIDAL<br />
ANTI-INFLAMMATORY DRUGS<br />
AND DRUGS USED TO TREAT GOUT ....................... 2<br />
2.1 Opioid Analgesics ..............................................2<br />
2.2 Non-Opioid Analgesics and NSAIDS................ 2<br />
2.3 Local Analgesics………………………………. 2<br />
2.4 Drugs used to treat Gout ................................ 2<br />
3: ANTI-ALLERGICS AND DRUGS USED IN<br />
ANAPHYLAXIS .............................................................3<br />
4: ANTI-EPILEPTICS ........................................................3<br />
5: ANTIINFECTIVE DRUGS .............................................3<br />
5.1 Anthelmintics ..................................................... 3<br />
5.2 Antibacterials ..................................................... 4<br />
5.3 Antituberculosis Drugs....................................... 6<br />
5.4 Antifungal Drugs................................................ 7<br />
5.5 Antiamoebic Drugs ............................................ 7<br />
5.6 Antiviral Drugs .................................................. 8<br />
5.7 Antimalarial Drugs and Prophylactics ............... 8<br />
5.8 Antileishmanial Drugs ....................................... 8<br />
6: ANTIMIGRAINE DRUGS .............................................8<br />
7: ANTIPARKINSONISM DRUGS....................................8<br />
8: DRUGS AFFECTING BLOOD ......................................9<br />
8.1 Antianaemic Drugs ............................................ 9<br />
8.2 Drugs Affecting Coagulation ............................. 9<br />
iv<br />
9: BLOOD PRODUCTS AND PLASMA<br />
SUBSTITUTES................................................................9<br />
10: CARDIOVASCULAR DRUGS.......................................9<br />
11: DERMATOLOGICAL DRUGS ....................................11<br />
12: DIURETICS...................................................................12<br />
13: GASTROINTESTINAL DRUGS ..................................12<br />
14: HORMONES, OTHER ENDOCRINE DRUGS AND<br />
CONTRACEPTIVES.....................................................13<br />
15: IMMUNOLOGICALS ...................................................14<br />
15.1 Diagnostics....................................................... 14<br />
15.2 Sera and Immunologicals................................. 15<br />
15.3 Vaccines for Universal Immunization.............. 15<br />
15.4 Vaccines for Specific Use ................................ 15<br />
15.5 Immunosuppressants........................................ 16<br />
16: MUSCLE RELAXANTS (PERIPHERALLY ACTING)<br />
AND CHOLINESTRASE INHIBITORS ...................... 16<br />
17: OPHTHALMOLOGICAL PREPARATIONS...............16<br />
17.1 Antiinfective Agents ........................................ 16<br />
17.2 Miotics and Antiglaucoma Drugs .................... 16<br />
17.3 Mydriatics and Cycloplegics Drugs ................. 16<br />
17.4 Corticosteroids ................................................. 17<br />
17.5 Non-steroidal Antiallergic/Decongestants ...... 17<br />
17.6 Topical Anaesthetics......................................... 17<br />
17.7 Others................................................................ 17<br />
18: OXYTOCICS AND ANTIOXYTOCICS ...................... 17<br />
19: PERITONEAL DIALYSIS SOLUTION .......................17<br />
20: PSYCHOTHERAPEUTIC DRUGS ..............................18<br />
21: DRUGS ACTING ON THE RESPIRATORY<br />
TRACT .........................................................................18<br />
22: SOLUTIONS CORRECTING WATER,<br />
ELECTROLYTE AND ACID BASE<br />
DISTURBANCES..........................................................19<br />
23: VITAMINS AND MINERALS ..................................... 19<br />
24: E.N.T. PREPARATIONS...............................................20<br />
25: ANTISEPTICS AND DIS-INFECTANTS ....................20<br />
25.1 Antiseptics........................................................ 20<br />
25.2 Disinfectants..................................................... 21<br />
v<br />
26: DENTAL PREPARATIONS (T) ...................................21<br />
27: DISPENSARY ITEMS (P,S,T)..................................... 21<br />
28: DRUGS FOR LOCAL PURCHASE.............................. 23<br />
28.1 Antidotes and other substances used in<br />
poisoning.......................................................... 23<br />
28.2 Antileprosy Drugs ............................................ 24<br />
28.3 Antineoplastics, Immunosuppressives and<br />
Drugs used in palliative care ............................ 24<br />
28.3.1 Immunosuppressive Drugs.................24<br />
28.4 Diagnostic Agents ............................................ 25<br />
29: DRUGS FOR SPECIALIZED CENTERS..................... 26<br />
29.1 Antiretroviral Drugs ........................................ 26<br />
INDEX ..................................................................................... 28<br />
vi<br />
PREFACE<br />
After the second World War the development and emergence of miracle drugs like antibiotics brought a revolution in the medical care. The<br />
obvious effectiveness of these new pharmaceuticals and intensive marketing efforts combined to catalyze wide spread use of modern medicine. A<br />
rapidly growing and profitable industry, together with an enthusiastic but largely uninformed audience and an unregulated market, resulted in<br />
excess of promotion and consumption alowgwith inflated level of expenditure. However, by 1970s it had become clear that least advantageous<br />
nations were not even meeting the basic needs of their people for essential life saving and health promoting drugs. As a result gradually a number<br />
of countries started concentrating on the development of a basic list of reliable drugs to meet the most vital basic needs of their people.<br />
A World Health Organization (WHO) Committee of Experts met in 1977 to determine the number of drugs, which were actually needed to ensure<br />
a reasonable level of health care for as many people as possible. Consequently, the first Model List of Essential Drugs was finalized in the same<br />
year. This list is being updated regularly by the WHO and is intended to be used as a guideline and provide basis for member countries to identify<br />
their own priorities and make their own selection. Through 1970s and 1980s the WHO started promotion of the concept of Essential Drugs<br />
Program in order to redress this imbalance. The program aimed at reduction in the number of drugs purchased/used by the hospitals/institutions to<br />
a minimum possible level in order to make best use of limited public funds.<br />
Essential drugs as defined by WHO are those that satisfy the health care needs of majority of the population. They should therefore be available at<br />
all times in adequate amounts and in the appropriate dosage forms.<br />
The National Essential Drugs List (NEDL) of Pakistan was first prepared in 1994 in consultation with relevant experts. The list was previously<br />
reviewed in 1995 and 2000. The present list is the third revision containing 452 drugs of different pharmacological classes.<br />
The health sector in general and public health sector in particular is expected to seriously consider adopting this list. The provincial health<br />
departments can play a pivotal role to encourage the hospitals/institutions for making bulk purchases from within this list. We hope that this list<br />
will find more acceptance among health care professionals.<br />
Maj. Gen. ® Mohammad Aslam HI (M)<br />
Director General Health<br />
EXPLANATORY NOTES<br />
Letters in parentheses following drug names indicate: (P) for Primary, (S) for Secondary and (T) for Tertiary.<br />
1. Classification of drugs for use at various levels of Health<br />
Services is as follows:<br />
(P) PRIMARY: For use at the Primary Health Care Level including Basic Health Units and Rural Health<br />
Centers.<br />
(S) SECONDARY: For use at the Secondary Health Center Level i.e; hospitals.<br />
(T) TERTIARY: For use at the specialized and sub-specialized levels for specific expertise diagnostic<br />
precision or special equipment required for proper use.<br />
II. Drugs subject to international controls under :<br />
(1) Single Convention on Narcotic drugs 1961:<br />
(2) Convention on Psychotropic Substances 1971; and<br />
(3) Convention on Illicit Traffic in Narcotic Drugs and Psychotropic Substances 1988.<br />
III. Special considerations ;<br />
(4) In renal insufficiency, contraindicated or dosage adjustments necessary;<br />
(5) To improve compliance;<br />
(6) Special pharmacokinetic properties;<br />
(7) Adverse effects diminish benefit/risk ratio;<br />
(8) Limited indications or narrow spectrum of activity;<br />
(9) For epidural anaesthesia;<br />
vii<br />
(10) Specific expertise, diagnostic precision, individualization of dosage or special equipment required for<br />
proper use;<br />
(11) Monitoring of therapeutic concentrations in plasma can improve safety and efficacy;<br />
(12) COMPLEMENTARY DRUGS: Choice to be made on the basis of cost effectiveness.<br />
IV. When the strength of a drug is specified in terms of a selected salt or ester, this is mentioned in brackets; when it<br />
refers to the active moiety, the name of the salt or ester in brackets is preceded by the word ‘as’.<br />
1<br />
ANAESTHETICS<br />
1.1 General Anaesthetics and Oxygen<br />
diazepam (P), (S), (T), (2) 10mg/2ml inj.<br />
ether, anaesthetic (P), (S), (T), (3,10) liquid for inhalation<br />
halothane (T) (10) liquid for inhalation<br />
ketamine (S), (T), (10) 50 mg/ml inj.(as hydrochloride)<br />
nitrous oxide (T), (10) Gas for inhalation<br />
(*propofol 10 mg/ml inj)<br />
thiopental (T), (10) 500 mg powder for inj. (as sodium<br />
salt)<br />
(*only in exceptional cases on the basis of cost effectiveness).<br />
1.2 Local Anaesthetics<br />
bupivacaine (T),(9), (10)<br />
0.25% & .5% (as hydrochloride) inj.<br />
ephedrine hydrochloride (S), (T), (3) 50 mg/ml Inj.<br />
lignocaine (S), (T) 1% & 2% inj. (as hydrochloride)<br />
5% (as hydrochloride) inj. for spinal<br />
anaesthesia<br />
2% & 4% (hydrochloride) topical<br />
solution<br />
2% (hydrochloride) gel.<br />
lignocaine + epinephrine (S), (T) 1% (hydrochloride) + epinephrine<br />
1:100 000 inj.<br />
2% (hydrochloride) + epinephrine<br />
1:200 000 inj.<br />
2% (hydrochloride) + epinephrine<br />
1:80 000 dental cartridge<br />
2<br />
1.3 Neuromuscular Blocking Agents.<br />
atracurium (T) 25&50 mg inj. (as besylate)<br />
pancuronium (T) 4 mg inj. (as bromide)<br />
suxamethonium (T), (10) 100 mg inj. (as chloride)<br />
1.4 Miscellaneous<br />
atropine (P), (S), (T) 1mg inj. (as sulfate)<br />
oxygen (P), (S), (T) gas for inhalation.<br />
2: ANALGESICS, ANTI TIPYRETICS, NON-STEROIDAL<br />
ANTI-INFLAMMATORY DRUGS AND DRUGS<br />
USED TO TREAT GOUT.<br />
2.1 Opioid Analgesics<br />
morphine (P), (S), (T), (1) 10mg & 30mg slow release tab.<br />
10mg/ml inj. (as sulfate or<br />
hydrochloride).<br />
pethidine (P), (S), (T), (1,4) 50 mg/ml inj. (as hydrochloride)<br />
2.2 Non-Opioid Analgesics and NSAIDS<br />
acetylsalicylic acid (P), (S), (T) 300 mg tab.<br />
diclofenac (T) 75 mg / 3 ml inj. (as sodium)<br />
ibuprofen (P),(S),(T) 200,400 and 600 mg tab.<br />
indomethacin (P),(S),(T) 25 mg cap or tab.<br />
paracetamol (P),(S), (T) 500 mg tab.<br />
2.3 Local Analgesics<br />
choline salicylate (P), (S), (T) 8.7% gel for local use.<br />
2.4 Drugs used to treat Gout<br />
3<br />
allopurinol (S), (T), (7) 100 & 300 mg tablet<br />
colchicine (S), (T), (4) 0.5 mg tab<br />
3: ANTIALLERGICS AND DRUGS USED IN<br />
ANAPHYLAXIS<br />
adrenaline (P), (S), (T) 1mg inj. (as hydrochloride)<br />
chlorpheniramine (P), (S), (T) 4mg tablet (as maleate), 2mg/5ml<br />
syrup (as maleate)<br />
dexamethasone (P), (S), (T) 0.5mg tab<br />
4&20mg inj.(as sodium phosphate)<br />
hydrocortisone (P),(S),(T) 100 mg inj.(as sodium succinate)<br />
prednisolone (P), (S), (T) 5 mg tablet<br />
promethazine (P), (S), (T) 10 & 25mg tab. (as hydrochloride)<br />
5mg/5ml elixir or syrup<br />
(as hydrochloride)<br />
25mg inj. (as hydrochloride)<br />
4: ANTI-EPILEPTICS<br />
carbamazepine (P), (S), (T) (11) 200 mg tab. Syp.<br />
diazepam (P), (S), (T) (2) 10 mg/2ml injection.<br />
ethosuximide (T)<br />
250 mg capsule/tab. 250 mg/5ml<br />
syrup.<br />
phenobarbitone (P), (S), (T), (2,11) 30 mg tab. 200 mg/ml inj.<br />
phenytoin (P), (S), (T), (7,11) 100mg tab./capsule (as sodium)<br />
phenytoin sodium (S), (T), (7,11)<br />
30mg/5ml syrup (as sodium)<br />
valproate sodium (T),(7,11) 200 mg tab. 200 mg/5ml syrup.<br />
4<br />
valproic acid (T), (7,11) 125 mg, 250 mg & 500 mg tab<br />
250 mg/5ml syrup).<br />
5: ANTI-INFECTIVE DRUGS.<br />
5.1 Anthelmintics<br />
albendazole (P), (S), (T) 200 mg tab. 100 mg/5ml susp.<br />
levamisole (T), (8) 40 mg tablet (as hydrochloride)<br />
40 mg/5ml syrup.<br />
mebendazole (P), (S), (T) 100 mg tab. 100 mg/5ml susp.<br />
niclosamide(P), (S), (T) 500 mg tab.<br />
pyrantel (P), (S), (T) 250 mg tab. (as pamoate)<br />
250 mg/5ml susp.(as pamoate).<br />
5.2 Antibacterials<br />
amoxicillin (P), (S), (T,), (4)<br />
250 & 500 mg capsule/tablet (as<br />
trihydrate).<br />
125 & 250 mg/5ml syrup (as<br />
trihydrate)<br />
ampicillin (P), (S), (T), (4) 250 & 500mg tab/cap (as<br />
anhydrous/trihydrate)<br />
125 mg/5ml syrup (as<br />
anhydrous/trihydrate)<br />
500mg inj.(as sodium salt).<br />
amikacin (T) 250 & 500 mg inj. (as sulphate)<br />
benzylpenicillin (P), (S), (T) 100.44 gm inj. (benzathine)<br />
600 mg (1 million IU) inj.<br />
(sodium/potassium)<br />
cefazolin (T) 250,500mg & 1gm inj.(as sodium<br />
salt)<br />
cefatazidime (T) 500 mg & 1 gm inj.<br />
5<br />
ceftriaxone (T) 250,500&1gm inj(as sodium salt)<br />
ceftizoxime (T) 250, 500mg & 1gm inj.(as sodium<br />
salt).<br />
cefixin (T) 100 mg cap.<br />
cefuroxime (T) 125,250 mg tab. (as axetil)<br />
250 and 750 mg inj. (as sodium)<br />
cephalexin (T) 250 & 500 mg cap.<br />
125 mg/5ml & 250mg/5ml syrup.<br />
cephradine (T) 250 & 500 mg cap.<br />
125 mg/5ml & 250 mg / 5ml syrup<br />
250, 500 mg & 1 gm inj.<br />
chloramphenicol (P), (S), (T), (7)<br />
250 mg capsule<br />
125mg/5ml syrup (as palmitate)<br />
1 gm inj. (as sodium succinate)<br />
ciprofloxacin (P), (S),(T) 250 mg tab.(as hydrochloride)<br />
clindamycin (T), (8) 300 & 600 mg inj. (as hydrochloride)<br />
cloxacillin (T) 250 mg cap. (as sodium)<br />
125 mg/5ml syrup (as sodium),<br />
250 mg inj. (as sodium)<br />
co-trimoxazole (P), (S), (T) 400mg+80mg & 800mg+160mg tab.<br />
(sulphamethoxazole+ trimethoprim),<br />
(4)<br />
200 mg+40 mg/5ml suspension<br />
800mg+160mg/3 ml injection.<br />
doxycycline (T), (5,6) 100 mg cap / tablets (as<br />
hyclate/hydrochloride)<br />
erythromycin (P), (S), (T) 250 & 500mg tablet (as stearate)<br />
200mg/5ml suspension (as ethyl<br />
succinate)<br />
500mg inj. (as lactobionate).<br />
gentamicin (P), (S,), (T,), (4,7,10,11) 40 & 80 mg inj. (as sulfate)<br />
6<br />
metronidazole (P), (S), (T), (8) 200, 400 mg tab.<br />
200 mg/5ml suspension (as benzoate)<br />
500 mg/100ml vial.<br />
nalidixic acid (P), (S), (T) 500 mg tablet<br />
300 mg / 5ml syrup.<br />
5000,000 IU tab<br />
100,000 IU/ml drops<br />
100,000 IU pessaries<br />
nitrofurantoin (P), (4,8) 100 mg<br />
nystatin (S), (T) 200 mg tab. (as hydrochloride)<br />
pefloxacin (T) 400 mg/5ml inj.<br />
phenoxymethylpenicillin (P), (S), (T) 250 & 500mg tab. (as potassium salt)<br />
125 mg/5ml syrup.<br />
procaine benzylpenicillin (P), (S), (T) 1 & 3 million IU inj.<br />
sulphasalazine (S), (T) 500 mg tab.<br />
tinidazole (S), (T) 300 & 500 mg tab.<br />
trimethoprim (S), (T), (8) 300 mg tab.<br />
5.3 Anti-Tuberculosis Drugs<br />
ethambutol (P), (S), (T), (4) 400mg tab.(hydrochloride)<br />
isoniazid (P), (S), (T) 50, 100 & 300 mg tab. Syrup.<br />
isoniazid + ethambutol<br />
(P),(S),(T),(5)<br />
150 mg +400 mg<br />
pyrazinamide (P), (S), (T) 500 mg tab.<br />
rifampicin (P), (S), (T) 150, 300, 450 & 600 mg tab/cap<br />
syrup.<br />
rifampicin + isoniazid (P),(S),(T) 150 mg + 100 mg tab./cap.<br />
7<br />
300 mg + 150 mg tab./cap.<br />
450 mg + 300 mg tab./cap.<br />
rifampicin + isoniazid +<br />
pyrazinamide (P),(S),(T), (5)<br />
150 mg + 75 mg + 400 mg<br />
rifampicin + isoniazid +<br />
pyrazinamide + ethambutol<br />
(P),(S),(T)<br />
150 mg + 75 mg + 400 mg + 275 mg<br />
streptomycin (P), (4) 1g inj. (as sulphate).<br />
thioacetazone (P), (S), (T) 50mg tab.<br />
thioacetazone + isoniazid (P), (S),<br />
(T), (7)<br />
(50 mg + 100 mg) tab. (150 mg +<br />
300 mg) tab<br />
5.4 Anti-Fungal Drugs<br />
amphotericin B (T), (4) 50 & 100 mg tab.<br />
griseofulvin (T), (7,8) 125 & 500 mg tab.<br />
ketoconazole (T) 200 mg tab. 100 mg/5ml oral<br />
suspension<br />
nystatin (P), (S), (T) 500 000 IU tablets<br />
100 000 IU/ml oral drops<br />
100 000 IU pessary<br />
5.5 Anti-Amoebic Drugs<br />
chloroquine (P), (S), (T) 150mg tab (as sulphate or<br />
phosphate)<br />
50 mg/5ml syrup,<br />
200 mg inj.<br />
8<br />
diloxanide (P), (S), (T) 500 mg tablet (as furoate).<br />
metronidazole (P), (S), (T) 200 & 400 mg tab.<br />
200 mg (as benzoate)/5ml<br />
suspension.<br />
9<br />
5.6 Antiviral Drugs<br />
acyclovir (T), (8) 200 mg tab 250mg inj.<br />
(as sodium)<br />
5.7 Antimalarial Drugs and Prophylactics<br />
chloroquine (P), (S), (T) 150mg tab (as sulphate orphosphate)<br />
50mg/5ml syrup&200 mg inj.<br />
primaquine (P), (S), (T) 7.5 mg tab.<br />
quinine (P), (S), (T) 200 mg tab. (as sulphate)<br />
300 mg tab. (as bisulphate)<br />
quinine dihydrochloride (S),(T) 600mg inj<br />
sulphadoxine + pyrimethamine (P),<br />
(S), (T)<br />
500 mg + 25 mg tab.<br />
5.8 Antileishmanial Drugs<br />
sodium stibogluconate (S) 100 mg inj.<br />
6: ANTIMIGRAINE DRUGS<br />
ergotamine (P), (S), (T), (7) 1mg tab. (as tartarate)<br />
0.5mg inj.<br />
7: ANTIPARKINSONISM DRUGS<br />
biperiden (P), (S), (T) 2 & 5 mg inj. (as lactate)<br />
carbidopa+levodopa (T),(5,6) 25 mg + 250 mg tab.<br />
procyclidine (S), (T) 5 mg. tab.<br />
selegiline (T) 5 mg tab.<br />
10<br />
8: DRUGS AFFECTING BLOOD<br />
8.1 Antianaemic Drugs<br />
ferrous salt (P), (S), (T) eq.to 60 mg iron tab. eq.to 25mg<br />
iron/ml syrup (as sulfate).<br />
folic acid (P), (S), (T), (10) 1 & 5mg tab.<br />
iron dextran (P), (S), (T), (5) eq. to 50mg iron/ml inj.<br />
8.2 Drugs Affecting Coagulation<br />
heparin (S), (T) 1000, 5000 & 20,000 IU inj.<br />
(as sodium)<br />
phytomenadione (S), (T) 10 mg inj. 10mg tab.<br />
tranexamic acid (S),(T) 250mg cap. 250 mg inj.<br />
warfarin (S),(T), (6,10) 1 & 5 mg tab. (as sodium)<br />
9: BLOOD PRODUCTS AND PLASMA SUBSTITUTES<br />
albumin (human) (T) 5% & 25% solution for inj.<br />
dextran 40 (P), (S),(T) 40% w/w for infusion.<br />
factor VIII concentrate (T), (8,10) inj.<br />
factor IX complex inj.<br />
conc. USP (T)<br />
immune human serum (T) inj.<br />
platelets human (T) inj.<br />
polygeline (T) 35% inj.<br />
10: CARDIOVASCULAR DRUGS<br />
acetylsalicylic acid(P), (S), (T) 150 mg, 300 mg tab.<br />
amiodarone (T) 200 mg tab.<br />
amlodipine (S), (T) 5 mg tab.<br />
atenolol (S), (T) 50 & 100 mg tab.<br />
11<br />
captopril (T) 25 & 50 mg tab.<br />
digoxin (P), (S), (T), (4) 500 mcg inj. 250 mcg tab.<br />
50 mcg/ml oral solution.<br />
diltiazem (T) 30, 60, 90 & 180 mg tab.<br />
(as hydrochloride) 10 & 50 mg inj.<br />
dobutamine (T) 250 mg inj.<br />
dopamine (S), (T) 200 & 800 mg<br />
inj. (as hydrochloride)<br />
(enalapril (S), (T) 5 & 10 mg tab), 100 mg inj).<br />
esmolol (T) 100 mg inj.<br />
gemfibrozil (T) 300 mg cap.<br />
hydralazine (T) 25 mg tab. 20 mg inj.<br />
isoprenaline (S), (T) 30 mg tab. 1mg inj.<br />
isosorbide dinitrate (P), (S), (T) 5mg tab (sublingual).<br />
10mg tab.<br />
labetolol (T) 100 & 200 mg tab. (as hydrochloride)<br />
5mg/ml inj. (as hydrochloride).<br />
lignocaine (P), (S), (T) 1% & 2% inj. (as hydrochloride).<br />
(lisinopril 5, 10 & 20 mg tab)<br />
losartan (S), (T) 25 mg tab.<br />
methyldopa (P), (S), (T), (7) 250 & 500 mg tab.<br />
250 mg inj.<br />
nicotinic acid (S), (T) 50mg tab.<br />
(nitroglycerin (P), (S), (T) 500 mcg tablet (sublingual)<br />
2.6 & 6.4 mg tab.<br />
5&10 mg patches)<br />
1mg/ml I.V. infusion (T)<br />
phenytoin (S), (T) 30 mg/5ml susp.<br />
25 mg cap. (sodium)<br />
12<br />
250 mg inj.<br />
prazosin (P), (S), (T) 1 & 2 mg tab.<br />
procainamide (T) 250 mg tab. 100 mg inj.<br />
propranolol (P), (S), (T) 10, 40, 80 & 160 mg tab.<br />
1mg inj.<br />
quinidine (T) 200 mg tab. (as sulphate)<br />
sodium nitroprusside (T), (8,10) 50 mg inj.<br />
verapamil (S), (T), (8,10) 40, 80 & 240 mg tab. 5mg inj. (T)<br />
11: DERMATOLOGICAL DRUGS (TOPICAL)<br />
benzoic acid + salicylic acid (P), (S),<br />
(T)<br />
6% + 3% ointment or cream<br />
benzoyl peroxide (T) 5% & 10% gel<br />
benzyl benzoate (P), (S), (T) 25% lotion<br />
betamathosone (S), (T) 0.1% oint/cream/lotion<br />
betamathosone + neomycin (S), (T) 0.1+0.5% oint/cream/lotion<br />
benzophenones (T) cream/lotion/gel<br />
calamine powder (P), (S), (T) for 15% calamine lotion<br />
clotrimazole (P), (S), (T) 1% cream/oint/solution<br />
coaltar liquid (P), (S), (T) for 7.5% lotion.<br />
gammabenzene hexachloride (S), (T) 1% cream<br />
gentian violet (P), (S), (T) 0.5% aq. solution<br />
hydrocortisone (P), (S), (T) 1% cream/oint (as acetate)<br />
hydrocolloid methoxasalen (S), (T) dressings<br />
10 mg tab.<br />
0.75% oint./cream/lotion.<br />
neomycin+bacitracin (P), (S), (T) 5mg neomycin sulfate<br />
+500 IU bactitracin zinc/g<br />
13<br />
neomycin (P), (S), (T) 0.5% oint/cream<br />
nystatin (P), (S), (T) 100,000 iu/gm oint/cream<br />
polymyxin + zinc bacitracin (P), (S),<br />
(T)<br />
ointment.<br />
permethrin (T) 1% & 5% cream<br />
salicylic acid (P), (S), (T) 5% topical solution/ lotion/gel.<br />
silver sulphadiazine (P), (S), (T) 1% cream<br />
sodium thiosulfate (P), (S), (T) 15% solution<br />
zinc oxide (P), (S), (T) 25% cream/ointment<br />
12: DIURETICS<br />
amiloride (S),(T), (4,7,8) 5 mg tab. (hydrochloride)<br />
furosemide (P), (S), (T) 20 & 40 mg tab. 10mg inj.<br />
hydrochlorthiazide (S), (T) 50 mg tab.<br />
mannitol (T) 10% & 20% inj.<br />
spironolactone (S), (T), (8) 25 & 100 mg tab.<br />
13: GASTROINTESTINAL DRUGS<br />
aluminium hydroxide (P), (S), (T) 500mg tablet<br />
320 mg/5ml oral suspension<br />
aluminium hydroxide + 400 + 400 mg tab.<br />
magenesium hydroxide (P), (S), (T) 200 + 200 mg/5ml susp.<br />
atropine sulphate (P), (S), (T) 1 mg tab. & 0.5mg inj.<br />
bisacodyl (P), (S), (T) 5mg tab<br />
cimetidine (P), (S), (T) 200 & 400mg tab. 200mg inj<br />
cyclizine (P), (S), (T) 50mg tab. 12.5 mg/5ml syrup. 50mg<br />
inj.<br />
hyoscine butylbromide (P), (S), (T) 10 mg tab & 20 mg inj.<br />
14<br />
ispaghulla husk (P), (S), (T) for solution<br />
lactulose (T) 50% syrup<br />
magnesium hydroxide (P), (S), (T) 550 mg/10ml susp. 400 mg tab.<br />
metoclopramide (P), (S), (T) 10 mg tab. 10mg inj.<br />
5mg / 5 ml syrup<br />
omeprazole (P), (S), (T) 20 mg cap.<br />
oral rehydration salt (P), (S), (T) components to reconstitute 1 litre<br />
glucose/electrolyte solution:<br />
sodium chloride 3.5g, trisodium<br />
citrate dihydrate 2.9g, potassium<br />
chloride 1.5g, glucose 20g.<br />
potassium chloride (P), (S), (T) 7.4% inj<br />
prochlorperazine (S), (T) 5 mg tab. 12.5 mg inj.<br />
promethazine (P), (S), (T) 10 & 25mg tablet. 1 mg/ml elixir.<br />
25 mg/ml inj.<br />
sulphasalazine (S), (T) 500 mg tab.<br />
14: HORMONES, OTHER ENDOCRINE DRUGS AND<br />
CONTRACEPTIVES<br />
bromocriptine (T) 2.5 mg tab.<br />
carbimazole 5mg tab.<br />
clomifene (T,8) 50 mg tablet<br />
condoms with or without<br />
spermicide (nonoxinol) (P), (S), (T)<br />
conjugated estrogen (S), (T) 0.625 mg / gm cream<br />
dexamethasone (P), (S), (T) 0.5mg tab. 4 & 20 mg inj.<br />
diaphragms with spermicide<br />
(nonoxinol) (P), (S), (T)<br />
ethynylestradiol + levonorgestrol 0.03 mg + 0.15 mg tab.<br />
15<br />
(S), (T)<br />
ethynylestradiol + norethisterone<br />
(P), (S)<br />
(0.05 mg + 0.5 mg), (35 mcg +<br />
1mg) tab.<br />
glibenclamide (P), (S), (T) 5 mg tab.<br />
human chorionic 1000 & 5000 iu inj.<br />
gonadotrophic hormone (T)<br />
hydrocortisone (S), (T) 100 & 250 mg inj.<br />
17-hydroxyprogesterone caproate<br />
(S), (T)<br />
250 & 500 mg inj.<br />
insulin comp. S100 IU/inj.<br />
zinc or isophane (P), (S), (T)<br />
insulin Regular (P), (S) , (T) 100 IU.<br />
intrauterine device copper T (P), (S),<br />
(T)<br />
levonorgesterol (P), (S) 0.75 mg tab.<br />
metformin (P), (S), (T) 500 mg tab. (as hydrochloride)<br />
norethisterone (S), (T) 5 mg tab. 200 mg inj. (as enanthate)<br />
oxytocin (S), (T) 10 units /ml; 1ml ampoule<br />
potassium iodide (P), (S), (T) 60 mg tablet<br />
prednisolone (S), (T) 5mg tablet<br />
propylthiouracil (T) 50 & 100 mg tab.<br />
thyroxine (T) 50mcg tab. (as sodium anhydrous)<br />
vasopressin/ADH (T) 20 IU/ inj.<br />
15: IMMUNOLOGICALS<br />
15.1 Diagnostics<br />
tuberculin PPD (T) inj.<br />
16<br />
15.2 Sera and Immunologicals<br />
anti-D immunoglobulin (T) inj.<br />
antiscorpian sera (P), (S), (T) inj.<br />
antivenom sera (P), (S), (T) inj.<br />
diphtheria antitoxin inj. (P), (S), (T) inj.<br />
hepatitis B immunoglobulin (T) inj.<br />
tetanus antitoxin (P), (S), (T) inj.<br />
tetanus toxid (P), (S), (T) inj<br />
15.3 Vaccine for Universal Immunization<br />
BCG (dried) vaccine (P), (S), (T) inj<br />
diptheria-pertussis tetanus vaccine<br />
(P), (S), (T)<br />
inj.<br />
dipatheria-tetanus vaccine (P), (S), (T) inj.<br />
measles-mumps-rubella<br />
vaccine (P), (S), (T) inj.<br />
measles vaccine (P), (S), (T) inj.<br />
poliomyelitis vaccine oral solution<br />
(live attenuated) P), (S), (T)<br />
tetanus vaccine (P), (S), (T) inj.<br />
15.4 Vaccines for Specific Use.<br />
hepatitis B vaccine (T) inj.<br />
meningococcal vaccine (T) inj.<br />
rabies vaccine (P), (S), (T) inj.<br />
rubella vaccine (T) inj<br />
yellow fever vaccine (T) inj<br />
17<br />
15.5 Immunosuppressents.<br />
cyclosporin (T), (10) 50 mg/ml inj.<br />
25 & 100 mg cap<br />
16: MUSCLE RELAXANTS (PERIPHERALLY ACTING) AND<br />
CHOLINESTERASE INHIBITORS<br />
pyridostigmine (S), (T), (8,10) 60 mg tab.<br />
17: OPHTHALMOLOGICAL PREPARATIONS<br />
17.1 Anti-Infective Agents<br />
acyclovir (T) 3% eye oint.<br />
chloramphenicol (P), (S), (T) 1% eye oint. 0.5% drops<br />
gentamicin (S), (T) 0.3% eye drops/eye oint.<br />
ketoconazole (T) 2 mg/ml eye drops<br />
polymixin B sulphate + bacitracin<br />
zinc (S),(T)<br />
10,000 IU + 500 IU/gm oint.<br />
sulfacetamide (P), (S), (T) 10%, 20% & 30% eye drops, 10%<br />
eye oint.<br />
tetracycline (P), (S), (T) ointment.<br />
17.2 Miotics and Antiglaucoma Drugs.<br />
dipivefrin (T) 0.1% eye drops<br />
(levobunalol 0.5% eye drops)<br />
pilocarpine (S) 1%, 2% & 4% eye drops.<br />
17.3 Mydriatics and Cycloplegics Drugs<br />
atropine (S), (T) 1% & 2% eye drops<br />
homatropine (S), (T) 2% eye drops<br />
phenylepherine (T) 0.12% eye drops<br />
tropicamide (S), (T) 1% eye drops<br />
18<br />
17.4 Corticosteroids<br />
prednisolone (T) 0.2% eye drops<br />
17.5 Non-steroidal Antiallergic/Decongestants<br />
antazoline (S), (T) eye drops<br />
(naphazoline (S), (T) eye drops)<br />
pheniramine maleate (S), (T) eye drops<br />
zinc sulphate + boric acid (P), (S),<br />
(T)<br />
0.46% + 1.6% eye drops<br />
17.6 Topical Anaesthetics<br />
oxybuprocaine (S), (T) 0.4% eye drops<br />
proparacaine (S), (T) eye drops<br />
17.7 Others<br />
artficial tears (T) eye drops<br />
flourescine sodium (S), (T) eye drops<br />
18: OXYTOCICS AND ANTIOXYTOCICS<br />
ergometrine (P), (S), (T), (7) 0.25mg tab. (hydrogen maleate) 200<br />
mg inj.<br />
19: PERITONEAL DIALYSIS SOLUTION<br />
intraperitonial dialysis parental<br />
solution<br />
(of appropriate composition) (T)<br />
19<br />
20: PSYCHOTHERAPEUTIC DRUGS<br />
amitryptyline (S), (T) 10, 25 & 50 mg tab.<br />
chloral hydrate(S), (T) 1 g / 5ml syrup<br />
chlorpromazine(S), (T) 10, 25, 50 &100 mg tab.<br />
25 mg/5ml syrup. 50 mg inj.<br />
clomipramine (T) 10 & 25 mg cap.(as hydrochloride)<br />
diazepam (P,2), (S), (T) 2, 5 & 10 mg tab. 10mg inj<br />
fluoxetine (S), (T) 20 mg cap.<br />
fluphenazine (S), (T) 25 mg inj (as decanoate)<br />
haloperidol (P), (S), (T) 0.25, 1.25 & 5 mg tab<br />
5mg inj. 2mg/ml oral drops<br />
imipramine (S) 25 mg tab.<br />
lithium carbonate (T) 400 mg tab.<br />
resperidone (S), (T) 1 mg, 2 mg, 3 mg tab.<br />
trifluperazine (P), (S), (T) 5 mg tab.<br />
21: DRUGS ACTING ON THE RESPIRATORY TRACT<br />
aminophylline (P), (S), (T), (10) 100 & 200 mg tab. 250 mg inj.<br />
baclomethasone (S), (T) 250 mcg aerosol(as dipropionate)<br />
cromoglycate (T) 1mg/dose aerosol (as disodium) 20<br />
mg cap. (as disodium)<br />
dextromethorphan compound (P),<br />
(S), (T)<br />
Syrup<br />
epinephrine (P), (S), (T) 1 mg inj.<br />
salbutamol (P), (S), (T), (10) 2 & 4 mg tab. 2mg/5ml syrup,100<br />
mcg/dose aerosol(T), 50mcg/5ml inj.<br />
5mg (as sulfate)/ml respirator<br />
solution for use in nebulizers,<br />
theophylline (P), (S), (T), (11) 180 & 270 mg tab. 350 mg tab.<br />
(S.R) 120 mg/5ml syrup.<br />
20<br />
22: SOLUTIONS CORRECTING WATER,<br />
ELECTROLYTE AND ACID BASE DISTURBANCES<br />
dextrose + saline (P), (S), (T) 10% + 0.9% IV solution, 5% +<br />
0.45% IV solution, 4.3% + 0.18%<br />
IV solution, 3% + 0.3% IV solution<br />
dextran 40 (P), (S), (T) IV solution<br />
dextrose (P), (S), (T) 5%, 10% & 25% IV solution<br />
normal saline (P), (S), (T) 0.9% & 0.45% IV solution<br />
potassium chloride (P), (S), (T) 500 mg tab. 7.4% IV solution<br />
ringer’s lactate (P), (S), (T) IV solution<br />
sodium bicarbonate (P), (S), (T) 0.7% IV solution<br />
water for inj. (P), (S), (T)<br />
23: VITAMINS AND MINERALS<br />
ascorbic acid (P), (S), (T) 100 mg tab.<br />
calcium gluconate (P), (S), (T) 100 mg/ml inj.<br />
calcium lactate (P)¸ (S), (T) 10 mg tab.<br />
D – 3 (S), (T) 300000 & 600000 Units<br />
erogocalciferol (P), (S), (T) 1.25 mg (50 000 IU) capsule/tablet,<br />
250 ug/ml (10 000 IU/ml) oral<br />
solution<br />
hexavitamin USP (P), (S), (T) tab. each tab. contains not less than:<br />
Vitamin A 5000IU, Vitamin D<br />
400IU Ascorbic Acid 75mg,<br />
Thiamine Hydrochloride 2mg,<br />
Riboflavin 3mg, Nicotinamide 20<br />
mg.<br />
nicotinamide (P), (S), (T) 50 mg tab.<br />
pyridoxin (P), (S), (T) 25 mg tab. (as hydrochloride)<br />
21<br />
retinol (P), (S), (T) 10000 IU tab. 100,000 IU inj.<br />
thiamine (P), (S), (T) 100mg/ml inj. (as hydrochloride)<br />
100mg tab. (as hydrochloride)<br />
24: E.N.T. PREPARATIONS<br />
boroglycerine (P)¸ (S), (T) 40%<br />
clotrimazole (T) 1% topical solution<br />
ephedrine nasal drops (P), (S), (T) 0.5%<br />
gentamycin + hydrocortisone (T) 3% + 0.1%<br />
gentian violet (P), (S), (T) 0.5%<br />
ichthamol glycerin BPC (P), (S), (T)<br />
polymyxin B sulphate + 10,000 IU + 50mg/ml ear drops<br />
lignocaine hydrochloride (P), (S),<br />
(T)<br />
prednisolone (T) nasal drops. 5mg tab.<br />
prochlorperazine (P), (S), (T) 5 mg tab.<br />
promethazine (P), (S), (T) 10 & 25 mg tab.<br />
1mg/ml elixir. 25mg inj.<br />
pseudoephedrine tab/syrup<br />
compound (S),(3)<br />
soda glycrine BPC (P), (S), (T)<br />
xylocaine (P), (S), (T)<br />
2% inj. 4% topical solution, 2%<br />
topical gel<br />
xylocaine + adrenaline (T) 2% + 1:80,000, 2% + 1:200,000<br />
xylometazoline (P), (S), (T) 0.1% nasal drops<br />
25: ANTISEPTICS AND DIS-INFECTANTS<br />
25.1 Antiseptics<br />
chlorhexidine gluconate (P), (S), (T) 1.5% solution<br />
22<br />
chloroxylenol (P), (S), (T) 4.8% solution<br />
glutaraldehyde (T) 10% solution<br />
glutoral 2% solution)<br />
hydrogen peroxide BP.(P), (S), (T) solution<br />
povidone iodine (P), (S), (T) 7.5% solution<br />
tincture benzoin co. BP (P), (S), (T)<br />
tincture iodine (P), (S), (T)<br />
25.2 Disinfectants<br />
calcium hypochlorite (T) powder for solution<br />
26: DENTAL PREPARATIONS (T)<br />
acidulated phosphate fluoride gel<br />
calcium hydroxide paste<br />
camphorated monochlorophenol.<br />
eugenol, also with fillers<br />
formocresol (formaldehyde 19% cresol 35% and glycerol 15%)<br />
iodoform compound paint<br />
mercury<br />
silver alloys<br />
sodium flouride drop/rinse/tab<br />
tannic acid powder<br />
triamcinolone acetonide paste<br />
zinc oxide + magnesium oxide in polyacrylic 40% cement.<br />
27: DISPENSARY ITEMS: (P), (S), (T)<br />
coal tar<br />
cresol<br />
23<br />
emulsifying wax<br />
formaldehyde<br />
gentian violet<br />
glucose<br />
glycerin<br />
hexylresorcinol throat paint<br />
hydrogen peroxide<br />
iodine<br />
kaolin<br />
linolic acid<br />
liquid paraffin<br />
magnesium sulphate<br />
methylated spirit<br />
paraffin, hard<br />
paraffin, yellow<br />
pectin<br />
peppermint oil<br />
potassium chloride<br />
potassium permanganate<br />
salicylic acid<br />
sodium acid citrate<br />
sodium bicarbonate<br />
soft paraffin wax<br />
sulfer sublime<br />
tannic acid<br />
tragacanth<br />
trisodium citrate dehydrate<br />
turpentine oil<br />
wool fat<br />
24<br />
zinc oxide powder<br />
zinc undeconate<br />
28: DRUGS FOR LOCAL PURCHASE<br />
Drugs in the following groups are required occasionally. Therefore drugs in<br />
these groups can be made available through local purchase by hospitals.<br />
Some of the illustrative drugs in these groups are mentioned below:-<br />
28.1 ANTIDOTES AND OTHER SUBSTANCES USED IN POISONING<br />
atropine (P), (S), (T) 2mg/ml inj. (as sulfate)<br />
charcoal, activated (P), (S), (T) powder<br />
desferrioxamine (S), (T) 500mg inj. (as mesylate)<br />
dimercaprol (S), (T) 100 mg inj.<br />
flumazenil (P), (S), (T) 500 mcg inj.<br />
magnesium sulphate (S,T) 50% inj.<br />
methionine (S), (T) 250 mg tab. (as racemate)<br />
naloxone (P), (S), (T) 0.04 & 0.4 mg inj. (as hydrochloride)<br />
neostigmine (T) 15 mg tab. (as bromide) 0.5mg inj.<br />
(methyl sulphate)<br />
obidoxime (T) 250 mg inj. (as chloride)<br />
penicillamine (T) 125 & 250 mg capsule or tablet,<br />
physostigmine (T) 1 mg inj. (salicylate)<br />
pralidoxime (T) 200 mg/ml Inj.<br />
protamine (T) 10 mg inj. (as sulphate)<br />
prussian blue (T) powder for topical use<br />
sodium calcium edetate (T) 1 gm inj.<br />
sodium nitrite (T) 300 mg inj.<br />
sodium thiosulfate (T) 500mg/ml inj. in 50 ml ampoule.<br />
25<br />
28.2 Antileprosy Drugs<br />
clofazimine (T) 100 mg cap.<br />
dapsone (T) 50 mg tab.<br />
28.3 ANTI-NEOPLASTICS, IMMUNOSUPPRESSIVES AND DRUGS USED<br />
IN PALLIATIVE CARE<br />
28.3.1 Immunosuppressive Drugs<br />
asparaginase (T), (10) 10,000 iu inj.<br />
aminogluthemide tab.<br />
anastrazole(T) 1 mg tab.<br />
azathioprine (S), (T), (10) 50 mg tablet<br />
100 mg inj. (as sodium salt)<br />
bleomycin (T), (10) 15 mg inj. (as sulphate).<br />
busulphan (T) 0.5mg tab.<br />
calcium folinate (T), (10) 15 mg tablet, 30 mg inj.<br />
carboplatin (T) 150 mg & 450 mg inj.<br />
chlorambucil (S), (T), (10) 2 mg tab.<br />
chlormethine (T), (10) 10 mg inj. (as hydrochloride)<br />
cisplatin (T), (10) 10, 25 & 50 mg inj.<br />
cyclophosphamide (T), (10) 50 mg tablet 200, 500 mg & 1 gm inj.<br />
cyproterone acetate (T) 50 mg tab.<br />
cytarabine (T), (10) 100 mg inj.<br />
dacarbazine (T), (10) 200 mg inj.<br />
dactinomycin (T), (10) 0.5mg inj<br />
di-ethylstilboestrol diphosphate<br />
sodium (S),(T)<br />
1mg tab.<br />
doxorubicin (T), (10) 10 & 50 mg inj.<br />
etoposide (T) 100mg cap.<br />
100mg inj.<br />
26<br />
flutamide (S), (T), (10) 250 mg tab<br />
5-fluorouracil (T) 250 mg inj.<br />
hydroxyurea (S), (T) 500 mg cap.<br />
ifosfamide (T) inj.<br />
lomustine (T) cap.<br />
medroxyprogesterone (T) 100 mg tab. 150 mg inj.<br />
megesterol acetate 2mg tab.<br />
mesna (T) 400 mg inj.<br />
melphalan (T) 100 mg inj.<br />
mercaptopurine (T), (10) 50mg tablet<br />
methotrexate (T), (10) 2.5, 5 & 10 mg tab. 5, 50 & 500 mg inj.<br />
mitomycin (T) inj<br />
mitozantrone (T) inj<br />
procarbazine (T) 50mg cap. (as hydrochloride)<br />
tamoxifen (S), (T) 10 & 20 mg tab<br />
6 thioguanine (T) 40 mg tab.<br />
vincristine (T), (10) 1 & 5 mg inj. (as sulfate)<br />
vinblastine (T), (10) inj<br />
vinorelbine (T) 10 & 50 mg inj.<br />
28.4 DIAGNOSTIC AGENTS<br />
barium sulphate (S), (T) powder for oral use<br />
iodinated poppy<br />
iodipamide (T) 50% inj.<br />
iohexol (T) 180 & 300 mg/ml inj<br />
iophendylate (T) 30.5% inj.<br />
iothalamate (T) 60% aqueous solution<br />
meglumine diatrizoate BP/USP (T) inj.<br />
meglumine diatrizoate+ 66% + 10% inj<br />
27<br />
sodium diatrizoate (T)<br />
meglumine iotroxenate (T) 0.105% & 1.26% solution for inj.<br />
meglumine ioxagalate 39% + 19.65% inj.<br />
+sodium ioxagalate (T)<br />
propyliodone (T) 10 gm inj<br />
seed oil (T) inj.<br />
sodium acetrizoate (T) 40% inj<br />
sodium ipodate (T) 500 mg cap.<br />
29: DRUGS FOR SPECIALIZED CENTERS<br />
29.1 Antiretroviral drugs<br />
didanosine (DDI), (T) buffered chewable, dispersible<br />
tablets 25mg, 50mg, 100mg,<br />
150mg, 200mg, buffered powder<br />
for oral solution 100mg, 167mg,<br />
250mg packets, unbuffered enteric<br />
coated capsule 125mg, 200mg,<br />
250mg, 400mg.<br />
efavirenz (T) capsule 50mg, 100mg, 200mg, oral<br />
solution 150mg/5ml<br />
indinavir (T) capsule 200mg, 333mg, 400mg, (as<br />
sulfate)<br />
lamivudine (3TC), (T) tablet 150mg, oral solution<br />
50mg/5ml<br />
nelfinavir (T) tablet 250mg (as mesilate)<br />
nevirapine (T) tablets 200mg, oral suspension<br />
50mg/5ml<br />
ritonavir (T) capsule 100mg, oral solution<br />
28<br />
400mg/5ml<br />
saquinavir (T) capsule 200mg<br />
stavudine (D4T), (T) capsule 15mg, 20mg, 30mg, 40mg,<br />
powder for oral solution 5mg/5ml<br />
zalcitabine (DDC), (T) tablets 0.375mg, 0.75mg<br />
zidovudine (ZDV), (T) tablet 300 mg, capsule 100mg, oral<br />
solution or syp. 50mg/5ml solution,<br />
for IV infusion injection 10mg/ml<br />
in 20ml vial.<br />
29<br />
INDEX<br />
acetylsalicylic acid.............................................................................................. 2, 9<br />
acyclovir ........................................................................................................... 8, 16<br />
adrenaline................................................................................................................ 3<br />
albendazole ............................................................................................................. 3<br />
albumin (human)..................................................................................................... 9<br />
allopurinol............................................................................................................... 2<br />
aluminium hydroxide............................................................................................ 12<br />
aluminium hydroxide + magnesium hydroxide ................................................... 12<br />
amikacin.................................................................................................................. 4<br />
amiloride ............................................................................................................... 12<br />
aminogluthemide .................................................................................................. 24<br />
aminophylline ....................................................................................................... 18<br />
amiodarone ........................................................................................................... 9<br />
amitryptyline......................................................................................................... 18<br />
amlodipine .............................................................................................................. 9<br />
amoxicillin ............................................................................................................ 4<br />
amphotericin ........................................................................................................... 7<br />
ampicillin .............................................................................................................. 4<br />
anastrazole ............................................................................................................ 24<br />
antazoline.............................................................................................................. 17<br />
anti-D immunoglobulin ........................................................................................ 15<br />
antiscorpian sera ................................................................................................... 15<br />
antivenom sera ...................................................................................................... 15<br />
artficial tears ......................................................................................................... 17<br />
ascorbic acid ......................................................................................................... 19<br />
asparaginase.......................................................................................................... 24<br />
atenolol.................................................................................................................... 9<br />
atracurium............................................................................................................... 2<br />
atropine ....................................................................................................... 2, 16, 23<br />
atropine sulphate................................................................................................... 12<br />
azathioprine........................................................................................................... 24<br />
baclomethasone .................................................................................................... 18<br />
barium sulphate..................................................................................................... 25<br />
BCG (dried) vaccine............................................................................................. 15<br />
benzoic acid + salicylic acid................................................................................. 11<br />
benzophenones...................................................................................................... 11<br />
benzoyl peroxide................................................................................................... 11<br />
benzyl benzoate .................................................................................................... 11<br />
benzylpenicillin ...................................................................................................... 4<br />
betamathosone ...................................................................................................... 11<br />
betamathosone + neomycin .................................................................................. 11<br />
biperiden ................................................................................................................. 8<br />
30<br />
bisacodyl ............................................................................................................... 12<br />
bleomycin ............................................................................................................. 24<br />
boroglycerine ........................................................................................................ 20<br />
bromocriptine........................................................................................................ 13<br />
bupivacaine............................................................................................................. 1<br />
busulphan.............................................................................................................. 24<br />
calamine powder................................................................................................... 11<br />
calcium folinate .................................................................................................... 24<br />
calcium gluconate ................................................................................................. 19<br />
calcium hypochlorite ........................................................................................... 21<br />
calcium lactate ...................................................................................................... 19<br />
captopril ................................................................................................................ 10<br />
carbamazepine ........................................................................................................ 3<br />
carbidopa+levodopa ............................................................................................... 8<br />
carbimazole........................................................................................................... 13<br />
carboplatin .......................................................................................................... 24<br />
cefatazidime............................................................................................................ 4<br />
cefazolin ................................................................................................................ 4<br />
cefixin ................................................................................................................... 4<br />
ceftizoxime ............................................................................................................ 4<br />
ceftriaxone ............................................................................................................ 5<br />
cefuroxime .............................................................................................................. 4<br />
cephalexin............................................................................................................... 5<br />
cephradine............................................................................................................... 5<br />
charcoal, activated ................................................................................................ 23<br />
chloral hydrate ...................................................................................................... 18<br />
chlorambucil ......................................................................................................... 24<br />
chloramphenicol ............................................................................................. 5, 16<br />
chlorhexidine gluconate........................................................................................ 20<br />
chlormethine ......................................................................................................... 24<br />
chloroquine ......................................................................................................... 7, 8<br />
chloroxylenol ........................................................................................................ 21<br />
chlorpheniramine ................................................................................................... 3<br />
chlorpromazine ..................................................................................................... 18<br />
choline salicylate .................................................................................................... 2<br />
cimetidine ............................................................................................................. 12<br />
ciprofloxacin........................................................................................................... 5<br />
cisplatin................................................................................................................. 24<br />
clindamycin ........................................................................................................... 5<br />
clofazimine ........................................................................................................... 24<br />
clomifene ............................................................................................................ 13<br />
clomipramine ........................................................................................................ 18<br />
clotrimazole .................................................................................................... 11, 20<br />
cloxacillin ............................................................................................................... 5<br />
31<br />
coaltar liquid ......................................................................................................... 11<br />
colchicines .............................................................................................................. 2<br />
condoms with or without spermicide (nonoxinol) ............................................... 13<br />
conjugated estrogen .............................................................................................. 13<br />
co-trimoxazole ........................................................................................................ 5<br />
cromoglycate......................................................................................................... 18<br />
cyclizine ................................................................................................................ 12<br />
cyclophosphamide ................................................................................................ 24<br />
cyclosporin............................................................................................................ 16<br />
cyproterone acetate ............................................................................................... 24<br />
cytarabine.............................................................................................................. 24<br />
D – 3...................................................................................................................... 19<br />
dacarbazine ........................................................................................................... 24<br />
dactinomycin......................................................................................................... 24<br />
dapsone ................................................................................................................. 24<br />
desferrioxamine .................................................................................................... 23<br />
dexamethasone.................................................................................................. 3, 13<br />
dextran .................................................................................................................. 19<br />
dextran 40 ............................................................................................................... 9<br />
dextromethorphan compound............................................................................... 18<br />
dextrose................................................................................................................. 19<br />
dextrose + saline ................................................................................................... 19<br />
diaphragms with spermicide (nonoxinol)............................................................. 13<br />
diazepam ..................................................................................................... 1, 3, 18<br />
diclofenac ………………………………………………………………………..2<br />
didanosine ............................................................................................................. 26<br />
di-ethylstilboestrol diphosphate sodium............................................................... 24<br />
digoxin ................................................................................................................ 10<br />
diloxanide ............................................................................................................... 7<br />
diltiazem ............................................................................................................... 10<br />
dimercaprol ......................................................................................................... 23<br />
dipatheria-tetanus vaccine .................................................................................... 15<br />
diphtheria antitoxin inj. ........................................................................................ 15<br />
dipivefrin............................................................................................................... 16<br />
diphtheria-pertussis tetanus vaccine..................................................................... 15<br />
dobutamine ........................................................................................................... 10<br />
dopamine............................................................................................................... 10<br />
doxorubicin ........................................................................................................... 24<br />
doxycycline............................................................................................................. 5<br />
efavirenz ............................................................................................................... 26<br />
enalapril ................................................................................................................ 10<br />
ephedrine hydrochloride......................................................................................... 1<br />
ephedrine nasal drops ......................................................................................... 20<br />
epinephrine ........................................................................................................... 18<br />
32<br />
ergometrine ........................................................................................................... 17<br />
ergotamine .............................................................................................................. 8<br />
erogocalciferol ...................................................................................................... 19<br />
erythromycin........................................................................................................... 5<br />
esmolol.................................................................................................................. 10<br />
ethambutol .............................................................................................................. 6<br />
ether ........................................................................................................................ 1<br />
ethosuximide .......................................................................................................... 3<br />
ethynylestradiol + levonorgestrol ....................................................................... 13<br />
ethynylestradiol + norethisterone ....................................................................... 14<br />
etoposide ............................................................................................................. 24<br />
factor IX complex .................................................................................................. 9<br />
factor VIII concentrate ......................................................................................... 9<br />
ferrous salt .............................................................................................................. 9<br />
flourescine sodium................................................................................................ 17<br />
flumazenil ............................................................................................................. 23<br />
5-fluorouracil ........................................................................................................ 25<br />
fluoxetine ............................................................................................................ 18<br />
fluphenazine ........................................................................................................ 18<br />
flutamide ............................................................................................................. 25<br />
folic acid ............................................................................................................... 9<br />
furosemide .......................................................................................................... 12<br />
gammabenzene hexachloride .............................................................................. 11<br />
gemfibrozil .......................................................................................................... 10<br />
gentamicin ....................................................................................................... 5, 16<br />
gentamycin + hyrocortisone ................................................................................. 20<br />
gentian violet .......................................................................................... 11, 20, 22<br />
glibenclamide ...................................................................................................... 14<br />
glutaraldehyde .................................................................................................... 21<br />
glutoral ................................................................................................................ 21<br />
gonadotrophic hormone........................................................................................ 14<br />
griseofulvin............................................................................................................. 7<br />
haloperidol ............................................................................................................ 18<br />
halothane ................................................................................................................ 1<br />
heparin .................................................................................................................. 9<br />
hepatitis B immunoglobulin ............................................................................... 15<br />
hepatitis B vaccine .............................................................................................. 15<br />
hexavitamin USP ................................................................................................ 19<br />
homatropine .......................................................................................................... 16<br />
human chorionic ................................................................................................. 14<br />
hydralazine............................................................................................................ 10<br />
hydrochlorthiazide .............................................................................................. 12<br />
hydrocolloid methoxasalen................................................................................... 11<br />
hydrocortisone .......................................................................................... 3, 11, 14<br />
33<br />
17-hydroxy progesterone caproate ...................................................................... 14<br />
hydrogen peroxide BP .................................................................................. 21, 22<br />
hydroxyurea ........................................................................................................ 25<br />
hyoscine butylbromide ......................................................................................... 12<br />
ibuprofen…………………………………………………………………………2<br />
ichthamol glycerin BPC ....................................................................................... 20<br />
ifosfamide ............................................................................................................. 25<br />
imipramine............................................................................................................ 18<br />
immune human serum ............................................................................................ 9<br />
indinavir................................................................................................................ 26<br />
indomethacin……………………………………………………………………..2<br />
insulin comp. zinc or isophane............................................................................. 14<br />
insulin regular ....................................................................................................... 14<br />
intraperitonial dialysis parental solution .............................................................. 17<br />
intrauterine device copper T................................................................................. 14<br />
iodinated poppy .................................................................................................... 25<br />
iodipamide ............................................................................................................ 25<br />
iohexol ................................................................................................................ 25<br />
iophendylate.......................................................................................................... 25<br />
iothalamate............................................................................................................ 25<br />
iron dextran............................................................................................................. 9<br />
isoniazid ................................................................................................................ 6<br />
isoniazid + ethambutol ........................................................................................... 6<br />
isoprenaline........................................................................................................... 10<br />
isosorbide dinitrate ............................................................................................... 10<br />
ispaghulla husk .................................................................................................. 13<br />
ketamine.................................................................................................................. 1<br />
ketoconazole ..................................................................................................... 7, 16<br />
labetolol ................................................................................................................ 10<br />
lactulose ................................................................................................................ 13<br />
lamivudine ............................................................................................................ 26<br />
levamisole ............................................................................................................... 4<br />
levobunalol ........................................................................................................... 16<br />
levonorgesterol ..................................................................................................... 14<br />
lignocaine.......................................................................................................... 1, 10<br />
lignocaine + epinephrine ........................................................................................ 1<br />
lignocaine hydrochloride .................................................................................... 20<br />
lisinopril................................................................................................................ 10<br />
lithium carbonate .................................................................................................. 18<br />
lomustine............................................................................................................... 25<br />
losartan ................................................................................................................ 10<br />
magenesium hydroxide......................................................................................... 13<br />
magnesium sulphate ..................................................................................... 22, 23<br />
mannitol ................................................................................................................ 12<br />
34<br />
measles vaccine .................................................................................................... 15<br />
measles-mumps-rubella vaccine........................................................................... 15<br />
mebendazole .......................................................................................................... 4<br />
medroxyprogesterone ........................................................................................... 25<br />
megesterol acetate ............................................................................................... 25<br />
meglumine diatrizoate BP/USP............................................................................ 25<br />
meglumine diatrizoate+sodium diatrizoate .......................................................... 26<br />
meglumine iotroxenate ....................................................................................... 26<br />
meglumine ioxagalate + sodium ioxagalate......................................................... 26<br />
melphalan.............................................................................................................. 25<br />
meningococcal vaccine......................................................................................... 15<br />
mercaptopurine ..................................................................................................... 25<br />
mesna .................................................................................................................... 25<br />
metformin ............................................................................................................. 14<br />
methionine ............................................................................................................ 23<br />
methotrexate ......................................................................................................... 25<br />
methyldopa ......................................................................................................... 10<br />
metoclopramide .................................................................................................. 13<br />
metronidazole ................................................................................................... 5, 7<br />
mitomycin ........................................................................................................... 25<br />
mitozantrone ....................................................................................................... 25<br />
morphine ................................................................................................................. 2<br />
nalidixic acid ......................................................................................................... 6<br />
naloxone .............................................................................................................. 23<br />
naphazoline .......................................................................................................... 17<br />
nelfinavir ............................................................................................................. 26<br />
neomycin ............................................................................................................. 12<br />
neomycin+bacitracin .......................................................................................... 11<br />
neostigmine ......................................................................................................... 23<br />
nevirapine ........................................................................................................... 26<br />
niclosamide ........................................................................................................... 4<br />
nicotinamide ....................................................................................................... 19<br />
nicotinic acid ....................................................................................................... 10<br />
nitrofurantoin ........................................................................................................ 6<br />
nitroglycerin ........................................................................................................ 10<br />
nitrous oxide ......................................................................................................... 1<br />
norethisterone ..................................................................................................... 14<br />
normal saline ....................................................................................................... 19<br />
nystatin ........................................................................................................ 6, 7, 12<br />
obidoxime ............................................................................................................ 23<br />
omeprazole ........................................................................................................... 13<br />
oral rehydration salt ............................................................................................. 13<br />
oxybuprocaine ..................................................................................................... 17<br />
oxygen .................................................................................................................... 2<br />
35<br />
oxytocin ............................................................................................................... 14<br />
pancuronium .......................................................................................................... 2<br />
Paracetamol……………………………………………………………………….2<br />
pefloxacin .............................................................................................................. 6<br />
penicillamine ........................................................................................................ 23<br />
permethrin ............................................................................................................ 12<br />
pethidine ................................................................................................................ 2<br />
pheniramine maleate ............................................................................................ 17<br />
phenobarbitone ..................................................................................................... 3<br />
phenoxymethylpenicillin ....................................................................................... 6<br />
phenylepherine ..................................................................................................... 16<br />
phenytoin ........................................................................................................ 3, 10<br />
phenytoin sodium .................................................................................................. 3<br />
physostigmine ...................................................................................................... 23<br />
phytomenadione ..................................................................................................... 9<br />
pilocarpine ........................................................................................................... 16<br />
platelets human ...................................................................................................... 9<br />
poliomyelitis vaccine (live attenuated) ............................................................... 15<br />
polygeline .............................................................................................................. 9<br />
polymixin B sulphate + bacitracin zinc ......................................................... 12, 16<br />
polymyxin B sulphate + lignocaine hydrochloride …. ....................................... 20<br />
potassium chloride ................................................................................... 13, 19, 22<br />
potassium iodide .................................................................................................. 14<br />
pralidoxime .......................................................................................................... 23<br />
prazosin ................................................................................................................ 11<br />
prednisolone ......................................................................................... 3, 14, 17, 20<br />
primaquine ............................................................................................................. 8<br />
procainamide ........................................................................................................ 11<br />
procaine benzylpenicillin ....................................................................................... 6<br />
procarbazine ......................................................................................................... 25<br />
prochlorperazine ............................................................................................ 13, 20<br />
procyclidine ........................................................................................................... 8<br />
promethazine .............................................................................................. 3, 13, 20<br />
proparacaine ......................................................................................................... 17<br />
propofol .................................................................................................................. 1<br />
propranolol ......................................................................................................... 11<br />
propyliodone ........................................................................................................ 26<br />
propylthiouracil .................................................................................................. 14<br />
protamine ............................................................................................................. 23<br />
povidone iodine ................................................................................................... 21<br />
prussian blue ........................................................................................................ 23<br />
pseudoephedrine .................................................................................................. 20<br />
pyrantel .................................................................................................................. 4<br />
pyrazinamide .......................................................................................................... 6<br />
36<br />
pyridostigmine ..................................................................................................... 16<br />
pyridoxine ............................................................................................................ 19<br />
quinidine .............................................................................................................. 11<br />
quinine ................................................................................................................... 8<br />
quinine dihydrochloride ......................................................................................... 8<br />
rabies vaccine ....................................................................................................... 15<br />
resperidone ........................................................................................................... 18<br />
retinol ................................................................................................................... 20<br />
rifampicin ............................................................................................................... 6<br />
rifampicin + isoniazid ............................................................................................ 6<br />
rifampicin + isoniazid + pyrazinamide ................................................................. 6<br />
rifampicin + isoniazid + pyrazinamide + ethambutol .......................................... 7<br />
ringer’s lactate ..................................................................................................... 19<br />
ritonavir ................................................................................................................ 26<br />
rubella vaccine ..................................................................................................... 15<br />
salbutamol ........................................................................................................... 18<br />
salicylic acid .................................................................................................. 12, 22<br />
saquinavir ............................................................................................................. 27<br />
seed oil ................................................................................................................. 26<br />
selegiline ................................................................................................................ 8<br />
silver sulphadiazine ............................................................................................. 12<br />
soda glycrine BPC ............................................................................................... 20<br />
sodium acetrizoate ............................................................................................... 26<br />
sodium bicarbonate ........................................................................................ 19, 22<br />
sodium calcium edetate ....................................................................................... 23<br />
sodium ipodate ..................................................................................................... 26<br />
sodium nitrite ....................................................................................................... 23<br />
sodium nitroprusside ............................................................................................ 11<br />
sodium stibogluconate ........................................................................................... 8<br />
sodium thiosulfate .......................................................................................... 12, 23<br />
spironolactone ...................................................................................................... 12<br />
stavudine .............................................................................................................. 27<br />
streptomycin .......................................................................................................... 7<br />
sulfacetamide ....................................................................................................... 16<br />
sulphadoxine + pyrimethamine ............................................................................. 8<br />
sulphamethoxazole+ trimethoprim ........................................................................ 5<br />
sulphasalazine .................................................................................................. 6, 13<br />
suxamethonium ...................................................................................................... 2<br />
tamoxifen ............................................................................................................. 25<br />
tetanus antitoxin ................................................................................................... 15<br />
tetanus toxid ......................................................................................................... 15<br />
tetanus vaccine ..................................................................................................... 15<br />
tetracycline ........................................................................................................... 16<br />
theophylline ......................................................................................................... 18<br />
37<br />
thiamine ............................................................................................................... 20<br />
thioacetazone ......................................................................................................... 7<br />
thioacetazone + isoniazid ...................................................................................... 7<br />
6-thioguanine ...................................................................................................... 25<br />
thiopental ............................................................................................................ 1<br />
thyroxine .............................................................................................................. 14<br />
tincture benzoin co.BP ......................................................................................... 20<br />
tincture iodine ...................................................................................................... 21<br />
tinidazole ................................................................................................................ 6<br />
tranexamic acid ...................................................................................................... 9<br />
trifluperazine ........................................................................................................ 18<br />
trimethoprim .......................................................................................................... 6<br />
tropicamide .......................................................................................................... 16<br />
tuberculin PPD ..................................................................................................... 14<br />
valproate sodium .................................................................................................... 3<br />
valproic acid .......................................................................................................... 3<br />
vasopressin/ADH ................................................................................................. 14<br />
verapamil ............................................................................................................ 11<br />
vinblastine ............................................................................................................ 25<br />
vincristine ............................................................................................................ 25<br />
vinorelbine ........................................................................................................... 25<br />
warfarin .................................................................................................................. 9<br />
water for inj. ......................................................................................................... 19<br />
xylocaine .............................................................................................................. 20<br />
xylocaine + adrenaline ......................................................................................... 20<br />
xylometazoline ..................................................................................................... 20<br />
yellow fever vaccine ............................................................................................ 15<br />
zalcitabine ............................................................................................................ 27<br />
zidovudine ............................................................................................................ 27<br />
zinc oxide ....................................................................................................... 12, 23<br />
zinc sulphate + boric acid .................................................................................... 17</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-66507039061075589412011-07-25T07:50:00.000-07:002011-07-25T07:52:12.822-07:00Insulin dosage<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzY1WZ31BD_f8v-YbrCVHLwyuTNWEuXRbE13EaVOujd4saHfLWOL0H4AMkTnTyvbQlpFGA9XcQqZhFVux-klOX10gROH71uDx3BxSptb5bT8ESPstz0lcnK7tiPv_Iygz9t7JA5GycTJrs/s1600/insulin33.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzY1WZ31BD_f8v-YbrCVHLwyuTNWEuXRbE13EaVOujd4saHfLWOL0H4AMkTnTyvbQlpFGA9XcQqZhFVux-klOX10gROH71uDx3BxSptb5bT8ESPstz0lcnK7tiPv_Iygz9t7JA5GycTJrs/s200/insulin33.jpeg" width="200" /></a></div><br />
<div class="MsoNormal"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 14pt; line-height: 115%;">INSULIN AND ITS DOSAGE FORMS<br style="mso-special-character: line-break;" /> <br style="mso-special-character: line-break;" /> <o:p></o:p></span></b></div><div class="MsoNormal">1-Rate of insulin infusion:<br />
i-If blood glucose level is less than 4mmol/lit. than give 0.5 units of insulin per hour.<br />
ii-If blood glucose level is less than 4-15mmol/lit. than give 2 units per hour.<br />
iii- If blood glucose level is less than 15-20mmol/lit. than give 4 units per hour</div><a name='more'></a><br />
<br />
<div class="MsoNormal"><br />
</div><div class="MsoNormal">2-TYPES OF INSULINS</div><div class="MsoNormal"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt; line-height: 115%;">All insulin is not the same. Insulin actually comes in several forms. Each of these forms are designed to work at different rate. The following are seven of the common forms of insulin that are commonly administered to a diabetic:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">1. Lispro<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Lispro is a very rapid acting form of insulin. Within five minutes of administering Lispro blood glucose levels begin to drop. It remains active in lowering blood glucose levels for about 2.5 hours, though it is most effective when it has been in the blood about 1 hour. Because it does not remain active very long, Lispro has less chance of inducing a hypoglycemic reaction several hours later.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">2. Normal insulin<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Normal insulin starts working in about thirty minutes. It works most effectively after it has been in the body for about three hours, but it can continue working in the bloodstream for nearly seven hours.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">3. NPH<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">This form of insulin has been designed to mimic the insulin produced inside the human body. It lowers blood glucose levels at a more consistent rate. It reaches its peak when it has been in the bloodstream about 2 hours, but remains at peak for up to 12 hours. It continues working for about 24 hours total, though not as vigorously in the last 10 hours<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">4. Lente<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Lente is another insulin that is designed to work like the insulin that naturally occurs inside the human body. It works over long periods of time, but takes about two hours to reach its peak effectiveness in lowering blood sugar. It will continue at its peak for about half of the day and then function more moderately the second half of the day.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">5. Ultralente<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Ultralente was designed with the idea of providing a once per day insulin option. It takes nearly six hours after taking Ultralente before it starts lowering blood glucose levels. However, it continues functioning effectively all day long.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">6. Glargine<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Glargine is a popular insulin that is used mainly with type 1 diabetes. This is a long acting form of insulin that is injected just once per twenty four hours. Great care must be taken not to contaminate this insulin with the other forms of insulin by using the same syringe or storage equipment.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">7. Pre-Mixed Insulin<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Pre-mixed insulins are popular because they help take patient dosage and administration errors out of the diabetic treatment equation. e.g HUMULIN 70/30<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><b style="mso-bidi-font-weight: normal;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Dosage forms of insulin<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">1-Standard mode of therapy:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">Standard mode of insulin therapy is subcutaneous injection using conventional disposable needle and syringes.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">2-Portable pen injection:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">To facilitate subcutaneous injection of insulin, particularly during intensive insulin therapy. portable pen sized injections have been developed.It inject measureable quantity of insulin.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">3-Disposable insulin pens:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">disposable insulin pens are also available for selected formulations e.g regular insulin ,insulin lispro, insulin aspart, insulin glulisine, glargine etc<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">4-Continuous insulin infusion devices(insulin pumps):<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">These are external open loop pumps for insulin delivery. it has user programmable pump that delivers individualized basal and bolas insulin replacement doses based on blood glucose self monitoring results. these are implanted subcutaneously always.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">5-Buccal dosage forms :<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">As insulin is degraded in acidic pH. buccal film of insulin may be very useful for the treatment of diabetes more efficiently. the release mechanism is diffusion controlled and rate of diffusion was by first order kinetics. a significant reduction of blood sugar was observed at 2 hr<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">6-Inhalation:<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;">A new ultra rapid acting mealtime insulin that is orally inhaled for absorption via the lung ,that closely mimics the normal early insulin response seen in healthy individuals. a thumb size device is used and patient inhales a small amount of the powder, this drug is rapidly absorbed ultra rapid so it become effective much more quickly than an injection of same drug(matches the body’s natural responses in processes like secretion).</span> <v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape alt="http://www.sedico.net/english/images/InhaledInsulin/spacer1.JPG" id="Picture_x0020_1" o:spid="_x0000_i1025" style="height: 150.75pt; mso-wrap-style: square; visibility: visible; width: 269.25pt;" type="#_x0000_t75"> <v:imagedata o:title="spacer1" src="file:///C:\DOCUME~1\USMANI~1\LOCALS~1\Temp\msohtmlclip1\01\clip_image001.jpg"> </v:imagedata></v:shape><br />
Fig: Insulin inhalation device<span style="color: #4b4b4b; font-family: Verdana, sans-serif; font-size: 10pt;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 12.3pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgB8WuvsTpoBM40x58LUKqlF5Wt9hexbys3fKWFCVRSc6XGe8LZggezFjQB-YQcNLDbm-ThCmJSqb8yvFsNiLjYrm4-d99xwRR2sWqlEXBvarKnlO6-PqY57V7Ax6kHFde3wAP7hkmHiOLn/s1600/insulin.bmp" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgB8WuvsTpoBM40x58LUKqlF5Wt9hexbys3fKWFCVRSc6XGe8LZggezFjQB-YQcNLDbm-ThCmJSqb8yvFsNiLjYrm4-d99xwRR2sWqlEXBvarKnlO6-PqY57V7Ax6kHFde3wAP7hkmHiOLn/s400/insulin.bmp" width="400" /></a></div><div class="MsoNormal"><br />
</div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-46426771583455555102011-07-19T12:22:00.000-07:002011-07-21T11:32:41.711-07:00Oral anti hypertension therapy is preferred over parenteral therapy<div dir="ltr" style="text-align: left;" trbidi="on"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLwegr4IBE9s7J7dgKhHK_CBHvaR0cKA95RHD1dZ4A-QiF7ya_JgUnd3allZ2xEvDEMRqJRP98udpfF9IhWglRxC5mxbTebLAzATld_Buj8s8JlmqTgO4IVEznSXbYc82SN1beiIGPC-bL/s1600/03gradman.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="224" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLwegr4IBE9s7J7dgKhHK_CBHvaR0cKA95RHD1dZ4A-QiF7ya_JgUnd3allZ2xEvDEMRqJRP98udpfF9IhWglRxC5mxbTebLAzATld_Buj8s8JlmqTgO4IVEznSXbYc82SN1beiIGPC-bL/s320/03gradman.gif" width="320" /></a>Oral anti hyertension therapy is preferred over parenteral hypertension therapy because, chronic hypertension is associated with auto regulatory changes in cerebral blood flow.<br />
<a name='more'></a><br />
<br />
Parenteral anti hypertensive drugs lower the blood pressure rapidly so when the blood pressure is lowered rapidly it can lead to cerebral hypo perfusion and brain injury.<br />
<br />
Blood pressure should be lowered only 25% initially maintaining diastolic blood pressure not less than 125-100mm Hg, subsequently the blood pressure may be reduced to normal level by oral therapy over several weeks.<br />
<br />
By doing these measures the treatment time is decreased with subsequent decrease in price of therapy, and this will ultimately effect the health of an individual.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-40799975089082443912011-07-19T04:08:00.000-07:002011-07-21T11:18:15.584-07:00selected candidates by Govt of punjab(Health department) as HOSPITAL PHARMACIST/DRUG INSPECTOR.<div dir="ltr" style="text-align: left;" trbidi="on"> <br />
<div align="center" class="MsoPlainText" style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQr3tQR6LZwhKgmsFcH1R9HHY51YyIF8Z0HUywSNZUwmcs3hj6eEuAXhu1kv6hWJakWJkf-PnM1mzR_hXHIdInQo8mCa-PW29Kq-EMFDfCXHsMX49Rl60HgqnrqFQ-tWYbmuyU3ls5l8Ym/s1600/Punjab-Public-Service-Commission-PPSC-logo.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQr3tQR6LZwhKgmsFcH1R9HHY51YyIF8Z0HUywSNZUwmcs3hj6eEuAXhu1kv6hWJakWJkf-PnM1mzR_hXHIdInQo8mCa-PW29Kq-EMFDfCXHsMX49Rl60HgqnrqFQ-tWYbmuyU3ls5l8Ym/s200/Punjab-Public-Service-Commission-PPSC-logo.jpg" width="200" /></a><b><u><span style="font-family: Tahoma, sans-serif; font-size: 13pt;">PUNJAB</span></u></b><b><u><span style="font-family: Tahoma, sans-serif; font-size: 13pt;"> PUBLIC SERVICE COMMISSION</span></u></b></div><div align="center" class="MsoPlainText" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 13pt;"> NOTICE BOARD</span></u></b></div><div class="MsoPlainText"><br />
</div><div class="MsoPlainText"><br />
</div><div class="MsoPlainText" style="line-height: 150%; text-align: justify; text-indent: .5in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt; line-height: 150%;"> </span></b><span style="font-family: Tahoma, sans-serif; font-size: 12pt; line-height: 150%;">The Punjab Public Service Commission announces that the under mentioned candidates have been recommended to the Provincial Government for appointment to the posts of <b style="mso-bidi-font-weight: normal;"><u>HOSPITAL PHARMACIST/DRUG INSPECTOR (BS-17) IN THE PUNJAB HEALTH DEPARTMENT.</u></b></span></div><div class="MsoPlainText" style="text-align: justify;"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> </span></b><br />
<a name='more'></a><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> </span></b><span style="font-family: Tahoma, sans-serif; font-size: 8pt;"></span></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">MERIT/APP. NAME OF THE CANDIDATE DOMICILE</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NO.____</span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> <u>WITH FATHER'S NAME </u> ________<u> </u></span></b></div><div class="MsoNormal"><br />
</div><div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 14pt;">AGAINST OPEN MERIT</span></u></b><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif;"></span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">1/15980745 MUNAZA RIAZ LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> RIAZ UD DIN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">2/15981214 ASIMA HAMEED LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MIRZA ABDUL HAMEED BAIG</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">3/15981170 MUHAMMAD MUBASHER OKARA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ISHAQ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">4/15980913 MUHAMMAD IMRAN SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ASGHAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">5/15980053 AHMED JAVAID KHAN SIALKOT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SHABBIR AHMED KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">6/15980562 KAMAL SIKANDAR LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SIKANDAR AMEEN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">7/15981622 MUHAMMAD FAISAL NADEEM JHANG</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> HAFIZ MUKHTAR AHMED GONDAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">8/15982898 MUHAMMAD ANSAR SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> FAQIR MUHAMMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">9/15981524 HAROON ARSHAD SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MIRZA MUHAMMAD ASLAM BAIG</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">10/15980387 ABDUR RAUF KHAN KHUSHAB</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">11/15980261 SUMBAL NOSHEEN LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> FAHIM ARIF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">12/15980192 SAMREEN HECTOR LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> M.D HECTOR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">13/15980332 SHAISTA JAMIL LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> JAMIL AKHTAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">14/15980914 NAGINA RASHID FAISALABAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ABDUL RASHID</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">15/15982907 ADIL MAQBOOL LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MAQBOOL AHMED</span></b></div><div align="right" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: right;"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">P.T.O</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"></span></b></div><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span></b> <br />
<div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><br />
</div><div align="center" class="MsoBodyText" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">113 Posts of Hospital Pharmacist/Drug Inspector (BS-17) <br />
in the Punjab Health Department.</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">MERIT/APP. NAME OF THE CANDIDATE DOMICILE</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NO.__ </span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> <u>WITH FATHER'S NAME </u> ________<u> </u></span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">16/15981480 ABDUL REHMAN GUJRANWALA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD FAZAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">17/15982795 AMMARA CH. BAHAWALPUR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD SHAFIQ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">18/15980752 SEHRISH SULTAN LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SULTAN AHMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">19/15982182 WASEEM ASHRAF MULTAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ASHRAF SAEED</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">20/15980832 AKBAR ALI LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MIAN RAFAQAT ALI</span></b></div><div align="right" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: right;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">21/15980503 SEHER KIRAN LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD WASIF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">22/15981647 IRUM IFTIKHAR SHEIKHUPURA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> CH. IFTIKHAR AHMAD KISANA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">23/15981890 ABDULLAH GILL LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ZUBAIR AHMED GILL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">24/15980712 FAISAL USMAN M.B. Din</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> FAIZ AHMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">25/15981162 FASIHA BATOOL LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MIAN MUHAMMAD HANIF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">26/15982817 ASRAR MUHAMMAD R.Y. KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> DUR MUHAMMAD NIAZI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="margin-right: -27.35pt; tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">27/15982991 AMNA SAEED BAHAWAL NAGAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SAEED AHMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">28/15981650 NAZISH RAZZAQ R.Y. KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ABDUL RAZZAQ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">29/15980607 FAZEELAT LIAQAT LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> LIAQAT HUSSAIN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> 30/15981034 SAADIA MAHWISH LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> AKHTAR HUSSAIN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">31/15980743 AMMAR SARWAR NAROWAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD SARWAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">32/15980769 IDREES AHMAD MALIK MIANWALI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MALIK SHER AHMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">33/15980588 JAVARIA CHISHTI OKARA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> IFTIKHAR HUSSAIN NAJAM</span></b></div><div align="right" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: right;"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">Contd…P/</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"></span></b></div><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span></b> <br />
<div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><br />
</div><div align="center" class="MsoBodyText" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">113 Posts of Hospital Pharmacist/Drug Inspector (BS-17) <br />
in the Punjab Health Department.</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">MERIT/APP. NAME OF THE CANDIDATE DOMICILE</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NO.__ </span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> <u>WITH FATHER'S NAME </u> ________<u> </u></span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">34/15980250 KISHWER SULTANA M.B. Din</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD FAROOQ AMJAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">35/15980492 MUHAMMAD SHAHZAD ALI LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ILYAS</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">36/15980013 TAHIR MAHMOOD M.B. Din</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> KHURSHID AHMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">37/15981761 NOSHEEN KHALID LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD KHALID</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">38/15980082 FAIZA NASAR GUJRAT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NASAR IQBAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">39/15982390 ASIMA SAFDAR BAHAWALPUR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SAFDAR ALI ASIF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">40/15980030 HASSAN KHAN HAFIZ BHAKKAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> JAN MUHAMMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">41/15980213 MIDHAT ABBAS LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SHABBIR ABBAS</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">42/15982996 ASAD ULLAH FAIZ GHALIB R.Y. KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> FAIZ ULLAH FAIZ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">43/15981916 KHURRAM WAJIH MAHMOOD LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ZAIGHAM MAHMOOD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">44/15981450 MUHAMMAD AAMIR SHAKEEL LAYYAH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NASIR ABBAS</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">45/15982987 WAJEEHA ARSHAD BAHAWALPUR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ARSHAD MIRZA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">46/15982361 FARRUKH HUSSAIN NIAZI D.G. KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MAULA BAKSH NIAZI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">47/15981854 SHUMAILA MIRAJ LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MIRAJ DIN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">48/15980233 SHER MUHAMMAD ZAMAN LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MANZOOR AHMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">49/15982753 MARRIAM SHAHEZADI RAWALPINDI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ASGHAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">50/15980570 FARWA MANSOOR JHANG</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> GHULAM ABBAS MANSOOR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">51/15980719 SAIMA SHARIF LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD SHARIF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div align="right" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: right;"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">P.T.O</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"></span></b></div><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span></b> <br />
<div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><br />
</div><div align="center" class="MsoBodyText" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">113 Posts of Hospital Pharmacist/Drug Inspector (BS-17) <br />
in the Punjab Health Department.</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">MERIT/APP. NAME OF THE CANDIDATE DOMICILE</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NO.__ </span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> <u>WITH FATHER'S NAME </u> ________<u> </u></span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">52/15980182 MUHAMMAD FAISAL MAHBOOB D.G. KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MAHBOOB ULLAH KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">53/15980067 ZAUFISHAN RAHMAN DR. LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> HABIB UR RAHMAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">54/15982966 IMTIAZ AHMAD BAHAWALPUR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> RAFIQ AHMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">55/15980157 GHAZALA RAFIQUE SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD RAFIQUE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">56/15982360 ZAHEER ABBAS JHANG</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> QALB E ALI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">57/15981749 RABIA NAVEED LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NAVEED AHMAD SHEIKH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">58/15982912 JAVARIA NAZIR SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NAZIR AHMED</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">59/15981978 ZUBIA IHSAN GUJRAT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> CH. IHSAN ULLAH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">60/15982762 SADAF ZAHRA SYEDA SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ZAHID HUSSAIN SHAH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">61/15980356 SABA SALEEM SHEIKHUPURA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> CHAUDHARY MUHAMMAD SALEEM</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">62/15981504 TAHIRA LATIF LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> LATIF AHMAD KHAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">63/15982471 MUHAMMAD KAMRAN NAWAZ RAWALPINDI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> RAJA RAB NAWAZ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">64/15980407 NIGHAT SAEED GUJRANWALA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD SAEED</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">65/15982434 NAZIMA ASGHAR SIALKOT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> HAKIM MUHAMMAD ASGHAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">66/15981484 SABA MAHWISH KHANEWAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ANWAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">67/15980416 WAQAR HAIDER GUJRAT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> FAZAL HUSSAIN SHAH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">68/15980750 SHAHID RASOOL SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> WALI MUHAMMAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">69/15981541 RABEEA SULTAN RAWALPINDI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD SULTAN</span></b></div><div align="right" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: right;"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">Contd…P/</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"></span></b></div><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span></b> <br />
<div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><br />
</div><div align="center" class="MsoBodyText" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">113 Posts of Hospital Pharmacist/Drug Inspector (BS-17) <br />
in the Punjab Health Department.</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">MERIT/APP. NAME OF THE CANDIDATE DOMICILE</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NO.__ </span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> <u>WITH FATHER'S NAME </u> ________<u> </u></span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">70/15980180 OMER SALMAN QURESHI MULTAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ANNS QURESHI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">71/15980341 ZAHRA DURRANI LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ZAFAR SAEED DURRANI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">72/15980181 AYISHA SHAUKAT LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SHAUKAT JAVED BUTT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">73/15982682 HUMAIRA SHAMSHAD SYEDA KHANEWAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SYED SHAMSHAD ALI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">74/15980682 USMAN SABIR SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SABIR ALI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">75/15981467 MUHAMMAD AZEEM MUGHAL SIALKOT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD AZAM MOGHAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">76/15982486 MAHROO ARSHAD JHELUM</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ARSHAD RAHMAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">77/15980883 HAFIZ MUHAMMAD FAISAL GUJRANWALA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> DR. M. MUNIR TAHIR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">78/15982252 LIAQAT ALI VEHARI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD HANIF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">79/15980135 MUHAMMAD KASHIF RIAZ LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD RIAZ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">80/15980880 MARIA RAFIQUE SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD RAFIQUE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">81/15981390 FARHAT JABEEN LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> AZIZ UR REHMAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">82/15980892 FARHANA KHALID JHANG</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> M. HUSSAIN KHALID</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">83/15981974 HUMA RAO LODHRAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> RAO MUHAMMAD ALAM</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">84/15981459 IQRA FAYYAZ LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD FAYYAZ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">85/15982437 SADIA HUSSAIN SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> AMAN ULLAH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">86/15980807 AYESHA JAVEED LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD JAVEED</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">87/15981875 GOHAR UR REHMAN SIALKOT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SHAKEEL UR REHMAN</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> </span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"></span></b></div><div align="right" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: right;"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">P.T.O</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"></span></b></div><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span></b> <br />
<div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><br />
</div><div align="center" class="MsoBodyText" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">113 Posts of Hospital Pharmacist/Drug Inspector (BS-17) <br />
in the Punjab Health Department.</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">MERIT/APP. NAME OF THE CANDIDATE DOMICILE</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NO.__ </span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> <u>WITH FATHER'S NAME </u> ________<u> </u></span></b></div><div class="MsoNormal" style="margin-right: -18.35pt; tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="margin-right: -18.35pt; tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">88/15980019 HAROON UR RASHEED BAHAWAL NAGAR</span></b></div><div class="MsoNormal" style="margin-right: -13.85pt; tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ABDUL RASHEED NAEEM</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">89/15980036 TAIMOUR JAWAID CHAUDHARY LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> M. ANWAR UL HAQ JAWAID</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">90/15982356 SAQIB ZAKA HAFIZ VEHARI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ZAKA ULLAH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">91/15982863 MISBAH NOREEM SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ASHRAF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">92/15981599 ZAFAR IQBAL FAISALABAD</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD IQBAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">93/15980998 WAJEEHA IJAZ LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> IJAZ SHAFI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">94/15980664 SANA IQBAL GUJRANWALA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD IQBAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">95/15981886 NAVEED SARWAR SIALKOT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SARWAR HUSSAIN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">96/15982422 UMER ZEB ABBASI RAWALPINDI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> HAROON UR RASHID</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">97/15980031 OSAMA JAVED LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> BAKHT JAVED ALI SHAH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">98/15980001 FAHEEM ZIA SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> ALTAF HUSSAIN ZIA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">99/15980722 ADNAN AKRAM BAHAWALPUR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD AKRAM</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 14pt;">AGAINST WOMEN QUOTA</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">102/15981609 ASMA IQBAL LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD IQBAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">103/15980502 SADAF RAUF LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> KHALIFA ABDUL RAUF</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">104/15981006 SONIA ARSHAD GUJRANWALA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD ARSHAD WARAICH</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">105/15980501 HINA SHAHBAZ LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD SHAHBAZ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">106/15981212 IMMAMA HUSSAIN SYEDA LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> SYED ASHFAQ HUSSAIN SHAH</span></b></div><div align="right" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: right;"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">Contd…P/</span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"></span></b></div><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" /> </span></b> <br />
<div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><br />
</div><div align="center" class="MsoBodyText" style="text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">113 Posts of Hospital Pharmacist/Drug Inspector (BS-17) <br />
in the Punjab Health Department.</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">MERIT/APP. NAME OF THE CANDIDATE DOMICILE</span></b></div><div class="MsoPlainText" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> NO.__ </span></u></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> <u>WITH FATHER'S NAME </u> ________<u> </u></span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">109/15980218 SADIA AKHTAR SARGODHA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> AKHTAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 14pt;">AGAINST DISABLED QUOTA</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">392/15981239 AMMARA AHMAD SIALKOT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> AHMAD ALI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">420/15980005 AZEEM AHMAD IQBAL LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> IFTIKHAR IQBAL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">536/15980646 SARDAR ALI WATTOO OKARA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MUHAMMAD SARWAR WATTOO</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div align="center" class="MsoNormal" style="tab-stops: 1.5in 4.75in; text-align: center;"><b style="mso-bidi-font-weight: normal;"><u><span style="font-family: Tahoma, sans-serif; font-size: 14pt;">AGAINST MINORITIES QUOTA</span></u></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">335/15982349 JOHNSON KAMRAN GILL MULTAN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> AFZAL MASIH GILL</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">346/15980490 SHELOKH ANWAR LAHORE</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> MAQSOOD ANWAR</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">441/15980978 SONAILA KANWAL GUJRAT</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> YAQOOB GHAURI</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">741/15981299 IRAM SHAHZADI GUJRANWALA</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> JAMES JOHN</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;">881/15981018 FAIZ AHMAD AYAZ JHANG</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> RASHEED AHMAD AYAZ</span></b></div><div class="MsoNormal" style="tab-stops: 1.5in 4.75in;"><br />
</div><div class="MsoPlainText"><br />
</div><div class="MsoPlainText"><b><span style="font-family: Tahoma, sans-serif; font-size: 12pt;"> </span></b><span style="font-family: Tahoma, sans-serif; font-size: 11pt;"></span></div><div class="MsoPlainText"><br />
</div><div class="MsoPlainText"><br />
</div><div class="MsoPlainText"><br />
</div><div class="MsoPlainText"><br />
</div><div class="MsoPlainText"><span style="font-family: Tahoma, sans-serif; font-size: 11pt;"> <b style="mso-bidi-font-weight: normal;">DATED</b>: <b> 19-07-2011</b> </span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Tahoma, sans-serif; font-size: 14pt;">SECRETARY</span></b><span style="font-family: Tahoma, sans-serif; font-size: 11pt;"></span></div><div class="MsoNormal"><span style="font-family: Tahoma, sans-serif;"> </span><b><span style="font-family: Tahoma, sans-serif; font-size: 11pt;">CASE NO. 5-RC-2010</span></b></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-63486109860625828762011-07-01T07:49:00.000-07:002011-07-21T11:29:16.624-07:00Morphine addiction and treatment<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHWhJvgDIo7BIlZlICkFnVYlobhghSMmCMFXdl00ajPulPahYDZFLf-8nij4FEzGWHeUdOwA7jcBLDBPOoMeUkq0uVneszliFdq6i9LPr_CkmNQHBpD92O54JQTwDdwvKjrv3B-Ss3QcDq/s1600/05addict.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHWhJvgDIo7BIlZlICkFnVYlobhghSMmCMFXdl00ajPulPahYDZFLf-8nij4FEzGWHeUdOwA7jcBLDBPOoMeUkq0uVneszliFdq6i9LPr_CkmNQHBpD92O54JQTwDdwvKjrv3B-Ss3QcDq/s1600/05addict.jpg" /></a></div>OPIOIDS has great propensity to cause addiction and its effect on health is always detrimental.<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgivUi0Qxl5NNCU8je4Mk2a_mxZLwBusC172o55q_CWDKBYStAi4d9i2obs5wIqIbXEfNnF-AyB8z1LgdXkWGMX2hSjzmuaTxjXqNq6D3DyIyIppa5t7fWIFW2fbzrDVar09kDEXiRTKWey/s1600/morphine-addiction-treatment.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgivUi0Qxl5NNCU8je4Mk2a_mxZLwBusC172o55q_CWDKBYStAi4d9i2obs5wIqIbXEfNnF-AyB8z1LgdXkWGMX2hSjzmuaTxjXqNq6D3DyIyIppa5t7fWIFW2fbzrDVar09kDEXiRTKWey/s200/morphine-addiction-treatment.jpg" width="200" /></a>The opoids addiction is one of the most common behavioral process and by this process person use it again and again, with out caring about his health.<br />
This long lasting use is leading way to produce craving for narcotics particularly morphine and its derivatives.<br />
The drug use starts when person start facing difficulties in his life and wanted to be remain soothe and calm so, to soothe his emotions and difficulties he starts taking drugs particularly MORPHINE.<br />
<a name='more'></a><br />
Teenagers are particularly susceptible to this and scum b to drug craving very easily,they think that they can escape problems by taking drugs and one of the effect of narcotics is blurring of reality,due to use of morphine or opioids they feel false perception of happiness or pleasure.<br />
<br />
Another reson for craving a drug is that once person takes drug a little bit of it remains in the body. sometime people become physically dependent to opioids because they become physically dependent on painkillers prescribed to them for relieving pain.<br />
<br />
Morphine is highly addictive drug.<br />
It has low tolerence level mean that exceedingly high level of drug is needed to produce the desired response after single dose,so physiological and physical dependence produce very rapidly.<br />
<br />
<b>Withdrawal symptoms of morphine:</b><br />
The withdrawal symptoms of morphine use are sweating, nausea, chills, yawing,pinpoint pupil that lasts for almost three days.<br />
<b>Adverse effects:</b><br />
Morphine can also cross the placental barriers of pregnant women and thus can produce withdrawal symptoms in the babies of mothers who use morphine.<br />
It can also damage their normal development procedure and poses a great risk to their health.<br />
<br />
Morphine acts centrally that it effect is on brain apart from its pain relieving properties the MORPHINE also effects physical and mental performance, alleviates anxiety and fear and induces euphoria.<br />
Morphine also inhibit hungers, it hampers the cough reflex ,causes constipation and can impair sex drive. It effects the menstrual cycle of women using MORPHINE.<br />
MORPHINE can hamper the normal respiratory function of the body, the nausea induces by the morphine can cause vomiting because it stimulate the chemo receptor trigger zone in the brain stem, it also causes the itching of nose and skin reaction due to its histamine releasing effect.<br />
people who are addicted to morphine experience acute sense of hopelessness in their life, they usually face problems in their jobs and relationships,the only desire in their life is to acquire the drug by any means.<br />
the effects of addiction spread rapidly in the society and it effects not only the life of drug addict also also the peoples linked to their life .<br />
<br />
<br />
<b>Treatment:</b><br />
However it is important not to stigmatized the drug user as mentally or physically ill.<br />
addiction must be considered as problem that must be curbed with effective program of awareness about drug use.<br />
Both psychological and behavioral treatment is needed under the supervision of experienced person.<br />
patient may remain in drug addict center for effective therapy, it has been proved that strong religious views can be helpful in treating drug carving. <br />
<br />
<b>Drugs used in treatment:</b>Mostly BUPRINORPHINE and NALTROXONE is used in treatment of opioid detoxification.</div>Unknownnoreply@blogger.com2tag:blogger.com,1999:blog-7029755624526795943.post-77236668179004003172011-06-25T00:02:00.000-07:002011-07-21T11:22:47.007-07:00Aloe vera is a drug of wonder<div dir="ltr" style="text-align: left;" trbidi="on"><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgn4642zoXBKSQ8Pyf10p4xo3iFW1-GCd3jmyO7jXcxabb9HuNU2zxUT6nX-rIUA0t8ULvnIT2nZQW0JBbMe3Mnia2OSkY0Ab1_jY9l3w1jmCNhWVXAVNu7KspH_OcwDEMSgHM4R_BRYHQF/s1600/aloe_vera-417x300.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="230" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgn4642zoXBKSQ8Pyf10p4xo3iFW1-GCd3jmyO7jXcxabb9HuNU2zxUT6nX-rIUA0t8ULvnIT2nZQW0JBbMe3Mnia2OSkY0Ab1_jY9l3w1jmCNhWVXAVNu7KspH_OcwDEMSgHM4R_BRYHQF/s320/aloe_vera-417x300.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Aloe barbadensis</td></tr>
</tbody></table>Aloe vera is a drug of wonder that is obtained from Aloe barbadensis. A succulent plant spreading by off set..<br />
In PAKISTAN it is called QUARGANDAL.<br />
<br />
It contain Anthraquinone glycosides mainly a loin,barbaloin,emodin and to some extent socaloin.<br />
<br />
The juice leaves and gels are extracted and used for variety of skin conditions and Aloe Vera has long been used for the nourishment and beauty of skin,due to its soothing effects on skin.Now a days it has also been used for its anti inflammatory and pain relieving properties.<br />
It is use in most cosmetics as moisturizer.<br />
<br />
PHARMACEUTICALY<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9z5YBKfc1Sd1CY74J33ePSuBI5z6ps-2WI9t6osoWBw375Cv-EaBvo2ntaCfGcngBTfdQv494Dqm_iCaR-q_cx3ClHHaTSn9tBHURzJ7-p0N-cW996BikjG4zZ1QkEZAIDp3LA5wDaLUL/s1600/aloe-vera.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="188" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9z5YBKfc1Sd1CY74J33ePSuBI5z6ps-2WI9t6osoWBw375Cv-EaBvo2ntaCfGcngBTfdQv494Dqm_iCaR-q_cx3ClHHaTSn9tBHURzJ7-p0N-cW996BikjG4zZ1QkEZAIDp3LA5wDaLUL/s320/aloe-vera.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Aloe vera</td></tr>
</tbody></table>Its extract is used for dilution of semen in artificial fertilization of sheep, and food preservative and water conservation in small farms.<br />
The extracts from ALOE are used as experimental agents as immunostimulant in animal studies.<br />
It is laxative and used for gastric problems.<br />
Also used in gingivitis.<br />
<a name='more'></a><br />
<br />
<br />
THE MAIN USES ON SKIN ARE<br />
<br />
Aloe is effective in treating wrinkles stretch marks and pigmentation,a small amount of extract or drug is rubbed on skin and it will decrease the pigmentation and black spots.<br />
Aloe vera keeps the skin firm and also used for acne problems,Dry scaly skin,boils and even eczema is cured after its regular use.<br />
Aloe vera is best for pimple treatment<br />
for dry scaly face apply small quantity of aloe on your face your skin will looks enchanting and attractive.<br />
It is used in genital herpes and psoriasis.<br />
It is also been trying in ulcerative colitis<br />
ALOE MAINLY CONTAINS<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGbgRGDvXNI-E74QCQopFBtqcWx7GcaAKIOsjIdkGD3TGFXbvySeXm6P72Izw-Z6SK3OdTmCQspSsbXfURp_GczEuL4Sn7XEPEwS8Se7ehWK0qWxIW8KMpiNptg9-WJWVMdAw177HfBj7h/s1600/natural.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="183" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGbgRGDvXNI-E74QCQopFBtqcWx7GcaAKIOsjIdkGD3TGFXbvySeXm6P72Izw-Z6SK3OdTmCQspSsbXfURp_GczEuL4Sn7XEPEwS8Se7ehWK0qWxIW8KMpiNptg9-WJWVMdAw177HfBj7h/s200/natural.jpg" width="200" /></a>ALOE has about 18 amino acids, vitamins mainly vitamin B and vitamin C, niacin-amide, and minerals like magnesium, zinc,sodium,potassium,manganese and all these are use full for radiant skin<br />
<br />
YOU WILL LOOK BEAUTIFUL WITHOUT ANY MAKE UP WITH THE USE OF ALOE VERA,THAT IS CALLED NATURAL BEAUTY.<br />
SO TRY TO GROW ONE ALOE PLANT IN YOUR LAWN FOR YOUR NATURAL BEAUTY.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-69398627420802837442011-06-23T06:01:00.000-07:002011-07-21T11:23:25.714-07:00Pregnant Womens should not touch finasteride<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjtjrXvVQpHKSAbCYS_LxVnSCaxksbpJUCaZoP2no-l0ODCEE9hIQ3ABVu_b4gtIydUzxDploCtoNuW5_Mw7o5nleEOzmQ-AuyOLe4kKTx9aYXjXz7iqrRkOnTIJ0kw9gW6PCbEn7FzXMrD/s1600/propecia.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="248" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjtjrXvVQpHKSAbCYS_LxVnSCaxksbpJUCaZoP2no-l0ODCEE9hIQ3ABVu_b4gtIydUzxDploCtoNuW5_Mw7o5nleEOzmQ-AuyOLe4kKTx9aYXjXz7iqrRkOnTIJ0kw9gW6PCbEn7FzXMrD/s320/propecia.jpg" width="320" /></a></div>Finasteride is an anti androgen that is mainly used for patients that are producing excess of steroids mainly testosterone.<br />
<br />
It is orally active and cause reductiion in levels of dihydrotestosterone the drug level begin after 8 hrs and lasts for 24 hrs.<br />
<br />
Finasteride cause shrinkage of prostate gland and relieve the symptoms of urinary retention caused by enlarged gland obstructing the out flow of urine from the bladder and reduce the risk of urinary retention,<br />
the drug act by reducing the androgenic stimulation of the prostate and inhibits the enzyme responsible for converting testosterone tomore active metabolite 5-dehydroxytestosterone(5-DT) within the gland.It is also prescribed to patiens having bleeding from the prostate<br />
<br />
It is also a TRICHOGENIC AGENT(that promote hair growth) and usefull for both men and women the underlying mechanism is that dihydrotestosterone(DHT) acts on hair follicles and damage them causing baldness in men and female pattern hair loss that is characterized by reduction in hair density over crown and frontal scalp area this condition is most prevalent in advance age continued treatment with finasteride is necessary to gain maximum benefits.It is also used in females with hirsutism.<br />
<a name='more'></a><br />
<br />
BUT ONE THING TO BE REMEMBERED BY USING THIS DRUG THAT PREGNANT WOMENS SHOULD NOT EVEN TOUCH THE FINASTERIDE.<br />
<br />
Finasteride is teratogen i.e causes malformation of fetus,Officially the women of chid bearing age should not take finasteride or even handel broken or crushed tablets.<br />
Male fetus is at more risk,it causes hypospadias i.e a congenitel abnormality in which he opening of urethra is on the underside of penis.<br />
Exposure to semen of man taking finasteride does not poses a real risk to women's male fetus<br />
.<br />
Finastride is approved by FDA only for men not for women but some times used in treating female androgenetic alopecia</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-6931404630942780332011-06-22T11:30:00.000-07:002011-07-21T11:34:39.837-07:00Bananas and Depression<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgW8EuZjLNB36rss1zN0Sgbjf10Yh44hrfAzDP6qmQb_dfmbpzhdsUBRo4xk_lFK82M4mE218jN2tLmw8r2wyJshP4E1UW-h9rPi6fwBChZKBR3Idqoe59tADY4rArh7yk2hyk3A5dfaNJZ/s1600/banana2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="211" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgW8EuZjLNB36rss1zN0Sgbjf10Yh44hrfAzDP6qmQb_dfmbpzhdsUBRo4xk_lFK82M4mE218jN2tLmw8r2wyJshP4E1UW-h9rPi6fwBChZKBR3Idqoe59tADY4rArh7yk2hyk3A5dfaNJZ/s320/banana2.jpg" width="320" /></a></div>You might be surprised that by eating bananas you can combat depression<br />
<br />
Yes you can.<br />
<br />
Of course they cannot be equal to chemotherapy but they are good for children<br />
It has been proved by research that bananas are useful in treating depressed patients because they have sufficient quantity of serotonin a brain chemical that regulate mood and it is assumed that depressed patient have low level of serotonin so, by taking bananas you feel better.<br />
<a name='more'></a><br />
<br />
<span class="Apple-style-span" style="color: #666666; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 14px; line-height: 22px;">Serotonin deficiency is often caused by a lack of the amino acid tryptophan – which the body cannot make itself and this tryptophan is provided by banana.</span><span class="Apple-style-span" style="color: #666666; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 14px; line-height: 22px;"><br />
</span><span class="Apple-style-span" style="color: #666666; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 14px; line-height: 22px;"><br />
</span>Another research revealed that banana peel contain much quantity of dopamine,health team suggests that boiling the peel with water and consuming water can help in easing depression<br />
<br />
Eating at least four bananas a week is useful</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-58550361297847185722011-06-21T11:52:00.000-07:002011-07-21T11:26:16.624-07:00OPium addiction and its treatment<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: left;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmrDrYwZo7PFYabOMzgnnLQQY7T_pBWbEkgaePxwXcJ8sIclN-Mx7EVV2le9Bl_6h_t7DJ__UQGVyTU3-DJj8dN-uxlM8cA6Rr1EAk5NF6GWjpeLtmkKrI3IZQIWHVJjEsXpLrfd1yY4Ef/s1600/methadone_treatment.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="177" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmrDrYwZo7PFYabOMzgnnLQQY7T_pBWbEkgaePxwXcJ8sIclN-Mx7EVV2le9Bl_6h_t7DJ__UQGVyTU3-DJj8dN-uxlM8cA6Rr1EAk5NF6GWjpeLtmkKrI3IZQIWHVJjEsXpLrfd1yY4Ef/s320/methadone_treatment.jpg" width="320" /></a>when addicted to heroin or opioids commonly obtained from GUL_E_LALA plant or Papaver somniferum or disambiguation all are the names of same plant.<br />
Use of this opium is associated with physical dependence and addiction most commonly seen with regular use.the most commonly observed effects with heroin addiction is <span class="Apple-style-span" style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: x-small;"> </span><span class="Apple-style-span" style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">malnutrition, </span><span class="Apple-style-span" style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">respiratory effects, </span><span class="Apple-style-span" style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">low blood pressure.</span><br />
<span class="Apple-style-span" style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">when the drug intake is interrupted the addict feel very much irritated and he take drug to achieve the same euphoria that is observed with the drug usage.</span><br />
<a name='more'></a><br />
<span class="Apple-style-span" style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">The following effects are observed with prolong use of opioids are</span></div><ul style="text-align: left;"><li style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">slow breathing</li>
<li style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">dizziness</li>
<li style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">calmly skin</li>
<li style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">tiredness</li>
<li><span class="Apple-style-span" style="color: #444444; font-family: Geneva, Arial, Helvetica, sans-serif;">pin point pupil</span><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif; line-height: 27px;">One of the most pressing challenges facing anyone enduring an opiate addiction is the strong physical dependence that invariably ensues with regular use, and the need to endure very uncomfortable and difficult detox. Opium treatment sometimes seeks to bypass the need for intensive detoxification through programs of opiate substitution and slow tapering of use, but these long term programs are widely criticized both for their efficacy, and for the long duration (years) of opium treatment that must ensue<br />
<span style="color: #333333; font-family: Arial, sans-serif; line-height: 115%;">Opium withdrawal pains start only hours after the last dosage has taken, and gain in intensity for a couple of days before withdrawal symptoms gradually begin to subside. Some of the characteristic symptoms of an opium detoxification are </span></span></li>
<li><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif; line-height: 27px;"><span style="color: #333333; font-family: Arial, sans-serif; line-height: 115%;">nausea,</span></span></li>
<li><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif; line-height: 27px;"><span style="color: #333333; font-family: Arial, sans-serif; line-height: 115%;"> extreme pain,</span></span></li>
<li><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif; line-height: 27px;"><span style="color: #333333; font-family: Arial, sans-serif; line-height: 115%;"> irritability, </span></span></li>
<li><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif; line-height: 27px;"><span style="color: #333333; font-family: Arial, sans-serif; line-height: 115%;">depression, </span></span></li>
<li><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif; line-height: 27px;"><span style="color: #333333; font-family: Arial, sans-serif; line-height: 115%;">insomnia, </span></span></li>
<li><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif; line-height: 27px;"><span style="color: #333333; font-family: Arial, sans-serif; line-height: 115%;">vomiting </span></span></li>
<li><span class="Apple-style-span" style="color: #333333; font-family: Arial, sans-serif;"><span class="Apple-style-span" style="line-height: 18px;">diarrhea, among others. During professional opium treatment, detoxification pains can be managed through continual medical observation and care, and through the use of non narcotic pain relievers, anxiolytics and anti depressant medics<br />
Naloxone is most commonly used drug for detoxification it is available mostly in injection form.</span></span></li>
</ul><br />
</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-28026098272100341652011-06-15T06:50:00.001-07:002011-06-15T06:50:29.356-07:00Right choice at righttime makes your therapy effective<div dir="ltr" style="text-align: left;" trbidi="on"><br />
</div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-7029755624526795943.post-55456071409392184902011-06-15T06:37:00.001-07:002011-06-27T02:27:55.736-07:00Health and overdose<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-lCaNd5lc9e4/SQrleOdXaTI/AAAAAAAAAnQ/4UVsQtYLR6g/s640/MIC051LH.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://1.bp.blogspot.com/-lCaNd5lc9e4/SQrleOdXaTI/AAAAAAAAAnQ/4UVsQtYLR6g/s320/MIC051LH.JPG" width="320" /></a>Some time you have to use more than one drug i such a case it is highly recommended that you should consult your pharmacist so that possible side effects can be prevented.<br />
<br />
<br />
Use of more than one drugs is called poly-pharmacy,in such case the recommendations of pharmacist should be followed strictly and do not use the drugs with out consulting your doctor or pharmacist.<br />
<br />
<br />
Poly pharmacy is detrimental to your health if it is practiced with out consulting health authorities.<br />
one thing to be remembered that your health is wealth and you know the worth of this wealth when you fell ill</div><br />
</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-11879881556392460592011-06-15T06:34:00.000-07:002011-06-23T13:26:40.533-07:00Taking one or more medicines can be harmfull<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="http://findmeacure.com/wp-content/uploads/2008/12/expired-medicines-1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="212" src="http://findmeacure.com/wp-content/uploads/2008/12/expired-medicines-1.jpg" width="320" /></a></div><br />
</div>It has been postulated that multipule drug use is associated with more serious adverse effects some time because of DRUG DRUG INTERACTION.<br />
different drugs that have different pharmacological activity interact in a different way and is associated with special adverse effects.<br />
When more than one drugs are used than the may interact with each other and poses serious health hazards to patient using them<br />
SO,<br />
you should consult your pharmacist that can tell you the right therapy at right time, this will effect your drug therapy and you will feel better.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-2071916553385894642011-06-15T06:08:00.000-07:002011-06-27T02:28:45.563-07:00Herbal medicines helps a lot in treatment<div dir="ltr" style="text-align: left;" trbidi="on"><div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSnpWmf8HaKxemxwMuTj8hUhJZMOnZ4GQWDUpGPpnDcnJNhs7cSTtwoE0s9NdQ9ReKfT5deX38Xg3_PJMjAjB1cxGkWkJx7D_Nfnfz7x7DNg0QyZ3NY-PyWIXB2XGjgnxyZEgPBRh8romZ/s1600/herbalremedies.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSnpWmf8HaKxemxwMuTj8hUhJZMOnZ4GQWDUpGPpnDcnJNhs7cSTtwoE0s9NdQ9ReKfT5deX38Xg3_PJMjAjB1cxGkWkJx7D_Nfnfz7x7DNg0QyZ3NY-PyWIXB2XGjgnxyZEgPBRh8romZ/s1600/herbalremedies.jpg" /></a></div><br />
</div>herbs have long been used in the treatment of many diseases in ayuervedic medicines every medicine comprises a plant product that is extracted from different plant parts e.g stem roots and leaves.<br />
now a days most of the drugs are synthetically made but the importance of plant in therapy cannot be denied.<br />
Most of the drugs are either extracts or made by substitution of plant extracts.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-29101847874601099772011-06-15T06:03:00.001-07:002011-07-21T11:33:46.179-07:00Vitamin C helps to nourishe your skin<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQOjf5IbIAZRIRlvpWZhBwYQPhVuUHeO1nnQ4XOqQpP0ye4WJc6ELiHpvm2VYWthhvG60Y0beBjCOWrPaGn_u-9WUp9V96onFm4L9mhAb1GYpS6BqFCO_3acYk2850dd-r1JVbQDXkMZVl/s1600/DSC1510.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="223" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQOjf5IbIAZRIRlvpWZhBwYQPhVuUHeO1nnQ4XOqQpP0ye4WJc6ELiHpvm2VYWthhvG60Y0beBjCOWrPaGn_u-9WUp9V96onFm4L9mhAb1GYpS6BqFCO_3acYk2850dd-r1JVbQDXkMZVl/s320/DSC1510.jpg" width="320" /></a></div><br />
<br />
<br />
Vitamin C commonly known as ASCORBIC ACID, has been using for skin nourishment along with VITAMIN E since long time.<br />
Skin care personnel recommend the use of vitamin C and E on the face and parts of body that are exposed to sun light mostly because it protects against the harmful UV radiations.<br />
Study has proved that vitamin C is also anti aging.<br />
Vitamin C promotes the growth of collagen and decrease pigmentation.<br />
ONE THING THAT MUST BE CONSIDERED USING VITAMIN C <br />
-it may be oxidized by air and may cause more damage than its beneficial effects.<br />
SOURCES OF VITAMIN c<br />
1-CITRUS FRUITS<br />
2-Mango<br />
3-Strawberries<br />
4-Watermelon<br />
5-spinach<br />
6-cabbage<br />
7-tomato<br />
8-Green and red pepper<br />
9-papaya<br />
10-Turnips<br />
<br />
Heating and cooking destroy the efficacy of Vitamin C so care should be taken,the best source is uncooked raw food<br />
SIDE EFFECTS OF VITAMIN C<br />
1-Bleeding gums<br />
2-Gingivitis<br />
3-Rough dry scaly skin<br />
4-Nose bleeds<br />
5-Dry splitting hairs</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7029755624526795943.post-6598834723285135532011-06-15T06:01:00.000-07:002011-06-15T06:01:24.398-07:00<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhJexGTqoNRwRMW08ZQdd_R4nsgQV9pPrH9vxB2TCWxz4lxpHEMB8Ko0zNoH-wSU12AibVGxh2K1b9H0y1I_FM4jDOUbyqtl_Dgx8C8KhktzvufDNslpc_CphjBAxTz_vZvctRwbcVjwCc/s1600/medicine2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="196" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhJexGTqoNRwRMW08ZQdd_R4nsgQV9pPrH9vxB2TCWxz4lxpHEMB8Ko0zNoH-wSU12AibVGxh2K1b9H0y1I_FM4jDOUbyqtl_Dgx8C8KhktzvufDNslpc_CphjBAxTz_vZvctRwbcVjwCc/s320/medicine2.jpg" width="320" /></a>soft gelatin capsules</div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgssLmvJEPJ00BZqHV47iAoW6J9QVrKpe00DDKKzk38FoRZCIWDPXJghNMnUwIabGvAngyYsPOkjfAZJm_VI1fSDABdDTUBTioWulABvpzAtOAZREyvEY6Ral0vL10jU1RY6j4EXU_m0pE8/s1600/medicines.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgssLmvJEPJ00BZqHV47iAoW6J9QVrKpe00DDKKzk38FoRZCIWDPXJghNMnUwIabGvAngyYsPOkjfAZJm_VI1fSDABdDTUBTioWulABvpzAtOAZREyvEY6Ral0vL10jU1RY6j4EXU_m0pE8/s320/medicines.jpg" width="320" /></a></div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGHGoc-rPMciMnn33i2noGwE7zdIznDqawXMlrdQdS-etpSzlKWGVJKYH6_ijV7IEm4Gw0El0Ro1Cr6kCIqEmF4H1ek_wl6kpq9y2nOccVlsaJrZwuksdHsSflzRCHeUWaHYCWsI_sIRle/s1600/medicines-storage%255B1%255D_1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="220" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGHGoc-rPMciMnn33i2noGwE7zdIznDqawXMlrdQdS-etpSzlKWGVJKYH6_ijV7IEm4Gw0El0Ro1Cr6kCIqEmF4H1ek_wl6kpq9y2nOccVlsaJrZwuksdHsSflzRCHeUWaHYCWsI_sIRle/s320/medicines-storage%255B1%255D_1.jpg" width="320" /></a>medicines in a pharmacy</div><br />
</div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-7029755624526795943.post-7722875911161034232011-06-14T10:06:00.000-07:002011-06-14T10:06:45.827-07:00<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyITVjhVDdQBck7DdL5uwasuqA5JkTx-FEoclLaUoqC3NQc3yLC8ZF6vOgnkXD8pEkB7rvqit1VL0ebWz4qPgLmB4H879TwQ-9ZOy7zNMNudpJ8IWgBVsXMBti3h2tz0Rdj9jSVqs2khex/s1600/Slide3.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyITVjhVDdQBck7DdL5uwasuqA5JkTx-FEoclLaUoqC3NQc3yLC8ZF6vOgnkXD8pEkB7rvqit1VL0ebWz4qPgLmB4H879TwQ-9ZOy7zNMNudpJ8IWgBVsXMBti3h2tz0Rdj9jSVqs2khex/s320/Slide3.png" width="320" /></a></div><br />
</div>Unknownnoreply@blogger.com1