Assignment

Pharmacy practice- 1V A
(Hospital pharmacy)

Submitted to: Dr. Shahid Shah

Submitted by: Azka Fatima
Roll no. : 16944
Semester: 8th
Session: 2017-2022

Department of Pharmacy Practice

Faculty of Pharmaceutical Sciences,
Government College University, Faisalabad.
 Drugs

Generic Mechanism of Indications Side effects Dose Multinational

name action brands
1. Gemfibrozil activates Gemfibrozil is used to Common side effects are:  GEMPAR
peroxisome proliferator- treat: Adult dose:  GEMZIL
activated receptor-α  Epigastric distress 300mg cap.
(PPARα), which alters lipid  Coronary heart  Loose motions 1200 mg administered in two  NORMOLIP
metabolism. disease  Skin rashes divided doses 30 minutes 300mg cap.
2. This activation leads to  Hyperlipidemias of  Body ache before the morning and
 LOPID
increased HDL, apo AI, apo type IIa, IIb, III  Eosinophilia evening meals
300 mg cap.
AII, lipoprotein lipase and IV  Impotence
(LPL), inhibition of apo B  Hyperlipo-  LOPID
 Headache Paedriatic dose:
synthesis, peripheral 600 mg and 900 mg
proteinaemia  Blurred vision
lipolysis, decreased removal tabs.
Gemfibrozil  Nausea Not recommended in this age
of free fatty acids by the  Vomiting group
liver, and increased
 Diarrhea
clearance of apo B.
 Numbness Neonatal dose:
3. Up regulated LPL
 Tingly feeling
reduces plasma triglyceride
levels. Decreased hepatic
 Unusual taste Not recommended in this age
group
removal of fatty acids
decreases the production of
triglycerides.
4. The effects on apoB
synthesis and clearance
decrease VLDL production
which also reduces plasma
triglyceride levels.
Generic Mechanism of Indications Side effects Dose Multinational
name action brands
1. Fenofibrate activates Fenofibrate is primarily Common side effects are  The initial dose is  FENOLIP
peroxisome proliferator activated indicated in conditions  Myalgia 50 to 150 mg per  LIPICARD
receptor alpha (PPARα), like  Hepatitis day. 200 mg cap.
increasing lipolysis, activating  Hypercholestero  Rashes  EQULIP
lipoprotein lipase, and reducing lemia
apoprotein C-III. PPARα is a  Cholelithiasis 48 mg tabs.
 Hyperlipoprotein
nuclear receptor and its activation  Rhabdomyolysis  Dosage should be and 145 mg
aemia
alters lipid, glucose, and amino  Headache individualized tabs.
 Prophylaxis of
acid homeostasis.  Back pain according to patient  FERNORAT
Fenofibrate 2. Activation of PPARα activates NSAID-
 Indigestion response, and 54 mg tabs.
transcription of gene associated should be adjusted
transcription and translation that  Stuffy or runny nose and 160 mg
gastric or if necessary
generates peroxisomes filled with tabs.
duodenal ulcer following repeat
hydrogen peroxide, reactive lipid determination  FIBRA
oxygen species, and hydroxyl at 4 to 8 week 67 mg tabs.
radicals that also participate in intervals.  ZIBRATE TS
lipolysis. 134 mg caps.
3. This mechanism of increased
 TRICOR
lipid metabolism is also
 The maximum dose  ANTARA
associated with increased of fenofibrate
oxidative stress on the liver.  LIPOFEN
capsules is 150 mg
once daily.  FENOGLIDE
 TRIGLIDE
 TRILIPIX
Generic Mechanism of Indications Side effects Dose Multinational
name action brands

1. It inhibits absorption of Ezetimibe is used to treat: Common side effects are:  The recommended  ZETICA
cholesterol (and of plant  Hypercholes- dose of ezetimibe  EZEDOC
stanols) from the duodenum terolemia  Muscle pain is 10 mg once 10 mg tab.
by blocking a transport  Primary  Muscle tenderness daily.  BITORVA
protein (NPC1L1) in the hypercholes- or weakness  LIPIVAS-EZ
brush border of enterocytes, terolemia  Fever  LIPONORM-EZ
without affecting the  primary  Unusual tiredness Atorvastatin 10
absorption of fat- soluble hyperlipidemia  Dark colored urine  It can be mg + ezetimibe
Ezetimibe vitamins, triglycerides or  Homozygous  Thrombocyto-penia administered with 10 mg tab.
bile acids. familial  Hepatitis or without food.  SIMVAS-EZ
2. There is compensatory hypercholes-  Pancreatitis  STARSTAT-EZ
increase in hepatic CH terolemia.  Rhabdomyolysis Simvastatin 10
synthesis, but LDL-CH mg + ezetimibe
level is lowered by 15–20%. 10 mg tab
The enhanced CH synthesis
can be blocked by statins,
and the two drugs have
synergistic LDL-CH
lowering effect.
Generic Mechanism of Indications Side effects Dose Multinational
name action brands

1. It is a complex Acarbose is used to treat: Common side effects are: Initial dose:  GLUCOBAY
oligosaccharide which  Chronic acidotic The recommended starting 50 mg and 100 mg
reversibly inhibits α- states  Acute renal failure dosage of acarbose is 25 tabs.
glucosidases, the final  Diabetes mellitus  Carbohydrate mg given orally three times  ASUCROSE
enzymes for the digestion of  Duodenal or malabsorption daily at the start of each  GLUCAR
carbohydrates in the brush benign gastric  Abdominal main meal. 50 mg tabs.
border of small intestine ulcer associated distension  PRECOSE
mucosa. It slows down and with Pylori  Flatulence Maintenance dose:
decreases digestion and  Prostate cancer  Loose stools The maintenance dose
absorption of  Secondary  Sleepiness ranges from 50 mg t.i.d. to
Acarbose polysaccharides (starch, bacterial infection  Weakness 100 mg t.i.d.
etc.) and sucrose. 2. In of acute bronchitis  Dizziness
addition, GLP-1 release is  Vertigo Maximum dose:
promoted which may  Headache The maximum
contribute to the effect. recommended dose for
 Nausea
3. Acarbose also inhibits patients ≤ 60 kg is 50 mg
pancreatic α-amylase, t.i.d. The maximum
thereby interfering with the recommended dose for
breakdown of starch to patients > 60 kg is 100 mg
oligosaccharides. t.i.d.
4. This drug neither
stimulates insulin release
nor increase insulin action
in target tissues.
Generic Mechanism of
name action
1. Reduce hepatic glucose Metformin is used to
production treat:
(gluconeogenesis), which is
markedly increased in type
2 diabetes.
2. Reduced hepatic
gluconeogenesis is
especially important. The
mechanism involves
activation in hepatocytes of
AMP activated protein
kinase (AMPK), an
important enzyme in
metabolic control.
Metformin Activation of AMPK
increases expression of a
nuclear receptor that
inhibits expression of genes
that are important for
gluconeogenesis in the liver
3. Increase glucose uptake
and utilization in skeletal
muscle (i.e. they reduce
insulin resistance).
4. Reduce carbohydrate
absorption increase fatty
acid oxidation.
5. Reduce circulating low-
density and very-low-
density lipoprotein.
Indications Side effects Dose Multinational
brands
Common side effects are: 1.Immediate-release  METAMIDE
 Malabsorption of tablet or solution: 100mg tabs.
 Diabetes mellitus vit. B12 Initial dose:  GLUMETZA
 Hyperlipo-  Vasculitis 500 mg orally every 12  FORTAMET
proteinaemia  Hypoglycemia hours or 850 mg orally  GLUCOPHAGE XR
 Insulin dependent  Pneumonitis once/day with meals;  BIGUANIL
diabetes mellitus  Malabsorpton of increase every two weeks.  GLUCOFORMIN
 Insulin resistance folic acid Maintenance doses:
and non-insulin  Megaloblastic 1500-2550 mg/day taken
dependent anemia orally divided once every
diabetes mellitus  Lactic acidosis 8-12hours with meal. Not
 Obesity  Abdominal to exceed 2550 mg/day.
distension
 Flatulence 2.Extended-release tablet
 Nausea or solution
Glucophage XR: 500 mg
 Vomiting
orally once/day with
 Anorexia
dinner; titrate by 500
 Diarrhea mg/day each week; not to
 Skin reactions exceed 2000 mg/day
 Weight Loss Fortamet: 500-1000 mg
 Hypersensitivity orally once/day; titrate by
 Metallic taste 500 mg/day each week;
not to exceed 2500 mg/day
Glumetza: 1000 mg orally
once/day; titrate by 500
mg/day each week; not to
exceed 2000 mg/day
References:

 kd-tripathi-essentials-of-medical-pharmacology, 7th edition

 Rang and Dale's Pharmacology, 7th edition
 Lippincott’s Illustrated Reviews: Pharmacology 5th edition
 https://go.drugbank.com/drugs/DB01241
 http://www.druginfosys.com/drug.aspx?drugcode=335&type=1
 https://www.rxlist.com/lopid-drug.htm#indications
 http://www.druginfosys.com/Drug.aspx?drugCode=1454&drugName=fenofibrate&type=1
 https://go.drugbank.com/drugs/DB01039
 https://www.healthline.com/health/fenofibrate-oral-tablet#side-effects
 https://www.rxlist.com/fenofibrate-drug.htm#dosage
 https://www.rxlist.com/fortamet-drug.htm#indications
 https://medlineplus.gov/druginfo/meds/a601052.html
 http://www.druginfosys.com/Drug.aspx?drugCode=1674&drugName=ezetimibe&type=1
 https://go.drugbank.com/drugs/DB00973
 https://www.rxlist.com/zetia-drug.htm
 https://go.drugbank.com/drugs/DB00284
 http://www.druginfosys.com/Drug.aspx?drugCode=25&drugName=acarbose&type=1
 https://www.rxlist.com/precose-drug.htm
 http://www.druginfosys.com/Drug.aspx?drugCode=458&drugName=metformin&type=1
 https://go.drugbank.com/drugs/DB00331
 https://www.rxlist.com/consumer_metformin/drugs-condition.htm