Compilation of some useful examples

Drugs that are almost completely absorbed on Some folate antagonists

oral ingestion (~100% bioavailability) • Sulfonamides • Pyrimethamine
• Diazepam • Minocycline • Trimethoprim • Proguanil
• Chlordiazepoxide • Valproic acid • Methotrexate • Dapsone
• Lithium • Indomethacin • Pemetrexed
• Salicylic acid • Phenobarbitone
Prodrugs
• Digitoxin • Linezolid
Drugs that undergo extensive first pass metabolism • Levodopa  Dopamine
• Prednisone  Prednisolone
• Propranolol • Metoprolol
• Enalapril  Enalaprilat
• Lignocaine • Chlorpromazine • Bacampicillin  Ampicillin
• Verapamil • Morphine • Cortisone  Hydrocortisone
• Pentazocine • Pethidine • Azathioprine  Mercaptopurine
• Nitroglycerin • Insulin • Cyclophosphamide  Aldophosphamide
• Testosterone • Isoprenaline • Zidovudine  Zidovudine triphosphate
• Hydrocortisone • Levodopa
Hit and run drugs
Drugs that are highly bound to plasma proteins
• Reserpine • Omeprazole
• Warfarin • Phenytoin
• Diazepam • Sulfonamides Drugs metabolised by zero-order kinetics
• Phenylbutazone • Salicylates • Alcohol • Phenytoin
• Indomethacin • Tolbutamide • Salicylates • Heparin
• Clofibrate • Frusemide • Phenylbutazone
Absorption increased by fatty food Drugs that undergo enterohepatic recycling
• Halofantrine • Griseofulvin
• Tetracyclines • Amphetamine
• Albendazole • Efavirenz
• Doxorubicin • Metronidazole
• Atovaquone • Posaconazole
• Mefloquine • Morphine
Apparent volume of distribution (Vd) • Indomethacin • Phenytoin
• Estradiol
Low Vd drugs High Vd drugs
• Heparin • Pethidine Drugs available as transdermal patches
• Warfarin • Digoxin
• Nitroglycerin • Hyoscine
• Aminoglycosides • Chloroquine
• Fentanyl • Estrogen
• Aspirin • Nortriptyline
• Testosterone
• Furosemide • Fluoxetine
• Ampicillin • Haloperidol Drugs to which tolerance develops easily
• Amoxicillin • Amiodarone • Nitrates • Hydralazine
Some microsomal enzyme inducers • Barbiturates • Opioids
• Phenobarbitone • Phenytoin Agents which exhibit tachyphylaxis
• Rifampicin • Griseofulvin • Ephedrine • Amphetamine
• Tolbutamide • Metronidazole • 5-HT • Tyramine
• Phenylbutazone • Cigarette smoke
• DDT • Alcohol Drugs which need tapering (after long-term use)
• Carbamazepine • -blockers • Glucocorticoids
Some microsomal enzyme inhibitors • Antiepileptics • Clonidine
• Cimetidine • Fluoxetine • Sedatives • Antidepressants
• Erythromycin • Quinidine • Antipsychotics
• Omeprazole • Ketoconazole
• Grape fruit juice • Chloramphenicol
• Allopurinol

Contd...
 Compilation of some useful examples (contd...)

Drugs with very short t½ (2–10 min) Drugs which need plasma concentration
monitoring
• Dobutamine • Sodium nitroprusside
• Dopamine • Alteplase • Lithium • Carbamazepine
• Esmolol • 5-Fluorouracil • Digoxin • Theophylline
• Adenosine • Aminoglycosides

Drugs with long t½ Some teratogenic drugs

Drug t½ in days • Thalidomide • Tetracyclines
• Chloroquine 10–24 • Sodium valproate • Phenytoin
• Etanercept 3–4 • Carbamazepine • Phenobarbitone
• Phenylbutazone 3–4 • Lithium • Glucocorticoids
• Mefloquine 16–24 • Androgens • Oestrogens
• Gold salts 7 • Progestins • Antithyroid drugs
• Suramin 90 • Anticancer drugs
Drugs to be used with caution in renal
Some haemodialysable drugs
failure
• Isoniazid • Ethyl and methyl alcohol
• Aminoglycosides • Amphotericin
• Barbiturates • Amphetamines
• Cyclosporine • Acyclovir
• Methaqualone • Lithium
• Foscarnet • Pentamidine
• Phenytoin • Salicylates
• Ifosphamide • NSAIDs
• Theophylline
• ACE inhibitors • Sulphonamides
• Anticancer drugs like • Penicillamine
Histamine liberators cisplatin, methotrexate
• Morphine • Tubocurarine
• Pentamidine • Vancomycin Drugs that can produce gingival hyperplasia
• Hydralazine • Amphetamine • Phenytoin • Cyclosporin
• Calcium channel blockers
Drugs that colour urine
Orange red Drugs that can induce haemolysis in G6PD
• Rifampicin • Vitamin B complex (yellow) deficient patients
• Phenazopyridine • Nitazoxanide (green) • Sulfonamides • Primaquine
• Daunorubicin
• Nitrofurans • NSAIDs
Nitric oxide donors • Vitamin K analogs • Dapsone
• Sodium nitroprusside • Nitrites • Some vegetables
• Nitrates
Drugs excreted in saliva
Drugs with low therapeutic index • Clarithromycin • Metronidazole
• Digoxin • Lithium • Phenytoin • Disulfiram
• Theophylline • Quinidine • Metoclopramide
 DRUG INTERACTIONS

TABLE 1 Selected clinically important drug interactions

Precipitant drug* Object drug£ Likely interaction and comments

1. Ampicillin Oral contraceptives Interruption of enterohepatic circulation of the estrogen →
Amoxicillin failure of contraception; Advise alternative contraception.
Oral anticoagulants Inhibition of gut flora → decreased vit K production in
gut → risk of bleeding; Monitor INR and reduce anticoagu-
lant dose if needed.
2. Probenecid Penicillin Inhibition of tubular secretion → prolongation of antibiotic
Ampicillin action; Desirable interaction utilized for single dose therapy.
Cephalosporins
3. Allopurinol Ampicillin Increased incidence of rashes; Avoid concurrent use.
6-Mercaptopurine Inhibition of metabolism; Reduce dose of 6-MP/azathioprine
Azathioprine to 1/3.
Warfarin Inhibition of metabolism; Monitor and reduce dose of object
Theophylline drug.
4. Carbenicillin Aspirin and other Perturbation of surface receptors on platelets → additive
Ticarcillin antiplatelet drugs platelet inhibition → risk of bleeding; Avoid concurrent use.
5. Ceftriaxone Oral anticoagulants Additive hypoprothrombinaemia → bleeding; Monitor INR
Cefoperazone and reduce dose of anticoagulant.
6. Sulfonamides Phenytoin Displacement$ + inhibition of metabolism → phenytoin
Cotrimoxazole toxicity; Avoid concurrent use.
Warfarin Displacement + inhibition of metabolism + decreased
production of vit K in gut → risk of bleeding; Monitor INR
and reduce dose of warfarin.
Sulfonylureas Displacement + inhibition of metabolism → hypoglycaemia;
Avoid concurrent use.
Thiazide diuretics Increased incidence of thrombocytopenia; Avoid concurrent
use.
Oral contraceptives Interruption of enterohepatic circulation of the estrogen →
failure of contraception; Advise alternative contraception.
7. Metronidazole Alcohol Possibly accumulation of acetaldehyde → disulfiram-like or
Tinidazole bizarre reactions; Warn the patient not to drink alcohol.
Cefoperazone
8. Metronidazole Lithium salts Decreased excretion → Li+ toxicity; Monitor Li+ level and
Tinidazole reduce lithium dose.
Warfarin Inhibition of metabolism → risk of bleeding; Avoid
concurrent use.
9. Ciprofloxacin Theophylline Inhibition of metabolism → toxicity of object drug; Monitor
Norfloxacin Warfarin and reduce dose of object drug.
Pefloxacin
10. Erythromycin Terfenadine Inhibition of metabolism by CYP3A4 → rise in blood level
Clarithromycin Astemizole of object drug → dangerous ventricular arrhythmia;
Ketoconazole Cisapride Concurrent use contraindicated.
Itraconazole Phenytoin
Fluconazole Carbamazepine
Protease inhibitors Warfarin
Sulfonylureas Inhibition of metabolism by CYP3A4 → toxicity of object
Diazepam drug; Avoid concurrent use or readjust dose of object drug.
Theophylline
Cyclosporine
HIV protease inhibitors
Statins Inhibition of metabolism, higher risk of myopathy;
Avoid concurrent use.
* Precipitant drug is the drug, which alters the action/pharmacokinetics of the other drug. Contd...
£
Object drug is the drug whose action/pharmacokinetics is altered.
$
Displacement of plasma protein bound drug.
 MISCELLANEOUS DRUGS

TABLE 1 Contd...

Precipitant drug* Object drug£ Likely interaction and comments

11. Gemfibrozil Statins Increased risk of myopathy; Caution in concurrent use.
Nicotinic acid
12. Tetracyclines Oral contraceptives Interruption of enterohepatic circulation of the estrogen →
failure of contraception; Advise alternative contraception.
Lithium salts Rise in plasma Li+ level due to decreased excretion; Avoid
use of tetracycline or monitor and reduce dose of lithium.
13. Iron salts Tetracyclines Decreased absorption due to formation of complexes in
Calcium salts Fluoroquinolones g.i.t. → failure of antibiotic therapy; Stager drug
Antacids administration by 2–3 hours.
Sucralfate
14. Furosemide Minocycline Enhanced vestibular toxicity; Avoid concurrent use.
Aminoglycoside Additive ototoxicity and nephrotoxicity; Avoid concurrent
antibiotics use.
15. Diuretics Tetracycline Antianabolic effect of tetracycline increases urea production
which is retained by the diuretic; Avoid concurrent use.
Lithium Decreased excretion—rise in Li+ level—toxicity; Reduce
dose of lithium and monitor level.
Digoxin Hypokalaemia caused by diuretic increases digoxin toxicity;
Give K+ sparing diuretic/K+ supplements.
16. Tetracyclines Penicillins Bactericidal action of penicillins and cephalosporins may
Chloramphenicol Cephalosporins be antagonized by the bacteriostatic antibiotics; Avoid
Macrolide antibiotics concurrent use.
Clindamycin
17. Clindamycin Erythromycin Mutual antagonism of antibacterial action due to proximal
Clarithromycin binding sites on bacterial ribosomes; Avoid concurrent use.
Azithromycin
Chloramphenicol
18. Phenobarbitone Metronidazole
Phenytoin Doxycycline
Carbamazepine Chloramphenicol Induction of metabolism → loss of efficacy of object drug;
Rifampin Protease inhibitors Avoid concurrent use or increase dose of object drug with
Warfarin monitoring.
Corticosteroids
Oral contraceptives
Sulfonylureas
Antidepressants
19. Chloramphenicol Warfarin Inhibition of metabolism → toxicity of the object drug.
Phenytoin Avoid concurrent use or monitor and reduce dose of object
Sulfonylureas drug.
20. NSAIDs Ciprofloxacin and Enhanced CNS toxicity, seizures; Avoid concurrent use.
other fluoroquinolones
21. Aspirin and Sulfonylureas Displacement and/or reduced elimination → toxicity of
other NSAIDs Phenytoin object drug; Avoid concurrent use/substitute NSAID with
Valproate paracetamol.
Methotrexate
Warfarin Enhanced risk of bleeding due to antiplatelet action and
Heparin gastric mucosal damage; Avoid concurrent use.
ACE inhibitors Reduced antihypertensive effect due to inhibition of renal
β blockers PG synthesis; Avoid concurrent use.
Thiazide diuretics
Furosemide Reduced diuretic action due to PG synthesis inhibition in
kidney; Avoid concurrent use.
Contd...
 DRUG INTERACTIONS

TABLE 1 Contd...

Precipitant drug* Object drug£ Likely interaction and comments

Aspirin and Alcohol Increased risk of gastric mucosal damage and gastric
other NSAIDs Corticosteroids bleeding; Concurrent use contraindicated.
22. Aspirin Spironolactone Reduced K+ conserving action due to decreased tubular
secretion of canrenone (active metabolite of spironolactone);
Avoid concurrent use.
23. Chronic Paracetamol Hepatotoxic dose of paracetamol is reduced; doses
alcoholism < 3 g/day are safe.
24. Chlorpromazine Morphine
Imipramine and Pethidine Enhanced CNS and respiratory depression; Avoid
other TCAs Codeine concurrent use.
25. Chlorpromazine Levodopa-carbidopa Antagonism of antiparkinsonian effect; Concurrent use
Haloperidol contraindicated.
Metoclopramide
26. Levodopa-carbidopa ACE inhibitors Excessive postural hypotension; Reduce dose of
Vasodilators antihypertensives.
Prazosin
27. TCAs Adrenaline (added to Potentiation due to neuronal uptake inhibition → rise in
local anaesthetic) BP; Use plain local anaesthetic solution.
28. Promethazine
Alcohol Diazepam and other Additive CNS and respiratory depression, motor
Opioids benzodiazepines impairment; Avoid concurrent use.
Antipsychotics
29. Cimetidine Diazepam and Inhibition of metabolism → exaggerated CNS depression;
Isoniazid other benzodiazepines Avoid concurrent use or reduce benzodiazepine dose.
30. Sildenafil Nitrates Marked potentiation → precipitous fall in BP;
Tadalafil Concurrent use contraindicated.
31. Propranolol Adrenaline (injected with Rise in BP due to blockade of vasodilator action of adrenaline
local anaesthetic) that enters systemic circulation; Avoid adrenaline containing
local anaesthetic.
Lidocaine Reduced hepatic clearance of lidocaine; Ceiling amount
used in local anaesthesia is reduced.
32. Lidocaine β-blockers Enhanced bradycardia and hypotension; Avoid concurrent
use.
Quinidine and other Exaggerated cardiac depression, precipitation of
antiarrhythmic drugs arrhythmias; Avoid concurrent use.

NSAIDs: Nonsteroidal antiinflammatory drugs

TCAs: Tricyclic antidepressants
Appendix 4 Drugs in Breastfeeding

Administration of drugs to women who are
breastfeeding may have ill effects on the suckling
infant, and/or affect lactation. Estrogens (in oral
contraceptives) and bromocriptine (D2 agonist)
decrease milk production. Toxic effects on the
infant are largely dependent on entry of the drug
in milk in pharmacologically significant amounts.
In the case of large number of drugs (except those
acting on CNS and few others), the concentration
in milk is low, and the breastfed infant receives
insufficient quantity to produce adverse effects.
Maternal medication or breastfeeding should not
be interfered in case of such drugs. However,
currently available data are insufficient to make
specific recommendations in the case of many
drugs and the list given below is not exhaustive.
Manufacturer’s recommendations/package inserts
should be consulted.

A. Drugs whose amount in milk is too small to be harmful to the infant, or

those found to be safe in ordinary doses

Acetazolamide Insulins
Albendazole Ipratropium Br. (inhalation)
Antacids Iron dextran (i.m.)
Antifungal drugs (topical) Iron salts (oral)
Aspirin (low dose) Ketoprofen
Baclofen Lidocaine
Beclomethasone (Inhaled) Loperamide
Benzyl benzoate (topical) Mebendazole
Bupivacaine Methyldopa
Buprenorphine Naproxen
Cephalosporins Nefopam
Cloxacillin Niclosamide
Codeine Paracetamol
Cromoglycate sod. Permethrin (topical)
Dextropropoxyphene Piperacillin
Diclofenac Piperazine
Digoxin Piroxicam
Domperidone Praziquantel
Ergometrine Pyrantel
Erythromycin Pyrazinamide
Ethambutol Salbutamol (inhalation)
Folic acid Sucralfate
Gentamicin Terbutaline (inhalation)
Heparin Valproate sod.
Hydralazine Vitamins (maintenance dose)
Ibuprofen Warfarin
 APPENDICES

B. Drugs to be used with special precaution in breastfeeding

women or drugs contraindicated
Drug Comment / possible adverse effect on breast-fed infant

ACE inhibitors : S/P amount in milk small, magnitude of risk not known,
(Enalapril, Lisinopril) watch for hypotension
Acenocumarol : S/P; give prophylactic vit K to infant
Acyclovir : S/P; significant amount in milk
Alcohol : Intoxication, reduced suckling
Allopurinol : S/P; secreted in milk; no data on risk to infant
Amiloride : C/I; no information on risk to infant; may reduce lactation
Aminoglycosides : S/P; risk not known, most manufacturers advise caution
Amiodarone : C/I; risk of hypothyroidism from released iodine
Amlodipine : S/P; no data on risk to infant
Amphetamines : C/I; significant amount in milk
Ampicillin/Amoxicillin : S/P; diarrhoea, candidiasis in the infant
Androgens : C/I; masculinization of female infant, precocious development of
male infant, reduced lactation
Anthraquinones (senna, etc.) : C/I; diarrhoea in the infant
Anticancer drugs : C/I; anaemia, diarrhoea, immunosuppression
Anticonvulsants : S/P; monitor infant for side effects
Antidepressants (tricyclic) : S/P; use doses < 150 mg amitriptyline per day or equivalent; monitor
infant for side effects, sedation, respiratory depression
Antihistamines (H1) : S/P; significant amount in milk, watch for drowsiness, respiratory
depression
Antihistamines (2nd generation) : No data on risk to infant; manufacturers advise avoid
Antipsychotics : S/P; drowsiness, muscle dystonia; avoid chlorpromazine, haloperidol,
APPENDICES

clozapine; amount in milk small, but long-term effect on developing

nervous system not known
Aspirin : S/P; Avoid high doses, bleeding, Reye’s syndrome
Atorvastatin : Avoid; no data on risk to infant
Atropine : S/P; monitor for anti-muscarinic effects
Azathioprine : C/I; immunosuppression
Azithromycin : Avoid; no information on risk to infant
Barbiturates : S/P; drowsiness, lethargy, withdrawal symptoms
Benzodiazepines : S/P; compatible in single dose; avoid repeated doses; lethargy, hypotonia,
reduced suckling, weight loss
Beta blockers : S/P; amount in milk generally small; bradycardia, hypotension, cyanosis
Bromocriptine : Suppresses lactation
Buspirone : Avoid; no information on risk to infant
Caffeine : Avoid regular consumption of large amounts; irritability, CNS effects
Carbamazepine : S/P; amount in milk small but monitor infant
Carbimazole : S/P; hypothyroidism, use lowest effective dose, or suspend breastfeeding
Carisoprodol : S/P; concentrated in milk; avoid
Chloral hydrate : C/I; sedation
Chloramphenicol : C/I; diarrhoea, bone marrow depression
Chloroquine : S/P; amount in milk small; haemolysis in <1 month old infant and
in G-6-PD deficient
Cimetidine : S/P; significant amount in milk, but no harmful effect reported
Ciprofloxacin : C/I; high concentration in milk, theoretical risk of arthropathy
Clindamycin : S/P; amount in milk small, but risk of diarrhoea, watch for blood in
stools

C/I=Contraindicated or suspend breastfeeding

S/P = Use with special precaution while breastfeeding and monitor infant
Contd...
 DRUGS IN BREASTFEEDING

Drug Comment / possible adverse effect on breast-fed infant

Clofazimine : S/P; skin discolouration

Clonidine : S/P; sedation, hypotension
Corticosteroids : S/P; compatible in single doses; pituitary-adrenal suppression possible
with >10 mg prednisolone daily to mother, impaired growth
Cotrimoxazole : S/P; folate deficiency, risk of kernicterus, haemolysis in G-6-PD deficient;
safe for healthy older infants
Cyclosporine : C/I; significant amount in milk
Dapsone : S/P; haemolytic anaemia, jaundice
Depot medroxyprogesteron : Compatible with breastfeeding from 6 weeks postpartum
acetate (i.m.)
Diltiazem : S/P; significant amount in milk
Disopyramide : S/P; small amount in milk, antimuscarinic effects
Doxepin : S/P; sedation, respiratory depression
Ephedrine : S/P; irritability, sleep disturbance
Ergotamine : C/I; ergotism in the infant; may suppress lactation
Estrogens : C/I; gynaecomastia in male infant, may suppress lactation
Ethosuccimide : C/I; hyperexcitability, poor suckling
Famotidine : S/P; present in milk, but harm to infant not known
Fluconazole : C/I; secreted in milk, but harm to infant not known
Fluoxetine : S/P; small amount in milk, but can accumulate in infant; avoid if possible
Furosemide : S/P; small amount in milk, electrolyte disturbances in the infant
Gemfibrozil : Avoid; no information on risk to infant
Indomethacin : C/I; CNS effects, convulsions
Iodine/Iodides : C/I; concentrated in milk, hypothyroidism and goiter in the infant
Iodine radioactive : C/I; suspend breastfeeding for 24 hr after diagnostic dose and for long-
term after therapeutic dose

APPENDIX 4
Isoniazid : S/P; neuropathy, convulsions, jaundice, give prophylactic pyridoxine
Itraconazole : Avoid unless essential; amount in milk small
Ketoconazole : C/I; secreted in milk but harm to infant not known.
Ketorolac : Avoid as no data on safety
Lansoprazole : Avoid unless essential; no data on safety
Levodopa/Carbidopa : S/P; no data on safety
Lithium carbonate : C/I; intoxication in the infant, cardiac arrhythmias
Losartan : S/P; magnitude of risk not known; avoid if possible
Mefloquine : S/P; secreted in milk, but harm to infant unlikely
Metformin : C/I; secreted in milk; hypoglycaemia, lactic acidosis
Mesalazine : S/P; amount in milk small; watch for diarrhoea
Methotrexate : C/I; toxicity in infant
Metoclopramide : S/P; watch for diarrhoea, dystonia in infant
Metronidazole : Significant amount in milk: avoid high doses; suspend breastfeeding
for 12 hr after single dose therapy
Montelukast : Avoid; no data on risk to infant
Morphine : S/P; usual doses unlikely to affect infant; lethargy, poor growth,
(and other opioids) withdrawal symptoms in infants of dependent mothers
Nalidixic acid : S/P; small risk of haemolytic anaemia; avoid if possible
Neostigmine : S/P; small amount in milk but monitor infant
Nifedipine : S/P; small amount in milk but monitor infant
Nitrofurantoin : S/P; small amount in milk, haemolysis in G-6-PD deficient infant
Norfloxacin : Avoid; no information on risk to infant
Omeprazole : Not known to be harmful, manufacturer advises ‘avoid’
Oral contraceptives : Avoid until 6 month after birth, see estrogens
Penicillins : Toxicity unlikely but risk of allergy
Phenolphthalein : C/I; diarrhoea, rashes

Contd...
 APPENDICES

Drug Comment / possible adverse effect on breast-fed infant

Phenytoin : S/P; small amount in milk, but monitor infant

Progestins : Low doses safe, may suppress lactation at high doses
Propylthiouracil : S/P; hypothyroidism with high doses only
Pyrimethamine-sulfadoxine : S/P; significant amount in milk; appears safe if infant is older
Quinidine : S/P; significant amount in milk but harm to infant not known
Ranitidine : S/P; significant amount in milk but harm to infant not known
Rifampin : S/P; amount in milk small, but monitor infant for jaundice
Sertraline : S/P; present in milk but no harm reported in short-term
Spironolactone : S/P; drowsiness, hirsutism, gynaecomastia
Streptomycin : Compatible with breastfeeding; monitor infant for diarrhoea and thrush
Sulfonamides : S/P; rashes, small risk of kernicterus in neonate, haemolysis in
G-6-PD deficient; safer for older infants
Sulfonylureas : S/P; no adverse effect reported, but watch for hypoglycaemia
Tetracyclines : C/I; growth retardation, candidiasis, tooth discolouration
Theophylline : S/P; irritability, CNS effects
Thiazide diuretics : S/P; amount in milk small; may reduce lactation
Thyroxine : S/P; monitor for hyperthyroidism
Tinidazole : S/P; present in milk; suspend breastfeeding till 3 days after stopping
Vancomycin : S/P; present in milk, but absorption from infant’s gut unlikely
Verapamil : S/P; small amount in milk, but monitor infant
Vigabatrin : C/I; present in milk, no data on risk to infant
Vitamin A and D : Avoid high doses, risk of hypervitaminosis
Zolpidem : Avoid unless essential; amount in milk small, but watch for sedation
in infant
APPENDICES
 Prepared by Pshtiwan Gh.Ali
Principles of prescribing during pregnancy
• Where possible use nondrug therapy.
• Prescribe drugs only when definitely needed.
• Choose the drug having the best safety record over time.
• Avoid newer drugs, unless safety is clearly established.
• Over-the-counter drugs cannot be assumed to be safe.
• As far as possible, avoid medication in the initial 10 weeks of gestation.
• Use the lowest effective dose.
• Use drugs for the shortest period necessary.
• If possible, give drugs intermittently.
3/3/2021
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Prepared by Pshtiwan Gh.Ali

3/3/2021

Prepared by Pshtiwan Gh.Ali

CHOICE OF DRUGS FOR COMMON PROBLEMS DURING PREGNANCY

Prepared by Pshtiwan Gh.Ali

3/3/2021
3/3/2021

Prepared by Pshtiwan Gh.Ali

3/3/2021

Prepared by Pshtiwan Gh.Ali