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General Medicine

Acetylcysteine (N-Acetylcysteine or NAC) Injection is a medication with various clinical uses, particularly in treating acute poisoning and respiratory conditions. It is the injectable form of NAC, which is also available in oral and inhalation formulations. 🔹 Common Uses of Acetylcysteine Injection (NAC Injection): 💊 Acetaminophen (Paracetamol) Overdose: Primary and well-established use: Acetylcysteine is the antidote for acetaminophen toxicity (overdose). It works by replenishing glutathione, a crucial antioxidant in the liver, thus preventing liver damage caused by acetaminophen metabolism. Early administration is key: Can prevent or minimize liver damage if administered within 8–10 hours of overdose. 🫁 Chronic Obstructive Pulmonary Disease (COPD) / Respiratory Conditions: Mucolytic action: NAC helps to break down and thin mucus in the lungs, making it easier to cough up. Often used in COPD, chronic bronchitis, asthma, and other conditions where thick mucus obstructs airways. Nebulized NAC is sometimes used for inhalation to directly treat respiratory conditions. 🧬 Kidney Protection (Preventing Contrast-Induced Nephropathy): Prophylactic use in patients who are at high risk of contrast-induced kidney damage (e.g., before receiving contrast media in imaging procedures like CT scans). NAC may help protect kidney function from damage caused by the contrast agents used during these procedures. 🔬 Antioxidant Therapy in Critical Care: NAC is used as an antioxidant to reduce oxidative stress in various conditions such as sepsis, acute respiratory distress syndrome (ARDS), and other critical illnesses. It helps to reduce inflammation and cell damage by neutralizing free radicals. 🧪 Treatment of Cystic Fibrosis (CF): While primarily in oral or nebulized form, acetylcysteine may sometimes be used intravenously to help manage mucus buildup in the airways in CF patients, although this is less common. 🍸 Alcohol-Induced Liver Injury: NAC has been investigated in treating alcohol-induced liver damage, as it helps with glutathione replenishment and reduces oxidative stress. It’s sometimes used in the hospital setting for patients with alcoholic liver disease. 💉 How It’s Administered: Intravenously (IV) is the most common method for acetaminophen overdose or critical care. It is usually given as a slow infusion, with the dosage adjusted based on the severity of the condition being treated (e.g., for acetaminophen toxicity, a specific dosing regimen is followed). ⚠️ Precautions & Side Effects: Common Side Effects: Nausea or vomiting (especially with high doses) Rash Fever Hypotension (low blood pressure) during IV administration Severe Reactions: Rarely, an allergic reaction (e.g., anaphylaxis) may occur. Bronchospasm (tightening of the airways) in patients with a history of asthma, though this is less common with IV use. Kidney function should be monitored, especially in patients at high risk of renal issues or those receiving contrast agents. ✅ Summary of Acetylcysteine Injection Uses: Condition Use of Acetylcysteine (NAC) Injection Acetaminophen overdose ✅ Primary antidote Mucolytic (thinning mucus) for respiratory conditions ✅ COPD, chronic bronchitis, asthma Kidney protection in contrast nephropathy ✅ Prevent contrast-induced kidney damage Antioxidant therapy in critical care ✅ Sepsis, ARDS, oxidative stress Cystic Fibrosis (mucus management) ✅ Less common, but used Alcohol-induced liver injury ✅ Investigational (glutathione replenishment)

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Anti Cancer Medicine

Ondican 4 Injection, also known by the generic name Ondansetron 4 mg Injection, is an antiemetic medication primarily used to prevent and treat nausea and vomiting associated with various medical conditions and treatments. Common Uses 1. Chemotherapy-Induced Nausea and Vomiting (CINV): Ondican 4 is administered to prevent nausea and vomiting caused by chemotherapy. It is typically given 30 minutes before the start of chemotherapy sessions. 2. Radiation Therapy-Induced Nausea and Vomiting: It is used to prevent nausea and vomiting associated with radiation therapy, usually administered 1–2 hours before treatment. 3. Postoperative Nausea and Vomiting (PONV): Ondican 4 helps prevent and treat nausea and vomiting following surgery. It is administered immediately before or within 2 hours after surgery. 4. Other Causes of Nausea and Vomiting: It may also be used to manage nausea and vomiting due to other causes, such as gastroenteritis or certain medical conditions. Mechanism of Action Ondican 4 works by blocking the action of serotonin, a chemical in the body that can trigger nausea and vomiting. By inhibiting serotonin receptors in the brain and gastrointestinal tract, it effectively prevents these symptoms. Administration Ondican 4 Injection is administered intravenously (IV) by a healthcare professional in a hospital or clinic setting. The dosage and timing depend on the specific condition being treated and the patient's medical history. Side Effects Common side effects may include: • Headache • Constipation • Dizziness • Fatigue • Injection site reactions These side effects are generally mild and temporary. However, if they persist or worsen, consult your healthcare provider. Precautions Before receiving Ondican 4, inform your doctor if you have: • Liver disease • Heart problems • Electrolyte imbalances • Blockage in the stomach or intestines Additionally, disclose any other medications you are taking, as interactions may occur. Pregnant or breastfeeding individuals should consult their healthcare provider before use.

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Immunoglobulins

Tacrocord 0.5mg Capsule contains the active substance Tacrolimus. It is an immunosuppressant that belongs to the class of medications called calcineurin inhibitors. This capsule is used along with other medications to prevent organ transplant rejection in people receiving liver, kidney, heart, or other transplants. It is also indicated to control your body’s immune response, enabling it to accept the transplanted organ. Do not take this Tacrocord 0.5mg Capsule if you are allergic to tacrolimus or any of the other ingredients of this medicine. Report your physician if you are allergic to any antibiotic group. Inform your doctor if you have or had a liver or heart disease before initiating the treatment. Notify your physician immediately if you develop fever, bruising under the skin (which may appear as red dots), unexplained tiredness, confusion, yellowing of the skin or eyes, reduced urine output, vision loss, and seizures after taking this medicine. Limit exposure to sunlight and UV light while consuming Tacrocord 0.5mg Capsule by wearing appropriate protective clothing and sunscreen with a high sun protection factor. This is because of the potential risk of malignant skin changes with immunosuppressive therapy. This medicine may cause diarrhea; inform your physician if you have diarrhea for over a day. If you need to receive any vaccinations, consult your doctor once before receiving them.

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Kidney Disease Medicine

Zynesp 200 mcg Injection belongs to the class of medication called 'blood-forming agent' primarily used to treat anaemia (low red blood cell count) in person with long-term serious (chronic) kidney disease and persons receiving chemotherapy for some types of cancer (except for bone marrow or blood cells' cancer). Zynesp 200 mcg Injection helps to reverse anaemia and reduce the need for blood transfusion. Anaemia occurs when the body has a lower amount of red blood cells or haemoglobin. In chronic kidney disease, the kidney gets damaged and doesn't filter the blood, leading to anaemia. Zynesp 200 mcg Injection contains a protein 'Darbepoetin alfa' which works by providing signals to the bone marrow to make more red blood cells. Zynesp 200 mcg Injection is a biologic response modifier and erythropoiesis-stimulating protein. In chronic kidney disease, when the kidney fails to produce sufficient 'erythropoietin protein' which aids in the formation of red blood cells, Zynesp 200 mcg Injection stimulates the production of this protein in the bone marrow. Zynesp 200 mcg Injection will be injected by the healthcare provider. Do not self-administer. The most common side effects of Zynesp 200 mcg Injection are shortness of breath, cough, low blood pressure during dialysis, headache, body aches, diarrhoea, injection site pain and abdominal pain. Most of these sides effects of Zynesp 200 mcg Injection do not require medical attention and gradually resolve over time. However, if the side effects are persistent, reach out to your doctor. If you have uncontrolled/untreated high blood pressure or red cell aplasia (a type of anaemia) due to darbepoetin alfa or epoetin alfa, please inform your doctor before taking Zynesp 200 mcg Injection to avoid any complications. Also, mention all the other medications you are taking to affect the way Zynesp 200 mcg Injection works. Inform your doctor immediately, if you feel weak, lightheaded, tired, or short of breath, or if your skin looks pale as it may be signs that the body has stopped responding to Zynesp 200 mcg Injection .

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Anti Cancer Medicine

INTRODUCTION ABOUT I DOX 20MG INJECTION I DOX 20MG INJECTION contains Doxorubicin which belongs to the group of medicines called Anti-cancer agents. It is used to manage certain types of cancers. It is used either alone or along with other anti-cancer medicines. Cancer is a disease in which some of the cells of the body grow uncontrollably and spread to other parts of the body. Before receiving I DOX 20MG INJECTION, inform your doctor if you have or ever had heart disease, either before or during radiotherapy, had or having live or live-attenuated vaccinations, are currently taking or have recently taken Trastuzumab (used in the management of certain cancers). There are no adequate and well-controlled studies in pregnant women. Consult your doctor during breast-feeding before starting management with this medicine as it may pass through the breast milk and possibly harm your child. Consult your doctor for advice before receiving the medicine. The most common side effects of I DOX 20MG INJECTION are infection, lack of appetite, inflammation in the mouth, diarrhea, nausea, vomiting, reddening, swelling, pain, numbness and tingling in the palms and feet may also occur whilst being managed with this medicine. Hair loss is very common and may be quite severe, beard growth may stop in men, fever, feeling weak, chills, abnormal ECG (electrical trace of the heart) results, raised levels of liver enzymes (as detected by a blood test) can determine if the medicine is having an abnormal effect on your liver, weight increased in patients with early breast cancer. USES OF I DOX 20MG INJECTION Used to manage certain types of cancer HOW I DOX 20MG INJECTION WORKS I DOX 20MG INJECTION works by suppressing the activity of an enzyme (topoisomerase II) involved in the DNA multiplication of the cancer cells. On the other hand, this also forms harmful chemicals (free radicals) which cause damage to the DNA. This slowdown the growth of cancer cells and eventually works against them. DIRECTIONS FOR USE I DOX 20MG INJECTION will be administered intravenously (IV) into the vein by your doctor or nurse. Your doctor will administer the correct dose and duration for you depending upon your age, body weight and disease condition. SIDE EFFECTS OF I DOX 20MG INJECTION COMMON infection lack of appetite inflammation in the mouth diarrhea nausea, vomiting hair loss beard growth may stop (in men) redness, swelling and blistering on the palms of the hands and soles of the feet (palmar-plantar erythrodysesthesia syndrome) chills weakness abnormal ECG raised levels of liver enzymes weight increased in patients with early breast cancer blood poisoning heart problems conjunctivitis (red watery eyes) lacrimation, excess tear production shortness of breath and swelling of the ankles increased heart rate inflammation of the throat and gullet stomach pain skin rashes, redness, hives nails and skin may appear darker than usual injection site reactions such as redness and swelling neutropenia thrombocytopenia malaise/asthenia infertility (in women) absence or decrease in sperm count (in men) UNCOMMON embolism (blockage in the bloodstream) RARE Stop receiving I DOX 20MG INJECTION and contact your doctor immediately if you experience any of the following side effects: dizzy, feverish, short of breath with a tight chest or throat or having an itchy rash anemia (low red blood cell count) decrease in white blood cell counts which in turn causes an increase in infections and a raised temperature (fever) platelets can be affected which could make a bruise or bleed more easily decreased activity in bone marrow reddening of urine dehydration inflammation of veins irritation or bleeding in the intestines inflammation of the lining of the stomach heartburn soreness or ulcers in the mouth

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Anti Cancer Medicine

INTRODUCTION ABOUT RITUXIREL 100 INJECTION RITUXIREL 100 INJECTION contains Rituximab which belongs to the group of medicines called Anticancer drugs. It is used to manage blood cancer (leukaemia) and lymph cancer (lymphoma). It can also be used to manage various auto-immune disease conditions such as rheumatoid arthritis, granulomatosis with polyangiitis or microscopic polyangiitis (inflammation of blood vessels) and pemphigus vulgaris (severe skin blistering and peeling especially on the mouth, nose, throat, eyes and genitals). It is mostly used in combination with other cytotoxic anticancer agents to achieve better results. It is suitable for use both in adults and in children (aged 6 months or older). RITUXIREL 100 INJECTION will be administered to you only by an oncologist or a trained professional into your vein (as intravenous infusion). Before receiving RITUXIREL 100 INJECTION inform your doctor if you have any heart problems (such as chest pain, heart attack, heart failure or abnormal heartbeat). You must also inform your doctor if you currently have or previously had hepatitis B infection or any other mild infections (including minor cough and cold) as a precaution. RITUXIREL 100 INJECTION is not recommended for use in pregnant or breastfeeding women. Both men and women receiving RITUXIREL 100 INJECTION must use a suitable contraceptive method to avoid pregnancy while undergoing therapy with RITUXIREL 100 INJECTION. The most common side effects of receiving this medicine are fever, chills, skin rashes with itching, shortness of breath and low blood pressure. Consult your doctor if any of these side effect worsens. USES OF RITUXIREL 100 INJECTION It is used to manage: Blood cancer (Chronic lymphocytic leukaemia) Lymph cancer (Non-Hodgkin’s Lymphoma) Rheumatoid arthritis (joint pain and inflammation) Granulomatosis with polyangiitis or microscopic polyangiitis (inflammation of blood vessels) Pemphigus vulgaris (severe skin blistering and peeling especially on the mouth, nose, throat, eyes and genitals) HOW RITUXIREL 100 INJECTION WORKS RITUXIREL 100 INJECTION is a monoclonal antibody. It destroys the immune cells (B-cells) that triggers cancer formation. It also reduces the production of certain chemicals within the body (such as rheumatoid factor, T-cells, cytokines) that causes inflammation, pain and swelling which helps in managing various autoimmune diseases. DIRECTIONS FOR USE RITUXIREL 100 INJECTION will be given to you only by a doctor or a nurse into the vein (intravenously). Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition. SIDE EFFECTS OF RITUXIREL 100 INJECTION COMMON increased infections (bacterial, viral or fungal) low RBC, WBC and platelet counts in blood nausea, vomiting, diarrhea, stomach pain, constipation, indigestion mouth ulcers hair loss fever, chills, pneumonia, shingles, cold, sinusitis thrush, urinary tract infection headache, dizziness, tiredness, weakness hepatitis B infection high blood sugar and cholesterol levels weight loss, lack of appetite numbness, tingling, pricking, burning sensation on the skin restlessness, problems in falling asleep, anxiety, depression flushing (skin redness) eye inflammation or watery eyes ringing sound in the ears, ear pain uneven or fast heart rate, high or low blood pressure shortness of breath, runny nose, nasal itching and repeated sneezing increased sweating, night sweats muscle pain, joint pain, back pain, neck pain pain while passing urine fungal foot infection (athlete’s foot) tremors (shakiness) swelling of the hands or ankles UNCOMMON blood clotting problems changes in taste slow heart rate chest tightness and lung problems RARE Contact your doctor immediately if you experience any of the following side effects: fever, chills, shivering, nausea, vomiting, skin rashes with blisters and itching, flushing, pain at the infusion site, headache, tiredness, wheezing, high blood pressure, palpitations, swelling of throat or tongue, runny or itchy nose and chest pain fever, cough, sore throat, burning pain while passing urine, feeling weak or generally unwell signs of brain problem (such as memory loss, trouble thinking, difficulty in walking or vision problems) signs of severe skin reactions (such as severe skin blistering and redness that may appear on the on the mucous membranes, such as inside the mouth, the genital areas or the eyelids, with fever)

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Anti Cancer Medicine

INTRODUCTION ABOUT RITUXIREL 500MG INJECTION RITUXIREL 500MG INJECTION contains Rituximab which belongs to the group of medicines called Anticancer drugs. It is used to manage blood cancer (leukaemia) and lymph cancer (lymphoma). It can also be used to manage various auto-immune disease conditions such as rheumatoid arthritis, granulomatosis with polyangiitis or microscopic polyangiitis (inflammation of blood vessels) and pemphigus vulgaris (severe skin blistering and peeling especially on the mouth, nose, throat, eyes and genitals). It is mostly used in combination with other cytotoxic anticancer agents to achieve better results. It is suitable for use both in adults and in children (aged 6 months or older). RITUXIREL 500MG INJECTION will be administered to you only by an oncologist or a trained professional into your vein (as intravenous infusion). Before receiving RITUXIREL 500MG INJECTION inform your doctor if you have any heart problems (such as chest pain, heart attack, heart failure or abnormal heartbeat). You must also inform your doctor if you currently have or previously had hepatitis B infection or any other mild infections (including minor cough and cold) as a precaution. RITUXIREL 500MG INJECTION is not recommended for use in pregnant or breastfeeding women. Both men and women receiving RITUXIREL 500MG INJECTION must use a suitable contraceptive method to avoid pregnancy while undergoing therapy with RITUXIREL 500MG INJECTION. The most common side effects of receiving this medicine are fever, chills, skin rashes with itching, shortness of breath and low blood pressure. Consult your doctor if any of these side effect worsens. USES OF RITUXIREL 500MG INJECTION It is used to manage: Blood cancer (Chronic lymphocytic leukaemia) Lymph cancer (Non-Hodgkin’s Lymphoma) Rheumatoid arthritis (joint pain and inflammation) Granulomatosis with polyangiitis or microscopic polyangiitis (inflammation of blood vessels) Pemphigus vulgaris (severe skin blistering and peeling especially on the mouth, nose, throat, eyes and genitals) HOW RITUXIREL 500MG INJECTION WORKS RITUXIREL 500MG INJECTION is a monoclonal antibody. It destroys the immune cells (B-cells) that triggers cancer formation. It also reduces the production of certain chemicals within the body (such as rheumatoid factor, T-cells, cytokines) that causes inflammation, pain and swelling which helps in managing various autoimmune diseases. DIRECTIONS FOR USE RITUXIREL 500MG INJECTION will be given to you only by a doctor or a nurse into the vein (intravenously). Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition. SIDE EFFECTS OF RITUXIREL 500MG INJECTION COMMON increased infections (bacterial, viral or fungal) low RBC, WBC and platelet counts in blood nausea, vomiting, diarrhea, stomach pain, constipation, indigestion mouth ulcers hair loss fever, chills, pneumonia, shingles, cold, sinusitis thrush, urinary tract infection headache, dizziness, tiredness, weakness hepatitis B infection high blood sugar and cholesterol levels weight loss, lack of appetite numbness, tingling, pricking, burning sensation on the skin restlessness, problems in falling asleep, anxiety, depression flushing (skin redness) eye inflammation or watery eyes ringing sound in the ears, ear pain uneven or fast heart rate, high or low blood pressure shortness of breath, runny nose, nasal itching and repeated sneezing increased sweating, night sweats muscle pain, joint pain, back pain, neck pain pain while passing urine fungal foot infection (athlete’s foot) tremors (shakiness) swelling of the hands or ankles UNCOMMON blood clotting problems changes in taste slow heart rate chest tightness and lung problems RARE Contact your doctor immediately if you experience any of the following side effects: fever, chills, shivering, nausea, vomiting, skin rashes with blisters and itching, flushing, pain at the infusion site, headache, tiredness, wheezing, high blood pressure, palpitations, swelling of throat or tongue, runny or itchy nose and chest pain fever, cough, sore throat, burning pain while passing urine, feeling weak or generally unwell signs of brain problem (such as memory loss, trouble thinking, difficulty in walking or vision problems) signs of severe skin reactions (such as severe skin blistering and redness that may appear on the on the mucous membranes, such as inside the mouth, the genital areas or the eyelids, with fever) HOW TO MANAGE SIDE EFFECTS Constipation Try to eat more high-fibre foods such as fresh fruit, vegetables, cereals, and drink plenty of water. Try doing exercise regularly (going for a daily walk or run). If this does not help, inform your doctor for receiving alternate managements for constipation.

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Eye Care

Tropind Plus is a combination ophthalmic solution containing Tropicamide 0.8% and Phenylephrine 5%. This formulation is primarily used for both diagnostic and therapeutic purposes in ophthalmology. 🩺 Primary Uses of Tropind Plus 1. Pupillary Dilation (Mydriasis): The combination of Tropicamide and Phenylephrine effectively dilates the pupil, allowing eye care professionals to conduct thorough examinations of the retina, optic nerve, and other internal structures. 2. Cycloplegia: Tropicamide paralyzes the ciliary muscle, preventing accommodation (focusing), which is useful in refractive error assessments. 3. Uveitis Management: In cases of uveitis, Tropind Plus helps alleviate pain and prevents further spasms of the eye muscles. 4. Preoperative Preparation: Before surgeries like cataract extraction or retinal procedures, dilating the pupil is essential for clear visualization of the posterior segment. 5. Retinal Imaging: Facilitates procedures such as fundus photography and optical coherence tomography (OCT) by ensuring adequate pupil dilation. ⚙️ How It Works • Tropicamide is a parasympatholytic agent that inhibits the contraction of the circular muscle and paralyzes the ciliary muscle, leading to pupil dilation and cycloplegia. Phenylephrine is a sympathomimetic drug that causes contraction of the radial muscle of the iris, contributing to pupil dilation. Together, these agents produce rapid and effective dilation of the pupil, facilitating detailed eye examinations and procedures. ⚠️ Side Effects Common side effects may include: • Eye pain or stinging • Blurred vision • Sensitivity to light (photophobia) • Allergic reactions These effects are typically temporary and resolve shortly after the examination. 🧪 Safety and Precautions • Driving and Operating Machinery: Avoid activities that require clear vision, such as driving, immediately after application, as the solution can cause temporary blurred vision. • Pregnancy and Breastfeeding: Consult a healthcare provider before use during pregnancy or while breastfeeding, as safety data may be limited. • Drug Interactions: Be cautious when using Tropind Plus with certain medications, especially monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants, as interactions may occur.

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Eye Care

Tobi-D (Tobramycin with Dexamethasone) Eye Drops is a prescription ophthalmic solution combining an antibiotic and a corticosteroid to treat specific bacterial eye infections accompanied by inflammation. ________________________________________ ✅ Primary Uses Tobi-D is primarily used for: • Bacterial Conjunctivitis: Infection of the conjunctiva (the membrane covering the white part of the eye and the inner surface of the eyelids). • Keratitis: Infection of the cornea. • Post-surgical Infections: Prophylactic treatment or management of infections following eye surgeries. It addresses both the infection and the inflammation associated with these conditions. ________________________________________ 💊 Dosage and Administration • Standard Dosage: Instill 1–2 drops into the affected eye(s) every 4–6 hours, or as directed by your healthcare provider. • Application Tips: o Wash your hands before use. o Avoid touching the dropper tip to any surface, including the eye, to prevent contamination. o If you wear contact lenses, remove them before applying the drops and wait at least 15 minutes before reinserting them. ________________________________________ ⚠️ Contraindications and Cautions • Contraindications: o Hypersensitivity to tobramycin, dexamethasone, or any component of the formulation. o Active viral infections of the eye, such as herpes simplex keratitis. o Untreated fungal or mycobacterial infections of the eye. • Cautions: o Use with caution in patients with a history of glaucoma, as corticosteroids can increase intraocular pressure. o Prolonged use may lead to cataract formation or secondary ocular infections. o Consult your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. ________________________________________ 🧪 Mechanism of Action • Tobramycin: An aminoglycoside antibiotic that inhibits bacterial protein synthesis, leading to bacterial cell death. • Dexamethasone: A corticosteroid that reduces inflammation by inhibiting the release of inflammatory mediators. Together, these components address both the infection and the inflammation associated with certain eye conditions.

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