Uses and side effects of Azee tablets and Dry powder Suspension

Azee is a semisynthetic antibiotic in macrolide family. Its generic name is Azithromycin. It is used for wide variety of infections such as respiratory tract infections, ear infections, skin infections, and genital infections. 

Azee is generally a well tolerated and commonly used antibiotic. However, It has certain interactions with other medications, which can be important.

Common brands of this generic drug are Zithromax, Azithrocin, and Zithrin. This drug has broader spectrum than other macrolides.

Uses of Azee

Oral Azee is used for moderate upper and lower respiratory tract infections. It is also used for genital infections like, infections in cervix and urethra, and in gonorrhea.

This is furthermore used in treatment and prevention of mycobacterium avium complex infection in HIV infected patients.

Another indication, which is unlicensed, is typhoid fever. In addition, oral Azeeis used in children for the treatment of acute ear infection, sore throat, infection in tonsils, and mid pneumonia.

Common side effects of Azee

1. Nausea
2. Vomiting
3. Gastric irritation
4. Constipation

Nausea and vomiting is a common side effect.

Gastro intestinal side effects are the commonest. They include nausea, vomiting, gastritis, and constipation. Some patients will get headache with azithromycin.

Certain patients have complained of disturbance in taste and smell.

Rarely patients can get seizures (fits). Liver damage is another rare side effect.

Preparations

Suspension (Dry syrup)

Suspensions are available in 100mg in 5ml and 200mg in 5ml forms for children. Parent should dissolve it with 10ml of water (boiled and then cooled) and shake it well before use. Put water upto the mark mentioned in bottle.

Keep it in refrigerator and if not used, discard after seven days. It is available in film coated tablets as well. Intravenous form is available for serious infections.

Tablets are usually in strengths of 250mg and 500mg.

It is important to tell your doctor whether you have liver disease before getting the prescription. 

Or Allergies to medications and food stuffs. 

Hives are common sign of allergies so mention if you get them to the doctor before prescription. 

How it is given

Usually administer once daily. Typical duration of treatment is three to four days. This can be taken with or without food.
Cautions

Doctors will not prescribe Azee for patients with severe liver impairment, severe renal impairment and acute porphyria. Before prescribing, if you have history of heart disease, doctor may ask for an electro cardiogram (ECG).

Pregnancy

Not known to be harmful in pregnancy and breast feeding (very small amount in breast milk).


Drug interactions

Azee inhibits liver enzymes that are used to eliminate certain drugs. This results in rising blood levels of those drugs. Few examples are ergotamine, cyclosporine, digoxin, phenytoin sodium, pimozide, warfarin (interaction causes increased bleeding) and theophylline (drug used to treat asthma and cough).

How it works

Azee inhibits bacterial growth by inhibiting protein synthesis in susceptible bacteria. Its concentration is high (around 400 times) in and around the areas of infections in body. This drug eliminates slowly from the body via hepatic metabolism.

Sources

British National Formulary (www.bnf.org)
AHFS Drug Information

Side effects of Clopivas tablets

Clopivas is a medication prescribed by the doctors to treat and prevent ischemic heart diseases (In patients with heart attacks). It is a platelet aggregation inhibitor and it inhibits platelet action. It is a commonly prescribed well-tolerated drug. Its generic name is Clopidogrel. Its available as 75mg, 150, 300mg  tablets. Sometimes it is combined with aspirin and called Clopivas AP.

Clopivas 75mg Tablets

What are the less dangerous but common side effects?

Dyspepsia,
Abdominal pain,
Diarrhea,
Headache,
Pins and needles,
Dizziness,
Rrashes
Nausea are common side effects.

In addition, doctors will not prescribe Clopivas to patients with bleeding disorders, kidney diseases, liver diseases and history of trauma.

"If you have any bleeding disorder or bleed excessively after minor cut injuries you should inform your doctor before getting the prescription."

If you have excessive bleeding then inform your doctor before getting prescription.
Source :Wikimedia

If you are breast feeding, then this medication is not suitable for you. In addition, doctors prescribe Clopivas cautiously to pregnant women.



What are the serious side effects?

Most serious side effects are due to delay in blood clot formation such as in bleeding inside the brain. But it is very rare and doctors prescribe this medication after thoroughly assessing you for risk of brain bleeding.

Bledding inside the brian can be dangerous side effect of this medication but is very rare
Source : Wikimedia

This medication can also cause serious allergic reactions such as anaphylactic shock. If you develop widespread hives, pallor, and chest tightness, edema of the lips and mouth and shortness of breath, stop the medication and seek emergency medical help. This is also rare.

Hives or wheals are common form of allergic reaction. This medication can very rarely cause allergy. Sometimes it can be dangerous.
Source : Wikimedia

In addition, seek medical help if you develop features suggestive of bleeding inside the brain (stroke) such as,

* Sudden weakness of one side of the body
* Sudden headache
* Confusion
* Problems with balance
* Vision problems
* Speech problems

In addition seek medical help if you get yellowish discoloration of the body.

What are the things you should know before taking this drug?

This drug may cause you to bleed excessively. Especially if you are wounded so do the necessary first aid and contact your doctor if the bleeding cannot be stopped. Do not use alcohol, because alcohol is known to increase gastric bleeding. Contact your doctor if you happen to pass black color stools, or develop vomiting mixed with blood.

Very Important !

If you are planning to undergo surgery or do a dental checkup, inform about this drug to your surgeon or Anesthetist before undergoing any procedure. 

Do not take over the counter NSAIDS when you are taking Clopivas without your doctor’s advice. NSAIDS such as Motrin, Naprosyn and Aspirin can increase the chances of gastric bleeding.

How Clopivas works?

A disease process called Atherosclerosis leads to Heart attacks, stroke and peripheral vascular diseases. In atherosclerosis blood vessel lumen is partially obstructed by the cholesterol and various lipids. This increases the chances of blood clot formation inside the artery and can leads to complete block. Platelets play a big role in forming these blood clots. Being an antiplatelet agent, Clopivas prevents blood clot formation and allow smooth flow of blood to heart and other organs.

Summary

Clopivas is a commonly prescribed drug for heart diseases. Main side effects are prolonged bleeding and stroke (rarely). In addition nursing mothers should not use this drug.

Sources

British National Formulary

Uses and side effects of Losacar

Losacar is a brand name manufactured in india of the generic medication Losartan potassium. Losacar is an antihypertensive medication in the Angiotensin receptor blocker family. This drug widens the arteries and reduces blood pressure. This drug does not cause troublesome dry cough as a side effect, unlike ACE inhibitors like Enalapril.

 This drug is prescribed in high blood pressure, heart failure and in the early stages of diabetes kidney damage (diabetes nephropathy).

Losacar is a common medication used for high blood pressure

  Before starting this medication, the doctor should know your complete medical history, including over the counter medication patient is on.  Combining this medication with NSAIDs can have problems.

 What the doctor should know before prescribing?

  If the patient has a kidney disease called bilateral renal artery stenosis, then the doctor will not prescribe Losartan. If the patient has liver problems, doctor should know that as well. If a patient has a heart disease called Aortic or Mitral valve stenosis then the doctor may not prescribe this medication. Conditions like hypertrophic cardiomyopathy can cause problems with this drug as well.

The doctor may check patient’s potassium levels in the blood before starting Losacar, because serum potassium levels can go up with this medication.

 If the patient is pregnant or nursing, doctor will not start Losartan. Taking Losacar in pregnancy can harm the unborn baby. This drug is present in breast milk in significant amounts, so it should not be used in breast feeding as well.

Doctors usualy get cautious when starting this medication in pregnancy

 What the patient should know before taking?

 This medication should be taken as a whole with a full glass of water and it should not be crushed to minimize side effects. This medication can be taken with or without meals. It should not be shared with others. Patient should not take beverages containing alcohol during the therapy.



  What are the common side effects?

 Some patients can commonly get dizziness due to low blood pressure. It is marked in the initial phase of treatment. Therefore, it is advised not to get up in from the morning quickly. First you need to sit on the bed for a while then get up from the bed.

Most elderly people get this side effect frequently. In addition, it is dangerous to drive vehicles or operate machinery due to initial light headed ness that occur with this medication, This side effect is usually goes off quickly.

If you get persistent low blood pressure or persistent faintishness then call your doctor.

Lack of energy and strength, vertigo and easy fatigability are common side effects. Gastro intestinal disturbances like nausea and vomiting are also common. This drug is a potent antihypertensive, so patient can get faintishness especially in the first few days of the treatment. So patients are advised to stay in the home at least in the first day.

How to minimize common side effects?

You can minimize common side effects  by taking the medication without crushing it and with a full glass of water. Also sitting at one place once you have taken the medications greatly helps. Do not exceed the dose recommended by the physician.

 What are the less common side effects?

Less common side effects are cardiac rhythm abnormalities (atrial fibrillation), headache and dizziness.

Few patients may get shortness of breath and muscle/joint pains with this medication.

Notable drug interactions

In elderly patients with multiple medical problems such as diabetes, hypertension, and heart problems this medication can aggravate some side effects of such medications. Usually elderly patients get large amount of prescription medications that there can be harmful drug interactions. So it is better you discuss with your doctor regarding the drug interactions and try to simplify drug regime.

Many patients of Loasacar could be getting cocktail of many other drugs for their hypertension, diabetes and heart diseases.

 What are the rare side effects?

Chest pain, edema, flatulence, nervousness, depression, sleep problems, blurred vision, impotence and back pain are relatively rare side effects.

  Very few patients can get an allergic reaction to this medication. These include rashes, hives and itchiness. Sometimes it can lead to an anaphylactic shock. This is characterized by widespread hives, low blood pressure, shortness of breath and pallor. Patient should seek immediate medical help if he/she gets this problem.

Summary

Losarcar is a medication prescribed for hypertension. It has some side effects commonest is faintishness due excessive low blood pressure. 

Best Allergy Medications

Allergies are a common problem seen in the primary care setting. In addition, sometimes allergies can become life threatening. However, they can be treated effectively with drugs.

 How allergies are caused?

People get allergic reactions when they are exposed to allergens. Allergens are substances that cause abnormal secretion of histamines from the immune system. However, types of allergens can be varied from person to person. For an example some people may be allergic to tomatoes and others may be allergic to tuna fish, but not allergic to tomatoes.

Histamine is a naturally occurring chemical that is secreted from the immune system. Histamine acts on various tissues which cause the symptoms of allergy. Medications that are prescribed in allergies inhibit the action of histamine or lower the potency of the immune system in general.

What are the medications prescribed in allergy?

There are numerous anti-allergy medications available as over the counter or prescription only form. However, most over the counter medications such as Diphenhydramine can cause drowsiness. They can even cause weight gain in long term use. It is because they cross the blood brain barrier and enter into the brain in large amounts.

 What are the best drugs that are prescribed for allergies?

However, newer antihistamines do not cross the blood brain barrier in large amounts. Therefore they cause less drowsiness. In addition they cause less weight gain. Following drugs are prescribed commonly in allergies.

 Cetirizine (Zyrtec®)

Cetirizine is categorized as a non-sedating antihistamine. However, it can cause some sedation in practice. It is usually available as tablets and syrups. In addition, it is usually prescribed once a day.

 Levocetirizine (Xyzal®)

 This is an isomer of the drug cetirizine. It is similar to cetirizine. Therefore it can also cause some sedation. Levocetirizine is available as tablets and syrups.

 Loratidine (Claritin®)

 This medication is a non-sedating antihistamine. Compared to cetirizine, it produces minimal or no drowsiness. It is also given in convenient once daily dosage.

 Desloratidine (Clarinex®)

This is a derivative of the drug Loratidine. It also causes minimal drowsiness. This medication is available as tablets and syrups.

Fexofenadine (Allegra® or Telfast ®)

Compared to other allergy medications fexofenadine is a rather newer drug. It causes minimal drowsiness and sedation. Similar to above drugs, this is also given once a day.

 Steroids

Sometimes steroids are prescribed to treat allergies. In addition, they are usually given in life threatening anaphylactic reactions. Steroids are also given in resistant allergies that do not respond to antihistamines.

 Montelukast (Singulair®)
This medication acts by inhibiting the leukotriene receptors and preventing the action of naturally occurring interleukins. Recent studies have found that it is quite effective in people with allergies associated with bronchial asthma [2]. This medication is usually given to patients with long term allergies.

 Summary

Allergic symptoms are common in primary care. However some medications that are available for this condition can cause drowsiness and weight gain. But newer medications can be taken once daily and they cause fewer side effects.