Tab Duphaston - Uses, Dosing and Other Information

 

Introduction: Tab Duphaston contains dydrogesterone 10mg which is a synthetic orally active progestogen. 

Indications: 

- Treatment of painful menstrual periods that are not managed by over the counter pain killers.
- Treatment of endometriosis.
- Treatment of missed periods.
- Treatment of irregular cycles.
- Treatment of abnormal uterine bleeding.
- Treatment of pre-menstrual syndrome.
- Treatment of threatened abortion, associated with proven progesterone deficiency.
- Treatment of habitual abortion, with history of repeated miscarriages  associated with proven progesterone deficiency.
- Treatment of infertility due to luteal insufficiency.
- Luteal support as part of an Assisted Reproductive Technology (ART) treatment.
- Hormone replacement therapy.

Duphaston should only be taken upon prescription from your doctor. Different indications need different dosing and duration of treatment. 

Dosing: 

For hormone replacement therapy(Usually Given in post menopausal woman): In combination with continuous oestrogen therapy, take one tablet daily for 14 consecutive days of a 28 day cycle.

 Dysmenorrhoea (painful menstruation): Take one tablet twice daily from day 5 to day 25 of the cycle.

Endometriosis (abnormal growth of uterine tissues outside the uterus): Take one tablet two or three times daily from day 5 to day 25 of the cycle or continuously (as prescribed by the doctor).

Dysfunctional bleeding (to stop bleeding): Take one tablet twice daily for five to seven days.

Dysfunctional bleeding (to prevent bleeding): Take one tablet twice daily from day 11 to day 25 of the cycle.

Amenorrhoea (missed periods with a negative pregnancy test): The doctor should prescribe an oestrogen along with Duphaston. Then take the oestrogen once daily from day 1 to day 25 of the cycle, together with one tablet of dydrogesterone twice daily from day 11 to day 25 of the cycle.

Premenstrual syndrome: Take one tablet twice daily from day 11 to day 25 of the cycle.

Irregular cycles: Take one tablet twice daily from day 11 to day 25 of the cycle.

Threatened abortion(history of bleeding or spotting in early pregnancy): Take four tablets at once, then one tablet every eight hours until symptoms subside.

Habitual abortion(history of repeated miscarriages): Take one tablet twice daily until the twentieth week of pregnancy.

Infertility due to luteal (yellow body) insufficiency (Deficiency of natural production of progesterone hormone): Take one tablet daily from day 14 to 25 of the cycle. Continue the treatment for at least six consecutive cycles. In addition, it is advisable to continue treatment for the first few months of pregnancy as described under "Habitual abortion". If the patient is uncertain about how long to continue the treatment, talk to the doctor.

Luteal support as part of an Assisted Reproductive Technology (ART) treatment: Take one tablet three times daily (30mg daily) starting at the day of oocyte retrieval and continuing for 10 weeks if pregnancy is confirmed.

Side Effects: Duphaston is considered one of the safe drugs with minimal side effects. Some adverse effects observed are 

- Headache

- Nausea/Vomiting

- Abdominal Pain

- Breast tenderness.

Contraindicated to be used when any history of allergy to the medicine and should be avoided when breastfeeding. 

Rh(D) Immunoglobulin / Anti D Immunoglobulin - Uses And Dose.

Rho(D) immune globulin is a medication used to prevent Rh isoimmunization in mothers who have a Rh negative blood group. 

When a a woman with RhD negative blood is exposed to RhD positive blood in pregnancy she can develops an immune response to it and develop anti D antibodies. In later pregnancies, anti-D antibodies can cross the placenta, causing rhesus haemolytic disease in the Rh positive fetus, and is worsened with subsequent pregnancies. 

Rhesus disease can largely be prevented by giving an injection of a medication called anti-D immunoglobulin to the Rh negative mother.

The anti-D immunoglobulin neutralizes any RhD positive antigens that may have entered the mother’s blood during pregnancy. If the antigens have been neutralized, the mother’s blood won't produce antibodies.

It is often given both during and following pregnancy. 

Indications

• Following potentially sensitizing events in pregnancy, it is recommended that anti-D Ig should be administered as soon as possible and always within 72 hours of the event.
• If, exceptionally, this deadline has not been met, some protection may be offered if anti-D Ig is given up to 10 days after the sensitizing event.
• It may also be used when Rh negative people are given Rh positive blood.
• Anti D Immunoglobulinis also used to treat idiopathic thrombocytopenic purpura (ITP) in people who are Rh positive.

Brief Summary Of Benzodiazepines

Introduction:
Benzodiazepines are a class of drugs also know as tranquilizers that acts on the central nervous system and are mainly used to treat different anxiety disorders.

Mechanism of action:
Although the exact mechanism of action is not known these drugs effect the GABA neurotransmitter in the brain. The response to this inhibitory neurotransmitter is enhanced and thus it becomes resistant to excitation.

Common Drugs In this Group:
All benzodiazepines are similar in pharmacological action but have different potencies, and some bezodiazepines work better in the treatment of certain conditions than the other. They are used mainly as sedatives, hypnotics, muscle relaxants, anxiolytics and anticonvulsants. Common drugs in this group include:

• Alpralzolam
• Lorazepam
• Midazolam
• Bromazepam
• Diazepam etc

Medical Uses: Benzodiazepines may be prescribed for one of these conditions:

• Anxiety
• Insomnia
• Alcohol Withdrawal
• Seizures
• Depression
• Sedation prior to surgery or any diagnostic procedure
• Panic disorders
• Muscle spasms

Side Effects: The common side effects may include:

Acetaminophen- A Brief Introduction

What Is Acetaminophen?
A widely used medicine that almost every one knows also known as Paracetamol or Tylenol. It is a pain reliever and fever reducer. It is classified as a mild analgesic drug.

Medical Uses:Acetaminophen is commonly used for a wide variety of conditions like :

• Headaches
• Backache
• Muscle ache
• Toothache
• Arthritis
• Common cold
• Fever
• Pain due to menstrual periods
• Prevention of pain and fever in reaction to vaccinations. etc

How To Use It ?
Acetaminophen comes in the form of tablets, chewable tablets, solution, suspension, suppositories and is available easily over the counter without a need for prescription. While giving it to children it is important to calculate the dose according to the weight of the child. The usual dose for an average adult is 500 mg every 8 hrs but it may vary depending on the condition for it is prescribed. It is also available in various combinations like used for severe pain or post surgical pain in combination with opioid analgesics or in combination with an antihistamine for symptoms of cold and fever.

Alprazolam- A Brief Introduction

Alprazolam belongs to a group of drugs known as benzodiazepines. It is a short acting anxiolytic drug. It is commonly used to treat anxiety and panic disorders.

Mode of Action: It acts by binding on the GABA receptors of the brain leading to inhibitory or calming effects. After oral administration it is readily absorbed and its metabolites are excreted primarily in urine.

Clinical uses: Alprazolam is used in the treatment and management of conditions like:

• Anxiety disorders
• Panic attacks ( not a first line drug )
• Anxiety conditions with co morbid depression
• Chemotherapy induced nausea and vomiting.

Side effects: Patients taking alprazolam may experience adverse effects like:

• Drowsiness
• Lightheadedness
• Headache
• Dizziness
• Dry mouth
• Nausea
• Urinary retention
• Skin rash
• Anterograde amnesia
• Problem concentrating
• Unusual changes in behavior and mood.

Phenytoin – Anticonvulsant Drug.

Introduction: Phenytoin is a drug that is used to control,treat and prevent certain type of seizures. It is an anti-epileptic drug also known as the anticonvulsant drug.

Mechanism of Action: Phenytoin acts by blocking voltage dependent sodium channels and thus prevents seizures to occur. Its anticonvulsant activity is through blocking sustained high frequency repetitive firing of the action potentials. Its primary site of action appears to be in the motor cortex where it prevents the spread of the seizure activity.

Clinical Uses: Phenytoin is widely used in medicine for conditions like:

• Complex-partial seizures
• Generalized tonic clonic seizures
• Status epilepticus
• As an antiarrythmic drug to control an abnormal heart beat.
• Arrythmias caused by digoxin toxicity.
• Second choice for trigeminal neuralgia.

Precaution while Using Phenytoin:

• Phenytoin has a narrow therapeutic index and needs monitoring of plasma concentration.

Loop Diuretics - A Brief Summary

Introduction: A diuretic is a medicine that causes an increase in urine and the amount of water excreted from the kidneys. Loop diuretics are the drugs that act on the the ascending loop of Henle in the kidney to cause diuresis and are so named as loop diuretics.

Mode of Action: Loop diuretics inhibit the Na+/K+/2Cl- co-transporter in the thick ascending loop of Henle, in the kidneys and stop the transport of sodium chloride out of the tubule into the interstitial tissue, causing a decrease in sodium and chloride re-absorption. They act on the chloride-binding site and have a direct inhibiting effect on the carrier.
Inhibition of this transporter leads to a significant increase in concentration of ions in the tubule and reduced hypertonicity in the surrounding interstitium, causing less water to be reabsorbed into the blood. This causes more urine to be produced and a decrease in blood volume.

Clinical Uses: Loop diuretics are basically used for following conditions;

• Edema associated with heart failure
• Fluid accumulation in renal impairment or nephrotic syndrome.
• Edema with Hepatic cirrhosis
• Hypertension
• Sometimes as an adjuvant in cerebral or pulmonary edema where rapid diuresis is required.