How to treat a stye Naturally And Medically ?

How to treat a stye

A Red pimple on eye,a stye, is a small cyst that appears on the skin eyelids and it is not only painpul but is also very irritating and make you look ugly.The most common cause behind the stye is the blocking of eyes glands due to any reason.
Stye is more common in people who touch their eyelids with dirty hands and people with a history of a chalazion.But the problem is not a serious one.

Symptoms

Symptoms include,Red eyelid,Irritation of the eyelids,Pain,Watery eyes,and swelling of the eyelids.

Causes of Stye

Some of the causes are Hormonal changes,stress,use of low quality makeup,blockage of eye gland and some inflammatory diseases of the eyes like acne rosacea,blephritis etc

How to treat a stye Naturally ?

Most of the stye heal on their own with few days while some need home remedies to help them ease the pain and heal faster.

(1)Finger
Rub your finger with your palm and then Hold that warm finger on your stye.The heat helps increase blood circulation to the area and promotes drainage of the gland.
Do it for atleast 5-10 times a day .

(2)Use of Teabags
Holding a warm teabag with your eye will help increase the flow of blood around the eye due to which your stye will disappear soon .Apart from this there are some antibacterial properties in the teabag due to which less bacteria grow in your eyes which in turn will help you heal your eyes.Do it for atleast 3-4 times a day untill your stye disappears.

(3)Aloe Vera
Aloe vera juice is one of the best natural remedy for healing stye.Place some aloe juice on your stye for 20 minute and then wash it with warm water and dry it with a soft cloth.

(4)Massage the area Around Your Eyelids
You can massage the area to promote drainage. Massage the area gently with clean hands. Once the stye drains, keep the area clean and avoid touching your eyes. Don’t do it if it hurt you.

(5)Warm Compress
This is one of the best natural remedy for stye .Soak a soft cloth in hot water and wring out the excess.Hold this warm, moist cloth on your closed eyelid for 5 to 10 minutes. It also helps reduce pain and swelling.
Repeat 3 to 4 times a day for 2 weeks

(6)Garlic
Take one pod of Garlic cut it and Hold the cutted surface with your stye for 2-3 minutes.This treatment should be done atleast 6 times per day until the stye disappear.Chane The Garlic after 2 hours.

How to treat a stye medically ?

  • If your stye is very painful, otc pain killer,such as ibuprofen,or paracetamol may help ease the pain.Keep that in mind If Your Stye is painful and affect your normal life its better to consult your GP.
  • Your doctor may give you a steroid shot to reduce swelling.Your Doctor may also prescribe an antibiotic cream for infections.
  • You can also buy over the counter ointments for your stye at your pharmacy.Avoid using topical steroids for your stye. They may cause side effects. Make sure that any product you use is made to be used in or on the eye. Some antibiotic eye drops also work for external styes.

Migraine Medication /s Or Migraine Treatment

Migraine Medication

 Introduction

Migraine is a type of headache which usually occurs in adolescents or young adults.Headache of migraine occur on one side of the head or in the whole head and 60-80% of migraine headache are familial.Migraine is more common in female than in males.Migraine headache occurs in attacks and each attacks of headache usually last from a few hours to 2 days while the frequency of attacks may varry from one or more attacks in a week to one attack in a year.Migraine is usually precipitated by emotional or physical stress apart from this migraine can also be precipitated by missed meals ,sleep disturbances,menstrual periods,alcohol,foods and oral contraceptives.Severity of Headache varies in different patients it may he throbbing pain or some time it may be dull.migrainenmay also be assoiciated woth vomiting and nausea.it may be preceded or accompanied by certain neurological symptoms such as luminous visual hallucination.Migraine occur due to the involement of trigeminal the perivascular spaces.This perivascular oedema mau cause the stretching of pain receptors in the dural membrane,causing headache of migraine.Also it has been found that sometimes during migraine,amplitude of pulsation of temporal arteries is increased .During aura there is abnormal release of serotinin from the platelets,but during headache of migraine serum serotinin fall below normal.

There is another type of migraine headache which is more common in males than in females which is called Cluster Headache in this type of headahe there is very severe pain around an eye with redness of the eye and watering from the nose and eye .Usually occurs in people age 30 or more and its attack usually occur after every 12-18 months.Attack occur usually at night and each attack last 1-2 hours.They remain for one to three weeks during each cluster.

Classifiacation Of Migriane Drugs / Migraine Medication /s
There are two group of Migraine Medication /s Which are ,

(A) Drugs For the treatment of Acute Attack

(1)5-HT1 Agonist:

Zolmitriptan
Sumatriptan
Rizatriptan
Naratriptan

(2)Other Migraine Medication /s

Ergotamine
Paracetamol
Opioids
Dihydroergotamine
NSAIDs

(B)Prophylactic Drugs

Aspirin
Pizotifine
Propranolol
Amitryptyline
Fluoxetine
Flunarizine
Cyproheptadine
Clonidine
Methylsergide
Sertraline

Ergotamine

Ergotamine is one of the best Migraine Medication and It is an alkaloid obtained from a fungus known as cleviceps purpurea.This Fungus infest the rye and some other grains and grasses.
Pharmacokinetics

It is given orally,sublingually,inhalationaly,by rectal route and by intramuscular injection.When given orally it is absorb from the intestine and its absorption is variable.After metabolism the drugs is excreted in urine.Caffeine increases its absorption from the intestine.

Adverse Effects:

Nausea ,vomiting and diarrhea are the most common adverse effects.
Large doses can cause spasm of the blood vessels of the arms and legs thatmay lead to their gangrene.Rarely gangrene of intestine can occur due to spasm of mesentric artieries.

Contraindications

Perilheral vascular disease such as Reynaud disease and buerger disease.in these disease arteries of the limb are narrowed .
Collagen disease.
Ischemic heart disease
Its better to avoid in pregnant women though there is no evidence of harmful effects.

Triptans

These are a group of drugs that are recently being most commonly used in acute attack of migraine.Their mechanism of action appears to be similar to that of ergot alkaloids.

Sumatriptan

It is a 5HT1B and 5HT1D agonist and it is a great Migraine Medication which is effective in both migraine headache and cluster headache.its effectivenessin these conditions is equal to or more than that of ergot alkaloids.

Pharmacokinetics
When given orally only 15% of sumitriptan is absorbed into the systemic circulation.its plasma half life is two to three hours.it can be used orally,subcutaneously and as a nasal spray.

Adverse effects:
Sumitriptan is well tolerated .it can cause mild degree of abnormal sensation such as dizziness,muscle weakness,tingling,pain in the chest ,pain in the neck and pain at the site of injection.
As it is short acting several doses of drug maybe need during a prolonged attack of migraine.However no more than two doses should be given per day.

Other triptans

Naratriptan

It is also a 5HT1B and 5HT1D agonist.
Use 2.5mg of naratriptan orally after an attack of migraine .
When used orally 40-70% of drug is absorbed from the intestine into systemic circulation.
If migraine recurs then 2.5mg can be used again after 4 hours of intial dose.
If the patient doesn’t respond to the first dose don’t use it again for the same attack.
A maximum of 5mg can be used per day.
Not recommended for patient below 18 year of age.
Plasma half life is about 6 hours
Mechanism and adverse reactions are similar to that of sumitriptan.

Rizatriptan

This drug is also a 5HT1B and 5HT1D agonist and is also a best Migraine Medication .
Mechanism and adverse effect are similar to that of sumatriptan.
when used orally 40-70% absorbed from the small intestine into the systemic circulation.
10mg can be used orally at the onset of an attack and if the migraine recurs then a second dose can be given after 2 hours of the first dose.
Keep that mind if the patient doesn’t respond to first dose then second dose is not used.
Maximum daily dose is 20mg and it is not recommended for children below 18 years.

Almotriptan

Daily recommended Dose is 25 mg.
It is used in a dose of 12.5mg orally as soon as possible after the onset of migraine attack.
For recurrence of migraine a second dose should not be given before 2 hours of the first dose.
If there is no response to the first dose,second dose is not given for the same attack .
It is not recommended in children below 18 years.

Eletriptan

It is used in a dose of 40mg orally as soon as possible after the onset of migraine attack and repeated after 2 hours if recurs.
A second dose is not used if there is no response to the first dose.

Contraindications of triptans

Almotriptan is contraindicated in severe hypertension.

All of 5HT1 Agonist are contraindicated in agina pectoris,because they produce spasm of coronary arteries.

Zolmitriptan is contraindicated in wolf-parkinson-white syndrome.

Sumatriptan,rizatriptan,almotriptan,eletriptan,and zolmitriptan are short acting drugs and therefore several doses of these drugs are required during a prolonged attack.

Noratriptan and almotriptan are contraindicated in severe hepatic and renal diseases and in peripheral vascular diseases.

NSAIDS

All NSAIDs can be used as a Migraine Medications in the treatment of acute attack of migraine.
Opioids may be used in severe cases of migraine not responding to other drugs.As they cause addiction ,care should be taken during their use.

Prophylactic Migraine Medication /s

Following are the important Migraine Medication /s that can be used in the prevention of migraine.

Drugs          Prophylactic Dose
Aspirin        300mg twice daily
Prpranolol   80-240mg/Day in 3-4 doses
Imipramine 10-150mg daily in single dose
Amitriptyline 10-150mg daily in single dose
Fluoxetine    20-60mg in a single dose
Sertraline     50-200mg in a single dose
Clonidine      0.2-0.6mg daily
Mrthylsergide maleate 4-8 mg daily
Verapamil      80-160mg daily
Ergonovine maleate 0.6-2mg daily
Cyprophetadine   12-20mg daily.

New Antibiotic That is 1000 times more powerful against bacterial resistance

New Antibiotic That is 1000 times more powerful against bacterial resistanceNew Antibiotic That is 1000 times more powerful against bacterial resistance

Scientists re-engineered an old version of antibiotic into a life saving drug that is more effective against all those bacteria which were resistant to previous one.because resistance of certain bacteria against antibioics is the major problem to the world health these days.
The World Health Organisation warns antibiotic resistance is one in all the most important threats to international health, food security and development, with major diseases becoming harder to treat as a result of the medication used on them are getting less effective.

The antibiotic, vancomycin, has been prescribed by physcians for 60 years and bacterium are only currently becoming resistant to it.The New Antibiotic That is 1000 times more powerful against bacterial resistance is the newer version of vancomycin .
Researchers at The Scripps research Institute (TSRI) in America have made some changes in Vancomycin and build it 1000 time more powerful than the prevailing one .This antibiotic attack the microorganism from three different sites making it a lot of harder for them to develop resistance.
According to Researchers this version of antibiotic will be ready within the next 5 years.
The researchers said physcians could use the modified type of vancomycin without concern of resistance emerging.

According to some Reports approximately 50,000 people die per annum in USA and Europe because of the development of resistance against antibiotics.

Previous studies by the Researchers team showed it absolutely was possible to add two modifications to vancomycin, a drug they labeled “magical” as a result of its strength against infection, to make it even more potent and reduce the number of the drugs required to have a similar impact.This means that scientists will build a third modification which interferes with a bacterium’s cell wall in a very new way,with promising results. Combined with the previous modifications, this alteration offers vancomycin a 1000 fold increase in activity.

Quinolones and Fluoroquinolones

Quinolones And Fluoroquinolones

Introduction:

Quinolones and Fluoroquinolones are a group of synthetic broad spectrum antibiotics.These antibiotics were also isolated from natural resources. One of the most important member of quinolone group of antibiotic was Nalidix Acid.The Problem with this compound was that it was narrow spectrum and it has moderate gram negative activity but it has no gram positive activity.Apart from this issue the nalidix acid was poorly distributed in the body and that is why quinolones are not effective for systemic bacterial infections.so with the passage of time scientist added flourine with mother compound i.e Nalidix acid to improve their activity  so “a group of broad spectrum antibiotics which are flourinated analogues of nalidix acid are called fluoroquinolones ”
These antibiotics are the most famous drugs these days because of their good absorption and spectrum of activity against all type of bacteria and these agents can be effectively used in systemic infections.

Why they are so important ?

A)Very Good Oral Absorption.
B)Very good distribution means deep peneteration in the tissues very effiently.because of their deep penetretion they can kill intracellular organisms.e.g chlamydia,TB,Legionella,brucella.
C)Newer agents are very broad spectrum.
D)They have high potency.
E)They are very well tolerated (Very safe drugs compare to other antibiotic drugs)

What is the mechanism of action of quinolones on bacteria?
OR
How does quinolone work?
OR

Mechanism of action of Quinolones and Fluoroquinolones :

  • These drugs are bactericidal But the question is how they kill the bacteria ?
    Quinolones And Fluoroquinolones are acting on enzymes called topoisomerases or DNA Gyrase.They inhibit bacterial replication by interfering with their DNA replication pathway. DNA is the core genetic material of the cells, and is responsible for correct functioning of the cell. During protein synthesis and DNA replication, the double-stranded DNA must unwind into one stranded structure, that allows for complementary base pairing to occur and synthesis of messenger RNA to procede. Normally This moving of DNA within the bacterium is completed by enzymes called DNA topoisomerase type 2 or DNA gyrase There are two functional Domains Of Topoisomerase 2 enzyme i.e Nuclease domain And Ligase domain.Basically this DNA gyrase (Nuclease Domain) cut the one side of two stranded DNA  and then (Ligase domain ) reseal it after unwinding.This Process continue and the bacteria keep growing but quinolones and fluoroquinolones inhibit or didn’t allow the enzyme Ligase sub doamin to refix or reseal the broken or cut edge of DNA and that is why the bacteria is unable to replicate or even synthesize proteins.First & Second Generation fluoroquinolones Work On this Enzyme .
  • There is another enzyme which is called topoisomerase type 4 which is little different from the type 2 enzyme they also have two domains but the nulcease domain has two sub domain which is responsible for cutting of untangled DNA into fragments the mechanism of fluoroquinolones is same like Topoisomerase 2 they inhibit the function of Ligase and make it dysfunctional.Nuclease domain keep on cutting the DNA into fragments but the ligase is not able to reseal it and the DNA Convert into small fragments and bacteria die.Third and Fourth generation Work Best on both type 2 and type 4 Topoisomerases.And that is the reason Third and Fourth Generation drugs are more broad spectrum in activity .
  • Initially the quinolone and fluoroquinoles first and second generation drugs were best work on gram negative bacteria.but the newer group work on both gram negative and gram positive .

 

  • Mnemonics For Mechanism:
  • Quinolones & Fluoroquinolones: Topple the Queen“: Quinolone interferes withTopoisomerase II.

Classification of quinolones and fluoroquinolones

The first generation i.e Nalidix acid is only quinolone other 3 classes are flouroquinolones.All Other compounds are the derivaties of Nalidix acid.Following are some classes of quinolones and fluoroquinolones ;

  • A)First Generation:
  • Nalidix acid
    B)Second Generation :
  • Ciprofloxacin
  • Norfloxacin
  • Ofloxacin
  • Lomefloxacin
  • Enoxacin
    Norfloxacin don’t absorb very well and they are not used most commonly While ciprofloxacin is the most commonly used drug in this class.
    C)Third Generation :
  • Levofloxacin
  • Gatifloxacin
  • Sparfloxacin
    (D)Fourth Generation :
  • Moxifloxacin
  • Trovafloxacin

Spectrum of activity 

1)First Generation Nalidix acid is moderatly effective (Not very effective) against gram negative bacteria.This drug is not used these day because of poor distribution in the body so it is use in rare uncomplicated urinary tract infections.because this drug is eliminated from the body through renal system and it concentrate into urinary system.

2)Second Generation
They become more effient against gram negative as compare to Nalidix acid.And Also have some less gram positive coverage but keep in mind it doesn’t work on streptococcus pneumoniae .
Ciprofloxacin is also effective against atypical organism like chalymdia ,mycoplasma both of these organism cause respiratory tract infections.
Means second generation has expanded its spectrum from moderate to more effective against gram negative bacteria some added benefits to gram positive bacteria and to atypical organisms.

Ciprofloxacin show more activity against pseudomonas aeruginosa than other fluoroquinolones.

Ciprofloxacin and ofloxacin are also good against Mycobacterium tuberculosis,mycobacterium Fortuitum and Mycobacterium Kansasii.but if use alone these are effective against M.avium infection.So for M.avium treatment they have to be combined with other antituberculous drugs.

Norfloxacin shows least activity against both gram postive and gram negative organisms.

Uses / Indications Of Ciprofloxacin

Where not to use this antibiotic ?
Don’t use this antibiotic more often because of the development of resistant strain and due to over usage, ciprofloxacin is failing against bacteria because of development of resistance.
Every doctor know there is one resistance type of organism i.e MRSA (Methicillin resistance staphylococcus aureus )it is resitant to many other antibiotic and the latest news is even ciprofloxacin is failing on this .
Don’t use this antibiotic in Pneumococcus and Enterococcus infections .

Where to Use Ciprofloxacin ?
A)GIT :Its very effective in traveller diarhea caused by toxic ecoli.
B)Ciprofloxacin is more effective in cystic fibrosis due to infection by pseudomonas auregenosa.
Usually flouroquinolones is contraindicated in children under the age of 18 because in animal model it is approved that flouroqinolones can damage the cartilages and they can produce arthropathy so it should not be used in pregnant women.

C)Ciprofloxacin and Ofloxacin are effective in treatment of typhoid fever .

D)Ciprofloxacin can be used to eradicate the nasopharyngeal carrier -state with meningococci.

E)Ciprofloxacin is the drug of choice in the treatment and prevention of anthranx.

3)Third Generation: Levofloxacin
Good against gram negative but has more activity against gram positive including streptococcus pnemoniea means levofloxacin can be used in pnemonia and that is why this is also called respiratory quinolones .
Levofloxacin is also effective against chlamydia ,mycoplasma and atypical pnemonia.

Levofloxacin and sparfloxacin show improved activity against streptococci and also effective against penicillin resistant pneumococci.

Levofloxacin
DON’T Use this antibiotic
if you are allergic to this drug or other drugs of this class like ciprofloxacin,norfloxacin,moxifloxacin.

Avoid taking antacids, vitamin or mineral supplements, sucralfate  or didanosine powder or chewable tablets within 2 hours before or after you take levofloxacin.

Before taking levofloxacin, tell your doctor if you have muscle weakness ,kidney or liver disease,or trouble breathing,seizures,joint problems, diabetes, myasthenia gravis, a history of head injury of brain tumor, a condition called pseudotumor cerebri, a personal or family history of Long QT syndrome,low levels of potassium in your blood,or if you have ever had an allergic reaction to an antibiotic.

Levofloxacin may cause swelling or tearing of a tendon, especially in the Achilles’ tendon of the heel. These effects may be more likely to occur if you are over 60, or if you have had a kidney,heart, or lung transplant.
if you take steroid medication, Stop taking levofloxacin and call your doctor at once if you have sudden pain, swelling, tenderness, stiffness.

Uses of levofloxacin
Levofloxacin is used to treat bacterial infections that cause bronchitis or pneumonia,means that action of this drug is more extended against pneumococci and also used to treat people who have been exposed to anthrax or plague.
Levofloxacin is also used to treat bacterial infections of the sinuses,skin,kidneys, bladder, or prostate.

4)Fourth Generation.Moxifloxacin
Levofloxacin and moxifloxacin both are called respiratory quinolones .
Its spectrum of activity further broaden against gram positive cocci and gram positive bacilli .
Moxifloxacin can kill the anaerobic organisms and that is why this can be used in mixed infections .

Moxifloxacin ,Gatifloxacin,Sparfloxacin and Gemifloxacin are effective against gram positive organism especially against pneumococci and to some extent staphylococci.

Moxifloxacin Uses
Moxifloxacin is used to treat a variety of bacterial infections. It works by stopping the growth of bacteria.

Moxifloxacin is used to treat bacterial infections, including:
community acquired pneumonia,throat, sinus, and lung infections stomach infections skin infections

Don’t Touch It : Drug That Can Kill You If You Touch It

Drug That Can Kill You If You Touch It
Photo Credit: RT.com

Drug That Can Kill You If You Touch It :US police have issued an imperative public alert when a series of deaths from a Drug That Can Kill You If You Touch It .

The opioid referred to as furanyl fentanyl – a powerful version of the artificial painkiller analgesic 50 times more stronger than heroin– will cause a fatal overdose simply by being absorbed through the skin. It’s reportedly caused nineteen deaths within the state of Georgia over the last year.

The warning comes when 10kgs of pills and powder were taken over during a raid on a pill industrial plant in January, Georgia Bureau of Investigation (GBI) employees became alarmed once they discovered that a box containing pills marked ‘Oxycodone’, a non-hazardous opioid, was in fact furanyl fentanyl.

The (GBI) has reacted to the quantity of overdoses and incidents associated with the drug, as well as others, by provision a public safety alert Thursday.

The drug was placed on the Schedule I list of controlled substances last year after being related to 128 deaths across 5 states in 2015 and 2016. Schedule I is reserved for medication with the very best levels of addictiveness.
“U-47700 and furanyl fentanyl are each Schedule I medication and employed in a similar manner as heroin. Schedule I medication have a high potential for abuse and no presently accepted medical treatment use within the U.S. The medication are distributed in either powder or Tablet form,” GBI said in a very statement.

“Because furanyl Fentanyl and U-47700 are fatal at terribly low doses, law enforcement and therefore the public should use caution once handling these medication. they’ll be inhaled or absorbed through the skin and are very deadly within the smallest quantities.”

Gwinnett County Deputy Shannon Volkadov said: “When I acknowledged what I truly had, [I was] undoubtedly slightly frightened as a result of the quantity that was submitted. something could have happened, however fortunately with the protecting gear and therefore the staff that I had, every thing went Ok.”

According to a GBI Crime research lab chemist Dineen Kilcrease“Oxycodone to the touch it’s still going to be terribly safe. To the touch Furanyl analgesic might fully be fatal, simply through the skin.”

Fentanyl itself has been on the increase within the US in recent years, surpassing heroin because the most ordinarily detected drug in fatal opioid overdoses in Long Island and Connecticut. Last year, the drug was responsible for 188 fatal overdoses in Connecticut, according to figures from the state’s chief doctor.

50 Pharmacology Facts That Every Student Should Know

Pharmacology Facts
Photo Credit : Edinburgh Instruments

50 Pharmacology Facts That Every Student Should Know :

Pharmacology is a very vast Subject Thats why  Its very difficult to summarise every Pharmacology Facts in one article,this list goes some way toward that goal.We Have Made a list of Very important Pharmacology Facts These facts are listed on the basis of mechanisms of action,Drugs Interaction,Uses,Side Effects and Other clinical factors.Hope These Pharmacology Facts will Help Every Student In Medical exams.

Pharmacology Facts

(1)Aspirin Increase the risk of bleeding in olders,those who drink alcohol and those who take NSAIDs and other blood thinning agents.

(2)First Generation Antihistamine Such as chlorphenramine,Diphenhydramine,Dimenhydrinate-cause more sedation than their second generation equivalents such as acrivastine,cetrizine,loratidine and fexofenadine .These second generation has less penetration through the blood brain barrier.These medicine are used in the treatment of hay fever and Allergy.

(3)ACE Inhibitors are known to cause Continous Dry cough-Because of the accumulation of Kinins in the lungs.Patient are sometimes then switched to ARBs (Anhiotensin receptor blockers)-Though Cough May persist.

(4)Amoxicillin is typically the first choice drug in the treatment of otitis media (Inflammation of the middle ear).

(5)Clavulanic Acid Is A beta -Lactamse inhibitor,Meaning it inhibit the enzyme i.e Beta lactamases this enzyme is responsible for the breakdown of antibiotics that contain beta lactam ring.

(6)Paracetamol Overdose causes depletion of glutathione,the compound responsible for ejecting toxic NAPQI(N.acetyl-p-benzoquinone imine) .Acetylcysteine can be administered to fill/restore glutathione levels.

(7)Statins drugs are associated with an increased risk of muscle damage/pain (myopathies)and in some cases can lead to the potentially fatal rhabdomyolysis.

(8)Proton Pump inhibitors like esomeprazole,lansoprazole and pantoprazole inhibit the final step production of acid in the stomach by irreversibly blocking the H+/K+ Atipase of gastric parietal cells.

(9)H2 Receptor Blockers also inhibit or block the production of acid but not in the final phase.Ranitidine and Famotidine are longer acting than cimetidine,With fewer drug reactions and fewer adverse effects.

(10)Tetracycline causes tooth discolouration and phototoxicity.Tetracycline absorption is impaired by drugs or foods containing calcium,magnesium,iron or aluminium iron.

(11)Flouroquinolones like ciprofloxacin and moxifloxacin are associated with an increased risk of tendon damage.

(12)Beta Blockers should be avoided in asthamtic patients because of their potential to precipitate acute asthamtic attacks.

(13)Protamine sulfate is used as antidote to heparin toxicity.

(14)Methyldopa ,Labetalol and Nifedipine are the drugs of choice for hypertension in pregnant womens.

(15)Aminoglycosides like Gentamicin and tobramycin are associated with nephrotoxcity and ototoxicity.

(16)Salbutamol is a short acting beta 2 agonist and is a bronchodilator.its side effects include headache,tachycardia(fast heart rate) tremors,anxiety and dizziness.

(17)Opioids such as morphine,heroin,oxycodone,and fantanyl stimulate the parasympathetic nervous system,causing constricted pupil.This is a common identifier of opioid toxicity.

(18)Calcitonin is used to treat osteoporosis in womens who are atleast 5 years past menopause.

(19)Pramipexole is a dopamine agonist which is used to treat Parkinson disease and restless legs syndrome.

(20)Methotrexate is an antifolate,immunosuppressant drug used to treat various types of cancer and autoimmune diseases.side effects include fatigue,hair loss,nausea,ulcerative stomatitis,leukopenia and hepatoxicity and is teratogenic.This drug cause folate deficiency.

(21)Narrow therapeutic window drugs like Digoxin,lithium and warfarin need close monitoring because very small changes in dose can have very serious clinical consequences.

(22)There are two types of Insulin analogue i.e short and long acting analogues.Short acting analogues includes insulin glulisine,insulin aspart,and insulin lispro.
Long acting include insulin detemir and insulin glargine.insulin degludec is an ultra long acting insulin analogue.

(23)Naproxen is an NSAID Used to treat pain and inflammation and is associated with an intermediate risk of stomach ulceration,compared to low risk ibuprofen,and high risk indomethacin.

(24)isoniazid in combination with other drugs used for the treatment of TB (Tuberculosis).Side effect includes elevated liver enzymes ,reduced blood count,peripheral neuropathy and pyridoxine dificieny.

(25)Acetylsalicylic acid or ASA toxicity can cause ringing of the ear (Tinnitus)

(26)Don’t Use Narcotics in patient with head trauma.

(27)Don’t Give antacids with food because it delay gastric emptying.

(28)Avoid Warfarin with acetaminophen and acetylsalicylic acid because it increase bleeding and increased INR.

(29)Hydroxycholoroquine is an antimalarial drug also used to treat rheumatoid arthritis.its chronic use is associated with eye toxicity.That is why patient should be monitored for the presence of any ocular damage.

(30)Senna is used in the treatment of constipation.it is recommended to be taken at bedtime because it takes 6-12 hours to show effect.

(31)Furosemide is used to treat edema in CHF (Congestive cardiac failure),Kidney disease and liver diseases.Side effects includes ototoxicity ,increased urination,hyperglycemia,hyperuricemia,,hypokalemia and hypotension.

(32)Fusidic acid is used to treat skin infections of gram positive organism.

(33)Warfarin is an anticoagulant that works by inhibting the vitamin k dependent synthesis clotting factors 2,7,9 and 10.Risk increase in the first phase of therapy.

(34)Antitussive drugs like codeine,pholcodine,and dextromethorphan are used to suppress cough.

(35)Antifungal Drugs work by inhibiting the enzyme,lanosterol-14alpha-demethylase,this enzyme responsible for converting lanosterol into ergosterol.

(36)Domperidone is a Selective D2 receptor antagonist.its used as an antemetic and gastroprokinetic agent.

(37)Global Pharmaceutical Market is more than $300 Billion.

(38)Lipitor is the best selling drug of all time.

(39)Insulin is one of the most commonly used drugs that cause adverse effects.

(40)Antihypertensive drugs like ganglion blocker drugs are not used these days because of serious adverse effects.

(41)Atomoxetine is used to treat attention deficit hyperactivity disorder (ADHD)it inhibit norepinephrine and serotinine transporters.side effects include dry mouth,nausea,decreased appetite,trouble in sleep,drowsiness and dizziness.

(42)Ziprasidone should be taken with food to enhance bioavailibility.it is a typical antipsychotic drug.

(43)Metformin is the first line drugs in the treatment of type 2 diabetes and long term use and high doses could lead to vitamin B12 malabsorption and its subsequent dificiency.

(44)Antidote is a greek word used to “give against”are those agents used to oppose the effects of poison with out causing damage to the normal cells.

(45)Maximum dose of paracetamol is 4 grams per day other wise will cause hepatotixcity.

(46)MRSA(Methicillin resistant staphylococus aureus) Super bug is a bacterium responsible for various difficult to treat infection in humans .

(47)Benzodiazepine are classified in term of their elimination half life .short acting benzodiazepine includes trizolam,alprazolam,midazolam and oxazepam while intermediate acting drugs include lorazepam,clonazepam,temazepam, and long acting benzodiazepines include diazepam,flurazepam,cholrdiazepoxide.

(48)Drug of choice in hypertensive emergencies is sodium nitroprusside.

(49)5-HT3 antgonist drugs like,ondansetron,palonosetron and granisetron are used to treat nausea and vomiting,especially effective in treating nausea and vomiting caused by chemotherapy.

(50)Drugs of choice in Congestive cardiac failure are ACE inhibtors like enalapril,lisinopril .

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Important Antidotes List

Antidotes

What are Antidotes ? 

The Word Antidote Derived From A Greek Word “antididonai”  Which Means Give Against So ” Antidotes are Any Substance  which Are Used To oppose the effects of poisons without causing any damage to The body” .

How The Poison Enter Into The Body ?

The Poison In Any Form may be  taken in by the breath Or swallowed, Absorbed Through the thinner and more delicate mucous membranes, Or absorbed through the skin, or implanted by stings, bites, or other wounds.

There Are A lot Of Antidotes In The Medical Field Today But Some Antidotes Are Very Important And Need To Be Remembered Because Of Their Frequent Use In The Emergency Situations.  Knowledge About Antidotes Is Very Important For All Medical Professionals Especially Those Who Are Working In Health Care Settings.Here Are Some Of The Types And List Of Very Important And Frequently Used Antidotes ;

Types of Antidotes

1:Universal Antidotes :This type of antidote is Given when unknown poison is ingested

Composition:
(1):powdered charcoal 2 parts
(2):Magnesium oxide 1 part
(3):Tannic Acid 1 Part

2:Chemical Antidotes :These substances neutrilize the chemical action or oxidize the poison into nontoxic or insolouble form
eg:

Dilute alkali(milk of magnesia)

Dilute acetic acid,

Potassium permangante

Tannin(strong tea).

3:Physiological or pharmacological Antidotes
These produce effects opposite to that of poison
eg:

Naloxone for morphine,

Atropine and oxime for organophosphorous poison,

N-acetylcysteine for acetaminophen

4:Mechanical or physical Antidotes :
These substances prevents the absorption of poison by their presence
eg:Activated charcoal is used for strychinine,emulcents(fats,oils,milk,eggalbumin) are used for corrosive and irritant poisoning,Bulky food used for glass poisoning ,And mineral poisoning(dose 30-60 gms for childreb and 60-100gms ofr adults)

5:Chelating agents:
These are substances which form chelates(non ionized complexes) with cations.These are mostly used in heavy metal poisoning
eg:

N-pencillamine for mercury,lead,copper

BAL(dimercepol) is used in heavy metal poisons

EDTA is used in Arsenic,mercury,lead
versenate is used in Arsenic,mercury and lead
Desferoxamine is used for iron.

Important Antidotes List :

Antidotes For

Non-specific poisons except cyanide, iron, lithium, caustics and alcohol = Activated charcoal

Cobra bite = Snake Anti-Venin.

Heparin = Protamine Sulfate

GAS=Use artificial respiration,Remove patient to air, apply heat to extremities; send for doctor.

ABSINTHE = Give an active emetic; then flaxseed tea freely; stimulate

Insulin reaction = Glucose (Dextrose 50%)

ALKALI, VOLATILE = Drink freely of water with vinegar or lemon juice in it.

ANTIMONIAL WINE = Give warm water freely to encourage vomiting.

AQUA FORTIS = Magnesia or soap dissolved in water, every two minutes.

BED BUG POISON = Give milk or white of eggs in large quantities.

BELLADONNA = Active emetic; stimulate.

Acetaminophen/Paracetamol  = N-Acetylcysteine or Mucomyst

Anticholinergics, diphenhydramine, dimenhydrinate =Physostigmine

BenzodiazepinesZaleplonZolpidem = Flumazenil (Romazicon)

Calcium Channel Blockers = Calcium Chloride, Glucagon

Cyanide = Amyl nitrite, sodium nitrite, sodium thiosulfate

Iron  = Deferoxamine

For Chemicals causing methemoglobinemia in patients with G6PD deficiency = Vitamin C
For Lead = EDTA, dimercaprol, succimer

Methanol = Folic acid

AMMONIA = Lemon juice, diluted vinegar or acetic acid.

Methotrexate = Leucovorin calcium

Potassium = Insulin + Glucose, Kayexalate

MERCURY = White of eggs freely; afterwards evacuate; mild drinks

Valproic acid  = L-Carnitine

Isoniazid, ethylene glycol = Pyridoxine HCl (Vitamin B6)

Tricyclic antidepressants = phyostigmine or NaHCO3

Sulfonylureas = Octreotide (Sandostatin )

Alpha  agonists (e.g., clonidine), Opioids (e.g., codeine, diphenoxylate, fentanyl, heroin, meperidine, morphine and propoxyphene = Naloxone

Arsenic,  Copper,  Lead,  Mercury = D-Penicillamine (Cuprimine )

Neuromuscular blockade = anticholinesterase agents.

Anticholinesterase = atropine sulfate or pralidoxime.

Fluoride ingestion = Calcium salts

Digoxin = digibind digoxine immune fab

Beta blockers and calciumchannel blockers = glucagon

Ergotamine = Heparin

Dopamine = Phentolamine.

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Scientists Develop Artificial Womb To Help Premature Babies

Artificial Womb

 

Scientists Develop Artificial Womb To Help Premature Babies:
Scientists in the United States have developed a womb-like bag called an extra-uterine support device that would transform care for extremely premature babies, considerably rising probabilities of survival.While the new development isn’t specifically a synthetic uterus tank, physicians have created a uterus-like “biobag” that’s capable of sustaining premature foetal lambs very shortly when they start development.
Doctors said that the pioneering approach may radically improve outcomes for babies born so early that they can not breathe, feed or fight infection without medical help.

The team spent three years evolving their system through a series of four prototypes – starting with a glass incubator tank and reaching to the present fluid-filled bag.

Six preterm lambs tested within the most up-to-date prototype were physiologically similar to a 23- or 24-week-gestation human baby and were ready to grow during a temperature-controlled, near-sterile surroundings

In pre-clinical studies with lambs, the researchers were ready to mimic the uterus surroundings and therefore the functions of the placenta, giving premature offspring a vital chance to develop their lungs and other organs.
The lambs were kept within the biobags for four weeks. throughout this time, they grew hair; their lungs developed; and that they reached the point where they might survive on their own.

Remarkably, the eight lambs within the trial developed commonly within the artificial womb and every survived, proving that the biobag with success mimicked the natural conditions found within the uterus—and paving the means for a brand new life-saving device for humans.

At that age, a human baby weighs very little quite 500 grams, its lungs don’t seem to be ready to deal with air and its probabilities of survival are low. Death rates are up to 70 % and people who do survive face life-long disability.

The scientists created amniotic fluid in their science lab and originated the system so that this flowed into and out of the bag.
The team is in discussions with the United States of America Food and Drug Administration (FDA) and predicts that babies might be incubated within the system within three years in the 1st clinical test.
In light of this progress, specialists assert that artificial wombs could also be a reality within the next 10-20 Years.

Drugs Used In Pregnancy

Drugs Used In Pregnancy

 

Drugs Can Have Harmful Effects On The Fetus At any Time In Pregnany.Its Very Important To Keep In Mind When Prescribing For A Pregnant Women.In The First Trimester Of Pregnany Drugs Can Produce Malformation (Teratogenesis).Third And eleventh Week Of Pregnany Is more Critical Time For Teratogenesity.

The Second And Third Trimester Can Effect The Growth And Functional development Of The Fetus. And Drugs Given Just Before Term Or During Labour Can Have Adverse Effects On The Neonates Or On The Labour.

According To FDA There Are Five Categories Of Drugs ,A,B,C,D or X

Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the foetus within the first trimester of pregnancy (and there’s no evidence of risk in later trimesters).

Category B

Animal studies have failed to demonstrate a risk to the foetus and there are not any satisfactory and well-controlled studies in pregnant women.

Category C

Animal reproduction studies have shown an adverse impact on the foetus and there are not any adequate and well-controlled studies in humans, however potential advantages might warrant use of the drug in pregnant women despite potential risks.

Category D

There is positive evidence of human fetal risk based on adverse reaction information from investigational or marketing experience or studies in humans, however potential advantages might warrant use of the drug in pregnant girls despite potential risks.

Category X

Studies in animals or humans have demonstrated foetal abnormalities and/or there’s positive proof of human fetal risk based on adverse reaction information from investigational or marketing expertise, and therefore the risks concerned in use of the drug in pregnant girls clearly outweigh potential advantages.

 

In This Article We Will Talk About The Drugs Safely Used During Pregnancy In general, it’s best to avoid any unnecessary Use Of Drugs early in your pregnancy. During the first trimester, fetal organs develop rapidly, making them extremely vulnerable to the potential risks of drugs.

Prescription Drugs Used In Pregnancy

  • Folic Acid and Vitamin B6
  • Levothyroxine
  • Insulin
  • During 18 and 32 weeks of pregnancy may increase the risk of hyperactivity and behavioral problems in children according to a study published in JAMA Pediatrics.)
  • Methyl dopa, and hydralazine
  • Heparin
  • Some antibiotics namely Amoxycillin, Ampicillin, Cephalosporins, Erythromycin (not estolate)

Drugs Used In Pregnancy For Pain Relief

A cold compress and rest will help alleviate headaches and muscle pain throughout pregnancy, however if you wish further relief, your doctor might recommend acetaminophen. once this drug is used as directed, it is a safe choice. However, it is best to avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and naproxen . Some studies recommend that taking these medications close to conception or in early pregnancy might increase the chance of miscarriage and birth defects.

Drugs Used In Pregnancy For Colds & Allergies

Few women get through 9 months without cold or hypersensitivity reaction symptoms. The safest way to go is to try nondrug remedies: Rest, drink a lot of fluids -particularly warm ones — and use a saline nasal spray to assist relieve stuffiness. the great news is that while a cold will make you miserable, it poses no special risks throughout pregnancy. The flu, however, are often more serious in pregnant ladies, and typically leads to pneumonia. Since influenza shots are safe for both you and baby, it’s knowing get one throughout flu season if you are in your second or third trimester.

If cold or hypersensitivity reaction symptoms interfere together with your ability to eat or sleep, your health care provider could suggest medication, especially if you are past the first trimester. several doctors believe the antihistamine chlorpheniramine  is that the safest choice, because it has been used for several years by pregnant ladies and is not better-known to cause birth defects. unfortunately, very little is known regarding newer medication like loratadine therefore it’s wise to avoid them.

To relieve a cough, doctors usually recommend a drug known as dextromethorphan  However, you should avoid cough product that contain iodine, which might cause doubtless life-threatening thyroid problems within the fetus, still as those that contain high levels of alcohol.

If you need a decongestant, your doctor could recommend a nasal spray that contains oxymetazoline, as a result of only alittle quantity of the drug is absorbed into your system.

Drugs Used In Pregnancy For Digestive Discomforts

Heartburn, constipation, and hemorrhoids are among the foremost common complaints of pregnancy. Luckily, there are many drug-free solutions you’ll use to stop these problems. to move off heartburn, avoid consumption large meals, particularly in the evening, and select smaller, more frequent ones instead. you should additionally steer clear of rich, fried, or spicy foods, which frequently trigger stomach irritation. Sleeping on an incline may stop the contents of your stomach from splashing into your esophagus, causing symptom.

If symptoms persist, your doctor could suggest a safe antacid, like calcium carbonate (Tums). however if additional relief is required, your doctor could recommend sucralfate, usually called carafate, a drug that coats and protects the abdomen lining.

To prevent constipation and also the hemorrhoids that usually follow, drink lots of water and eat fiber-rich foods. Exercise, along with your doctor’s approval, may facilitate to keep constipation unfree. If issues persist, your doctor could recommend a bulk-fiber laxative, like Metamucil or Fiberall. However, you should avoid stimulant laxatives, like castor oil, which may trigger labor. once treating hemorrhoids, use product that contain glycerine or witch hazel, however avoid hydrocortisone, that hasn’t verified to be entirely safe and might be absorbed into your system.

 

Top 100 Drugs Of Choice For Different Diseases

Drugs Of Choice

Drugs Of Choice For Different Diseases are categorized on the basis of diseases .Following are the most important classes of drugs used as a first choice in the treatment of different diseases .

Drugs Of Choice List in infections

(1)Penicillin G
Streptococcus pneumoniae, S.Viridans,Hemolytic Streptococci group A,B,C,G,Staphylococcus (Non-Penicillinase producing)
Neisseria Meningitidis,Clostridium(ABC)Bacillus Cereus,Actinomyces.Treponema Pallidum, T.Pertene
(2)Ampicillin
Listeria,Enterococcus faecalis.
(3)Vancomycin
MRSA,Coagulase negative staphylococcus,Enterococcus faecium.
(4)Erythromycin
Corynebacterium
(5)Doxycycline
Bacillus anthracis,
Borelia burgdorferi, B.Recurrentis.
Chalmydia & Rickettsiae.
(6) Cotrimoxazole
Nocardia
(7) Azithromycin
Hemophilus ducreyi & Mycoplasma .
(8) Ceftriaxone
Proteus,E.coli,Salmonella
(9)Carbapenems
Serratia,Enterobacter,Acinetobacter
(10)(Metronidazole
Bacteriocides
(11)Ceftazidime
Burkholderia pseudomallei

Drugs Of Choice List in pregnancy (12)Choloroquine
Drug of choice for malaria in pregnancy
(13) Alpha-Methyldopa
DoC for hypertension in pregnancy
(14)Heparin
DOC for anticoagulation in pregnancy.
(15)Labetalol
DOC for hypertensive crisis in pregnant women.
(16)Acetaminophen
Analgesic DOC
(17)Phenobarbitone
DoC for epilepsy in pregnant women.
(18)Doxylamine & Pyridoxine
DoC for nausea in pregnancy.

Drugs Of Choice List for various types of seizures: (19)Valproate
Tonic seizures
Absence seizures
Grand mal (GTCS)
Clonic seizures
Atonic seizures
Myoclonic seizures
(20)Carbamazepine
Partial seizures
(21)Vigabatrin
Infantile spasm with tuberous sclerosis
(22)ACTH
Infantile spasm
(23)Lorazepam (IV)
Status epilepticus
(24)Diazepam
Febrile seizures
(25)Magnesium Sulphate
Seizure in eclampsia

Drugs Of Choice List in poisoning  (26)Physostigmine
Atropine, Belladona  & Dhatura poisoning
(27)Atropine
Carbamate,Early mushroom poisoning,Organophosphate poisoning.
(28)Flumazenil
Benzodiazepine poisoning
(29)Acetylcystine
Acetaminophen poisoning
(30)Nalaxone
Opoid poisoning
(31)Deferiprone
Chronic iron poisoning
(32)Desferrioxamine
Acute iron poisoning
(33)Glucagon
Beta blockers poisoning
(34)Amyl nitrate
Cyanide poisoning

Drugs Of Choice List in bronchial asthma (35)Salbutamol
Acute attack of bronchial ashtma in normal patient and pregnant women.
Exercise & Aspirin-induced acute attack of bronchial asthma.
(36)Ipratropium
Acute attack of bronchial asthma during labour.
Acute attack of bronchial ashtma on beta-blockers therapy.
(37)Corticosteroids
Prophylaxis of bronchial asthma ,exercise induced and aspirin-induced asthma.

Drugs Of Choice List In Antimicrobials Prophylaxis (38)Ampicillin
Group B streptococcus infection
(39)Amoxicillin
Endocarditis and Otitis media
(40)Azithromycin
Mycobacterium avium complex (MAC) Pertussis
(41)Benzathine penicillin
Rheumatic fever
(42)Procaine Penicillin
Gonorrhea and syphilis
(43)Tetracycline
Rickettsial infection and plague.
(44)Cefazoline
Surgical Prophylaxis
(45)Doxycycline
Anthrax
(46)Trimethoprim and sulphamethoxazole
Toxoplasmosis , Pneumocystis jerveci UTI
(47)Rifampicin
Hemophilus influenza type B.
(48)Oseltamivir
Influenza Type A & B.

Anesthetic Drugs Of Choice List (49)Propofol
Day care
(50)Sevoflurane
Congenital heart disease,ASD,VSD,PDA
(51)Etomidate
Ischemic heart disease
(52)Ketamine
Asthma and COPD
Shock
CHF, and congenital heart disease (Right to left shunt)
(53)Thiopentone
Epilepsy
Thyrotoxicosis
(54)Methohexitone
Electroconvulsion therapy
(55)Isoflurane
Cardiac surgery
Neurosurgery
For producing deliberate hypotension

Drugs Of Choice List in Endocrinological Disorders (56)Insulin
Type 1 DM
Diabetes Mellitus in pregnancy.
Diabetic Ketoacidosis.
Uncontrolled DM.
(57)Metformin
Type 2 DM
Diabetes mellitus in obesity
(58)Sildenafil
Erectile Dysfunction
(59)Hydrocortisone
Acute and chronic adrenal insufficiency.
(60)Nateglinide
Post prandial hyperglycemia.
(61)Methotrexate
Ectopic pregnancy
(62)Oxytocin
Post partum hemorrhage
Induction of labour
(63)Cabergoline
Acromegaly
Hyperprolactinemia.
(64)Finasteride
Andogenital alopecia.
(65)Alendronate
Osteoporosis

Drugs of choice in fungal infections(66)Amphotericin B
Meningeal histoplasmosis
Endocarditis by candida
Sever or CNS blastomycosis
Induction i cryptococcal meningitis(For 2 weeks)
Exserohium
(67)Fluconazole
Candida albicans
Maintainance in cryptococcal meningitis
(68)itraconazole
Non meningeal histoplasmosis
Sporotrichosis
Para Coccidiodomycosis
Mild or non CNS blastomycosis
Chromoblastomycosis
Penicillium mameffei
(69)Prednisolone+itraconazole/Voriconazole
Allergic bronchopulmonary aspergillosis.
(70)Capsofungin
Candida glabarata,and candida krusei .

Drugs of choice in gastrointestinal disorders(71)PPIs
Gastric ulcer ,Duodenal ulcer ,stress ulcer,NSAIDs-induced ulcer.
GERD,& Zolinger elison syndrome.
(72)Metoclopramide
Migraine associated or drug or disease associated vomiting
(73)Domperidone
Levodopa induced vomiting
(74)Ondansetron
Post operative or radiation induced vomiting
(75)5HT3 antagonist
Cisplatin induced early vomiting
(76)Lactulose
Hepatic encephalopathy
(77)Methyl naltrexone
Opioid induced constipation
(78)Octreotide
Diarhea in carcinoid syndrome

Drugs of choice in Hematological Disorders (79)Warfarin
DVT prophylaxis
Chronic atrial fibrillation in mitral stenosis, advanced kidney disease and mechanical prosthetic heart valves
(80)Heparin+Warfarin
Initiation of therapy in DVT.
(81)Vitamin K
Warfarin overdose
(82)Protamine
Heparin overdose

Drugs of Choice in Hypertension (83)Thiazide diuretics
Hypertension
(84)Prazosin
Hypertension With BPH
(85)Beta Blockers
Hypertension with ischemic heart disease.(Angina)
(86)ACE inhibitors
Hypertension with chronic kidney diseases.
(87)Alpha methylDopa
Hypertension in pregnancy
(88)Phentolamine
Hypertensive emergencies with cheese reaction
(89)Nitroprusside+Esmolol
Hypertensive emergencies in aortic dissection.
(90)Labetalol
Hypertensive emergencies in pregnancy .

Drugs of choice in shock(91)Adrenaline
Anaphylactic shock
(92)Dopamine or nor adrenaline
Cardiogenic shock
(93)Phenylephrine
Distributive shock
(94)Prazosin
Secondary shock
(95)Dopamine
Shock with oliguria
(96)Corticosteroids
Shock due to adrenal insufficiency

Drugs of choice For viral diseases(97)Ribavirin
Viral hemorrhagic fever
Measles
Respiratory syncytial virus(in high-risk patient
(98)Zanamivir
Oseltamivir-resistant influenza
Oseltamivir
Seasonal influenza and avian influenza (bird flu)
(99)Acyclovir
Herpes simplex and varicella.
Valacyclovir
Acute herpes zoster.
(100)Gancyclovir
Cytomegalovirus retinitis.