What some medical personnels do not know about LORATIDINE.

    Loratidine is a piperidine derivative related to azatadine..
  It is a long-acting,non sedating tricyclic antihistamine with selective peripheral H1-receptor antagonist activity,with no significant sedative or anti-muscarinic activity.
  Loratidine is rapidly absorbed from the G.I.T after administration.
  Peak plasma concentrations are beign attained at about one hour.
  Loratidine is 98% bound to plasma protein and undergoes extensive metabolism,maily to decarboethyloratidine,which has less ootent anti-histamine activity.
 Loratidine has an half-life of 8.4 hours.

 INDICATIONS
 Loratidine is indicated for relief of symptoms with allergic rhinitis such as sneezing,nasal discharge (rhinorrhea) and itching, ocular itching and burning.

 It is also indicated for relief of symptoms of chronic urticaria and other dermatological disorders.


  CONTA-INDICATIONS
 Loratidine is contra-indicated  in :
-Bladder obstruction
-Protastic hypertrophy
-Urinary retention,
-glaucoma or sensitivity to loratidine.

 

 USE IN PREGNANCY AND LACTATION
The safe use of loratidine in pregnancy has not been established because small amounts of it are excreted in breast milk and therefore,risk benefits should be considered due to increased risk of antihistamines in infants.


    DOSAGE
Usual dose for adults and children weighing 30 and above  is 10mg dly.

 For children less than 30kg,a dose of 5mg dly is recommended.

 

   DRUG INTERACTION
Increased plasma concentration has been reported when loratidine is used concomitantly with buscopan,erythromycin,ketokonazole and cimetidine.

See what you should know about the drug, FLUCONAZOLE!

     

    Flucinazole is an antifungi drug active        against the following:

-Treatment of cryptococcal meningitis in patients who are unable to tolerate amphorericin B.

-Maintenance therapy to prevent relapse of cryptococcal meningitis in Px. with AIDS.

- Treatment of oropharyngeal and oesophageal candidiasis in AIDS and other immunosuppressed px.

- Secondary prophylasis of oropharyngeal candidiasis in px with HIV infection.

- Serious and life threatening candida infections in px. unable to tolerate amphoteric B.

- Vagina Candidiasis on failure of topical therapy.

- Treatment of extensive tinea corporis,tinea curis,tinea pedis infection in immunocompetent px. in whom topical therapy is not a practical treatment option.


        Dosage and Administration
Fluconazole is normally administered orally. If possible,it may be administered through I.V.F at a rate not exceeding 200mg/hr.
  Since the oral absorption is rapid and almost complete,there is no need to change the daily dosage and tranferring from I.V.F to oral or vice versa.
   The daily dose of fluconazole should be based on the infectiing organism and the px. response to therapy and treatment should continue until clinical parameters or laboratory test shows that the fungal infection has subsided.

**The IVF is compatible with Ringers Solution and normal saline.

 Adult:

-Cryptococcal meningitis in patients who are unable to take or tolerate amohotericin B: the usual dose is 400mg stat ;followed by 200mg daily.
 A dosage of 400mg daily may be used,based on medical judgement of the px's response to treatment.
 For px. not responding to treatment for uo to 60 days would appear unlikely to respnd to Fluconazole.
 The treatment duration for for cryptococcal infections depend on the clinical and mycological response,but should continue 10-12 wks after CSF culture becomes negative .

- Prevention of relapse of cryptococcal meningitis in AIDS px:
 After the pxreceives a full course of primary therapy,flucinazole may be administered at a daily dose of 100-200mg.

- Oropharyngeal Candidiasis:
 The recommended dose is 100mg stat;followed by 50mg daily.
 For oesophageal candidiasis,the recommended dose is 200mg stat;then 100mg daily.
  Clinical evidence of candidiasis usually resolves in few days,but treatment should continue for 2-3 wks at least,especially in px. with severely compromised immune system.

-Secondary prophylasis against oropharyngeal candidiasis in px. with HIV infection: the recommended dose is 150mg as a single dose once weekly.

- Serious and Life threatening Candidal infections in px. with Amphoteric B intolerance: The usual dose is 400mg stat; then, 200mg daily, depending on the clinical response.

-Vaginal Cadidiasis on failure of topical therapy:  A single oral dose of 150mg should be administered.

-For extensive tinea corporis,tinea curis or severe tinea pedis in immunocompetent px. in whom topical therapy is not practical: The recommended dose is 150mg weekly for 4 weeks.


Children

 As with similar infections in adult,the duration of treatment is based on the clinical and mycological response .
 The recommended child dose is 3-6mg/kg.

Elderly
 Dosage should be reduced for elderly px with renal impairment.


              Conta-indications
Fluconazole is contra-indicated for pxs. with known sensitivity to Fluconazole or related azole compounds or it's esipients.