drugs Mechanism of actions along with adrs and indication.pptx

It contains a detailed description of the disease and case study

1. Mechanism of Actions

2. MECHANISM OF ACTION Mechanism of Action ADRs MP Ceftriaxone : It exhibit bactericidal effect by inhibiting the cell wall synthesis of bacteria by inhibiting the enzyme called transpeptidases Nausea Vomiting Abdominal pain CBP and signs of allergic reaction Doxycycline : Doxycycline inhibits bacterial protein synthesis by binding to the 30S & 50s ribosomal subunit. Photosensitivity Diarrhoea nasopharyngitis CBP LFT RFT Paracetamol: Paracetamol works by inhibiting prostaglandin synthesis, primarily in the central nervous system, exerting its analgesic and antipyretic effects. Stomach pain Nausea Vomiting Fever Pain A rtesunate: The endoperoxide of DHA reacts with heme generating free radicals which inhibit protein and nucleic acid synthesis of plasmodium . Jaundice, Hemoglobinuria LFT, CBP

3. MECHANISM OF ACTION Mechanism of Action ADRs MP Potassium chloride: Potassium ions participate in a number of essential physiological processes including the maintenance of intracellular tonicity, the transmission of nerve impulses, the contraction of cardiac, skeletal and smooth muscle and the maintenance of normal renal function. Diarrhea, Flatulence, Nausea, Vomiting Sr.potassium levels Potassium citrate: Potassium citrate is used to replenish potassium levels in the body, crucial for proper cellular and muscular function. Additionally, It helps correct the acid-base imbalance in dRTA by providing alkali in the form of citrate, which neutralizes excess acid in the blood and urine, thus improving the condition and preventing complications such as kidney stones and bone demineralization. Abdominal pain, Diarrhea, Nausea, Vomiting Serum electrolytes, ABG analysis

4. MECHANISM OF ACTION Mechanism of Action ADRs MP Ceftriaxone : It exhibit bactericidal effect by inhibiting the cell wall synthesis of bacteria by inhibiting the enzyme called transpeptidases Nausea Vomiting Abdominal pain CBP and signs of allergic reaction Pantoprazole: It binds to H+/K+ ATPase Pump and thereby inhibiting gastric acid and basal acid secretion. Headache Stomach pain Monitor GI symptoms Sodium bicarbonate: Increases plasma bicarbonate levels and buffers excess hydrogen ion concentration and rises blood pH, there by reversing the Clinical manifestations of acidosis. skin ulcers, metabolic Alkalosis ABG analysis Ondansetron: It works by blocking 5HT3 receptors peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone (CTZ), thereby preventing vomiting. Constipation, Diarrhoea, Headache, Fever Reduction in Nausea and Vomitings , serum electrolytes

5. MECHANISM OF ACTION Mechanism of Action ADRs MP Mannitol: It promotes diuresis by increasing the osmolarity of the glomerular filtrate and thereby blocking the tubular reabsorption of water and enhancing excretion of sodium and chloride. Nausea Vomitings Headache Dehyt Urine output, chloride levels BP Nifedipine: NIFEdipine is a peripheral vasodilator causing arterial vasodilation, producing a reduction in peripheral vascular resistance. Hypotension, Palpitations, Headache Blood pressure, Pulse rate Atorvastatin: Atorvastatin works by blocking an enzyme called HMG-CoA reductase, which reduces the liver's production of cholesterol. This leads to more LDL receptors on the liver, which helps remove "bad" cholesterol from the blood, resulting in lower cholesterol Levels Diarrhea Arthralgia Myalgia Lipid Profile LFT

6. MECHANISM OF ACTION Mechanism of Action ADRs MP Paracetamol: Paracetamol works by inhibiting prostaglandin synthesis, primarily in the central nervous system, exerting its analgesic and antipyretic effects. Stomach pain Nausea Vomiting Fever Pain B-Complex: B complex vitamins, particularly B12, B6, and folic acid, play roles in reducing homocysteine levels. Elevated homocysteine is associated with an increased risk of cardiovascular issues, including stroke. Amlodipine: It also reduces peripheral vascular resistance and lowers blood pressure by acting directly on vascular smooth muscle. Edema, fatigue, Nausea Blood pressure

7. DRUG MECHANISM OF ACTION ADVERDE DRUG REACTIONS MONITOING PARAMETERS Amoxicilin act by binding to penicillin-binding proteins that inhibit a process called transpeptidation (cross-linking process in cell wall synthesis), leading to activation of autolytic enzymes in the bacterial cell wall. Nausea Allergic reaction Rash Vomiting Diarrhea Perform CBC and RFT in the elderly patients Cefixime It is a braod spectrum antibiotic it kills the bacteria by preventing bacterial cellwall synthesis Vomiting Diarrhea Epigastric pain Nausea Monitor prothrombin time and dialysis patients closely Paracetomol Reduces fever by inhibiting the formation and secretion of prostaglandins specially COX – 2 Constipation Nausea Vomiting Insomnia Fever and pain reduction is indicative of efficacy DRUG CHART :-

8. Ipatropium bromide  Blocking cholinergic receptors decreases the production of cyclic guanosine monophosphate (cGMP). This decrease in the lung airways will lead to decreased contraction of the smooth muscles Dryness in mouth Bitter taste Nose bleeds Monitor RFT and reduction in the symptoms of asthma Salbutamol is a short-acting β 2  adrenergic receptor agonist which works by causing relaxation of airway smooth muscle. Tremor Head ache insomnia Dizziness Improvement in clinical symptoms indicative of efficacy Budesonide binds to intracellular glucocorticoid receptors (GRs), blocking the release of  arachidonic acid  from membrane phospholipids and preventing the synthesis of prostaglandins and leukotrienes, both mediators of inflammation. Headache, Respiratory tract infection, Back pain, Indigestion, Reduction in symptoms and improvement in the pulmonary function test

9. Ambroxol It is active n- desmethyl metabolite of mycolytic bromhexine it increases quantity and decreases the viscosity of tracheobranchial Secretions Dizziness, Headache, Rash, Itching, Stomach discomfort Vomiting Monitor for hypersensitivity reactions and symptoms of Vomiting Patient counselling :- Regarding disease – Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs Regarding Drugs :- AUGMENTIN 1.2 g should be taken through injection form twice a day to treat bacterial infections DICLOTAL Should be taken through injection form twice a day to treat Fever and flu symptoms PCT 650 mg / 100 ml should be taken through injection form when needed to treat fever and flu symptoms Neb duolin budecart should be taken when needed used to prevent symptoms of asthma like sob, coughing Combither 120 mg should be taken through injection form twice a day Pantoprazole It is a proton pump inhibitor it inhibits the H+/k+ Atpase enzyme at the parietal cells and decrease the release of gastric acid Headache, Dizziness, Weakness, Loss of appetite, Muscle pain Monitor Mg and vit B 12 levels in the patient

10. MECHANISM OF ACTION Mechanism of Action ADRs MP Levothyroxine : Triiodothyronine (T3) and levothyroxine (T4) diffuse into the cell nucleus and bind to thyroid receptor proteins attached to DNA. This hormone nuclear receptor complex activates gene transcription and synthesis of messenger RNA and cytoplasmic proteins. The physiological actions of thyroid hormones are produced predominantly by T3, the majority of which (approximately 80%) is derived from T4 by deiodination in peripheral tissues. Palpitations Sweating Weight loss Fatigue Increased appetite Thyroid profile Heart Rate Atorvastatin: Atorvastatin works by blocking an enzyme called HMG-CoA reductase, which reduces the liver's production of cholesterol. This leads to more LDL receptors on the liver, which helps remove "bad" cholesterol from the blood, resulting in lower cholesterol Levels Diarrhea (up to 14.1% ) Arthralgia (up to 11.7% ) Myalgia (up to 8.4% ) Lipid Profile LFT Sr.Creatin kinase Pantoprazole : It covalently binds to the H+ K+ ATPase pump at the secretory surface of gastric parietal cells and inhibits the gastric acid and basal acid secretion Abdominal pain, Diarrhoea, Headache Monitor GI symptoms

11. MECHANISM OF ACTION ADVERSE DRUG REACTIONS CEFTRIAXONE : (cephalosporins) I t selectively and irreversibly inhibits bacterial synthesis by binding to transpeptidases which are PBP’S which helps in forming bacterial cell wall Diarrhea , rashes , impaired liver function PANTAPRAZOLE: (proton pump inhibitors) Supresses gastric acid secretion by inhibiting the parietal H+/K+ ATP pump Diarrhea , nephritis DRUGS MECHANISM OF ACTIONS : TRAMADOL : (opiate analgesic ) Binds to mew opiate receptors in CNS causing inhibition of ascending pathways altering the perception of and response to pain also , inhibits reuptake of Nor-epinephrine , serotonin which also modifies pain pathway Nausea , dizziness , dry mouth

12. THIAMINE : (vitamin ) an essential co enzyme in carbohydrate metabolism by combining with ATP to thiamine pyrophosphate Hypersensitivity reactions ONDANSETRON : ( antiemetic ) Blocks the effects of Serotonin at 5-HT3 receptor sites located in vagal nerve terminals and the chemoreceptors trigger zone in CNS Headache , dizziness , constipation RANITIDINE : (H2 antagonists) competitive inhibition of histamine at the receptors of the gastric parietal cells, which inhibits gastric acid secretion , gastric volume , hydrogen ion reduces Headache ,diarrhea AMLODIPINE : (calcium chain blockers ) it blocks the influx of calcium ions into cardiac and vascular smooth muscles , reduces PVR and decreases BP by acting on smooth muscle Edema , abdominal pain , nausea

13. Drugs Mechanism of Actions: Mechanism of action ADRs MP Ciprofloxacin: Ihibition of the enzyme topoisomerase II (DNA gyrase) and topoisomerase IV which are imp for the bacterial DNA replication, trascription and repair. Rashes , diarrhea, Headache, Vomiting, Nasal discharge Signs & symptoms of infections, hypersensitivity 2. Ranitidine: Ranitidine reversibly inhibits the action of histamine at the histamine H2-receptors, including receptors on the gastric cells and there by preventing gastric acid secretion. Abdominal pain, Constipation, Diarrhea, Headache endoscopic improvement , CBC

14. 3. Ceftriaxon: It exhibit bactericidal activity by inhibition of bacterial cell wall synthesis Injection site pain diarrhoea,thrombocytosis fever symptomatic improvement CBC hepatic/renal function 4. Tramadol: Tramadol inhibits both serotonin reuptake and norepinephrine reuptake, enhancing inhibitory effects on pain transmission in the spinal cord. The complementary and synergistic actions of the two enantiomers improve the analgesic efficacy and tolerability profile of the racemate. Flushing, pruritus, Constipation, nausea, vomiting , dizziness, headache Pain Improvement, hypotension, Hypoglycemia,

15. 5. Ondansetron : Ondansetron may work by blocking 5-HT3 receptors peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone. Constipation, Diarrhea, headache, fever. Reduction in nausea and vomitings and ECG Propronolol: It decreases the portal hypertension by blocking the beta adrenergic receptors causing decreased cardiac output and ultimately decreasing the blood flow Diarrhoea,vomiting, dizziness, sleep disturbances Monitor BP, HR, ECG

16. Mechanism of Action ADRs MP UDILIV : Ursodeoxycholic acid (UDCA) protects hepatocytes and cholangiocytes from bile acid-induced damage, such as reactive oxygen species (ROS)-induced inflammation and mitochondrial dysfunction. UDCA was shown to reserve hepatocyte cell structures and stimulate anti-apoptotic pathways It was also shown to prevent the production of ROS by Kupffer cells and resident macrophages in the liver, thus attenuating oxidative stress in the liver. Rash, Constipation,Diarrhoea, Nausea LFT Thiamine : Thiamine deficiency is commonly associated with alcoholic liver disease conditions therefore thiamine supplementation is given in order to prevent serious complications like Wernicke's encephalopathy pruritus, diaphoresis, nausea, and pharyngeal edema Symptomatic improvement

17. Librium : Chlordiazepoxide is used to relieve symptoms of anxiety, including nervousness or anxiety that happens before a surgery. It may also be used to treat symptoms of alcohol withdrawal. Edema, Constipation,Nausea, Somnolence Monitor CBP and LFT on chronic administered Pantoprazole : It covalently binds to the H+ K+ ATPase pump at the secretory surface of gastric parietal cells and inhibits the gastric acid and basal acid secretion Abdominal pain, Diarrhoea, Headache Monitor GI symptoms Vitamin K : Vitamin K is essential for the synthesis of coagulation factors II, VII, IX, and X.Vitamin K is used to reduce the risk of bleeding in liver disease Allergic reaction, apnea, dyspnea Monitor Prothrombin time and INR

18. Sucral-O : sucralfate will reacts with HCL in the stomach and forms a chemical complex that binds to the ulcer site to establish a protective barrier Oxetacaine is a local anesthetic whose numbing effect provides fast relief from pain caused due to ulcers or acidic injury in the stomach Constipation Monitor GI symptoms Hepamerz - l-ornithine l-aspartate (LOLA) has been known as an effective ammonia-lowering agent.It speeds up the detoxification process of ammonia in the body by synthesis of urea and by the synthesis of glutamine via the enzyme glutamine synthetase. Nausea, vomiting stomach pain Monitor GI symptoms

19. ADR’s & MONITORING PARAMETERS Drug Name ADRs MP Tramadol Difficulty in breathing, flushing, constipation, Headache, Dizziness, Nausea, Vomiting Pain reduction, signs and symptoms of pulmonary function Pantoprazole Abdominal pain, Diarrhoea, Headache GI symptoms Ondansetron Constipation, Diarrhoea, Headache, fever. Reduction in Nausea and Vomitings , serum electrolytes. Thiamine Contact Dermatitis Symptomatic improvement Ciprofloxacin Rash, Irritability, Nausea, Vomiting, Headache, Diarrhoea Monitor for skin rash, and Hypersensitivity and GI symptoms

20. ADR’s & MONITORING PARAMETERS Drug Name ADRs MP Paracetamol Nausea, Vomiting, Constipation, pruritus Allergic reactions, serum electrolytes Duolin Ipratropium Bromide: Dryness of mouth, Bitter taste, Nose bleed Monitor for RFT, reduction in Respiratory symptoms Levosalbutamol: Tremors, Headache, Insomnia, Dizziness Improvement in clinical symptoms Budecort Headache, Respiratory tract infection, Back pain, Indigestion Reduction in symptoms and Improvement in pulmonary function

21. MECHANISM OF ACTION Mechanism of Action ADRs MP Thiamine: Is an essential water-soluble vitamin required for cellular energy production in most internal, especially in neurons and the heart. Non-allergic anaphylaxis symptomatic improvement, Monitor vitamin levels Spironolactone: It inhibits the effect of aldosterone by competorgansing for the aldosterone-dependent sodium-potassium exchange site in the distal tubule cells. Electrolytes imbalance Serum electrolytes Pantoprazole : It covalently binds to the H+ K+ ATPase pump at the secretory surface of gastric parietal cells and inhibits the gastric acid and basal acid secretion Abdominal pain, Diarrhoea, Headache Monitor GI symptoms

22. MECHANISM OF ACTION Mechanism of Action ADRs MP Acenocoumarol: It acts by inhibition of vitamin K epoxide reductase, which impairs gamma carboxylation of glutamic acid residues of the precursor proteins of factors II, VII, IX, and X. Hemorrhage INR, prothrombin time Eplerenone: Is a selective aldosterone receptor antagonist that inhibits the actions of aldosterone in the distal tubules and collecting ducts of the kidney, leading to decreased sodium reabsorption and potassium retention. Hypotension, Electrolyte imbalance Blood pressure, Serum electrolytes Torsemide: It inhibits reabsorption of sodium and chloride in the luminal membrane of the ascending limb of the loop of Henle by interfering with the chloride binding site of the 1Na+, 1K+, 2Cl− cotransport system. Hypotension Blood pressure

23. MECHANISM OF ACTION Mechanism of Action ADRs MP Furosemide: Furosemide exhibits diuretic activity primarily through inhibiting the absorption of sodium and chloride in the proximal and distal tubules, as well as in the loop of Henle. Hypotension Loss of electrolytes Serum electrolytes Metoprolol succinate: Metoprolol is a selective beta-1 adrenergic receptor antagonist, diminishing the effects of catecholamines on the heart. This leads to decreased heart rate and contractility, thereby lowering blood pressure. Bradycardia Hypotension Heart Rate Blood pressure

24. Mechanism of action: Mechanism of action ADRs MP Ceftriaxone It exhibit bactericidal activity by inhibition of bacterial cell wall synthesis Injection site pain diarrhoea,thrombocytosis fever symptomatic improvement CBC hepatic/renal function 2. Paracetamol It inhibits the synthesis of prostaglandins by inviting the enzyme COX - 2 which in turn results in the inhibition of release of pyrogens Pruritis, Constipation, Nausea, Vomiting Monitor LFT

25. Mechanism of action ADRs MP Amikacin Binds to the 30 S bacterial ribosome subunit, resulting in interfers with mRNA binding and tRNA acceptor sites and their by inhibition of protein synthesis Nephrotoxicity Renal function test

26. Mechanism of action ADR Monitoring Ceftriaxone - It exhibit bactericidal effect by inhibiting the cell wall synthesis of bacteria by inhibiting the enzyme called transpeptidases Nausea Vomiting Abdominal pain CBP and signs of allergic reaction Pantoprazole - pantoprazole inhibit the final step in gastric acid production. In the gastric parietal cell of the stomach, it covalently binds to the H+/K+ ATP pump to inhibit gastric acid and basal acid secretion Blurred vision Dry skin stomach pain Monitor GI symptoms Doxycycline - Doxycycline inhibits bacterial protein synthesis by binding to the 30S & 50s ribosomal subunit. Photosensitivity Diarrhoea nasopharyngitis CBP LFT RFT

27. Hydrocortisone - An adrenocortical steroid that inhibits accumulation of inflammatory cells at inflammation sites, phagocytosis, lysosomal enzyme release and synthesis, and release of mediators of inflammation. Increased BP Body fluid retention Weight gain Monitor BP CBP Blood glucose levels Azithromycin - Azithromycin prevents bacteria from growing by interfering with their protein synthesis. It binds to the 50S subunit of the bacterial ribosome, thus inhibiting translation of mRNA. Nausea Diarrhoea Headache Anorexia Monitor foy hypersensitivity reactions Syndopa - Levodopa works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. Nausea dryness of mouth constipation dizziness Monitor LFT and RFT

28. Pacitane - Trihexyphenidyl belongs to a class of medication called anticholinergics that work by blocking a certain natural substance (acetylcholine) decrease muscle stiffness, sweating, siallorhea and helps improve walking ability Abdominal pain Nausea Vomiting Skin rash Stomach pain Monitor BP LFT RFT Deriphylline - It causes bronchodilation by relaxing the smooth muscles of lungs by inhibiting the phosphodiesterase III and IV enzymes Nausea Vomiting headache Insomnia Monitor pulmonary function Selegeline - It selectively inhibit the MAO B enzyme which results in the inhibition of the metabolism of dopamine Constipation indigestion nausea backache Monitor GI Symptoms

29. MECHANISM OF ACTION ADVERSE DRUG REACTIONS 3. VOMISET - Blocks the serotonin receptors in the chemo receptor trigger zone that decreases vomiting center to decrease vomitings Headache Dizziness Constipation Diarrhea 4. B- Complex - It prevents infections and helps to promote cell health and growth of RBC Restlessness Nausea Insomnia 5. ORS - It stimulates Na and fluid absorption in small intestine via a cyclic AMP independent process Vomiting High Na levels 6. IFA - Iron combines with porphyrin and globin chains to form Haemoglobin Nausea Diarrhea Dizziness Rashes

30. MECHANISM OF ACTION ADVERSE DRUG REACTIONS 7. DOXYCYCLINE - Inhibits protein synthesis by binding to 30s ribosomes in susceptible microorganism Liver damage Phototoxicity 8. PANTAPRAZOLE - It binds to H+/K+ ATPs Pump and thereby inhibiting gastric acid and basal acid secretion Headache Stomach pain Nausea Diarrhea 9. PARACETAMOL - Inhibition of prostaglandin synthesis or through an active metabolite influencing cannabinoid receptors Allergic reaction Dizziness 10. ARTEMETHER and LUMEFANTRINE - Lumefantiene binds to hemin produced during hemoglobin brakdown, preventing detoxification to crystalline material pigment, during this ARTEMETHER peroxide group binds to heme and releases toxic free radicals Nausea Vomiting Anorexia Itching

31. TAZOMAC: Piperacillin/ Tazobactum: It shows bacteriocidal effect against both gram +ve and -ve bacteria by inhibiting bacterial spectrum formation and cell wall synthesis. ADR: Rash, constipation, Diarrhoea, Nausea, Headache,Fever. Sodium bicarbonate: Increases plasma bicarbonate levels and buffers excess hydrogen ion concentration and rises blood pH, there by reversing the Clinical manifestations of acidosis. ADR: skin ulcers, metabolic Alkalosis. Pantoprazole: Pantoprazole covalently binds to the H+,k+ - ATPase enzyme system at secretory surface of gastric parietal cells and suppress the gastric acid production. ADR: Abdominal pain, Diarrhoea, Headache.

32. Ondansetron: It works by blocking 5HT3 receptors peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone (CTZ), thereby preventing vomiting. ADR: Constipation, Diarrhoea, Headache,Fever. NEFROSAVE: Acetylcysteine: It is sulfhydryl compoundcompound and acts to increase synthesis of glutathione in the liver. Glutathione subsequently acts as an antioxidant and facilitates conjugation to toxic metabolites. Taurine: It is an antioxidant, suppressing the toxicity of hypochlorite and hypobromite produced physiologically. ADR: Rash, Diarrhoea, Nausea, vomiting, constipation. POTASSIUM CHLORIDE: Is an electrolyte replenisher, participates in several physiological processes in the body including the transmission of nerve impulses, the maintenance of normal renal function and intracellular tonicity, and the contraction of skeletal, cardiac and smooth muscle

33. ADR: Over consumption leads to Hyperkalemia, Cardiac arrest, Abdominal pain, Nausea, Vomiting. ULTRACET: Paracetamol/Acetaminophen: It acts by inhibiting prostaglandin synthase activity in CNS. Tramadol: It exerts it's effect through binding of parent drug and M1 metabolite (O-desmethyl-tramadol) and mu-opioid receptor and through weak inhibition of norepinephrine and serotonin reuptake. ADR: Pruritis, Constipation, Diarrhoea, Nausea, Vomiting, Headache. CLAVAM: Amoxicillin: It is an analog of Ampicillin, is semi synthetic antibiotic that inhibits the biosynthesis of cell wall mucopeptide. Clavulanic acid: Support respiratory and cardiovascular function. ADR: Skin rash,Diarrhoea, Nausea, Vomiting, Headache, Wheezing.

34. Mechanism of action ADRs MP Clotting Factor -VIII The human antihemophilic factor replaces the coagulation factor VIII. It acts as a co-factor for factor IX to activate factor X in the intrinsic pathway of blood coagulation. Cough, nausea, fever headache Factor -VIII Inhibitors, Levels of factor-VIII 2. Paracetamol It inhibits the synthesis of prostaglandins by inviting the enzyme COX - 2 which in turn results in the inhibition of release of pyrogens Pruritis, Constipation, Nausea, Vomiting Monitor LFT

35. Mechanism of action: Ceftriaxon : It exhibit bactericidal activity by inhibition of bacterial cell wall synthesis ADR: Injection site induration, diarrhoea,thrombocytosis Pantoprazole : Pantoprazole covalently binds to the H+,k+ - ATPase enzyme system at secretory surface of gastric parietal cells and suppress the gastric acid production. ADR: Abdominal pain, Diarrhoea, Headache. Human Insulin : Insulin binds to insulin receptors on muscle and adipocytes and lower blood glucose levels by facilitating the cellular uptake of glucose. Insulin Simultaneously inhibits out put of glucose from the Liver. ADR: Hypoglycemia, peripheral edema, hypersensitivity reactions. Gatifloxacin: Gatifloxacin inhibits bacterial DNA topoisomerases required for bacterial DNA replication, transcription, repair and recombination of DNA. ADR: Taste sense altered, exacerbation, excessive tear production. Clindamycin: Clindamycin inhibits bacterial protein synthesis by binding to 23s RNA of the 50s subunit of the ribosomes. ADR: Dry skin, Diarrhoea, Nausea.

36. Clindamycin: Hypromellose is a nonpyrogenic viscoelastic solution that occupies space and protects tissue and prolongs adhesion, enhances moistening of the cornea and conjunctiva and allows for a smoother movement of the conjunctiva over the cornea ADR: Headache, Blurred vision, Pain in eye, Cataract, Raised intraocular pressure.

37. MECHANISM OF ACTION Mechanism of Action ADRs MP Naproxen: Inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclooxygenase (COX) isoenzymes, COX-1 and COX-2 May inhibit chemotaxis, alter lymphocyte activity, decrease proinflammatory cytokine activity, and inhibit neutrophil aggregation; these effects may contribute to anti-inflammatory activity Abdominal pain, Constipation, Dizziness, Nausea, Edema RFT, CBP, electrolytes Pantoprazole: It binds to H+/K+ ATPase Pump and thereby inhibiting gastric acid and basal acid secretion. Headache Stomach pain Monitor GI symptoms Levetiracetam: It may inhibit voltage-dependent N-type calcium channels; may bind to synaptic proteins that modulate neurotransmitter release; through displacement of negative modulators may facilitate GABAergic inhibitory transmission Asthenia, Headache, Somnolence, Drowsiness, Anorexia, Weakness Seizure activity, LFT, RFT Dexamethasone: It inhibits pro-inflammatory cytokines and mediators, stabilizes cell membranes, and reduces capillary permeability. This action helps control inflammation, immune response, and edema, especially in neurological and autoimmune conditions. Skin irritation, HTN Improvement in the condition

38. MECHANISM OF ACTION Mechanism of Action ADRs MP Albendazole: Causes degeneration of cytoplasmic microtubule in intestinal and tegmental cells of intestinal helminths. Nausea, Vomiting, Headache, Abdominal pain Monitor for GI functions Gabaneuron: Gabapentin: Mechanism for analgesic and anticonvulsant activity unknown Nortriptyline: Neurotransmitter (especially norepinephrine and serotonin) reuptake inhibitor; increases concentration of neurotransmitter in the CNS Dryness in mouth, Decreased white blood cell count, Peripheral edema, Weakness Improvement in headache

39. MECHANISM OF ACTION Mechanism of Action ADRs MP Ceftriaxone : It exhibit bactericidal effect by inhibiting the cell wall synthesis of bacteria by inhibiting the enzyme called transpeptidases Nausea Vomiting Abdominal pain CBP and signs of allergic reaction Pantoprazole: It binds to H+/K+ ATPase Pump and thereby inhibiting gastric acid and basal acid secretion. Headache Stomach pain Monitor GI symptoms Hypromellose: Enhances moistening of the cornea and conjunctiva and allows for a smoother movement of the conjunctiva over the cornea Headache, pain in eye, raise intraocular pressure intraocular pressure Gatifloxacin: Gatifloxacin inhibits bacterial DNA topoisomerases required for bacterial DNA replication, transcription, repair and recombination of DNA. Taste sense altered, exacerbation, excessive tear production. Improvement in signs and symptoms of bacterial conjunctivitis Clindamycin: Clindamycin inhibits bacterial protein synthesis by binding to 23s RNA of the 50s subunit of the ribosomes. Dry skin, Diarrhoea, Nausea. monitor for diarrhea, nausea

40. MECHANISM OF ACTION Mechanism of Action ADRs MP Telmisartan: Telmisartan is an angiotensin II receptor blocker (ARB) that selectively blocks AT₁ receptors , leading to vasodilation, reduced aldosterone secretion, and lower blood pressure . cough, upper respiratory tract infection Blood pressure Paracetamol: Paracetamol works by inhibiting prostaglandin synthesis, primarily in the central nervous system, exerting its analgesic and antipyretic effects. Stomach pain Nausea Vomiting Fever Pain