Pharmacology - major drugs used in surgical practice

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  1. Dose of drugs
    • Pethidine + Phenargan - 50mg+25mg IM sos
    • Ketorolac 30mg IV tds
    • Calcium dobesilate for varicose vein
    • Tab cefadroxil 500mg BD
    • Inj Phenytoin 100mg TDS
    • Tab Cotrim DS 1 tab po BD
    • Inj Octreotide 100micro gram sc TDS 
    • 10% calcium gluconate, 10ml over 10 minutes 
    • Inj UFH 5000 IU SC BD
    • Tab Strocit (Citicholine) 500mg PO BD
    • Tab Stemetil (Prochloroperazone) 5mg IV sos
    • Inj Rallidex NS (Dextran 40) - for hypovolemic shock/ septic shock/severe burns
    • Seranace - haloperidol 
    • Laxopeg - laxative + PEG 
    • Inj Granisatron 1mg IV OD 


    Inj MgSO4, 1gm in 100ml NS IV over 4 hours
  2. Pain management
    • Tab TRD contin 1 tab PO BD 
    • Morphine 3mg TDS 
    • Durogesic (Fentanyl transdermal patch) Local application for pain management 

    • Syp Mor 5ml (2mg/ml) SOS
    • Tab Morcontin 10mg PO sos
  3. Supportive medicines and total parenteral nutrition
    • Pentasure + Soyaprotein 2tsf each in a glass of milk TDS 
    • Triptene buscits 2piece BD 

    • Inj Alanine I unit IV BD
    • Inj Celemin (amino acids + sorbitol) I pint IV BD 
    • Inj Celepid (intravenous fat) I pint IV OD 
    • Inj Oliclinomol 1 litres IV over 16 hours and 8 hours gap 

    Use 10% dextrose in between the TPN to prevent hypoglycemia. TPN is given for 16 hours, and then 10% dextrose in eight hours
  4. Urinary system
    Tab flavoxate 200mg PO TDS -  anticholinergic, indicated for symptomatic relief of interstitial cystitis, dysuria, urgency, nocturia, suprapubic pain, frequency and incontinence as may occur in cystitis, prostatitis, urethritis

    Oxyspas (Oxybutynin) 2.5/5mg - anticholinergic-  to treat overactive bladder

    Tab Urimax (Tamsulosin) 0.4mg PO HS - alpha 1 adrenergic blocker

    Tab Alfuzosin 10mg PO OD - alpha 1 adrenergic blocker
  5. GI system drugs
    Itopride (Ganaton, Gantoon) 50mg PO TDS. It is a prokinetic benzamide derivative unlike metoclopramide or domperidone. It is used in dyspepsia of a non-ulcer/dysmotility type (gastric "fullness", discomfort, and possible pain), delayed gastric emptying and anorexia

    For ulcerative colitis 

    Mesacol (Meselamine) 400mg PO TDS - 1 hr before food or 2 hours after food
  6. Respiratory system drugs
    • Seroflo rotacap - Contain salmeterol + Fluticasone
    • Tiova - Tiotropium
    • Nacfil (N acetylcysteine) 600mg PO tds as mucolytic agent
  7. Cardiovascular system
    • Inj Amiodarone 900mg in 500ml NS over 24 hours. (amiodarone in 150mg/3ml injection)
    • Amiodarone 
    • - 1ml = 50mg, 1ampoule = 150mg 
    • - How to prepare - 7ampoules (1050mg in 50ml (21ml drug + 29ml 5% dextrose) 
    • - Bolus dose - 150mg over 10 minutes jQuery110101646906235989285_1485174722241jQuery110104313412200343545_1498016749827?


    GTN 30microgram/kg/min 


    Labetalol - bolus 2.5mg IV stat

    Tab Diazepam (NOTEN) 2mg PO BD
  8. Endocrine system
    Zoledronic acid 5mg/100ml IV infusion - is a biphosphonate used in Bone complications of cancer, osteoporosis and paget's disease
  9. Neuro drugs
    • Tab Pregabalin 75mg PO BD
    • Diamox (acetazolamide) 250mg TDS
  10. Immunosupresents -
    • Immunosupressents in Renal Transplant 
    • - Tab Pangraf (tacrolimus) 2.5mg PO BD 
    • - Tab Mycofit (Mycophenolate) 1gm PO BD 
    • - Tab Cortilone 20mg PO OD

    Anti-thymocyte globulin (ATG)  60mg in 500ml of NS -  is an infusion of horse or rabbit-derived antibodies against human T cells, which is used in the prevention and treatment of acute rejection in organ transplantation and therapy of aplastic anemia.
  11. Blood disease
    Neupogen (filgrastim)  0.5ml sc stat - is a  granulocyte colony-stimulating factor (G-CSF) analog, used to stimulate the proliferation and differentiation ofgranulocytes

    Acitrom (Acenocoumarol) 2mg 

    Enoxaparin (LMWX) 60mg SC
  12. ATT drugs dose
    HRZES  5, 10, 25, 15, 15 mg/kg/day
  13. Triple drug regimen in IV
    • Inj Pantocid 40mg IV BD 
    • Inj Clavum 1.2gm IV BD 
    • Inj Levoflox 500mg IV BD
  14. Oral hypoglycemic drugs
    Tab Glycazide 5mg PO BD continue (for mild renal failure, upto grade III CKD)
  15. Insulin
    • Fast acting
    • - regular insuin (Huminsulin, Soluble insulin, actrapid)
    • - insulin lispro (Humalog)
    • - Insulin aspart (Novorapid) 


    Intermediate acting - NPH (Isophane, Insulatard)

    • Long acting
    • - Glargine (Lantus) -
  16. What is Mixtard?
    • Mixtard contains both fast-acting (soluble) and long-acting (isophane) insulin:
    • Mixtard 30: soluble insulin 30% and isophane insulin 70%;
    • Mixtard 40: soluble insulin 40% and isophane insulin 60%;
    • Mixtard 50: soluble insulin 50% and isophane insulin 50%.



    • Novomix 30 - 
    • - Soluble insulin aspart (rapidly-acting insulin, within 10 to 20 minutes)
    • - Protamine-crystallised insulin aspart  (intermediate-acting insulin) -  It takes longer to act, but its effects last much longer.
  17. Cardiovascular system
    Tab TGR (Fenofibrate) 160mg OD for 3 months - to reduce cholesterol and triglyceride
  18. Renal system drugs
    • Desmopressin (Minirin) 2 puff stat and repeat
    • Inj Vasopressin 2U s/c stat

    If Urine output is >1000ml/hr, 500ml in two consecutive hour or >300ml in three consecutive hours


    Tab Fludrocortisone 200mg PO BD
  19. What is nupogen?
    Neupogen is used to stimulate the production of granulocytes (a type of white blood cell) in patients undergoing therapy that will cause low white blood cell counts
  20. Broad spectrum coverage
    • Inj Tazopip 4.5 gm iv TDS 
    • Inj Clindamycin 600mg iv TDS
  21. What to look for patients on anticoagulants
    • New spots of bleeding 
    • Intracranial bleeding leading to hypertension
  22. GIK
    10U regular insulin with 10mEq/L  potassium in 500ml of 10% dextrose at 100ml/hr

    • Uses in 
    • - Myocardial infarction 
    • - Septic shock
  23. Drug of choice for any bite
    Amoxyclave
  24. Antibiotics
    • Cell wall inhibitors 
    • - Inj Imipenam 500mg +Cilastatin 500mg - 1gm IV TDS or QID (Not more than 4gm/day and >1.5gm/dose)

    - Inj Meropenam 1gm IV in 100ml of NS BD 

    - Vancomycin (500mg in a vial)  - 10 mg/kg per dose given every six hours, concentrations of no more than 5 mg/mL and rates of no more than 10 mg/min are recommended in adults.


    • Inj Acyclovir 800mg IV TDS
    • - Inj Teicoplanin (Targocid) 400mg IV stat followed by 200mg IV OD. Teicoplanin is 


    • Protein synthesis inhibitor 
    • - Inj Clindamycin 600mg IV tds 
    • - Inj Streptomycin 750mg IM OD


    • Nucleic acid synthesis inhibitor 
    • - Levofloxacin 750mg OD for hospital acquired pneumonia



    • Tigecycline and Polymyxin B most strongest antibiotics, very expensive. Polymyxin B is an antibiotic primarily used for resistant Gram-negative infections
    • Polymyxin B 5 lakhs units diluted in 500ml of 5% dextrose over 1-1.5 hours BD
    • Inj Tigecycline 100mg IV stat followed by  50mg IV BD
  25. What is Teicoplanin?
    • Teicoplanin owns a molecular structure which is related to that of vancomycin with similar spectrum of activity. Its mechanism of action is to inhibit peptidoglycan polymerization. 
    • Due to its reduced rate of side effects that does not require close monitoring, its longer serum half-life and a simplified mode or application, teicoplanin is a valuable alternative of Vancomycin and has become the glycopeplide or choice in many hospitals.
  26. What is tigecycline?
    This antibiotic is the first clinically available drug in a new class of antibiotics called the glycylcyclines. It is structurally similar to the tetracyclines. 

    • Tigecycline is active against
    • - Gram-positive bacteria
    • - Gram-negative bacteria
    • - Anaerobes
    • - Methicillin-resistant Staphylococcus aureus (MRSA)

    It has no activity against Pseudomonas spp. or Proteus spp.
  27. Alcohol withdrawal
    Tab Chlorodiazepoxide 15mg PO BD
  28. Trade names
    • Magnex Forte - Sulbactam and cefoperazone
    • Cilanem - Imipenam + Cilasten
  29. Tazobactam
    Decreases platelets
  30. Immunosupressant drugs
    • Tab Tacrolimus 1mg po BD
    • Tab Mycophenolate 500mg PO BD
  31. Different drugs available at
    Cholestyramine sachet in Norvik hospital
  32. Vitamins
    Thiamine 

    Riboflavin - 25, 50mg 

    Pyridoxine - 10mg tablet
  33. Unit and Pint
    • Unit - 350 ml 
    • Pint - 500 ml
  34. Pleurodesis
    Oxytetracycline (50mg/ml) - 20ml of Oxytetracycline (1gm) in 70ml of NS with 10ml of xylocaine,  tetracycline is irritant, so needs lignocaine
  35. Bicarbonate replacement
    Number of ampules =  (0.3 X base deficit X weight)/9
  36. Ionotropes dose
    • Dopamine and Dobutamine 
    • - Dopamine - 1ampule - 200mg 
    • - Dobutamine - 1ampule - 250mg 
    • - preparation - body weight X 3 mg in NS/D5
    • - ml/hr = mcg/kg/min 
    • - Dose - 5-20mch/kg/min 

    • Noradrenaline/Adrenaline 
    • - Noradrenaline - 1ampule - 4mg 
    • - Preparation - 4mg in 50ml of NS/D5
    • - Dose - 0.01-0.3 mcg/kg/min

    • GTN 
    • - 1ampule - 25mg
  37. Goals of resiscutitation
    • SBP > 90mmHg 
    • MAP >65 mmHg 
    • CVP 8-12 mmHg (12-15 mmHg in mechanically ventilated patients)
    • Urine output - >0.5ml/kg/hr 
    • ScVO2 >70%
  38. Doses of vasopressors
    • Escalate every 5 minutes 
    • Descelate every 30 minutes 

    • Dopamine and dobutamine 
    • - Preparation - body weight X 3 mg in 50ml NS/D5W
    • - ml/hr = mcg/kg/min 
    • - Dose - 5-20 mcg/kg/min 
    • - Route - peripheral/central line 

    • Noradranaline and adrenaline 
    • - Preparation - 4mg in 50ml NS/D5W or 8mg in 100ml NS/D5W
    • - Dose - 0.01-0.3 mcg/kg/min
    • - Route - central line
  39. Hemorrhoids
    Protek oinment - Lidocaine, Hydrocortisone, Zinc oxide and allantoin
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Pharmacology - major drugs used in surgical practice
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Pharmacology
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