DRUG STUDY

MEDICATION

Omeprazole
DOSAGE: 40mg / Once a day
Mechanism of Action
Description: Omeprazole is a substituted benzimidazole gastric antisecretory agent and is also
known as PPI. It blocks the final step in gastric acid secretion by specific inhibition of
H+/K+ ATPase enzyme system present on the secretory surface of the gastric parietal cell. Both
basal and stimulated acid are inhibited.
Onset: Approx 1 hr.
Duration: Up to 72 hr.
Absorption: Rapid but variably absorbed (oral). Bioavailability: Oral: Approx 30-40%. Time to
peak plasma concentration: Approx 1-2 hr.
Distribution: Plasma protein binding: Approx 95%.
Metabolism: Hepatic metabolism via CYP2C19 isoenzyme to form hydroxyl-omeprazole and
CYP3A4 to form omeprazole sulfone.
Excretion: Mainly via urine (approx 77%), the remainder in faeces (via the bile). Elimination
half-life: 0.5-3 hr.
MIMS Class
Antacids, Antireflux Agents & Antiulcerants

Furosemide
DOSAGE: 50mg via IV / Every 8 hours (4pm-12mn-8am)
Mechanism of Action
Description: Furosemide inhibits reabsorption of Na and chloride mainly in the medullary
portion of the ascending Loop of Henle. Excretion of potassium and ammonia is also increased
while uric acid excretion is reduced. It increases plasma-renin levels and secondary
hyperaldosteronism may result. Furosemide reduces BP in hypertensives as well as in
normotensives. It also reduces pulmonary oedema before diuresis has set in.
Pharmacokinetics:
Absorption: Fairly rapidly absorbed from the GI tract (oral).
Distribution: Crosses the placenta and enters breast milk. Protein-binding: 99%.
Excretion: Via urine (as unchanged); 2 hr (elimination half-life), may be prolonged in neonates
and renal and hepatic impairment.

MIMS Class
Diuretics

Ranitidine
DOSAGE: 50mg via IV / Every 8 hours (11am-7pm-3am)
Mechanism of Action
Description: Ranitidine competitively blocks histamine at H2-receptors of the gastric parietal
cells which inhibits gastric acid secretion. It does not affect pepsin secretion, pentagastrin-
stimulated intrinsic factor secretion or serum gastrin.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract. Bioavailability: Approx 50%. Time to peak
plasma concentration: Approx 2-3 hr (oral); approx 15 min (IM).
Distribution: Widely distributed; enters breast milk, crosses the placental barrier. Volume of
distribution: Approx 1.4 L/kg. Plasma protein binding: Approx 15%.
Metabolism: Hepatically metabolised. Small portion is converted to N-oxide (major metabolite,
approx 4-6% of a dose), S-oxide and desmethylranitidine.
Excretion: Via urine (oral: Approx 30%, IV: 70%) as unchanged drug and in the faeces.
Elimination half-life: Approx 2-3 hr.

MIMS Class
Antacids, Antireflux Agents & Antiulcerants

Human Albumin
DOSAGE: 50cc as slow drip in IV for 1 hour every 23 hours (6am-6pm)
Description Albumin (Human) 25% is a sterile aqueous solution for intravenous use, mainly
containing the albumin component of human plasma. The effective oncotic pressure of the 25%
solution largely depends on its albumin content and is approximately five times that of human
plasma.
ATC Classification: Belongs to the class of blood substitutes and plasma protein fractions. Used
as blood substitutes

MIMS Class
Intravenous & Other Sterile Solutions

Maalox
DOSAGE: 1 tablet (200mg) / 3 times a day

Indications: Symptomatic relief of hyperacidity.

Administration: Should be taken with food: Take 20-60 min after meals. Tab: Chew well.
Contraindications: Severe debilitation, kidney failure.
Special Precautions: Low phosphate diet, prolonged use.
Adverse Drug Reactions: Rarely, GI disturbances.
Drug Interactions: Inhibits absorption of tetracyclines, vit if taken concurrently.
ATC Classification: A02AD01 - ordinary salt combinations ; Belongs to the class of
combinations and complexes of aluminium, calcium and magnesium-containing antacids.
Regulatory Classification: Non-Rx

MIMS Class
Antacids, Antireflux Agents & Antiulcerants

Hydrocortisone
DOSAGE: 200mg INT / every 8 hours (7pm-3am-11am)
Mechanism of Action
Description: Hydrocortisone is a corticosteroid used for its anti-inflammatory and
immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration
of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be
used as replacement therapy in adrenocortical insufficiency.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract (oral); sodium phosphate and sodium succinate
esters are rapidly absorbed but the free alcohol and its lipid soluble ester are slowly absorbed
(IM); Acetate is slowly absorbed (intra-articular inj); absorbed from the skin (denuded areas).
Distribution: Crosses the placenta. Protein-binding: >90%.
Metabolism: Hepatic (metabolised to hydrogenated and degraded forms).
Excretion: Via urine (as conjugates and glucuronide, with small portion as unchanged drug).

MIMS Class
Corticosteroid Hormones / Eye Corticosteroids / Topical Corticosteroids

Prednisone

DOSAGE: 50mg 1 tab / Once a day

Mechanism of Action: Prednisone is a glucocorticoid receptor agonist. It is first metabolized in

the liver to its active form, prednisolone. Prednisolone crosses cell membranes and binds with
high affinity to specific cytoplasmic receptors. The result includes inhibition of leukocyte
infiltration at the site of inflammation, interference in the function of mediators of inflammatory
response, suppression of humoral immune responses, and reduction in edema or scar tissue.
Pharmacokinetics:
Administration: Should be taken with food: Take immediately after meals.
Absorption: Readily absorbed from the gastrointestinal tract. Rayos, the delayed-release
formulation, has a 4-hour release time.
ATC Classification: H02AB07 - prednisone ; Belongs to the class of glucocorticoids. Used in
systemic corticosteroid preparations.

MIMS Class
Corticosteroid Hormones

Cefuroxime
DOSAGE: 500mg / Twice a day
Mechanism of Action
Description: Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which
inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus
inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Pharmacokinetics:
Absorption: Absorbed from the GI tract with peak plasma concentrations after 2-3 hr (oral); may
be enhanced by the presence of food.
Distribution: Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic
concentrations). Crosses the placenta and enters breast milk. Protein-binding: Up to 50%.
Metabolism: Rapidly hydrolysed (intestinal mucosa and blood).
Excretion: Via the urine by glomerular filtration and renal tubular secretion (as unchanged); via
bile (small amounts); 70 min (elimination half-life); prolonged in neonates and renal impairment.

MIMS Class
Cephalosporins
Simvastatin
DOSAGE: 40mg
Mechanism of Action
Description: Simvastatin, an antilipemic agent, is a competitive inhibitor of HMG-CoA
reductase, the enzyme that catalyses the early and rate-limiting step in cholesterol biosynthesis. It
reduces total cholesterol, LDL-cholesterol and triglycerides and increases HDL-cholesterol
levels.
Pharmacokinetics:
Absorption: Well absorbed from the GI tract (85%). Bioavailability: <5%. Time to peak plasma
concentration: 1-2 hr.
Distribution: Plasma protein binding: Approx 95%.
Metabolism: Extensively hepatic via CYP3A4 isoenzyme to -hydroxyacid (major active
metabolite).
Excretion: Mainly via faeces (60% as metabolites); urine (10-15%, inactive form). Elimination
half-life: 1.9 hr (active metabolite).

MIMS Class
Dyslipidaemic Agents

Diumide-K
DOSAGE: 1 tab / Once a day every morning
Indications: Cardiac, pulmonary, hepatic, renal & peripheral edema of various etiologies.
Administration: Should be taken with food: Swallow whole, do not chew/crush.
Contraindications: Hyperkalemia, precomatose states associated w/ liver cirrhosis, Addison's
disease; concomitant administration of K-sparing diuretics; prostatic hypertrophy; impairment of
micturition; latent diabetes.
Special Precautions: Renal insufficiency; 1st trimester of pregnancy.
Adverse Drug Reactions: Allergic reaction; hyperuricemia; bone marrow depression.
Drug Interactions: May enhance effect of hypotensive agents. May potentiate nephrotoxic effect
of cephaloridine. Can enhance the ototoxicity of aminoglycosides antibacterials & other ototoxic
drugs. Affected by cardiac glycosides, mineralocorticoids.
ATC Classification: C03CB01 - furosemide and potassium ; Belongs to the class of high-ceiling
sulfonamide diuretics in combination with potassium. Used as diuretic.

MIMS Class
Diuretics