Ranitidine + Ondansetron Pharmacology
Ranitidine + Ondansetron
Ranitidine
Anaesthetic adjuncts: It is used in patients undergoing prolonged operations, caesarian section,obese patients those are at increased risk of gastric regurgitation and aspiration pneumonia. It raises pH of gastric juice and also reduces its volume and thus chances of regurgitation. It is now routinely used before prolonged surgery.
2. Dizziness
3. Constipation
4. Vertigo
5. Confusion
6. Rash
7. Blurred vision
8. Thrombocytopenia
9. Leukopenia
2. Renal impairment
3. Acute Porphyria
NEONATES: Contraindicated
2. Benign gastric ulcer
3. Zollinger- Ellison syndrome
4. Gastroesophageal reflux
5. Acid indigestion
6. Heart burn
7. Sour stomach
8. Stress ulcers
9. Oesophagitis
10.Preanaesthetic medication
Diazepam: Efficacy of diazepam decreased.
Procainamide: Renal clearance of procainamide decreased.
Sulfonylureas: Hypoglycemic effects of glipizide enhanced.
Theophyllines: Increased efficacy of theophyllines with possible toxicity.
Warfarin: Increased hypoprothrombinemic effects.
Lab tests: False positive tests for urine proteins with multistix may occur.
Duodenal ulcer, benign gastric ulcer: 300 mg /day as single dose at bed time or in 2 divided dose (morning and bed time) for minimum of 4 weeks.
Maintenance dose: 150 mg / day at bed time.
Zollinger- Ellison syndrome: 300 - 450 mg / day in 2 - 3 divided doses; dose can be increased if necessary to a maximum up to 6g / day .
Gastroesophageal reflux: 300 mg / day as single dose at bed time or in 2 divided doses (morning and bed time) for maximum 2 months. In severe conditions dose can be increased to 600 mg / day in 4 divided doses for 3 months
Acid indigestion, Heart burn, Sour stomach: Dose: 75 mg once daily to a maximum up to 150 mg / day.
Oesophagitis: 150 mg/ day.
Dyspepsia: 75 - 300 mg / day depending on the severity of disease.
PAM: 150mg given night and in the morning before surgical procedures.
Children:
Duodenal ulcer, benign gastric ulcer: 4 - 8 mg / kg body weight / day in 2 divided doses.
Maximum dose: 300 mg / day
Ondansetron
Cytotoxic chemotherapy is associated with release of Serotonin from Enterochromaffin cells in the small intestine. Serotonin triggers vomiting through 5HT3 vagal receptor that activates the vomiting reflex. Since Ondansetron is a 5HT3 receptor antagonist, it is indicated for the prevention of nausea and vomiting associated in chemotherapy.
Anaesthetic adjuncts: It is used preoperatively in order to reduce the post operative vomiting.
Distribution: It is distributed in protein bound form.
Metabolism: Ondansetron is extensively metabolised in the liver.
Excretion: It is excreted mainly in urine.
2. Dizziness
3. Constipation
4. Musculoskeletal pain
5. Chills
6. Allergic reactions
7. Agitation
8. Chest pain
9. Malaise
10. Urinary retention
11. Elevation in hepatic enzymes
12. Hypotension
2. Intestinal obstruction
Below 6 months : Contraindicated
2. Post operative nausea and vomiting
Oral :
Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy:8 mg should be given 1 - 2 hour before chemotherapy or radiotherapy and repeat the same dose after the procedure every 12 hours for 1 - 2 days.
Post operative nausea and vomiting: 16 mg should be given 1 hour before anesthesia or soon after operation
IV Injection :
Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy: 0.15 mg / kg IV infusion over 15 minutes should be given half an hour before starting treatment and repeat the same dose 4th and 8th hour after first dose or a single dose of 32 mg IV infusion over 15 minutes should be given half an hour before starting the treatment.
Post operative nausea and vomiting: 4 mg IV should be given immediately before anesthesia or soon after operation
Children :
Oral :
Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy:8 mg should be given 1 - 2 hour before chemotherapy or radiotherapy and repeat the same dose after the procedure every 12 hours for 1 - 2 days
Injection:
Nausea and vomiting associated with cytotoxic chemotherapy or radiotherapy:0.15 mg / kg IV infusion over 15 minutes should be given half an hour before starting treatment and repeat the same dose 4th and 8th hour after first dose
Children below 2 years: 0.1 mg / kg body weight as IV infusion
Maximum dose: 4 mg
If you missed a dose and feel nauseated then take the missed dose as soon as possible.
Home Delivery for Ranitidine + Ondansetron in Your City
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