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- Pharmacology For Nebivolol + Hydrochlorothiazide
Nebivolol + Hydrochlorothiazide Pharmacology
Nebivolol + Hydrochlorothiazide
About Nebivolol + HydrochlorothiazideN/AMechanism of Action of Nebivolol + HydrochlorothiazideN/APharmacokinets of Nebivolol + HydrochlorothiazideN/AOnset of Action for Nebivolol + HydrochlorothiazideN/ADuration of Action for Nebivolol + HydrochlorothiazideN/AHalf Life of Nebivolol + HydrochlorothiazideN/ASide Effects of Nebivolol + HydrochlorothiazideN/AContra-indications of Nebivolol + HydrochlorothiazideN/ASpecial Precautions while taking Nebivolol + HydrochlorothiazideN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Nebivolol + HydrochlorothiazideN/AInteractions for Nebivolol + HydrochlorothiazideN/ATypical Dosage for Nebivolol + HydrochlorothiazideN/ASchedule of Nebivolol + HydrochlorothiazideN/AStorage Requirements for Nebivolol + HydrochlorothiazideN/AEffects of Missed Dosage of Nebivolol + HydrochlorothiazideN/AEffects of Overdose of Nebivolol + HydrochlorothiazideN/ANebivolol
About NebivololThird generation cardio selective beta-1 receptor antagonist, Antihypertensive.Mechanism of Action of NebivololNebivolol is a 3rd generation cardio selective beta-1 receptor antagonist which reduces vascular resistance, acutely lowers arterial blood pressure without depressing left ventricular function and exerts anti hypertensive effects. The drug causes coronary vasodilatation and improves myocardial ischaemia through nitric oxide release.Pharmacokinets of NebivololAbsorption: Well absorbed orally, Distribution: It is distributed in to the body, Metabolism: It is extensively metabolized inside the body give active hydroxyl metabolite. Excretion: Excreted mainly through urine and rest of drug is excreted through faecesOnset of Action for Nebivolol2 to 6hoursDuration of Action for NebivololN/AHalf Life of Nebivolol24hoursSide Effects of Nebivolol1.Dizziness
2.Headache
3.Tiredness
4.Gastrointestinal problems
5.Nausea
6.Rash
7.Fatigue
8.Vomiting
9.Diarrhoea
10.Raynaud`s syndrome
11.Paraesthesia
12.Dyspnoea
13.Oedema
Contra-indications of Nebivolol1.Hypersensitivity to the drug
2.Uncontrolled heart failure
3.Second or third degree heart block
4.Cardiogenic shock
5.Bradycardia
6.Phaeochromocytoma
7.Hepatic impairment
8.Sick sinus syndrome
9.Chronic obstructive pulmonary disorders
10.Metabolic acidosis
11.Hypotension
12.Peripheral vascular disorders
13.Along with Verapamil
Special Precautions while taking Nebivolol1.Cardiac insufficiency
2.First degree heart block
3.Prinzmetal angina
4.Raynaud`s syndrome
5.Renal impairment
6.The drug should be gradually withdraw with caution
7.Chronic obstructive pulmonary diseases
Pregnancy Related InformationContraindicated.Old Age Related InformationUse with caution.Breast Feeding Related InformationContraindicated.Children Related InformationContraindicated.Indications for Nebivolol1.HypertensionInteractions for NebivololN/ATypical Dosage for Nebivolol5mg once daily
Patients above 65years of age: Starts with 2.5mg and increases to 5mg based on patient`s response
Renal impairment: Starts with 2.5mg and increases to 5mg based on patient`s response
Schedule of NebivololHStorage Requirements for NebivololStore in a dry place below 25 degree C. Keep out of reach of children
Effects of Missed Dosage of NebivololTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of NebivololTreatment is supportive and symptomatic. After ingestion empty the stomach by induced emesis or gastric lavage. Administer activated charcoal to reduce absorption. Treat Bradycardia with atropine. If required administer Isoproterinol with caution; in heart block. Treat hypotension with glucagons and vasopressors like epinephrine. Treat cardiac failure with diuretics and cardiac glycosidesHydrochlorothiazide
About HydrochlorothiazideThiazide derivatibve, Diuretic.Mechanism of Action of HydrochlorothiazideIt is thiazide diuretic which exerts its action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It has additional carbonic anhydrase inhibitory actions in proximal tubules. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.
Vertigo: Diuretics are used in vertigo in assumption that vertigo is due to endolymphatic hydrops. They reduce labyrinthine fluid pressure
Pharmacokinets of HydrochlorothiazideAbsorption: It is absorbed after oral administration.
Metabolism: It is not metabolized in the body.
Excretion: Excreted unchanged in urine.
Onset of Action for Hydrochlorothiazide1 to 3 hoursDuration of Action for Hydrochlorothiazide12 to 16 hoursHalf Life of Hydrochlorothiazide5 to 15 hoursSide Effects of Hydrochlorothiazide1. Dizziness
2. Blurred vision
3. Confusion
4. Tingling fingers
5. Dry mouth
6. Nausea
7. Diarrhoea
8. Constipation
9. Vomiting
10. Weakness
11. Hypokalaemia
12. Hyponatraemia
13. Hyperuricaemia
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
16. Polyuria
17. Electrolyte imbalance
18. Jaundice
19. Rashes
20. Photosensitivity
21. Fever
22. Itching
23. Myalgia
24. Muscle cramps
25. Arthralgia
26. Blood dyscrasias
27. Ototoxicity
Contra-indications of Hydrochlorothiazide1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
5. Anuria
6. Hypersensitivity to the drug
7. Hyper sensitivity to sulfonamides
8. Fluid and electrolyte imbalance
Special Precautions while taking Hydrochlorothiazide1. Gout
2. Diabetes mellitus
3. Renal impairment
4. Hepatic impairment
5. Monitor and correct Fluid and electrolyte imbalance
6. Hyper parathyroidism
7. Cirrhosis
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationMay be usedIndications for Hydrochlorothiazide1. Hypertension
2. Oedema associated with heart failure
3. Oedema due to renal and hepatic diseases
4. Diabetes insipidus
5. Idiopathic hypercalciurea.
6. Vertigo
Interactions for HydrochlorothiazideCholestyramine & Colestipol: decrease absorption of hydrochlorothiazide.
Diazoxide: Additive action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretics induced hypokalaemia may precipitate digitalis toxicity.
Lithium: Hydrochlorothiazide potentiates therapeutic and toxic effects by increasing its renal excretion.
Frusemide: Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants: Diuretics induced hypokalaemia enhances efficacy.
Sulfonylureas: Efficacy decreased due to hydrochlorothiazide induced glucose intolerance.
Chlorpropamide: Hypokalaemia.
Propantheline: Bioavailability of hydrochlorothiazide increased.
Metoclopramide: Bioavailability of hydrochlorothiazide decreased.
NSAIDs: Natriuretic effect of hydrochlorothiazide decreased.
Typical Dosage for HydrochlorothiazideAdults:
Hypertension: 25mg once daily or in divided doses. Increased to 50mg if required; depending up on the patient`s response.
Children: 1mg/kg single daily dose.
Oedema:
Adults:
Starts with 25 to 50mg. Increased the dose until desired response is obtained.
Maximum dose: 200mg/day
Maintenance dosage: 25 to 100mg daily or on alternate days.
Children: 1mg/kg single daily dose or 1 to 3mg/kg/day in two divided doses
Schedule of HydrochlorothiazideGStorage Requirements for HydrochlorothiazideStore at room temperature in a well closed container and protected from light.Effects of Missed Dosage of HydrochlorothiazideTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.Effects of Overdose of HydrochlorothiazideTreatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.Home Delivery for Nebivolol + Hydrochlorothiazide in Your City
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