Vol - 2 Issue - 2 May- 2017

Editorial

Safety Alerts

Generic Drugs

Antidotes

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2

3

4

Antidotes

Vol - 2 Issue - 1 May- 2017

For any query on drugs, (Damdawi chungchangah zawhna I neih chuan):

Mail to- Drug Information Centre Department of Pharmacy, RIPANS. Zemabawk, Aizawl. Pin 796017

Email: dicripans@gmail.com Facebook page: DRUG INFORMATION CENTRE,RIPANS. SMS: 8730955168 Please login to the website: www.ripans.in

Antidote are any substance which are used to oppose the effects of poisons without causing any damage to the body. The poison n any form may be taken in by the breath or swallowed, Absorbed through the thinner and more delicate mucous membranes, or absorbed through the skin, or implanted by stings, bites, or other wounds. There are many antidotes available, only some very important antidotes are mentioned which should be remembered in case of emergency. Types of antidotes:

1: Universal antidote: It is given when unknown poison is ingested. (1):powdered charcoal 2 parts

(2):Magnesium oxide 1 part (3):Tannic Acid 1 Part 2: Chemical antidotes:

These substances neutrilize the chemical action or oxidize the poison into non-toxic or insolouble form. eg:Dilute alkali(milk of magnesia), Dilute acetic acid,Potassium permanganate, Tannin (strong tea).

3: Physiological or pharmacological antidotes These produce effects opposite to that of poison eg:Naloxone for morphine, atropine and oximes for organophosphorous

poison,N-acetylcysteine for acetaminophen 4: Mechanical or physical antidote:

These substances prevents the absorption of poison by their presence. eg: Activated charcoal is used for strychinine,emulcents (fats,oils,milk,egg albumin) are used for corrosive and irritant poisoning, Bulky food used for

glass poisoning, And mineral poisoning(dose 30-60 gms for children and 60-100gms for adults) 5: Chelating agents:

These are substances which form chelates(non ionized complexes) with cations.These are mostly used in heavy metal poisoning eg:N-pencillamine for mercury,lead,copper, BAL(dimercepol)-used in heavy metal poisons, EDTA-used

in Arsenic,mercury,lead, Desferoxamine is used for iron. List of important antidotes:

POISON/DRUG ANTIDOTE POISON/DRUG ANTIDOTE

Snake bite Snake Anti-Venom Sulfonylureas Octreotide

Heparin Protamine Sulphate Methotrexate Leucovorin calcium

Insulin reaction Glucose (Dextrose 50%) Dopamine Phentolamine.

Alkali, volatile Water with vinegar or lemon juice in it.

Methanol Folic acid /Ethanol

Antimonial Wine Warm water freely to encour-age vomiting.

Ammonia Lemon juice, diluted vinegar or acetic acid.

Conditions that cause methe-moglobinemia

Methylene blue Potassium Insulin + Glucose

Thiophylline Beta blockers Opiods overdose Naloxone HCl

Acetaminophen/Paracetamol N-Acetylcysteine Valproic acid L-Carnitine

Anticholinergics Physostigmine Ergotamine Heparin

Benzodiazepines Flumazenil Fluoride ingestion Calcium salts

Calcium Channel Blockers Calcium Chloride, Glucagon Isoniazid, ethylene glycol Pyridoxine HCl (Vitamin B6)

Cyanide Amyl nitrite, sodium nitrite, sodium thiosulfate

Arsenic, Copper, Lead, Mer-

cury

D-Penicillamine

Iron Deferoxamine Tricyclic antidepressants Phyostigmine or NaHCO3

Neuromuscular blockade (paralytics)

Anticholinesterases Absinthe Active Emetic

Vol - 2 Issue - 1 May- 2017 Vol - 2 Issue - 1 May- 2017

Editorial Sawrkar kum thar 2017 April thla kan lo chuangkai leh ta, Drug

Information Centre RIPANS pawhin hma a sawn ve zel a, hriselna

lama thawktu leh mipuiten damdawi hman chungchangah hma kan

sawn zel theihna turin hna a thawk ve reng a, mi tamtakin zawhna te

rtawn zawtin, kan chanchinbu min hlut saktu an awm reng thin

avangin kan lawm em em a ni. May thla 2017 atang hian Drug Infor-

mation Bulletin pawh thlatin chhuak tura ruahman a ni a, in lo hman

tangkai theuh kan beisei.

April ni 21, 2017 khan Medical Council of India(MCI) chuan ram-

chhung hmun hrang hranga a MCI hriatpuina hnuaia medical doctor in

registere zawng zawngten damlo hman tur damdawi an chawhin

damdawi brand hming nilo a generic hminga ziak vek turin thupek a

chhuah a, he thupek zawmlo te chu hrem theih an nih dawn thu pawh a

tarlang nghe nghe a ni. He bulletin-ah hian enge brand name chu ni a,

enge generic name chu a nih hrilhfiahna article tawifel tak tarlan a ni a.

Damdawi inang theuh theuh si eng vanga hming hran hran lo awm ta

nge a nih a, generic drug chu enge a nihna tak chungchang tarlan a ni.

Miin tur a lo ei emaw, damdawi a lo ei tam lutuk a nih chuan a tur/

damdawi thahna pek vat a ngai thin a, chumi chungchanga hriattur

pawimawh tawite tarlan a ni a, Central Drugs Standard Control Or-

ganisation hnuaia Pharmacovigilance Programme of India (PvPI) in

April thla a a tihchhuah, damdawi thenkhata fimkhur ngaihna te tar-

SAFETY ALERT:

The preliminary analysis of Suspected Unexpected Serious Adverse Reaction (SUSARs) from the PvPI database re-veals that the following drugs are associated with the risks as given in the table below:

Health care professionals, Patients/Consumers are advised to closely monitor the possibility of the above adverse events associated with the use of above drugs. If such events are encountered please report to the NCC-PvPI either by filling of Suspected Adverse Drug Reactions Reporting Form/ Medicines Side Effect Reporting Form for Consumer (http://www.ipc.gov.in) or by PvPI Helpline No.1800-180-3024. *Anyone may also kindly report to the Drug Information Centre, RIPANS by email-dicripans@gmail.com or sms-8730955168

As we are on the new financial year 2017 of the govern-ment, the Drug Information Centre, RIPANS is also moving forward in providing different information on drug use to healthcare workers of different fields and to the general public. Many queries have been received and answered by the Drug Information Centre and we thank each and everyone for appre-ciating this drug information bulletin. The Drug Information C entre bulletin is planned to be published every month from May 2017, I hope it will continue to benefit all the readers. On April 21st , 2017, the Medical Council of India issued an order to all the registered medical doctors under MCI notic-ing to prescribe drugs to the patients by generic names and not by the trade names, the notice stated that any practitioner who are found not writing prescription in generic names are liable to be punished. This bulletin includes a brief article on generic and branded drugs , stating the differences between the two, it ex-plains briefly on how a generic drug is similar/bioequivalent to the branded drugs. The issue also contains basic antidotes for different kinds of intoxication due to poison or drug overdose. Safety alert on few drugs published by the Pharmacovigilance Programme of India (PvPI) under the Central Drugs Standard Control Organisation is also highlighted.

Generic Drugs Generic name Damdawi pakhat hian hming/sawina chi hrang hrang a nei thei a. Damdawia atoms leh molecules te inremkhawm dan (chemical structure) atangin chemical name a nei a. Chemical name hi a sei deuh thin a, sawi awlsam nan a siamtute chuan code name pawh an pe ve leh thin. Generic name chu damdawi nihna tarlang thei leh khawvel ina Official-a a pawm hming a ni a. A tlangpuiin generic name-ah hian, kha damdawi kha a nihna hriat theihna tur eng emaw a inphum tel thin. Entirnan, thisensang damdawi chi khat, thisena thau awm tihniam thei (Cholesterol lowering drugs) te chu an generic name tawpah ‘Vastatin’ tih dah a ni thin. Entirnan, Atorvastatin, Lovastatin, Pravastatin, Simvastatin etc. Heng damdawi hming te hi generic name an tih chu a ni. Tin, generic name hi Non-Proprietary Name tiin an sawi bawk thin. Brand name Damdawi siamtu company te hian an damdawi siam chu Brand Name/ Trade Name an vuah ve thin a. Heng brand/trade name te hi company ten an damdawi siam chhuah chu chhinchhiah a awlsam zawk nan (identification) te, a hming lam awlsam zawk nan te leh kawng dang dang atan vuah an ni thin. Entirnan, Crocin chu nachhawkna ‘Paracetamol/Acetaminophen’ an siam atana GlaxoSmithkline Company-ina brand name an pek a ni. Paracetamol/Acetaminophen chu Generic/Non-proprietary name a ni a, Crocin chu brand name a ni. Tichuan Crocin tablet kan tih chuan Paracetamol kan tihna pawh a lo ni thei ang. Brand name hian damdawi product hriat hranna (identification) leh a hming lam awlsamna piah lamah Patented rights leh exclusivity (neitu/hmuchhuaktu) nihna a kawh tel theih avangin Brand Name leh Generic Name piah lamah hian Branded Drugs leh Generic Drugs awmzia leh danglamna kan zirchian deuh erawh a tul ang. Generic Drugs leh Branded Drugs Damdawi thar hmuhchhuah hi hna hautak tak mai a ni a. Sum leh hun tam tak khawhral ngai a ni. Hetianga mi in kum tam tak research an lo tih hram hramna man hi an tel theih nan sawrkar in damdawi thar hmuchhuaktu hnenah neitu nihna ‘patented rights’ a pe thin a. Hei hi kum 20 chhung atan a ni thin. Hemi chhung hian midangin kha damdawi kha an siam chhuak ve thiang lova, an thawhrim man telin sum an lalut ta hem hem mai thin a. Hetianga damdawi hmuch-huaktuin damdawi a hralh chhuahte hi ‘branded drugs’ emaw ‘innovators product’ emaw an ti thin. Kum 20 a lo ral erawh chuan chu an neitu nihna (patented rights & exclusivity) chu a lo tawp ta a. Kha damdawi ang kha midang pawhin an lo siam ve thei ta a ni. Hetianga branded drugs-te patent rights & exclusivity a lo tawp a, company dangin an lo siam (copy) ve kha generic drugs an tih chu a ni. Generic drugs-te hi brand name (innovators product) drugs-te nena inang, a hnathawh dan kawng engkima danglam lo leh a tlukpui te an ni a. Generic drugs-te hian branded drugs-te hi an pianzia (shape), rawng (colour) leh a rim/taste (flavour) ah erawh an copy tur a ni lo thung. Eng vangin nge generic drugs-te hi branded drugs-te aia nasa taka a tlawm theih? Generic leh branded drugs-te hi inang tih ni mah se, an man erawh a inthlau hle thung. Generic-te hi an man a let tam takin a tlawm zawk thin. Ram thenkhatah phei chuan a let sawm (10 times) aia into hleih te an ni. Generic drugs siamtute hian damdawi hmuchhuaktu in enchhinna hrang hrang a neih te kha an tih ve a ngai tawh lova. A hnathawh dan (Pharmacological activity), laboratory, rannung leh mihringa a test an lo neih tawh data kha a ring ve thei a ni. A hmuchhuaktu in heng zawng zawng a paltlang nana sum tam tak leh kum 10-15 thleng a lo sen kha a pumpelh a. Chu-vangin research tihna atan sum leh hun khawhral a ngai ve ta lo. A tihtur awm chhun chu a hmuchhuaktu siam (Innovator’s product) nen khan a inang em tih chiah a en a tul a. Hetianga test neih atanga a inang a ni tih an finfiah theih a, damdawi quality tha leh him tawk an siam theih chuan thuneitu ten an lo pawmsak mai thin a ni. Generic leh branded drugs te an intluk em? Generic drugs te hi man tlawm zawk mah se, a branded version nena intluk tura duan leh enchhin vek an ni thin. Damdawi intluk leh tluk loh hriatna hi ‘Bioequivalency test’ an ti a. Generic drug siamtu ten an damdawi siam chu Branded drugs nen a intluk (Bioequivalent) a ni tih an finfiah ngei tur a ni a. Damdawi pahnih te hi 80-125 % (Bioavailability) a an intluk a nih chuan Bioequivalent atana pawm an ni thin. Hetianga enchhin leh finfiah thlap an nih thin avangin generic drugs te hi branded drugs te nen intluk tlang ngei tura ngaih an ni. Dr.Lalduhsanga Pachuau Asst. Prof. Deptt. of Pharmaceutical Sciences Assam University

Sl.No.

Suspected Drugs Indication Adverse Reactions

1. Deferasirox Treatment of chronic iron overload in patients with non-transfusion dependent thalassemia

(NTDT) syndrome

Osteoporosis

2. Ambroxol All forms of tracheobronchitis, emphysema with bronchitis pneumoconiosis, chronic

inflammatory pulmonary conditions,

bronchiectasis, bronchitis with bronchospasm asthma

Lacrimation

3. Lurasidone Treatment of patients with Schizophrenia Thrombocytopenia

4. Etoricoxib Short term use in acute painful condition. Skin hyperpigmentation.