Isotonic Dextrose Saline


Brand Name given by Opso Saline is IDS
Isotonic Dextrose Saline are ideal for the replacement of Insensible fluid loss, as insensible fluid losses comprises by water loss and a very minimum of electrolyte loss -

What is Insensible fluid loss?

- Fluid loss that is not readily measured and consists mostly of water lost via evaporation through the
skin (two thirds) and respiratory tract (one third).


- Insensible fluid loss also depends on the postnatal age. Because skin thickness intensifies with the age,
the Insensible fluid loss decreases as premature neonates mature.


- Insensible fluid loss ventilated infants receive humidified gas. Therefore, Insensible fluid loss from the
lungs is eliminated in these infants.


IDS are also effective in case of sensible fluid loss -

What is Sensible fluid loss?

- Fluid loss that is measurable and consists of water & electrolyte lost via urine, stool (eg, diarrhea and
Cholera etc.), nasogastric or orogastric drainage and cerebrospinal fluid (eg, ventricular drainage)

Ref: PMD, OSL, Bangladesh

GLOBAL HEAVY CHEMICALS LTD IN BANGLADESH

Global Heavy Chemicals Ltd (GHCL) is the largest manufacturer and supplier of Chlorine, Caustic Soda, Hydrochloric Acid, Sodium Hypochlorite, Bleaching Powder, Chlorinated Paraffin Wax (CPW) and other related products in Bangladesh. GHCL a sister concern of OPSONIN GROUP is located at Hasnabad, Keranigonj, Dhaka. Within this Group OPSO SALINE Ltd was established in 1987 in Barisal, which is using the latest state of the art BFS (Blow Fill & seal) technology of Switzerland. Till now, Opso Saline Ltd is the largest manufacturer of IV Fluids/Antibiotics, Ophthalmic/Otic/Nasal Drops & Ointment and Medical Equipments (Disposable Syringe, Infusion Set, Butterfly Needle etc.) in Bangladesh. Another SBU of this group is Global Capsules Ltd (GCL) established at Rupatoli, Barisal is the manufacturer of Gelatin, empty hard gelatin capsule (EHGC) & Dicalcium Phosphate (DCP).

Clotech is a popular chemical disinfectant made of 5.25% Sodium Hypochlorite (NaOCl) and combined with DM water for enhanced stability. Clotech is often used to clean if they have no metal parts and to disinfect and decontaminate water lines. Clotech is also used in Food processing Plants, Dairies & poultry plants, Laundry, Textiles, Clinic, Hospital and other Health Institutions. Clotech is available in 2 liter, 4liter plastic container in the market. Clotech plays a vital role during flood & cyclone in Bangladesh ensuring safe drinking water.

Products of GHCL are important components in the manufacture of a variety of products that we all rely on as part of our modern way of life. In fact, each time we read a newspaper, use bleach in our laundry, ride in a car, enjoy safe drinking water or take drugs to relieve from disease. Populations of the country are being benefited from one or more of our products.

Chlorine is used as “building blocks” in more than 85% of all pharmaceutical products, 95% of all crop protection chemicals, 60% other commercial chemicals. They are also used in manufacturing of other industrial products.

The crucial balancing factor for putting any Chlore-Alkali industry in Bangladesh is to make avenue to consume Chlorine safely unless all these efforts will go in vein.

ACTIVITIES OF OPSO SALINE GROUP IN BANGLADESH

Industry Overview

Global Heavy Chemicals Limited is located on the southern part of Dhaka district in Hasnabad union under Keranigonj Thana on the south bank of the river Buriganga. Keeping the industrial heritage of Keraniganj in mind, GHCL has set-up its production unit on a 10.5 acars of land. In this project a few blocks has been designed by the consultant engineers based on maximum assurance of safety & utilization of space. Around all the sections there are sufficient space and connecting roads for free movement of vehicles & personnel. The main units of this industry are-

ž Front office area including main gate, security house, guesthouse, weighing bridge & parking area.
ž Administrative building including office block, canteen, workshop etc.
ž 10 MW Power plant including Diesel Generator & Boiler House.
ž 1800 MT water storage tank including two-pump house & cooling tower.
ž Bi-polar membrane cell house including rectifier, rectifier transformer, DCS control room, anolyte & catholyte tank, de-chlorination building as well as quality control department.
ž Utility building including DM plant, Nitrogen plant, Absorption chillers & compressors. This block has got HCl synthesis building including storage tank and delivery platform.
ž Primary & Secondary brine purification area including Salt Saturator, Reactor, Chemical-Dosing tanks, Main Clarifier, Anthracite Filter, Candle Filter, Polished Brine Tank, Ion-Exchange Resin Column and Purified Brine Storage Tank.
ž Automatic Salt washer unit, including separate storage area for raw & washed salt, conveyers, small clarifier etc.
ž Chlorine Drying & Compression building including Bottling area as well as four large storage tank and delivery platform.
ž Caustic Evaporation and Flaking building including bagging and storage facility
ž Hydrogen gas compression and Bottling building
ž Automatic Effluent treatment plant for industrial water treatment

Every individual of Global Heavy Chemicals Ltd. will feel utmost satisfaction to be associated with the development process of other industries by rendering our humble service and high quality products.


Ref: PMD, OSL, Bangladesh

WORLD CHEMICAL PRODUCTS & GLOBAL HEAVY CHEMICALS LTD.

Global Heavy Chemicals Ltd., (GHCL) was incorporated on the 19th of September 2000. In the beginning of 21st Century, GHCL starts its journey as the first private sector Chlore-Alkali Industry in Bangladesh. Significantly related to all the hopes and expectations of the new century, GHCL has energized the vision to open new horizon for industrial development in the country. Integrating the visionary imagination for basic industrial development in this country by our Founder Chairman Late Abdul Khaleque Khan, the successors have already established a number of innovative & import substitute industrial unit mainly in the pharmaceuticals and related sectors.

Chlorine is one of just 20 or so elements that make up all living things. Chlorine and chlorine-related chemicals as disinfectants and pharmaceuticals have saved more lives than any other chemical in the history of human kind. Of the 112 elements that make up the world we live in, 99 percent of the Earth's crust, atmosphere and oceans are comprised of just 12 elements by weight. They are oxygen, silicon, aluminum, iron, calcium, sodium, potassium, magnesium, hydrogen, phosphorous, carbon, and chlorine. In fact, chlorine accounts for more than two percent by weight of all seawater alone.

Chlorine-purified water hailed as one of LIFE’S top achievements of the millennium. Along with the discovery of gravity, printing and landing on the moon, the use of chlorine-purified water was recently named as one of the millennium’s greatest historical events by “LIFE” magazine.

Chlorine has an unusual ability to bind to other elements and compounds to form new matter. Chlorine's outer shell is missing one electron, which makes it highly attractive to other atoms and electrons. This is why chlorine is so useful in producing many man-made products, from thousands of consumer goods to pharmaceuticals and other industrial products.

Ref: PMD, OSL, Bangladesh

Dextrose 10% Injection
Source of water & energy


Dextrose is one of the heat origin for human body, 16.7 kJ heat can be produced from one gram dextrose. So dextrose is usually be used for the supplement of heat and treatment of hypoglycaemia. Fast intravenously administered of Dextrose 10% injection can make tissue dehydrate, so the product can be used as dehydrating agent. Moreover, dextrose is main material, which can maintain and adjust osmotic pressure of peritoneum dialysate.
Dextrose administered by IV route usually enters the blood circulation directly. It is oxidized completely to produce CO2 and H2O and excreted by lung and kidney, accompanied with the production of heat. Available capacity of common people for dextrose is about 6mg/kg/minute. 10% DA is used for supplement of energy and body liquid, for the scarcity of feeding and body liquid caused by all cases i.e. intravenous hyperalimentation, ketosis etc.


Ref: PMD, OSL, Bangladesh

THE NOSE & IT'S COMMON DISORDER

The Nose is a special sense organ for smell and respiration. This smell is supplied by the olfactory nerve. The olfactory nerve fibres originate from the special olfactory cell on the roof of nose. The olfactory nerves carry impulses of the smell to the olfactory area of the temporal lobes of the brain where sensation and impulses are interpreted and give smell.

Common Functions:

• Air is cooled down and is made moist
• The odor of the inspired air can be easily taken
• The dust particles and bacteria are caught up and removed

Common disease of the Nose

Rhinitis: It is an inflammation of the mucous membranes of the nose with symptoms of sneezing, itching, nasal discharge and congestion. It can be allergic, non-allergic, or both.

Seasonal allergic rhinitis: It is caused by substances that trigger allergies, called allergens.

Perennial allergic rhinitis: It is an IgE-mediated reaction to allergens that show little or now seasonal variation. It is persistent, chronic and generally less severe than seasonal allergic rhinitis.

Ref: PMD,OSL,Bangladesh

Common disorders of the Endocrine System
are-
1) Hyperthyroidism
2) Hypothyroidism
3) Hyperparathyroidism
4) Hypoparathyroidism
5) Diabetes mellitus
6) Acromegaly
7) Diabetes insipidus

Hyperthyroidism is a condition caused by an overactive thyroid gland. The gland makes too much T4 and T3 hormones. Hormones are substances that affect and control many important functions in the body. Weight loss, Increased appetite, Restlessness, Heat intolerance, Fatgue & Nervousness are the common symptoms of Hyperthyroidism.

Hypothyroidism is a condition in which the thyroid gland fails to produce enough thyroid hormone. Weakness Fatigue Cold intolerance Constipation Weight gain Depression Joint or muscle pain Thin and brittle hair are the common symptoms of Hypothyroidism.

Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin or when cells stop responding to the insulin that is produced, so that glucose in the blood cannot be absorbed into the cells of the body. Symptoms include frequent urination, lethargy, excessive thirst, and hunger. Diabetes mellitus is a chronic disease that causes serious health complications including renal failure, heart disease, stroke, and blindness. The treatment includes changes in diet, oral medications, and in some cases, daily injections of insulin.

Acromegaly is a hormonal disorder that results when the pituitary gland produces excess growth hormone. Most commonly it is a benign GH producing tumor derived from a distinct type of cells and called pituitary adenoma. Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious pathogenesis and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years.

Diabetes insipidus (DI) is caused by the inability of the kidneys to conserve water, which leads to frequent urination and pronounced thirst. The amount of water conserved is controlled by antidiuretic hormone, also called Vasopressin.

Ref: PMD, OSL, Bangladesh

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Some disorders of the Urinary System

Urinary tract infections: UTIs are caused by the bacteria. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of fluids also helps by flushing out the bacteria. There are three main types of UTI.


Cystitis: Inflammation of the urinary bladder.


Urethritis: Inflammation of the urethra.


Pyelonephritis: inflammation of the kidney tissue and the renal pelvis. The most common type of renal disorder, pyelonephritis may be chronic or acute.


Common symptoms associated with UTIs are-
a) Frequent urination
b) Burning or pain during urination
c) The feeling of having to pee even though little or no urine actually comes out
d) Pain in the lower abdomen
e) Pain above the pubic bone (in women)
f) A full feeling in the rectum (in men)
g) Bloody or foul-smelling urine
h) Fever
i) A general feeling of shakiness and fatigue

Kidney stones: It is the term commonly used to refer to stones in the urinary system. Stones form in the kidneys and may be found anywhere in the urinary system.

Prostatitis: It is an inflammation of the prostate gland. It is characterized by frequency urination with urgency, painful urination. In some cases, prostatitis is caused by bacterial infection and can be treated with antibiotics.

Proteinuria: Presence of abnormal amounts of protein in the urine. Healthy kidneys take wastes out of the blood but leave in protein. Protein in the urine does not cause a problem by itself. But it may be a sign that kidneys are not working properly.

Renal failure: Results when the kidneys are not able to remove waste products from the blood. Acute renal failure (ARF) is the sudden onset of kidney failure. This condition can be caused by an accident that injures the kidneys loss of a lot of blood or some drugs or poisons. Chronic kidney disease (CKD) is the gradual reduction of kidney function that may lead to permanent kidney failure, or end-stage renal disease (ESRD).

Causes of urinary system disease: Problems in the urinary system can be caused by aging, infections or injury (blood loss). As get older, changes in the kidneys’ structure cause them to lose some of their ability to remove wastes from the blood.

Ref: PMD, OSL, Bangladesh

---------------------------------

Peptic Ulcer


Peptic Ulcer : An ulcer is a sore or painful wound. The term “peptic ulcer” refers an ulcer in the lower oesophagus, stomach or duodenum. Ulcers in the stomach or duodenum may be acute or chronic; both penetrate the muscular tissue and mucosa. Depending on their location, peptic ulcers have different names.

Gastric ulcer: This is a peptic ulcer that occurs in your stomach.

Duodenal ulcer: This type of peptic ulcer develops in the first part of the small intestine

Esophageal ulcer: An esophageal ulcer is usually located in the lower section of your esophagus. It's often associated with chronic gastroesophageal reflux disease.

Both a gastric ulcer and a duodenal ulcer result when H. pylori or a drug (NSAIDS) weakens the protective mucous coating of the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. Both the acid and the bacteria can irritate the lining and cause an ulcer to form.

Ref: PMD, OSL, Bangladesh

Common Otic Disorder


External Otitis: The most common disorder of the outer ear. The process develops due to loss of the protective cerumen and excessive moistures in the ear canal. This leads to maceration of the canal skin allowing bacterial growth and invasion. Symptoms include otalgia, mild hearing loss, and scant otorrhea.

Otitis Media: Inflammation of the middle ear. It may be acute, chronic, suppurative or secretory.

Acute otitis media occurs commonly in children. It's incidence rises during the winter months. It is a result from disruption of Eustachian tube patency.

Suppurative otitis media occurs due to respiratory tract infection, allergic reaction, or positional changes during feeding. Allow reflux of nasopharyngeal flora through the eustachian tube and colonization in the middle ear. Pathogens involve Pneumococci, beta hemolytic streptococci, Hemophilus influenza and other gram- negative bacteria.

Secretory otitis media occurs due to obstruction of the eustachian tube results in negative pressure in the middle ear that promotes transudation of sterile serous fluid from blood vessels in the membrane of the middle ear that promotes transudation of sterile serous fluid from blood vessels in the membrane of the middle ear.

Chronic secretory otitis media is cause by an adenoidal tissue overgrowth that obstructs the eustachian tube that obstructs the eustachian tube, edema resulting from allergic rhinitis or chronic sinus infection, and inadequate treatment of acute suppurative otitis media.

Chronic suppurative otitis media: It is in most cases the result of inappropriate treatment of acute suppurative otitis media. It is a chronic inflammation of the mucous membrane, periost and even osseous tissue of the middle ear. Symptoms: A long period of recurrent otopyorrea which is very difficult to get cured, hypoacusis and perforation of the tympanic membrane


Ref: PMD, OSL, Bangladesh

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FIVE DIGESTIVE JUICE

Saliva: This is the combined secretion from the salivary glands and the small mucus secreting glands of the lining of the oral cavity. Saliva consists of water, mineral salts & enzyme ptyalin. Ptyalin split cooked starch to maltose. Maltose further breaks down into glucose with the help of the enzyme maltase in the small intestine.

Gastric Juice: It is a strong acidic liquid secreted into the stomach by gastric glands. Its main components are digestive enzymes pepsinogen and rennin, hydrochloric acid and mucus. Pepsinogen with hydrochloric acid converted in to active Pepsin, which digests proteins up to the stage of peptone. Rennin coagulates caseinogens of milk. Gastric lipase digests fat to some degree. Hydrochloric acid helps to hydrolyze foodstuffs.

Pancreatic juice: Produced by the pancrease and enter into the duodenum. It contains a variety of enzymes. They include trypsinogen, chymotrypsinogen, elastase, carboxypeptidase, pancreatic lipase and pancreatic amilase. Pancreatic juice is alkaline in nature due to the high concentration of bicarbonate ions. This is useful in neutralizing the acidity, allowing for effective enzymic action. Trypsinogen and chymotrypsinogen with enteropeptidase converts peptones in to peptides and polypeptides. pancreatic amilase converts all digestible polysaccharides not affected by ptyalin to disaccharides.Lipase converts fats to faty acid and glycerol.

Bile: A digestive chemical that is produced in the liver, stored in the gall bladder, and secreted into the duodenum. The main components of bile are water, bile salts, bile pigments, and cholesterol. Bile salts act as emulsifying agents in the digestion and absorption of fats. Cholesterol and bile pigments from the breakdown of hemoglobin are excreted from the body in the bile.

Intestinal juice : Secrets from the glands of small intestine . It consists of water, mucus & enzyme enteropeptidase. Its function is to complete the process begun by pancreatic juice; the enzyme trypsin exists in pancreatic juice in the inactive form trypsinogen, it is activated by the intestinal enteropeptidase. Trypsin can then activate other protease enzymes and catalyze the reaction.

Ref: PMD, OSL, Bangladesh.

HISTAMINE AND ITS RECEPTORS


Histamine: It is an amino acid derivative, usually secreted from the mucosal mast cells of the stomach. Histamine is produced primarily by mast cells and basophils, which are abundant in the skin, GI tract, and respiratory tract. Histamine is stored in granules in mast cells and basophils until it is released. It is found that histamine serves as the stimulator of the parietal cells to secret hydrochloric acid.

Histamine Receptors: Histamine, whether formed in the body or come from the out side, cannot perform its action until it can reaches at their specific receptors. Histamine receptors have been classified as H1, and H2, and H3

a) H1 receptor: receptors are present mainly in the smooth muscles of intestine, bronchi and blood vessels. H1 receptors are involved in allergic reactions that cause dermatitis, rhinitis, conjunctivitis, and other forms of allergy.

b) H2 receptor: receptors are mainly present in the gastric parietal cells and the smooth muscles of some blood vessels. H2 receptors are primarily concerned with gastric acid secretion but they are also involved in allergic reactions.

c) H3 receptor: These are presynaptic receptors located on nerve terminals. Activation of these receptors inhibits the release of histamine and other neurotransmitters.


Ref : PMD, OSL, Bangladesh

Accessory Organs of Human Body

Liver - a large organ located above and in front of the stomach. It filters toxins from the blood, and makes bile and some blood proteins.
Pancreas - an enzyme-producing gland located below the stomach and above the intestines. Enzymes from the pancreas help in the digestion of carbohydrates, fats and proteins in the small intestine.

Gallbladder - a small, sac-like organ located underside of the liver. It stores and releases bile into the small intestine through common bile duct.

Salivary glands - glands located in the mouth that produce saliva. Saliva contains enzymes that break down carbohydrates (starch) into smaller molecules. There are three pairs of salivary glands. They are:

a) 2 Parotid glands
b) 2 Sub-mandibular glands
c) 2 Sublingual glands

Spore: These are highly resistant structures formed in response to adverse conditions. They has a thick keratin like coat, that is responsible for the remarkable resistance to heat, dehydration radiation and chemicals, spore has no metabolic activity and can remain dormant for many years, when they come contact of available water & food they comes to life. All bacteria cannot form spore. Mainly gram positive Bacillus and clostridium can form spore.

Classification of Bacteria

Bacteria are three types based on shape. They are –
Cocci: Round shaped Bacteria; i.e.-Gonococci, Diplococcus Pneumonia, Streptococci etc.
Bacillus: Rod shaped or stick shaped bacteria; Streptobacilli
Spirochetes: Spiral shaped, flexible, Coiled Bacteria.

Bacteria are two types based on gram staining
Lipid bilayer (Lipopolysaccharide) is found in Gram-negative bacteria but not in Gram-positive bacteria.
Gram-positive bacteria: Staphylococcus aureus, Streptococcus pneumonia, Clostridium botulinum, Clostridium titani, Streptococcus pyrogens etc.

Gram-negative bacteria : Eschericia coli , Salmonella spp, Shigella species, Vibrio spp., Neisseria gonorrhoea, Neisseria meningitides, Klepsiella spp etc.

Bacteria are four types based on Gaseous requirements. They are-
a) Aerobic bacteria: Require O2 for growth, (21% O2)
b) Anaerobic bacteria: Don’t use O2 to obtained energy. Some can tolerate low level of O2 but other cannot tolerate even low level of O2 and may die upon brief exposure to air.
c) Facultatively anaerobic bacteria: Don’t require O2 for growth, although they may use O2 for energy production.
d) Microaerophilic bacteria: Require low level of O2 for growth but cannot tolerate the level of O2 present in air (21% O2).

VIRUS

Virus: Non-cellular organisms. They are innate, but alive within the host. Diameter is 0.02 – 0.2mm. They have no Nucleus, Ribosome and Mitochondria.

Characteristics of Virus
Viruses depend upon living host for Replication.
Contain DNA or RNA but not both.
Use the living cell’s energy stores, substrates and Synthetic machinery.
Can have a benign or very destructive relationship with the host.

FUNGI

Fungi: Eukaryotic microorganisms. Most fungi are obligate aerobes some are facultatively aerobes. Diameter 3 – 10 mm. Size of ribosome is 80s. It comprises Mold and Yeast. Molds are filamentous and multi-cellular. Yeasts are unicellular. Example: Aspergillus, Candida, Trychophyton, etc.
Characteristics of Fungi
Fungi lack pigments to manufacture their own food and therefore depend upon other
organisms for life
Includes Yeast & Mushrooms
Suffix – mycosis refer to fungus
PROTOZOA

Protozoa: Eukaryotic microorganisms that have the following features.
More Complex Organism
Unicellular, Mobile, lacking cell wall
Examples: Trichomaniasis, Malaria, Entamoeba histolytica, Giardia lamblia etc.

Antiseptic: Agent that kills or inhibits the growth of microorganisms on the external surface of the body. Toxicity is very low for the host cells. It can be used directly on skin, mucous membrane and wounds.
Example: Alcohol, Iodine, Hydrogen peroxide, Boric Acid, etc.

Antibiotic: Agent, which kills or inhibits the growth of microorganisms internally, is called antibiotic. It is sufficiently nontoxic to the host. It is used in the treatment of infectious disease of man, animals and plants. Example: Tetracycline, Ciprofloxacin, Gentamicin, Mertonidazole, Penicillin etc.

Disinfectant: A chemical, which kills bacteria, virus and other microorganisms on a non-living surface. A complete disinfectant is able to kills spore of microorganisms.Infectious disease in human being is caused by Bacteria, Virus, Fungi, Protozoa and Helminths. Infectious pathogen may spread via water and food. Diarrhoea, Typhoid, Giardiasis, Amebiasis etc. are the common public health problem till today which are the consequence of contaminated water and food

DNS

Hypovolaemia is the consequence of water and electrolyte Loss. Body fluid may be reduced by-
ž Haemorrhage or other medical conditions (Surgery, Diarrhea etc)
ž Reduced fluid intake (Dysphagia, coma)

Sign & Symptons of Hypovolaemia
ž Decrease Bloood Pressure, Increase Heart rate, Decrease urine output, Dry mucous membrane & Flattened neck vein
ž Thirst, Skin Turgor

In Hypovolaemic condition the body try its level best to restore body fluid by means of Reabsorption (through water Balance of the body). If failure, Multi system of the body is collapsed

So, if a patient losses water & electrolyte (Hypovolaemia), it will have to consider DNS to overcome from the Hypovolaemic condition.

Various anti-inflammatory drugs developed so far have directed against various mediators (histamines, leukotrienes etc) of inflammation. Anti-inflammatory drugs can be broadly classified as-

1) Corticosteroids
2) NSAIDS (Non- steroidal anti-inflammatory drugs)
3) Immunosuppressive agents

Many ocular disorders are treated by the judicious use of corticosteroids commonly know as steroids (Corticosteroids or glucocorticoids, often just called “steroids”). They are involved in a wide range of physiologic system such as stress response, immune response, regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels and behavior. Some effects of steroid & mechanisms in human body are given bellow-

Effect of Steroid
Mechanism
Anti-inflammatory
; Reduce T cells & B cells responsible for Inflammatory response
; Inhabit mast cell & Neutrophil migration
; Inhabit prostaglandin by inhibition of Phospholipase A2
; Inhibits synthesis of histamine within mast cells
Allergic Reaction
; Reduce symptom (unknown mechanism)
Hyperglycemia
; Increase Liver glycogen storage
; Inhibits glucose oxidation
; Increase insulin resistance by cell
Alteration of lipid distribution
; Increase fat deposits on face/ neck
; Decrease fat from extremities
; Increase lipid production from protein
Blood cell constituents
; Increase RBC & polymorphonuclear leukocyte number
; Decrease Eosinophil, Basophil & Monocyte
Central Nervous System
; Various mood change (unknown mechanism)


Most commonly used steroid for the treatment of ocular disorders are-
Dexamethasone
Betamethasone
Prednisolone
Hydrocortisone
Rimexolone &
Fluorometholone

Fluorometholone is corticosteroids, most often used after laser-based refractive surgery all over the world. Fluorometholone ophthalmic suspension is indicated for use in the treatment of steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the eye.
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NGS
Eye Drops


Composition: Each ml Suspension contains Fluorometholone USP 1 mg.

Description: Fluorometholone is a powerful antiinflammatory agent of steroid group. It prevents the release of substances in the body that cause inflammation.
Fluorometholone ophthalmic suspension is used to treat eye swelling caused by infections, injury, surgery or other conditions.

Indications: For steroid responsive Inflammation of the conjunctiva, cornea and anterior segment of the globe, like-
q Scleritis and Episcleritis
q Traumatic inflammation of the eye
q Panuveitis
q Disciform and Interstitial Keratitis
q Post Surgical Inflammation

Dosage & administration: Instill 1-2 drops into conjunctival sac every hour during day, every 2 hours at night until favorable response is obtained, then use 1 drop every 4 hours; for mild to moderate inflammation, instill 1-2 drops into conjunctival sac 2-4 times/day.

Contraindications: Hypersensitivity to Fluorometholone or any component of the formulation; viral diseases of the cornea and conjunctiva, mycobacterial or fungal infections of the eye, untreated eye infections which may be enhanced by a steroid.

Pediatric Use: Not recommended in children <2 years of age
Use in pregnancy: The extent of systemic absorption is not known. Use with caution in pregnant women.

Use in lactation: Excretion of Fluorometholone in breast milk is unknown, Use with caution in lactating women.

Side effects: Anterior uveitis, burning or stinging upon application, cataract formation, conjunctival hyperemia, conjunctivitis, corneal ulcers, glaucoma with optic nerve damage, perforation of the globe, secondary ocular infection (bacterial, fungal, viral), intraocular pressure elevation, visual acuity and delayed wound healing.

Precaution: Prolonged use may result in glaucoma, elevated intraocular pressure or other ocular damage; may exacerbate severity of viral infections, Use cautiously in patients with history of herpes simplex.

Drug interaction: No data reported.

Package quantities: NGS Eye Drops are available in 5 ml Polyethylene bottle.

Storage: Keep in a dry & cool place, Protect from light. Keep out of the reach of children.


---------------------------------------------------------------------------------------------------------------------------------
Unique Feature

® Microfine suspension, ensures uniform particle distribution, longer residence time & rapid absorption
® Well-established efficacy on ocular surface
® Safer than currently available low dose hydrocortisone preparation
® Liquifilm advantages soothes, cools, enhances patients comfort
® Least risk to raise IOP



Ref: Product Management Department, Opso Saline Ltd., Bangladesh

FLOMOX

Eye Drops




Executive Summary



One of the New, 4th Generation Fluoroquinolones

Excellent invitro-activity against Gram-negative organisms that fluoroquinolones are known to treat.

Expanded activity against Gram- positive organisms including resistant Gram- positive organisms.

Moxifloxacin has tremendous activity as monotherapy against numerous organisms which are difficult to treat.

Able to treat keratitis caused by the organisms resistant to the earlier generation of Fluoroquinolones



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Flomox
Eye Drops

Composition : Each ml solution contains Moxifloxacin 5 mg as Moxifloxacin Hydrochloride INN. Preservative: Benzalkonium Chloride 0.01%
Description: Moxifloxacin is a fourth-generation 8- methoxy fluoroquinolone antibacterial agent having an enhanced broad-spectrum activity against Gram-positive bacteria and Gram-negative bacteria. It is also active against atypical microorganisms, Mycobacterium and anaerobes. It works by stopping the life cycle of bacteria.

Mechanism of Action: Moxifloxacin inhibits bacterial enzyme topoisomerase II (DNA gyrase) and topoisomerase IV. Topoisomerases are essential enzymes which play a crucial role in the replication and repair of bacterial DNA. This mechanism is lethal to susceptible bacteria.

Indications: Flomox eye drops are indicated in the treatment of a variety of ocular infections caused by susceptible bacteria. Such as-
î Conjunctivitis î Blepharitis î Blepharo-conjunctivitis î Corneal ulcer î Dacryocystitis î Traumatic ocular injuries î Meibomianitis î Keratitis î Eliminate conjunctival microorganisms prior to ocular surgery & î In the treatment of postoperative infections

Dosage & administration: Instill one drop in the affected eye(s) 3 times a day for 7 days.

Contraindications: Moxifloxacin ophthalmic solution is contraindicated in patients with a history of hypersensitivity to Moxifloxacin, to other quinolones or to any of the components of the preparation.

Pediatric Use: The safety and effectiveness of Moxifloxacin ophthalmic solution in infants below 1 year of age has not been established. There is no evidence that the ophthalmic administration of Moxifloxacin solution has any effect on weight bearing joints.

Use in pregnancy: Moxifloxacin should be used during pregnancy only if the potential benefit justifies against the potential risk to the fetus.

Use in lactation : Moxifloxacin has not been measured in human milk, although it can be presumed to be excreted in human milk. Caution should be exercised when Moxifloxacin Solution is administered to nursing mothers.

Side effects: The most frequently reported ocular side effects were conjunctivitis, decreased visual acuity, dry eye, keratitis, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage and tearing. These events occurred in approximately 1-6% of patients.


Precaution: In patients receiving systemically administered quinolones, including Moxifloxacin, serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported following the first dose. Some reactions were accompanied by cardiovascular collapse, loss of consciousness, angioedema (including laryngeal, pharyngeal or facial edema), airway obstruction, dyspnea, urticaria, and itching. If an allergic reaction to Moxifloxacin occurs, discontinue the drug. Serious acute hypersensitivity reactions may require immediate emergency treatment.

Drug interaction: Drug-drug interaction studies have not been conducted with Moxifloxacin solution. In vitro studies indicate that Moxifloxacin does not inhibit CYP3A4, CYP2D6, CYP2C9, CYP2C19, or CYP1A2 indicating that Moxifloxacin is unlikely to alter the pharmacokinetics of drugs metabolized by these cytochrome P450 isozymes

Package quantities: Flomox Eye Drops are supplied in 5 ml Polyethylene bottle

Storage: Keep in a dry & cool place, Protect from light. Keep out of the reach of children.
Ref: Product Management Department, Opso Saline Ltd., Bangladesh.

A change to make a difference


GATIDEX
Eye Drops


Gatifloxacin is a broad-spectrum 8- methoxy fluoroquinolone effective against a wide range of bacterial pathogens and has an increased potency against gram-positive and gram-negative bacteria. Dexamethasone is a long acting synthetic powerful steroid. It has the most potent anti-inflammatory and the most potent anti-allergic action. Thus, the combination will effectively resolve infection and associated inflammation in severe eye conditions.

Gatifloxacin inhibit bacterial DNA gyrase, the enzyme responsible for replication, transcription and repair of bacterial DNA and Topoisomerase IV responsible for partitioning of the chromosomal DNA during bacterial cell division, thus cause death of bacteria. Dexamethasone suppresses the inflammation by decreasing the production of inflammatory mediators through the inhibition of the enzyme Phospholipase A2.


Feature:
Gatidex Eye Drops – there are Benzalkonium Chloride (BAK) as Preservative

Advantage:
* Prevent contamination of solution in the Bottle & Keep the drug stable
* Help to augment antimicrobial activity of Gatifloxacin
* Help penetration of drugs in to the Target Organisms

Benefit:
Increase the speed of killing of Susceptible Pathogens


Feature:
Gatidex Eye Drops – there are Dexamethasone as Active Ingredient

Advantage:
Dexamethasoneis a Powerful steroid, reduces the irritation, redness, burning and swelling caused by chemicals, heat, radiation, infection, allergy or foreign bodies.

Benefit:
Promptly reduces ocular Inflammation


Feature:
There are Gatifloxacin, A new 4th generation Fluoroquinolone

Advantage:
# 8-methoxy group expands the spectrum of activity of the agents to include gram-positive pathogens and
even anaerobes
# Cyclopropyl group maintain gram-negative Activity
# Bactericidal Mechanism of Action, Biocompatibiliy & Bioavailibility with favourable pharmacodynamics
#Start action within 15 minutes of exposure

Benefit:
Cures a wide range of Infections & Ensures patients’ compliance


Composition : Each ml solution contains Gatifloxacin 3 mg as Gatifloxacin Sesquihydrate INN & Dexamethasone Phosphate 1 mg as Dexamethasone Sodium Phosphate BP. Preservative: Benzalkonium Chloride 0.01%

Indications : Steroid responsive inflammatory conditions with involvement of bacteria;
Such as-
¨ Blepharitis, Scleritis, Episcleritis, Iritis, Cyclitis, Iridocyclitis, Choroiditis, Optic neuritis and chronic anterior uveitis.
¨ Disciform and interstitial keratitis
¨ Allergic corneal marginal ulcers
¨ Corneal injury from chemical radiation or thermal burns

Dosage & administration : Instill 1-2 drops into the conjunctival sac 3 to 4 times a day.

Contraindications : Gatidex Eye Drops are contraindicated in fungal disease of ocular structures, viral conjunctivitis and Hypersensitivity to any of the components of the formulation.

Pediatric Use : The safety in Paediatric patients has not been established.

Pregnancy : Gatidex eye drops should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.

Lactation : Gatifloxacin or Dexamethasone has not been measured in human milk, although it can be presumed to be excreted in human milk following topical administration. Caution should be exercised when the combination is administered to a nursing woman.

Side Effects : Frequently reported reactions related to Gatifloxacin are transient ocular burning or discomfort. Other reported reactions include chemosis, redness, dry eye, pain, itching, swelling of the eyelid & reduced visual acuity. The reactions due to steroid component are elevation of intraocular pressure (IOP) with possible development of glaucoma, infrequent Optic nerve damage, delayed wound healing and posterior subcapsular cataract formation. Secondary infection may develop after use of combination containing steroid & antibacterial. Fungal or viral infections of the cornea are particularly prone to develop coincidently with long-term use of steroids.

Warning & Precaution : If the product is used for 10 days or more, intra ocular pressure should be monitored routinely. Prolonged use of steroid may result in glaucoma, elevated intraocular pressure or other ocular damage. It may exacerbate severity of viral infections. Use cautiously in patients with history of herpes simplex.

Package quantities : Gatidex Eye Drops are supplied in 5 ml Polyethylene bottle

Storage : Keep in a dry & cool place, Protect from light. Keep out of the reach of children.



Ref: Product Management Department, Opso Saline Ltd., Bangladesh

Hartmann's Solution

HS is an isotonic crystalloid fluid, it remain isotonic after administration and are therefore effective volume expanders for a short period of time. However, both the water and the electrolytes in the solution can freely cross the semi-permeable membranes of the vessel walls (but not the cell membranes) into the interstitial space and will achieve equilibrium in two to three hours.

HS using for fluid replacement to support blood pressure from blood loss, it should be borne in mind that 3 ml of HS solution are needed to replace 1 ml of patient blood. This is because approximately two-thirds of the infused crystalloid solution will leave the vascular spaces by about one hour.