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SC GC-SF 300 mcg od. Stimulation of granulocyte production in chemotherapy- induced neutropenia Severe chronic neutropenia P atients undergoing peripheral.

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Presentation on theme: "SC GC-SF 300 mcg od. Stimulation of granulocyte production in chemotherapy- induced neutropenia Severe chronic neutropenia P atients undergoing peripheral."— Presentation transcript:

1 SC GC-SF 300 mcg od

2 Stimulation of granulocyte production in chemotherapy- induced neutropenia Severe chronic neutropenia P atients undergoing peripheral blood progenitor cell collection

3 Stimulates production, maturation and activation of neutrophils Activates neutrophils to increase both motility and cytotoxicity

4 Chemotherapy-induced neutropenia : 5 mcg/kg/day, doses may increase by 5 mcg/kg base on duration and severity. Subcutaneous Severe chronic neutropenia : 6 mcg/kg twice daily (congenital), 5 mcg/kg/day (cyclic/idiopathy) Bone marrow transplantation : 10 mcg/kg/day, adjust dose base on duration and severity.

5 Fever Alkaline phosphatase increase Bone painSplenomegalyPetechiae, rashEpistaxisNausea, vomitting

6 First dose should be given no sooner than 24 hours after chemotherapy. In myeloid malignancies, GCSF potentially act as growth factor for any tumor type.

7 Maxolon tablet 10 mg tds

8 Gastroesophageal reflux Symptomatic treatment of diabetic gastric stasis

9 Blocks dopamine and serotonin receptors in chemoreceptor trigger zone of CNS Enhances response to acetylcholine of tissue in upper GIT Enhance motility an accelerate gastric emptying time Increase lower esophageal sphincter tone

10 Oral Gastroesophageal reflux : 10-15 mg/dose up 4 times/day 30 minutes before meals or food and at a bedtime. Single dose of 20 mg for provoking situations. Diabetic gastric stasis : 10 mg 30 minutes before each meal and at bedtime.

11 Oral Chemorherapy-induced emesis Moderate risk : 0.5 mg/kg every 6 hours or 20 mg 4 times/day on days 2-4. Low risk : 20-40 mg every 4-6 hours.

12 CVSCNS restlessnessfatique Drowsiness (10-70%) bradycardia Fluid retention

13 Metoclopramide o Extrapyramidal symptoms or risk when use concurrently with antipsychotic agents o Cyclosporine levels o CNS depression (synergistic with opiate analgesics and ethanol) Metoclopramide’s actions antagonize by anticholinergic agents

14 Ciprofloxacin tablet 500 mg bd

15 Treat bacterial infection (gram +ve and –ve) Urinary tract infection Lower respiratory infection Chronic bacterial prostatitis Acute uncomplicated cystitis (female) Skin, bone and joint infection

16 Inhibits DNA gyrase in susceptible organism Inhibits relaxation of supercoiled DNA Promotes breakage of double-stranded DNA

17 Oral : 250-750 mg every 12 hours (500 mg twice daily)

18 neurologic events (dizzines, insomnia, somnolence,nervousness) Nausea, vomitting, diarrhea COMMON

19 Ciprofloxacin  Serum level of tizanidine  Effects/toxicity of caffeine  Tendon rupture risk, use with corticosteroids  Risk of seizures, use with NSAIDs or foscarnet Probenecid increase ciprofloxacin levels

20 Ciprofloxacin  Phenytoin levels Ciprofloxacin level  Taken with dairy product  Enteral feedings  Antacids, oral electrolyte supplement, quinapril, sucralfate


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