NORMO-TEARS EYE DROPS (Each 1ml contains 1mg/ 3mg)

Indications

• Constipation
• Faecal impaction

Dosage

Children: For children aged 1 month to 5 years, the recommended dosage is 2.5 to 5 mL twice daily. Dosage may vary based on individual response and should be guided by a healthcare professional.

Adults: For adults, the typical dosage is 1 to 2 tablespoons (around 15 to 30 mL) mixed with at least 240 mL of water, taken up to three times daily. It is important to ensure adequate fluid intake to avoid gastrointestinal obstruction.

Mechanism of action

Methylcellulose acts as a bulk-forming laxative by absorbing water in the gastrointestinal tract. This increases the stool's bulk and promotes bowel motility through mechanical stimulation of the intestinal walls, which enhances peristalsis. It does not undergo significant metabolism and directly influences the physical properties of the stool.

Pharmacodynamics

The pharmacodynamic profile of methylcellulose indicates that it increases stool bulk and moisture content, facilitating easier passage of stool. The osmotic effect helps to soften the stool, while the bulk created stimulates intestinal contractions, reducing the time stool remains in the colon and alleviating constipation.

Pharmacokinetics

Methylcellulose is not absorbed systemically as it is a non-digestible fiber. Its effects are localized to the gastrointestinal tract. After oral administration, it acts primarily in the intestines, where it retains water to form a gel-like mass. The onset of action may vary, with effects usually observed within 24 to 72 hours.

Adverse effects

• abdominal discomfort
• bloating
• diarrhea
• nausea

Precautions

• Ensure adequate fluid intake to prevent intestinal blockage.
• Use cautiously in patients with pre-existing gastrointestinal disorders.

Pregnancy

Methylcellulose is generally considered safe during pregnancy. However, it is advisable to consult with a healthcare professional before use.

Breast-feeding

Methylcellulose is excreted in breast milk. Consult a healthcare provider for advice on use while breastfeeding.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Oral liquid
• Granules

Indications

• Hypovolemia
• Shock
• Surgery
• Burns

Dosage

Children: Refer to the specific product information or guidelines for paediatric dosage, as it may vary based on the indication and formulation used.

Adults: Refer to the specific product information or guidelines for adult dosage, as it may vary based on the indication and formulation used.

Mechanism of action

Dextran acts as an osmotic agent. When administered intravenously, it increases plasma volume by drawing water into the vascular space. This expansion of blood volume helps in maintaining blood pressure and improving perfusion to tissues.

Pharmacodynamics

The pharmacodynamics of dextran involves its ability to enhance blood flow and reduce blood viscosity. It can improve rheological properties of blood, thereby facilitating better circulation. Dextran's molecular size allows it to remain in the circulation for an extended period, contributing to its volume-expanding effects.

Pharmacokinetics

Dextran is administered intravenously and is distributed in the vascular compartment. Its elimination occurs through renal filtration, and it is eventually degraded by enzymatic action in the liver. The half-life can vary depending on the molecular weight of the dextran used, with larger molecules generally having a longer half-life.

Contra-indications

• Hypersensitivity to dextran or any component of the formulation
• Severe renal impairment
• Congestive heart failure
• Active bleeding or hemorrhagic disorders

Adverse effects

• Allergic reactions, including anaphylaxis
• Fluid overload
• Hypotension
• Headache
• Nausea and vomiting
• Fever
• Thrombocytopenia
• Acute kidney injury

Interactions

• Anticoagulants - may enhance the effects of anticoagulants leading to increased bleeding risk
• Diuretics - may increase the risk of fluid overload and electrolyte imbalances

Precautions

• Use with caution in patients with cardiovascular disease
• Monitor fluid balance closely in patients with renal impairment
• Careful administration in patients with a history of allergic reactions

Pregnancy

Safety during pregnancy has not been established. Use only if clearly needed and potential benefits justify potential risks.

Breast-feeding

Excretion in human milk is unknown. Caution is advised when administering to nursing mothers.

Storage

Store at room temperature, away from direct sunlight and moisture. Do not freeze.

Formulations

• Injectable solution for intravenous infusion
• Oral formulations (less common, specific to certain indications)

Indications

• Dry eye syndrome
• Ocular surface disorders
• Topical lubrication
• Formulation thickening agent

Dosage

Children: Refer to specific product guidelines or consult a pharmacist for appropriate dosing based on formulation.

Adults: Refer to specific product guidelines or consult a pharmacist for appropriate dosing based on formulation.

Mechanism of action

Hydroxypropyl functions primarily as a polymer that can form a gel-like consistency when dispersed in water. This property allows it to retain moisture and provide a protective barrier on mucosal surfaces, which is beneficial in reducing irritation and enhancing comfort in formulations.

Pharmacodynamics

The pharmacodynamic properties of hydroxypropyl are largely attributed to its ability to modify the physical properties of formulation matrices. It enhances the viscosity and stability of solutions, which can improve the bioavailability of active pharmaceutical ingredients. Hydroxypropyl also exhibits mucoadhesive characteristics, facilitating prolonged contact with mucosal tissues and enhancing the therapeutic effects of co-administered drugs.

Pharmacokinetics

Hydroxypropyl is not absorbed systemically when administered topically or orally, as it primarily acts locally at the site of application. Its degradation and elimination are dependent on the formulation and the route of administration. In general, hydroxypropyl is considered to have a high safety profile with minimal adverse effects.

Pregnancy

Hydrocypropyl should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus, as there is limited data on its safety.

Breast-feeding

Due to the lack of comprehensive studies, caution should be exercised when administering hydrocypropyl to nursing mothers.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.