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1.aspirin ↔ calcium carbonate
Applies to: Aspirin Buffered (aluminum hydroxide/aspirin/calcium carbonate/magnesium hydroxide), calcium carbonate
Using calcium carbonate together with aspirin may decrease the effects of aspirin. , you may need a dose adjustment or special test to safely use both medications.

2.magnesium hydroxide ↔ cholecalciferol
Applies to: Aspirin Buffered (aluminum hydroxide/aspirin/calcium carbonate/magnesium hydroxide), Vitamin D3 (cholecalciferol)
Ask your doctor before using cholecalciferol together with magnesium hydroxide. If you are undergoing chronic kidney dialysis treated with cholecalciferol you should avoid magnesium hydroxide. Using these medications together can cause high magnesium levels, particularly in chronic kidney dialysis. This can cause nausea, vomiting, flushing, low blood pressure, a slow heartbeat, drowsiness, coma, and death. High magnesium levels may also play a role in the development of bone disease in dialysis patients.

3.estradiol ↔ metformin
Estradiol may reduce the effects of metFORMIN in lowering your blood sugar. . You may need a dose adjustment or more frequent monitoring of your blood sugar if you have been using metFORMIN and are starting treatment with estradiol. Likewise, if your metFORMIN dose has been adjusted during treatment with estradiol, the dose may need to be readjusted after you discontinue estradiol.

4.calcium carbonate ↔ risedronate
Risedronate and calcium carbonate should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of risedronate and reduce its effectiveness. You should take calcium carbonate at least 30 minutes after the risedronate dose

5.aspirin ↔ risedronate

If you take a medication like risedronate by mouth, combining it with aspirin may increase your risk of developing gastrointestinal ulcers and bleeding. Contact your doctor immediately if you develop severe abdominal pain, bloating, sudden dizziness or lightheadedness, nausea, vomiting (especially with blood), loss of appetite, and/or black, tarry stools. On the other hand, if you receive a medication like risedronate by IV infusion, you may have an increased risk of kidney problems if you also use aspirin on a regular or long-term basis. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek medical attention if you experience signs and symptoms that may suggest kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. Be sure to drink plenty of fluids if you develop diarrhea or vomiting during treatment with these medications, as dehydration can also affect the kidney. It is important to tell your doctor about all other medications you use, including vitamins and herbs


clinical implication

Ancef,-antibiotic for infection
Elavil,-reducing anxiety,restlessness,neuropathic pain,migraine

calcium carbonate,-for osteoporosis
Vitamin D,-for osteoporosis

Actonel,-for osteoporosis
vagifem,-hormone replacement
imitrex,-migaine

metformin -anti diabetic

Buffered aspirin-avoid risk of cardiovascular disease

Take care

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Hello XXXXXXX
For making ancef 750 mg use 75 percent of 1 gm vial.

DOSES AND ROUTES SAFE

Ancef,- 1 gram IV 12 hrly
Elavil,-one tab daily or BID[twice a day]
calcium carbonate,- Tab 500 mg OD or BID
Vitamin D,- tab. 0.25 mcg [calcitriol ]daily OR XXXXXXX 0000 IU cholecalciferol once in week

Actonel,- Tab 35mg once in a week
vagifem,-10 mcg vaginal tab once day for 2 weeks ,then twice a week for 50 weeks
imitrex,- tab 50 mg once a day

metformin - tab 500 mg once or twice day

Buffered aspirin-contains magnesium oxide

Take care

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hello XXXXXXX

1 Ancef -effective in GRAM [-] strain of bacteria

2 cellilitis is a type of deep skin infection so it is controlled by antibiotic

3Ancef-
In vitro tests demonstrate that the bactericidal action of cephalosporins results from inhibition of cell wall synthesis. By binding to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, it inhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins.

Thus kills bacteria and reduce infection

Elavil[ amitryptilin]-
Amitriptyline inhibits the membrane pump mechanism responsible for uptake of norepinephrine and serotonin in adrenergic and serotonergic neurons. Pharmacologically this action may potentiate or prolong neuronal activity since reuptake of these biogenic amines is important physiologically in terminating transmitting activity. This interference with reuptake of norepinephrine and/or serotonin is believed by some to underlie the antidepressant activity of Amitriptyline.

thus it helps as antidepressant in old age patient with chronic illness

cholecalciferol-
Cholecalciferol is a vitamin D3. Vitamin D is important for the absorption of calcium from the stomach and for the functioning of calcium in the body. Cholecalciferol is used to treat or prevent many conditions caused by a lack of vitamin D, especially conditions of the skin or bones.

thus it helps in osteoporosis ,diabetic patient are prone for severe osteoporosis

Actonel-[residronate ]--
Bisphosphonates are drugs that inhibit mineralization or resorption of the bone by blocking the action of osteoclasts. Bisphosphonates are enzyme-resistant analogues of pyrophosphate, which normally inhibits mineralization in the bone. Their effect is dose dependent and they reduce the turnover of bone by inhibiting recruitment and promoting apoptosis of osteoclasts.

Bisphosphonates are used to treat postmenopausal and glucocorticoid induced osteoporosis,

vagifem-
Estradiol is a form of estrogen, a female sex hormone that regulates many processes in the body. Some estradiol products placed directly into the vagina are used for "local" treatment of vaginal menopause symptoms involving the secretions and surrounding tissues of the vagina.

imitrex-[sumatriptan]
The 5-HT1B and 5-HT1D receptors function as autoreceptors, which inhibit the firing of serotonin neurons and a reduction in the synthesis and release of serotonin upon activation. After sumatriptan binds to these receptors, adenylate cyclase activity is inhibited via regulatory G proteins, incrases intracellular calcium, and affects other intracellular events. This results in vasoconstriction and inhibtion of sensory nociceptive (trigeminal) nerve firing and vasoactive neuropeptide release.

Thus it helps during migraine attack by constricting dilated extracerebral blood vessels

metformin -
Metformin decreases blood glucose levels by decreasing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. These effects are mediated by the initial activation by metformin of AMP-activated protein kinase (AMPK), a liver enzyme that plays an important role in insulin signaling, whole body energy balance, and the metabolism of glucose and fats.

Thus helping in controlling blood sugar level in diabetic patient

Buffered aspirin-.
The platelet aggregation-inhibiting effect of acetylsalicylic acid specifically involves the compound's ability to act as an acetyl donor to cyclooxygenase; the nonacetylated salicylates have no clinically significant effect on platelet aggregation. Irreversible acetylation renders cyclooxygenase inactive, thereby preventing the formation of the aggregating agent thromboxane A2 in platelets. Since platelets lack the ability to synthesize new proteins, the effects persist for the life of the exposed platelets (7-10 days). Acetylsalicylic acid may also inhibit production of the platelet aggregation inhibitor, prostacyclin (prostaglandin I2), by blood vessel endothelial cells; however, inhibition prostacyclin production is not permanent as endothelial cells can produce more cyclooxygenase to replace the non-functional enzyme
Thus helping in preventing blood clotting and avoiding ischemic episode

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