B. pharmacy TU Pharmacotherapeutics old question paper/ 2081/2082

 

Medicine to Delay Periods – How to Take? Side Effects

Hello, with festivals approaching, one of the common concerns for many women is their period. Even when planning a long journey, periods often become a worry. Many wish if periods could be postponed for a while. There are certain medicines that can delay periods, but they should not be used unless absolutely necessary.

✓ First, for women already using contraceptive pills: if you finish 21 days of pills and instead of taking the usual 7-day break you directly start the next month’s pack, then your period will be delayed.

✓ Second, for women not using contraceptive pills: there is a medicine called Norethisterone. In Nepal, it is available under different brand names such as Femitrone, Norgest, Feminine, Primount, Noreth, etc.

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How does it work?

Norethisterone tablets work like the natural hormone progesterone in women. As long as you continue taking the medicine, your period will be stopped. You need to take one tablet three times a day, starting at least three days before your expected period. It should not be taken for more than 17 days. While on the medicine, periods will be delayed, and once you stop taking it, your period usually comes within three days.

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What does this tablet do?

Norethisterone is a synthetic form of the hormone progesterone. It prevents the lining of the uterus (endometrium) from breaking down. Normally, when this lining sheds, bleeding (period) starts. The tablets usually come in 5 mg doses, taken three times daily to postpone periods.

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How long can it be taken?

It can be taken for up to 17 days at most. It should not be taken longer than this because side effects may increase, and it can disturb the body’s hormonal balance.

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How to take the medicine?

Take a 5 mg Norethisterone tablet three times a day, always at the same time.

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Possible side effects

Since it is only used for a short time, major side effects are uncommon. However, some women may experience nausea, dizziness, headache, irregular periods later, or breast tenderness.

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Does it prevent pregnancy?

No, this medicine does not prevent pregnancy.

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What if the period does not start even after stopping the medicine?

Normally, periods occur within 2–3 days after stopping the medicine, sometimes it may take 3–4 days longer. If periods do not occur, a pregnancy test should be done.

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Who should not take this medicine?

• Anyone allergic to the medicine

• Pregnant women

• Women with blood clotting problems

• Those with deep vein thrombosis (DVT)

• Those with heart disease or history of heart attack

• Women with liver problems

• Women who had jaundice during pregnancy

🌿 How to Get Rid of Dandruff: Home Remedies & Best Medicated Anti-Dandruff Shampoos

 Dandruff is a common issue that most people experience. Some have dandruff only during winter, while others face it in both winter and summer. It often causes intense itching and discomfort, making people eager to find a solution.

Today, I will be discussing how to get rid of dandruff.

Dandruff is not a severe medical condition, but for young people, it can be embarrassing to have visible flakes in their hair. It causes itchiness and results in white flakes appearing on the scalp.

Causes of Dandruff

Dandruff can occur due to various reasons, including:

• Oily scalp: People with excessive oil production on their scalp are more prone to dandruff.
• Fungal infection: A type of fungus called Malassezia can infect the scalp, leading to dandruff.
• Skin conditions: Issues like psoriasis, eczema, or contact dermatitis can cause dandruff.
• Hair products: Some hair products can trigger dandruff in certain individuals.
• Poor hygiene: Not washing hair regularly or maintaining poor personal hygiene is one of the most common causes.

Home Remedies for Dandruff

There are several home remedies as well as medicated shampoos for treating dandruff. My recommendation is to try home remedies first, and if they do not work, you can opt for medicated treatments.

1. Maintain Proper Hygiene

• Use a good anti-dandruff shampoo and wash your hair every other day.
• If you have an oily scalp, you need to take extra care and wash your hair more frequently.

2. Aloe Vera (Ghieu Kumari)

• Apply aloe vera gel to your scalp 2-3 hours before washing your hair.
• Consistent use every time you wash your hair can help eliminate dandruff.

3. Coconut Oil

• Avoid using other oils when you have dandruff.
• However, applying 4-5 teaspoons of coconut oil to your scalp one hour before washing can help reduce dandruff.
• Studies suggest that coconut oil has antibacterial and antifungal properties.

4. Apple Cider Vinegar, Baking Soda, and Lemon Water

• Applying any of these to the scalp for a few minutes before washing can help reduce dandruff.
• However, these remedies may cause hair fall if used excessively.

Medicated Shampoos for Dandruff

If home remedies do not work, you can use medicated shampoos to treat dandruff. The most effective shampoos contain antifungal properties that help eliminate dandruff.

Common Medicated Shampoos

• Ketoconazole shampoo (most widely used)
• Salicylic acid-based shampoo
• Pyrithione zinc shampoo
• Coal tar shampoo
• Selenium sulfide shampoo

These shampoos are readily available at pharmacies. Among them, Ketoconazole shampoo is the most commonly used.

How to Use Ketoconazole Shampoo?

1. Wet your hair with water.
2. Apply the shampoo to the scalp and massage gently.
3. Leave it on for 10 minutes before rinsing.

• If you have an oily scalp, wash your hair daily and use Ketoconazole shampoo twice a week.
• If your hair is dry or frizzy, using Ketoconazole shampoo once a week is sufficient.
• Apply the medicated shampoo only to the scalp and use your regular shampoo for the rest of your hair.
• Stop using Ketoconazole shampoo once your dandruff disappears (after 2-4 weeks).

How to Prevent Dandruff?

• Eat a balanced diet rich in vitamins and nutrients.
• Maintain scalp hygiene by washing your hair regularly.
• Allow your hair to dry in natural sunlight after washing.
• Avoid excessive use of hair styling products containing chemicals.

By following these simple steps, you can effectively prevent and treat dandruff.

Let me know if you need any modifications or further improvements! 😊

How to Take Abortion Pills? What is Medical Abortion?

 Many women take abortion pills at home without proper guidance, which has even resulted in loss of lives. To prevent such risks and to save women’s lives, I have tried to provide some advice and information regarding this medicine.

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What is Medical Abortion?

✓ Medical abortion means terminating a pregnancy by taking medicines.
✓ In medical abortion, surgery is not required. It can be done at home under the supervision of a trained health worker.
✓ This method is safe within the first 10 weeks of pregnancy (or within 70 days from the last menstrual period).
However, it is very important to get detailed information before proceeding with this process.

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Information About the Medicines

1. 1 tablet 💊 Mifepristone 200 mg

2. 4 tablets 💊💊💊💊 Misoprostol 200 mcg each (total 800 mcg)

• Mifepristone blocks the effect of the hormone progesterone, which is necessary for pregnancy.

• Misoprostol causes the uterus to contract, leading to abortion.

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Method of Taking the Medicines

1. First, swallow Mifepristone with water.

2. After taking Mifepristone, wait for 24–48 hours.

3. Then take Misoprostol:

   • Place 4 tablets either under the tongue (sublingual) or 2 on the right cheek and 2 on the left cheek (buccal).

   • Keep them for 30 minutes without swallowing.

   • After 30 minutes, swallow the remaining medicine with water.

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What Happens After Taking the Medicines?

• After taking Mifepristone, some women may start bleeding, while others may not notice any changes.

• After Misoprostol (24–48 hours later), bleeding should occur.

• Abdominal pain, cramping, nausea, and vomiting are common.

• Bleeding may be heavier than a normal period. Each woman experiences bleeding and abdominal pain differently.

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What to Do if Side Effects Occur?

✓ If nausea/vomiting occurs → take antiemetics like Ondansetron
✓ If abdominal pain occurs → take painkillers like Brufen (Ibuprofen)
✓ If there is heavy bleeding → use sanitary pads
✓ On the day of taking Misoprostol, side effects like nausea, headache, fever, or diarrhea may occur.
✓ If side effects do not improve within 1 day → visit the nearest health facility.

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When to Be Extra Careful?

✓ If there is excessive bleeding (soaking 2 sanitary pads within 1 hour, for 2 hours continuously)
✓ If dizziness, extreme tiredness, or weakness occurs
✓ If there is severe abdominal pain or foul-smelling vaginal discharge
✓ If high fever occurs
✓ If feeling extremely unwell or persistent vomiting

Visit doctor or hospital

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How to Know if the Medicine Worked?

✓ If bleeding and abdominal cramps occur after taking the medicine → the abortion has worked.
✓ If no bleeding occurs, or only very light bleeding continues even after 4–5 days → the medicine has not worked, and you may still be pregnant.

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When Can Sexual Intercourse Resume?

After taking the medicines, sexual activity can be resumed only once all side effects are gone and the body has recovered.

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How to Prevent Future Unwanted Pregnancies?

• Repeated abortions can cause serious health problems.

• Therefore, it is important to use contraceptive methods like birth control pills, injections, condoms, or permanent methods to prevent future unwanted pregnancies.

What happens if you take Sildenafil tablet (Viagra) for long term?

 Sildenafil tablets (Viagra), is a medication, that is widely consumed recreationally, especially among young people. In Nepal, this drug is available under various brand names, including Viagra, Zenegra, Aryagra, and Silagra. It is available in 50 mg and 100 mg doses in the market.

What is Sildenafil?

Sildenafil is a medication used for men's sexual health. It is primarily prescribed to treat Erectile Dysfunction (ED), a condition where a man has difficulty achieving or maintaining an erection.

How does it work?

Sildenafil increases blood flow to the penis, helping achieve and sustain an erection. It is particularly beneficial for men who experience ED due to diabetes, heart disease, high blood pressure, or aging.

Recreational Use

Many young people are now using this medication without a doctor's prescription for recreational purposes. Some take it to boost confidence or enhance sexual performance.

Effects of Long-Term Use

If Sildenafil is misused for a long time:

• It can reduce confidence in engaging in sexual activity without the drug.
• Users may develop a psychological dependence on the medication.
• This condition is known as Psychogenic Erectile Dysfunction, where the ability to achieve an erection without the drug is compromised.

Who Should Be Cautious While Using This Drug?

If you have any of the following conditions, consult a doctor before using Sildenafil:

✔️ Heart disease, high blood pressure, diabetes, or liver/kidney problems

✔️ Currently taking nitrate medications

✔️ Serious eye conditions

✔️ Blood disorders

👉 Do not take this medication without a doctor's prescription if you have any of these conditions.

Proper Usage Guidelines

✔️ Always follow your doctor's prescription.

✔️ Typically, a 50 mg tablet is taken one hour before sexual activity.

✔️ Do not take it more than once a day, as excessive use can be harmful.

Serious Side Effects

Seek immediate medical attention if you experience:

❗ An erection lasting more than 4 hours

❗ Headache, chest pain, blurred vision, or hearing loss

❗ Increased heart rate or feeling weak

👉 Visit a doctor immediately if you experience these symptoms.

Long-Term Risks of Using Sildenafil

1️⃣ Heart Problems: It can increase blood pressure and the risk of heart attack.

2️⃣ Vision Issues: It may cause blurred vision or even sudden vision loss.

3️⃣ Hearing Problems: It can lead to tinnitus (ringing in the ears) or sudden hearing loss.

4️⃣ Psychological Dependence: Users may lose confidence in performing without the drug.

5️⃣ Digestive Issues: Long-term use can cause acidity, gastric problems, or indigestion.

Final Message

🚨 If you are using this drug recreationally, be cautious!

👉 Improper use can have severe health consequences.

👉 Do not take Sildenafil without medical advice.

If you found this information helpful, like, comment, and share.

🙏 Thank you! 

Can we use Vitamin E Capsules directly on face and hair ? Tips to use Vitamin E Capsule

 

Nowadays, many people visit pharmacies to buy Vitamin E capsules for application on their skin and hair. But is it really appropriate to apply Vitamin E capsules directly to the skin and hair? Today, I will discuss this topic.

Before that, let’s first understand Vitamin E.

Vitamin E is also known as the "beauty vitamin" because it has antioxidant properties. It is found in abundance in dry fruits like almonds, cashews, walnuts, sunflower seeds, and sesame seeds; green vegetables like spinach, cabbage, and fenugreek leaves; and fruits like kiwi, avocado, and mangoes.

• Vitamin E helps reduce age-related skin issues like blemishes and wrinkles.
• It keeps the skin hydrated and radiant.
• It helps reduce hair fall, prevents split ends, and strengthens the hair.
• It boosts the immune system, protecting the body from infections and diseases.
• It helps balance cholesterol levels.
• It improves blood circulation, reducing the risk of heart attacks.
• It strengthens eye muscles and helps maintain clear vision.
• It aids in the faster healing of small wounds, burns, and scars.

These are the benefits of Vitamin E. If you are consuming the foods mentioned above regularly, you don’t need to take Vitamin E capsules separately. However, many people nowadays apply Vitamin E capsules directly to their skin and hair.

To clarify, the Vitamin E capsules available in pharmacies are meant for oral consumption, not for direct application to the skin and hair. If you need Vitamin E for skincare, you can use moisturizers or creams that contain Vitamin E. Similarly, for hair care, you can use shampoos and conditioners enriched with Vitamin E.

If you still want to apply Vitamin E from capsules to your skin and hair, how should you do it?

It is best not to apply Vitamin E oil directly to your skin and hair, as it may cause allergic dermatitis. Instead, mix the oil from the capsule with aloe vera, coconut oil, almond oil, or rose water before applying.

How did you find this ? If you found it helpful, please don’t hesitate to like, comment, and share. Thank you! 

Isotretinoin, Side effects, Contraindication and Precautions

 Acne, is a common issue among many young people. No matter how much treatment some receive, they never seem to improve, and they keep running to hospitals wondering how they will recover. Today, I will provide information about a medication used for acne, i.e. isotretinoin. It is not enough to just know how to take this medication; it is also important to understand the potential side effects and the situations in which it should not be used.

"Isotretinoin is a Vitamin A derivative that reduces the activity of oil-producing glands in the skin. It helps in the regeneration of the skin."

For what type of acne is this medication suitable?

1. It is suitable for those with more severe forms of acne.
2. It is also appropriate for those who have not responded to other treatments such as antibiotics or creams. However, it should only be used with a doctor's recommendation.

This medication comes in capsule form, and the dosage is 0.5 mg/kg per day. If you weigh 60 kg, you should start with 30 mg per day or 15 mg in the morning and evening. Always take isotretinoin after a meal, and make sure to drink a glass of water with it. For more severe acne, the medication should be taken for 15 to 20 weeks.

Now, let’s talk about the potential side effects:

1. Dry and cracked lips: Use lip balm for this.
2. Dry  mouth and dry eyes: Use moisturizer for the mouth and artificial tears for the eyes.
3. The skin becomes more sensitive to the sun: Use sunscreen when going out in the sun. Avoid using any kind of cleansing or waxing on your face while on this medication.
4. Hair may become thin or fall out, but this issue gradually decreases after stopping the medication.
5. Some may experience body aches as well.

In more severe cases, isotretinoin may cause:

• A decrease in high-density lipoproteins (HDLs),
• Elevated liver function tests (LFTs),
• Decreased blood levels, including hemoglobin and hematocrit. Red and white blood cell counts may decrease, while platelet count may increase. If a decrease in white blood cells is noticed, stop the medication immediately.

What precautions should be taken while on this medication? 

• Patients taking isotretinoin should not donate blood during treatment and for one month after stopping the treatment. 
• If isotretinoin is combined with tetracycline, pseudotumor cerebri (a condition with increased pressure around the brain) may occur. Therefore, isotretinoin should not be given with tetracycline. If symptoms of pseudotumor cerebri occur, stop isotretinoin immediately and refer the patient to a neurologist for further evaluation.

Who should not take isotretinoin? 

• Isotretinoin is contraindicated in pregnant women and women who may become pregnant. It has been shown to cause serious harm to a developing baby when taken during pregnancy. Women should use birth control pills or avoid sexual activity while taking isotretinoin and for some time after stopping it. Men who are taking isotretinoin should not participate in sperm donation while on the medication. 
• Those who are allergic to Vitamin A should also avoid taking this medication.