As per US FDA guidelines as per USPDA 1997

It is the intention to bring out the salient features. Hence relevent details as prescribed by US FDA guidelines as per USPDA 1997  are brought out clearly in the following chapters. 

Descriptons are detailed only to the Group Head and the indiviual items can be seen by visiting the Web Site 

ULCER HEALING DRUGS, G I SEDATIVES, AND ANTISPASMODICS-

1.ANTIDOPAMINERGICS- promotes gastric emptying by increasing persostalsis  and relaxing the pylorus

2.ANTISPASMODICS  for patients with muscular spasm include -

Atropine, Balladona, Clinidium, Dicyclomine, Glycopyrrolate, Hyoscymine, Mephenzolate, Propantheline, Scopolamine

Refer - Glycopyrrolate

1.Strictly take the medicine as per the doctors advise.

2.Do not take more of it or more often than prescribed.

3.Do not take for longer time than your doctor has ordered.

4. Allergy- Tell your doctor if you ever had any allergic reaction to any of the natural belladona products (atropine, blladona ,hyoscyamine and scopolamine) or any of related products. Also tell your doctor if you are allergic to any food products.

5. Pregnancy- If you are pregnant or may become pregnant make sure that your doctor knows iabout it.

 Tell your Doctor about if  are taking any medicine that contains  Atropine or other products that may affect the conditions during pregnancy

6. Breast feeding- though these medicines may pass into the breast milk they have not been reported to cause problems in nursing babies. Flow of breast milk may be reduced in some patients. Use of dicyclomine in nursing mothers has been reported to cause breathing problems in infants.

7. Children- unusual excitemet, nervousness, restlessness, or irritability and unusual warmth ,dryness, and flushing of the skin are more likely to occur in children who are more sensitive to the effects of anticholenergic.  Shortness of breath or difficulty in breathing has occurred in children taking dicyclomine.

8. Older adults- Confusion or memory loss, constipation, diffculty in urination, drowsiness, dryness of mouth, nose throat, or skin, and unusual excitement, nervousness, restlessness, or irritability, may be more likely to occur in the elderly. Also eye pain may be sign of glaucoma.

9. 0ther medicines-  Your Doctor should know about other medicines you are taking so he can advice accordingly.

10. Other medical problems- Other medical problems may affect the use of anticholinergics/antispasmodics.Tell your your Doctor about your other medical problems.

 11. Dosing- Dose of anticholinergics/antispasmodics are different  from patient to patient.  Follow your doctors instructions. on the  dosing schedule.

3.ANTICHOLINERGICS- include Dicyclomie,Propantheline, ambutonium, Atropine, Belladonna alkaliods, Atropine, Glycopyronium ,Hyoscyamine, Isopropamide, Mepenzolate,Pentheienate, Pipenzolate, Piperidolate, Polidine, and Clinidium

4.HISTAMINE H2 ANTAGONISTS- cimetidine,ranitidine, famotidine

CYTOPROTECTANTS- Carbenoxolone, Deglyrrhizinised liquorice, sucralfate, Misoprostol, Tripotasssium dicitro bismuthate

REFLUX SUPRESSANTS- Alginic acid

PROTON PUMP INHIBITORS- Omeprazole, lansoprazole, pantoprazole,esomeprazole, and rabeprazole

DIRECT ACTING SMOOTH MUSCULE RELXANTS- Mebevarine, Helicobacter pylori infection

HISTAMINE H2 ANTAGONISTS- CIMETIDINE, FAMOTIDINE, RANITIDINE, NIZANTIDINE

1.Take with or immediately following a meal

2.Stagger doses of antacids and cimetidine

3.Inform doctor of any cocomittant drug therapy

4.Inform doctor,if diarrhoea,dizziness,somnolence,rash or hallucinatins occur.

5.Inform doctor,if there are any symptoms that suggest bleeding,such as black tarry stools or coffee ground vomitus

6.Allergies- tell your doctor if you have ever had any unusual or allergic reaction to cimetidine ,famotidine, nizatidine or ranitidine. Also tell your doctor if youare allergic to any other substances, such as foods, presrvatives or dyes.

7.Pregnancy - make sure if you are pregnant or you may become pregnant before taking H2 blockers

8.Breast feeding- be sure you have discussed the risks and benefits of this medicine with your doctor

9 Children - medicine has not been been shown to cause different side effects or problems than it does in adults.

10. Elderly- confusion and dizziness may be especially likely to occur in elderly patients

11. Other medicines - Let your doctor know what other medicines you are taking, so that he can advice you accordingly. Aminophylline or Anticoagulants or Caffeine or Metoprolol or Oxytriphylline or Phenytoin or Propranol or Theophylline or Tricyclic antidepressants- use of these medicines with cimetidine has been shown to increase the effects of cimetidine .

 12. Other medical problems - Tell your doctor if you have any other medical problems especially - Kidney disease or Liver disease - H2 blocker may build up in the blood stream which may increase therisk of side effects

13. Missed dose - If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time for the next dose, skip the missed dose. Do not double doses.

14. Storage - Keep out of reach of children. Store away from heat or direct sunlight. Do not store the capsule in bathroom, near the kitchen sink, or in other damp places.

15. Outdated medicines - Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of reach of children.