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OUR PEDIATRIC THERAPY

During the growth stages from infancy to young adulthood, children encounter many diseases, especially in the early months and years of life, which includes some upper respiratory viral or bacterial infections-such as colds, bronchiolitis, or croup-are quite common and difficult to avoid.

Although the parents would make sure that their children are nourished in a hygienic atmosphere, right from their birth, the little ones are often affected by one health problem or the other. Any kind of health problem needs to be treated as soon as possible, because they might hamper the development of the child, if left untreated. Hence, it becomes important for the parents to know about the common disorders observed in children and the common medications for them.

Our Major Pediatric Therapy Products consists of Antibiotics- mainly cephalosporins, Analgesics and Antipyretics, Antitussives and Multivitamins.

We Supply pediatric medications in various dosage forms which majorly include:

  • Oral Liquids: Syrups, Suspensions
  • Granules for Oral Suspensions in Sachets
  • Lozenges

SRS Pharmaceuticals is one of the few manufacturers and Suppliers of granules for Oral Suspension.

Oral Route of administration is the most preferred route of administration for children.

The major factor of concern while dealing with pediatric therapies is patient's acceptance. Pediatric Patients tend to become un-co-operative during the administration of oral medication; the most common reason being the taste of the oral formulation administered among the children.

Most of the Antibiotics, multivitamins and other medicines administered orally have a bitter taste making it unpleasant for Children to consume.

The solution for this is Taste masking and the major application of taste masking can be observed in Granules for oral suspension.

Granules for Oral Suspension, is a flavored, sweet to taste formulation used for administration among pediatric patients. Due to its varied flavors and sweet taste, the formulation is palatable and widely accepted in Pediatric patients all over the world.

Moreover these granules for oral suspension are packaged uniquely as single dose sachets made of 4 layered aluminum foils making the formulation extremely stable and convenient to carry.

Granules for oral suspension in sachets enhances the convenience of single dosage regimen and accuracy single dosing of medication compared to liquid suspension where the dosing is comparatively less accurate and administration of the drug is Rheology dependent.

The dry powder pharmaceutical suspension composition is stable on storage and when constituted with an ingestible liquid for administration, the corresponding liquid suspension is stable for the duration in which the therapy is required.

Some of Our Pediatric Products include:

ELIKSIR Cough Syrup (100ml)

Category: Antitussive
Contains: Vasaka patra 250 mg + Mulethi 100 mg + Haldi 100 mg + Pippali 50 mg + Nirgundi 100 mg


ANTI-GRIPP EFFECT Syrup (60 ml)

Category: Analgesic and antipyretic
Contains: Paracetamol 125mg+ Phenylephrine 2.5mg+Chlorpheneramine Maleate 1mg


BURATINO Syrup (60 ml)

Category: Multivitamin
Contains: Multivitamin + Mineral


BROMHEXINE SRS Syrup (50 ml)

Category: Antitussive
Contains: Bromhexine -4mg/ 5 ml


PARACETAMOL SRS Suspension (60 ml)

Category: Analgesics and antipyretics
Contains: Paracetamol -125mg /5 ml


AMPICILLIN CPC Oral Suspension (100 ml)

Category: Analgesics and antipyretics
Contains: Ampicillin -125mg /5 ml

NO-GRIPP Syrup (60 ml)

Category: Analgesic and Antipyretic
Contains: Phenylephrine HCl 5mg+ Chlorpheniramine Maleate BP 2mg + Paracetamol BP 125mg

PARACETAMOL EFFECT Suspension (60 ml)

Category: Analgesic and Antipyretic
Contains: Paracetamol -125mg /5 ml


CAL-D Suspension (60 ml)

Category: Vitamin supplement
Contains: Calcium Carbonate BP (from oyster shell) -625mg, equivalent to elemental Calcium 250 mg Vitamin D3 BP 125 IU

Antibiotics:

Cephalosporins in antibiotic therapy:

The introduction of Cephalosporins into pediatric practice did not result in the conquest of infections that were previously untreatable. Cephalosporins often allow an alternative approach to therapy, which in selected patients may possess advantages over other methods.

Cephalosporins belong to beta- lactam antibiotics similar to penicillins. These antibacterial agents kill bacteria by preventing the cell wall synthesis. Similar to penicillins in their mode of action but they treat a broader range of bacterial infections. They have structural similarities to penicillins and many people with allergies to penicillins may also have allergic reactions to Cephalosporins.

Oral cephalosporins are well tolerated by most children. Severe toxicities are rare; however, many children experience mild adverse effects. Approximately five to twenty percent of all patients will experience transient gastrointestinal effects, including abdominal pain, nausea, vomiting, or diarrhea.

Spectrum of activity:

Classification

Spectrum

I Generation : Cefazolin, Cephalexin, Cefadroxil, Cephradine

Good activity against Gram +ve organisms; modest against Gram -ve organisms. Streptococci (except Penicillinase resistant), Staphylococci (except Methicillin resistant strain)

II Generation: Cefuroxime, Cefoxitin, Cefprozil, Cefaclor, Cefuroxime axetil, Loracarbef, Cefotetan, Cefranide

Improved activity against Gram -ve but much less active than III generation cephalosporins. Gram -ve organisms Enterococcus, Klebsiella, Haemophilus influenza; Not active against Gram +ve as I generation.

III Generation: Cefotaxime, Cefpodoxime, Ceftibuten, Cefdinir, Ceftriaxone, Ceftizoxime, Cefoperazone, Ceftazidime

Less active against Gram +ve than I generation. More active against Enterobacteriaceae including a brownheader producing bacteria.

IV generation: Cefepime, Cefpirome

Extended spectrum of activity than III generation cephalosporins and have increased stability against hydrolysis by alpha-brownheaders



Division of the cephalosporins into generations has been used for many years to help group them into easily recognizable categories. Traditionally, the first generation agents are known to have greater activity against Gram-positive organisms with little Gram-negative activity. These agents are used most frequently for skin and soft tissue infections.

Second generation cephalosporins typically retain their Gram-positive activity and provide greater activity against Gram-negative organisms, including Haemophilus influenzae . Several new second generation agents have been introduced in the last five years, targeted at the pediatric population for the treatment of otitis media and pharyngitis.
The third generation agents lose some Gram-positive activity, but demonstrate superior activity against Gram-negative organisms.

Cefixime provides excellent coverage against Gram-negative bacteria, but is relatively ineffective against Streptococcus pneumoniae.

Ceftibutin, the newest of the oral cephalosporins, has a similar spectrum to cefixime.
Cefpodoxime is usually considered a third generation agent due to its Gram-negative spectrum; however, it is sometimes listed with the second generation agents since it maintains activity against most Staph. and Strep. species.

Stability against hydrolysis by beta-brownheader producing bacterial strains increases from first to third generation. Many communities have high rates of resistant Moraxellacatarrhalis and H. influenzae. The ability to overcome bacterial resistance has been suggested as one of the primary reasons for choosing the newer (second and third generation) oral cephalosporins over traditional, less expensive, therapies for otitis media and pharyngitis in these communities.

The efficacy of these newer oral cephalosporins in treating common infections has been well established.

Read more on Antibiotics and Antibacterials

Analgesics and Antipyretics:

Fever is an important symptom of underlying disease condition and in general is considered harmful in pediatric age group as it may lead to febrile seizures, stupor, dehydration, increase work of breathing, discomfort and tachycardia. The increased metabolic demands stress the patient with marginal cardiac and cerebral vascular supply. The hypothalamus controls the body temperature. The fever results due to resetting of the hypothalamus that occurs due to the prostaglandins produced by the pyrogens.

Fever is treated variedly by the pediatricians. The physical therapy offers a simple and cost effective way of lowering the body temperature. The drugs as paracetamol, nimesulide and ibuprofen lower the temperature by inhibiting the prostaglandin synthesis. Paracetamol is considered the safest of all the antipyretic drugs. It is recommended that a combination of physical therapy such as tepid sponging and paracetamol is best way of controlling temperature.

Fever and pain are the most common issues in pediatric patient management. Acetaminophen, aspirin, and dipyrone are the most commonly used drugs and are equivalent in their efficacy. The salicylates have anti-inflammatory effects making them appropriate for the treatment of patients with juvenile rheumatoid arthritis, but they are gastric irritants, may impair clotting, and, because of saturable kinetics, may lead to accumulation and toxicity. Acetaminophen is an effective antipyretic and analgesic with few side effects that is toxic only in massive overdose.

Read more on Analgesics and Antipyretics.

Antitussives:

Cough is a common symptom that can be self-limiting or persistent. Ideally, treatment of the underlying cause(s) of cough with specific treatments should eliminate cough. This approach may not be successful if no cause can be established or if the treatment of the cause fails. Suppression of cough may be disease-specific or symptom-related. There has been a long tradition in acute cough usually due to upper respiratory tract infections to use symptom-related antitussives. In chronic cough, suppression of cough may be achieved by disease-specific therapies, but in many patients it may be necessary to use symptomatic antitussives. The efficacy of some over-the-counter symptomatic antitussives is often no better than that of a placebo.

Patients with chronic cough need effective antitussives that could be used either on demand or on a long-term basis.

Considering various complementary and alternative medicines (CAMs) in the treatment of cough and of the conditions associated with it; in particular asthma and upper respiratory tract infections. These therapies mainly work as follows:
  1. peripherally, at the sites in the airways and lungs at which cough is being activated,
  2. in the brainstem, where the neural "cough center" is situated, or
  3. at the cerebral cortex, where cough can be initiated, suppressed or modified by conscious or unconscious controls.
Of the large number of trials of CAMs against cough, most are inadequate in design. It may be difficult to randomize selection.

Many herbal extracts are known to show a true Antitussives action. Of nonherbal treatments, the few drugs such as Bromhexine, and strong opoidal analgesics have shown effective antitussive action.

Read more on Antitussives.


Multivitamins and Iron Supplements:

Daily Multivitamins with Iron are known to prevent Anemia in High-Risk Infants. The most common reason for iron deficiency anemia in infants and children is the inadequate supply of iron in the diet. Iron is a mineral the body needs in order to make red blood cells. Other causes include:
  • Breast feeding exclusively after six months of age
  • The introduction of cow's milk before twelve months of age or over reliance
  • Introducing solid foods later that six months of age
  • Lack of meat in the diet
  • Inadequate food intake
Treatment involves improvement in dietary habits, taking multivitamins, iron supplements or taking Vitamin C which facilitates Iron absorption from other sources.

It is observed that breast feeding a child with increased pigmentation for at least 12 months and direct sunshine exposure does not completely satisfy their vitamin D requirement because melanin completes within 7-dehydrocholestrol, thus decreasing vitamin D synthesis. Vitamin D supplement should be administered to all exclusively or predominantly breast-fed infants to prevent rickets. The development of rickets in breast-fed infants is not due to deficiency of vitamin D in breast-milk but to failure of the infants to receive adequate sunlight exposure. Because of concerns about sun exposure in young infants and lack of information about the dose of sunlight necessary to prevent rickets, in infants with darkly pigmented skins, adequately defined.
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