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	Why Paracetamol is the anti-pyretic of choice for children with viral infection or chicken pox *-Although Cidophage (Metformin) is an anti-diabetic drug but it used for treatment of (PCOs ) also……HOW why Paracetamol is an anti-pyretic analgesic haven’t anti-inflammatory action -why we found vitamin B6 (pyridoxine Hcl) in components of some effervescent which indicated for hyper oxalurea vitamin B12 (cyanocobalamin ) containing drugs especially injection form prescribed by different doses…??**
	Why Paracetamol is the anti-pyretic of choice for children with viral infection or chicken pox Answer : -Because Aspirin giving during viral infection (e.g influenza) has been associated with an increased incidence of Reye s Syndrome. Note: Reyes Syndrom rare childhood disease: a rare and serious childhood disease, usually following a respiratory infection, causing vomiting, fatty deposits in the liver, disorientation, and swelling of the kidneys and brain GO UP
	*-Although Cidophage (Metformin) is an anti-diabetic drug but it used for treatment of (PCOs ) also……HOW???**
	-Answer : -PCOs(poly cystic ovarian syndrome )or hyper chronic an ovulation is an endocrine disorder found in 5-10% of women. -it is a syndrome consist of amenorrhea ,hirsutism, obesity &enlarged poly cystic ovaries. -in the past it was thougt that(PCOs) was caused buyexcess androgen production, but recent research has shown that the hidden factor which causes the problem is Insulin Resistance which result in Hyper insulinemia over production of testosterone concomitant with decrease in sex hormone binding globulin(SHBG) result in (PCOS) . NOTE : 1)dose of metformin for (PCOs) : 1st weak :500mg/day 2nd weak :500mg twice daily. Then :850mg twice daily or 1500mg/day (taken with meals ) 2)Metformin is a normoglycemic drug as it lower elevated blood sugar level in diabetics , when given to non-diabetic they only lower insulin level in blood &blood sugar level will not changed…GO UP
	why Paracetamol is an anti-pyretic analgesic haven’t anti-inflammatory action
	-Answer : - the analgesic action results from inhibition of synthesis of prostaglandins. - the antipyretic action through the hypothalamic heat regulating center to produce peripheral vasodilatation&heat loss. they have weak effect on cyclooxygenase enzyme(Cox) in peripheral tissuesGO UP why we found vitamin B6 (pyridoxine Hcl) in components of some effervescent which indicated for hyper oxalurea Answer - the role of vit.B6 is to cut the mechanism of the formation of endogenous hyper oxalurea. -endogenous oxalate which produced from metabolic process make complex with calcium ions &form Ca.Oxalate crystals . -vit.B6 catalyze the pyridoxal enzyme which responsible for conversion of endogenous oxalate to glyoxalate (protein form). &so no endogenous Ca.oxalate crystals will be formed. Note : vit.B6 found inCitrocid Mg plus effervescentGO UP vitamin B12 (cyanocobalamin ) containing drugs especially injection form prescribed by different doses…??* -Answer : -vit.B12 found in market in three foms one is short acting&the other two is long acting . short acting : -cyanocobalamine which found in Tri-B ampoule in combination with vit.B6 &B1. -Dose is ampoule day after day. Long acting a)Hydroxocobalamin . e.g Depovit ampoule - common dose :ampoule every 3 days. b)cyanocobalamin-tannin . e.g Betolvex ampoule -common dose : ampoule/weak. -Note that cyanocobalamin-tannin is longer than Hydroxocobalamin . . GO UP*

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