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Atenolol blocks beta-1 receptors, which are present on the heart. This prevents the action of nerve chemicals adrenaline and noradrenaline on the heart. As a result, heart beats at a slower rate and with lesser force, and thus pumps out lesser blood into blood vessels.

This action of atenolol reduces blood pressure in the hypertensive patients. Since the heart treated with atenolol beat slowly and with less force, it uses lesser energy thus relieving pain in angina and also reduces the risk of heart attack. Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) prescribed to treat mild-to-moderate musculoskeletal pain. It helps to relieve: • Tenderness, stiffness, and inflammation due to,,. • Musculoskeletal pain due to sprains, strains or other causes. • headache and other types of headache. • Painful menstrual cramps.

• Pre and post-operative pain. • Pain due to kidney stones and gallstones. Diclofenac works by blocking the effects of the cyclo-oxygenase enzyme thereby reducing the synthesis of prostaglandins, which are responsible for causing pain and inflammation.

Duloxetine belongs to a class of drugs known as serotonin-norepinephrine reuptake inhibitors. It is prescribed for depression, generalized anxiety disorder and for managing chronic musculoskeletal pain caused by fibromyalgia and other conditions.

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It is used to treat diabetic peripheral neuropathy (damage to the nerves due to diabetes). Duloxetine acts by increasing the levels of both serotonin and norepinephrine neurotransmitters in the brain, which maintains the mental balance and stops the transmission of pain signals in the brain. • Menstrual disorders: Since the drug supports normal growth and shedding of the uterine lining, it is used for treating menstrual disorders like absent or irregular menstruation, painful menstruation, secondary amenorrhea and premenstrual symptoms. • Prevent miscarriage: Since the drug helps in maintaining integrity of the endometrial lining in a pregnant womb, it is used for preventing habitual and recurrent abortion. • Endometriosis: Dydrogesterone relieves the pain during menstruation due to endometriosis without inhibiting ovulation.

• Infertility: The drug is used during IVF (in-vitro fertilization) cycle to achieve successful implantation. • In combination with hormonal replacement therapy (HRT): Dydrogesterone prevents thickening of the uterine lining in the patient taking HRT. Melitracen is prescribed to treat depression and anxiety. It is also available as a combination drug along with flupentixol which is indicated for different types of depression (psychogenic, masked, menopausal, in alcoholics), depressive neuroses, psychosomatic affections accompanied by anxiety and apathy, and dysphoria in alcoholics. It is also given as a maintenance dose in psychogenic depressions and other psychoses.

Melitracen comes under the category of tricyclic antidepressants (TCAs) which act by decreasing re-uptake of neurotransmitters like norepinephrine and serotonin at the nerve synapse. This causes a high concentration of the neurotransmitters in the next neuron causing an antidepressant effect. Melitracen acts similarly as other TCAs regarding efficacy against depression and anxiety.

It has an added advantage of improved tolerability and a slightly faster onset of action. Pregabalin is an anticonvulsant used as an additional treatment of partial seizures. It is also effective against nerve-related pain as it decreases the number of pain signals sent out by the damaged nerves in the body. It is used in the management of postherpetic neuralgia (nerve pain caused by the chicken pox virus), painful peripheral neuropathy due to diabetes, nerve-related pain due to spinal cord injury and fibromyalgia (a condition where the patient has muscle and connective tissue pain).

It is also used in the treatment of generalized anxiety disorder.