Aug
1
Cholestyramine
August 1, 2009 | Leave a Comment
Generic Name
Cholestyramine (kol-es-TYE-rah-meen) 0
Brand Names
LoCHOLEST Questran
LoCHOLEST Light Questran Light Prevalite
The information in this profile also applies to the following drugs:
Generic Ingredient: Colesevelam Hydrochloride WelChol
Generic Ingredient: Colestipol Hydrochloride Colestid
Type of Drug
Anti -hyperli pidemic (blood-fat reducer).
Prescribed For
High blood-cholesterol levels; generalized itching associated with bile duct obstruction—cholestyramine only; colitis; digitalis or thyroid overdose; and pesticide poisoning.
General Information
Cholestyramine resin lowers blood-cholesterol levels by absorbing bile acids in the bowel. Since the body uses cholesterol to make the bile acids—needed to digest fat—fat digestion can only continue by making more bile acid from blood cholesterol. This results in lower blood-cholesterol levels 4-7 days after starting cholestyramine.
Cholestyramine w3Cks entirely Within the bowel and is never absorbed into the bloodstream. Though usually given 3-4 times a day, there appears to be no advantage to taking it more often than twice a day. The cholesterol-lowering effect of cholestyramine may be increased when it is taken with an HMG-CoA inhibitor or nicotinic acid. In some kinds of hyperlipidemia, colestipol may be more effective in lowering total blood cholesterol than clofibrate.
Cautions and Warnings
Do not use cholestyramine if you are allergic or sensitive to any of its ingredients or if your bile duct is blocked. The powder form should not be taken dry; doing so may result in the inhalation of powder into your lungs or a clogged esophagus.
If you are being treated for hypothyroidism, diabetes, kidney or blood vessel disorder, obstructive liver disease, or alcholism, consult your doctor before taking cholestyramine.
Cholestyramine may cause or worsen constipation and hemorrhoids. Most constipation is mild, but some people may need to stop the medication or take less of it.
Possible Side Effects
✓ Most common: constipation, which may be severe and in rare cases result in bowel impaction. Hemorrhoids may be worsened.
♦ Less common: abdominal pain and bloating, and bleeding disorders or black-and-blue marks due to interference with the absorption of vitamin K, a necessary factor in the blood clotting process. One person developed night-blindness because the medication interfered with vitamin A absorption into the blood. Other side effects include belching, gas, nausea, vomiting, diarrhea, heartburn, and appetite loss. Your stool may have an unusual appearance because of a high fat level.
✓ Rare: Rare side effects can affect your mouth, stomach and intestines, muscles and joints, mental status, urinary tract, and breathing. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
O Cholestyramine interferes with the absorption of virtually all oral drugs, including acetaminophen, amiodarone, aspirin, cephalexin, chenodiol, clindamycin, clofibrate, contraceptive drugs, corticosteroids, diclofenac, iopanoic acid, iron, digitalis drugs, furosemide, gemfibrozil, glipizide, hydrocortisone, imipramine (an antidepressant), methyldopa, mycophenolate, nicotinic acid, penicillin, phenobarbital, phenytoin, piroxicam, propranolol, tetracycline, thiazide diuretics, thyroid drugs, tolbutamide, trimethoprim, ursodiol, warfarin and other anticoagulant (blood-thinning) drugs, and vitamins A, D, E, and K. Take other medications at least 1 hour before or 4-6 hours after taking cholestyramine.
Food Interactions
Take this medication before meals. The powder may be mixed with soda, water, juice, cereal, or pulpy fruits, such as applesauce or crushed pineapple. Cholestyramine bars should be thoroughly chewed and taken with plenty of fluids. Colestipol pills are swallowed whole.
Usual Dose
Cholestyramine: 4 g (1 packet) or 1 level scoopful taken 1-2 times a day or up to 6 times a day.
Colesevelam: 6 tablets once a day or in 2 divided doses. Colestipol: 2-16 g (1-6 packets) once a day or in divided doses.
Overdosage
The most severe effect of overdose is obstruction of the gastrointestinal tract. Take the overdose victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Do not swallow the granules or powder in their dry form. Prepare each packet of powder by mixing it with soup, cereal, or pulpy fruit or by adding the powder to a 6-oz. glass of liquid, such as a carbonated beverage. If some of the drug sticks to the sides of the glass, rinse it with liquid and drink the remainder.
Constipation, gas, nausea, and heartburn may occur and then disappear with continued use of this medication. If constipation is a problem, your doctor may recommend drinking more fluids and taking a fiber supplement. Call your doctor if these side effects persist or if you develop unusual problems such as bleeding from the gums or rectum.
If you miss a dose of cholestyramine, skip it and continue with your regular scheduke. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: While cholestyramine does not affect the fetus directly, it may prevent the absorption of vitamins A, D, and E and other nutrients essential to the fetus’ proper development–even when you take, a prenatal vitamin supplement.
When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Cholestyramine is not absorbed into the body. However, reduced absorption of vitamins A, D, and E and other nutrients may make your milk less nutritious. Nursing mothers who must take cholestyramine should use infant formula.
Seniors: Seniors are more likely to experience side effects, especially those relating to the bowel.
Jul
16
Adderall
July 16, 2009 | Leave a Comment
Brand Name
Adderall
Generic Ingredients
Dextroamphetamine Sulfate + Dextroamphetamine Saccharate + Amphetamine Aspartate + Amphetamine Sulfate
Other Brand Names Adderall XR
The information in this profile also applies to the following drugs:
Generic Ingredient.* Dextroamphetamine Sulfate RE Dexedrine Dextrostat
Generic Ingredient., Lisdexamfetamine Dimesylate Vyvanse
Type of Drug
Central-nervous-system (CNS) stimulant.
Prescribed For
Attention-deficit hyperactivity disorder (ADHD) and narcolepsy (uncontrollable desire to sleep).
General Information
Amphetamines are stimulants that work on the brain’s feeding center. Adderall, which is a mixture of two forms of amphetamine, may be used as a short-term aid in weight reduction. It should not be taken for longer than a few months for this purpose.
Amphetamines may also be prescribed for childhood ADHD, a condition characterized by distractibility, short attention span, hyperactive behavior, emotional instability, and difficulty controlling impulses. They should be used only after a complete evaluation of the child has been done. Frequency and severity of symptoms and their appropriateness for the age of the child determine whether drug therapy is required. Many experts believe that amphetamines offer only a temporary solution because they do not permanently change behavioral patterns. Psychological, educational, and social measures must also be taken to ensure successful treatment in the long term.
Cautions and Warnings
Do not take Adderall if you are allergic or sensitive to any amphetamine or have heart disease, a heart defect, high blood pressure, hardening of the arteries, liver or kidney disease, tics or Tourette’s syndrome, seizures or abnormal brain wave tests, thyroid disease, glaucoma, or a history of drug abuse.
Amphetamines should be used with extreme caution because they are highly addictive and easily abused.
New or worsening thought patterns, bipolar illness, aggressive or hostile behavior, psychotic behavior, and new manic symptoms can develop during treatment with amphetamines.
Stimulants like amphetamines are not effective and may be dangerous for children whose symptoms are related to environmental factors or primary psychiatric conditions, including psychosis.
Stimulants can cause weight loss and stunted growth in children under age 10. Blurred vision and difficulty focusing can occur.
Possible Side Effects
✓ Common: heart palpitations, restlessness, overstimulation, dizziness, sleeplessness, increased blood pressure, rapid heartbeat, upper abdominal pain, and weight loss.
✓ Less common: euphoria (feeling “high”), hallucinations, muscle spasms and tremors, headache, dry mouth, unpleasant taste in the mouth, diarrhea, constipation, upset stomach, nausea, vomiting, rash, itching, changes in sex drive, and impotence.
✓ Rare: psychotic drug reactions. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Combining an amphetamine and a monoamine oxidase inhibitor (MA01) antidepressant may cause a severe increase in blood pressure as well as bleeding inside the skull. Wait at least 2 weeks after stopping an MAGI before taking an amphetamine.
• Amphetamines may reduce the effectiveness of high blood pressure medicines.
• Gastrointestinal and urinary acidifying agents such as methenamine reduce the effectiveness of amphetamines.
• Gastroinstestinal alkalizing agents, such as sodium bicarbonate, and urinary alkalizing agents (acetazolamide, some thiazides) may increase and prolong the effects of amphetamines.
• Antipsychotic medications such as chlorpromazine, haloperidol, and lithium carbonate inhibit the stimulatory effects of amphetamines and can cause amphetamine poisoning.
• Amphetamines may enhance the effects of tricyclic antidepressants, norepinephrine, phenobarbital, phenytoin, and meperidine.
• Amphetamines may decrease the effectiveness of beta blockers.
• Amphetamines may counteract the sedative effect of antihistamines.
• Amphetamines can delay the absorption of ethosuximide into the bloodstream.
• Propoxyphene increases the CNS-stimulating effect of amphetamines. Fatal convulsions have occurred in propoxyphene overdose with amphetamines.
Food Interactions
These drugs may be taken without regard to food or meals.
Usual Dose
Dextroamphetamine and Adderall
ADHD
Child (age 6 and older): 5-40 mg once or twice a day.
Child (age 3-5): 2-5 mg a day. Dose may be increased weekly until maximum response is achieved.
Narcolepsy: 5-60 mg a day.
Weight Control: 5-30 mg a day in divided doses 30-60 minutes before meals; alternately, a single, long-acting dose may be taken in the morning.
Adderall XR
Adults: 20 mg a day.
Child (age 13-17): 10-20 mg every morning. Child (age 6-12): 10-30 mg every morning. Child (under age 6): not recommended.
Lisdexamfetamine
Child (age 6-12): 30 mg every morning. Daily dose may be increased up to 70 mg.
Child (under age 6): not recommended.
Overdosage
Symptoms include tremors, muscle spasms, restlessness, exaggerated reflexes, rapid breathing, dry mouth, constipation, hallucinations, confusion, panic, and overaggressive behavior. These may be followed by depression, exhaustion, abnormal heart rhythms, blood pressure changes, nausea, vomiting, diarrhea, convulsions, and coma. Take the victim to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Amphetamines should be used very cautiously and only when considered absolutely necessary.
When taken for weight control, this drug should be used only when other methods have failed, and will gradually lose its effectiveness as the body starts breaking it down faster. Do NOT increase your dosage when this occurs. The drug must be discontinued.
Amphetamines are addictive and commonly abused. If you feel you have developed a tolerance or dependence to Adderall, contact your doctor. Do not increase your dosage without your doctor’s approval.
Amphetamines may impair your ability to drive or operate heavy machinery. Use with caution. To prevent this drug from interfering with sleep, take it at least 6-8 hours before bedtime.
Do not crush or chew the sustained-release form.
If you forget your once-daily dose, skip it and go -back to your regular schedule the next day. If you take the drug 2-3 times a day and miss a dose, take it as soon as you remember. If it is within 3 hours of your next dose, skip the one you forgot and continue with your regular schedule. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: Use of amphetamines during the early stages of pregnancy may cause birth defects. Amphetamines also increase the risk of premature delivery and low-birth-weight infants and may cause drug withdrawal symptoms in newborns. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Amphetamines pass into breast milk. Nursing mothers who must take them should use infant formula.
Seniors: Seniors are more sensitive to this drug’s effects.
Jul
16
Acetazolamide
July 16, 2009 | Leave a Comment
Generic Name
Acetazolamide (uh-sete-uh-ZOLE-uh-mide) [6j
Type of Drug
Carbonic-anhydrase inhibitor.
Prescribed For
Glaucoma and prevention or treatment of mountain sickness; also prescribed for epilepsy and treatment of drug-induced swelling or swelling due to congestive heart failure.
General Information
By blocking an enzyme in the body called carbonic anhydrase, acetazolamide produces a weak diuretic effect that helps to treat glaucoma by reducing pressure inside the eye. Acetazolamide’s antiseizure properties are also produced by its effect on carbonic anhydrase, though exactly how acetazolamide prevents seizure is not well understood.
Cautions and Warnings
Do not take acetazolamide if you are allergic or sensitive to any of its ingredients or to sulfa drugs.
Do not take acetazolamide if you have low blood sodium or potassium, diabetes, or serious kidney, liver, or Addison’s disease.
Possible Side Effects
Side effects of short-term therapy are usually minimal.
✓ Most common: nausea or vomiting; tingling feeling in the arms, legs, lips, mouth, or anus; appetite and weight loss; a metallic taste; increased frequency in urination; diarrhea; not feeling well; occasional drowsiness; and weakness. You may also experience rash, drug crystals in the urine, painful urination, low back pain, urinary difficulty, and low urine volume.
♦ Rare: Rare side effects can affect the liver, mental state, blood sugar, muscles, and senses. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Avoid over-the-counter drug products that contain stimulants or anticholinergics, which tend to aggravate glaucoma and cardiac disease.
• Acetazolamide may increase blood concentrations of cyclosporine (used to prevent the rejection of transplanted organs).
• Acetazolamide may block or delay the absorption of primidone (prescribed for seizure).
• Avoid aspirin because it may enhance acetazolamide side effects.
• Combining diflunisal and acetazolamide can result in an excessive lowering of eye pressure.
Food Interactions
Acetazolamide may be taken with food if it upsets your stomach. Because acetazolamide can increase potassium loss, take this drug with potassium-rich foods such as bananas, citrus fruits, melons, and tomatoes.
Usual Dose
Glaucoma
Adult: 250-1000 mg a day.
Child: 4.5-6.75 mg per lb. a day in divided doses.
Diuresis in congestive heart failure or drug-induced swelling Adult: 250-375 mg a day.
Child: 2.25 mg per lb., once daily in the morning.
Epilepsy: 375-1000 mg a day in divided doses.
Mountain Sickness: 500-1000 mg a day. If possible begin medication 24-48 hours before ascent.
Overdosage
Symptoms of overdose include drowsiness, loss of appetite, nausea, vomiting, dizziness, tingling in the hands or feet, weakness, tremors, or ringing or buzzing in the ears. In case of overdose, induce vomiting as soon as possible with ipecac syrup—available at any pharmacy—and take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Acetazolamide may cause minor drowsiness and confusion, particularly during the first 2 weeks of therapy. Be careful when driving or doing any task that requires concentration.
Call your doctor if you develop sore throat, fever, unusual bleeding or bruises, tingling in the hands or feet, rash, or unusual pains.
Acetazolamide can increase sensitivity to the sun. Avoid prolonged sun exposure and protect your eyes while taking this drug.
Be sure to drink plenty of water or fluids while taking acetazolamide.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: High doses of this drug may cause birth defects or interfere with fetal development. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Small amounts of acetazolamide may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors are more sensitive to this drug’s side effects.
Jul
16
Acetaminophen
July 16, 2009 | Leave a Comment
Generic Name
Acetaminophen (uh-SEE-tuh-MIN-uh-fen) RE
Brand Names
Acephen Mapap-
Aceta Mapap Children’s
Acetaminophen Uniserts Mapap Extra Strength
Apacet Mapap Infant Drops
Aspirin Free Anacin Maximum Maranox
Strength Neopap
Aspirin Free Pain Relief Oraphen-PD
Dynafed, Children’s JR Panadol*
Dynafed EX Redutemp
Dynafed Extra Strength Silapap
Feverall Silapap Children’s
Feverall, Infants Silapap Infants
Genapap” Tapanol
Genebs Tempra*
Liquiprin Tylenol*
*Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug
Antipyretic and analgesic.
Prescribed For
Relief of pain and fever for people who cannot or do not want to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID). Acetaminophen may be given to children about to receive a
DTP vaccination to reduce the fever and pain that commonly follow the vaccination.
General Information
Acetaminophen is generally used to relieve pain and fever associated with the common cold, flu, viral infections, or other disorders where pain or fever may occur. It is also used to relieve pain in people who are allergic to aspirin, or those who cannot take aspirin because of potential interactions with other drugs such as oral anticoagulants. It can be used to relieve pain from a variety of sources, including arthritis, headache, muscle ache, menstrual cramping, and tooth and periodontic pain, although it does not reduce inflammation.
Cautions and Warnings
Do not take acetaminophen if you are allergic or sensitive to any of its ingredients. Do not take acetaminophen for more than 10 days in a row (5 days for children) unless directed by your doctor. Do not take more than is prescribed or recommended on the package.
Use this drug with extreme caution if you have kidney or liver disease or viral infections of the liver. Large amounts of alcohol increase the liver toxicity of large doses or overdoses of acetaminophen. Avoid alcohol if you regularly take acetaminophen. Some people are more sensitive to this effect than others.
Possible Side Effects
This drug is relatively free from side effects when taken in recommended doses. For this reason it has become extremely popular, especially among those who cannot take aspirin. V Rare: large doses or long-term use may cause liver dam-
age, rash, itching, fever, lowered blood sugar, stimulation,
yellowing of the skin or whites of the eyes, and/or a change
in the composition of your blood. Contact your doctor if
you experience any side effect not listed above.
Drug Interactions
o Large doses of barbiturate drugs, carbamazepine, phenytoin and similar drugs, izoniazid, rifampin, and sulfinpyrazone may increase the chances of liver toxicity if taken with acetaminophen.
• Alcoholic beverages increase the chances for liver toxicity
and possible liver failure associated with acetaminophen.
Food Interactions
None known.
Usual Dose
Adult and Child (age 12 and over): 325-650 mg 4-6 times a day,
or 1000 mg 3-4 times a day. Avoid taking more than 4 g (twelve
325-mg tablets) a day for long periods of time. Child (age 11): 480 mg 4-5 times a day. Child (age 9-10): 400 mg 4-5 times a day. Child (age 6-8): 320 mg 4-5 times a day. Child (age 4-5): 240 mg 4-5 times a day. Child (age 3): 160 mg 4-5 times a day. Child (age 1-2): 120 mg 4-5 times a day.
Child (age 4-11 months): 80 mg 4-5 times a day. Child (under age 4 months): 40 mg 4-5 times a day.
Overdosage
Acetaminophen is a commonly used ingredient in many over-the-counter (OTC) medications. Always check the list of ingredients when using more than one OTC medication to ensure that the combined dosage is within guidelines and to avoid accidental overdose.
Acute acetaminophen overdose may cause nausea, vomiting, sweating, appetite loss, drowsiness, confusion, abdominal tenderness, low blood pressure, abnormal heart rhythms, yellowing of the skin and whites of the eyes, and liver and kidney failure. Liver damage has occurred with 12 extra-strength tablets or 18 regular-strength tablets, but most people need larger doses-20 extra-strength or 30 regular-strength tablets—to damage their livers. Regular use of large doses for long periods-30004000 mg a day for a year—can also cause liver damage, especially if alcohol is involved. In case of overdose, induce vomiting as soon as possible with ipecac syrup—available at any pharmacy —and take the victim to a hospital emergency room. ALWAYS bring the acetaminophen bottle or container.
Special Information
Unless abused, acetaminophen is a beneficial, effective, and relatively nontoxic drug. Follow package directions and call your doctor if acetaminophen does not relieve pain in 10 days for adults or 5 days for children. Call your doctor if fever gets worse or persists longer than 3 days.
Alcoholic beverages will worsen the liver damage that acetaminophen can cause. People who take this drug on a regular basis should limit their alcohol intake.
If you forget to take a dose, take it as soon as you remember. If it is within an hour of your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Acetaminophen ‘is considered safe during pregnancy when taken in usual doses. Taking continuous high doses of the drug may cause birth defects or interfere with fetal development. Three cases of congenital hip dislocation appear to have been associated with acetaminophen. Check with your doctor before taking this drug if you are or might be pregnant.
Small amounts of acetaminophen may pass into breast milk, but the drug is considered harmless to nursing infants.
Seniors: Seniors may take acetaminophen as directed by a doctor.