Aug
1
Cevimeline
August 1, 2009 | Leave a Comment
Generic Name
Cevimeline (seh-VIM-ih-lene) 9
Brand Name Evoxac
Type of Drug Cholinergic.
Prescribed For
Dry mouth in people with syndrome.
General Information
Sj6gren’s syndrome jS a group 0j symptoms related to a lack of bodily secretions. People with this condition have very dry eyes and mucous membranes, facial lesions, and neck swelling. It often occurs in menopausal woman and is often associated with rheumatoid arthritis, poor blood circulation in the legs, and tooth decay. Cevimeline increases secretions in the mouth by binding to specific nervous system receptors and causing the release of more saliva.
Cautions and Warnings
Do not take cevimeline if you are allergic or sensitive to any of its
ingredients.
This drug may make breathing more difficult and worsen lung conditions such as asthma, chronic bronchitis, or chronic obstructive pulmonary disease (COPD).
Eye conditions like glaucoma or inflammation of the iris may be worsened by cevimeline.
Cevimeline may affect the heart, and some people with severe heart disease, including those with a history of severe angina or heart attack, may not be able to compensate for this effect.
Cevimeline may worsen gallstones and kidney stones and should be avoided by people with a history of these conditions.
Cevimeline may cause visual blurring, especially at night.
Possible Side Effects
✓ Most common: excessive sweating, headache, nausea, sinus irritation, respiratory infection, runny nose, and diarrhea.
✓ Common: upset stomach, abdominal pains, urinary infection, coughing, and sore throat.
✓ Less common: vomiting, back pain, injury, rash, conjunctivitis (pinkeye), dizziness, bronchitis, severe joint pain, fatigue, bone pain, sleeplessness, hot flushes, excess salivation, chills, and anxiety.
✓ Rare: frequent urination, weakness, and flushing. Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Combining cevimeline with a beta blocker can lead to heart rhythm disturbances.
• Cevimeline may interfere with the effects of anticholinergics, found in Some medications for abdominal or stomach spasms or cramps.
• Cholinergics such as bethanechol, donepezil, physostigmine, pilocarpine, and pyridostigmine can add to the effects of cevimeline.
• Some drugs may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. These include amiodarone, celecoxib, chlorpheniramine, cimetidine, ciprofloxacin, clarithromycin, clomipramine, cocaine, diltiazem, erythromycin, fluconazole, fluoxetine, halofantrine, indinavir, itraconazole, ketoconazole, methadone, mibefradil, nelfinavir, paroxetine, quinidine, ranitidine, ritonavir, saquinavir, and terbinafine.
Food Interactions
Grapefruit juice may interfere with the breakdown of cevimeline in the liver, increasing the chance of drug side effects. Food interferes with the absorption of cevimeline into the bloodstream. Take this drug on an empty stomach.
Usual Dose
Adult: 30 mg 3 times a day. Child: not recommended.
Overdosage
Overdose symptoms can include exaggerated drug side effects including headache, visual impairment, excess tearing and/or sweating, difficulty breathing, stomach or intestinal spasms, nausea, vomiting, diarrhea, changes in heart rhythm, blood pressure changes, shock, mental confusion, and tremors. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
cevimeline may cause blurred vision, possibly interfering with driving or performing tasks that require reliable vision, especially at night or in low light.
If you sweat excessively while taking cevimeline, be sure to drink a lot of water. Excessive sweating can lead to dehydration.
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Pregnant women should take cevimeline only if it is considered crucial by your doctor, since its effect on the developing fetus is not known.
It is not known if cevimeline passes into breast milk, but nursing mothers who must take this drug should consider using infant formula.
Seniors: Older adults should be cautious about using this drug because of its possible effects on the kidney, liver, and heart, and on other diseases or medications.
Jul
1
Drugs for Angina Treatment
July 1, 2009 | Leave a Comment
Angina pectoris
Angina pectoris is a painful cardiac condition that occurs when the work load on the heart and the onsequent oxygen demand of the myocardium exceed the ability of the cardiovascular system to meet that demand. The pain may vary from a relatively mild ache to a crushing chest pain which may radiate to the left shoulder and left arm and other areas. It is often triggered off by exertion, and usually subsides rapidly with rest. It is basically a stress response to factors that increase cardiac demand and output, and is often linked with an atheromatous narrowing of the coronary arteries.
Treatment of angina is with coronary vasodilator drugs that reduce cardiac drive and lower the myocardial oxygen demand (many of which are also used in the treatment of hypertension. They include the time-honoured glyceryl trinitrate (which can be given by several routes), other nitrates, calcium channel blocking agents, beta-adrenergic receptor blocking agents and potassium channel activators. Glyceryl trinitrate is of particular value when a rapid response is required. The following Table gives an indication of the wide range of anti-anginal products currently available.
sublingual tablets 300, 500, 600 mg spray 400 mg/dose spray 400 mg/dose 400 mg/dose
long-acting tablets, 6.4 mg long-acting tablets, I mg, 3 mg, 5 mg long-acting tablets, 2.6 mg, 6.4 mg
patches 5 mg
patches 5 mg, 10 mg, 15 mg
patches 2.5 mg, 5 mg, 10 mg, 15 mg patches 5 mg, 10 mg
ointment 2%
glyceryl trinitrate Coro-Nitro Spray* Glytrin Spray Nitrolingual Spray
Nitro-Continua Suscard
Sustac
Nitrocine injection Nitronal injection
Deponit
Minitran
Nitro-Dur Trasiderm-Nitro
Percutol
Note: Sprays (1 -2 doses) are given under the tongue; the mouth should then be closed.
sorbide Isordil tablets 5mg, 10 mg, 30 mg
idinitrate Sorbichew tablets 5 mg
Sorbitrate tablets 10 mg, 20 mg
long-acting products Cedocard-Retard 20 mg, 40 mg
Isoket Retard 20 mg, 40 mg
Isordif Tembids 40 mg
Sorbid-SA 20 mg, 40 mg
Isoket injection 500 mg
tablets 10, 20, 40 mg tablets 10, 20, 40 mg tablets 20mg
tablets 10, 20mg
tablets 10, 20, 40 mg
long-acting products
capsules 25 mg, 50 mg
capsules 60 mg tablets 40 mg capsules 50 mg tablets 40 mg capsules 40mg
Table 4 Drugs used in angina. Continued over.
isosorbide mononitrate
Elantan
Ismo
Isotrate
Monit Mono-Cedocard
Elantan LA lmdur
Ismo Retard MCR-50
Monit SR Monomax SR
pentaerythritol Mycardol tablets 30 mg tetranitrate
acebutolol Sectral capsules 100mg, 200mg tablets 400 mg
atenolol Tenormin tablets 25, 50, 100mg
bisoprolol Emcor, Monocr tablets 5 mg, 10 mg
metoprolol Betaloc, Lopresor tablets 50 mg, 100 mg
nadolol Corgard tablets 40 mg, 80 mg
oxprenolol Trasicor tablets 20 mg, 40 mg, 80 mg
Slow-Trasicor tablets 160 mg
pindolol Visken tablets 5 mg, 15 mg
propranolol Inderal tablets 10, 40, 80 mg
Inderal-LA tablets 160 mg
amlodipine Istin tablets 5mg, 10 mg
dittiazem Adizem tablets 60 mg
Tildiem tablets 60 mg (long-acting diltiazem products are:
Adizem-XL AAngil SR Calcicard CR, Diazem SR, Diazem XL, Slozem,
Tildiem LA, Tildiem Retard)
felodipine Plendil tablets 5 mg, 10 mg
Anicardipine Cardene tablets 20 mg, 30 mg
nifedipine Adalat capsules 5mg, 10 mg (long-acting nifedipine products are:
Adalat LA, Adalat Retard, Adipine MR, Angiopine MR, Cardilate MR,
Coracten, Hypolar Retard, Nifelease, Nifensar XL, Unipine XL)
(verapamil Cordilox tablets 40, 80, 120, 160 mg
Securon tablets 40 mg, 80 mg, 120 mg:potassium channel activator
nicorandil Ikorel tablets 10mg, 20mg