Aug
13
Estazolam - Estrogens - Eszopiclone - Exemestane - Exenatide
August 13, 2009 | Leave a Comment
Generic Name
Estazolam (es-TAZ-oe-lam) V
Type of Drug Benzodiazepine sedative.
Prescribed For
Insomnia and sleep disturbances.
General Information
Estazolam is a member of the group of drugs known as benzodiazepines. They work by a direct effect on the brain. Benzodiazepines make it easier to go to sleep and decrease the number of times you wake up during the night. Estazolam is considered an intermediate-acting sedative and generally remains in your body long enough to give you a good night’s sleep with minimal “hangover.”
Cautions and Warnings
Do not take estazolam if you are allergic or sensitive to any of its ingredients. Severe allergic reactions may occur. People with respiratory disease taking estazolam may experience sleep apnea (intermittent cessation of breathing during sleep). People who already have, or suspect they have, sleep apnea should not take estazolam.
People with kidney or liver disease should be carefully monitored while taking estazolam. Take the lowest possible dose to help you sleep.
Clinical depression may be increased by estazolam, which can depress the nervous system. Intentional overdose is more common among depressed people who take sleeping pills than among those who do not.
All benzodiazepines can be addictive if taken for long periods of time and can cause drug withdrawal symptoms if discontinued suddenly. It should be used With caution in people with a history 0 YATUg dependence. Withdrawal symptoms include tremors, Muscle cramps, insomnia, agitation, diarrhea, vomiting, sweating, and convulsions.
People with a history of seizures should not abruptly stop taking estazolam.
Possible Side Effects
♦ Common: drowsiness, headache, dizziness, talkativeness,
nervousness, apprehension, poor muscle coordination, light-
headedness, daytime tiredness, muscle weakness, slow-
ness of movement, hangover, and euphoria (feeling “high”).
♦ Less common: nausea, vomiting, rapid heartbeat, confusion, temporary memory loss, upset stomach, stomach cramps and pain, depression, blurred or double vision and other visual disturbances, constipation, changes in sense of taste, appetite changes, stuffy nose, nosebleeds, common cold symptoms, asthma, sore throat, cough, breathing difficulties, diarrhea, dry mouth, allergic reaction, fainting, abnormal heart rhythm, itching, acne, dry skin, sensitivity to bright light or to the sun, rash, nightmares or strange dreams, sleeplessness, tingling in the hands or feet, ringing or buzzing in the ears, ear or eye pain, menstrual cramps, frequent urination and other urinary difficulties, blood in the urine, discharge from the penis or vagina, lower back and joint pain, muscle spasms and pain, fever, swollen breasts, and weight changes.
✓ Rare: Rare side effects can affect your heart, stomach and intestines, urinary tract, blood, muscles, and joints. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• As with all benzodiazepines, the effects of estazolam are enhanced if it is taken with an alcoholic beverage, antihistamine, sedative, barbiturate, anticonvulsant medication, antidepressant, or monoamine oxidase inhibitor antidepressant.
• Carbamazepine and phenytoin may reduce blood levels and the effectiveness of estazolam by stimulating liver enzymes responsible for its breakdown.
• Ketoconazole, itraca(\ailzAe, netazodone, fluvoxamine, diltiamm,’isoniazid, some macrolide antibiotics, contraceptive drugs, cimetidine, and disulfiram may increase the effect of estazolam by interfering with the drug’s breakdown in the liver. Probenecid also increases estazolam’s effects by interfering with it passing through the kidneys into urine.
• Cigarette smoking, rifampin, and theophylline may reduce the effect of estazolam.
• Levodopa + carbidopa’s effectiveness may be decreased by estazolam.
• Estazolam may increase the amount of zidovudine (an HIV drug—also known as AZT), phenytoin, or digoxin in your bloodstream, increasing the chances of side effects.
• The combination of clozapine and benzodiazepines has led to respiratory collapse in a few people. Estazolam should be stopped at least 1 week before starting clozapine treatment.
Food Interactions
Estazolam may be taken with food if it upsets your stomach.
Usual Dose
Adult (age 18 and over): 1-2 mg at bedtime.
Senior: 1 mg at bedtime. Small or frail patients should start on 0.5 mg. Dosage should be increased cautiously.
Child (under age 18): not recommended.
Overdosage
The most common overdose symptoms are confusion, sleepiness, depression, loss of muscle coordination, and slurred speech. Coma and death may also occur. People who take an estazolam overdose must be made to vomit with ipecac syrup—available at any pharmacy—to remove any remaining drug from the stomach: Call your doctor or a poison control center before doing this. The victim must be taken to a hospital emergency room for treatment if 30 minutes have passed since the overdose was taken or if symptoms have begun to develop. ALWAYS bring the prescription bottle or container.
Special Information
Never take more estazolam than your doctor has prescribed. Avoid alcoholic beverages and other nervous system depressants while taking estazolam.
Exercise caution while performing tasks that require concentration and such as driving: estazolam may make you tired, dizzy, or lightheaded. People taking estazolam or any other sleeping medicine may experience unusual and complex reactions while asleep, such as driving, making phone calls, and cooking with no memory of the event.
If you take estazolam daily for 3 or more weeks, you may experience some withdrawal symptoms when you stop taking the
drug, especially temporary sleep disturbance. In rare cases, patients discontinuing estazolam have suffered seizures or delirium. Patients with a history of seizures should taper when stopping use
of this drug.
If you forget to take a dose of estazolam and remember within about 1 hour of your regular time, take it right away. If you do not remember until later, skip the dose you forgot and go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Estazolam absolutely should not be used by pregnant women or by women who may become pregnant.
Estazolam passes into breast milk. The drug should not be taken by nursing mothers.
Seniors: Seniors are more susceptible to the effects of estazolam. Type of Drug
Estrogens (ES-troe-jens)
Brand Names
Generic Ingredient: Conjugated Estrogens Premarin Premarin Cream
Generic Ingredient: Conjugated Estrogens (Synthetic) Cenestin Enjuvia
Generic Ingredients: Conjugated Estrogens + Medroxyprogesterone
Premphase Prempro
Generic Ingredient: Esterified Estrogens Menest
Generic Ingredients: Esterified Estrogens + Methyttestosterone Estratest
Generic Ingredient: Estradio(& Alora,
Climara Divigel Elestrin Estrace Estraderm
Estring Estrogel
Evamist Transdermal Spray Femring
Femtrace Gynodiol
Innofem Menostar Vagifem
Vivelle Vivelle-Dot
Generic ingredients: Estradiol + Drospirenone Angeliq
Generic Ingredients: Estradiol + Levonorgestrel Climara Pro Nuvaring
Generic Ingredients: Estradiol + Norgestimate 99 Pretest
Generic Ingredient: Estropipate
Ogen Cream Ortho-Est
Generic Ingredients: Ethinyl Estradiol + Norethindrone Activella Combipatch FemHRT 1/5
Prescribed For
Moderate to severe menopausal symptoms such as hot flashes, night sweats and sleep problems, vaginal dryness and irritation (creams and gels); also prescribed for ovarian failure, osteoporosis prevention, male breast cancer, advanced prostate cancer, abnormal bleeding of the uterus, female castration, Turner’s syndrome, and birth control.
General Information
Six estrogens have been identified in women but only 3 are present in large amounts: estradiol, estrone, and estriol. Estradiol is the most potent and most important. Other estrogens are produced by chemical conversions in the body. Estradiol, for example, is transformed into estrone, which in turn becomes estriol. Estrogens all have the same actions and side effects; only potency varies. More potent types require smaller dosages to produce the same effect.
Millions of women have taken hormone replacement therapy (HRT) to manage menopausal symp<oms, but studies show that HRT doeq WMpYove quality of life for most. Women who experience severe menopause symptoms must weigh the benefits of prolonged hormone replacement therapy against its risks.
Estrogens are largely responsible for the growth and maintenance of the female reproductive system and sex characteristics. They affect the release of hormones from the pituitary gland (con-troller of hormone production and regulator of basic bodily functions). These hormones control the functioning of capillaries (smallest blood vessels), may cause fluid retention, affect protein breakdown in the body, prevent ovulation and breast engorgement after childbirth, and influence the shaping and maintenance of the skeleton through an effect on calcium.
Estrogen products differ in their hormone content and dosage. Some may affect one part of the body more than another. Generally, though, estrogens are interchangeable as long as dosage differences are taken into account.
Cautions and Warnings
Do not take estrogens if you are allergic or sensitive to any of their ingredients.
Products containing an estrogen and a progestin should not be used for the prevention or treatment of bladder-control problems, heart disease, or mental decline (dementia).
Women with an intact uterus who choose hormone replacement therapy for menopausal symptoms should take the lowest effective dose for the shortest possible time to minimize the risks associated with these medicines. The results of a very large study called the Women’s Health Initiative (WHI) first published in 2002 and updated with new reports, have drastically changed the face of estrogen replacement therapy. The study found a small but insignificant increase in the risk of non-fatal heart attacks. There was no increase in heart disease in the estrogen plus progestin part of the WHI. Early results of the WHI found 4-6 more cases of invasive breast cancer for every 10,000 women in the study and tumors were harder to detect. But this result was not confirmed after more than 7 years of additional study. Estrogens may also lead to abnormal mammograms. An increased risk of a stroke was found in the WHI study. The risk of blood clots forming in the body was doubled in women taking hormone therapy. This study did show some benefits of long-term hormone replacement in colon cancer and osteoporosis, but these benefits may not outweigh the risks of hormone replacement therapy.
Women with liver damage or disease, blood-clotting problems, or abnormal vaginal bleeding whose cause is unknown, should not take estrogens.
Women who smoke cigarettes and take estrogen have a greater risk of cardiovascular side effects, including stroke and blood clotting.
Estrogens may increase the risk of endometriat cancer by 4.514 times in postmenopausal women taking them without progestin for prolonged periods of time; the risk depends on duration of treatment and dosage. Women who have a strong family history of breast cancer or who have breast nodules or cysts or an abnormal mammogram should be cautious about using estrogens. Women with estrogen-dependent cancer or breast cancer should not take estrogens, except some being treated for breast cancer that has spread. Women taking an estrogen for breast cancer that has spread to their bones can develop large increases in blood calcium.
Postmenopausal women taking estrogen are 2-3 times more likely to develop gallbladder disease.
Estrogens can raise blood pressure. Pressure usually returns to normal when the drug is stopped.
People with thrombophlebitis should avoid these drugs. The risk is greatest with very high dosages. Lower hormone dosages may not be a problem.
Estrogens should not be used to treat painful breast enlargement that sometimes develops after giving birth.
Estrogens can cause significant increases in blood triglycerides and cause pancreas inflammation in women with inherited blood-fat disorders.
Vaginal estrogen cream may stimulate bleeding of the uterus. It may also cause breast tenderness, vaginal discharge, and withdrawal bleeding if the product is suddenly stopped. Women with endometriosis may experience heavy vaginal bleeding.
Women taking hormone replacement therapy are at a 50% greater than normal risk of senile dementia.
Drospirenone, a progestin and an ingredient in Angeliq, can raise blood potassium levels in some people because it opposes the hormone aldosterone. It should not be used in people with conditions that can lead to high blood potassium such as kidney disease or a poorly functioning adrenal gland. Drospennone should be used with caution by women who we also taking other medicines that raise tl(QW potassium, such as nonsteroidal antiWkvmmMory drugs (NSAIDs), potassium-sparing diuretics, potassium supplements, angiotensin-converting enzyme (ACE) inhibitors, All receptor antagonists, and heparin. Your doctor may want to check your blood potassium level if you might be at risk of high blood potassium.
Possible Side Effects
v Most common: breast enlargement or tenderness, ankle and leg swelling, appetite loss, weight changes, water retention and bloating, nausea, vomiting, and abdominal cramps. The estrogen patch may cause rash, irritation, and redness where it is applied.
V Less common: bleeding gums, breakthrough vaginal bleeding, vaginal spotting or discharge, changes in menstrual flow, painful menstruation, premenstrual syndrome (PMS), absence of menstrual periods during and after estrogen use, uterine fibroid enlargement, vaginal Candida infection, a cystitis-like condition, mild diarrhea, yellowing of the skin or whites of the eyes, eye lesions, contact-lens intolerance, rash, hair loss, development of new hairy patches, migraine, mild dizziness, depression, increased sex drive (women), and decreased sex drive (men).
♦ Rare: stroke, blood-clot formation, dribbling or sudden passage of urine, loss of coordination, chest pain, leg pain, breathing difficulties, slurred speech, and changes in vision. Men who take large estrogen dosages for prostate cancer have a greater risk of heart attack, phlebitis, and blood clots in the lungs. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Phenytoin, ethotoin, mephenytoin, and topiramate may interfere with estrogen’s effects.
• Estrogens may reduce the effect of oral anticoagulant (blood-thinning) drugs. Your anticoagulant dosage may need an adjustment.
• Estrogens may increase the side effects of antidepressants and phenothiazine sedatives.
• Low estrogen dosages may increase 0\enolhiazine’s effectiveness.
% ‘ittrogens may increase cyclosporine and corticosteroid blood levels. Dosage adjustments of the non-estrogen drugs may be needed.
• Estrogens may reduce the effectiveness of thyroid replacement therapy.
• Rifampin, barbiturates, carbamazepine, St. John’s wort, and other drugs that stimulate the liver to break down drugs may reduce estrogen blood levels.
• Estrogens may interfere with tamoxifen and bromocripline.
• Women, especially those ova. 35, who smoke cigarettes and take estrogen have a much greater risk of developing stroke, hardening of the arteries, or blood clots in the lungs. The risk increases with age and tobacco use.
• Estrogens interfere with many diagnostic tests. Make sure your doctor knows you are taking estrogen before conducting any blood tests or other diagnostic procedures.
Food Interactions
Estrogens may be taken with food to reduce nausea and upset stomach. Avoid drinking grapefruit juice if you are taking this drug.
Usual Dose
Dosage varies. All of these products, including the transdermal skin patch, may be taken continuously or on a cyclic schedule of 3 weeks on, 1 week off.
Tablets
Chlorotrianisene: 12-200 mg.
Conjugated estrogens: 0.3-30 mg.
Conjugated estrogens, synthetic: 0.625-1.25 mg. Esterified estrogens: 0.3-30 mg.
Estradiol: 0.5-30 mg.
Estropipate: 0.625-7.5 mg.
Ethinyl estradiol: 0.02-3.0 mg.
Estradiol Transdermal Patch (0.025, 0.0375, 0.05, 0.075, or 0.1 mg) Alora, Estraderm, and Esclim: 1 patch twice a week: or use 1
patch twice a week for 3 weeks, stop for 1 week, then start again. Climara and Fempatch: 1 patch every week; or use 1 patch once
a week for 3 weeks, stop for 1 week, then start again.
Estradiol Transdermal Spray: 1-3 Sprays (1.53 mg estradiol in each spray
face of the forearm, starting near the elbow. Do not allow the sprays to overlap each other. Allow the spray to dry for about 2 minutes and do not wash the arm for 30 minutes. Do not apply the spray to any other part of the body.
3Wkw1 Onext to each other every morning on the inner sur-Estradiol Gel: Spread 1 pumpful of the gel as thinly as possible over the entire area on the inside and outside of your arm from wrist to
shoulder, once a day at the same time every day.
Vaginal Cream
Conjugated estrogens: 0.52 g a day for 3 weeks; stop for 1 week,
then start again.
Dienestrol: 1 applicatorful 12 times a day for 12 weeks, half the
original dosage for another 12 weeks, then 1 applicatoviO 13 times
a week.
Estradiol: 24 g a day for 2 weeks, half the starting dosage for an-
other 2 weeks, then 1 g 13 times a week.
Estropipate: 24 g a day for 3 weeks; stop for 1 week, then start again.
Estradiol Ring
Insert once every 3 months.
Overdosage
Symptoms may include nausea and vaginal bleeding in adult women. Call your local poison control center or a hospital emergency room for information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop breast pain or tenderness, swelling of the feet and lower legs, rapid weight gain, chest pain, breathing difficulties, pain in the groin or calves, unusual or persistent vaginal bleeding, missed menstrual period, lumps in the breast, sudden severe headache, dizziness or fainting, disturbances in speech or vision, weakness or numbness in the arms or legs, abdominal pain, sudden severe vomiting, depression, yellowing of the skin or whites of the eyes, or jerky or involuntary muscle movement.
Women taking estrogens or combined estrogen and progestin therapy should have yearly lamasN exams, perform monthly breast self -Paw i)26ions, and have regular mammograms.
Talk to your health care provider about ways to reduce risk factors for heart disease (blood-pressure control, improving your diet, stopping tobacco use) and osteoporosis (an appropriate diet, vitamin D and calcium supplements, weight-bearing exercise).
Tell your doctor if you are having surgery or require bedrest: your doctor may have you stop taking estrogen 4-6 weeks beforehand to prevent the risk of blood clots.
Your doctor should reevaluate your need for estrogen vaginal cream every 36 months. Do not stop using the drug suddenly because this may increase your risk of developing unpredicted or breakthrough vaginal bleeding.
Women using the cream who develop breast tenderness, start to bleed, or have other vaginal discharge should contact their doctors at once.
Estrogen skin patches should be applied to a clean, dry, non-oily, hairless area of intact skin, preferably on the abdomen. Do not apply it to your breasts or waist, or to any area where tightfitting clothes may loosen the patch from your skin. The application site should be rotated to prevent irritation, and each site should have a patch-free period for 7 days.
Good dental hygiene is important while taking estrogen because estrogen may increase your risk of oral infection. Dental work should be completed prior to starting estrogen, if possible.
Vaginal estrogen cream should be inserted high into the vagina, about 2/3 of the length of the applicator.
Press the vaginal ring into an oval and insert as deeply as possible in the upper 1/3 of the vagina.
Some of these products contain tartrazine (a commonly used orange dye and food coloring). If you are allergic to tartrazine or have asthma, check with your pharmacist to find out if your estrogen product contains this coloring agent.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Authorities note that the risk of serious complications for an individual woman taking hormone replacement therapy is very small. Thus, you may decide to take hormones but your decision should be based on a complete discussion of the facts and your individual situation with your doctor. Continue to talk with your doctor regularly about weighing tt% i1%’Ks against the benefits of taking estrQ(;e5\.
Special Populations
Pregnancy/Breast-feeding: Estrogens harm the fetus and should never be used during pregnancy for any reason.
Estrogens pass into breast milk and reduce its flow. Nursing mothers who must take them should use infant formula.
Seniors: The risk of side effects increases with age, especially if you smoke. Women age 65 or older taking estrogens may be more likely to develop a stroke, blood clot, or dementia, a condition where people suddenly or gradually lose normal mental function and intellectual capacity.
Generic Name
Eszopiclone (ess-oh-PIK-lone)
Brand Name Lunesta
Type of Drug Sedative.
Prescribed For Insomnia.
General Information
Eszopiclone is a nonbenzodiazepine sleeping pill that is believed to work in much the same way as the drug zolpidem and as benzodiazepine-type sleeping pills and sedatives. Unlike the benzodiazepines, however, eszopiclone has little muscle-relaxing or antiseizure effects. This drug is rapidly absorbed and usually starts working within a few minutes. Eszopiclone causes little or no “hangover,” and there are no rebound effects after stopping the drug. In studies of eszopiclone, tolerance to its effects did not develop even after 6 months of continued use. Eszopiclone is broken down in the liver, and the level of this drug in the body does not increase after you take it for several days.
Cautions and Warnings
Do not take eszopiclone if you are allergic or sensitive to any of its ingredients.
People With severe liver disease should use eszopiclone with caution and must take less of this medication than those with normal liver function or mild liver disease.
Sleeping problems often result from a physical or psychological illness. Eszopiclone does not affect the underlying causes of
insomnia. It should be taken only with your doctor’s knowledge. If you cannot sleep even after 7-10 days of taking eszopiclone, con-
tact your doctor.
Eszopiclone has caused amnesia (memory loss), but this happens mostly at dosages larger than 2 mg per night.
Suddenly stopping eszopiclone after having taken it for some time may produce drug withdrawal (symptoms include fatigue, nausea, flushing, lightheadedness, crying, vomiting, stomach cramps, panic, nervousness, and general discomfort).
People with a history of substance abuse may be more likely to develop drug dependence on eszopiclone. Eszopiclone doses of 612 mg are similar to 20 mg of diazepam in their potential for abuse.
Eszopiclone is a nervous system depressant and may cause loss of coordination and concentration. It should be taken just before bedtime. People taking sleep medicine may experience unusual and complex reactions while asleep, such as driving, making phone calls, or cooking with no memory of the event. Eszopiclone may also interfere with normal activities the next day, especially if taken with alcohol.
Eszopiclone should be avoided by people with severe depression, severe lung disease, and sleep apnea (intermittently stopping breathing when you are asleep). You should not take this drug if you are drunk.
Possible Side Effects
Adults
Some side effects are more likely with larger doses (viral infection, dry mouth, dizziness, hallucinations, infections, rash, and unpleasant taste).
♦ Most common: headache, drowsiness, unpleasant taste, and lung infections.
✓ Common: dry mouth, dizziness, and nausea.
✓ Less common: nervousness, vomiting, viral infections, anxiety, confusion, depression, hallucinations, reduced sex drive, rash, male breast e”k-aigement and/or pain, painful meR%k5UMlrjn, chest pain, migraines, and swelling of the arms or legs.
♦ Rare: 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
• Mixing eszopiclone with olanzapine can affect your coordination and ability to perform tasks.
• Mixing eszopiclone with ketoconazole more than doubles blood levels of eszopiclone. Other drugs that may have a similar interaction include itraconazole, clarithromycin, nefazodone, troleandomycin, ritonavir, and nelfinavir.
• Rifampin can be expected to drastically reduce the effectiveness of eszopiclone because it increases levels of liver enzymes that break down eszopiclone.
• Avoid combining eszopiclone with alcohol and other nervous system depressants, including sedatives, narcotics, barbiturates, antidepressants, and antihistamines.
Food Interactions
For the most rapid and complete effect, take eszopiclone on an empty stomach at least 2 hours after a meal. It will take longer for eszopiclone to work if you have had a high-fat meal immediately before taking it.
Usual Dose
, abnormal dreaming, nery
Adult (q% 1% and over): 2-3 mg immediately before bedtime or after you are in bed and have trouble falling asleep. Eszopiclone can act very quickly.
Child (up to age 17): not recommended.
Senior: 1-2 mg immediately before bedtime.
People with liver disease: 1 mg.
Possible Side Effects (continued) Seniors
Some side effects are more com the cluding dry mouth, pain, and unpleasant easant
♦ Most common: headache.
♦ Common: pain, dry mouth, diarrhea, rrhea, and upset
♦ Less common: accidental injury,
ousness, nerve pain, itching, and urinary• Rare: Rare side effects can occur in almost any part body. Contact your doctor if you
ou experience any side ef fect not listed above.
infection. of - , mon with larger doses in
Overdosage
Overdose can result in nervous system depression, from unconsciousness to light coma. Combining eszopiclone with alcohol or other nervous system depressants may be fatal or affect other body organs. One person took up to 36 mg of eszopiclone and fully recovered. Take the victim to a hospital emergency room at once. ALWAYS bring the prescription bottle or container.
Special Information
Eszopiclone may cause tiredness, drowsiness, and an inability to concentrate. Be careful when driving or performing any task that requires concentration on the day following a dose. Make sure you get 7-8 hours of sleep after taking eszopiclone.
People taking eszopiclone on a regular basis may develop a drug withdrawal reaction if the medication is stopped suddenly (see “Cautions and Warnings”).
Do not take a double dose of this medication.
Special Populations
Pregnancy/Breast-feeding: Some animal studies with doses of eszopiclone up to 800 times the human equivalent showed it did not affect a developing fetus, and other studies showed some modest effects. However, there is no information on the use of eszopiclone in pregnant women. If your doctor considers eszopiclone crucial for you, its potential benefits must be carefully weighed against its risks.
It is not known if eszopiclone passes into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors, who are likely to be more sensitive to eszopiclone and its side effects, should start on a 1 -mg dose and take the lowest effective dosage.
Generic Name
Etanercept (eh-TAN-er-sept)
Brand Name Enbrel
Type of Drug
Immune system modulator.
Prescribed For
Rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis.
General Information
Etanercept binds to a specific protein in the body known as tumor necrosis factor (TNF) and blocks it from interacting with cell surfaces. TNF is involved in normal inflammatory and immune responses and the inflammatory processes of rheumatoid arthritis, juvenile rheumatoid arthritis, and other conditions. Etanercept can also interfere with biological actions that are either caused or regulated by TNF.
Cautions and Warnings
Do not use etanercept if you are allergic or sensitive to any of its ingredients.
Serious infections and malignancies are possible in people using etanercept because of its ability to suppress the immune response. This may be more common in people with other conditions that predispose them to infections such as advanced or uncontrolled diabetes.
Levels of blood platelets and some white blood cells may be reduced in rare cases, leading to persistent fever, bruising, bleeding, and pale skin. Contact your doctor if any of these symptoms develop.
Etanercept may increase the risk of some nervous system disorders including multiple sclerosis.
Etanercept may cause or worsen congestive heart failure.
In rare cases people taking etanercept have developed a lupus-like syndrome which may disappear when the drug is discontinued.
People taking etanercept should not receive any live vaccines, because the body may not be able to respond as expected to the vaccine.
Possible Side Effects
RPndmt may develop at the site where etanercept is injected. Injection sites should be rotated among the thigh, abdomen, and upper arm to avoid excessive bruising or other skin damage.
Possible Side Effects (continued)
♦ Most common: infection, injection-site reactions, upper respiratory infection, headache, and runny nose.
♦ Common’. nausea, dizziness, sore throat. cough, weak-
ness, abdominal pain, rash, and respiratory problems.
♦ Less common: upset stomach, sinus irritation, vomiting.
swelling in the legs or feet, mouth sores, and hair loss.
✓ Rare: malignancy, stroke, seizure, tingling in the hands or feet, nervous system irritation similar to multiple sclerosis, eye inflammation, joint pain, generalized pain, appetite loss, blood vessel inflammation in the skin, dry eyes, lumps under the skin, fever, flu-like symptoms, weight gain, chest pain, flushing, diarrhea, taste changes, difficulty breathing, worsening of existing lung conditions, itching, and skin reactions. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Do not mix etanercept in the same syringe as another drug.
• Using etanercept with anakinra increases the risk of serious infections.
Food Interactions None known.
Usual Dose
Adult: rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis-50 mg a week. Plaque psoriasis: 50 mg twice a week, reducing to 50 mg a week after 3 months.
Child (age 4-17): 0.36 mg per lb. of body weight, up to 50 mg a week, 3-4 days apart.
Child (under age 4): not recommended.
Overdosage
In one study, ‘A patient accidentally self-administered 62 mg of etanercept twice a week for 3 weeks with no ill effects. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
Etanercept is taken by injection under the skin. Be sure you understand how to measure the proper dose of etanercept and how
to self-inject it.
To mix and inject etanercept: Withdraw all the water supplied with the medicine into a syringe and slowly inject it into the vial containing etanercept. Swirl the mixture gently to avoid excess foaming in the vial. Do not shake the vial.
Do not combine etanercept with any other injectable drug. Etanercept may be stored in a refrigerator for up to 14 days after it is mixed.
Single-use pre-filled syringes must be refrigerated. Do not use past the provided expiration date.
If you forget to administer a dose, do so as soon as you remember. Remember that etanercept doses must be administered at least 3 days apart. Call your doctor or pharmacist if you have any questions about how to time your etanercept doses.
Special Populations
PregnancylBreast-feeding. The safety of using etanercept during pregnancy is not known. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if this drug passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors are more likely to develop infections while using etanercept.
Generic Name
Exemestane (ex-eh-MES-tane)
Bnj(kod WaYne Aromasin
Type of Drug Aromatase inhibitor.
Prescribed For
Breast cancer. Also prescribed for prostate cancer prevention.
General Information Some breast cancers depend on the presence of the hormone estrogen to stimulate their growth. Depriving these cancers of estrogen is an effective way of treating the condition. Exemestane significantly reduces the amount of estrogen in the blood by binding permanently to an enzyme called aromatase, an essential element in the conversion of androgen (male hormones) to estrogen in premenopausal and postmenopausal women. Exemestane does not affect other hormones in the body. Exemestane is broken down in the liver.
Cautions and Warnings
Do not take exemestane if you are allergic or sensitive to any of its ingredients.
Exemestane may be prescribed for men and postmenopausal women only.
Possible Side Effects
✓ Most common: fatigue, hot flashes, pain, depression, sleeplessness, anxiety, nausea, and breathing difficulties.
✓ Common: flu-like symptoms, leg swelling, high blood pressure, dizziness, headache, vomiting, abdominal pain, leg swelling or other fluid retention, sweating, appetite loss, constipation, and coughing.
✓ Less common: increased appetite, diarrhea, fever, weakness, tingling in the hands or feet, broken bones, bronchitis, sinusitis, rash, itching, urinary infection, and swollen lymph glands.
♦ Rare: chest pain; confusion; reduced sensitivity to stimulation; upset stomach; joint, back, or other bone pain; respiratory infection; sore throat; runny nose; and hair loss. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Estrogen-containing drugs reduce the effectiveness of exemestane. Do not combine these drugs.
• Rifampin, phenytoin, carbamazepine, phenobarbital, and St. John’s wort may potentially reduce the effectiveness of
exemestane.
Food Interactions
Take this drug with a meal. The amount of exemestane absorbed into the blood is increased by 40% when taken with a high-fat meal.
Usual Dose
Adult: 25 mg once a day with or just after a meal. Dose adjustment is not needed in people with kidney or liver disease. Child: not recommended.
Overdosage
Doses as large as 600 mg have been well tolerated by women with advanced breast cancer. Overdose victims should be taken to a hospital emergency room for evaluation and treatment. ALWAYS bring the prescription bottle or container.
Special Information
If you forget a dose, skip the forgotten dose and continue with your regular schedule. Contact your doctor if you skip more than one dose.
Special Populations
Pregnancy/Breast-feeding: Exemestane is intended only for postmenopausal women. It can cause birth defects and miscarriage and should not be used by pregnant women or women who may become pregnant.
Exemestane may pass into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors may take this drug without special precaution.
Generic Name
Exenatide (ex-EN-ah-tide)
Brand Name Byetta
7Vpe of Drug Incretin mimetic.
Prescribed For Type 2 diabetes.
General Information
Exenatide is a unique drug that improves blood sugar control in people with type 2 diabetes who have been unsuccessful with diabetes pills. It is added to existing therapy and does not replace other treatments. Exenatide has many of the same actions as GLP-1, a natural incretin hormone. It differs chemically and works differently from other diabetes medications, including insulin.
Exenatide begins working about 30 minutes after injection and continues to work for at least 8 hours. It helps the pancreas to release insulin into the blood in response to sugar levels, so insulin rises when blood sugar is high and declines as blood sugar declines. It reduces the production of a hormone called glucagon, which raises blood sugar. Exenatide also keeps food in the stomach longer, which in turn helps reduce the amount of sugar absorbed from dietary sources. Exenatide increases the number of beta cells (that produce insulin) in animals and may have the same effect in humans. This could help reduce the need for other medicines and improve diabetes control.
Cautions and Warnings
Do not take exenatide if you are allergic or sensitive to any of its ingredients.
This drug is not a substitute for insulin. Exenatide has only been studied together with metformin, glitazones, and/or sulfonylureas. It has not been studied with other diabetes pills or insulin.
People with severe kidney disease should not use exenatide.
People with severe stomach or intestinal disease should not use exenatide.
Inflammation of the pancreas can occur with this drug. Symptoms include nausea, vomiting, fever, rapid pulse, and painful and swollen abdomen that may develop slowly and worsen when you eat or may be severe and constant.
Low blood sugar may ziccurit you are taking exenatide with a S\00ny)urea-type antidiabetes drug or with a glitazone.
Antibodies to exenatide may develop, but antibody levels generally go down with time. Most patients who develop antibodies still have good sugar control and similar types of side effects as people who do not develop exenatide antibodies.
Possible Side Effects
♦ Most common: nausea, vomiting, diarrhea, and low blood sugar (when mixed with a sulfonylurea-type drug or metformin plus a sulfonylurea).
♦ Less common: low blood sugar (when mixed with a glitazone), feeling jittery, dizziness, headache, and upset stomach.
✓ Rare: rash, abdominal swelling and pain, constipation, and kidney failure. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Exenatide has been studied with a number of other medications commonly taken by people with diabetes (digoxin, lovastatin, lisinopril, and acetaminophen) and no significant interactions were noted.
• Combining exenatide with a sulfonylurea-type drug may lead to hypoglycemia (low blood sugar). Your doctor may change your sulfonylurea dose to solve this problem.
• Take all oral medicines at least 1 hour before you inject exenatide to ensure maximum absorption. If you must take oral drugs with food or meals, take them with a snack or meal when exenatide is not being injected. Exenatide extends the time that drugs remain in the stomach and may reduce the amount of medication absorbed when taken by mouth.
• Exenatide may reduce the effectiveness of oral contraceptive pills. Take them at least 1 hour before an injection of exenatide.
• Exenatide may increase the amount of warfarin in the body and increase the risk of bleeding.
Food Interactions
None known. Usual Dose
Adult: 5 or 10 mcg twice a day by subcutaneous injection %M)iT) an hour before breakfast and dk”"tj.
CAWVEOnafide has not been studied in children. Overdosage
The effects of an exenatide overdose are severe nausea, severe vomiting, and severe, rapid drops in blood sugar levels. An oral sugar source may help, but overdose victims should be taken to a hospital emergency room for evaluation and treatment. ALWAYS bring the exenatide pen with you.
Special Information
Each dose of exenatide must be given as an injection under the skin of the thigh, abdomen, or upper arm within 1 hour before your breakfast and dinner meals. For information on how to properly administer this drug, see page 1242.
If you forget a dose of exenatide, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Exenatide injection is clear and colorless. Do not use if it has any color, is cloudy, or if there are any particles floating in it.
Keep this drug in the refrigerator, and do not use it after the expiration date has passed.
This drug may lead to a loss of appetite and loss of body weight. Do not change your regular dosage if this happens to you.
Special Populations
PregnancylBreast-feeding. In animal studies using doses equal to 3 times the usual human dose, exenatide was shown to affect the growth of the fetus. If you are or might be pregnant and your doctor considers this drug crucial, its potential benefits must be weighed against its risks.
Small amounts of exenatide may pass into breast milk and may affect a nursing infant. Nursing mothers taking this drug should use infant formula.
Seniors: Seniors may take this drug without special restriction. Generic Name
Aug
1
Cilostazol
August 1, 2009 | Leave a Comment
Generic Name
Cilostazol (sil-oe-STAY-zol) Lq
Brand Name Pletal
Type of Drug Antiplatelet.
Prescribed For Intermittent claudication.
General Information
In intermittent claudication, leg muscles go into spasm due to reduced blood flow. This occurs when plaque buildup narrows blood vessels leading to the calf or other leg muscles. People with this condition often develop leg pain after walking only a short distance. Cilostazol prevents blood platelets from “clumping together” to begin the process of forming a blood clot, which can further obstruct arteries and worsen intermittent claudication. This drug is broken down in the liver.
Cautions and Warnings
Do not take this drug if you are allergic or sensitive to any of its ingredients.
?P,Ople with congestive heart failure (CHF) should not take cilostazol. Some studies indicate that long-term use of this drug may cause cardiovascular problems.
People with hemostatic disorders or active pathologic bleeding should not take cilostazil.
Drug Interactions
• Avoid mixing cilostazol with ketoconazole, itraconazole, fluconazole, miconazole, fluvoxamine, fluoxetine, nefazodone, or sertraline because this interaction may slow the breakdown of cilostazol, prolonging its effects. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
• Aspirin can increase the anticoagulant (blood-thinning) effect of cilostazol, but this combination has not caused serious bleeding problems. There is no information on the effect of combining cilostazol and other antiplatelet or anticoagulant drugs. Cilostazol dosage is reduced by 50% when it is combined with any of these drugs.
• Diltiazem increases cilostazol blood levels by about 50%. Cilostazol dosage is reduced by 50% when it is combined with diltiazem.
• Erythromycin and similar antibiotics increase cilostazol blood levels. Take half the regular dose of cilostazol when combining it with any of these drugs.
• Combining cilostazol and omeprazole increases the effects of cilostazol. Cilostazol dosage is reduced by 50% when it is combined with omeprazole.
• Smoking reduces the Olectiveness of cilostazol by causing the liver to break it down faster.
Food Interactions
Take this drug on an empty stomach at least 30 minutes before or 2 hours after meals. Do not drink grapefruit juice at any time while
above. with dosage.
dache, infection, abdominal pain, ab- arrhea.
pitations, rapid heartbeat. dizziness, sea, sore throat, runny nose, back pain, arms or legs.
cough, fainting, and muscle aches. cts can occur in almost any part of the doctor if you experience any side ef- e.
Possible Side Effects
The risk of side effects
♦ Most common: headache
• stool, and diarrhea. • Common: heart palpitations
• stomach, nausea
• swelling in the
♦ Less common: gas,
♦ Rare: Rare side effects body. Contact your fect not listed taking cilostazol because it can interfere with the breakdown of the drug.
Usual Dose
Adult: 100 mg twice a day. 50 mg twice a day when combined with other drugs that may increase the effect of cilostazol. Child: not recommended.
Overdosage
Symptoms of overdose are likely to be the most common side effects. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Several weeks of cilostazol treatment may be necessary before you notice any improvement in symptoms. Maximum benefit usually occurs after 12 weeks.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Animal studies suggest that cilostazol may harm the fetus, but there is no information on the effect of cilostazol in pregnant women. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
cilostazol may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors can take this drug without special precaution.
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.
Aug
1
Cetirizine
August 1, 2009 | Leave a Comment
Generic Name
Cetirizine (seh-TERE-ih-zene)
Brand Name Zyrtec
The information in this profile also applies to the following drugs:
Generic Ingredient: Azelastine
Generic Ingredient: Fexofenadine 91 Allegra
Generic Ingredient: Levocetirizine 91 Xyzal
Type of Drug Antihistamine.
Prescribed For
Azelastine: runny nose, sneezing, nasal itching, and post-nasal drip. Cetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching and for asthma. Fexofenadine: sneezing, stuffy and runny nose; scratchy throat and mouth; and itchy, watery, and red eyes caused by seasonal allergies. Levocetirizine: stuffy and runny nose, itchy eyes, and scratchy throat caused by seasonal and year-round allergy, and for other symptoms of allergy such as rash, itching, and hives; also prescribed for chronic itching.
General Information
Antihistamines generally work by blocking the release of histamine (a chemical released by body tissue during an allergic reaction) from the cell at the H, histamine receptor site, drying up secretions of the nose, throat, and eyes. Cetirizine causes less sedation than older antihistamines and appears to be just as effective. Levocetirizine is the active portion of the cetirizine molecule and is as effective as cetirizine with a similar side effect profile.
Cautions and Warnings
Do not take cetirizine if you are allergic or sensitive to any of its ingredients.
People with kidney disease should receive reduced dosages of cetirizine and levocetirizine. Do not take these drugs if kidney disease is severe. Children with kidney disease should not receive levocetirizine.
Possible Side Effects
✓ Common: headache, drowsiness, fatigue, dry mouth, bitter taste in the mouth, dizziness, runny nose, and sore throat.
✓ Less common: nosebleeds, stuffy nose, sneezing, cough, nausea, upset stomach, changes in bowel habits, nervousness, and fever (children).
♦ Rare: fainting and weight gain. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Cimetidine may increase the level of azelastine in the blood.
• Cetirizine is less likely than other antihistamines to interact with drugs.
• Ritonavir increases the amount of levocetirizine and slows its breakdown in the body. This may result in increased levocetirizine side effects.
Food Interactions
• Ceterizine and levocetirizine may be taken without regard to food or meals.
Usual Dose
Azelastine Nasal Spray
Adult and Child (age 12 and over): 1-2 sprays in each nostril twice a day.
Child (age 5-11): 1 spray in each nostril twice a day.
Cetirizine
Adult and Child (age 6 and over): 5-10 mg once a day depending on symptoms. Reduce dosage in people with kidney disease. Child (age 1-5): 2.5-5 mg a day.
Child (age 6 months-1 year): 2.5 mg a day.
Fexofenadine
Adult (age 12 and over): 60 mg twice a day or 180 mg once a day. People with kidney disease should take 60 mg a day.
Child (age 6-11): 30 mg twice a day.
Levocetirizine
Adult and Child (age 12 and over): 5 mg every evening.
Child (age 6-11): 2.5 mg (1h tablet) every evening. Dosage for children should not exceed 2.5 mg a day. Child (under age 6): not recommended.
Overdosage
Drug overdose is likely to cause severe side effects. Overdose victims should be Oven ipecac syrup—available at any pharmacy—to make them vomit and be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Use extra caution while doing anything that requires concentration, such as driving a car or operating hazardous machinery.
Report sore throat, unusual bleeding, bruising, tiredness, weakness, or any other unusual side effect to your doctor. Do not combine these drugs with alcohol or other nervous system depressants. Do not put azelastine nasal solution into your eyes.
If you forget to take a dose of cetirizine, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Oral antihistamines are generally considered safe for use during pregnancy. But do not take any antihistamine without your doctor’s knowledge if you are or might become pregnant—especially during the last 3 months of pregnancy, because newborns may have severe reactions to antihistamines.
Small amounts of antihistamine pass into breast milk. Nursing mothers who must take cetirizine should use infant formula.
Seniors: Antihistamines are more likely to cause dizziness, sleepiness, and confusion in seniors. Dosage reduction may be recommended depending on kidney function.
Jul
16
Aggrenox
July 16, 2009 | Leave a Comment
Brand Name
Aggrenox
Generic Ingredients
Dipyridamole + Aspirin
Type of Drug Antiplatelet.
Prescribed For
Prevention of recurrent stroke or transient ischemic attack (TIA)— “mini-stroke.”
General Information
Stroke is often the result of a clot blocking flow in a blood vessel supplying the brain. Aggrenox helps prevent blood clot formation by reducing the “stickiness” of platelets, blood cells that stick together to form the beginnings of all clots. In one study, Aggrenox reduced the risk of stroke by over 30% compared to placebo in people who had recently had a stroke or TIA.
Cautions and Warnings
Do not use this drug if you are allergic or sensitive to any of its ingredients or any nonsteroidal anti-inflammatory drug (NSAID). People who have asthma, nasal polyps, or chronic runny nose, are likely to be sensitive to aspirin.
The aspirin in Aggrenox can cause Reye’s syndrome, a severe reaction (vomiting, lethargy, and belligerence, and possibly worsening to coma) in children under age 16.
People with a history of stomach ulcers or stomach problems should avoid Aggrenox.
People who have angina or have had a recent heart attack should be very cautious about taking this drug. It may worsen chest pain.
People with low blood pressure, liver disease, or kidney failure should be cautious about taking this drug.
People taking Aggrenox may bleed for longer amounts of time. Those with bleeding disorders should avoid Aggrenox.
Possible Side Effects
✓ Most common: headache, upset stomach, abdominal pain, nausea, and diarrhea.
✓ Common: pain, tiredness, and vomiting.
✓ Less common: convulsions, rectal bleeding, blood in the stool, hemorrhoids, back pain, accidental injuries, stomach bleeding, feeling unwell, weakness, fainting, memory loss, arthritis, joint or muscle pain, coughing, and respiratory infection.
✓ Rare: 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
• Avoid alcohol. People who take 3 or more drinks a day while using any aspirin-containing product are more likely to develop stomach ulcers or bleeding.
• Aspirin may reduce the blood-pressure-lowering effects of angiotensin-converting enzyme (ACE) inhibitor drugs, beta blockers, and diuretics.
• Combining aspirin and acetazolamide or an NSAID can cause kidney problems.
• Aspirin can increase the blood-thinning effects of anticoagulant (blood-thinning) drugs such as warfarin. Avoid this combination.
• Aspirin can increase the effects of oral antidiabetes drugs, possibly leading to low blood sugar.
• Aspirin counteracts the uric-acid-eliminating effects of probenecid and sulfinpyrazone.
• Aspirin can increase the toxic effects of anticonvulsant drugs and methotrexate.
• Dipyridamole increases the level of adenosine in the blood and may increase cardiovascular-related side effects. The adenosine dosage may need to be adjusted when these two drugs are combined.
• Dipyridamole may interfere with cholinesterase inhibitors used to treat myasthenia gravis.
Food Interactions
Aggrenox is best taken on an empty stomach but may be taken with food if it upsets your stomach.
Usual Dose
Adult: 1 capsule (200 mg of sustained-release dipyridamole and 25 mg of aspirin) morning and evening.
Child: not recommended.
Overdosage
Symptoms include a sensation of warmth, flushing, sweating, restlessness, weakness, dizziness, low blood pressure, and rapid heartbeat. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you experience blood in your stool, persistent diarrhea, or abdominal or stomach pain.
Avoid alcohol while taking this drug.
In people taking Aggrenox, minor cuts may take longer than normal to stop bleeding.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule.
Swallow Aggrenox tablets whole; do not crush or chew them.
Special Populations
Pregnancy/Breast-feeding: Pregnant women should avoid Aggrenox because of its aspirin content. Aspirin can cause bleeding problems in mother and fetus and result in a low-birth-weight infant. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Both ingredients in Aggrenox pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may need a reduced dose of Aggrenox.
Jul
16
Acitretin
July 16, 2009 | Leave a Comment
Generic Name
Acitretin (ah-sih-TREH-tin)
Brand Name
Soriatane
Type of Drug Antipsoriatic.
Prescribed For
Severe psoriasis; also prescribed for a variety of other skin conditions.
General Information
Acitretin is related to vitamin A and prescription drugs such as etretinate and isotretinoin. Acitretin is produced when etretinate is broken down in the body and its effects are very similar to etretinate. The way that acitretin works is not known. Its full benefit is not likely to be seen until you have taken it for 2 or 3 months. Your doctor is urged to use this medication only in cases of severe psoriasis that have not responded to other treatments because of the risks associated with acitretin.
Cautions and Warnings
Do not take acitretin if you are allergic or sensitive to any of its ingredients. Women who take acitretin must not be pregnant during treatment or for 3 years after the completion of treatment. It is not known if acitretin taken by men before conception is also a risk to the fetus.
A small number of people taking this drug have developed liver damage including jaundice (symptoms include yellowing of the skin and whites of the eyes). Acitretin has also been associated with hepatitis. People with kidney failure have much less acitretin in their blood than people with normal kidneys. Caution is advised for people with liver or kidney damage.
Cholesterol levels rise in 25-560/6 of people taking acitretin. Very large increases in triglycerides may be responsible for the few cases of pancreatitis (pancreas inflammation) that have been reported. Your doctor should measure your blood fat levels before you start taking acitretin and monitor them weekly or biweekly until your response to the medication has been determined. People with diabetes, who are obese, or who have a history of these conditions are at increased risk for high cholesterol levels as are people who drink alcohol excessively.
Drugs similar to acitretin have been associated with pseudo-tumor cerebri (increased pressure in the brain). Symptoms of pseudotumor cerebri include visual disturbances, headache, nausea, and vomiting. Report these or any unusual symptoms to your doctor at once.
People taking acitretin who had spine or bone—including knee or ankle—problems before starting the drug may find that their problems worsen while on the drug.
People with diabetes may find it more difficult to control their blood sugar while on acitretin.
Possible Side Effects
✓ Most common: hair loss or change in texture, peeling skin, and inflammation of the lips.
✓ Common: dry eyes, chills or stiffness, dry skin, fingernail problems, itching, rash, tingling in the hands or feet, increased sensory awareness, loss of some sections of skin, sticky skin, and runny nose.
✓ Less common: drying and thickening of eye tissue; eye irritation; eyebrow or eye lash loss; changes in appetite; swelling; fatigue; hot flashes; flushing; sinus irritation; headache; pain; earache; insomnia; depression; Bell’s palsy; crusting of the eyelids; blurred vision; conjunctivitis (pinkeye); double vision; itchy eyes or eyelids; cataracts; swelling inside the eye; unusual sensitivity to bright light; dry mouth; nausea; stomach pain; diarrhea; bleeding gums; joint; back; and muscle pain; and worsening of existing spinal problems.
✓ Rare: 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
• People combining acitretin and glyburide (an antidiabetic) may have unusually low blood-sugar levels. Your doctor may have to adjust your diabetic treatment program while you are taking acitretin.
• Combining acitretin with methotrexate increases the risk of liver damage.
• Acitretin reduces the effectiveness of low-progestin oral contraceptives (the “mini-pill”). If you are taking one of these contraceptives, switch to another type of birth control and use at least one other contraceptive method for at least 3 years after treatment is completed.
• Combining alcohol with acitretin produces acitretin’s parent compound, etretinate. Etretinate stays in the body much longer than acitretin and may therefore affect the fetus for an even longer period of time than might acitretin. Avoid alcoholic beverages.
• Do not take a vitamin A supplement that has more than the standard minimum daily requirement (1000 mcg). Excess vitamin A plus acitretin exposes you to possible vitamin A toxicity.
• Combining acitretin with tetracyclines may increase the risk of severe pressure on the brain.
• Notify your doctor if you are taking etretinate, isotretinoin, oral or topical tretinoin, or cyclosporine.
Food Interactions
Acitretin is best absorbed when taken with food or meals. Usual Dose
Adult: 25-50 mg a day with your main meal. Dosage may increase after 4 weeks to 25-75 mg a day. Dosage must be individualized to your specific needs.
Child: not recommended.
Overdosage
Symptoms of acitretin overdose include vomiting, headache, and vertigo. Call your local hospital emergency room or local poison control center for more information. ALWAYS bring the prescription bottle or container.
Special Information
Contact your doctor at once if you become pregnant while taking acitretin or in the 3 years following treatment. The risk of birth defects persists as long as the drug is in your body. In one case,
small amounts of etretinate were found in blood plasma and fatty tissue more than 5 years after treatment.
Some people have experienced decreased night vision while taking acitretin. Be careful when driving at night.
Report visual disturbances, headache, nausea, vomiting, or anything unusual to your doctor at once.
Do not drink any alcoholic beverages during acitretin treatment and for at least 2 months after treatment has been completed. Avoid excess vitamin A (see “Drug Interactions”).
Some birth control methods, including low-dose progestin contraceptives and tuba) ligation may fail while taking this drug. Use at least one additional form of contraception while taking acitretin to avoid pregnancy.
You may have problems tolerating contact lenses while you are taking acitretin.
Do not donate blood while taking acitretin or for 3 years afterwards because your blood might be given to a pregnant woman.
Avoid exposure to excessive sunlight or to sunlamps because of unusual sensitivity caused by acitretin.
If you forget to take a dose of acitretin, take it with food as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
A worsening of psoriasis may initially occur with treatment, and the full benefit of acitretin may not be seen for 2-3 months.
Special Populations
Pregnancy/Breast-feeding: Acitretin causes birth detects and may damage the fetus. Women who take acitretin must be sure they are not pregnant before starting therapy by using reliable contraception for at least 1 month before starting the drug and taking a pregnancy test within 1 week of starting treatment. Women must use 2 reliable contraceptive methods during treatment and for 3 years following the completion of treatment.
Acitretin may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors have twice as much acitretin in their blood as do younger adults but may take acitretin without special precaution.
Jul
15
Prostatectomy.
July 15, 2009 | Leave a Comment
Prostatectomy is an operation to remove part or all of the prostate gland on cocaine dj caffeine . It always necessitates a stay in hospital lithium titanite .
Surgery is still the treatment of first choice in the great majority of cases of an enlarged prostate cipro side effects precautions . It is, in fact, a
very common operation, with some 40,000 operations being performed each year in Britain minipress generic . In the US, an astonishing
400,000 operations are performed each year allegra d effects . Prostatectomy is, in fact, the fourth most common operation performed on men
in the US, with the competition for top place coming from cataract removal, hernia repair, and gall-bladder operations celexa medicene .
Estimated total cost spent on prostate removal in the US is over 1,500 million dollars using paxil xr for sleep disorders .
Prostatectomy is usually performed for one of two reasons cheap tramadol cod 89.00 . These are:
• When the gland is so enlarged that it obstructs the flow of Urine sony lithium cell battery .
• When prostate cancer had been diagnosed and surgery is considered to be the best option diflucan and lamictal .
Success rates
The chances of success of a prostatectomy, in terms of the removal of obstruction and the resulting relief of symptoms,
are very high indeed premarin affect fsh results . Looked at from the point of view of doctors, with reference to the removal of the urethral
obstruction, the success rate is an amazing 90 per cent seroquel crushing the tablets . And looked at from the point of view of patients, with reference
to the relief of their symptoms, the success rate is 80 per cent darkside caffeine .
Getting the timing right
It is important, if you are having a prostatectomy, to get the timing right online parm viagra . Have it too early, when your symptoms are
still mild, and you have a lower than average chance of relieving symptoms and a higher than average chance of having to
have a repeat operation later doxazosin medline . A repeat operation is particularly likely if you have your first operation before you are
60, as did Ronald Reagan glucophage xr tab 500mg . If, on the other hand, you have it too late, your prostate problem may by then be so severe
that it will have affected your general health so much that doctors consider it too risky for you to have the operation
at all, or your bladder may never be able to recover its former strength disorganized speech prednisone .
It is often not possible for doctors to predict how quickly, or how slowly, a man’s condition is likely to deteriorate tramadol com . A
man with moderate symptoms may not get any worse for many years, while another man with slight symptoms may suddenly find
he needs emergency treatment mestinon dosing .
Equally, it is often impossible for a doctor to predict what effect an operation will have lipton tea caffeine . It will probably bring
dramatic and substantial improvement, but it may not zoloft wikipedia .
APPROACHING THE PROSTATE GLAND
The prostate gland is situated in a very inaccessible part of the body diclofenac poisioning in vultures . This means that an operation to remove it can be
difficult 500 mg dose of ciprofloxacin .
The other possible problem is that, because it is close to the opening of the bladder, there is a danger of damaging the
delicate muscles that prevent urine from leaking between acts of urination topiramate for pain .
There arc two ways of approaching the prostate gland off label indications celexa . It can be approached:
• Via the bladder, in an operation known as transurethral prostatectomy (TURP) medication endep .
• Via the abdomen, in an operation known as open prostatectomy argentine toprol .
The end result of the two operations are basically similar, but an open prostatectomy is a more major operation than a
TURP, so you can expect to feel worse for a longer period of time than after a TURP alesse no prescription .
TRANSURETHRAL PROSTATECTOMY (TURP)
This is the removal of the prostate gland by way of the urethra, without making any incision through the skin are there generic drug for asacol . TURP is by
far the more common method of surgery chemical properties for asprin . It is used in as many as 90 per cent of patients undergoing a prostatectomy checking clomid .
The advantage of TURP is that the patient has no surgical incision muscle cramps levothyroxine . This means that there is no need for general
anaesthetic, it is a much less invasive and safer procedure, and the patient suffers less discomfort or pain after the
operation isotretinoin embryopathy close set eyes . TURP is a far less traumatic procedure altogether for the body, and patients therefore make a much quicker
recovery antidepressants celexa . It necessitates a hospital stay for about four or five days scared fucked around with clozapine .
How it is done
The man’s legs are placed in padded stirrups, rather like what sometimes happens when a woman is having a baby, and the
genitalia are washed with detergent and water lexapro and paroxetine . A fine, telescope-like type of cystoscope, or bladder viewing tube, known
as a resectoscope, is then passed up the penis into the bladder atorvastatin pm . This instrument, which has a fibre-optic light and a
lens system, enables the surgeon to look at the urethra and at the obstructing part of the prostate signs that you have low testosterone . It also has a
special cautery (searing) device with a heated wire loop on the end, which is attached to an electric current side effects of low testosterone . Each time
the wire loop moves through the tissue, little pieces of tissue in the prostate gland are chipped away, in much the same
way as an apple is cored drug lotrel .
The new growth in the prostate occurs in the centre, so the operation removes this tissue, working back outwards to the
original prostate tissue, in much the same way as you insert a knife into the core of an apple and remove the flesh from
the inside back towards the skin until all the core has been removed information on enalapril prescription medication . The TURP procedure takes about an hour severe headache when taking bactrim .
The pieces of prostatic tissue are washed out through the resectoscope, and bleeding vessels are cauterised by an
electrode, which is passed up the tube tadalafil cheep . The resectoscope is then removed, and a catheter is passed up the urethra into
the bladder, in order to drain urine and allow blood to be removed gabapentin street abuse . This is left in place for several days does cymbalta have maoi .
It may take some time for symptoms to settle down after a TURP, though they usually do settle down, sometimes with the
aid of medication taking flomax . In a few cases - around 15 per cent - the prostate gland continues to enlarge after surgery, and
symptoms eventually recur so that another TURP is needed only a few years - usually around eight years - later levitra blood pressure .
This happened to Ronald Reagan, who had a second prostate operation during his first term as President caverta mail order . You may remember
seeing him on the television as he went into Washington’s Bethesda Naval Hospital accompanied by his wife Nancy, with the
words, “We’ve been here before!” topamax and irregular vaginal bleeding .
Modern equipment
It wasn’t until sometime between the two World Wars that prostate surgery through the urethra became a practical
procedure buy cheap accutane online . Even then, before the invention of the fibre-optic light source and the lens system used for this operation,
transurethral prostatic surgery used to be considered one of the most difficult operations for the surgeon to learn matria terbutaline pump .
Modern equipment has succeeded in revolutionising the operation, which is now relatively simply, quick and
straightforward buspar effectiveness .
Testing for cancer
In this way, the surgeon is able to collect some of the tissue for investigation under a microscope that will (in most
cases) rule out prostate cancer lithium battery tool combos . You will be told a day or two after the operation what the result is lithium futures . Unsuspected cancer
is found in about 5 per cent of patients undergoing a TURP esophagus fluoxetine hydrochloride .
Even if cancer cells are discovered, this is not necessarily a cause for any great alarm zyprexa induced parkinsonism . The presence of cancer cells in
the prostate gland is quite common in older men, and your surgeon should give you some idea of the extent of the cancer
found augmentin infant allergic reaction . You may be given some radiation or chemotherapy straight away, or you may be referred for further scanning or
other tests to establish whether the cancer has spread beyond the prostate viagra online href forum topic id . If your urologist did not detect the presence
of cancer during a rectal examination, this is unlikely declining estradiol levels .
OPEN PROSTATECTOMY
This operation is performed on only 10 per cent of men undergoing a prostatectomy how to ibuprofen . It is usually reserved for the removal
of a particularly large prostate gland prozac let-down nursing . It is also done where an operation on the bladder - say, the removal of bladder
stones, for example - has to be done at the same time prednisone dosage acute asthma .
An open prostatectomy is performed under general anaesthetic flomax urination . It usually means staying in hospital for seven to ten days cheap est xenical online .
How it is done
The operation entails making a cut across the lower abdomen, to expose the bladder and prostate viagra buy online . The prostate gland is
then approached via the space between the back of the pubic bone and the bladder sildenafil and overdose and blind .
The first open prostate operations were performed towards the end of the nineteenth century, both in England and in the
US herpes blood tests and valtrex . These early operations carried a high mortality rate and were therefore not performed very often, nor in many
hospitals does coumadin reduce folate . At the turn of the twentieth century, there were still only two common treatments for severe prostate
enlargement - catheterisation and, still more puzzlingly, vasectomy, which seems to have been a misguided procedure for
this condition increased irritability with toprol .
The first really successful open operations, which were not only effective but also safe - were performed by Sir Peter
Freyer of St Peter’s Hospital in Covent Garden welbutrin and zyprexa together . This was hailed as the moment when ‘a dangerous surgical adventure became
a routine operation’ sertraline sertraline . Open prostate operations became common in the years between the two World Wars, but there was still
a relatively high mortality rate of between 5 and 15 per cent casodex work .
The surgeon cuts open the capsule containing the prostate gland, which is then ’shelled out’ from the inside on-line doctors viagra . Bleeding
vessels are cauterised, and a catheter is passed up the urethra to drain urine from the bladder preparation benzene to amoxicillin . A tube is also inserted
beside the empty capsule to drain fluid and to prevent blood clots forming celexa 40mg oral . The abdomen is then sewn up and both catheter
and tube are usually left in place for approximately five to seven days after the operation, and are then removed as long
as there is no residual bleeding effexor la .
AFTER-EFFECTS
Bleeding may be so severe after the operation that blood transfusions are required buy prednisolone online . Any blood clots that form within the
bladder as a result of the operation can usually be washed out through the catheter, which is why it is left in place for
several days afterwards will viagra treat premature ejaculation .
When the catheter is removed, patients often notice that their urination has been affected cymbalta thyroid medicine . It is usually more frequent
than normal, and may also be painful does neurontin help with sciatica pain . Some patients even suffer from a mild form of incontinence for anything up to a few
weeks afterwards zofran liver gallbladder . It is important for patients to drink large amounts of fluid in order to help wash out any remaining
blood in the urine klonopin zoloft buspar .
Most patients resume all their normal activities after several weeks following the operation canadian mailorder viagra . They are likely to recover
more slowly after an open prostatectomy than they are after a TURP take nexium at night .
Serious complications
Most men have a straightforward recovery after a prostatectomy (see Chapter 7) avandia kansas . A few men, however - about one in five
men - may suffer from serious complications after an open prostatectomy of the kind that can happen after any operation wellbutrin and juices .
These include infection, or embolism in the lung singulair no presecription . A few others may develop minor problems such as urinary infections, or
more serious ones such as a stricture, or a narrowing of the urethra, which is usually caused by scarring ivermectin for demodex mites . This may cause
worse obstructive symptoms than those caused by the original prostate problem and will necessitate further surgery in
order to put it right side effects lexapro withdrawal .
The most serious complication is death lamictal 3 month supply . This is rare after prostatectomy, though general anaesthesia and surgery always
carry some degree of risk metformin hcl causing insomnia . You should be aware of this before deciding on surgery, though you should not dwell on it duration of ivermectin treatment .
RESUMING SEXUAL ACTIVITIES
A man’s sex life should not be affected after a prostatectomy kamagra bulk europe . Uncommonly, however, some men do experience sexual
problems -notably a decrease in sexual sensation and a change in the intensity of their orgasms take lithium orotate and lithium carbonate . This may, in turn, have
an adverse effect on their sex drive naltrexone and surgery .
A prostatectomy may cause some damage to the nerve supply to the penis, particularly with an open prostatectomy chris cipro . Some men
may therefore lose their potency after the operation, though this is rare mefloquine resistant malaria map .
Sterility
A much more common after-effect of a prostatectomy is for a man to become sterile compounds simpler to tamoxifen . This is because semen is expelled
backwards into the bladder at orgasm, as opposed to being ejaculated from the penis parkinsons prednisone . This condition is known as
retrograde ejaculation recommended amoxicillin doses for sinus infections . It happens because it is usually impossible to remove the obstructing part of the prostate gland
without also removing the muscle that contracts and blocks off the neck of the bladder during intercourse, and normally
ensures that a man ejaculates semen when he has an orgasm and not urine what time to take lexapro .
According to evidence given by urologists on both sides of the Atlantic, it is estimated that retrograde ejaculation
affects between 30 and 90 per cent of men who have had a prostatectomy who makes effexor . Retrograde ejaculation does not usually cause a
problem, and sperm will be voided, quite simply, the next time he urinates and empties his bladder levaquin 750 mg for boils . The presence of sperm
in the bladder is in no way harmful, and it does not harm the penis, the bladder, or you dangers of requip . Most men report that this does
have an effect on the sensation of orgasm urinary track infections from levaquin .
The only problem occurs if a man wants to have children in the Future citalopram recall stericycle . as he will now be subfertile fexofenadine and . It used to be
thought that most men undergoing prostatectomy are of an age when they will probably have completed their families and
are unlikely to wish to have any more children bioidentical estrogen replacement estradiol estriol sale . In this case, sterility would obviously not be a great problem can i lose weight on seroquel . But
nowadays, with an increasing divorce rate and more and more men marrying second (and often younger) wives, this
assumption can no longer be made hydrochlorothiazide medication and hair lose .
If a man wants to have children, or thinks he might want to do so in the future, it is possible to aspirate sperm from
the bladder and use this for artificial insemination loratadine childrens syrup . It is recommended, however, that he pre-empts this possibility by
having sperm frozen and stored in a sperm bank before he undergoes the operation abacavir and ribavirin .
This involves producing sperm by masturbation, and having it deep-frozen and stored lamictal patent ending . Success is not guaranteed, though it
does give you a pretty good chance nolvadex male risks . It is rarely available on the National Health Service, and it is worth comparing the
prices of several different services as they can vary a lot lexapro and panic disorder . Your best bet is to try hospitals that have a reputation for
infertility work seroquel illegal usage . You can also obtain a list of centres registered with the Human Fertilisation and Embryology AuthQrity amoxicillin and yeast infections .
The British Pregnancy Advisory Service and Marie Stopes both offer this as part of their service taking lamictal adderall and cymbalta .
Contraception
You may have looked upon the sterility associated with prostatectomy as a good thing - no more need to worry about
contraception accutane dry eyes . But although prostatectomy often causes sterility in a man, it offers no guarantees anxiety when starting prozac . Between 5 and 10 per
cent of men are, in fact, still fertile afterwards - which may be good news for some of you but bad news for others cymbalta and remeron . If
you want a reliable and permanent method of contraception, you should discuss the possibility of having a vasectomy with
your surgeon, as this can easily be done at the same time drug baclofen natural equivalent .
ADVANCES IN SURGERY
Surgery has come a long way in recent years and there are new advances all the time, which make the future a brighter and
more hopeful place allegra recomended dosage . The use of lasers, which are thought by many to be the most accurate and efficient of surgical tools,
in prostate surgery is still at an experimental stage dilantin i v infiltrate .
Even more amazingly, prostate surgery can now be done by a robotic surgeon - more quickly, accurately, precisely and
efficiently than could be done by any human being avandia home medical supplies . The TURP operation is different from most other operations in that it
involves a lengthy series of repetitive movements to cut away the enlarged tissues side effects of tricor medicine . Robots are particularly good at
performing repetitive tasks with great accuracy nizoral mexico . The robot also has an impressive understanding of three dimensions,
which is something that surgeons are not always so good at, and often have to go back to the initial starting position
during an operation to reorientate themselves septra ds and clindamycin for acne . Should you worry about the idea of being in the ‘hands’ of a robot, rest
assured: the surgeon can watch what is happening on a visual display unit and is thus able to monitor proceedings
throughout the operation allegra water .
The possibility of robotic surgery has tremendous implications for the patient, not least of which is that it takes less
time, which means that more patients can be treated on one patient list, and therefore dramatically shortens the
ever-increasing waiting-list for operations premarin pregnant mares urine . It gives every man hope for the future seroquel injection .
WAITING FOR SURGERY
There are thousands of men currently awaiting prostate surgery in Britain seroquel cod . Many of them will already have been waiting
for longer than six months, and some for over a year arteries and caffeine .
Judging by the latest statistics, the chances are high that you’ll spend considerable time on a hospital waiting-list purchase ranitidine pharmacy online .
Talk to yourconsultant, who will have a pretty good idea of how many patients he has on his waiting-list, and where your
case comes on his list in order of urgency celebrex 100 mg .
In the meantime, you might like to try one of the self-help measures outlined in Chapter 10 aleve debbie phoenix .
If you’re losing patience, there are various ways in which you might be able to move further up the queue connection between lipitor and vitamin e . Ask your
doctor to write to your consultant about any circumstances that might help your case - if your condition is making it
difficult for you to do your job, for example, or if your personal circumstances mean that you are finding it very
difficult to cope with life before your operation, or -perhaps most importantly - if your condition has worsened since
your consultant last saw you prostatitis flare up during treatment ofloxacin .
You may find it beneficial to move to a different hospital, where the waiting-list is shorter evista ad anouncer . Your doctor should be able
to help you, or you can call the College of Health’s Helpline (0181-983 1133, Monday to Friday 10 a testosterone cream california .m zyprexa for chronic pain . to 4 p pregnancy tramadol .m glyburide cost .), which
keeps all the latest information on waiting-lists thyroxine levothyroxine .
The other possibility, if you can afford it or if you are covered by private medical health insurance, is to go private citalopram hydrobromide picture .
Prices vary enormously, so do a bit of research and find out how much it costs where, and What is included in the price when atacand came to the market .
Prostate surgery
Prostate surgery is probably the most common urological operation performed in this country mg clomiphene citrate . It costs the National Health
Service an untold fortune celexa and bad taste in throat . It is responsible for filling thousands of hospital beds throughout the country, and several
thousands more are waiting for their operations lithium hydroxide monohydrate fines grade .