Aug
1
Ciclopirox
August 1, 2009 | Leave a Comment
Generic Name
Ciclopirox (sye-kloe-PERE-ox) &
Brand Names
Loprox Penlac
Type of Drug Antifungal,
Prescribed For
Fungus and yeast infections of the nails and skin, including athlete’s foot, candida, and dandruff.
General Information
Ciclopirox slows the growth of a variety of fungus organisms and yeasts and kills many others. The drug penetrates the skin, hair, hair follicles, and sweat glands. Ciclopirox nail lacquer is used for toenail and fingernail fungus infections. Ciclopirox shampoo is used for dandruff.
Cautions and Warnings
Do not use this product if you are allergic or sensitive to any of its ingredients.
Possible Side Effects
Common: burning, itching, stinging, or oozing at the application site.
Drug Interactions None known.
Usual Dose
Cream/Lotion
Adult and Child (age 10 and over): Massage into cleansed affected skin and surrounding area twice a day.
Nail Lacquer
Adult: Apply to infected nails once a day. Use in conjunction with monthly visits to a health care professional.
Child (under age 10): not recommended.
Shampoo
Adult: Wet hair and apply 1-2 tsp to the scalp. Lather and leave on hair and scalp for 3 minutes, then rinse. Avoid contact with eyes. Repeat twice weekly for 4 weeks.
Child (under age 16): not recommended.
Overdosage
Accidental ingestion may cause nausea and upset stomach. Call your local poison control center or hospital for more information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
This product can be expected to relieve symptoms within the first week of use. Follow your doctor’s directions for the complete 2-4 week course of treatment with the cream or lotion to gain maximum benefit. The nail lacquer may be used for up to 48 weeks. Stopping the medication too soon can lead to a relapse.
When using ciclopirox nail lacquer, do not apply it to any skin other than that which surrounds the infected nails, because of possible irritation. Do not apply nail polish or any other nail lacquer to infected nails while you are using this product.
Avoid using ciclopirox nail lacquer near an open flame, since the product is flammable.
Do not cover cream or lotion with a bandage.
Call your doctor if the affected area burns, stings, or becomes red after you use this product, 13y i1 your symptoms do not clear Up aher 4 weeks of treatment; by then it is unlikely that this product will be effective.
If you forget a dose of ciclopirox, apply it as soon as you remember. Do not apply more than the amount prescribed to make up for the missed dose.
Special Populations
PregnancylBreast-feeding., ciclopirox may pass to the fetus in very small amounts. In animal studies, high doses of ciclopirox given by mouth did not harm the fetus. Caution should be exercised when using ciclopirox during pregnancy.
It is unknown if ciclopirox passes into breast milk. Nursing mothers who must use this drug should consider using infant formula.
Seniors: Seniors may use this drug without special restriction.
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
15
The Prostate in Sexual Activity.
July 15, 2009 | Leave a Comment
The Prostate in Sexual Activity
The prostate is part of the male reproductive system and supplies part of the seminal fluid viagra and oxycodone . It is not essential for the
man’s sexuality, though, nor even for his ability to reproduce ezetimibe simvastatin lawsuit .
When a man’s prostate is removed, male sexuality is not normally affected ripped fuel testosterone booster . His sex drive is intact, and his ability to
achieve and maintain an erection is unchanged caffeine free pepsi one .
SEMINAL FLUID
Sperm makes up only a small part of the seminal (laid asprin ec 8 . In fact most of the fluid you ejaculate isn’t sperm at all seroquel negative side effects . Most
of the fluid consists mainly of secretions from a number of glands promethazine hcl and codeine phosphate syrup . The largest of these glands is the prostate lithium hydrated .
‘The various secretions from these glands probably serve the purpose of providing the sperm with a greater motility after
they have been ejaculated, which stimulates their activity and enables them to move towards the egg get rid of caffeine jitters .
It is thought by some people that the prostate also has a lot to do with the feeling that an orgasm gives you boniva model . When a man
has an orgasm, sperm fluid from the seminal vesicles and the secretions from the prostate all mix together as semen at
the top of the urethra, just below the bladder xanax and zyrtec . A man gets an intensely pleasurable sensation when the semen floods down
the urethra into the penis erythromycin in dogs . He also gets a pleasurable feeling when the semen squirts out of the penis and into the tight
region of a woman’s vagina casa allegra rockport tx . The prostate gland can be felt, as a man’s orgasm proceeds, to contract i-liythmically, which
some people believe to be very much an integral part of the pleasure he experiences on orgasm side effects celexa long term use .
What prostate fluid contains
• Water penicillin and bismuth .
• Salts steroid and benzoyl peroxide .
• Minerals labetalol for treating pregnancy induced hypertension .
• Proteins azithromycin and eating .
• Antibodies lamictal and libido .
• Enzymes prevacid for toddlers .
• Citric acid wellbutrin withdraw .
• Fats buy domain fioricet tramadol .
• Prostaglandins, which are hormone-like chemicals omeprazole sa 20mg .
PROSTATIC DISEASE
Prostatic disease can have an effect not only on the urinary system, but also on the reproductive system seroquel prescription . The male
reproductive and urinary systems are, of course, closely linked, if only because they share the same exit route - the
penis - or, to be more exact, the urethra which runs through the centre of the penis testosterone normal range .
The prostate gland is the site at which the male sex hormone testosterone, which is made by the testicles, is broken
down clomid and robitussin . It is here that it then forms another hormone called dihydrotestosterone (DHT) abilify rx . The conversion is controlled by an
enzyme called 5-alphareductase biaxin side effects in children .
Ina study conducted by Imperato-McGinley (Science, 1974), the males in an obscure tribe in the Dominican Republic are
deficient in 5-alpha-reductase and are often mistaken for girls until they reach puberty enalapril and muscle pain . Until then, they have a very
small penis and scrotum, which suddenly enlarge at puberty, along with the development of a deep voice angiomyolipoma finasteride . These males only
ever develop a very small prostate gland, they never go bald, and they do not suffer from acne check the price on plavix medicine .
It is this genetic deficiency in 5-alpha-reductase that has enabled researchers to comprehend the role played by
dihydrotestosterone in the enlargement of the prostate gland lamictal 2006 .
Testosterone
As well as prostate enlargement, the male hormone testosterone also has several other effects on the male body digoxin level after digibind pharmacokinetics .
These include the following:
• The growth of the penis how viagra works in the body .
• The growth of testes body resisting coumadin .
• The production of sperm
• A deeper voice amiodarone and thyroid function .
• The growth of facial and body hair preventative risperdal .
• The male sex drive cialis generic pills .
• Bone growth hair loss information propecia propecia .
• Strength pseudoephedrine hydrochloride .
• Acne erythema multiforme bupropion .
• Baldness
A MAN’S GREATEST FEARS
One of man’s greatest fears on seeing a urologist and considering the prospect of a prostatectomy is what effect this
will have on his sexuality allegra gomez . The idea of having any sexual organ tampered with by a surgeon is very frightening for most
men, who worry that it may have a deleterious effect on their sex lives allegra hotel golden sands .
Many men are so frightened that their prostate problems will affect their sex lives, particularly if they have to have an
operation, that they put off going to the doctor gastroparesis caused by prozac . And even when they do eventually go to the doctor, they may be too
embarrassed to discuss sexual matters generic cialis viagra caverta buy online . Sex is something that all too many men find difficult -if not impossible - to talk
about with their doctor zyprexa and parkinson’s disease symptoms .
But this is foolish ibuprofen therapy for dogs . It is only by talking the matter over with their doctor that they will find their fears were
groundless and that they can therefore be reassured naproxen while pregnant .
The doctor’s role
To make matters worse, some doctors and urologists are sometimes insensitive on this subject metformin side effects sleeping problems . It is quite wrong of them
to assume that their patients are too old to be interested in sex tocicity of ibuprofen . Sex can play an important role in the lives of many
rnen until well into old age, and they should treat their fears as real and serious lexapro concerta interactions .
A inan who is due to have a prostatectomy should not just fret about this in secret, he should talk to his doctors about
it - his GP, his consultant, his surgeon gabapentin 100mg tablets picture . Most importantly, the doctor should respect his fears, and him for coming to
air them with him bupropion hcl sulfa .
It’s not easy for any man to do this, and if he succeeds in overcoming his reluctance to do so, the doctor should
recognise what that has cost him altace blood pressure medicine side effects . If the doctor reacts badly, it might have catastrophic effects: it might just send him
scuttling back to his burrow, his pride injured, and he might never be able to take the risk again asprin and alzhiemer .
Only when both doctor and patient can talk about this calmly, sensibly, realistically, will the patient be reassured that
it will have no effect on his sexuality - neither on his libido, nor his ability to obtain or maintain an erection, nor
on his performance lexapro morning or night .
Retrograde ejaculation
What it may well do, however, is cause him to be infertile after the operation (see Chapters 7 and 
dostinex and bodybuilding .
Even a man who has no intention of becoming a father again may find the idea of losing his potential to be a father very
distressing cube carisoprodol . A man may find this emasculating, as if it were questioning his manhood methotrexate liver cancer . He’s only lost his ability to
procreate, not his sexuality, but this can have a devastating effect on him angle closure glaucoma from topamax . This is reminiscent of a woman who regrets
the loss of her womb after a hysterectomy, even though she is beyond childbearing, and feels she has lost her femininity prevacid 15 mg .
A doctor should have the sensitivity to talk to his patient about this dilantin and keppra combined . Only with patience and understanding can he help
him come to terms with his feelings of fear and loss following beverages originally contained lithium salts .
Retrograde ejaculation will not make a man impotent, nor - in most cases - will it prevent him from having orgasms heart attacks and plavix . It
will, however, make the sensation of orgasm a different one - and, in all honesty, probably not as good a one aldactone pharmacia . Some
women, too, are disappointed by the new feeling of a ‘dry’ climax in their male partner terazosin diarrhea .
These changes in a man’s sexuality should be addressed beforehand metformin surgery . He should be told what to expect toprol side affects . A sensitive doctor
will also help a couple come to terms with their new-found sexuality lithium orotate alzheimer’s .
Impotence
It is possible, though by no means certain - nor even common -that prostatectomy may cause impotence tramadol al english . Some men are
frightened that it might have this effect, probably because they have heard tales of the old perineal prostate operation
(which is hardly ever done nowadays) or the radical prostatectomy in which the entire prostate, including the capsule in
which it is enclosed, is removed (sometimes performed for prostate cancer) kamagra leverans stockholm . In both these operations, the nerves
supplying the penis were sometimes cut, which led to a man’s impotentence hydroxyzine hcl 10 . 11′ these operations are done today, it is
usually -though not always - possible to avoid cutting these nerves diflucan cipro . The problem of impotence is therefore unlikely but
it may arise can minocycline cause weight gain .
If a man is very frightened that the operation may lead to impotence, he may actually experience a kind of psychological
impotence afterwards board carisoprodol direc dynu net href . This underlines how important it is for a man to be reassured before the operation propecia medica . If a
psychological problem does occur, a counsellor or sex therapist should be able to deal with it lamictal cause hair loss .
An excuse to avoid sex
In spite of all the evidence that prostate surgery has no effect at all on a man’s sexuality (other than retrograde
ejaculation), it does occasionally seem to happen which works better motrin or darvocet . An obvious explanation for this is that some men may use surgery as an
excuse to avoid sex, which they had stopped enjoying ages ago anyway demadex 1 mg . Occasionally, if a man is not in very good health,
a prostate operation - which is, after all, a major operation requiring a long convalescence period - may be enough to
push his sexuality over the edge ranitidine drug class .
Generally, though, most men do not have any problems with their sex lives after the operation can zyrtec raise blood pressure . In fact, a man may
actually find that his sex life has greatly improved since he had his prostatectomy, if only because he now has full
control of his bladder adderal prozac combination .
AN EROGENOUS ZONE
Some people believe that the prostate gland is a highly erogenous zone and that awareness of this can greatly heighten a
man’s sexual pleasure breastfeeding levoxyl cranio .
Many sex therapists consider that the man’s prostate gland is the equivalent to a woman’s G-spot compazine suppository . In fact the female
G-spot and the male prostate gland are located in very much the same position heart problems and imitrex .
In order to find a man’s prostate gland, proceed in the following way:
• With the man lying face down on the bed, with a couple of pillows under his hips, insert a well-lubricated finger
into his rectum, palm facing downwards cyclosporine opthalmic .
• You should feel his prostate as a firm mass, about the size of a large chestnut diflucan safety . Stroke it with your fingers reaction to wellbutrin .
• Be guided by what he tells you erythromycin op oin fougera . This should feel very pleasurable and produce intense sexual sensations soma listening . Ask him
how it feels, and do what he likes best zyprexa lilly can you break .
• Keep on stroking his prostate until he ejaculates how does brethine stop labor . Many men ejaculate while this is being done without ever
having an erection depo provera health risks .
• An alternative position to this is with the man on his back and his legs drawn right up hydrochlorothiazide and depression . In this position, the prostate
can be felt on the front wall of the rectum nexium ec .
A woman’s objections
Some women object to doing this to their lover because they are frightened that it will be messy over night tramadol . It may be, but the
lower part of the rectum is usually empty anyway, so there should not be a problem ramipril slows .
One way of dealing with this is for the woman to use a latex finger stall, which is available from the chemist to cover a
finger that has an open wound on it how do i purchace viagra . This is intended to keep the finger waterproof side effect nightmares paroxetine .
Whatever you use - a naked finger or a finger with a finger stall -you should wash it carefully afterwards lovastatin anger effects . The anus is a
breeding ground for bacteria, and it pays to be careful about hygiene prevacid sexual side affects .
Some women are frightened that they might hurt their lover when they do this does white chocolate have caffeine . It is true that the anal area is very
sensitive and they should therefore always be careful tetracycline dose acne . They should, in particular, make sure that they do not have a
sharp or jagged nail on the finger they use to do this cymbalta night sweats .
They should be careful, too, not do this if they have any open cuts on the finger used, in case of the transmission of
HIV or hepatitis B mixing imitrex with crack cocaine .
Jul
3
Allergy: Diagnosis and FAQs
July 3, 2009 | Leave a Comment
ALLERGIES
• Install an Aprilaire HEPA-type air filter ****
• Use a high-quality vacuum cleaner (Miele) ****
• Rinse your nasal passages with saltwater
•Try vitamin C
• Experiment with the herbs stinging nettle and butterbur
*Take quercetin and bromelain
•Try NasalCrom (cromolyn) spray to prevent allergy symptoms
• Look for loratadine, an over-the-counter antihistamine
• Ask your doctor about a steroid nasal spray *****
• Consider pseudoephedrine for symptomatic relief
Breathing is basic. Most of the time we take it for granted. But if your nose is congested and your sinuses are stopped up, you are miserable. For one thing, your head feels as if it’s full of cotton. Studies have found that people suffering from allergies frequently experience sleep difficulties, fatigue, poor concentration, drowsiness, irritability, delayed reaction times, memory problems, and cognitive impairment.19 When you are in the middle of an allergy attack it is hard to drive safely even if you are not sneezing. Making decisions or operating other kinds of machinery can also be problematic.
Paradoxically, although antihistamines are the mainstay of allergy treatment, they can also cause drowsiness, delayed reaction times, sedation, and cognitive impairment. Even the so-called second-generation nonsedating antihistamines that are so heavily advertised to consumers may not be as benign as drug companies would have you believe. 20 When given in doses that are adequate to relieve symptoms, some of these nonsedating antihistamines may also make people drowsy and impair performance.
Research has shown that driving skills are affected with both the older and the newer antihistamines.” A massive study conducted for the National Highway Traffic Safety Administration discovered that driving while drowsy—no matter what the cause—increased the risk of a crash or near crash by four to six times. 23
Physicians often think of allergies as more of a nuisance than a life-threatening condition. But we now realize that impairment poses huge risks if people are driving. And allergy symptoms don’t just occur in the spring and fall, when pollen is in the air. Nowadays many folks are congested all year long. At last count, 50 million people are sensitive to things like dust mites, cat dander, cockroaches, mold spores, and pollens from oak, elm, and maple trees as well as ragweed and rye, blue,and Bermuda grasses.24 Symptoms include nasal stuffiness, runny nose, itching, sneezing, and coughing. Chronic sinusitis, which may develop as a consequence of allergies, affects more than 30 million people. And asthma, which can be life threatening, often has an allergic and inflammatory component.
What is so scary about these statistics is that they keep going up. No one knows why, but it appears that more people are suffering than ever before.
Conclusions
Allergies don’t get the respect they deserve. When you complain about your congestion, most friends and family members will barely sympathize. But allergies can slow you down and make you dangerous behind the wheel. Finding the right treatment to ease your symptoms without causing worse problems is a challenge. Combining several options, including environmental control, may be the most effective solution for solving this common problem.
• Use a HEPA-type air filter and a dehumidifier to remove allergens from the air you breathe and make the environment inhospitable for the three Ms of allergy—mold, mildew, and mites.
• Get a high-quality vacuum cleaner that won’t spew dust and dirt back into the air. Miele models rank high on our list.
• Wash your nasal passages with saline. A neti pot will help.
• Consider an herbal approach such as stinging nettle (Urtica dioica) or butterbur (Petasites hybridus). Men with prostate enlargement may find nettles especially helpful since some OTC allergy medicines may make this condition worse.
• The natural products quercetin and bromelain may help stabilize mast cells and prevent histamine release.
• Cromolyn (NasalCrom) is an OTC remedy that also stabilizes mast cells. It should be used preventively before exposure to allergens occurs. Cromolyn does not cause drowsiness.
• Oral antihistamines can control symptoms, but they may also make you dangerous on the highways. Even nonsedating products may interfere with driving ability. Generic loratadine (Claritin) is now available without a prescription.
• Among prescription allergy medicines, steroid nasal sprays offer the most effective symptom relief with a minimum of side effects. The cost is significant, since they are available only by prescription. One generic variety (flunisolide) is less expensive than brand-name products like Flonase and Rhinocort AQ.
• Pseudoephedrine can be surprisingly effective at controlling allergy symptoms. Beware of side effects such as insomnia, nervousness, high blood pressure, and irregular heart rhythms.
Jul
1
Drugs for Diabetes Treatment
July 1, 2009 | Leave a Comment
Diabetes ( nxkcirqv7h )
Diabetes mellitus is a deficiency caused by a lack of insulin, a specftffchormone secreted by the islet cells of the pancreas, or by a failure of the insulin-release mechanism. As a result of that insulin deficiency, carbohydrates and fats are not
fully metabolized. Glucose accumulates in the circulation and causes a diuresis,
so that polyuria and thirst are troublesome complications. Insulin-dependent
diabetes, which occurs mainly in children and young adults, can be controlled by
injections of insulin. Soluble insulin is used for rapid treatment and in
emergencies, but stabilized patients can be controlled by one of the longer-acting
forms of insulin such as insulin-zinc-suspension.. Insulin was once obtained from
pigs or cattle, but human types of insulin are now available and used to an
increasing extent. (See Table 12.)
In middle age, a non-insulin-dependent type of diabetes may develop. In such patients, the natural secretion of insulin still occurs, but the insulin is not released according to metabolic requirements. Release can, however, be induced by treatment with the orally active hypoglycaemic agents referred to as the
sulphonylureas, represented by chlorpropamide (see Table 13). The
sulphonylureas are most effective in mature patients who are already stabilized on low doses of insulin, or who do not respond to purely dietary control Patients receiving less than 20 units of insulin daily can usually be transferred directly to
an oral drug, but in other cases the transfer should be carried out over a few days.
For those patients who do not respond to the sulphonylureas, an alternative is
the biguanide metformin. The mode of action differs, as it functions mainly by
increasing the peripheral utilization of glucose. Guar gum has some antidiabetic 131
properties, possibly mediated by interfering with the absorption of carbohydrates,
and may be a useful supplementary treatment. Oral therapy with any antidiabetic
drug is not suitable for juvenile or unstable diabetics.
Diabetic
emergencies may hypoglycaemia which may also result in coma. The former requires
treatment with i.v. soluble insulin, preferably by an i.v. pump system, failing
which the insulin should be given by i.m. injection. Hypoglycaemic coma, which
may be due to an overdose of insulin, can be treated with the i.v. infusion of 50%
glucose solution, or by the injection of glucagon 1 m by any route. (Diazoxide is
used in the control of chronic hypoglycaemia which is due to the overproduction
of insulin. It has no place in the emergency treatment of diabetic coma.)
Insulin zinc (IZS) Human Ultratard
(crystalline) Humulin Zn
Protamine zinc Hypurin Protamine Zinc
Soluble insulin
Insulin zinc (IZS) (amorphous)
Isophane insulin (a complex
with protamine)
Biphasic insulin
Biphasic isophane insulin (a complex with protamine)
Insulin zinc (IZS) (amorphous)
Insulin zinc (IZS) (amorphous
+ crystalline)
Soluble
Human Actrapid Human Velosulin Humulin S Hypurin Neutral Velosulin
Insulin Lispro*
Semitard MC Hypurin Isophane Pork Insulatard Human Insulatard Humulin I Rapitard MC Pork Mixtard Human Mixtard Humulin M1-5 Semitard MC
beef 5-8 human-pyr human-emp human-prb beef
pork
humalog
pork 18-24 beef
pork
human-pyr human-prb beef & pork pork
human-pyr human-prb beef/pork
beef 24-36 beef/pork human-pyr human-prb
human-pyr 24-36 human-prb
beef
glibenclamide Daonil, Semi-Daonil, Euglucon
gliclizide Diamicron
glimepiride Amaryl
glipizide Glibenese, Minodiab
gliquidone Glurenorm
tolazamide Tolanase
tolbutamide Rastinon
biguanide
metformin Glucophage
acarbose Glucobay
guar gum Guarem
Iroglitazone* Romozin
Note: This new drug, an insulin enhancer, has recently been withdrawn pending investigations of reports of liver damage.
Table 13 Anti-diabetic drugs.
Jul
1
Drugs for Cough Treatment
July 1, 2009 | Leave a Comment
Cough
Cough is an explosive exptiation of air from the lungs, and is a protectiv-e–! mechanism to expel excessive exudate or foreign bodies from the respiratory tract,
but other irritant factors may also stimulate the cough reflex. Productive cough
should not be suppressed without good cause, such as when the patient finds
cough exhausting or prevents sleep, but suppression may then have the
undesirable effect of causing retention of sputum. On the other hand, suppression
of the dry, useless or unproductive cough may have corresponding advantages.
Many soothing and demulcent preparations represented by simple linctus have
been used for the symptomatic relief of cough, and another traditional remedy is
steam inhalation, assisted by the addition of Friar’s balsam and menthol.
Expectorant products such as ammonia and ipecacuanha mixture are also used,-,—,–.
even though pharmacological proof of their efficacy may be lacking. Cough
suppressants, represented by codeine, have a central depressant action on the
cough centre, but effective doses may have the disadvantage of causin
Extended use should be avoided because of the possible risk of
habituation. The treatment of severe cough in terminal lung cancer is with more potent cough suppressants such as diamorphine or methadone.
Approved names Brand names
codeine linctus Galcodine
pholcodine linctus
Table 9 Cough suppressants.
Galenophol, Pavocol D, Pholcomed
Jul
1
Drugs for Cancer Treatment
July 1, 2009 | Leave a Comment
Cancer
The treatment of cancer is difficult because cancer cells are cells that have escaped from the controls that govern normal cell growth and differentiation of function. As a result, uncoordinated growth may develop rapidly, and cancer cells may migrate and invade other tissues. Any anti-cancer drug is therefore likely to damage normal cells, particularly actively growing cells such as those of the bone marrow, and the dose of a cytotoxic agent is often a compromise between that having the desired anti-cancer action and that causing toxicity.
The drugs used in the treatment of cancer can be divided into four main groups, which attack the cells at different points. The alkylating agents interfere with the replication and function of DNA, modify protein synthesis, and have correspondingly wide effects. The antimetabolites interfere with cell metabolism by combining with cell enzymes, or by forming abnormal proteins, or otherwise inhibiting normal development. The cytotoxic antibiotics have an action similar to that of the antimetabolites, but they also have radiomimetic properties, and combined radiotherapy may increase the risks of damage to normal cells. These antibiotics, with the exceptions of dactinomycin and bleomycin, also have undesirable cardiotoxic properties, and dosage requires careful control. Amsacrine is a synthetic cytotoxic agent with some of the properties of the antibiotic group. Some recently introduced drugs include docetaxel, gemcitabine, letrozole, paclitaxel, raltitrexed and topotecan.
The vinca alkaloids are a class apart, as they are plant substances, and act at the metaphase stage of cell division. They are used mainly in acute leukaemias and some
122 lymphomas. Vincristine is almost free from any depressive effects on bone marrow function, vinblastine has some degree of myelosuppressive activity but is less neurotoxic. Vindesine occupies an intermediate position. Etoposide is a synthetic drug with some of the properties of the vinca alkaloids. Other and unclassified cytotoxic agents include the platinum complexes carboplatin and cisplatin, used mainly in ovarian cancer, and the enzyme crisantaspase used in acute lymphoblastic leukaemia. Some cancers are hormone dependent, and the symptoms may be controlled by suitable hormone antagonists. Breast cancer for example may respond to aminoglutethimide, anastrozole, formestane, letrozole and toremifene. Prostatic cancer can be treated with anti-androgens such as fosfesterol, bicalutamidc, cyproterone and flutamide. Certain hormone analogues such as buserelin, goserelin, leuprorelin and triptorelin are also used in cancer of the prostate. A distressing side-effect of high-dose cytotoxic chemotherapy was severe and intractable nausea and vomiting, which could be so intense that patients have been known to refuse further anti-cancer treatment. The problem has since been resolved by the introduction of potent antierneties of the ondansetron type.
Myleran
carmustine BiCNU
chlorambucil Leukeran
cyclophosphamide Endoxana
estramustine Estracyt
ifosfamide Mitoxana
lomustine CCNU
melphalan Alkeran
mustine Mustine
thiotepa Thiotepa
treosulphan Treosulfan
cladribine Leustat
gemcitabine mercaptopurine methotrexate
thioguanine Lanvis
Table 8 Anti-cancer drugs. Continued on pages 124-125.
cytarabine Alexan, Cytosar
fludarabine Fludara
fluorouracil Fluoro-Uracil, Efudix
Gemzar Puri-Nethol
Maxtrex
raltitrexed Tomudex
Approved names
-cytotoxic antibiotics -
Brand names
bleomycin Bleomycin
dactinomycin Cosmegen
daunorubicin DaunoXome
doxorubicin Doxorubicin
epirubicin Pharmarubicin
idarubicin Zavedos
mitomycin Mitomycin C
mitozantrone Novantrone
vinblastine Velbe
vincristine Oncovin
vindesine Eldesine
vinorelbine Navelbine
aldesleukin
amsacrine
bicalutamide
carboplatin
dacarbazine
Proleukin
Amsidine
Casodex
Paraplatin
DTIC
cisplatin Cisplatin
docetaxel Taxotere
etoposide
Vepesid
hydroxyurea
Hydrea
iritotecan
Campto
letrozole
Ferrara
octreotide
Sandostatin
paclitaxel
Taxol
pentostatin
Nipent
procarbazine
Natulan
razoxane
Razoxin
topotecan
Hycamptin
tretinoin
Vesanoid
aminoglutethimide
Orimeten
anastrozole
Armidex
buserelin
Suprefact
Cyprostat
Drogenil
flutamide
Lentaron
formestane
goserelin
Zoladex
tamoxifen
Torero
torasemide
Casodex
Emblon, Nottam, Notwadex, Tamofen
bicalutamide
cyproterone
Jul
1
Drugs for Bell’s Palsy Treatment
July 1, 2009 | Leave a Comment
Bell’s palsy
Bell’s palsy is a unilateral facial paralysis, characterizedby sudden onset and pain, usually behind the ear. The cause is unknown, but the symptoms are thought to be due to local swelling and a compression of the facial nerve. Patients should be reassured that the paralysis is unrelated to stroke and spontaneous recovery usually occurs after some weeks. Corticosteroids are effective if the condition is diagnosed early, and prednisolone is given initially in doses of 60-80 mg daily, decreasing by 10 mg every 2 days for about a week. As the palsy may prevent closure of the affected eye, local treatment with artificial tears or liquid paraffin may be required.
Approved names Brand names
hypromellose Tears Naturelle
(artificial tears) Isopto Alkaline & Plain
prednisolone Deltacortril, Deltastab, Precortisyl, Prednesol
liquid paraffin
Lacri-Lube
polyvinyl alcohol
Hypotears
Jul
1
Drugs for Anxiety Treatment
July 1, 2009 | Leave a Comment
Anxiety
Anxiety states may manifest themselves in a variety of ways from a general sense of uneasiness to acute panic attacks. The symptoms may also vary widely, from a minor physical disturbance such as dryness of the mouth and sweating of the hands and ‘butterflies in the stomach’ to breathlessness, hyperventilation and lightheadedness. Emotional stress often precipitates anxiety, and drug treatment is useful when the cause of the stress is ill-defined or cannot be removed. Such treatment should always be regarded as a short-term measure, as the prolonged use of anxiolytics involves the risks of dependence and the problems of eventual withdrawal. For such short-term treatment of severe anxiety, a benzodiazepine such as diazepam is often the drug of choice, but other drugs such as buspirone are also in use. Some of the potent antipsychotic agents are also given in small doses for the relief of anxiety. The beta-blockers are occasionally useful in controlling some of the symptoms of anxiety, when the possibility of stress can be anticipated, as in public speaking or performance.
117
Approved name Brand name Daily dose range
alprazolam Xanax 750-1500.Lig
bromazepam Lexotan 3-18 mg
ch lord iazepoxide Librium 30-100 mg
clorazepate Tranxene 7.5-22.5 mg
diazepam Atensine, Valium 5-30 mg
lorazepam Ativan 2.5-10 mg
oxazepam 45-120 mg
Table 5 Benzodiazepine anxiolytics.
Jul
1
Drugs for Anaemia Treatment
July 1, 2009 | Leave a Comment
Anaemia is essentially a deficiency of red blood cells, and may occur as the result of a lack of certain factors such as iron, folic acid or vitamin B, or from disease in which the rate of breakdown of red cells exceeds the rate of production of new cells. Iron-deficiency anaemia is the most common form, and may occur during pregnancy or as a consequence of restricted diets. Such a deficiency can be dealt with by the oral administration of a suitable iron salt, and ferrous sulphate is widely used. For patients who cannot tolerate ferrous sulphate, other salts are ferrous gluconate and fumarate. Some iron preparations for use during pregnancy also contain folic acid but are too numerous to list here. Slow-release iron products are also available. In all cases of iron-deficiency anaemia, oral treatment should be continued for some months to build up an adequate store of iron.
In a few cases, where oral iron therapy is not possible, iron-deficiency anaemia can be treated with iron-sorbitol solution by deep i.m. injection, using a ‘Z’ technique to avoid staining the skin. The dose is based on the degree of iron-deficiency. Oral iron should be stopped for at least 24 hours before injection treatment. (Jectofer).
Megaloblastic anaemias are less common, and are due to a deficiency of vitamin B,, or of folic acid, or to a defect in the absorption or utilization of those factors, and may be secondary to treatment with cytotoxic agents such as methotrexate. Pernicious anaemia is the most common form of vitamin B12 deficiency, and develops insidiously as the normally ample stores of the vitamin in the liver are slowly depleted. Treatment is replacement therapy with hydroxocobalamin, which is the preferred form of vitamin BIZ, as it is excreted more slowly than the older cyanocobalamin, and has a much longer action. Some oral preparations of vitamin B,, are available, but in general they are regarded as unsatisfactory for the treatment of vitamin B12 deficiency.
Aplastic anaemia is due to a marked reduction in the formation of red blood cell precursors, and is a disease of the bone marrow. It may occur from no known cause, or from exposure to some toxic agents, including cytotoxic drugs. Bone marrow transplants are the only effective treatment, although some androgens such as nandrolone have been used with occasional success. Sideroblastic anaemias are due to a disturbance in the normal utilization of iron, and may respond to large doses of pyridoxine. Haemolytic anaemia is characterized by an excessive breakdown of red blood cells, due to disease or toxic agents. Some of these less common anaemias may respond to corticosteroid therapy. The severe anaemia of end-stage renal disease in dialyzed patients differs from other anaemias in being due to a lack of erythropoietin, the kidney hormone that regulates red blood cell production by the bone marrow. It can now be treated with human erythropoietin obtained by recombinant DNA.
Approved names Brand names
ferrous sulphate Feospan
Ferrograd sustained release products
Slow
ferrous fumarate Fersaday Fersamol Galfer
ferrous gluconate
ferrous glycine sulphate Plesmet
Ferrocontin Continus
(sustained release product)
ferrous succinate Ferromyn
iron - polysaccharide complex Niferex
sodium iron edetate Sytron
iron-sorbitol injection Jectofer
hydroxocobalamin Cobalin-H, Neo-Cytamen
cyanocobalamin Cytacon (oral), Cytamen
nandrolone Deca-Durabolin
pyridoxine
epoetin (erythropoietin) Eprex, Recormon