Info Drugs

Safety Profile of Meropenem: An Updated Review of Over 6000 Patients Treated with Meropenem

2008-08-11T00:21:00.000-07:00

Meropenem is a broad-spectrum carbapenem antibacterial with potent antimicrobial activity against a broad range of Gram-negative, Gram-positive and anaerobic bacteria. The second parenteral carbapenem to be introduced worldwide, meropenem has been in clinical use since 1994. Two previous safety reviews have established that meropenem has a favourable and acceptable safety profile. This new review was conducted after the approval of meropenem in the US in 2005 for the treatment of patients with complicated skin and skin-structure infections, in addition to the previously approved indications of intra-abdominal infections and paediatric bacterial meningitis. The analysis includes the clinical trial data from the previous safety reviews, updated with expanded experience across a number of serious bacterial infections, including a large international study in patients with skin or skin-structure infections and further experience in patients with intra-abdominal infections and bacterial meningitis. A total of 6154 patients with 6308 meropenem exposures were compared with 4483 patients treated with comparator agents (4593 exposures), and the paediatric population base for which safety data are available has doubled to over 1000 patients.
The data presented reinforce the favourable safety profile of meropenem. In general, the incidence and pattern of adverse events occurring with meropenem were similar to those of the first carbapenem, imipenem/cilastatin, and to those of the cephalosporin- and clindamycin-based regimens to which it had been compared. The most common adverse events reported for meropenem were diarrhoea (2.5%), rash (1.4%) and nausea/vomiting (1.2%). No adverse event occurred in more than 3% of patient exposures to meropenem, indicating a low overall frequency of adverse events as well as excellent gastrointestinal tolerability. Furthermore, no unexpected adverse events were identified, and the very low incidence of seizures in patients with meningitis was not considered to be drug related. In infections other than meningitis, the incidence of seizures considered by investigators to be related to meropenem treatment was 0.07%. In the new studies that updated the earlier safety data, no new cases of drug-related seizure were reported for any treatment or patient group (meningitis/non-meningitis infections).
In conclusion, meropenem is well tolerated and has good CNS and gastrointestinal tolerability when used for the treatment of serious bacterial infections in a wide range of adult and paediatric patient populations.

Author: Linden, Peter1
Source: Drug Safety, Volume 30, Number 8, 2007 , pp. 657-668(12)
Publisher: Adis International

Nasal beclomethasone prevents the seasonal increase in bronchial responsiveness in patients with allergic rhinitis and asthma.

2008-07-21T00:23:00.000-07:00

Corren J, Adinoff AD, Buchmeier AD, Irvin CG.

National Jewish Center for Immunology and Respiratory Medicine, Department of Internal Medicine, University of Colorado Health Sciences Center, Denver.

Experimental studies have demonstrated that induction of a nasal allergic reaction can lead to an increase in bronchial responsiveness (BR). To assess the clinical relevance of these experimental changes to chronic asthma, we sought to determine the effect of nasal beclomethasone dipropionate (Bdp) on BR in patients with seasonal allergic rhinitis and asthma. Eighteen subjects with histories of seasonal allergic rhinitis and asthma during the fall pollen season with positive skin tests to short ragweed and bronchial hyperresponsiveness to inhaled methacholine were assigned to receive either nasal Bdp (336 micrograms/day) or placebo for the entire ragweed season. Patients recorded daily nasal and chest symptoms, nasal blockage index, oral peak expiratory flow rates, and supplemental medication use. BR to methacholine was measured during the baseline period and 6 weeks into the ragweed season. Although the Bdp group did have a significant improvement in nasal blockage index, there was no improvement in daily asthma symptom scores, oral peak expiratory flow, or asthma medication use. However, subjects treated with Bdp were protected from the increase in BR seen in the placebo group (geometric mean PC20 placebo group: baseline = 0.70, week 6 = 0.29; Bdp group: baseline = 0.80, week 6 = 0.93; intergroup difference, p = 0.022). We conclude that nasal corticosteroid therapy can prevent the increase in BR associated with seasonal pollen exposure in patients with allergic rhinitis and asthma.

Anti-insomnia drugs

2008-06-12T01:00:00.000-07:00

Definition
Anti-insomnia drugs are medicines that help people fall asleep or stay asleep.
Purpose
Physicians prescribe anti-insomnia drugs for short-term treatment of insomnia-a sleep problem in which people have trouble falling asleep or staying asleep or wake up too early and can't go back to sleep. These drugs should be used only for occasional treatment of temporary sleep problems and should not be taken for more than a week or two at a time. People whose sleep problems last longer than this should see a physician. Their sleep problems could be a sign of another medical problem.
Description
The anti-insomnia drug described here, zolpidem (Ambien), is a classified as a central nervous system (CNS) depressant. CNS depressants are medicines that slow the nervous system. Physicians also prescribe medicines in the benzodiazepine family, such as flurazepam (Dalmane), quazepam (Doral), triazolam (Halcion), estazolam (ProSom), and temazepam (Restoril), for insomnia. Benzodiazepine drugs are described in the essay on antianxiety drugs. Zaleplon (Sonata) is another anti-insomnia drug that is not related to other drugs with the same effect. The barbiturates, such as pentobarbital (Nembutal) and secobarbital (Seconal) are no longer commonly used to treat insomnia because they are too dangerous if they are taken in overdoses. For patients with mild insomnia, some antihistamines, such as diphenhydramine (Benadryl) or hydroxyzine (Atarax) may be used, since these also cause sleepiness.
Zolpidem is available only with a physician's prescription and comes in tablet form.
Recommended dosage
The recommended dose for adults is 5-10 mg just before bedtime. The medicine works quickly, often within 20 minutes, so it should be taken right before going to bed.
For older people and others who may be more sensitive to the drug's effects, the recommended starting dosage is 5 mg just before bedtime.
Zolpidem may be taken with food or on an empty stomach, but it may work faster when taken on an empty stomach. Check with a physician or pharmacists for instructions on how to take the medicine.
Precautions
Zolpidem is meant only for short-term treatment of insomnia. If sleep problems last more than seven to 10 days, check with a physician. Longer-lasting sleep problems could be a sign of another medical problem. Also, this drug may lose its effectiveness when taken every night for more than a few weeks.
Some people feel drowsy, dizzy, confused, lightheaded, or less alert the morning after they have taken zolpidem. The medicine may also cause clumsiness, unsteadiness, double vision, or other vision problems the next day. For these reasons, anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how zolpidem affects them.
This medicine has caused cause behavior changes in some people, similar to those seen in people whose behavior changes when they drink alcohol. Examples include giddiness and rage. More extreme changes, such as confusion, agitation, and hallucinations, also are possible. Anyone who starts having strange or unusual thoughts or behavior while taking this medicine should get in touch with his or her physician.
Zolpidem and other sleep medicines may cause a special type of temporary memory loss, in which the person does not remember what happens between the time they take the medicine and the time its effects wear off. This is usually not a problem, because people go to sleep right after taking the medicine and stay asleep until its effects wear off. But it could be a problem for anyone who has to wake up before getting a full night's sleep (seven to eight hours). In particular, travelers should not take this medicine on airplane flights of less than seven to eight hours.
Because zolpidem works work on the central nervous system, it may add to the effects of alcohol and other drugs that slow down the central nervous system, such as antihistamines, cold medicine, allergy medicine, medicine for seizures, tranquilizers, some pain relievers, and muscle relaxants. Zolpidem may also add to the effects of anesthetics, including those used for dental procedures. The combined effects of zolpidem and alcohol or other CNS depressants (drugs that slow the central nervous system) can be very dangerous, leading to unconsciousness or even death. People who take zolpidem should not drink alcohol and should check with their physicians before taking any other CNS depressant. Anyone who shows signs of an overdose or of the effects of combining zolpidem drugs with alcohol or other drugs should have immediate emergency help. Warning signs include severe drowsiness, severe nausea or vomiting, breathing problems, and staggering.
Anyone who takes zolpidem for more than 1-2 weeks should not stop taking it without first checking with a physician. Stopping the drug abruptly may cause rebound insomnia; increased difficulty falling asleep for the first one of two nights after the drug has been discontinued. In rare cases, withdrawal symptoms, such as vomiting, cramps, and unpleasant feelings may occur. Gradual tapering may be necessary.
Older people may be more sensitive to the effects of zolpidem. This may increase the chance of side effects, such as confusion, and may also increase the risk of falling.
In people with breathing problems, zolpidem may worsen the symptoms.
Special conditions
People with certain other medical conditions or who are taking certain other medicines can have problems if they take zolpidem. Before taking this medicine, be sure to let the physician know about any of these conditions:
ALLERGIES
Anyone who has had unusual reactions to zolpidem in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.
PREGNANCY
Women who are pregnant or who may become pregnant should check with their physicians about the safety of using zolpidem during pregnancy.
BREASTFEEDING
Women who are breastfeeding should check with their physicians before using zolpidem.
OTHER MEDICAL CONDITIONS
Before using zolpidem, people with any of these medical problems should make sure their physicians are aware of their conditions:
Chronic lung diseases (emphysema, asthma, or chronic bronchitis)
Liver disease
Kidney disease
Current or past alcohol or drug abuse
Depression
Sleep apnea
USE OF CERTAIN MEDICINES
Taking zolpidem with certain other drugs may affect the way the drugs work or may increase the chance of side effects.
Side effects
The most common minor side effects are daytime drowsiness or a "drugged" feeling, vision problems, memory problems, nightmares or unusual dreams, vomiting, nausea, abdominal or stomach pain, diarrhea, dry mouth, headache, and general feeling of discomfort or illness. These problems usually go away as the body adjusts to the drug and do not require medical treatment.
More serious side effects are not common, but may occur. If any of the following side effects occur, check with the physician who prescribed the medicine as soon as possible:
Confusion
Depression
Clumsiness or unsteadiness
Patients who take zolpidem may notice side effects for several weeks after they stop taking the drug. They should check with their physicians if these or other troublesome symptoms occur:
Agitation, nervousness, feelings of panic
Uncontrolled crying
Worsening of mental or emotional problems
Seizures
Tremors
Lightheadedness
Sweating
Flushing
Nausea or abdominal or stomach cramps
Muscle cramps
Unusual tiredness or weakness
Other rare side effects may occur. Anyone who has unusual symptoms after taking zolpidem should get in touch with his or her physician.
Interactions
Zolpidem may interact with other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes zolpidem should let the physician know all other medicines he or she is taking. Among the drugs that may interact with zolpidem are:
Other central nervous system (CNS) depressants such as medicine for allergies, colds, hay fever, and asthma; sedatives; tranquilizers; prescription pain medicine; muscle relaxants; medicine for seizures; barbiturates; and anesthetics.
The major tranquilizer chlorpromazine (Thorazine).
Tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil).

Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group The Essay Author is Nancy Ross-Flanigan.
This article was updated on 08-14-2006

The "Quit Smoking" Prescription Drug

2008-05-30T20:27:00.000-07:00

What is Champix?
Champix, generic name varenicline, is a prescription pill designed to help smokers stop smoking.

How does it work?
Champix works primarily in two ways. Firstly, it reduces the smoker's craving for nicotine by binding to nicotine receptors in the brain and reduces the symptoms of withdrawal. Secondly, it reduces the satisfaction a smoker receives when smoking a cigarette.

How successful was it in clinical trials?
In trials, 44% of the group treated with Champix had stopped smoking after being treated for 12 weeks, as opposed to 11% of smokers taking the placebo. Over the same duration, it was also shown to be twice as effective as Zyban (bupropion), the other main anti-smoking drug treatment.

Has Champix been approved by the European Commission and the FDA for use as an aid to quitting smoking?
The European Commission approved Champix on September 29th, 2006 as a "stop smoking" aid for adults, based on the results from clinical trials. It should be noted that continued abstinence from cigarettes is higher (70% compared with 50%) when patients take the drug for 24 weeks as opposed to 12, so it may be appropriate for patients who have succeeded in quitting smoking at the 12 week point to take the drug for a further 12 weeks.

The FDA approved the drug in May 2006. See FDA approves novel drug for smoking cessation for further details.

Is Champix available on the NHS?
On May 31st, 2007 Nice (the National Institute for Health and Clinical Excellence) published draft guidance recommending that this drug should be available on NHS prescription. Further details on the Final Appraisal Determination period can be found on the NICE website.

It was approved for prescription on the NHS in Scotland on 14th January, 2007.

How is the drug taken and what is the recommended dose?
It is taken orally. For the first three days, the dosage is 0.5 mg once daily (the 0.5 mg tablet is white). For days four to seven, the dosage is 0.5 mg twice a day. From day eight until the end of the treatment, the dose is 1 mg twice a day (the 0.5 mg tablet is blue).

You should set a date to quit smoking, and start taking the drug one week before this date.

Body weight changes associated with psychopharmacology

2008-05-28T20:47:00.000-07:00

The authors discuss changes in body weight associated with various psychopharmaceuticals. METHODS: A large number of articles and books about drug-induced changes in body weight, selected on the basis of various literature searches and the authors' clinical experiences with psychopharmaceuticals, were reviewed. RESULTS: Many psychotropic drugs with antipsychotic, mood stabilizing, and antidepressant properties are associated with weight gain. Others, such as fluoxetine, isocarboxazid, nefazadone, topiramate, and psychostimulants, may cause weight loss. The antipsychotic drugs chlorpromazine, clozapine, and olanzapine are often associated with weight gain. Among antidepressants, amitriptyline and mirtazapine are known to cause weight gain. However, reductions are sometimes observed, and each antidepressant has its own unique weight-effect profile. Mood stabilizers, especially valproate-related products, are also associated with weight gain. CONCLUSIONS: Careful monitoring and consideration of alternative therapies are essential.

Vanina Y, Podolskaya A, Sedky K, Shahab H,
Siddiqui A, Munshi F, Lippmann S.
Department of Psychiatry and Behavioral Science
of the University of Louisville,
Kentuchy 40202, USA.
Psychiatr Serv. 2002 Jul; 53(7): 842-7

Prescription Drug

2008-05-27T01:30:00.000-07:00

Depresants
Xanax™ (alprazolam) is from the benzodiazepine family of depressants. It is used to treat insomnia in patients with daytime anxiety or as an anticonvulsant. Alprazolam and diazepam are the two most frequently encountered benzodiazepines on the illicit market.

Valium™ (diazepam) is from the benzodiazepine family of depressants. It is utilized to treat insomnia in patients with daytime anxiety or as an anticonvulsant. It is among the most widely prescribed medications in the United States . Abuse is frequently associated with adolescents and young adults who take the drug to get high. Concurrent use of alcohol or other depressants with Valium™ can be life-threatening. Abuse of benzodiazepines is particularly high among heroin and cocaine abusers.

Stimulants

Methylphenidate (Ritalin™, Concerta™) is a stimulant which is prescribed for attention deficit/hyperactivity disorder. It has a high potential for abuse and produces many of the same effects as cocaine and amphetamines. Binge use, psychotic episodes, cardiovascular complications, and severe psychological addiction have all been associated with methylphenidate abuse.

According to the National Institute on Drug Abuse, methylphenidate is a valuable medicine, for adults as well as children with attention deficit and hyperactivity disorder. Research shows that individuals with ADHD do not become addicted to stimulant medications when taken in the form and dosage prescribed by doctors. In fact, it has been reported that stimulant therapy in childhood is associated with a reduction in the risk for subsequent drug and alcohol use disorders.

Adderall™ is an amphetamine which is used to treat attention deficit hayperactivity disorder (ADHD) in children 6 years of age and older and in adults. Amphetamines have a high potential for abuse. Taking amphetamines for long periods of time may lead to drug addiction. Misuse of amphetamine may cause sudden death and serious heart damage.

Pain Killer

2008-05-27T01:14:00.000-07:00

Hydrocodone
Hydrocodone is a semi-synthetic opioid similar in effects to morphine. Vicodin™ is hydrocodone mixed with acetaminophen. Hydrocodone products, when abused, can lead to dependence, tolerance, and addiction. Vicodin™ is one of the most frequently prescribed medications for pain. Other products include Vicoprophen™, Tussionex™, and Lortab™ .

Oxycodone
Oxycodone is used as an analgesic and is formulated into numerous pharmaceuticals including OxyContin™ (a controlled-release product) and with aspirin (Percodan™) or with acetaminophen (Percoset™). These drugs are prescribed for pain relief. They all require a doctor's prescription and are prescribed for moderate to severe pain.

FENTANYL™ is extensively used for anesthesia and analgesia. Duragesic™ is a fentanyl transdermal patch used in chronic pain management, and Actiq is a solid formulation of fentanyl citrate on a stick that dissolves slowly in the mouth for transmucosal absorption. Illicit use of pharmaceutical fentanyl first appeared in the mid-1970's in the medical community. To date, over 12 different analogues of fentanyl have been produced clandestinely and identified in the U.S. drug traffic. The biological effects are indistinguishable from those of heroin, with the exception that the fentanyls may be hundreds of times more potent. Fentanyls are most commonly used by intravenous administration, but like heroin, they may also be smoked or snorted.

ULTRAM™(tramadol hydrochloride) and ULTRACET™ (tramadol with acetaminophen) are prescription medications indicated for the management of moderate to moderately severe pain. Side effects include: dizziness, drowsiness, or headache; nervousness, tremor, or anxiety; nausea, vomiting, constipation, or diarrhea; or itching, dry mouth, or sweating.

Tramadol is habit forming. Physical and/or psychological dependence can occur, and withdrawal effects are possible if the medication is stopped suddenly after prolonged or high-dose treatment.

Insulin Pump

2008-05-21T23:06:00.000-07:00

If we have Patient diabetes mellitus with blood glucose level over 300mg% again though have put some anti diabetic oral we can use Insulin pump to decrease the blood glucose level. This is new treatment method there we can give intensive insulin after check level of blood glucose, insulin demand dose in the body. This is the best solution for treatment Diabetes Type 1 and Type 2.
Insulin Pump Danadiabecare have designed with high technology by two micro computer and the best safety system.
Insulin Pump will give insulin inject continous 24 hours with terapeutic dose that be made by a doctor depend on patient's insulin demand. The spectaculare news is insulin pump can be programmed to give injection from 0,01 unit/hour to the maximum dose that evaluation by a doctor.

1. Complication Prevention
Insulin pump will suplay insulin in the body continously with the doctor recommend dose. So, blood glucose level will be normal and prevents the diabetic complications, like renal disorder, eye disorder, stroke and ulkus diabeticum.

2. Lose The Level of Diabetes/ Recovery
Give the treatment dose insulin by insulin pump into the body that evaluation by demand of the Diabetes Mellitus Type 2 will give a rest for Beta Cells and make its get the function again. So, next time patient won't need out insulin again.

3. Increase Life Quailty
Patient with insulin pump get free diet than another patient. So, they have enough callory and feel better and they won't need the diabetic oral drugs again.

Diabetes Mellitus Friendship

2008-05-12T02:40:00.000-07:00

Diabetes Mellitus Friendship Seminar:
Date : May 17th, 2008 at 09.00 - 12.00 am
Place : Jogja International Hospital,
Jl. Ringroad Utara no. 160, Condong Catur, Depok, Sleman, Yogyakarta - Indonesia.55283
phone: +622744463535; fax: +622744463444.
e-mail: prabata@rs-jih.com

Anti-anxiety Medications

2008-05-10T01:14:00.000-07:00

Benzodiazepines are used to treat anxiety, but they can be addictive and are only prescribed only for short periods. One exception is panic disorder, for which they may be used for six months to a year.

Some people have withdrawal symptoms when they stop taking benzodiazepines, although reducing the dosage gradually can diminish bothersome symptoms. In certain instances, the symptoms of anxiety can rebound after these medications are stopped.

Other medications

If you have been diagnosed with an anxiety disorder, your doctor may give you a beta-blocker for going into a situation where an attack may happen. The beta-blocker can keep your heart from pounding, your hands from shaking and other physical symptoms from developing.

Before taking medication for an anxiety disorder:

Ask your doctor to tell you about the effects and side effects.
Tell your doctor about any alternative therapies or over-the-counter medications you are using.
Ask your doctor when and how the medication will be stopped. Some drugs have to be tapered slowly under a doctor's care.
Be aware some medications are effective in anxiety disorders only as long as they are taken regularly, and symptoms may come back if you stop the medication.

GLIMEPIRIDE

2007-08-26T19:18:00.000-07:00

DRUG CLASS AND MECHANISM:

Glimepiride is an oral blood sugar-lowering drug in a class of medicines for controlling diabetes called sulfonylureas. Glimepiride is related to other sulfonylureas including glyburide (Micronase; Diabeta), glipizide (Glucotrol), tolbutamide (Orinase) and tolazamide (Tolinase).
Glimepiride is used in type II diabetes, the most common type of diabetes that is found in 90% of patients with diabetes. In type II diabetes, insulin usually is not necessary to control the blood sugar. Instead, diet and oral medications often are sufficient. Intolerance to sugar that results in elevated blood sugar is caused by reduced insulin secretion by the pancreas and resistance to insulin's effects by the body's cells. Glimepiride lowers the sugar level in the blood by stimulating insulin to be secreted from the pancreas into the blood. Insulin causes sugar to leave the blood and enter cells throughout the body.

Glimepiride was approved by the FDA in December of 1995.

GENERIC AVAILABLE: yes

PRESCRIPTION: yes

PREPARATIONS: Tablets: 1mg, 2mg, 4mg.

STORAGE: Tablets should be stored below 86°F (30°C).

PRESCRIBED FOR:

It is believed that control of blood sugar in diabetics decreases the risks of eye, kidney, and nerve damage. Glimepiride is used to treat type II diabetes that cannot be controlled by a strict diabetic diet alone. If sulfonylureas are not effective, other oral drugs or insulin may be used.

DOSING:

Like other medicines used to treat diabetes, the dose of glimepiride is individualized using periodic measurements of blood sugar to determine the best dose.

DRUG INTERACTIONS:

Medicines that can increase blood sugar can reverse the action of glimepiride. These drugs include diuretics [e.g. hydrochlorothiazide, furosemide (Lasix)], corticosteroids such as prednisone and methylprednisolone (Medrol)], phenytoin (Dilantin), niacin, and sympathomimetics such as pseudoephedrine (Sudafed).
Beta-blockers such as propranolol (Inderal) and atenolol (Tenormin) can cause low or high blood sugar. Additionally, they can directly reverse the sugar-lowering effect of sulfonylureas and render them less effective. Beta-blockers also can blunt some of the body's protective responses to low blood sugar, thus making it difficult for patients to recognize reactions due to low blood sugar. This notwithstanding, beta-blockers have been used successfully in diabetic patients and have been associated with improved survival in diabetics with high blood pressure.
Rifampin increases the breakdown of two other sulfonylureas, tolbutamide (Orinase) and glyburide (Diabeta, Micronase). This might interfere with the effects of the drugs and result in higher levels of sugar in the blood. Although this same interference has not yet been reported with glimepiride, the possibility that it may occur should be kept in mind.

PREGNANCY:

In animal studies, glimepiride and other sulfonylureas have been associated with a higher risk of fetal death. However, there have been no good studies in women. On the other hand, abnormal blood sugar concentrations (high or low) during pregnancy increase the risk of abnormalities in the fetus. Therefore, physicians must carefully weigh the benefits and risks of sulfonylurea treatment during pregnancy.

NURSING MOTHERS:

It is not known if glimepiride is excreted in breast milk like other sulfonylureas. Because of the risk of low blood sugar in the infant, it is recommended that glimepiride be discontinued in nursing mothers. If therapy other than diet and exercise is needed, insulin is recommended.

SIDE EFFECTS:

Low blood sugar can occur during glimepiride therapy. Symptoms of low blood sugar include hunger, nausea, tiredness, perspiration, headache, heart palpitations, numbness around the mouth, tingling in the fingers, tremors, muscle weakness, blurred vision, cold temperature, excessive yawning, irritability, confusion, or loss of consciousness. Other side effects include dizziness (1 of every 60 persons), headache (1 of every 75), and nausea or vomiting (1 of every 90). A rash occurs in fewer than 1 of every 100 persons who receive glimepiride.

Lansoprazole

2007-07-27T20:19:00.000-07:00

Why is this medication prescribed?

Lansoprazole is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Lansoprazole is used in combination with other medications to eliminate H. pylori, a bacteria that causes ulcers. Lansoprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

How should this medicine be used?

Lansoprazole comes as a delayed-release (long-acting) capsule and granules to make a delayed-release solution (liquid) to take by mouth. Lansoprazole is usually taken once a day, before eating. When taken in combination with other medications to eliminate H. pylori, lansoprazole is taken twice a day (every 12 hours) or three times a day (every 8 hours) for 10 to 14 days. To help you remember to take lansoprazole, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lansoprazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
The capsule should be swallowed whole. If you have difficulty swallowing capsules, lansoprazole capsules can be opened, and the granules can be sprinkled on 1 tablespoon of applesauce, Ensure pudding, cottage cheese, yogurt, or strained pears and swallowed immediately. The granules should not be chewed or crushed. The capsules can also be emptied into 2 ounces of orange juice or tomato juice, mixed briefly, and swallowed immediately. Rinse the glass with some additional juice and drink immediately.
For patients who have a nasogastric tube, lansoprazole capsules can be opened and the granules mixed in 40 mL of apple juice. The mixture should be injected through the nasogastric tube into the stomach. Then the tube should be flushed with some more apple juice.
To use lansoprazole oral solution, empty the contents of a packet into a container containing 2 tablespoons of water. Stir well and drink immediately. If any granules remain, add more water, stir, and drink immediately. Do not use liquids or foods other than water. Do not crush or chew the granules.
Continue to take lansoprazole even if you feel well. Do not stop taking lansoprazole without talking to your doctor.

What special precautions should I follow?

Before taking lansoprazole,
tell your doctor and pharmacist if you are allergic to lansoprazole or any other medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: ampicillin (Omnipen, Polycillin, Totacillin), digoxin (Lanoxin), ketoconazole (Nizoral), theophylline (Theo-bid, TheoDur), and vitamins containing iron. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
if you are taking sucralfate (Carafate), take it at least 30 minutes after lansoprazole.
tell your doctor if you have or have ever had liver or kidney disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking lansoprazole, call your doctor.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Lansoprazole may cause side effects. Tell your doctor if either of these symptoms is severe or does not go away:
stomach pain
diarrhea
Lansoprazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
What storage conditions are needed for this medicine? Return to top
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor.
Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

Amlodipin

2007-07-21T02:20:00.001-07:00

Amlodipine is used alone or in combination with other medications to treat high blood pressure and chest pain (angina). It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. It controls chest pain by increasing the supply of blood to the heart. If taken regularly, amlodipine controls chest pain, but it does not stop chest pain once it starts.
Amlodipine controls high blood pressure and chest pain (angina) but does not cure them. Continue to take amlodipine even if you feel well. Do not stop taking amlodipine without talking to your doctor.

Special precautions
Before taking amlodipine,
Tell your doctor and pharmacist if you are allergic to amlodipine or any other medicines.
Tell your doctor and pharmacist if you are taking vitamins, nutritional supplements, and herbal products.
Tell your doctor if you have or have ever had heart failure or liver disease.
Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking amlodipine, call your doctor.

Side effects
Amlodipine may cause side effects:
swelling of the hands, feet, ankles, or lower legs
headache
upset stomach
stomach pain
dizziness or lightheadedness
drowsiness
excessive tiredness
flushing (feeling of warmth)
Some side effects can be serious. The following symptoms are uncommon:
more frequent or more severe chest pain
rapid, pounding, or irregular heartbeat
fainting
Symptoms of overdose may include:
dizziness
fainting
rapid heartbeat

Keep all appointments with your doctor.

What is the most important information I should know about cetirizine?

2007-07-20T22:53:00.000-07:00

Use caution when driving, operating machinery, or performing other hazardous activities. Cetirizine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking cetirizine.

While you are taking cetirizine, do not take other prescription or over-the-counter cough, cold, or allergy medications without first talking to your doctor or pharmacist.

What is cetirizine?

Cetirizine is an antihistamine. Cetirizine blocks the actions of the naturally occurring chemical histamine in the body. Cetirizine is less likely than some other antihistamines to cause side effects such as drowsiness and dizziness.
Cetirizine is used to treat the symptoms of allergies such as sneezing; runny nose; itching, tearing, and redness of the eyes; and hives.
Cetirizine may also be used for purposes other than those listed in this medication guide.

Do not take cetirizine without first talking to your doctor if you have had an allergic reaction to it or to the medication hydroxyzine (Atarax, Vistaril).
Before taking cetirizine, tell your doctor if you have kidney or liver disease. You may need a dosage adjustment or special monitoring during treatment.
Cetirizine is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take cetirizine without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Take cetirizine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Stop taking cetirizine and seek emergency medical attention if you experience a rare but serious allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).

Gatifloxacin

2007-07-17T23:12:00.000-07:00

Why is this medication prescribed?
Gatifloxacin is used to treat certain types of lung, sinus, skin, and urinary tract infections caused by bacteria. Gatifloxacin is also used to treat certain types of gonorrhea infections (a sexually transmitted disease). Gatifloxacin is in a class of antibiotics called fluroquinolones. It works by killing the bacteria that cause infection. Gatifloxacin will not work against colds, flu, or other viral infections.

How should this medicine be used?
Gatifloxacin comes as a tablet to take by mouth. It is usually taken with or without food once a day for 1 to 14 days. Take gatifloxacin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take gatifloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the tablets whole; do not split, chew, or crush them.
Take gatifloxacin until you finish the prescription, even if you feel better. If you stop taking gatifloxacin too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
You should begin to feel better soon after you begin your treatment with gatifloxacin. If your symptoms do not improve or if they get worse, call your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Other uses for this medicine
Gatifloxacin may be used to help treat or prevent infection in people who were or may have been exposed to anthrax spores in the air. Gatifloxacin is also sometimes used with other medications to treat tuberculosis (TB; an infection that may affect the lungs and other parts of the body). Talk to your doctor about the risks of using this medication for your condition.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before taking gatifloxacin,
tell your doctor and pharmacist if you are allergic to gatifloxacin (Tequin, Zymar) or other quinolone antibiotics including cinoxacin (Cinobac) (not available in the United States), ciprofloxacin (Ciloxan, Cipro), enoxacin (Penetrex) (not available in the United States), gemifloxacin (Factive), levofloxacin (Iquix, Levaquin, Quixin), lomefloxacin (Maxaquin), moxifloxacin (Avelox, Vigamox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin, Ocuflox), sparfloxacin (Zagam), or trovafloxacin and alatrofloxacin combination (Trovan) (not available in the United States); any other medications; or any of the ingredients in gatifloxacin tablets. Ask your pharmacist for a list of the ingredients.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain other antibiotics, including erythromycin (E.E.S., others); anticoagulants ('blood thinners') such as warfarin (Coumadin); antidepressants ('mood elevators'); antipsychotics (medications for mental illness); cisapride (Propulsid) (not available in the United States); diuretics ('water pills') including furosemide (Lasix) and hydrochlorothiazide (Diurel, others); certain medications to control irregular heartbeat including amiodarone (Cordarone), digoxin (Digitek, Lanoxicaps, Lanoxin); disopyramide (Norpace), dofetilide (Tikosyn), procainamide (Pronestyl),quinidine (Quinidex), and sotalol (Betapace); non-steroidal anti-inflammatory agents including ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); probenecid (Benemid); or sucralfate (Carafate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
if you are taking aluminum- or magnesium-containing antacids (some forms of Mylanta, some forms of Maalox, others); didanosine (Videx) chewable tablets or solution (liquid); or dietary supplements or multi-vitamins that contain iron (such as ferrous sulfate), magnesium, or zinc, you should take them 4 hours after you take gatifloxacin.
tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem that may cause fainting or irregular heartbeat); or an abnormal electrocardiogram (ECG, EKG; heart rhythm test); tell your doctor if you have or have ever had low levels of potassium in the blood;slow heartbeat; a recent heart attack. Also tell your doctor if you have or have ever had cerebral atherosclerosis [narrowing of blood vessels in or near the brain which can lead to stroke or mini-stroke (TIA)]; diabetes; seizures; or heart, kidney, or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking gatifloxacin, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking gatifloxacin.
you should know that this medication may cause dizziness, lightheadedness, and drowsiness. Do not drive a car, operate machinery, or participate in other activities requiring mental alertness and coordination until you know how gatifloxacin will affect you.
plan to avoid unnecessary or prolonged exposure to sunlight or artificial ultraviolet light (tanning beds) and to wear protective clothing, sunglasses, and sunscreen. Gatifloxacin may make your skin sensitive to sunlight. Call your doctor if you develop skin redness, blisters, or bumps.
you should know that your blood sugar may increase or decrease during your treatment with gatifloxacin. These changes in blood sugar may be serious or life-threatening. You are most likely to experience changes in your blood sugar if you have diabetes. However, you may experience changes in your blood sugar even if you do not have diabetes. Tell your doctor if you have diabetes or any other condition that causes your blood sugar to be too high or too low. If you have diabetes, your doctor will probably tell you not to take gatifloxacin. Also tell your doctor if you are taking other medications that may affect your blood sugar, such as insulin or oral medications for diabetes including glyburide (DiaBeta, Glycron, Glynase, Micronase, in Glucovance). Talk to your doctor about how to monitor your blood sugar during your treatment and the steps to take if your blood sugar increases or decreases.
tell your doctor if you have ever had tendonitis (swelling or tearing of a fiber that connects a bone to a muscle), if you participate in regular athletic activity, or if you are taking oral steroids such as methylprednisolone (Medrol) and prednisone (Deltasone). There is a risk that you may develop tendonitis while you are taking gatifloxacin. If you develop symptoms of tendonitis such as pain, swelling, tenderness, stiffness, or difficulty in moving a muscle, stop taking gatifloxacin, rest, and call your doctor immediately.

What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?
This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.
You may experience hypoglycemia (low blood sugar) while you are taking this medication. Your doctor will tell you what you should do if you develop hypoglycemia. He or she may tell you to check your blood sugar, eat or drink a food or beverage that contains sugar, such as hard candy or fruit juice, or get medical care. Follow these directions carefully if you have any of the following symptoms of hypoglycemia:
shakiness
dizziness or lightheadedness
sweating
nervousness or irritability
sudden changes in behavior or mood
headache
numbness or tingling around the mouth
weakness
pale skin
hunger
clumsy or jerky movements
If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately.
confusion
seizures
loss of consciousness
Call your doctor immediately if you have any of the following symptoms of hyperglycemia (high blood sugar):
extreme thirst
frequent urination
extreme hunger
weakness
blurred vision
If high blood sugar is not treated, a serious, life-threatening condition called diabetic ketoacidosis could develop. Get medical care immediately if you have any of these symptoms:
dry mouth
nausea and vomiting
shortness of breath
breath that smells fruity
decreased consciousness
Gatifloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
vaginal itching, swelling, or discomfort
stomach pain
loss of appetite
change in the way things taste
heartburn
gas
diarrhea
constipation
painful urination
sores or white patches in the mouth
sore tongue
tiredness
muscle or joint pain
leg cramps
ringing in the ears
dry skin
fever
chills
sore throat
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
rash or blisters on skin
itching
hives
swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
difficulty breathing or swallowing
hoarseness
tightness of the throat
fast or pounding heartbeat
chest pain
fainting
depression
paranoia (abnormal fear)
hallucinations (seeing things or hearing voices that do not exist)
difficulty falling asleep or staying asleep
nightmares
agitation
anxiety
yellowing of the skin or eyes
pain, burning, numbness, weakness, or tingling in the hands or feet
bloody stools
dark colored urine
decrease in urination
rapid weight loss
shaking of a part of the body that you cannot control
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children.Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to gatifloxacin.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the gatifloxacin, call your doctor.

Levofloxacin

2007-07-17T21:57:00.000-07:00

GENERIC NAME: levofloxacin
BRAND NAME: Levaquin

DRUG CLASS AND MECHANISM:
Many common infections in humans are caused by single cell organisms, called bacteria. Bacteria can grow and multiply, infecting different parts of the body. Medicines that control and eradicate these bacteria are called antibiotics. Levofloxacin is an antibiotic that stops multiplication of bacteria by preventing the reproduction and repair of their genetic material (DNA). It is in a class of antibiotics called fluoroquinolones, a class that includes ciprofloxacin (Cipro), norfloxacin (Noroxin), ofloxacin (Floxin), trovafloxacin (Trovan), and lomefloxacin (Maxaquin). Levofloxacin was approved by the FDA in 1996.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 250, 500, and 750 mg. Oral solution, 25 mg/mL.

STORAGE: Levofloxacin should be stored below 86°F.

PRESCRIBED FOR:
Levofloxacin is used to treat infections of the sinuses, skin, lungs, ears, airways, bones, and joints caused by susceptible bacteria. Levofloxacin also is frequently used to treat urinary infections, including those resistant to other antibiotics, as well as prostatitis. Levofloxacin is effective in treating infectious diarrheas caused by E. coli, campylobacter jejuni, and shigella bacteria. Levofloxacin also can be used to treat various obstetric infections, including mastitis.
DOSING: Levofloxacin usually is given once daily. It is important to take it at least 2 hours before or 2 hours after any antacid, or mineral supplement with iron, calcium, zinc, or magnesium since these minerals bind levofloxacin and prevent its absorption.
DRUG INTERACTIONS: Minerals with 2 or 3 positive charges, called divalent or trivalent ions, respectively, can attach to levofloxacin and other fluoroquinolones and prevent their absorption from the intestine into the blood. Therefore, such products (containing iron, calcium, zinc, or magnesium) as well as antacids, should be taken at least 2 hours before or 2 hours after levofloxacin. Other drugs which contain these ions and which can similarly interact with levofloxacin include sucralfate (Carafate) and didanosine, dDI.
Taking non-steroidal anti-inflammatory drugs (NSAIDs) with levofloxacin may increase the risk of CNS stimulation, resulting in over-excitation. There have been reports of changes in blood sugar in patients treated with other fluoroquinolones and antidiabetic agents. Other fluoroquinolones have been reported to increase blood levels of theophylline (Theodur), warfarin (Coumadin), and cyclosporine (Sandimmune; Neoral). There have not yet been similar reports with levofloxacin.

PREGNANCY:
Levofloxacin is not recommended for use in pregnant women since levofloxacin causes joint and bone deformities in juvenile animals of several species.

NURSING MOTHERS:
Levofloxacin is not recommended for use in lactating women since levofloxacin causes joint and bone deformities in juvenile animals of several species. In fact, levofloxacin is not recommended in persons under the age of 18 years.

SIDE EFFECTS:
The most frequently reported side events are nausea or vomiting (1 out of every 12 persons), diarrhea (1 out 20), headache (1 out 20), and constipation (1 out of 30). Less common side effects include difficulty sleeping, dizziness, abdominal pain, rash, abdominal gas, and itching.

Cotrimoxazole

2007-07-17T21:45:00.000-07:00

Content
per tab : Trimetroprim 80mg and Sulfamethoxazole 400mg.
Forte caplet: Trimetoprim 160mg and Sulfamethoxazole 800mg
Syrup: Per 5 mL syr Trimetoprim 40mg and Sulfamethoxazole 200mg

Indication:
Gastro Intestinal Tract, respiratorius tract, skin and other infections caused by sensitive microorganisms.

Dosis:
Adult 2 tab, Children 5 – 12 years 1 tablet/ syrup 2 tsp, Children 6 month – 5 years 1 tsp, children 2 month – 6 month ½ tsp. to be taken 2 times daily.
Severe infection: dosis may be increased.

Contra Indication:
Severly impaired hepatic or renal function. Hypersensitivity to sulfonamides, blood dyscrasias, Pregnancy and lactation. Infant < 2 month. Porphyria.

Special Precaution:
Folic Acid and G6PD deficiency. Poor nutritional status. Elderly and patients with reduced kidney function.
Adverse Reactions:
Gastro Intestinal Disturbances, Stevens-Johnson & Lyell’s syndrome, Rarely, hepatitis, blood disorders, pseudomembranous colitis.

Drug Interaction:
Effects reduced by PABA and procaine-type local anesth and enhanced by highly bound drugs. May potenciate effects of methotrexate, warfarin, sulfonylureas.

Amoxycillin

2007-07-17T21:39:00.000-07:00

Indication:
Treatment of infections caused by gram+ or gram- microorganisms susceptible to amoxicillin, upper and lower respiratorius tract, genitourinarius tract, skin and soft tissue infections, typhoid fever (but not drug of choice)

Dosis:
Adult and Children> 20kg 750 – 1500mg daily, to be taken in divided doses 8 hourly; <20kg 25 – 50mg/kg body weight/day.

Contra Indication:
Penicillin allergy

Special Precaution:
Assessment renal & hepatic function during prolonged treatment. Superinfection.

Adverse Reactions:
Nausea, vomiting, diarrhea, hay fever, pruritus and skin rash

Drug Interaction:
Probenecid prolongs half-life of amoxicillin.