Posts Tagged ‘failure’

Type of Drug
corticosteroids, Oral (kor-tih-koe-STER-oids)
Brand Names
Betamethasone Celestone
Gerzq(t St D?Pdient: Budesonide Entocort EC
Cortisone Acetate &I
Dexamethasone EQ Mymethasone
Fludrocortisone
Hydrocortisone Cortef
Methylprednisolone 19 Medrol
Prednisolone 10
Orapred    Pediapred
Orapred ODT    Prelone
Prednisone 0 Prednisone Intensol    Sterapred
Prescribed For
A wide variety of disorders from rash to cancer, including adrenal disease, adrenal hormone replacement, bursitis, arthritis, severe skin diseases including psoriasis and other rashes, severe or disabling allergies, asthma, drug or serum sickness, attacks of multiple sclerosis, severe respiratory diseases including pneumonitis, blood disorders, gastrointestinal (GI) disease including ulcerative colitis and Crohn’s disease, and inflammation of the nerves, heart, or other organs. Dexamethasone is also used to treat mountain sickness, vomiting, bronchial disease in premature babies, excessive hairiness, and hearing loss associated with bacterial meningitis. Fludrocortisone is used to treat Addison’s disease and for symptomatic orthostatic hypotension. Prednisone is used to improve strength and function of some muscular dystrophy patients. Methylprednisolone is used to decrease mortality in some patients suffering from severe alcoholism and chronic active hepatitis.
General Information
Produced by the adrenal gland, natural corticosteroids are hormones that affect almost every body system. The major dMeyences among corticosteroid drugs are potency and variation in secondary effects, 0OZ10r preference and past experience with a Mftosferoid usually determine which drug to prescribe for a specific disease.
Cautions and Warnings
Do not use an oral corticosteroid if you are allergic or sensitive to any of its ingredients.
Corticosteroids may mask symptoms of an infection. Because these drugs compromise the immune system, new infections may occur during corticosteroid treatment; when this happens, a relatively minor infection that would respond to ordinary treatment can turn serious. Corticosteroids may impair immune response to hepatitis B, prolonging recovery. They may reactivate dormant amebiasis (a parasitic infection). Corticosteroids should not be taken if you have a fungal blood infection, because they can allow the infection to spread more easily. They should be used with caution by people with herpes eye infection, tuberculosis or in any other bacterial, fungal, or viral infections.
Long-term use of any corticosteroid may increase the risk of developing cataracts, glaucoma, or eye infections, especially viral or fungal.
When stopping a corticosteroid, dosage must be reduced gradually under a doctor’s supervision—otherwise you may experience adrenal gland failure.
If you are taking large corticosteroid doses. you should not receive any live virus vaccine because corticosteroids interfere with the body’s reaction to the vaccine.
Hydrocortisone and cortisone may lead to high blood pressure. Other corticosteroids are less likely to affect blood pressure.
Corticosteroids should be used with caution if you have severe kidney disease.
High-dose or long-term corticosteroid therapy may aggravate or worsen stomach ulcers. This may occur when total dosage reaches 1000 mg of prednisone, 150 mg of betamethasone or dexamethasone, 5000 mg of cortisone. 4000 mg of hydrocortisone, 1000 mg of prednisolone, or 800 mg of methylprednisolone.
People who have recently stopped taking a corticosteroid and are going through a period of stress may need small doses of a rapid-acting corticosteroid, such as hydrocortisone, to get them through this period. Call your doctor if you think you might be experiencing this kind of stress reaction.
Use corticosteroids with caution if you have had a recent heart attack or have, Colitis, heart failure, high blood pressure, blood-clotting tendencies, thrombophlebitis, osteoporosis, antibiotic-resistant infections, Cushing’s disease, myasthenia gravis, metastatic cancer, diabetes, underactive thyroid disease, cirrhosis of the liver, or seizure disorders.
corticosteroid psychosis (symptoms include euphoria or feeling “high,” delirium, sleeplessness, mood swings, personality changes, and severe depression) may develop in people taking dosages greater than 40 mg a day of prednisone. These symptoms may also develop with other corticosteroids taken in equivalent doses (see “Usual Dose” for relative equivalencies). Symptoms of corticosteroid psychosis usually develop within 15-30 days of beginning treatment. These symptoms may also be linked to other factors—women and those with a family history of psychosis are more at risk.
Corticosteroids can cause loss of calcium, which may result in bone fractures and aseptic necrosis of the femoral and humorai heads (a condition in which the large bones in the hip degenerate from loss of calcium).
Prednisone may aggravate emotional instability.
Corticosteroids do not cure multiple sclerosis (MS) or slow its progression, though they may speed recovery from attacks of the disease.
. Corticosteroid products often contain tartrazine dyes and sulfite preservatives. Many people are allergic to these chemicals.
Possible Side Effects
✓    Most common: headache, respiratory infections, acne, and bruising.
✓    Common: water retention (swollen ankles), back pain, heart failure, upset stomach (possibly leading to stomach or duodenal ulcer), potassium loss, dizziness, fatigue, insomnia, weight gain, increased appetite, nausea, stomach gas, abdominal pain, general pain, muscle weakness, loss of muscle mass, slowed healing of wounds, increased sweating, allergic rash, itching, convulsions, excess hair growth, and worsening of a pre-existing psychiatric condition.
✓    Less common: irregular menstruation; slowed growth in children, particularly after lengthy periods of corticosteroid treatment; adrenal or pituitary gland suppression; diabetes; drug sensitivity or allergic reactions; blood clots; moon face; feeling unwell; euphoria; mood swings; personality Changes; and severe depression.
♦    Rare: Rare side effects can appear in any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Tell your doctor if you are taking any oral anticoagulant (blood-thinning) drug. If you begin taking a corticosteroid, your anticoagulant dosage may have to be adjusted.
•    Combining a corticosteroid and a diuretic such as hydrochlorothiazide may cause loss of blood potassium. Low blood potassium may increase the side effects of digitalis drugs.
•    Contraceptive drugs, estrogen, erythromycin, azithromycin, clarithromycin, and ketoconazole may increase the risk of corticosteroid side effects.
•    Barbiturates, aminoglutethimide, phenytoin and other hydantoin anticonvulsants, rifampin, ephedrine, colestipol, and cholestyramine may reduce the effectiveness of corticosteroids.
•    Corticosteroids may decrease the effects of aspirin and other salicylates, growth hormones, and isoniazid.
•    Combining a corticosteroid and a theophylline drug may require a dosage adjustment of either or both drugs.
•    Corticosteroids may interfere with laboratory tests. Tell your doctor if you are taking any of these drugs so that tests are properly analyzed.
•    Limit your intake of alcohol while on oral corticosteroids.
Food Interactions
Take corticosteroids with food or a small amount of antacid to avoid stomach upset. If stomach upset continues, notify your doctor. Grapefruit juice doubles the amount of some oral corticosteroids absorbed into the blood.
Usual Dose
Once-daily doses should be taken in the morning. Dosages vary greatly and depend upon the specific disease being treated. Dosages for infants and children should be individualized according to severity of disease and response to treatment.
Betamethasone: starting dosage-0.6-7.2 mg a day. Maintenance 1609age-0.6-7.2 mg a day.
Budesonide: 9 mg a day.
Cortisone: starting dosage-25-300 mg a day. Maintenance dosage-25-300 mg a day.
Dexamethasone: 0.75-9 mg a day. Daily dosage sometimes exceeds 9 mg. A temporary dosage increase may be necessary it you are experiencing emotional stress. In alternate-day therapy, twice the usual daily dose is taken every other day.
Hydrocortisone: 20-240 mg a day.
Methylprednisolone: starting dosage-4-48 mg or more a day. Maintenance dosage varies. A temporary dosage increase may be necessary if you are experiencing emotional stress. in alternate-day therapy, twice the usual daily dose is taken every other day.
Prednisone and Prednisoione: 5-60 mg a day. Daily dosage sometimes exceeds 60 mg. A temporary dosage increase may be necessary if you are experiencing emotional stress. In alternate-day therapy, twice the usual daily dose is taken every other day.
Equivalent doses: Using 5 mg of prednisone as the basis for comparison, equivalent doses of other corticosteroids are 0.6 mg-0.75 mg of betamethasone, 25 mg of cortisone, 0.75 mg of dexamethasone, 20 mg of hydrocortisone, 4 mg of methylprednisolone, and 5 mg of prednisolone.
Overdosage
Symptoms of overdose are anxiety, depression or stimulation, joint or muscle pain, blurred vision, stomach bleeding, increased blood sugar, high blood pressure, and water retention. The victim should be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Do not stop taking this medication without your doctor’s knowledge. Suddenly stopping any corticosteroid drug may have severe consequences; the dosage must be gradually reduced by your doctor.
G& your doctor if you develop unusual weight gain, black or tarry stools, swelling of the feet or legs, muscle weakness, vomiting of blood, menstrual irregularity, prolonged sore throat, fever, cold or infection, appetite loss, nausea and vomiting, diarrhea, weight loss, weakness, dizziness, or low blood sugar.
If you take several doses a day and forget a dose, take the dose you forgot as soon as possible. It it is almost time for your next dose, skip the one you forgot and double the next dose. If you take 1 dose a day and forget a dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
If you take a corticosteroid every other day and forget a dose, take it immediately if you remember it in the morning of your regularly scheduled day. If it is much later in the day, skip the dose you forgot and take it the following morning, then go back to your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Studies have shown that long-term corticosteroid therapy at high dosages may cause birth defects, as may chronic corticosteroid use during the first 3 months of pregnancy. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
Corticosteroids taken by mouth may pass into breast milk. Most nursing mothers who must take a corticosteroid should use infant formula, though low dosages of some of these drugs may be taken for short periods while breast-feeding. Consult your doctor.
Seniors: Seniors are more likely to develop high blood pressure while taking an oral corticosteroid. Older women are more susceptible to osteoporosis (a condition characterized by loss of bone mass due to depletion of minerals, especially calcium) associated with high dosages of oral corticosteriods. Lower dosages are just as effective in seniors and cause fewer side effects.

Type of Drug
Corticosteroids, Topical
(kor-tih-koe-STER-oids)
Brand NameS
CLASS 1–Super-potent topical products
Betamethasone Dipropionate gel, ointment 0.05% 91
Diprolene gel/ointment
C/obetasol Propionate 0.05% cream, foam, gel, lotion, shampoo, ointment 19
Clobex    Olux
Cormax    Olux E
Embeline    Temovate Embeline E
Difforasone Diacetate ointment 0.05% RE Olux-E Foam    Psorcon E
Fluocinonide cream 0.1 % 0 Vanos
Flurandrenolide tape 4 MCgICM2 Rfl Cordran Tape
Halobetasol Propionate cream/ ointment 0.05%
Ultravate
CLASS 2—High-potency topical products  Amcinonide ointment 0.1 % (0
Betamethasone Dipropionate cream 0.05%
Diprolene AF
Generic Ingredients: Betamethasone Dipropionate (0.064%) + Calcipotriene (0.005%) ointment
Taclonex
Desoximetasone Cream, ointment 0.25% and 0.05%; 0.05% gel DG
Topicort    Topicort LP
Generic 10gVEOUnt.- Diflorasone Diacetate cream, ointment 0.05% 91
Apexicon    Florone E
Apexicon E    Maxiflor
Florone    Psorcon
Fluocinonide cream, gel, ointment,
solution 0.05% 9
Lidex    Lidex E
Halcinonide cream, ointment, solution 0.1 % Halog
Mometasone Furoate ointment 0.1 % 91 Elocon
Triamcinolone Acetonide ointment 0.5% RE
CLASS 3—Upper mid-strength topical products  Amcinonide lotion 0.1 % 0
Betamethasone Dipropionate cream 0.05% (a
Diprolene    Teladar
Maxivate
Generic Ingredient.- Betamethasone Valerate ointment 0.1 %
Fluocinofone Acetonide [’61 Capex Shampoo
Fluticasone Propionate cream 0.05% 9 Cutivate
Triamcinolone Acetonide cream 0.5%
Delta-Tritex    Kenonel
Flutex    Triacet
Kenalog Cream    Triderm Kenalog-H
CLASS 4—Mid-strength topical products  Amcftnide cream 0.1% D3
Betamethasone Dipropionate lotion 0.05% and foam 0.12%®
Diprosone    Maxivate Lotion
Luxiq Foam
Desoximetasone cream 0.05% 19 Topicort
Fluocinolone Acetonide
Synalar Ointment 0.025%    Synalar-HP Cream 0.2%
Flurandrenolide ointment 0.05% Cordran
Fluticasone Propionate lotion 0.05% Cutivate
Hydrocortisone Valerate ointment 0.2% ED Westcort
Mometasone Furoate cream, lotion, solution 0.1
Elocon
Prednicarbate ointment 0.1 % 10 Dermatop E
Triamcinolone Acetonide 0.1 %
Aristocort A    Delta-Tritex Cream
Aristocort Cream and    Kenalog
Ointment    Triderm
CLASS 5—Lower mid-strength topical products  Betamethasone Valerate cream, lotion 0.1
Beta-Val    Dermabet
Betatrex    Valnac
Clocortolone Pivalate cream 0.1 % Cloderm
Desonide ointment 0.0511/0
Desonate    Tridesilon
UnOwen    Verdeso Foam Lokara
Fluocinolone Acetonide cream 0.025% 91 Synalar
Flurandrenolide cream, lotion M Cordran Lotion 0.05% Cordran SP 0.05% Cordran Ointment 0.25%
Fluticasone Propionate ointment 0.005% Cutivate
Hydrocortisone Butyrate Cream, ointment, solution 0.1 0
Locoid
Hydrocortisone Probutate 0.1% Pandel
Hydrocortisone Valerate cream 0.2% RE Westcort
Prednicarbate Cream 0.1 % RE Dermatop E
CLASS 6—Mild topical products
Alclometasone Dipropionate cream, ointment 0.05% 91
Aclovate
Desonide cream, lotion 0.05% DesOwen    Tridesilon Lokara
Fluocinolone Acetonide cream, shampoo, solution 0.01%
Derma-Smoothe/FS Oil    FS Shampoo
Flurosyn    Synalar
Flurandrenolide cream DG Cordran SP 0.025%
Generic Ingredient., Triamcinoione Acetonide cream 0.1 % MS10cort
Triamcinolone Acetonide cream 0.025% Flutex    Triacet
Kenalog
CLASS 7—Least potent topical products  Hydrocortisone A
1% HC    HydroSkin
Ala-Cort    HydroTex
Ala-Scalp    Hytone
Alcortin    Ivy Soothe
Analpram-HC    Maximum Strength Bactine
Anusol-HC    Maximum Strength Cortaid
Cetacort    Maximum Strength Cortaid
Cortaid Intensive Therapy    Faststick
Cortizone-5    Maximum Strength
Cortizone-10    KeriCort-1 0
Cortizone-10 Plus    Nutracort
Cortizone-10 Quickshot    Procort
Cortizone for Kids    Proctocream-HC
Delcort    Proctofoam-HC
Extra Strength CortaGel    Stie-cort
Hemril    Synacort
Hi-Cor 1.0    Tegrin HC
Hi-Cor 2.5    Texacort Hycort
Hydrocortisone Acetate cream, ointment 0.5% and 1%G
Cortef Feminine Itch    Lanacort
Corticaine    Maximum Strength Caldecort
Cortifoam    Micort-HC
Dricort    U-Cort Gynecort Female Creme
Prescribed For
Inflammation, itching, eczema, dermatitis, vitiligo (patchy loss of skin color), blistering skin diseases, lupus and other connective tissue diseases, psoriasis, and many other specialized skin problems; may also be used to Weal severe diaper rash.
General Information
Topical corticosteroids do not cure the underlying cause of skin problems, but they can relieve symptoms of rash, itching, or inflammation by interfering with the body mechanisms that produce them. You should never use a topical corticosteroid without your doctor’s knowledge because it could mask a symptom important in diagnosing your condition. Also, improper use of a topical corticosteroid could lead to unwanted and sometimes permanent side effects. In general, ointment forms of topical steroids are more potent and usually more effective than cream or lotion forms. Ointments are also less likely to cause allergic reactions because they contain fewer inactive ingredients.
Generic products in this group can vary in potency and produce different results from their brand-name counterparts, even though they contain the identical quantity of active ingredient. Topical steroids are rated from 1 (most potent) to 7 (least potent). Generally, products within a potency class are interchangeable. Ask your doctor or pharmacist which products are interchangeable. The lowest potency products are available without a prescription. Ointments tend to be more potent than creams and solutions and different product concentrations affect their classification.
Super-potent topical corticosteroids (class 1) should not be used on the face, neck, under the arms, or in the groin area. These products are generally reserved for situations in which less potent products have not worked. They should be used with caution, and should only be applied to the areas that are affected with the rash. Using a product in this category for longer than 2 weeks at a time increases the risk of permanent skin damage.
High-potency topical corticosteroids (classes 2 and 3) are best for the trunk, arms, and legs, but should not be used on the face, neck, under the arms, or in the groin area. Using a product in this category for longer than 2 weeks at a time increases the risk of permanent skin damage.
Intermediate-potency topical corticosteroids (classes 4 and 5) can be used in children for up to 1-2 weeks at a time. This type of medication is best for the trunk and extremities. It is safer for use on thin skin, and less effective on thicker skin.
Low-potency topical corticosteroids (classes 6 and 7) can be used on any part of the body, and can be used in children. They are the best choice for the face, uadera~m area, groin, neck, and i ftl Occluded areas such as skin folds.
Cautions and Warnings
Do not use a topical corticosteroid if you are allergic or sensitive to corticosteroids or to any ingredients of the aerosol, cream, gel, lotion, ointment, or solution. Do not use a topical corticosteroid as the sole treatment for bacterial skin infections such as impetigo, viral skin diseases such as herpes, fungal skin infections such as athlete’s foot, or known tuberculosis of the skin. These drugs should not be used in the ear if the eardrum is perforated. Do not use a topical corticosteroid on ulcerated skin, or to treat acne.
Skin problems can become less responsive with time if a product is applied continuously over a long period of time. This can re-
sult in a flare-up of the problem when the medication is stopped.
Using a less potent product may avoid this problem.
Rectal corticosteroid products should not be used if you have any serious bowel condition, including bowel perforation, obstruction, abscess, and systemic fungal infection.
The rectal foam is not expelled after it has been applied and may result in higher drug blood levels than those associated with rectal enema products. The risk of systemic (whole-body) side effects is greater when more of the drug enters the blood. If there is no improvement after 2 or 3 weeks of using a rectal corticosteroid, contact your doctor.
Using a topical corticosteroid around the eyes for prolonged periods may cause cataracts, glaucoma and/or permanent thinning and fragility of skin around the eyes where the corticosteroid is being applied.
Children may be more susceptible to serious systemic side effects from topical corticosteroids, including growth retardation, Cushing’s syndrome, and suppression of natural corticosteroid production, requiring a tapering of the medication, especially if the medications are applied to large areas over long periods. Super-potent topical corticosteroids are not recommended for children.
Possible Side Effects
♦ Most common: burning; itching; irritation; “steroid” acne; skin thinning, tightening, or discoloration; stretch marks; dry cracked skin; bruising; and secondary i0ection. These effects are more likely when the treated area is covered Stith al) occlusive bandage (one that prevents contact with water and air). Side effects are more likely with extended use of high-potency topical corticosteroid products and when the treated area is covered with a bandage that completely prevents skin contact with water and air.
Possible Side Effects (continued)
V Significant amounts of corticosteroids may be absorbed into the bloodstream if large amounts are used for long periods. This can result in systemic effects and may cause serious problems, particularly in people with liver disease. Systemic side effects include lightheadedness, hives, growth suppression, and adrenal suppression.
Drug Interactions None known.
Usual Dose
Adult
Cream, Ointment, Solution, Foam, and Aerosol: Apply a thin film to the skin 2-3 times a day. High- and super-potent products should be applied no more than twice a day, and should be used for short-term treatment, usually 2-3 weeks at a time. Some may have to be applied only once a day.
Rectal Enema: 100 mg nightly for 21 days.
Rectal Foam: 1 applicator’s worth, 1-2 times a day for 2-3 weeks.
Child: Dosages for children should be limited to the lowest possible potency.
Overdosage
Serious adverse effects are unlikely after accidental ingestion. Excessive use of large amounts of topical corticosteroids may cause overdose symptoms and require gradual discontinuation of the drug. Call your local poison control center or a hospital emergency room for more information. ALWAYS bring the prescription bottle or container.
Special Information
To prevent secondary infection, clean the skin before applying the drug. Apply a very thin film and rub in gently—effectiveness depends m contact area, not the thickness of the layer applied.
Do not wash, rub, or put clothing on the area until the medication has dried.
Topical corticosteroids have an additive effect: with continuous use, 1 or 2 applications a day may be as effective as 3 or more. Once the drug begins to take effect, your doctor may recommend reducing the dose to the minimum level needed to control the
condition.
Flurandrenolide tape comes with specific directions for use-, fol-
low them carefully.
If your doctor instructs you to apply plastic wrap or any other occlusive dressing, follow directions carefully. These dressings can increase the penetration of the drug into your skin by as much as 10 times, which may be a crucial element in the medication’s effectiveness. Occlusive dressings should not be used with any of the super-potent topical products.
If you are using one of these products for diaper rash, do not use tight-fitting diapers or plastic pants, which can cause too much drug to be absorbed into the blood.
Your doctor may prescribe a specific form of the product with good reason. Do not change forms without your doctor’s knowledge: a different form may not be as effective.
If you forget to administer a dose, do so as Soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not administer a double dose.
Special Populations
Pregnancy/Breast-feeding: Large amounts of corticosteroids applied to the skin for long periods of time may increase the risk of birth defects. When your doctor considers any of these drugs crucial, its potential benefits must be carefully weighed against its risks. Do not use any over-the-counter hydrocortisone product for more than a few days without your doctor’s knowledge.
Nursing mothers who must use a topical corticosteroid should consider using infant formula. If you apply a corticosteroid to the nipple area, be sure to completely clean the area prior to nursing. Nursing mothers should never use the highest potency corticosteroids (classes 1, 2 or 3) because of the risk of absorbing large amounts of drug into the system that could find its way into breast milk. Nursing mothers should discuss toqkoa1 corticosteroid use with their doctor befQ(e,applying any product.
Seniors: Seniors are more susceptible to high blood pressure and osteoporosis (a condition characterized by loss of bone mass due to depletion of minerals, especially calcium) associated with large dosages. These effects are unlikely with topical corticosteroids unless a high-potency medication is used over a large area for an extended period.

Brand Name
Cortisporin Otic
Generic Ingredients
Hydrocortisone + Neomycin Sulfate + Polymyxin B Sulfate RE
Other Brand Names
AK-Spore H.C. Otic    Octicair
Antibiotic    Otic-Care
Cortatrigen Ear Drops    Otocort
Drotic    Pediotic
Ear-Eze    UAD LazerSporin-C
Type of Drug
Antibiotic and corticosteroid combination.
Prescribed For
Superficial ear infection, ear inflammation or itching, and other outer ear problems.
General Information
Cortisporin Otic contains a corticosteroid to reduce inflammation and 2 antibiotics to treat local ear infections. This combination can be quite useful for local ear problems because of its dual method of action and its relatively broad applicability.
Cautions and Warnings
Do not use Cortisporin Otic if you are allergic or sensitive to any of its ingredients.
Cortisporin Otic is designed for use in the ear. It can be very damaging if placed into the eye.
Cortisporin should not be used if you have herpes simplex, vaccinia, or chickenpox. It also should not be used by patients sensitive to sulfite.
Cortisporin Otic should not be used iAyou have a perforated eardrum,
Possible Side Effects
V Local irritation, such as itching or burning, may occur as a drug sensitivity or allergic reaction.
Drug Interactions None known.
Usual Dose
3-4 drops in the affected ear 3-4 times a day. Treatment should not last beyond 10 days.
Overdosage
The amount of drug contained in each bottle is too small to cause serious problems. Call a hospital emergency room or your local poison control center for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Use only when prescribed by a physician. Overuse of this or similar products can result in the growth of new organisms, such as fungi. If new infections or problems appear, stop using the drug and contact your doctor.
Before administering drops, wash your hands, then hold the Closed bottle in your hand for a few minutes to warm it to body temperature. Shake well for 10 seconds. For best results, drops should not be self-administered, but given by another person. The person receiving the drops should lie on his or her side with the affected ear facing upward. Fill the dropper and instill the required number of drops directly in the ear canal.
If the drops are being given to an infant, hold the earlobe down and back to allow the drops to run in. If the drops are being given to an older child or adult, hold the earlobe up and back to allow them to run in. Do not put the dropper into the ear or allow it to touch any part of the ear or bottle. Keep the ear tilted for about 5 minutes after the drops have been put in or insert a soft cotton plug, whichever is recommended by your doctor.
If you forget to administer a dose of Cortisporin Otic, do so as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedQ%e. Do not apply a double dose.
Special Populations
Pregnancy/Breast-feeding: There are no studies of Cortisporin Otic in pregnant women but it does contain a corticosteroid, which when used over long periods of time in other formulations may increase the risk of birth defects. This drug should only be used during pregnancy after carefully weighing it potential benefits against its risks. Nursing mothers who must take this drug should use in-Pant formula.
Seniors: Seniors may use this product without special restriction.

Brand Name
Cosopt
Generic Ingredients  Dorzolamide + Timolol
Type of Drug
Carbonic anhydrase inhibitor and beta blocker combination.
Prescribed For
Open-angle glaucoma and ocular hypertension.
General Information
Cosopt contains 2 glaucoma drugs that work in different ways. It is intended for people whose glaucoma does not respond to either drug used alone. Small amounts of dorzolamide and timololthe active ingredients in Cosopt–enter the bloodstream.
Cautions and Warnings
Do not use Cosopt if you are allergic or sensitive to any of its ingredients or cannot take sulfa drugs or beta blockers. Cosopt should not be used by people with bronchial asthma, severe chronic obstructive pulmonary disease, slow heart rate or heart block, heart failure, or who are in shock.
People with diabetes or an overactive thyroid should use Cosopt with caution since beta blockers can mask the signs of low blood sugar or hyperthyroidism.
Small amounts of both ingredients enter the bloodstream and can produce the same kinds of systemic (whole-body) reactions associated with larger dosages of either a sulfa drug or beta blocker. Stop using the drug at once and call your doctor if a serious reaction develops.
4lt?18b)ockers may have to be discontinued prior to major surgery because they can affect the heart’s ability to respond normally. Some people taking a beta blocker experience severe reductions in blood flow while undergoing general anesthesia.
Dorzolamide should not be used by people with kidney disease and has not been studied in people with liver disease.
People with a history of severe allergic reactions who take a beta blocker may be at increased risk of experiencing a reaction because the drug blocks part of the body’s natural allergic
response.
Timolol can worsen the muscle weakness that accompanies myasthenia gravis.
Possible Side Effects
♦    Most common: changes in sense of taste, especially bitterness or sourness; increased sensitivity to light; and a burning or stinging sensation in the eye.
♦    Common: eye redness, irritation, or itching, and blurred vision.
♦    Less common: abdominal pain, back pain, eyelid inflammation, bronchitis, cloudy vision, eye discharge or swelling, conjunctivitis (pinkeye), corneal erosion, corneal staining, lens cloudiness, cough, dizziness, dry eye, upset stomach, drug particles in the eye, eye pain, tearing, eyelid scaling, eyelid pain or discomfort, sensation of something in the eye, headache, high blood pressure, influenza, lens discoloration, nausea, sore throat, cataracts, sinus irritation, respiratory infection, urinary infection, visual problems, and retinal detachment.
•    Rare: slow heartbeat, heart block or failure, chest pain, stroke, depression, diarrhea, dry mouth, breathing difficulties, low blood pressure, stuffy nose, rash, tingling in the hands or feet, kidney stones, and vomiting. Contact your doctor if you experience any side effect not listed above.
See Dorzolamide, page 200, and Timolol, page 1129, for fur-
ther side effect information.
Drug Interactions
•    If you use more than 1 eyedrop medkc;a~mn, separate doses of these drugs tai z& Y@ast 10 minutes.
•    COSOpt can increase the effect of other carbonic anhydrase inhibitors.
•    Combining Cosopt with an oral beta blocker or another calcium antagonist may increase the risk of side effects, especially changes in heart rhythm and low blood pressure.
•    Do not combine Cosopt and another beta-blocking eyedrop.
•    Combining Cosopt and reserpine can lead to low blood pressure, slowing of heartbeat, and dizziness or fainting.
•    Combining Cosopt with digitalis and a calcium antagonist, or with quinidine, can slow heartbeat.
See Dorzolamide, page 200, and Timolol, page 1129, for further drug interactions.
Usual Dose
Adult: 1 drop in the affected eye twice a day. Child: not recommended.
Overdosage
Little is known about the effects of Cosopt overdose or accidental ingestion. Possible overdose symptoms include dizziness, headache, shortness of breath, slow heartbeat, breathing difficulties, heart attack, and nervous system effects. Call your local poison control center or a hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Conjunctivitis (pinkeye) and eyelid reactions can occur due to an allergic reaction or as the result of local irritation. If you experience either of these problems, stop using the drug and call your doctor so that your condition can be evaluated.
To prevent infection, do not allow the eyedropper to touch your fingers, eyelids, or any surface. Wait at least 10 minutes before using any other eyedrops.
Cosopt contains benzalkonium chloride (a preservative), which may be absorbed by soft contact lenses. Remove your soft contact lenses before using the eyedrops; you may put them back in 15 minutes after a dose.
If you forget a dose of Cosopt, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule.
Store Cosopt away from sunlight.
Special Populations
Pregnancy/Breast-feeding: The safety of using Cosopt is not known. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
It is not known if dorMlamidle passes into breast milk, though timolol does. Nursing mothers who must use Cosopt should use
infant formula.
Seniors: Seniors may use Cosopt without precaution.

Generic Name
colchicine (KOLE-chih-sene)
Type of Drug Antigout medication.
Prescribed For
Prevention and treatment of gouty arthritis; also prescribed for Mediterranean fever; chronic progressive multiple sclerosis; cirrhosis of the liver; biliary cirrhosis; Beh~et’s disease’, pseudogout (a condition caused by calcium deposits); amyloidosis; very low blood-platelet count (also known as ITP); skin reactions, including scleroderma, psoriasis, Sweet Syndrome, and other conditions; and nerve disability associated with chronic progressive multiple sclerosis.
General Information
While no one knows exactly how colchicine works, it appears to help people with gout by reducing the inflammatory response to uric acid crystals that form inside joints and by interfering with the body’s mechanism for making uric acid. Unlike drugs that affect uric acid levels, colchicine does not block the progression of gout to chronic gouty arthritis; it will, however, relieve the pain of acute attacks and lessen the frequency and severity of attacks. It has no effect on other kinds of pain.
Cautions and Warnings
Do not use colchicine if you are allergic or sensitive to any of its ingredients or you suffer from any serious blood, kidney, liver, stomach, or cardiac condition.
Vomiting, abdominal pain, diarrhea, nausea, kidney damage, and blood in the urine may occur with colchicine, especially at maximum doses. This can worsen existing gastrointestinal (GI) or other conditions. Stop taking the medication and call your doctor if you develop one of these symptoms.
She weakness that people develop while taking colchicine is frequently related to high levels of colchicine in the blood caused by poor kidney function and improves without treatment 3-4 weeks after the drug is stopped. This reaction is often mistaken for other conditions.
Periodic blood counts should be done if you are taking
colchicine for long periods of time.
Colchicine interferes with the absorption of vitamin B12 by af-
fecting the lining of the GI tract.
Colchicine may affect the process of sperm generation in men. The safety and effectiveness for use by children have not been
established.
Possible Side Effects
V Common: vomiting, diarrhea, and abdominal pain may occur if you take maximum doses of colchicine for an acute gout attack. You may also experience severe diarrhea, kidney and blood-vessel damage, blood in the urine, and reduced urination.
✓    Less common: hair loss, rash, appetite loss, and muscle and nerve weakness.
✓    Rare: with long-term colchicine therapy—reduced whiteblood-cell and platelet counts, nerve inflammation, blood-clotting problems, rash, unusual bleeding or bruising, tingling in the hands or feet, red or purple spots under the skin, and other reactions. Colchicine may interfere with sperm formation. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Colchicine interferes with the absorption of vitamin B12.
•    Colchicine may increase sensitivity to central-nervoussystem depressants, such as sedatives and alcohol.
•    The following drugs may reduce colchicine’s effectiveness: anticancer drugs, bumetanide, diazoxide, thiazide diuretics, ethacrynic acid, furosemide, mecamylamine, pyrazinamide, and triamterene.
•    Taking phenylbutazone with colchicine increases the risk of side effects.
•    Mixing the anitiiofic clarithromycin with colchicine can lead to colchicine toxicity, especially in the elderly and those with kidney disease.
Food Interactions None known.
Usual Dose
Acute Gout Attack: 1-1.2 mg. This dose may be followed by 0.51.2 mg every 1-2 hours until pain is relieved or nausea, vomiting, or diarrhea occurs. The total dose needed to control pain and in-
flammation during an attack varies from 4-8 mg.
Gout Prevention: 0.5-1.8 mg daily. In mild cases, 0.5 mg or 0.6 mg may be taken 3-4 days a week.
Familial Mediterranean Fever: 1-2 mg a day.
Cirrhosis of the Liver: 1 mg a day for 5 days each week. Biliary Cirrhosis: 0.6 mg twice a day.
Amyloidosis: 0.5 mg 1-2 times a day.
Behqet’s Disease: 0.5-1.5 mg a day.
Pseudogout: 0.6 mg twice a day.
ITP: 1.2-1.8 mg a day for 2 weeks or more.
Scleroderma: 1 mg a day.
Sweet Syndrome: 0.5 mg 1-3 times a day.
Other Skin Disorders: up to 1.8 mg a day, depending on the specific condition.
Overdosage
The lethal dose is estimated at 65 mg, although people have died after taking as little as 7 mg at once. Usually 1-3 days pass between the time that an overdose is taken and symptoms begin. Overdose symptoms start with nausea, vomiting, stomach pain, diarrhea—which may be severe and bloody—and burning sensations in the throat or stomach or on the skin. If you think you are experiencing overdose symptoms, contact your doctor immediately, or go to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop rash, sore throat, fever, unusual bleeding or bruising, tiredness, weakness, numbness, or tingling. Seniors are move 4,ialy to develop drug side effects and should use this drug with caution.
Stop taking maximum doses of colchicine as soon as gout pain is relieved and reduce your dose to a maintenance level if your doctor has prescribed it for gout prevention. Stop taking the drug entirely and contact your doctor at the first sign of nausea, vomiting, stomach pain, or diarrhea.
If you forget a dose of colchicine, take it as soon as possible. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: colchicine can harm the fetus. Pregnant women should not take it unless the potential benefits clearly outweigh the risks.
It is not known if colchicine passes into breast milk. No problems with nursing infants are known, but nursing mothers who must take colchicine should consider using infant formula.
Seniors: Seniors, especially those with renal, hepatic, gastrointestinal, or heart disease, are more likely to develop side effects and should use colchicine with caution.

Type of Drug
Contraceptives
Plan B
Prescribed For
Prevention of pregnancy, endometriosis, excessive menstruation, and cyclic withdrawal bleeding. Ortho Tri-Cyclen and Estrostep may be prescribed for moderate acne in women over age 15.
General Information
Contraceptive drugs are synthetic hormones containing either progestin or a progestin-estrogen combination. The overall effects of any contraceptive are influenced by the interaction of all active ingredients, including those Huth -&))Otogenic and anti-estrogenic aqtk%(kkj.’%tte drugs are similar to natural female hormones, which cannot be used as contraceptives because very large dosages would be required. Synthetic hormones are more potent and are effective at smaller dosages. Contraceptive drugs work by preventing sperm from reaching the unfertilized egg, preventing the implantation of a fertilized egg in the uterus, or preventing ovula-tion (the release of an unfertilized egg from the ovaries). They prevent acne by balancing hormone levels.
When properly used, hormonal contraceptives can be 97-99% effective at preventing pregnancy. These products vary in their etfectiveness, and in the amount and type of estrogen or progestin used. The side effects of these drugs tend to increase with the amount of hormone they contain. While low hormone dosages are preferred, contraceptives with the smallest amounts of estrogen may be less effective in some women than others.
Single-phase products provide constant levels of estrogen and progestin throughout the entire month-long pill cycle. In 2-phase combinations, the amount of estrogen remains at a steady low level throughout the cycle, while progestin levels increase and then decrease. This variation in progestin allows normal changes to take place in the uterus. Three-phase products are meant to simulate the normal hormone cycle and reduce breakthrough bleeding. Throughout the cycle, estrogen levels remain the same while those of progestin change to create a 3-part wave pattern. The amount of estrogen in 3-phase products is considered low. Breakthrough bleeding may occur with the older combination products from day 8 through 16 of the cycle.
The mini-pill, a progestin-only product, may cause irregular menstrual cycles and may be less effective than estrogenprogestin combinations. Mini-pills may be recommended to older women or women who should avoid estrogens (see “Cautions and Warnings”).
The contraceptive patch releases small amounts of progestin and estrogen continuously over 3 weeks. The medication is absorbed into the blood vessels just below the skin. The patch works in the same way as contraceptive pills do.
The vaginal ring releases small amounts of etonogestrel, a progestin, and estradiol, an estrogen, in the vaginal canal over 3 weeks. The combination prevents pregnancy in the same way as combination pills do but may be less effective than contraceptive pills because some people find them harder to use.
Most contraceptive drugs are designed to simulate a normal Mt%VwM cycle. By not taking the hormones 1 week out of the month, you continue to have your regular period. In fact, these products are often used to stabilize a woman’s period. Two products, Seasonale and Seasonique, come in an 84-pill packet and are taken once a day for 3 months. This means you will only have your period once every 3 months. Another, Lybrel. is designed to be taken every day, eliminating monthly menstruation. Drosperinone, the progestin found in Yasmin and Yaz, has been found to relieve Premenstrual Syndrome (PMS) symptoms in addition to acting as an effective contraceptive hormone.
Levonorgestrel, a progestin, is used in implants that provide effective contraception for up to 5 years after surgical implantation under the skin of the upper arm or inside the uterus. Levonorgestrel implants should be replaced at least once every 5 years. Etonorgestrel implants are effective for 3 years. Implants can be removed at any time, reversing the contraceptive effect. The progestin intrauterine inserts provide effective contraception for about 1 year. The implant and intrauterine systems contain the same hormone found in the mini-pill and are associated with many of the same side effects and precautions as oral contraceptives.
Emergency contraceptives (sometimes referred to as the “morning-after pill”) contain high doses of estrogen and progestin. They are intended for use only after contraceptive failure or unprotected intercourse. They should never be taken by a pregnant woman.
Contraceptive drugs in any form are associated with risks. These risks are greatest in women over age 35 who smoke and have high blood pressure.
Cautions and Warnings
Do not take contraceptives if you are allergic or sensitive to them or any of their ingredients.
The risk of breast cancer may be slightly higher among current and recent users of combination oral contraceptives. This risk appears to decline after contraceptive use is stopped and is gone by 10 years after stopping combination contraceptive products. Breast cancers found in contraceptive users tend to be less advanced than those in non-contraceptive users.
You should not use contraceptive drugs if you are or might be pregnant, have had blood clots in veins or arteries, stroke, any blood-coagulation disorder, known or suspected cancer 0 the breast, sex organs, or liver. Products With more estrogen, or those t43.t jmmdr3higher sustained blood levels of estrogen, such as the contraceptive patch, are more likely to be associated with an increased risk of life-threatening blood clots.
Contraceptive drugs may cause eye lesions. Call your doctor at once if you develop visual difficulties of any kind.
Women taking the combination products Seasonale and Seasonique will have their period only once every 3 months and those taking Lybrel will not have a regular monthly period. It is absolutely essential for you to verify you are not pregnant if you think you may be pregnant for any reason.
The risks of contraceptive drugs increase if you are physically immobile or have asthma; cardiac insufficiency; epilepsy; migraine; kidney problems; a strong family history of breast cancer; benign breast disease; diabetes; endometriosis; gallbladder disease or gallstones; liver problems, including jaundice; high blood cholesterol; high blood pressure; estrogen or progestin intolerance; depression; tuberculosis; or varicose veins.
There is an increased risk of heart attack in women who have used contraceptive drugs for more than 5 years, or who are between age 40 and 49 and have other coronary risk factors such as smoking. obesity, high blood pressure, diabetes, and high blood cholesterol. This risk remains even after the medication is stopped.
Smokers in their mid-30s or older who use contraceptive drugs are 5 times more likely to have a heart attack than nonsmokers taking contraceptives and 10-12 times more likely to have a heart attack than nonsmokers who do not use the pill. Death due to circulatory disease also increases substantially in smokers taking contraceptive drugs, especially in women at least 35 years old. The risk of stroke is also increased in this group. Heavy smokers (more than 15 cigarettes a day) should not use hormonal contraceptives.
Women with a history of headaches, high blood pressure, or varicose veins should avoid estrogen-containing products, as Should older women and those who have experienced estrogen side effects.
Contraceptive drugs may mask the onset of menopause. Progestin-only products are associated with an increased risk of blood-clotting problems.
The progestin in Yasmin and Yaz raises blood potassium levels. Women with kidney, liver,,Dy adrenal gland disease should use eittlp_C pIrjdUcj with caution.
Intrauterine inserts have been associated with an increased risk of pelvic inflammatory disease (PID). The highest risk usually occurs within the first 20 days after insertion. Do not use intrauterine inserts if you have had an ectopic pregnancy.
Toxic Shock Syndrome has been associated with tampons, some barrier contraceptives, and the vaginal ring, although there is no proof that the product was the cause of the infection.
Possible Side Effects
♦ Common: Common side effects often result from using a product that is poorly suited to your body chemistry. Determining the right amount and type of hormone often minimizes these effects. If you are taking too much estrogen, you may experience nausea, bloating, high blood pressure, migraine, excess cervical mucous, skin discoloration, colon polyps, water retention, and swelling, or breast fullness or tenderness. Too little estrogen may cause early or mid-cycle breakthrough bleeding, spotting, or reduced periodic flow. Too much progestin is associated with weight gain and increased appetite, tiredness or fatigue, low periodic flow, acne, depression, breast regression, and androgen-related side effects (acne, oily scalp, hair loss, or excess hair growth). Too little progestin may cause late breakthrough bleeding, excessive periodic bleeding, or missed periods.
✓    Less common: abdominal cramps, infertility after discontinuance of the drug, breast tenderness, weight change, headache, rash, vaginal itching and burning, general vaginal infection, nervousness, dizziness, depression, cataracts, changes in sex drive, hair loss, and increased sensitivity to the sun.
✓    Rare: Women who use contraceptive drugs are more likely to develop several serious conditions, including blood clots in the deep veins, stroke, heart attack, liver cancer, gallbladder disease, and high blood pressure. Women who smoke cigarettes are at much higher risk for some of these adverse effects. Contact your doctor if you experience any side effect not listed above.
brug Interactions
•    Ampicillin, barbiturates, bexarotene, bosentan, carbamazepine, chloramphenicol, efavirenz, fluconazole, griseofulvin, ketoconazole, neomycin, nelfinavir, nitrofuratoin, oxcarbazepine, phenylbutazone, phenytoin, penicillin drugs, protease inhibitor drugs for HIV, rifampin, rifapentine, statin drugs (atorvastatin and rosuvastatin), St. John’s wort, sulfa drugs, tetracycline products, and sedatives can make all contraceptive drugs less effective. Use backup birth control while taking these medications together.
•    Contraceptive drugs may elevate blood levels of benzodiazepine sedatives and sleeping pills (midazolam, lorazepam, oxazepam, and temazepam), caffeine, cyclosporine, imatinib, metoprolol, corticosteroids, theophylline drugs, tizanidine, triptan-type migraine drugs, and tricyclic antidepressants, increasing the risk of side effects. Discuss mixing these medicines with your doctor. Dosage reductions may be needed.
•    Contraceptive drugs may increase the toxic liver effects of acetaminophen and reduce the drug’s effectiveness. Contraceptive drugs may increase or decrease the effect of anticoagulant (blood-thinning) drugs. Discuss the risks of this combination with your doctor.
•    Mycophenolate interferes with only those contraceptives that contain levonorgestrel (Alesse, Aviane, Lessina. Levora, Levlite, Lutera, Lybrel, Mirena, Nordette, Norplant II, Portia, Plan B, Seasonale, Seasonique, and Triphasil). Backup contraception is recommended.
•    Exenatide may reduce the effectiveness of contraceptive pills.
Take them at least 1 hour before an injection of exenatide.
•    Contraceptive drugs may reduce the effectiveness of clofibrate for elevated blood triglycerides, sulfonylurea drugs for diabetes, ursodiol for gallbladder disease, and pain relievers, including salicylates (aspirin).
•    Contraceptive drugs may increase blood-cholesterol levels and interfere with blood tests for thyroid function and blood sugar.
•    Acetaminophen may increase blood levels of ethinyl estradiol, a common contraceptive drug ingredient, increasing side effects and reducing contraceptive effectiveness.
•    Since Yasmin and Yaz raise blood potassium levels, nether should be used if you ate taking spironolactone or anD)ftr potassium-sparing diuretic, potassium supplements, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor antagonists, aldosterone antagonists, heparin, non-steroidal anti-inflammatory drugs (NSAIDs), or other medications on a long-term basis that may further increase potassium levels.
•    Contraceptive drugs may interfere with the effects of insulin
for diabetes.
•    Acitretin interferes with the contraceptive effect of progestin-
only mini-pills. It is not known if it also interferes with combination contraceptive drugs.
Food Interactions
None known. Usual Dose
Single-Phase, 2-Phase, and 3-Phase Combinations: The first day of bleeding is day 1 of the menstrual cycle. Beginning on the first day of the cycle, take 1 pill a day for 20-21 days according to the number of pills supplied by the manufacturer. If menstrual flow has not begun 7 days after taking the last pill, begin the next month’s cycle of pills. Some manufacturers recommend starting the pills on a Sunday to make it easy to remember to take them. In this case, start taking your pills on the first Sunday after your period begins. If menstruation begins on a Sunday, take the first pill that day.
Seasonale: Take 1 pink tablet every day for 84 consecutive days. Do not skip a day. Then, take 1 white pill a day for 7 days. Then, start a new pill cycle. You may be pregnant if you do not have a period while you are taking the white pills.
Seasonique: Take 1 light blue-green tablet containng levonorgestrel and ethinyl estradiol daily for 84 consecutive days, followed by 7 days of ethinyl estradiol tablets. Do not stop if spotting or breakthrough bleeding occurs. Report prolonged bleeding to your doctor.
Progestin-Only Mini-Pill: Take 1 pill every day.
Contraceptive Patch: Apply a new patch to the thigh, abdomen, or arm. Remove the patch after 3 weeks and then reapply a new patch after 1 week. Be sure to always apply a new patch on the same day of the week. If you are switching from birth control pmts, apply the first patch on the same day you would start a new cycle of pills.
Vaginal Ring: Keep the vaginal ring in the vaginal canal for 3 weeks. Remove it and put a new one in 1 week later. If you did not use a hormonal contraceptive in the previous month, insert the ring between day 1 and day 5 of your cycle.
If you are switching from a combination birth control pill, insert the ring anytime during the week after you took your last pill but before you would have started your next cycle of pills. No additional contraception is necessary.
If you are switching from a mini-pill, insert the ring on the day after you take your last mini-pill.
If you are switching from a progestin implant or an IUD, insert the ring on the same day your implant or IUD is removed.
If you are switching from a progestin injection, insert the ring on the same day you would have received your next injection.
If you are switching from a progestin-only mini-pill, implant, injection, or IUD, use another form of contraception for the first 7 days after you insert the ring.
Emergency Contraception: Emergency contraceptive kits have only a few pills. They should be taken with a full meal. Take half the pills (1 or 2 depending on the brand you use) within 72 hours of unprotected sex, however they are most effective when taken within the first 24 hours. Take the rest of the pills 12 hours after the first dose. Emergency contraceptives reduce the risk of pregnancy by 75%.
The pregnancy test in the kit can be used to determine if you became pregnant earlier in your cycle or during a previous cycle. If the test is positive, consult your doctor before taking emergency contraception. If you vomit within one hour of taking either dose, contact your doctor.
Overdosage
An overdose may cause nausea and withdrawal bleeding in adult women. Overdose victims should be taken to a hospital emergency room. ALWAYS bring the prescription package.
Special Information
Use backup birth control to prevent pregnancy in the first 3 weeks after you begin taking contraceptive drugs.
Contraceptive drugs do not protect against sexually transmitted diseases.
VM your pill at the same time each day to establish a routine and ensure maximum contraceptive protection.
Call your doctor immediately if you experience severe abdominal pain; severe or sudden headache; pain in the chest, groin, or leg, especially the calf; sudden slurring of speech; changes in vision; weakness, numbness, or pain in the arms or legs; coughing up of blood; loss of coordination; or shortness of breath. These symptoms may require emergency treatment.
Other problems that may require medical attention are bulging eyes; changes in vaginal bleeding; fainting; frequent or painful urination; a gradual increase in blood pressure; breast lumps or secretions; depression; yellowing of the skin or whites of the eyes; rash; redness or irritation; upper abdominal swelling, pain, or tenderness; an unusual or dark-colored mole; thick, white vaginal discharge; or vaginal itching or tenderness.
See your doctor for a check-up every 6-12 months.
Some manufacturers include 7 inert or iron pills in their packaging to be taken on days when the drug is not taken. This makes it easier for women to stay on schedule with their pills. The 7 pills bridge the gap between contraceptive cycles and allow women to take 1 pill every day without stopping.
For single- or 2-phase combinations: If you forget to take a pill for 1 day, take 2 pills the following day. If you miss 2 consecutive days, take 2 pills for the next 2 days. Then return to your schedule of 1 pill a day. If you miss 3 consecutive days, do not take any pills for the next 7 days and use another form of contraception; then start a brand new cycle.
Seasonale: The risk of pregnancy increases with each pink tablet you forget. Use another method of non-hormonal backup contraception any time you miss 2 or more pink tablets until you have taken a pink tablet every day for 7 consecutive days. You are protected against pregnancy if you miss 1 or more white tablets, as long as you begin taking the pink tablets again on the proper day.
Seasonique: The risk of ovulation and pregnancy increases with each forgotten light blue-green pill. If you miss 1 light blue-green pill, take it as soon as you remember and take the next pill at your regular time. This may mean you will take 2 pills on the same day. You don’t need to use a backup birth control method if you forget only 1 pill. If you forget 2 light blue-green pills in a row, take 2 pills on the day you remember and take 2 pills the ReYA day. -Then go back to taking 1 pill a day MMI you finish your pack. If you miss 2 01 MbreYight blue-green pills in a row, you must use non-hormonal backup contraception until you have taken a light blue-green pill daily for 7 days in a row. If you miss 1 or more yellow tablets, you are still protected against pregnancy provided you begin taking light blue-green pills again on the proper day.
For 3-phase combinations: If you forget to take a pill for 1 day, take 2 pills the following day. If you miss 2 consecutive days, take 2 pills for the next 2 days. Then return to your schedule of 1 pill a day. If you forget to take a pill for 3 days in a row, stop taking the drug and use an alternate means of contraception until your period starts. ALWAYS use a backup contraceptive method for the remainder of your cycle if you forget even 1 pill of a 3-phase combination.
If you forget to apply the contraceptive patch on the same day of the week once every 4 weeks, you risk a loss of effectiveness on the days after you should have applied it. If the patch comes off or is partially detached in mid-cycle, you must start a new 3-week cycle at once by removing the old patch and applying a new one.
If the vaginal ring is accidentally expelled during the 3 weeks it is normally retained, rinse it off with water and replace it within 3 hours. Do not use hot water. If the ring is not reusable, insert a new ring and continue with your regular schedule. If you do not replace the ring within 3 hours, its effectiveness may be reduced. If you are in week 3 of the cycle, throw the ring away; you may insert a new one immediately, which will begin a new 3-week cycle and cause you to skip a period. Or, you may wait a week, during which time you will have periodic bleeding, and insert a new ring no later than 7 days after the vaginal ring was expelled. This option should be chosen if you had used the ring for 7 days in a row before it was expelled.
If, when it is expelled, you are in week 1 or 2 of your cycle and the ring is out for more than 3 hours, reinsert it and use an additional form of contraceptive until the ring has been worn for 7 consecutive days. A vaginal ring may break and then slip out or cause discomfort. Throw the ring away if this happens.
Missing a pill reduces your protection. If you keep forgetting to take your pills, you must use another birth control method.
If you take drugs that reduce the effectiveness of contraceptive drugs (see “Drug Interactions”), use a backup contraceptive method during that cycle to PMNeiA accidental pregnancy.
GOOD tlL:Inlal hygiene is essential while taking contraceptive drugs. See your dentist regularly and brush and floss carefully because contraceptive drugs may increase the risk of an oral infection.
Contraceptive drugs may increase your sensitivity to the sun.
Wearing contact lenses may be uncomfortable while taking contraceptive drugs because the pills can cause minor changes in the shape of your eyes.
All contraceptive prescriptions come with a “patient package insert.” Read it thoroughly as it gives detailed information about the drug and is required by federal law.
Special Populations
PregnancylBreast-feeding., Contraceptive hormones cause birth defects and may interfere with fetal development. They are not safe for use during pregnancy. If you think you are pregnant, use another form of contraception and stop taking your birth control pills.
Contraceptive hormones pass into breast milk. Combination contraceptive products reduce the amount of milk produced. Nursing mothers who must use any of these drugs should use infant formula.
Seniors: These products are not intended for women who have completed menopause.

Celecoxib (sel-eh-KOX-ib)
Brand Name
Celebrex
Type of Drug
Cyclooxygenase-2 (COX-2) inhibitor nonsteroidal anti-inflammatory
drug (NSAID).
Prescribed For
Osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, acute pain, some colon polyps (FAR), menstrual pain, and arthritis of the spine (ankylosing spondylitis).
General Information
Traditional NSAIDs work primarily by blocking the effects of COX-2, a body enzyme that plays an important role in regulating pain and inflammation. But these NSAIDs also have an unwanted effect: They interfere with cyclooxygenase-1 (COX-1), a related enzyme that helps to maintain the stomach’s protective lining. NSAIDs that block the effects of this enzyme may produce side effects such as stomach irritation, gas, and stomach ulcers.
COX-2 inhibitors such as celecoxib are a class of NSAIDs that work about as well as the older NSAIDs. In fact, both 200 mg a day and 400 mg a day of celecoxib work as well as naproxen 500 mg twice a day. They interfere primarily with COX-2, leaving the stomach-protecting COX-1 relatively unaffected. This means that COX-2 inhibitor NSAIDs can relieve pain and inflammation just like traditional NSAIDs but are less likely to cause gastrointestinal (GI) side effects. Another advantage of celecoxib is that it does not cause thinning of the blood or affect blood platelets as can happen with older NSAIDs. Celecoxib is broken down in the liver.
Black patients absorb about 40% more celecoxib than Caucasians; its importance is unclear. Celecoxib is the first drug proven effective in reducing the number of intestinal polyps in people with the rare genetic disorder FAR
Cautions and Warnings
Do not take celecoxib if you are allergic or sensitive to any of its ingredients or to sulfa drugs. NSAIDs should not be taken by people with asthma or by those who have had a” allergic reaction to aspirin or another NSA13.1hey can develop a group of sympWMS V1Jnny nose with or without nasal polyps and a severe bronchial spasm) known as the aspirin triad.
COX-2 inhibitors, including celecoxib, have been associated with high blood pressure, kidney damage, heart attacks, and stroke. It should not be used to treat pain associated with heart bypass surgery. Two other COX-2 inhibitors were taken off the market because of safety concerns. Rofecoxib was removed because safety issues were noted after people had taken it for 18 months or more. Valdecoxib was taken off the market because of the lack of safety data, severe skin rashes, and concerns raised in people taking the drug after having had heart surgery.
NSAIDs can cause GI bleeding and ulcers and stomach perforation. This can occur at any time, with or without warning, in people who take NSAIDs regularly. Celecoxib should be used with caution by people who have had stomach ulcers or GI bleeding. Minor upper GI problems, such as upset stomach, are common and may occur at any time during NSAID therapy. People who develop bleeding or ulcers and continue NSAID treatment should be aware of the risk of developing more serious side effects. Risk of GI bleeding and ulcers is increased with longer duration of therapy as well as treatment with oral corticosteroids and anticoagulants, smoking, alcoholism, older age, and general poor health.
Children taking celecoxib may be more likely to vomit blood, suffer acute kidney failure, or develop rashes.
Celecoxib has not been studied in people with severe kidney disease. They should not use this drug unless their doctors closely monitor their kidney function.
Celecoxib can cause liver irritation and should be used with caution by people with hepatitis or cirrhosis. People with moderate liver disease can have twice as much celecoxib in their blood and require a reduced dosage. The effect of celecoxib in people with severe liver failure is not known.
Possible Side Effects
Side effects are similar to those of traditional NSAIDs. Stomach and intestinal side effects are about half as common.
♦    Most common: headache.
✓    Common: diarrhea, upset stomach, sinus irritation, and respiratory infection.
♦    Less common: abdominal pain, gas, nausea, back pain, swelling in the legs m arms, accidental injuries, sleeplessness, dizziness, sore throat, runny nose, and rash.
✓    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
•    Alcohol may increase the risk of serious GI-related side ef-
fects. Avoid alcohol.
•    Combining celecoxib with an aluminum and magnesium antacid slightly reduces the amount of drug absorbed. Separate doses of these antacids and celecoxib by 1-2 hours.
•    Fluconazole and lithium may raise celecoxib blood levels and increase the risk of side effects.
•    While celecoxib may be combined with low dosages of as-
pirin, taking these drugs together can increase the risk of
stomach or intestinal ulcers or other complications. The ulcer
risk associated with this combination is less than that posed
by single-drug therapy with a traditional NSAID.
•    Celecoxib can reduce the blood-pressure-lowering effect of angiotensin-converting enzyme (ACE) inhibitors and diuretic drugs. This combination can also increase the risk of kidney damage after chronic celecoxib use.
•    Celecoxib may affect lithium blood levels.
•    NSAIDS can reduce the effect of furosemide and thiazidetype diuretics.
•    Celecoxib should be used cautiously with warfarin. Concurrent use of these drugs may cause an increased risk of bleeding complications.
Food Interactions
Celecoxib can be taken without regard to Food or meals. For optimal effectiveness, avoid taking this drug with high-fat meals.
Usual Dose
Adult (age 18 and over): arthritis-100-200 mg once or twice a day. FAP-400 mg twice a day.
Child (age 2 and over): juvenile rheumatoid arthritis-22-55 lbs: 50 mg twice a day; over 55 lbs: 100 mg twice a day.
Child (under age 2): not recommended.
Overdosage
Overdosage symptoms include Mnargy, drowsiness, nausea, vomitiR(;, 16M Stomach pain. Stomach or intestinal bleeding or severe allergic reactions can occur. High blood pressure, kidney failure, breathing difficulties, and coma are rare.
The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor if you develop rash, itching, unexplained weight gain, nausea, fatigue, jaundice (yellowing of the skin or whites of the eyes), flu-like symptoms, lethargy, swelling, black stools, severe stomach pain, persistent headache, or any bothersome or persistent side effect.
If you forget a dose and remember within 1 or 2 hours of your scheduled time, take it right away. If you do not remember until later, skip the forgotten dose and continue with your regular schedule.
Special Populations
Pregnancy/Breast-feeding: celecoxib has caused birth defects in animal studies. Any NSAID may affect fetal heart development during the second half of pregnancy. Pregnant women should not take celecoxib without their doctor’s approval. When this drug is considered crucial by your doctor, its potential benefits must be carefully weighed against its risks.
NSAIDs may pass into breast milk. There is a possibility that a nursing mother taking celecoxib could affect her baby’s heart or cardiovascular system. Nursing mothers who must take this drug should use infant formula.
Seniors: Generally, seniors can take this drug without special precaution. Those who weigh less than 110 lbs. should begin with the lowest possible dosage.

Brand Name
BiDil
Generic Ingredients
Isosorbide Dinitrate Hydralazine Hydrochloride Type of Drug
Vasodilator combination. Prescribed For
Heart failure in black patients, in combination with other heart-failure treatments.
General Information
BiDil is a combiRatiZ0 101 Iwo drugs that dilate (open) both arter-
2nd veins. It is the first drug product to be specifically approved for people in a single racial group for any indication. The 2 ingredients in BiDil have been available generically for years and are prescribed for a variety of uses. Isosorbide dinitrate is prescribed for angina, heart failure, and spasms of the esophagus. Hydralazine hydrochloride is prescribed to treat high blood pressure and heart failure. When people with heart failure take this drug combination, it makes it easier for the heart to pump blood throughout the body by widening arteries and veins.
Cautions and Warnings
Do not take BiDil if you are allergic or sensitive to any of its ingredients.
Do not use erectile dysfunction drugs with BiDil.
This drug may be inappropriate for you if you have had a recent heart attack or have cardiomyopathy (loss of blood-pumping ability due to damaged heart muscle) or low blood pressure, especially postural low blood pressure (symptoms include dizziness or fainting when rising from a sitting or lying position).
Long-term administration of more than 200 mg a day of hydralazine may produce symptoms of lupus erythematosus (a chronic condition affecting the body’s connective tissue), including muscle and joint pain, skin reactions, fever, kidney inflammation, and anemia, although they usually disappear when the drug is discontinued. Report any fever, chest pain, feelings of ill health, or other unexplained symptoms to your doctor. The risk of developing lupus increases with higher dosages; approximately 5 out of 100 and 10% of people taking 200 mg a day of hydralazine develop lupus. The daily dosage of hydralazine when you take BiDil can be as high as 225 mg.
Hydralazine may cause a very rapid heartbeat, potentially leading to angina pain or a heart attack.
Taking pyridoxine (vitamin B6) may relieve tingling or numbness in the hands or feet caused by hydralazine.
Possible Side Effects
✓    Most common: headache and flushing—which should disappear after your body adjusts to the drug—nausea, dizziness, weakness, and chest pain.
✓    COmmQR*, k(a% UM16 pressure.
✓    Less common: blurred vision and dry mouth; sinus irritation, rapid heartbeat, heart palpitations, high blood sugar, runny nose, numbness or tingling in the hands or feet, vomiting, and high blood-fat levels.
Possible Side Effects (continued)
V Rare-. flushing, tearing, itching, or redness of the eyes, trem-
ors, muscle cramps, depression, disorientation, anxiety,
itching, rash, fever, chills, occasional hepatitis (symptoms
include yellowing of the skin or whites of the eyes), con-
stipation, urinary difficulties, and adverse effects on nor-
mal blood composition. Other side effects may affect any
organ or organ system. Contact your doctor if you experi-
ence any side effect not listed above.
Drug Interactions
•    Do not take sildenafil, vardenafil, or taldenafil with Bidil. The combination can result in a rapid and potentially fatal drop in blood pressure.
•    Taking this drug with a monoamine oxidase inhibitor antidepressant may increase the blood-pressure-lowering effect of the hydralazine component of BiDil. This combination should be used with caution.
•    Do not self-medicate with over-the-counter appetite suppressants and cough, cold, and allergy remedies, since many contain ingredients that may aggravate heart disease.
•    Taking this drug with large amounts of alcohol may rapidly lower blood pressure, resulting in weakness, dizziness, and fainting.
Food Interactions
Take this drug on an empty stomach. It is unknown how food affects BiDil.
Usual Dose
Adult: 1 or 2 tablets 3 times a day, 1 hour before or 2 hours after eating.
Overdosage
There have been no reports of BiDil overdose. Symptoms of INID11
overdose would be related to the Specific effects of each active in-
2ind can include reduced oxygen supply to heart muscle,
leading to a heart attack, abnormal heart rhythms, and profound
shock. Fainting, coma, and death may follow unless the victim is
treated. Overdose victims must be taken to a hospital emergency
room at once. ALWAYS bring the prescription bottle or container.
Special Information
Avoid alcohol.    headache, dizzi-
Call your doctor if you develop a persistent hea    ,
ness, facial flushing, blurred vision, or dry mouth.
It is important to make sure you drink plenty of fluids every day and pay attention to hot weather and exercise situations in which you might lose unusual amounts of fluids and salts. Fluid loss may lead to low blood pressure, dizziness, and possibly fainting.
If you forget to take a dose of BiDil, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule. Never take a double dose.
Special Populations
PregnancylBreast-feeding., Isosorbide dinitrate crosses into the fetal circulation, and hydralazine can cause low blood pressure in pregnant women and their babies. The potential benefits of B01 must be carefully weighed against its risks when your doctor considers this drug crucial.
it is not known if BiDil passes into breast milk. Nursing mothers who must take it should consider using infant formula. Seniors: Specifics about how seniors react to this drug are not
known. The lowest effective dose of BiDil should always be used, especially in people with reduced kidney and/or liver function.

FENUGREEK
Fenugreek is a seed used to spice Indian food compare diovan and cozaar . It has also been used in traditional medicine to treat symptoms that indicate diabetes saturday delivery tramadol . Studies done in humans suggest that it can be used in
well
type 1 as as type 2 diabetes in addition to,prescribed medi-
cation women excess testosterone . The powdered seed lowered blood sugar and HbAlc feline hypertrophic cardiomyopathy prednisone . 249
There are potential side effects, however zovirax insert . Fenugreek can cause diarrhea, flatulence, and allergic reactions celexa testimonies . It might, in theory, interact with warfarin (Coumadin) or other anticoagulant medicines and probably should be avoided by people who take them trazodone for bipolar . There is always a possibility of hypoglycemia when blood sugar–lowering botanical medicines are added to prescription drugs for blood sugar control, so careful monitoring is essential rx neurontin . The usual dose is around 1 or 2 grams of seeds three times a day, but it may also be taken as a tea 250
* 0 *
G atenolol personality changes . I found a spice in my spice rack that I had never heard of, and I had no instructions on how to use it lack of response to furosemide . I looked up fenugreek as a spice and found that it is a medicinal herb celebrex chemotherapy colon cancer .
It is used to lower cholesterol and control blood sugar provera for bodybuilders . The only side effect I found is nausea if you take too much specific heat lithium . What do you know about this herb? -
A adderall and selegiline together . Studies in animals and humans show that fenugreek can lower cholesterol and blood sugar methyl prednisone acetate . If diabetics take fenugreek, they should monitor their blood sugar to make sure it doesn’t fall too much xeno lithium .
Fenugreek seeds are rich in soluble fiber and can be used to treat constipation paroxetine heart rate . At high doses, this herb can cause digestive distress evista floaters in eyes .
o 0 *
GYMNEMA SYLVESTRE
This herb comes from India and has been used in traditional Ayurvedic medicine for centuries ms avoiding caffeine . Animal studies have demonstrated that it is capable of lowering blood sugar viagra lasting .”‘ No serious side effects have been reported, but perhaps the scarcity of well-controlled clinical trials explains that to some extent canadian pharmacy bupropion .
NOPAL (Opuntia sp caffeine in tea bags .)
One interesting botanical treatment has only a little bit of research to support it, but it is becoming increasingly popu-far viagra photo woman . We heard several years ago from a physician who said one of his diabetic patients had improved his blood sugar control with prickly pear tea side effects of stopping tamoxifen . This cactus, called nopal in Mexico, has been studied primarily in animals beta celexa citalopram interferon lyrica pregabalin . That research indicates that the cactus can help lower blood sugar fosinopril solium . 252,253 Research in humans is preliminary, but it suggests that nopal may also be useful in helping to control blood sugar in type 2 diabetes united states wellbutrin bupropion hcl . 254 Close monitoring and medical supervision are advised zithromax ear book .
lama family practitioner and want to share an herbal remedy with you allopurinol and blood pressure . A 60-year-old male Hispanic diabetic patient has had trouble controlling his blood sugar ovulation pain with clomid . Despite intensive diet changes and a prescription for Glucovance, his blood sugar still ran around 160 to 100-plus testosterone treatment and prostate cancer .
One day he came in with his diary showing consistent blood sugars of 90 to 100 fexofenadine solubility in isopropylalcohol . I asked what he was doing differently and he said in a low voice, “I’ve got a new girlfriend from Mexico online fexofenadine . She makes me tea from nopalito [prickly pear> cactus and has me drink it three times a day advil motrin recalls . Now my sugars are doing better buy celecoxib low cost . -
Finding fresh nopal cactus outside of Mexico or the desert of the southwestern United States could be tricky loratadine 180 . When we shared the story about nopalito tea (nopalito is a young stem segment from the cactus), we were inundated with questions from readers who wanted to know how they could get some nopal cactus leaves does prednisone cause sterility . Short of moving, you might try looking for this natural plant product in your local health-food store (or on the Web) voltaren info . Although it is unlikely you will find fresh leaves, you will be able to locate capsules labeled prickly pear cactus (Opuntia) or nopal cactus avandia zantac .
Careful blood sugar monitoring is essential age testosterone . One reader who blended cactus with apple juice kept careful track of his cholesterol levels, triglycerides, and glucose bladder infection ibuprofen . In 6 months, his triglycerides dropped from 191 to 139 and his total cholesterol went from 202 to 169 web md doxepin . More interesting, his blood glucose drifted down as well seafood allergies and atrovent . Here is his account:
I read your article about nopalito tea, so I started using cactus in April and had good results what’s the main resources of caffeine . My doctor knows about it zithromax for oral suspension . I blend one bag of cactus and 3 112 cups of apple juice into a drinkable liquid effexor memory . I drink 4 ounces three times a day mens viagra . Here are my results why is caffeine bad in pregnancy .
Blood Glucose (average)
Jan 147 no cactus
Feb 143 no cactus
Mar 158 no cactus
Apr 142 with cactus
May 132 with cactus
Jun 126 with cactus
Jul 135 with cactus
Aug 128 with cactus
I write down every food I eat every day and take my test every morning and keep a record of it natural alternative to caffeine . I can see which food does what, and I take my medicine as always and my doctor has been kept informed battery lithium watch .
This gentleman is the poster child for responsible blood sugar control doxycycline burns treatment . Not only is he tracking his sugar levels carefully, he is also working closely with his physician to make sure what he does is safe and effective amsterdam nederlands sildenafil .
STEVIA
Stevia (Stevia rebaudiana) is a nonsugar sweetener derived from the leaves of a South American shrub phenytoin effects lab values . It is not approved as a sugar substitute in the United States but is frequently used in Japan didanosine causing lipoatrophy . Some preliminary research suggests that using stevia instead of sugar might have a benefit beyond simply not consuming sugar on levoxyl but still having symtoms . A small study in Brazil found that stevia tea could improve glucose tolerance in nondiabetic individuals simvastatin 80mg tablet . 255 The plant can also lower blood pressure celexa twice normal dose . No significant toxicity has been reported do cardiologists order toradol .
Stevia is a natural sugar substitute fosinopril side effects . In addition to sweetening food and drinks without raising blood sugar, stevia may be capable of improving glucose tolerance 1 2 aa lithium 3.6v battery . Be sure to monitor your blood sugar when adding this sweetener to a medication regimen automobile lithium ion battery .
Downside: In laboratory tests, high doses of stevia interfered with animals’ reproduction ketorolac pediatric .
Cost: Approximately 10 or 20 per serving Easing Stress
There is a direct connection between your level of stress and your blood sugar paroxetine and . For someone without diabetes, this is probably no big deal, unless you are always under stress warfarin metallic taste . But for a diabetic, anxiety, fear, depression, and emotional pressure will boost blood sugar and make the condition harder to control lyrics for lithium .211,2″ Giving a speech, having a fight with your partner, or going in for your annual performance review at work can all affect your stress level and your blood sugar singulair and weight loss . Doctors often look at diet, exercise, and other physical factors ibuprofen crush . They are less likely to consider emotions, even though they have such a profound impact on a diabetic’s health novartis v pfizer zithromax .
How can a diabetic learn how to manage stress successfully? There is no cookie-cutter answer to this question is cipro sulfa based . Everyone handles stress differently phenergan sudaphed contraindication . For some, the only effective strategy might be to quit a highly demanding job and move to a cave decadron for oral surgery . Doing that would stress others out even more preparation of ethinyl estradiol . Finding the right approach may take trial and error xenical caps orlistat roche .
Avoiding people who make your hands cold is a good place to start hartford zyprexa attorneys . Buy a mood ring (a relic of the 1970s) aluminum lithium etchant . It reacts to skin temperature viagra side effects diarrhea . Whenever your hands get cold as a response to stress, you should do something different from your current activity to warm them up decadron contain only t4 . Relaxation tapes can be helpful if you can carve out time to listen lithium arizona . Our favorites are by Emmett Miller, MD chemical composition of neuronal soma . Dr felodipine reaction . Miller has been in this business a long time and has a soothing voice 7 day doxycycline symptoms disappear . We guarantee that if you listen to his Letting Go of Stress, you will be more relaxed afterward viagra levitra cialis comparison .
Some people may benefit from individual psychological counseling or biofeedback training to learn to cope with stress prednisolone hot flashes . But others may be able to find a group that is learning stress management techniques accutane colitis . 251 If you need a guide to doing it yourself, we suggest you look for a copy of Richard Surwit’s book, The Mind-Body Diabetes Revolution requip and compulsive gambling . It has some good
DR what does bactrim treat . MILLER’S SOOTHING SOUNDS
To purchase Dr metformin 500 571 . Miller’s CDs or tapes, you can visit his Web site, www topical oinment chloramphenicol .DrMiller methotrexate how long .com, or call 800-52-TAPES omnicef stomach . Letting Go of Stress or the Ten-Minute Stress Manager is a good starting place celebrex docing information .
tips on learning to relax and overcome stress as well as background on the importance of psychological issues in diabetes citalopram hydrobromide capsules .
When all else fails, an antianxiety agent can be surprisingly effective at controlling blood sugar in the short term remeron childrens studies . If, for example, you know that traveling makes you anxious and throws your blood sugar out of kilter, you may want to ask your doctor whether a short course of diazepam (Valium), alprazolam (Xanax), or some similar medicine might help you deal with the hassle of travel no prescription claritin .259 Such drugs can be habit-forming, however, so relying on them for long periods of time is not desirable veetids expire .
Depression also has a major impact on diabetes and messes up efforts to keep blood sugar where it should’be information about nexium . Everything feels much harder to manage when you’re down in the dumps, and your attention to exercise, diet, medication, and self-care may well suffer viagra doseages effects . Changes in brain biochemistry associated with depression might also contribute directly to a higher risk of diabetes complications lithium battery explosions . MO Blood clots leading to heart attacks or strokes are more likely when diabetics are depressed; so are irregular heart rhythms and inflammation methotrexate factoids . It’s just as crucial for a diabetic to be evaluated regularly for depression, and to get treatment when it is needed, as it is for her to get regular eye exams and foot care prostatitis and flomax .
Pills to Lower Blood Sugar
Quite often, diet and exercise alone are not enough to control blood sugar glyburide 2 mg . There is a bewildering array of medicine the doctor may prescribe: metformin, which also is dispensed under the brand name Glucophage; medicine with “glitazone” in the generic name, like pioglitazone (Actor); and old-fashioned blood sugar—lowering drugs similar to chlorpropamide or tolazamide, or their newer cousins glyburide (Micronase), glimepiride (Amaryl), or glipizide (Glucotrol) zoloft causing cardiac arrythmias . Newer drugs that stimulate insulin secretion, called nateglinide (Starlix) and repaglinide (Prandin), might be used instead of one of the older blood sugar—lowering drugs levaquin diflucan interactions . Eventually, if blood sugar and glycosylated hemoglobin can’t be brought down to acceptable levels, even type 2 diabetics may end up using insulin bacterial vaginosis flagyl did not work . But it usually makes sense to try oral medicines first metaloproteinase cipro .
It is difficult to tell which of these pills would work best for any given patient hold dose metoprolol . As with everything else pertaining to diabetes, people vary in their responses salbutamol and hyperstimulation . Some do well on a single drug, while others need a complicated regimen class action lawsuits against provera . Only you and your doctor can determine which medication(s) are likely to be safest and most effective for you amoxicillin dental work .
To try to sort out the patterns and give doctors some guidance, scientists at Kaiser Permanents, an enormous HMO in northern California, reviewed the organization’s vast database efficacit gel testosterone 50mg j . First they created a registry of the diabetic patients, and then they examined the data to see which drugs were most effective over time male devo provera . Even though most patients are started on one of the medicines like chlorpropamide or glyburide, this was the least effective treatment for getting HbAl down to
target personal experiences of people on wellbutrin .261
The most effective treatment was triple therapy: a
“glitazone”-type drug in combination with metformin and a drug like glyburide onset action lamictal days . Next best after that was metformin together with insulin pepcid indication gi protect .
One of the most interesting features of the Kaiser Permanents study was that patient behavior could be used to predict success, aside from the drug used hydroxyzine helps withdrawls of opium . Patients who monitored their blood sugar frequently and those who kept all or nearly all of their appointments were significantly more likely to get their blood sugar under control and keep it there clomipramine hcl tablets and alcohol . 262 Making sure that you are on top of your diabetes treatment, taking your medication, monitoring your blood sugar, keeping track of HbA, following a sensible diet and exercise regimen, and controlling your weight as much as possible may be nearly as important as which drugs your doctor prescribes atomoxetine medication diaes .
Metformin (Glucophage)
A review by the Cochrane Collaboration of most of the world’s diabetes literature shows that metformin (Glucophage) alone, if used to keep blood glucose under tight control, is an excellent treatment inderal la medicine .263 Metformin improves blood sugar control by improving the cells’ response to insulin and reducing the amount of sugar that the liver makes risperidone weight gain . Unlike some other oral diabetes drugs, it doesn’t lead to weight gain and may even help people get their weight under control amitriptyline mylan .
It can be dangerous, however, for people with kidney disease testosterone replacement therapy cycles . They should not take the drug, and everyone on metformin should have their kidney function monitored regularly (at least once a year) altace absorption . People with congestive heart failure should not take metformin, either sulfamethoxazole ds tabitp .
SYMPTOMS OF LACTIC ACIDOSIS
• Muscle aches or weakness
• Shortness of breath
• Stomachache, nausea, or vomiting
• Lethargy or drowsiness
• Irregular heartbeat
• Feeling generally awful
Metformin has two nasty side effects that patients must know about drugs and norvasc . One, lactic acidosis, is rare, but it is a medical emergency if it occurs villa allegra . Lactic acidosis can be lethal estrace homrmone . People with kidney disease or congestive heart failure are more susceptible to this problem, which is why they must not take metformin hormone replacement therapy weight premarin . Otherwise healthy diabetics might also develop lactic acidosis on metformin, especially if they drink alcohol watermellon viagra .
What makes metformin so tricky is that patients frequently experience digestive tract distress when they first start taking this medicine tramadol ships next day apo . Side effects can include diarrhea, nausea, vomiting, indigestion, and stomachache accutane atlanta attorney . After several weeks, however, these side effects should fade away strattera testimonies . If digestive symptoms
*** Metformin (Glucophage)
Metformin improves insulin sensitivity caffeine and hunger . It may control blood sugar alone or be combined with other diabetes drugs to improve blood sugar control attack heart ibuprofen . Common side effects include diarrhea, nausea and vomiting, flatulence, fatigue, indigestion, and headache intas strattera for sale online .
Avoid guar gum in low-fat foods (salad dressing, frozen desserts, etc depo provera transexual drug .), because it reduces metformin’s absorption and effectiveness is prevacid an nsaid .
Downside: Lactic acidosis, a rare reaction, requires emergency medical attention and can be fatal nifedipine ointment preparation .
Cost: Approximately $90 to $120 per month; generic $65 to $100
recur, they must be brought to the doctor’s attention immediately since they might be symptoms of lactic acidosis ct scan heart and lopressor .
The other side effect is depletion of vitamin B12 snorting bupropion . Because this vitamin is stored in the body, the depletion is gradual and the symptoms either may not be noticed or may be attributed to some other cause can lovastatin subscriptions cause cough . The physician should test for methylinaIonic acid (MMA) as well as for vitamin B,2 levels compare kytril and zofran . Fortunately, it is easy to treat vitamin B12 deficiency with supplements birth defect imuran . The vitamin does not need to be injected in such cases; oral supplements of around 1 milligram daily (a large dose of vitamin B12) will work prednisone before surgery . Do check with your doctor to find out if this is appropriate for you sten testosterone .
I am a retired physician with type 2 diabetes metoclopramide and dialysis . Metformin has kept my blood sugar in the normal range for 10 years malassezia ketoconazole dog . Despite good control of my blood glucose and glycosylated hemoglobin, my foot numbness was getting worse warfarin back pain . I was also a tilde unsteady on my feet though it was very subtle flomax pseudoephedrine .
I reviewed the medical literature and discovered that metformin interferes with vitamin B1, absorption fertility insemination estrace uterine lining . I suspected I might be deficient in this vitamin, and I started taking oral vitamin B,
Within a week, I noticed that my mental capacity was sharper combivir and other antivirals . I had not realized before this that I was having any cognitive problems new england journal of medicine lipitor . I stopped having any trouble walking, and my foot numbness has decreased effects effexor alcohol .
Many older diabetics take metformin doxycycline cellulitis . ff they developed subtle neurological and mental deficits as a result of lack of vitamin B,, these problems could be treated but may well be overlooked zoloft vs xanax .
Pioglitazone (Actos)
Pioglitazone (Actos) is a newer diabetes medicine that increases insulin sensitivity and decreases insulin resistance aldactone for treating acne . These actions reduce the amount of insulin in the bloodstream and should lower HbAl rash from paxil . Not only can this medication bring fasting blood sugar down, it can also help control blood sugar levels after meals 1 4 propecia .” In the Kaiser Permanents study mentioned above, drugs in this class were the medications most likely to get HbA,, down to normal range by themselves lithium ion battery car fire .
Actos has received a lot of attention from doctors who specialize in treating diabetes es because it has a favorable im- pact on some blood lipids vytorin side effects muscle pain . It doesn’t seem to do much for Pioglitazone (Actos)
Pioglitazone improves insulin sensitivity’and decreases insulin resistance reference range estradiol . It lowers triglycerides and raises HDL, which might result in a lower risk of cardiovascular problems viagra and reduced ammunity . It is taken once a day escitalopram with titration .
Downside: May interact with oral contraceptives to make them less effective
Cost: Approximately $100 to $115 per month
bad LDL cholesterol, but it raises good HDL cholesterol (no mean feat) and lowers triglycerides atrovent peanut . 265
No one knows if these improvements in blood fats will result in a lower risk of heart attack or other cardiovascular complications in the long run gabapentin gaba . That, after all, is the really important issue, since diabetics are at such high risk of cardiovascular catastrophes ibuprofen versus rofecoxib . But Actos is fairly effective in preventing the closing up of a cardiac stent after it is put into a coronary artery study volunteers for topamax and alcohol .266 And a head-to-head study of Actos and Avandia (a similar medication) showed that Actos has a better effect on several measures of cholesterol and blood lipids ibuprofen liquid mg per ml . 261 If this translates down the road into reducing the likelihood of a heart attack or stroke, it would certainly be worthwhile allopurinol lab hahnemann .
Pioglitazone can cause fluid retention and as a result is not appropriate for use by patients with congestive heart failure lotrel azor . Side effects include a greater susceptibility to sore throats, colds, bronchitis, and the like; headaches; toothaches; sinusitis; and muscle pain allegra beach resort . A competing drug, rosiglitazone (Avandia, Avandamet), has also been linked to fluid retention celexa cs zoloft . More worrisome, though, is the possibility that this drug may contribute to fluid accumulation in the back of the eye purpose of flagyl .This macular edema could lead to blurred vision and eye damage claritin and cold medicine .
Repaglinide (Prandin)
The goal of treating diabetes is to keep blood sugar within the normal range, because that reduces the likelihood of serious complications prozac overdose nuerological damage . If you can’t achieve this with metformin or one of the “glitazones,” the doctor may add a medicine to stimulate the secretion of insulin lamictal and sunburn . Two drugs, nateglinide (Starlix) Repaglinide (Prandin?
Repaglinide lowers blood sugar by stimulating insulin release and is especially effective for reducing blood sugar following a meal cellcept indications . Repaglinide is taken before meals, usually within 15 minutes before beginning to eat can zovirax treat epstein barr virus .
Downside: Blood sugar may fall too much (hypoglycemia) brompheniramine and pseudoephedrine extended release . Repaglinide may contribute to weight gain caffeine memory .
Cost: Approximately $130 to $140 per month
and repaglinide (Prandin), make beta cells in the pancreas pump out more insulin at mealtime edward drummond m d and cymbalta . 268 This helps keep blood glucose levels from going too high after eating effexor ejaculation .
Some studies have compared these two medicines alone or in various combinations scarring accutane . The results aren’t definitive, but comparing nateglinide alone to repaglinide alone suggests that there is an advantage to repaglinide whats stronger than ultram .269 Prandin lowered HbA, signifi- cantly more than Starlix did; it brought down fasting blood sugar better; and more than half (54 percent) of the patients on Prandin were able to get their HbA below 7 percent, whereas fewer than half (42 percent) of those or Starlix managed that osteoporosis lamotrigine . Of course, there’s a price amitza or zelnorm . Patients on Prandin were more likely to suffer from hypoglycemia (low blood sugar) rimonabant effect on abdominal fat . They also gained more weight (almost 4 pounds in 4 months), a discouraging side effect patient assistance program for accutane . -
These drugs are more effective in combination with metformin than they are on their own memory loss zoloft . 270 tricor cholesterol statin .27L272 Side effects of repaglinide include headache, joint or back pain, and tipper respiratory infection no prescription needed glyburide . Drugs such as ketoconazole (Nizoral) and clarithromycin (Biaxin) boost blood levels of repaglinide, and that could increase the likelihood of unpleasant reactions 2cialis compare levitra . Grapefruit affects the same enzyme (CYP3A4) and might have a similar effect side effects of mircette .
Exenatide (Byetta)
Exenatide (Byetta) is another treatment option for type 2 diabetics prograf pronounced . It has an interesting history zoloft user review . because it got started with research into the saliva of a poisonous Southwestern lizard called a Gila monster what is lexapro medicine . Byetta is injected and is used in combination with metformin or a blood sugar–lowering drug like glyburide claritin d warnings . Byetta reduces the bump in blood sugar after meals and can help diabetics lose weight kidney infection cipro .
The most common side effect is nausea, but the most serious is hypoglycemia sustiva drug . Adding Byetta to a medicine like glyburide increases the risk of a dangerous drop in blood glucose level difference between prilosec and zantac . Patients using Byetta must learn what to do if blood sugar drops too low zoloft causing excessive sweating . Other side effects include vomiting, diarrhea, dizziness, jitters, headache, and indigestion michael soma . Byetta should not be given to people with kidney problems or serious digestive disease prozac vs cymbalta . 273
Conclusions
By now, we hope you appreciate the importance of controlling blood sugar asacol delayed release tablet . Diabetes is common (some diabetologists believe it will soon affect nearly half the population), and its complications are devastating pfizer class action involving zoloft . We have tried to give you a variety of strategies to prevent or control this disease viagra and generic . Remember, though, that whatever tactics you adopt, you must work in close collaboration with your health-care providers prednisone and tracleer .
Below you will find an overview of our recommendations in this chapter rechargable aa lithium ion .
• Preventing diabetes is possible nolvadex steroids . Keep your weight under control, emphasize nonstarchy vegetables over pasta or bread, and avoid soft drinks, fruit juice, and processed meats you made everything possible again viagra .
• Get plenty of exercise, preferably including some time outdoors so you have 10 to 15 minutes of sunshine on your face and hands several days a week celexa proper dosage . If you don’t get outside, take 800 to 1,200 IU of vitamin D3 daily quetiapine and sustained release and dissolution .
• If you are diagnosed with diabetes, learn to monitor your blood sugar can toprol cause chronic abdominal distress . Keep track of how exercise and food affect it prozac and nerve receptors . Consider cinnamon or vinegar to help smooth out blood sugar in reaction to a carbohydrate meal nexium and indications .
• If you’re considering using herbs or dietary supplements such as chromium, bitter melon, fenugreek, Gymnema sylvestre, or nopal, check with your health-care providers before taking them zofran wafer . Monitor your blood sugar carefully ultram nopain .
• If medication becomes necessary, make sure that you and your physician find the safest and most effective option for you viagra nils . You shouldn’t have to suffer with dreadful side effects to keep your blood sugar under control iv ampicillin .

flumazenil A benzodiazepine antagonist used in anaesthesia to reverse the sedative effects of benzodiazepines.
Dose: 200µg initially by i.v. injection, with subsequent doses of 100 pg at I -minute intervals, up to a maximum of I mg. Further doses may be given by i.v. infusion if drowsiness returns, as the action of flumazenil is brief. ( Anexate).
flunisolide A potent corticosteroid used locally in the more severe forms of hay fever and other nasal allergies.
Dose: 1)), nasal inhalation, 50pg (2 sprays), 2 or 3 times a day, continued for 2-3 weeks, or longer if required. (Syntaris).
flunitrazepam A benzodiazepine with a hypnotic action used for the short-term treatment of insomnia.
Dose: 0.5-2 nig. Side-effects include drowsiness, ataxia and visual disturbances. (Rohypnol). See page 152 and Table 22.
fluocinolone A topically active potent corticosteroid. Used as cream, ointment or gel (0.00625-0.025%) in severe, inflamed, corticosteroid-responsive skin disorders. Excessive application should be avoided. (Synalar).
fluocino”ide A potent locally effective anti-inflammatory steroid similar to fluocinolone, used as cream, ointment or lotion (0.05%). (Metosyn).
fluocortolone A locally acting corticosteroid used as cream or ointment (0.25%) in severe, inflamed skin conditions. (Ultralanum).
fluorouracil A cytotoxic agent used in the palliative treatment of carcinoma of the breast and gastrointestinal tract and other solid tumours.
Dose: 15 ingft orally or by i.v. infusion weekly, up to a total dose of 12-25 g. Side-effects include alopecia and dermatitis, but haeniatotoxicity, severe gastrointestinal disturbance and haemorrhage may limit treatment. Fluorouracil is used locally as a 5% cream (Efudix) in malignant skin lesions.
fluoxetine An antidepressant that acts by selectively inhibiting the uptake of serotonin. Given in single daily doses of 20 mg. Dose: 60 mg daily are given in bulimia nervosa. Side-effects are gastrointestinal disturbances, dizziness and anorexia; rash is an indication of withdrawal. It should not be used with other drugs that influence serotonin uptake. (Prozac). See page 128 and Table 11.
flupenthixol A tranquillizer similar to fluphenazine and used in the treatment of schizophrenia with apathy and withdrawal. It also has an antidepressant action.
Dose: 6-18 ing daily initially, with subsequent adjustment according to need. It may cause some restlessness and insomnia. Dose by deep i.m. injection, 20-40 mg every 2-4 weeks. Dose in depression: 500 pg 31ngdaily.The side-effects are similar to those of chlorpromazine. (Depixol; Fluanoxol). See page 168 and Table 30.
fluphenazine An antipsychotic drug with the actions and uses of chlorpromazine, but with reduced sedative and anticholinergic side-effects, although extra-pyramidal symptoms may be increased. Dose: 2- 10 mg initially in schizophrenia adjusted up to 20 ing daily. In severe anxiety states 1-4 mg. For depot treatment, 12.5-100 ntg of the decanoate by deep i.m. injection every 12-14 days according to response. (Modecate; Moditen). See page 168 and Table 30.
fluorescein An orange-red dye; solutions have a strong green fluorescence. Used as eye drops (1-2%) for detecting corneal lesions, as areas of cornea denuded of epithelium stain green.
fluorometholone A corticosteroid used as eye drops (0.10%) for inflammatory conditions of the eye. (FML).
flurandrenolone A potent locally acting corticosteroid used as a cream or ointment (0.0125%) in severe skin disorders not responding to other therapy. (Haelan). An adhesive tape is used for small resistant dermatoses.
flurazepam A benzodiazepine hypnotic for
the short-term treatment of insomnia.

flurbiprofen A non-steroid anti-inflammatory drug with the actions, uses and side-effects of naproxen. It is used in the relief of pain and inflammation in rheumatoid and arthritic conditions, and in other
nitisculoskeletal disorders.
Dose: 150 mg daily, after food, increased tip to 300 mg daily if necessary. Suppositories of 100 nig are available. Care is necessary in peptic ulcer and in aspirin-sensitive asthmatic patients. (Froben). See page 165 and’I'able 29.
flutamide An androgen blocking agent that inhibits the action of androgens on target organs. It is used in advanced prostatic cancer not responding to other drugs, usually in association with goserelin or related agents.
Dose: 750 mg daily. Side-effects include gynacconiastia, and liver function should be checked. (Drogenil). See page 122 and Table 8.
folic acid A constituent of the vitamin B group. It is essential for cell division and the growth and development of normal red blood cells. The main therapeutic use is in the treatment of megaloblastic anaemias due to folic acid deficiency. Dose: 5 ing daily for 4 months initially;
ing weekly may be adequate after the haematological response has been obtained. Sometimes given with anti-epileptic drugs, as long-term therapy may cause a folic acid deficiency. Small doses are present in many iron preparations to prevent the inegaloblastic anaemia that may occur in later stages of pregnancy. It must not be used alone in pernicious anaemia, as it cannot prevent the degeneration of the central nervous system associated with that disease.
folinic acid A methotrexate antidote. It is given ai the end of a course of methotrexate to reduce the toxic effects on normal cells and in methotrexate-overdose. Dose: up to 120 mg over 24 hours by i.m. injection (or i.v.), with 60 mg orally for another 48-72 hours.
49
fluticasone A corticosteroid of increased potency. Used as a metered dose pump for the prophylaxis and treatment of seasonal allergic rhinitis and hay fever.
Dose: 100 pg (2 sprays) into each nostril mice a day in the morning. Maximum reliefmay not be obtained for 3-4 days. Systemic absorption extremely low. (Nixonaw.
fluvastatinV An inhibitor of the enzyme I I N46-CoA-reductase used in the treatment of hyperlipidaemia.
Dose: 20-40 ing daily in the evening. (Lescol). See page 146,’I'able 20 and atorvastatin, provastatin and ‘inivastatin.
fluvoxamine An antidepressant that acts by inhibiting the central re-uptake of serotonin. It is used mainly for maintenance treatment during depressive illness. Dose: 100-300 mg, daily in the evening; a steady plasma level is normally reached within 10-14 days. Side-effects after initial nausea may include somnolence, constipation and agitation. It should not be used with other drugs that increase scrotonin uptake, or with aminophylline or theophylline. (Faverin). See page 128 and Table 11.
follitropin A recombinant form of the follicle stimulating hormone used in some forms of infertility. It is given by injection in doses dependent on the degree of ovarian response. (Puregon).
formaldehyde A powerful but toxic germicide used mainly in the disinfection of rooms, and as’formalsaline’ (5% in normal saline) for the preservation of pathological specimens. Warts have been treated with a 3% solution.
formestane An inhibitor of aromatase, the enzyme that converts androgens to oestrogens. It is used in advanced postmenopausal breast cancer, as it has a cytotoxic action mediated by causing an oestrogen deficiency state.
Dose: 250 mg by deep intragluteal injection at intervals of 2 weeks, with variations of the injection site. Side-effect are rash, pruritus and occasional vaginal bleeding. Mentaron). See page 122 and Table 8.
foscarnet An antiviral agent for the treatment of sight-damaging cytomegalovirus retinitis in AIDS patients as an alternative to ganciclovir.
Dose: 60 mg/kg daily by i.v. infusion for 2-3 weeks, with subsequent infusion at a rate dependent on renal function. (Foscavir). See page 144 and,ribic ig.
fosfestrol A water-soluble derivative of stilboestrol. It is metabolized by the enzyme acid phosphatase to liberate stilboestrol in tissues rich in that enzyme, and so it is of value in prostatic carcinoma.
Dose: 1)), slow i.v. injection, 600-1200 rni, daily for 5 days or more. Oral maintenance dose: 120-360 nig daily. perinea) pain is a side-effect. (I lonvan). See page 122 and Table 8.
fosfomycin A phosphorus-containing antibiotic used mainly for infections of the lower urinary tract.
Dose: 3 g nightly after voiding the
bladder. Also used prophylactically before prostatectomy. Rash, nausea and diarrhoea are side-effects. (Monuril).
fosinopril An ACE inhibitor indicated in hypertension when standard therapy is ineffective or unsuitable.
Dose: 10 mg daily initially, adjusted after •1 weeks up to 40 nig according to need. It is eliminated by the liver as well as the kidneys, and may have some advantages in renal impairment. (Staril). See ACE inhibitors, page 148 and Table 21.
framycetin An antibiotic resembling neomycin in general properties. Used in eye infections as drops or ointment 0.5%. (Soframycin).
friar’s balsam Contains benzoin, storax, aloes, balsam of tolu. Official name Compound Tincture of Benzoin. See benzoin.
frusemide A loop diuretic with a powerful and intense action of short duration. Often effective in conditions no longer responding to thiazide diuretics.
Dose: 20-40 mg daily or on alternate days, or 20-50 mg i.ma or i.v. Much larger oral doses, varying front 250 nie, up to a single maximum dose of 2g may be required in renal failure and oliguria. Side-effects include nausea, diarrhoea and cramp. Masix). See page 141 and’Fable 18.
fusidic acid See sodium fusidate.
gabapentin An anticonvulsant used in the L11111101 of the partial seizures of epilepsy, although the mode of action is not yet clear. Dose: 300 mg initially, slowly increased to 1.2 g daily according to need. Drowsiness, tremor and weight gain are some side-effects. Withdrawal is with slowly reduced doses over 2-3 weeks. (Neurontin). See page 136 and Table I5.
gallamine A synthetic non-depolarizing (competitive) muscle relaxant.
Dose: 80-120 mg initially i.v. with small subsequent doses according to need and response. The action of the drug may be terminated by the injection of neostigmine, 2.5-5 mg, together with atropine, 0.5-1 mg. (Flaxedil). Now used less frequently as tachycardia is a side-effect.
gamolinic acid A derivative of linoleic acid present in evening primrose oil. It is said to be of value in atopic eczema.
Dose: 320-480 mg daily. It is also used in mastalgia (breast pain) in doses of
240-320 mg daily, but the response is slow (8-12 weeks). (Epogam; Ffarnast).
gammaglobulin See immunoglobulin.
ganciclovir An antiviral agent similar to aciclovir, but more toxic. It is used only in sight- and life- threatening infections with cytomegalovirus (CMV) in immunocompromised patients.
Dose: by i.v. infusion, 5 mg/kg every 12 hours for 14-21 days, with mainte nance (lose of 5 mg/kg daily. Later oral dose 3 g daily. The solution is very alkaline, and injection requires care. Regular blood counts are essential. (Cvnievene). See page 144 an(Frable 19.
G-CSF human urnan granulocyte colony stimulating factor. See filgrastim and lenograstim.
fusafungine An antibiotic with anti-inflammatory properties used for upper respiratory tract infections.
Dose: as aerosol spray 123 jig 5 boles  day. (Locabiotal).
Gee’s linctus A soothing cough linctus containing camphorated tincture of opium, oxymcl of squill and syrup of tolu.