Posts Tagged ‘hydrocortisone’

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.

ECZEMA
Eczema is one of those old-fashioned words, like apoplexy, that sounds as though it should have become obsolete doxycycline buy online . Unfortunately, the condition it describes is still very much in evidence, now perhaps more than ever buy paroxetine on sale . Dermatologists estimate that the red itchy rash of chronic eczema may affect as inuch as 20 percent of the population in Scandinavia, Australia, and England maoi inhibitors and requip .274 The United States has similar figures, compared to only about 2 percent of the population in places like Iran and China sulfamethoxazole prostitis .
Scientists don’t know why the rate of eczema varies so widely from one place to another tetracyclines cipro . A lot of other things are still pretty mysterious about eczema, too motilium and gerd . The researchers who study it have not come up with a single unified measure of eczema severity, so it is sometimes difficult to compare studies nbc candace downing zoloft . In fact, when dermatologists discuss eczema, they frequently use the term atopic dermatitis instead amoxicillin abdominal cramps . It means the same
• Apply moisturizer immediately after washing skin ***
•Take probiQtic supplements such as viable Lactobacillus GG
• Try hemp seed oil capsules **
• Season your food with salsa **
• Sip oolong tea ***
•Take vitamin E capsules daily ***
• Smear Noxzema (original) on itchy skin ****
• Try nonprescription hydrocortisone cream * ***
• Apply CamoCare Soothing Cream to itchy areas ***
• Follow doctor’s instructions for using prescription steroid creams
• Consider prescription Atopiclair ***
• Ask the doctor about Protopic or Elidel as a second-line prescription treatment
glyburide liver damage due to lipitor . Byetta reduces the bump in blood sugar after meals and can help diabetics lose weight does advil contain asprin .
The most common side effect is nausea, but the most serious is hypoglycemia soma vs salsa . Adding Byetta to a medicine like glyburide increases the risk of a dangerous drop in blood glucose level d150 lithium ion . Patients using Byetta must learn what to do if blood sugar drops too low macrobid uti . Other side effects include vomiting, diarrhea, dizziness, jitters, headache, and indigestion lupus testosterone treatment . Byetta should not be given to people with kidney problems or serious digestive disease metformin and sinus inflamation . 273
Conclusions
By now, we hope you appreciate the importance of controlling blood sugar diabetics taking aleve . Diabetes is common (some diabetologists believe it will soon affect nearly half the population), and its complications are devastating how much does nexium cost . We have tried to give you a variety of strategies to prevent or control this disease naproxen acne . Remember, though, that whatever tactics you adopt, you must work in close collaboration with your health-care providers replace lithium with alkaline .
Below you will find an overview of our recommendations in this chapter generic atorvastatin online .
• Preventing diabetes is possible zoloft fedex . Keep your weight under control, emphasize nonstarchy vegetables over pasta or bread, and avoid soft drinks, fruit juice, and processed meats 1 5mg propecia .
• 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 augmentin tablet . If you don’t get outside, take 800 to 1,200 IU of vitamin D3 daily apo sildenafil .
• If you are diagnosed with diabetes, learn to monitor your blood sugar prescription viagra from canada without prescription . Keep track of how exercise and food affect it celexa success . Consider cinnamon or vinegar to help smooth out blood sugar in reaction to a carbohydrate meal naltrexone and behavior .
• 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 using loratadine in cats . Monitor your blood sugar carefully ranitidine used to stop itching .
• If medication becomes necessary, make sure that you and your physician find the safest and most effective option for you caffeine remedies . You shouldn’t have to suffer with dreadful side effects to keep your blood sugar under control caffeine coke coffee .
thing: a nasty, itchy rash, especially in places where the skin creases (like inside the elbows and on the backs of the knees) kamagra barata . It may be associated with dry skin, redness, and irritation on the cheeks or forehead, as well as asthma or hay fever vigorex or viagra .
Very young kids with eczema may have family members with asthma or hay fever can accutane make your periods shorter . Atopic dermatitis is pretty common in children and may start early, at as young as 2 or 3 months of age managing levothyroxine dosing . 275 If it is severe, the itching can drive the sufferer crazy and even keep him or her awake at night pseudoephedrine and hypertension . It is no wonder patients and their parents are anxious to get relief hypothyroidism and glucophage .
Skin Care Basics
There is a huge overlap between eczema and dry skin, so it makes sense that the very first things to try for eczema are recognized as elementary care for dry skin 12.5 cr mg paxil .
Especially in adults, eczema frequently affects the hands light period after taking clomid . Avoid soaking your hands in water side effects of drug lamisil . If they are dirty, by all means wash them college pharmacy pre tramadol . But if you need to do the dishes or wipe off the counters, wear waterproof gloves generic equivalent to zoloft . Likewise, if you are working out in the yard, wear garden gloves properities of caffeine . Apply a moisturizer you like as soon as you finish washing your hands nizoral shampoo helps acne . (We’re fond of Udder Cream atavan and prozac .) You might even consider applying a heavy-duty ointment-type moisturizer at night and wearing cotton gloves to bed, so the sheets are protected and the ointment really gets a chance to sink in duration of celexa withdrawal symptoms .
CeraVe Cleanser and Moisturizer
These skin products contain no fragrances, soap, or detergent atorvastatin joint pain . The cleanser is an emulsified formulation that contains cetearyl alcohol, one of the primary ingredients in Cetaphil cleanser will zelnorm ever come back . But both the moisturizer and the cleanser also contain ceramides when does zyrtec’s patent expire . fSo does Dove Facial Lotion hereditary allergies cipro .) Skin with eczema is depleted of ceramides, 276 and the CeraVe products are supposed to restore these natural skin fats and keep skin from drying out dangers of prozac and peptic ulcers .
Downside: No real downside, but other products may be less expensive bp-2l5 lithium battery .
Cost: A 12-ounce bottle runs about $12 and should last several months detector bandwidth characteristics lithium tantalite .
What about rashes that affect other parts of the body? Basically, follow the same principles testosterone prices . Bathing or showering are okay, but shouldn’t be prolonged free testosterone level normal older . Don’t use soap or detergent, if you can avoid it; instead, use a gentle, nonsoap cleanser such as CeraVe or Cetaphil simvastatin niacin . Gently pat your skin dry and apply moisturizer as soon as you step out of the tub or shower stall weight gain while on synthroid .”‘
Moisturizers don’t actually make eczema better by themselves clomid pcos story success woman .”‘ What they do is improve the symptoms of dry skin, so the skin looks better and itches less accutane weight lose . In addition, a topical medication may work better on skin that is properly moisturized canada cr123a lithium . So, there are reasons to start with a moisturizer, although it’s unlikely to be enough of a treatment on its own doxazosin medications .
Dietary Approaches
The connection between eczema and other allergies has inspired people to search for the source of the allergies and try to avoid them ganciclovir acyclovir . Avoiding one of the most common allergens, dust mites, is very difficult nolvadex or clomid for testosterone boost . Dust mites live in bedding, furniture, carpets, and even stuffed animals lamisil dosage . As it happens, though, even extreme measures such as encasing the mattress in plastic don’t reduce eczema in adults reds lithium .”‘ We don’t have good research on whether this would help in babies or young children discount pharmacy zyrtec .
Dietary recommendations are aimed at reducing a child’s exposure to foods that could be triggering eczema co diovan . One trap that parents sometimes fall into is restricting the diet too much, so that the child isn’t getting enough nutrients doxycycline for std . Scientists say that most of the time, dietary restriction isn’t very helpful for improving eczema zyprexa and high blood sugar . If a child reacts to eggs, though, avoiding them is likely to help clear up the skin caffeine efffects .211 Switching a baby from cows’-milk formula to soy-based formula is often advised and occasionally helpful tadalafil fails .
Luckily, kids often “outgrow” their food allergies as they get older viagra bloody nose . The big exception is peanuts prozac gain weight . Children who are allergic to peanuts need to avoid them scrupulously, and will probably need to do so indefinitely non asprin pain relievers .
I’ve had eczema since childhood, and it had been getting worse, despite applying steroids three times daily sildenafil rdt . I had read advice about cutting back on trans fats and adding omega-3 fats but I had no success until I tried completely eliminating trans fats imitrex withdrawals . Since getting hydrogenated oils out of my diet, my eczema has nearly dis-appeared and I have discontinued the steroids for the first time in 3 years cymbalta teeth clenching . The trans fats that apparently caused this problem were coming from one or two servings of packaged cookies per day what is fluoxetine for .
Probiotics
Most Americans are familiar with the idea of using antibiotics to kill germs when there is an infection itching all over from doxycycline . But probiotics are not nearly as popular in the United States as they are elsewhere in the world, especially in Europe diovan great . Probiotics are beneficial bacteria that are used in an attempt to colonize the gut with “good guys” and crowd out dangerous bacteria regular use of ibuprofen .
There is evidence that babies with eczema may benefit from treatment with probiotics, particularly if they have evidence of allergic-type immune-system activation soma spa ottawa . Doctors determine this by measuring the amount of an immune globulin, IgE, in the blood nnt zocor . It is usually elevated in people who are experiencing an allergic reaction amoxicillin clavulanic acid in ruminants . Adding probiotics such as Lactobacillus fermentum or Lactobacillus GG to formula helped ease the condition in very young children with severe eczema ranitidine expiration date . 281,282,283
We don’t know why probiotics can make eczema better, but some researchers speculate that they may cause a low level of inflammation that stimulates the immune system in a different direction from allergy prilosec nexium compare . 21 More research is needed before that hypothesis can be confirmed—or tossed out does levaquin contain sulfa . For adults, many probiotics are considered relatively safe ‘285 although there are some theoretical risks whenever living microbes are
Probiotics
Beneficial bacteria such as Lactobacillus GG, Lactobacillus reuteri, or Lactobacillus fermentum seem to reduce the severity and extent of eczema in young children neurontin for back pain . This approach is reasonably safe286 and might be worth a try trazodone wikipedia .
Downside: Probiotic products are sold as dietary supplements, so the quality is not regulated charger rechargeable lithium cr123a 3.7v battery . Check www konica rechargeable lithium ion battery pack .consumerlab avelox prescription assistance .com for quality evaluation and price information zithromax dosage 23 pounds . It is important that the supplement contain viable organisms spironolactone for ascites and hyperkalemia .287 Cost: Approximately $10 to $30 per month introduced into the bod y lipitor gross income .288 For very young children, it would be sensible to follow the pediatrician’s recommendation information about levora .
Oil Supplements
We already mentioned that the connection between eczema and diet has led to research investigating various dietary restrictions symptoms of testosterone use . For the most part, a really restricted diet just makes life more difficult without any payoff for the skin augmentin generic . (One big exception is in the case of celiac disease anxiety bupropion . This intolerance of gluten can cause a distinctive skin reaction—herpetiform dermatitis—along with a wide range of other symptoms glimepiride dosage indication . For a person with celiac disease, avoiding gluten completely not only clears up the skin, but also has many additional health benefits lithium ion battery pack 7.2v .)
We have heard from many eczema sufferers who have found that various supplements have helped to clear up their rash, at least for a while naproxen and garlic . Borage oil and black currant seed oil are among the most popular supplements digoxin medicine . They supply fatty acids, especially gamma-linolenic acid, that may be underrepresented in the typical American diet ketorolac surgery .
I have been plagued with persistent eczema carisoprodol mg . The skin on my hands was always red, itchy, cracked, and often bleeding anxiety meds similar to zoloft . My hands were always covered with bandages estrace dosage .
Dermatologists prescribed cortisone creams of increasing strength, but none was helpful over the long-term reduction of prednisone side affects . An allergist I saw for an unrelated problem was concerned that the open wounds on my hands put me at risk of infection what is nifedipine er . He suggested borage oil zyrtec ambien interaction .
I tried it (one capsule after breakfast and one before bed), and
Hemp Seed Oil
Hemp seed offers a balance of omega-6 and omega-3 fatty acids lexapro definition . One study demonstrated that it reduces eczema symptoms significantly more than olive oil does hectoral coumadin .
Downside imipramine histamine h2 ., A single study is not enough for a full evaluation of the supplement’s benefit diovan black box warnings . Another, larger study might not show a significant effect evista fossamax .
Cost: Approximately $5 to $16 per month
within a few months the eczema on my hands disappeared completely cymbalta long term use . While I still have some outbreaks behind my ears, the condition is now only a minor annoyance generic metoprolol succinate 100mg . What a difference!
Although some individuals have found gamma-linolenic sources such as borage oil, evening primrose imrose oil, and black currant seed oil helpful, scientifically controlled studies of these supplements are disappointing acyclovir cream buy . 219 They do seem to be safe, but overall they don’t reduce the rash or itching any more than placebo capsules do zithromax 1 gram . 290
One well possible exception is hemp seed oil overview of rx diltiazem cd . It contains omega- 3 as as omega-6 fatty acids, including gamma-linolenic acid amlodipine besylate norvasc . One placebo-controlled study found that hemp seed oil capsules reduced itchiness and dryness in skin viagra online store . (The placebo capsules contained olive oil caffeine body slimmer .) Patients on the active supplement used less topical medicine for their dermatitis during the 5 months the trial lasted norvasc a drug .291 We hope other dermatologists will continue to study this treatment to see if it stands up to further investigation diprivan interactions with zoloft .
Low-Carb Diet
One of the most unusual testimonials we have received about controlling eczema with diet was from a woman who adopted a low-glycemic-index diet for other reasons ms cymbalta . She found that it helped clear up her itchy rash reis urso and ewald rutland vermont . Cutting sugar, white bread, and pasta out of the diet may well have other health benefits estriol estradiol cream . Most dietary experts agree that these foods are not very nutrient-dense trimox for erectile dysfunction . Your body won’t miss them, even if your taste buds do luvox tablets .
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Q buying generic cialis . I used to get urinary tract infections or yeast infections every other month ptsd using prazosin hcl 1 mg . Then I changed my diet and cut out sugar, white flour, and starches like potatoes or rice methadone xanax diphenhydramine fluoxetine . Since then I have had only one urinary tract infection clomid while breastfeeding .
I’ve lost 20 pounds and my eczema is 99 percent better what is synthroid made from . I have a flare-up only when I eat cake or milk chocolate cipro diarrhea .
I was surprised that diet could have such an effect on my system valacyclovir c gsk dartford . Other people with eczema or seborrheic dermatitis might benefit the way I did synthroid iodine .
A site about tramadol climate . There is next to no research linking a high-carbohydrate diet to urinary tract infections or eczema ultram and ejaculation . On the other hand, reducing the amount of sugar, starch, and refined carbohydrates seems like a simple enough experiment wellbutrin and prices . If it works for some people with such hardto-treat conditions, it might be worth the trouble soma boulder . Thanks for sharing your interesting story sertraline therapy canine .
9 * *
This approach has not been well studied, to say the least omnicef price . German researchers have investigated a sugar-free diet in 29 patients free testosterone blood level in women . 292 After 1 week of a strict sugar-free diet, they were given a food that contained either sugar or an artificial sweetener voltarol side effects on stomach . There was no discernable difference between the reaction to sugar and the reaction to an artificial sweetener merck co propecia .
You may feel that this study was small and perhaps didn’t give the diet enough of a chance online prozac online . If so, go ahead and conduct your own personal study proscar and psa . It won’t have scientific significance for anyone else, but if it helps your skin, that’s all you really need to know levothyroxine cytomel together .
Hot Salsa
Believe it or not, some people have done their own experiments on one dietary staple trazodone chemical components . After one person reported that his increased consumption of salsa had been correlated with a decrease in the severity of his lifelong psoriasis, other people decided to try salsa or hot chili peppers for eczema penicillin vk 250mg . At least a few of them have found capsaicin consumption helpful caffeine free low sugar cocoa . (Capsaicin is the compound in chili peppers that makes them hot description of omeprazole . We have no idea if eating it has any role in making eczema better can synthroid affect anti-tpo test .)
I read your column about eating salsa fora skin condition benzapril hydrochlorothiazide . I tried it and it worked forme side effects prednisolone withdrawal . For over a year I’ve been free of the eczema I had for 8 years before that ramipril interactions . I ate salsa daily for about a month amoxicillin color description .
Capsaicin is an ingredient in some topical liniments or rubs designed to alleviate arthritis pain diflucan over the counter . Usually, there is a warning for such products not to apply them to broken skin finasteride prostate treatment . For one thing, capsaicin on a cut or sore would hurt horribly depakote er and bipolar . There is also no evidence that capsaicin cream would be effective for The People’s Pharmacy has received a number of testimonials claiming that eating salsa eased eczema atenolol myl . No clinical trials have been conducted as far as we know vardenafil raw material .
Side effect: Sore mouth
Downside: Not everyone likes salsa anavar or testosterone . Cost: $6 to $10 a month
eczema blach cohosh celexa . A review of the evidence in veterinary medicine concluded that more studies are needed to see if topical capsaicin works for dogs with itchy spots citalopram and bruises . 293 If more data are needed for dogs, you can well imagine how much more evidence is needed for humans!
Oolong Tea
If you think that salsa is on the strange side, you might be nonplussed by oolong tea generic vs brand name wellbutrin . It has one major advantage over salsa, though: A study of people with atopic dermatitis showed that it helped to reduce their symptoms itraconazole for cats .” People with severe eczema that had not responded well to standard treatments were given tea bags and told to make and drink a liter (about a quart) of oolong tea daily aldosterone norvasc . Their symptoms were recorded neonatal thyroxine . Although there wasn’t any placebo tea, researchers and almost two-thirds of the patients noticed an improvement within a couple of weeks paxil antidepressant . The improvement, which lasted for the entire 6 months of the study, might have been due to the anti-allergy activity of the polyphenol compounds in oolong tea winston churchill and penicillin .
9 9 0
G klonopin prozac interaction . Thank you for your advice to try oolong tea for eczema phenylephrine hci and loratadine . It’s been like a miracle flomax tamsulosin virginia .
I’ve had eczema on my scalp for most of my life naproxen review . I would have terrible itching and scaling on my scalp that would usually bleed and scab over damage prozac overdose . It’s worse around the hairline and is embarrassing as well as painful withdrawal recovery effexor .
I had tried everything my doctor prescribed: Nizoral, Elidel, topical steroids in oils and shampoos, and even an injection abilify hoarding . Nothing worked until the tea no caffeine . I’ve been Oolong Tea
Oolong tea is a popular beverage in China and Japan can prilosec otc raise blood sugar . More than half of the patients in the only study that has been done had good improvement that tasted 6 months tacrolimus ointment .
Side effect: Oolong tea, like other tea, contains some caffeine and could be stimulating artane heat .
Downside: American taste buds need to get used to the flavor alternatives to mesalamine .
Cost: $3 to $5 a month
drinking it for about 2 weeks now and I’d say there’s been at least an 85 percent improvement caffeine culture tour .
A sr wellbutrin xl . You aren’t the only reader to find oolong tea helpful cod shipped tramadol . One person with hard-to-treat eczema reported: “The last time I had an outbreak, I tried oolong tea and the results were amazing wellbutrin and buspirone . Within 24 hours, the itching and inflammation were gone zantac use . It took a couple of days, but the lesions disappeared and didn’t leave scars active ingredients in aleve .”
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Oolong tea is available in many grocery stores, although black tea and green tea are better known in the United States levothyroxine if you miss dose . All three teas are made from the same plant, but the leaves are processed differently gout not sensitive to allopurinol . Green tea leaves are processed very little; black tea leaves are “fermented” and oxidized; and oolong tea leaves are partially oxidized diltiazem and side effects . It’s an acquired taste, but it could be a taste worth acquiring c e s conjugated estrogens

Vitamin D
If you can exercise outside and get at least 5 to 10 minutes of sunshine on your face and hands three or four times a week, you will be doing one more valuable thing to prevent diabetes canine inj dexamethasone . For those few minutes, don’t use sunscreen, because it can block the formation of the “sunshine vitamin,” vitamin D cyclosporine side effects thyroid .There is growing evidence that lack of this essential nutrient may predispose people to metabolic syndrome and diabetes paroxetine formula . 225 Low levels of vitamin D make it harder for the body to make or secrete insulin elavil and immodium .
Vitamin D deficiency is far more common than you would imagine ultram no prescription needed . Experts report that the majority of the elderly lack adequate amounts of vitamin D circulating in their bloodstream low maintainance prednisolone . 221 That might be understandable drug classification of sertraline . Older people might not drink much vitamin-D-fortified milk because of digestive issues fexofenadine hcl tabs allegra . They probably spend less time outside, especially in the winter, and when they do go out, they bundle up, exposing very little skin to sunlight mixing alleve and asprin . They may also be more care-
“Solid evidence exists that vitamin D deficiency is detrimental to beta cell function, leads to glucose intolerance in animal models and humans, and predisposes to type 2 diabetes finasteride or dutasteride for steroids . food supplement anhydrous caffeine powder . plavix verdict . meperdine phenergan . A major practical conclusion that can be drawn from the studies conducted on vitamin D and diabetes to date is that vitamin D deficiency is undesirable, not only for calcium and bone, but also for glucose metabolism how does caffeine effect plant growth .”227
—C atenolol diabetes brittian . Mathieu et al dreampharmaceuticals online generic ultram ., Diabetologia, July 2005
***** Vitamin D
The sunshine vitamin is the best deal in town because it is free arimidex vs clomiphene for pct . This nutrient is associated with a lower risk of osteoporosis, fractures, depression, cancer, arthritis, and diabetes adalat la . Five to 10 minutes of sun exposure on the hands, arms, and face every 2 or 3 days is about enough to do the job for most people caffeine or coffee and plant growth . 228
If oral supplements of vitamin D are necessary because sun exposure is not practical, we recommend anywhere from 800 to 1,200 IU per day zyrtec generic form . Do not overdose, though india generic topiramate 200mg prices . Keep total intake under 2,000 IU daily prilosec risk .
Cost: $0 if you get your vitamin D from sunshine; for supplements, you could spend less than $30 per year
ful about putting on sunscreen in the summer to prevent skin cancer plavix and platelets . This will block 95 to 98 percent of vitamin D formation in the skin liquid baclofen medtronics .
What is more surprising is that younger people may also be vitamin D deficient dissolving naproxen . Researchers recruited physicians, medical students, and hospital visitors at Boston University Medical Center and asked them to give blood during a vitamin D awareness program erythromycin antibiotic vomiting . The investigators discovered that “36 percent of young adults aged 18 to 29 years had vitamin D deficiency at the end of winter side effects of zyrtec-d .”229 While we cannot prove that a lack of this nutrient is contributing to the diabetes epidemic, we would be surprised if it weren’t part of the story different names for fluoxetine .
There is will still no proof that getting adequate amounts of vi- tamin D wiprevent diabetes isosorbide mononitrate nursing management . Nevertheless, we think making sure you get enough of it makes sense for lots of other reasons (osteoporosis, arthritis, and cancer prevention, to name just three) etoposide capsules stability . If you cannot go outside three or four times a week for some sun exposure, consider a supplement doxycycline pediatric dosing .
Breastfeeding Protects Mom
Nursing a baby at the breast used to be the normal way of feeding a child until she got big enough to chew and swallow solid food birth control levitra pill . That changed in the early 20th century, though, as canned milk and infant formula became readily available seroquel and urinary retention . Many new mothers were urged to use the “modern”technology of bottle-feeding does actos afect the heart . Today, breastfeeding is still less common than formula feeding, even though scientists have discovered that it is better for the baby in many subtle ways depression libido viagra . But the latest discovery,is that it is also better for the mother, especially if she is at risk of developing type 2 diabetes later in her life information on the medication omeprazole .
Investigators affiliated with Harvard studied two large groups of nurses (one cohort had more than 83,000 women in it; the other, 73,000) for more than a decade metformin actos januvia . The longer a woman breastfed her infant, the less likely she was to be diagnosed with diabetes later cheap imitrex free consultation . The benefit didn’t really kick in, though, until she had nursed her baby for at least 6 months with no formula feedings on the florr dj caffeine . 230 Women who breastfed exclusively for at least a year got the most benefit, a 44 percent drop in the risk for type 2 diabetes spotting right before period on clomid . Unfortunately, though, lactation did not protect women who had developed gestational diabetes—high blood sugar during pregnancy phenazopyridine side effects . These women need to be treated for diabetes during the pregnancy; though their blood sugar may return to normal after delivery, they are at higher risk of developing type 2 diabetes for the rest of their life allegra farm horse carrage service ct .
Type 2 Diabetes
If a doctor suspects that a patient has diabetes, she will probably order a blood test prevacid and raw onions . When fasting plasma glucose is 126 mg/dl or higher, the diagnosis is clear how long does clomid work . Another approach is to administer a 2-hour glucose tolerance test cream diflucan . In this test, a person’s fasting blood sugar is measured and then he or she is given a sugary drink with a standard dose of glucose neonate ampicillin dose . Blood sugar is then measured at intervals over the next 2 hours cephalexin cost . If it is 200 mg/dl or higher, the doctor will probably diagnose diabetes caffeine strength and conditioning journal .
Diabetes treatment is not a do-it-yourself project maxalt and effects on pregnancy . Because this condition is so serious, it absolutely requires a close working partnership between patient and physician greenstone ltd peapack nj azithromycin . But it is too important to leave entirely up to the doctor paroxetine and . For the best control, a person with diabetes should be monitoring blood sugar at home and striving to keep it as close to the target range as possible riva clindamycin . A daily glucose diary that can be shared with the doctor will help to optimize the treatment program viadrene or levitra .
Monitoring Blood Sugar
It is sometimes possible to overcome type 2 diabetes with exercise, diet, and weight loss effectiveness clomid . To follow your progress, it makes DRUGS THAT MAY RAISE BLOOD SUGAR 231,232
amiloride + hydrochlorothiazide (Moduretic)
amlodipine + atorvastatin (Caduet) amphotericin B (AmBisome) amprenavir (Agenerase) arsenic trioxide (Trisenox) asparaginase (Elspar)
atovaquone (Mepron)
basiliximab (Simulect)
benzthiazide (Exna)
betamethasone (Celestone) bicalutamide (Casodex) budesonide (Entocort)
bumetanide (Bumex)
busulfan (Busulfex IV)
celecoxib (Celebrex)
chlorthalidone (Clopres, Tenoretic, Thalitone)
ciprofloxacln (Cipro IV)
clozapine (Clozaril)
cyclosporine (Neoral)
dexamethasone (Decadron) diazoxide (Hyperstat IV) didanosine (Videx)
doxorubicin (Doxil Injection) emtricitabine + tenofovir (Truvada)
estradiol (Activella, Alora, Cenestin, Climara, Esclim, Estrace, Estraderm, Femhrt, Premarin, Prempro, Vivelle, etc buy now norvasc .)
fentanyl (Actiq)
fludarabine (Fludara injection) furosemide (Lasix)
gatifloxacin
gemtuzumab (Mylotarg injection) goserelin (Zoladex)
hydrochlorothiazide
hydrochlorothiazide + losartan (Hyzaar)
hydrochlorothiazide + moexipril (Uniretic)
hydrocortisone (Cortef) indapamide (Lozol)
interferon alpha-2b (Intron A) leflunomide (Arava)
leuprolide (Lupron Depot)
levalbuterol (Xopenex Inhalation Solution)
lovastatin + nicotinic acid (Advisor) megestrol (Megace)
metformin + rosiglitazone (Avandamet)
methylprednisolone (Medrol) mycophenolate (CellCept) mycophenolic acid (Myfortic) nicotinic acid (Niaspan)
nilufamide (Nilandron)
octreotide (Sandostatin)
ofloxacin (Floxin)
olanzapine (Zyprexa)
olmesartan (Benicar)
oral contraceptives with 35 micrograms ethinyl estradiol or more
(Brevicon, Demulen 1/35, Enpresse, Modicon, Mononessa,
Necon 1/35, Norinyl 1 +35, Nortrel 1/35, Ortho-Cyclen, OrthoNovum 1/35, OrthoTri-Cyclen, Ovcon 35, Sprintec,Tri-Levlen, Tri-Norinyl,Triphasil,Trivora, Zovia 1/35E, etc avandia glipizide .)
pegaspargase (Oncaspar) pentamidine
prednisolone
prednisone
ritodrine (Yutopar)
rituximab (Rituxin)
rosiglitazone (Avandia)
salmeterol (Serevent Diskus) saquinavir (Invirase)
sargramostim (Leukine)
sirolimus (Rapamune)
sotalol (Coreg)
tacrolimus (Prograf)
tenofovir (Viread)
terbutaline
testosterone (AndroGel) tiotropium (Spiriva HandiHaler) torsemide (Demadex)
triamcinalone
triamterene + hydrochlorothiazide (Dyazide, Maxzide) valganciclovir (Valcyte)
sense to get a home blood sugar monitor and learn to use it on a regular basis tramadol blood test intefere . Exactly what is regular will vary from one person to another and is something you and your doctor will need to work out kamagra oral jel . Some people have a lot of difficulty stabilizing their blood sugar and may need to measure it several times a day, both fasting and 1 to 2 hours after meals spironolactone for hormonal acne . Until blood glucose is brought under control, you should plan on measuring it at least twice a day and possibly more often vigora .’33 When blood sugar is consistently at target levels, you might do fine measuring blood glucose just a few times a week 150 cheap fluconazole generic mg .
There are many different blood sugar monitors on the market; you may want to check Consumer Reports fora recommendation celexa message boards toc . Whenever you measure your blood sugar, be sure to record the time of day and the circumstances as well as the value to help your doctor figure out the best treatment plan and evaluate any medications he may have prescribed drug generic form of finasteride .
will
Your physician also be taking regular blood tests to assess your glycosylated hemoglobin edinburgh viagra mmr find search . Having elevated levels of glucose in the blood eventually affects hemoglobin, an oxygen-carrying molecule concerta and prozac . The measure is called HbA, , and it offers a way to assess blood sugar control over several months benazepril side effects eye . This will give you and your doctor a way to tell how well your regimen is working to keep your blood glucose under control what company makes cialis . In people without diabetes, HbAl atarax sl80 . runs somewhere between 4 and 6 per- cent and varies slightly from lab to lab acomplia side affects . Your doctor will want you to try to keep your HbA,, under 7 percent zyrtec toddlers .’ Monitoring your blood sugar at home on a regular basis can help you in this endeavor, and might reduce your risk of serious complications like heart attack and stroke pepcid drugs .’-35
Diabetes Triggered by Drugs
When you are first diagnosed, you should discuss with your doctor whether your diabetes might have been triggered by a medicine you take buy imitrex tablets . In some cases, your physician may be able to prescribe a different medication and your blood sugar level may drop nizoral tinea versicolor . In other cases, there is no acceptable substitute for a lifesaving medication milk thistle coumadin . Treating the resultant diabetes could be considered a fair trade for being alive can you take valtrex while pregnant .
It is not always possible to predict whether a medication will cause hyperglycemia (high blood sugar) in a particular patient illinois ephedrine pseudoephedrine sales tracking log . People vary enormously in susceptibility to this effect; some people react strongly to a diuretic, for example, while many others are unaffected digoxin usual dosage . Although a very small proportion of women on oral contraceptives may experience this problem, so many women use them that it may add up to quite a few people lithium c500 .
The list on the preceding pages is not complete, but it offers a snapshot of some of the drugs for which this reaction has been reported snort ibuprofen mixed with acetaminophen . If you take one of them, do not stop the medication on your own periodic table of caffeine beverages . Discuss your concerns with your physi- cian cvs paxil . You may also discover, as some people have reported to us, that medications not on the list, such as the cholesterol-lowering drug Lipitor (atorvastatin) and some other statins, may occasionally raise blood sugar hydrochlorothiazide erection problems .
Diet Does Count
Your doctor will surely urge you to watch your diet lexapro comments . Here again, we suggest you check out Dr clomid iui tender nipples hot flashes . Richard K low dose naltrexone chron’s disease . Bernstein’s suggestions labetalol 100 mg iv . In addition to The Diabetes Diet, Dr amoxicillin 500mg side affects . Bernstein’s Diabetes Solution goes beyond diet to total diabetes management, and his suggestions are worth consideration amiodarone lawsuits . Our earlier recommendations on diet for preventing diabetes mostly hold for people who already have diabetes as well, with two big exceptions generic prozac for menopausal symptoms . Once a person has actually developed diabetes, chocolate and coffee may destabilize blood sugar too much in the short term and in many cases should be avoided avoiding caffeine .
Cinnamon
There are some other unexpected items you might want to include in your diet, though tramadol 120 ea cheap . One is cinnamon alternative strattera . Surprising as it seems, 1/4 to 1/2 teaspoon of cinnamon from the spice rack added to food or a beverage can help lower blood sugar if the rest of the diet is sensible gemfibrozil 600mg . Cinnamon appears to increase insulin sensitivity loratadine orally . 216 Giving a cinnamon extract to diabetic mice lowered blood sugar, raised HDL cholesterol, and reduced triglycerides soma 44 pics . 237
There are two types of cinnamon, and the benefit appears to be primarily from cassia cinnamon (Cinnamomum cas-
238
sia) royal jelly warfarin . Although this is the common cinnamon from the spice shelf, some grocery store cinnamon contains a compound called coumarin vliet estradiol day 21 . With regular use, coumarin could be toxic to the liver side effects of zoloft dopamine depletion . It may also interact with anticoagulants such as warfarin (Coumadin) can prednisone stop orgasm in women .
Cinnamon can help stabilize blood sugar, and may help control cholesterol and triglycerides antabuse no prescription . Effects are mild, so cinnamon should not be substituted for medical treatment imitrex weight .
Downside: Heartburn; possible liver damage from coumarin contamination
Cost: $30 to $40 a month for Cinnulin
People who use cinnamon regularly should be monitored for any potential toxicity lifetime synthroid therapy . Richard A aldactone sinus pressure . Anderson, PhD, one of the scientists doing research on cinnamon, says a water-based extract is effective and safer than plain cinnamon side effect gabapentin . People can take cinnamon capsules such as Cinnulin PF, or they can put cinnamon in a coffee filter and pour hot water over it to create their own water extract pamelor and dose .
The Value of Vinegar
Another dietary addition that is worth consideration is vinegar interactions levitra niacin . This old remedy has been floating around for decades, if not centuries syrup zantac gastroesophageal . But if you were to ask most registered dietitians whether vinegar is helpful for diabetics, you would probably get a blank stare lipitor plavix . Surprisingly, there is now good science to support the value of vinegar infrmation on tenoretic . Researchers in Sweden report that when vinegar is given with white bread, it reduces blood sugar and insulin levels lamictal and ovulation . 139 It also helps people feel fuller up to 2 hours later dosage prescription info for albuterol .
Japanese researchers have found that vinegar can counteract the effect of white rice on blood sugar cialis the dangers fda . 240 And investigators at Arizona State University report that 2 tablespoons of vinegar or a handful of peanuts before a starchy meal can significantly dampen the resulting rise in blood glucose morphine ami chf atenolol .241 Pickles may be the most palatable way to consume vinegar; drinking it, even mixed with water, may be difficult for some people prozac loss of sex drive .
I suffer with type 2 diabetes ritalin bupropion . My doctor prescribed Glucotrol for my blood sugar It helped to a degree, but I have found that by adding apple cider vinegar and cinnamon to a careful diet, I can control my blood sugar even better Oolong Tea
Consider sipping oolong tea with your meal what year was penicillin found . This type of tea is made from a partially fermented leaf, midway between green tea and black tea blood in urin caused by plavix . Research from Taiwan indicates that drinking oolong tea (1,500 milliliters per day, or around 6 cups) significantly lowered both blood glucose and fructosamine, a longer-term measure of blood sugar control bristol-myers squibb income lipitor .141 (Blood glucose measures sugar in the blood right now; fructosamine indicates how much sugar has been in the blood over the past 2 or 3 weeks; HbAl is a signal of blood sugar over the previous 6 weeks or more 2 weeks breast soreness clomid .) Oolong tea can be an acquired taste, but it’s definitely worth a try impact penicillin 20th century lives . It can’t hurt, and it might help what is after femara .
Herbs and Supplements
A huge array of botanical medicines and dietary supplements is offered to diabetics tramadol hydrochloride capsules 50g . Although several natural products can help control blood sugar, none is a substitute fora diet designed to keep blood sugar under control erythromycin 870 . If you decide to try an herb or supplement to help with-blood glucose control, be sure to inform your physician and get approval ultram bipolar . Monitor your blood sugar carefully and keep good records possible side effects from boniva . That way, you will be able to work with your doctor to adjust the dose of your medicine, if necessary, and you will be able to look back over your notes to evaluate if what you were taking lowered your HbAlc us prescription cialis . Because the quality of herbal products and dietary supplements varies widely in this country, keeping close track of how well you do may help you find a more effective or more consistent formulation soma water beds .
CHINESE HERBAL FORMULAS
There are a number of Chinese herbs that are traditionally prescribed in complex formulas allegra hives . Several herbs are included to help potentiate and balance the main ingredient or ingredients topamax used for pain . An objective analysis of available research evidence by the Cochrane Library found that several of these have been reported to lower blood sugar in controlled trials, but that the quality of the studies is fairly questionable overall 20mg lipitor qoclick .241 The reviewers suggest that herbal medicines such as holy basil or Bushen Jiangtang Tang merit further study 12v small lithium battery . We can’t disagree celexa increses anxiety . Any diabetic who chooses to try traditional Chinese herbs needs two doctors, though: one skilled in traditional Chinese medicine and the other up-to-date on endocrinology, espe-cially diabetes treatment medroxyprogesterone pregnancy test . It might be challenging to organize their close collaboration, but it is essential metformin and bowel movements .
BITTER MELON
Bitter melon, or Momordica charantia, is a plant in the cucumber/squash family that is used as a vegetable as well as a medicine in much of China phenytoin cognitive decline .” It does not increase insulin production, but it seems to improve sugar uptake by the cells trazadone used with cymbalta . Bitter melon has been reported to lower fasting blood sugar celecoxib content .245 It may be helpful not as a substitute for standard diabetes medicines, but in addition to them buy antabuse no prescription . Careful blood sugar monitoring is necessary tramadol from india pictures . Children and pregnant women should not take this herb, because it may be dangerous to them sun allergy and amoxicillin . Some children have died after eating the bright red seed coverings lexapro makes me drowsy .
A family friend told us that bitter melon could help reduce blood sugar We went to our local health food store and bought a bottle, and it seems to work! My husband takes metformin and glyburide for diabetes low levels of estradiol fsh hormones . After he added this supplement, his blood sugar level was down considerably wellbutrin xl and heart .
CHROMIUM
Chromium is an essential nutrient that is needed in minute quantities cialis lawyer columbus . It plays a role in glucose utilization and increases insulin sensitivity in tissue culture studies rayovac cr2020 lithium 3 volt . Chromium picolinate, which is often found in supplements, is relatively well
246
absorbed how many viagra can you take . Questions remain, however, regarding its safety accutane vision problems .
Some studies suggest that chromium picolinate supplements (200 micrograms per daZ) may improve glucose tol- erance in type 2 diabetics generic viagra and bargain . 141,2 Not all studies have been conclusive, however pseudoephedrine pill . Like the other supplements, chromium is better as an addition to rather than a substitute for exercise, diet, and medication to control blood sugar genetic testing for coumadin . Careful blood sugar monitoring and medical supervision are advised straight out of junior high valtrex .

triamcinolone A glucocorticosteroid with the actions, uses and side-effects of hydrocortisone, but differing by promoting sodium excretion, and so is of no value in adrenal cortex deficiency states. It is used in a wide range of inflammatory, allergic and respiratory states, and in inflammatory skin conditions.
Dose: 8-24 mg daily. It is also given as triamcinolone acetonide in doses of 40 ing by deep i.m. injection for a depot action. The acetonide is also given by iniraarticular injection in doses of 2.5-40 mg in local inflammation of the joints, and by intra-lesional injection in doses of 2-3 mg at any one site for the treatment of skin lesions. Triamcinolone actonide is also used as a 1% cream or ointment in severe inflammatory skin conditions. The side-effects are those of the corticosteroids (see hydrocortisone), but triamcinolone may also cause myopathy with high dose treatment. (Kenalog; Ledercort).
triamterene A potassium sparing diuretic, used mainly in association with more powerful drugs. It is indicated in oedematous conditions generally, and, as it causes some retention of potassium, its use avoids the need for supplementary potassium therapy.
Dose: 150-250 mg daily, with lower doses for the elderly and when given in association with other diuretics. Rash .ind gastrointestinal disturbances are ,ide-effects. (Dytac). See page 148 and Kahle 21.
tribavarin An inhibitor of viral replication used in severe viral bronchiolitis in infants.
Dose: by aerosol inhalation of a solution (20 ing/ml) for 12-18 hours daily liar 3-7 days, together with supportive therapy. (Viravid).
triclofos A derivative of chloral, with the sedative properties of the parent drug, but less irritant to the gastric mucosa.
Dose: I 2gdaily.
alternative to penicillamine in other conditions. The main side-effect is nausea.
trifluoperazine A powerful tranquillizing drug of the chlorpromazine type. It is used mainly in schizophrenia and similar psychoses, and in severe anxiety.
Dose: 10-20 nig or more daily according to need. In severe anxiety, 2-6 ing daily. In acute conditions, 1-3 mg daily by deep i.m. injection. As an antiemetic, it is given in doses of 2-4 mg or 1-3 ing by injection. The side-effects are similar to those of chlorpromazine, including extra-pyramidal symptoms, but the anticholinergic and sedative side-effects are less severe. (Stelayine). See page 168 and Table 30.
tri-iodothyronine See liothyronine.
trilostane An inhibitor of enzyme systems concerned with production of mineraloand glucocorticosteroids by the adrenal cortex, and so resembles metyrapone to some extent. It is used to control adrenal cortex hyperfunction and the excessive production of aldosterone.
Dose: 240 ing daily initially, adjusted tip to a maximum of 480 mg daily, according to the plasma corticosteroid levels. Care is necessary in liver and kidney dysfunction. (Modrenal).
trimeprazine A sedative antihistamine used in the treatment of pruritus and allergic itching conditions, and for premedication.
Dose: 30-100nig daily; pre-medication dose: 3 mg/kg. (Vallergan).
trimetaphan A short-acting ganglionic-blocking agent. It is used to produce a controllable reduction in blood pressure (luring neuro- and vascular surgery when a relatively bloodless field is necessary. Dose: by i.v. infusion, 3-4 nighnin initially, with subsequent doses carefully adjusted to the response. Side-effects are tachycardia and respiratory depression. Frequent determination of blood pressure during use is essential.
triclosan A chlorinated phenolic antiseptic, used mainly in surgical scrubs and similar preparations. (Manusept; Ster-Zac).
trientine A copper-chelating agent used in Wilson’s disease, but only for patients unable to tolerate penicillamine.
Dose: 1.2 -2.4 g daily. It is not an
trimethoprim An antibacterial agent similar in action to the sulphonamides. It is used in the prophylaxis and treatment of urinary tract and respiratory infections due to sensitive bacteria.
Dose: in chronic infections, 200-400 nig daily; prophylactic dose, 100mg daily. In severe infections, 130-250 mg twice daily by slow i.v. injection. Side-effects are nausea, vomiting,rash and pruritus, and possible bone marrow depression. (lpral;
Monotrim). See co-trimoxaole.
trimetrexateV An antibacterial agent used like atovaquone in AIDS patients with Pnettinocystis carinii pneumonia.
Dose: 45 ing/nidaily by i.v. infusion for 21 (lays, followed by calcium folinate 80 nighty daily for 28 days, orally or i.v. (Neutrexin).
I Tyr
oral antidiabetic drugs by increasing the sensitivity to endogenous insulin, and so acts as an insulin enhancer.
Dose: 200 mg daily with breakfast, increased if required by 200 mg at intervals of 2-4 weeks up to 600 mg daily. Side-effects are diarrhoea, fatigue and malaise. (Romozin). See page 131 and Table 13.
tropicamide A short-acting mydriatic agent similar to homatropine. Used as 0.5% and I% solution.
trimipramine A sedative anti-depressant with the action and side-effects of amitriptyline. It is valuable in depression complicated by anxiety.
Dose: 75-300 mg daily. (Surmontil).
triple vaccine Diphtheria, tetanus and pertussis vaccine for the primary ininitinization ofchildren.
Dose: 0.5 ml by i.m. or deep s.c. injection.
triptorelin A synthetic form of gonadorelin, used in the treatment of advanced prostatic cancer. Such cancers are testosterone-dependent, and triptorelin acts by depressing pituitary function, and so indirectly reduces the plasma level of testosterone.
Dose: It has been formulated so that a single i.m. injection of 4.2 ing depresses testosterone production for 28 days. Initially there may be a temporary flare-up of symptoms, which can be prevented by giving an anti-androgen for 3 days before treatment, and continued for 2-3 weeks. Patients should be monitored for uleric obstruction and spinal cord compression during the first months of treatment. DecapepivI Sr). See page 122.
tropisetron A 5–HT.,-receptor antagonist, similar to ondansetron bill with a longer action. It is used to control the nausea and vomiting induced by cancer chemotherapy.
Dose: initially as a 5 mg dose i.v. shortly before such therapy, and followed 1)), oral doses of 5 mg daily, I hour before food, for 5 days. Side-effects are dizziness, headache and gastrointestinal disturbance. (Navoban). See page 122.
tryparsamide Used in late trypansomiasis when the CNS is involved.
Dose: 1-3 g by injection weekly, up to a maximum Lill) of 24 g. May damage optic nerves.
tryptophan\7 An amino acid involved in the biosynthesis of serotonin. It is used in specialist centres for the treatment of severe and prolonged depression resistant to other drugs, and where a deficiency of serotonin may be a factor. (Optimax). See page 128 and Table 11.
tuberculin A product obtained from cultures of Mycobacterium tuberculosis. It is used in the diagnosis of tuberculosis. See BGC vaccine.
103
trisodium edetate A chelating or binding agent that is sometimes used in hypercalcaernia. The calcium complex so formed is excreted in the urine.
Dose: slow i.v. infusion tip to 70 rng1kg daily according to need and response, as shown by plasma calcium measurement. It is also used as a 0.4% solution for
ophthalmic use in lime burns of the eyes. Side-effects after injection are nausea, diarrhoea and cramp. Contraindicated in renal impairment. (Limclair).
troglitazone A new drug for non-insulin dependent diabetes. It differs from other
tulobuterol A selective beta,-adrenergic agonist of the salbutamol type, used in the prophylaxis and treatment of bronchospasm in asthma and related conditions. Dose: 4-6 mg daily. (Respacal). See page 118 and’fable 6.
tyrothricin A minor antibiotic used as
lozenges for mouth infections.

undecenoic acid An organic acid with useful antimycotic properties. It is used mainly as powder or ointment (5%), often with zinc undecenoate in the treatment of athlete’s foot and associated conditions.
urea An osmotic diuretic. It has been used orally in doses of 5-15 g. Applied locally as a 10% solution, it promotes granulation and reduces odour front•    foul ulcers.
urofollitrophin A preparation of human lollide-stimulating hormone (FSH) used with nienotrophin for the induction of ovulation. Dose and duration of treatment require careful control to avoid Over-stimulation. (Metrodin; Orgafol).
I Vas
allergen vaccines, used for desensitization to various allergens such as grass pollens, arc not true vaccines, but weak solutions of allergen extracts. They may precipitate allergic reactions in susceptible patients, and should be used only when emergency resuscitation measures are immediately available.
valaciclovirV A pro-drug of acyclovir used in herpes zoster. It is well absorbed orally, and quickly converted to the parent drug and promotes an improved response.
Dose: 3 g daily for 7 days, reduce([ in severe renal impairment. Dose in herpes simplex I g daily. Side-effects are headache and nausea. (Valtrcx). See page 144 and Table 19.
valproic acid (Convulex). See sodium valproate.
104
urokinase A plasmin activator obtained from human urine. It is used mainly in the thrombolysis of blocked i.v. shunts, and in the lysis of blood clots in the eye. Dose: 5000-37 500 units, instilled into the shunt; similar doses are injected into the anterior chamber of the eye for the resolution ofl)l blood clots. (Ukidan).
ursodeoxycholic acid The acid appears to be a solvent of cholesterol, and is given orally to promote the dissolution of cholesterol-containing gall stones.
Dose: 8-12 mg/kg as a single daily dose, hut prolonged treatment is required, which should be continued after the dissolution of the stones to inhibit recurrence. The dissolution of calcium-containing or radio-opaque stones is unlikely to occur. (Destolit; Ursofalk).
valsartan An angiotensin II receptor antagonist used in hypertension. It has a more selective action than the ACE-inhibitors. Dose: 80 mg daily. Combined treatment with a potassium-sparing diuretic is not advisable. (Diovan). See page 148 and Table 21.
vancomycin An antibiotic used in severe antibiotic-associated staphylococcal colitis ( pseudomembranous colitis).
Dose: 0.5 g daily for i-10 days. It is also given by injection in resistant bacterial endocarditis; I g twice a day by slow i.v. infusion over 1-2 hours, as rapid injection may cause anaphylactic shock. Blood concentrations of the antibiotic should be monitored, as the many side-effects include renal damage, ototoxicity and ncutropenia. Pruritus and upper body flushing may occur, and tinnitus is an indication that the drug should be withdrawn. (Vancocin).
vaccines Bacterial vaccines are suspensions or extracts of dead bacteria, but sonic anti-viral vaccines are also available. They may be given by s.c. or i.m. injection, and are used mainly for prophylaxis against a particular infection. The most commonly used vaccines include those for typhoid, cholera, diphtheria, influenza, tetanus and polio. Protection against mumps, measles, pertussis, rubella, yellow fever and hepatitis can also be obtained. The so-called
vasoconstrictors Drugs such as noradrenaline that constrict the peripheral vessels, and so cause a temporary rise in blood pressure. They are useful in hypotensive conditions when the blood volume is still adequate, and in controlling the fall in blood pressure that occurs in spinal and general anaesthesia.

gelatin A protein obtained by the hydrolysis of animal tissues. Used orally as nutrient jellies, and specially refined solutions have been used as blood volume expanders (see dextran). (Gelofusine; Haemaccel).
I Gil
nephrotoxic side-effects, and dosage requires care when renal function is inadequate, and also in elderly patients. Gentarnicin is also used locally as cream or ointment (0.3%) and as eye drops (0.3%). (Cidomicin; Genticin).
gemcitabineV A cytotoxic agent related
to cytarabine, but with increased
potency and a longer action. It blocks cancer cell replication by inhibiting DNA synthesis, and may enhance the action of other agents. It is used mainly in the palliative treatment of non-small cell lung cancer.
Dose: 1000 mg/m-’ by slow i.v. infusion over 30 minutes, once a week for 3 weeks, repeated after a rest period. It is generally well tolerated, but a common side-effect is a transient influenza-like reaction. Myelosuppression is less severe than that of related cytotoxic agents. (Gemzar). See page 122 all(] Table 8.
gentian violet See crystal violet.
gestrinone An antiprogestogen used in ctidonictriosis that acts indirectly by suppressing gonadotrophin production. Dose: 2.5 ing twice weekly oil the same day,, each week for o months. Side-effects arc fluid retention, acne and voice changes. ( Dimetriose).
gestronel A synthetic progestogen used in the treatment of breast and endonietrial carcinoma and benign prostatic hypertrophy.
Dose: 200-400 ing i.m. once a week. (Depostat).
51
gemeprost A synthetic prostaglandin used to dilate the cervix uteri in first trimester abortion.
Dose: I mg, as a pessary 3 hours before surgery. Side-effects are mild uterine pain and vaginal bleeding initially, nausea and di.11 I hoc.).
gernfibrozil A plasma lipid regulating agent, with the actions and uses of hez.afibrate and clofibrate.
Dose: 901) ing-1.3 mg daily, with regular checks oil plasma lipid levels. Treatment should be withdrawn after 3 months if the response is unsatisfactory. Gernfibrozil may potentiate the action of oral anticoagulants, the dose of which should be adjusted. Side-effects include nausea, diarrhoea, abdominal pain, rash and dizziness. (Lopid). See page 146 and Table 20.
gentamicin An aminoglycoside antibiotic, active against a wide range of Gram-negative organisms, including Pseudomonas aeruginiosa, as well as against many Gram-positive bacteria, although it is not very active against anaerobic organisms. It is of great value in septicaemia and meningitis, as well as in bacterial endocarditis.
Dose: 2-3 nig/kg daily by i.m. injection or i.v. infusion. In serious or undiagnosed infections, supplementary treatment with a penicillin or metronidazole may be require(]. In common with other arninoglycosides, goitarnicin has ototoxic and
glibenclarnide An orally active hypoglycaenfic agent similar to chlorpropamide. Dose: 5-15 nig daily, according to need and response. (Daonil; Euglucon). See
page 131 and’I'able 13.
gliciazide A sulphonylurea with the actions and uses of chlorpropamide and related drugs.
Dose: 40-320 mg orally. (Diarnicron). See page 131 and Table 13.
glimepiride A sulphonylurea used in non-ill Sidi 11 -dependent (Type 11) diabetes mellitus.
Dose: 2 mg after breakfast, increased ill, to .1 mg daily. Side-effects include
transient visual disturbances, rash and urticaria. (Amaryl). See page 131 and Table 13.
glipizide A sulphonylurea, used like chlorpropamide in diabetes, but effective in much lower doses.
Dose: 5 mg initially, maintenance dose 2.5-40 nig daily. (Glibenese; Minodiab). See page 131 and Table 13.
gliquidone An oral hypoglycaemic agent similar to chlorpropamide. Effective in maturity-onset diabetes.
Dose: I5 ing initially; maintenance dose 40-60 nig daily, but up to 180 mg daily have been given. (Glurenorni). See page 131 and Table 13.

glucagon A hormone of the alpha cells of the pancreas which raises the blood sugar level by mobilizing liver glycogen. Used in acute hypoglycaemia.
Dose: 0.5-1 mg by s.c., i.m. or i.v. iniection. (GlucaGen). Give i.v. glucose if there is no response within 10 minutes.
glucocorticoids Those corticostcroids with an anti-inflammatory action similar to hydrocortisone, as distinct from the mmerailocorticoids, such as fludrocortisone, used in Addison’s disease. Thel, differ in anti-inflammatory potency, and 0.75 mg of dexamethasone is considered equivalent to 20 mg of hydrocortisone. See Table 36.
glucose Also known as dextrose. A readily absorbed carbohydrate present in many
man
sweet fruits, but obtained commercially by the hydrolysis of starch. It is given orally as a dietary supplement; in acidosis; and to raise the glycogen reserves of the liver in hepatic damage. Given by i.v. infusion as a 5% solution, or as a glucose-saline infusion in dehydration and shock, and after surgery until fluids call be taken by mouth.
glutaraldehyde A disinfectant of the formaldehyde type, but with a more rapid and powerful action. Effective against a wide range of organisms, including
viruses. Used mainly for instrument sterilization as a 2% solution. Usually activated before use by the addition of a corrosion inhibitor. Such activated solutions are stable for about 2 weeks. It is also used as a 10% solution for the removal of plantar warts.
glycerin (glycerol) A clear syrupy liquid used as a sweetening agent in mixtures and linctuses. It promotes drainage when applied to inflamed areas, and is used as a paste with magnesium sulphate for boils. It is also used as suppositories for constipation.
Dose: sometimes given orally in doses of ]- 1.5 g/kg in glaucoma and before surgery to lower the intraocular pressure.
glyceryl trinitrate A powerful but short-acting vasodilator used in the control of angina pectoris. See page 114.
Dose: 300, 500 or 600 pg tablets which should be dissolved under the tongue for a rapid response. An aerosol spray (400g per
dose), as well as long-acting tablets are also available. Tolerance may occur with prolonged therapy. Side-effects are a throbbing headache, flushing and tachycardia. It is also used locally for all extended action, particularly at night, as ointment and medicated patches. Also given by i.v. infusion to control hypertension and ischaemia during cardiovascular surgery and in left ventricular failure. Dose: 10-200 pg/min in dextrose-saline. A new use of the drug is as an ointment (0.2%) to promote healing of anal Fissure. See page 1] 4 and Table 4.
glycopyrronium A synthetic atropine-like antispasmodic used for preoperative medication.
Dose: 200-400 pg by Lill. or i.v. injection. I i has the side-effects of anticholinergic drugs such as dryness of the mouth and blurred vision. Contraindicated in glaucoma. (Robinul).
GM-CSF Granulocyte-macrophage colony stimulating factor. See molgramostim. gold therapy See sodium aurothionialate.
gonadotrophins The follicle-stimulating hormone (FSH) and the luteinizing hormone (1-11) of the anterior pituitary gland. They stimulate ovarian development and the production of oestrogens; ill the male LH controls the formation of androgens. See gonadorclin.
gonadorefin A synthetic form of the gonadot roph in -releasing hormone of the pituitary gland (M-111-1). It is used to assess pituitary function.
Dose: 100 pg by i.v. injection normally
rise to a rapid rise in the plasma level of the luteinizingand follicle-stimulating hormones. In amenorrhoea and infertility due to gonadorelin insufficiency, it is given by pulsed s.c. infusion in doses of 1-20pg every 90 minutes, day and night. Treatment for up to 6 months may be required. Side-effects are uncommon. (Fertiloli Relefact). Sonic analogues of gonadorelin are used in remain cancers. See page 122.
goserelin A synthetic analogue of the hypothalamic hormone (LH-RH). It
suppresses the production of testosterone, d
anis used in the treatment of hormone-
dependent carcinoma of the prostate. It is also used in endometriosis and postmenopausal breast cancer.

Dose: 3.6 ing by s.c. injection every 28 days or as an implant. Side-effects include impotence, hot flushes, rash, breast swelling and tenderness. (Zoladex). See page 122 and ‘I able 8.
gramicidin A mixture of antibiotics effective against many Gram-positive organisms, but it is too toxic for syitenii, use. Used topically in infected skin conditions, usually in association with neomycin and hydrocortisone.
granisetron A scrotonin (5—HT) antagonist with a highly selective and powerful antiernetic action mediated by its effects on the 5-4-11′, receptors. It is used in the prevention and treatment of the severe nausea and vomiting induced by potent cytotoxic drugs such as cisplatin.
Dose: I mg I hour before treatment, then I ing twice daily, or by i.v. infusion in doses of 3 mg, repeated up to 3 times over 24 hours. For prophylaxis, a dose of 3 mg should be given before chemotherapy is commenced. Headache, rash and consti pation are common side-effects. (Kytril). See page 158.
griseofulvin An orally effective but slow
acting antifungal antibiotic that is
deposited selectively in the skin, hair and nails. It is used in the systemic treatment of ringworm and other dermatophyte infections of the keratin-containing tissues, but only when local treatment has failed.
Dose: 0.5-1 g daily, but prolonged therapy is required. Side-effects are headache, nausea, dizziness, rash and photosensitivity. 11 may also reduce the effects of oral contraceptives. (Fulcin; Grisovin).
growth hormone See soma(ropin.
guanethidine An anti-hypertensive drug that [)rings about a reduction in blood pressure by blocking transmission in adrenergic nerves, and preventing the release of noradrenaline. It has been used in the treatment of hypertension, often with a thiazide diuretic, but its use has declined as it may cause postural hypotension. Still used as part of combined therapy in resistant hypertension.
Dose: 20 mg daily, increased by 10 ing at weekly intervals according to response, up to 50 mg daily, although sometimes larger doses are required. Dose by i.m. injection,
10-20 nig as required. Diarrhoea, weakness, nasal congestion and bradycardia are common side-effects. (Ismelin). See page 148 and Table 21. Guanethidine is occasionally used as eye drops (1-3%) in glaucoma. (Ganda). See page 138 and Table 16.
guar gum A vegetable gum that, when taken with food, appears to retard the absorption of carbohydrates. It is used in the supplementary treatment of diabetes mellitus.
Dose: up to 15 g daily, usually sprinkled mi food. It is essential that a dose should he taken with an adequate fluid intake, and that the final dose is not taken at bedtime. Side-effects are flatulence and abdominal distension. (Guarem). See page 131 and Table 13.
halcinonide A powerful corticosteroid used iii severe inflammatory skin conditions not responding to other corticosteroids. It is applied sparingly as a 0.1% cream. (Halciderin).
halibut-liver oil A rich source of vitamins A ‘Ind 1).
Dose: 0.2-0.5 mi.
halofantrine An antimalarial, acting at the erythrocytic stage of the life cycle of plasmodium, and useful in chloroquine 01 MUlti-drug resistant malaria.
Dose: 500 nig 6-hourly for 3 doses between meals. Side-effects are nausea, vomiting and diarrhoea. It must not be given with or after mefloquine (risks of fatal arrhythmias). Contraindicated in pregnancy. 0 lalfan).
haloperidol A powerful tranquillizer used in schizophrenia, mania and psychoses. Dose: 5-20 ing daily, up to a maximum of 200 mg, reduced later according to
response. Dose by i.m. injection for rapid control of hyperactive psychotic patients, 5-30 mg initially, followed by 5 ing or more as required. For depot treatment, it is given as haloperidol decanoate, 50-300 mg by deep i.m. injection every 4 weeks. It is also given orally in doses of 500 g twice daily in severe anxiety. Doses of 1.5 nig

cytarabine A cytotoxic agent that prevents cell development by inhibiting the formation of nucleic acid. It is used mainly in the control of acute mycloblastic leukaemia.
Dose: 0.5-3 mg/kg daily by i.v. or s.c. injection. Close haematological control is essential as the drug is a powerful myclodepressant. Other side-effects are those of the cytotoxic drugs, generally, but fever, myalgia and bone pain may also occur. Alexan; Cv cos: r).
Dose:    nig/kg, daily for 10 days, repeated after 4 weeks. Side-effects are severe nausea, bone marrow depression and an influenza-like syndrome. The drug should be handled with care, as it is a tissue irritant. (DTIC).
dactinomycin See actinomycin D.
dalteparin A low-molecular weight heparin given by s.c. injection for pre- and postoperative thrombo-embolic prophylaxis. Dose: 2500 units daily for 5 (lays. (Fragmin). See enoxaprin and tinzaparin.
cytotoxic drugs A term applied to drugs that can kill cancer cells. In practice, many factors influence their therapeutic value. They are rarely selective, and therapeutic doses usually have a toxic effect on sonic normal cells. They may attack cancer cells at different stages of development, as actively dividing cells are more susceptible than resting cells. They may not reach the cancer cells in adequate concentration, or resistance to the drug may develop. The dose may also depend to some extent on the patient’s tolerance of the drug, and combined treatment with two or more drugs may have the advantages of increased potency with reduced toxicity. All cytotoxic drugs, with the exception of bleomycin and vincristine, bring about a depression of the bone marrow, which may be severe, and some degree of hair loss, which is usually reversible. Severe nausea and vomiting are also common, and early use of powerful antiemetics is essential. Many cytotoxic agents are tissue irritants, and with i.v. treatment great care must be taken to avoid extravasation, as severe local tissue damage can occur. See alkylating agents and antimetabolites. See page 122.
clacarbazine A cytotoxic drug that appears to depress purine metabolism and the formation of DNA. It is used mainly in malignant melanoma, and in combination with other agents it is of value in other malignant conditions.
clanazol A derivative of ethisterone that inhibits the release of pituitary gonadotrophins. Used in conditions such as endometriosis and gynaecomastia. Dose: 200-800 ing daily, starting during menstruation. Side-effects are nausea, dizziness, rash, flushing and hair loss. Care is necessary in cardiac, renal or hepatic impairment, and in epilepsy and diabetes. (Danol).
danthron A synthetic anthraquinone laxative used mainly for constipation in the aged, and in drug-induced constipation in the terminally ill. Not suitable for routine use by other patients.
Dose: given in doses of 25–25 mg as codanthramer, and acts within 6-12 hours. the urine may be coloured red.
dantrolene A skeletal muscle relaxant that acts on the muscle fibre, and not at the myoneural junction. The action may be linked with an interference with the movement of calcium ions. It is used in the severe and chronic spastic states that occur after stroke, spinal cord injury, and in multiple sclerosis.
Dose: 21 ing daily initially, increased at weekly intervals up to a maximum of 400 mg daily, as the response is slow and May be inadequate. The side-effects of weakness and Gangue are mild, and often transient, but liver function tests during treatment are essential. Dantrolene is also of value in malignant hyperthermia, a rare but serious complication of anaesthesia, and is given in doses of I mg/kg by i.v. injection as soon as the condition is diagnosed,

dapsone A sulphone compound used in the ti,atnient of leprosy.
Dose: 25-400 mg orally twice weekly and continued for some years. Resistance to dapsone may occur, and combined treatment with clofazimitic and rifarnpicin may lie necessary. Dapsone is sometimes given with pyrimetharnine in chlotoquine-resistaut malaria. Side-effects are nausea, rash, neuropathy and myelodepression.
duration of action. Used in the diagnosis and control of diabetes insipidus, and in the treatment of nocturnal eneuresis. Dose: 10-20pg intranasally once or twice
a day; 1-4 pg daily by injection. IMAM.
desoxymethasone A corticosteroid, for local application in acute inflammatory and allergic skin conditions. Used as oily cream 0.25%. (Stiedex).
daunorubicin See doxorubicin.
debrisoquine An adrenergic neurone blocking agent with the actions, uses and side-effects of guanethidine, except that it is less likely to cause diarrhoea. It is used mainly in resistant hypertension, in association with other drugs. (Declinax).
See page 148 and Table 21.
deflazacort A glucocorticoid with the actions and uses of related drugs, and comparable in activity with prednisolone. Dose: initially in acute conditions up to 120 mg daily; maintenance dose 3-18 mg daily. (Calcort). See hydrocortisone, page 55 and Table 36.
demeclocycline An antibiotic with the actions, uses and side-effects of tetracycline, but more likely to cause photo-allergic reactions.
Dose: 600 mg daily. Used occasionally in hyponatraemia due to overactivity of the antidiuretic hormone. (Ledermycin).
desferrioxamine A chelating agent that combines with iron salts to form a soluble non-toxic complex. Of great value in acute ferrous sulphate poisoning in children. Dose: 2 g immediately by i.m. injection, together with gastric lavage (2 g of desferrioxamine/1) followed by a single oral dose of 10 g. It may also be given by continuous i.v. infusion, 15 mg/kg hourly up to a maximum of 80 mg/kg. It may cause hypotension if the infusion is given too rapidly. It is also useful in the treatment of iron-overload caused by repeated blood transfusions, and for aluminium overload in patients On dialysis. (Desferal).
desflurane An inhalation anaesthetic
similar to CuflUrane. (Suprane).
desmopressin A derivative of vasopressin, with increased potency and longer
dexamethasone A potent synthetic corticosteroid, with reduced salt-retaining properties. Useful in all conditions requiring systemic corticosteroid therapy (except Addison’s disease), including inflammatory and allergic disorders, shock, cerebral oedema and adrenal hyperplasia.
Dose: 0.5-2 mg daily up to a MaXiMUM Of’ 15 mg daily; in shock, 5-20 mg by slow i.v. injection or infusion; in cerebral oedema, 10 ing initially by i.v. injection, followed by 4 mg i.m. 6-hourly. Dexamethasone is also given by infra-articular injection for local inflammation of joints in doses of
0.4-4 mg. It is also used as eye drops (0.1%)
in uveitis, but care is necessary with prolonged treatment as with some patients a ’steroid glaucoma’ may be precipitated. (Decadron). See page M and Table 36.
dexamphetamine sulphate A central nervous system stimulant. It is used in the treatment of narcolepsy and, paradoxically, it is sometimes useful in hyperkinesia in children.
Dose: in narcolepsy, 20-60 mg daily; in hyperkinesia 2.5 mg initially, slowly increased up to a maximunl’of 20 mg daily. Side-effects are insomnia, anorexia and agitation. Dependence and tolerance may occur early. (Dexedrine).
dextran A blood-plasma substitute
obtained from sucrose solutions by bacterial action, and used as solutions of varying molecular weight (dextran 40, 70). Dextran 70 is used as a blood volume expander by i.v. injection in some cases of shock; dextran 40 is used mainly to improve postoperative peripheral circulation, reduce blood viscosity, and to prevent thrombo-embolism. Care must be taken to adjust dose to avoid overloading the circulation. Any blood-matching should be carried out before giving dextran. (Gentran; Macrodex; Rheomacroclex).

co-fluampicil -tablets of flucloxacillin and ampicillin
co-flumactone Tablets of spironolactone and hydrochlorothiazide.
colchicine The alkaloid obtained from meadow saffron. It is used in acute gout. Dose: 500mg every 2 hours until relief is obtained. A total dose of 10mg should not be exceeded, but relief of pain or the onset of vomiting or diarrhoea usually renders full doses unnecessary. It is also used prophylactically in doses ol’500pg 2 or 3 times a day during early treatment with allopurinol, probericcid and sulphiripyrazone. Gire is necessary in the elderly, and in renal impairment. See page 140 and’I'able 17.
corticotrophin The adrenocorticotrophic hormone of the anterior pituitary gland. It stimulates the production of corticosteroid hormones by the adrenal cortex. It is now used mainly as a test of adrenocortical function. See tetracosactrin.
Hydrocortisone.
cortisone one of the corticosteroids secreted by the adrenal cortex. Although it is rapidly absorbed orally, it is inactive until converted in the liver to hydrocortisone. It therefore has the actions, uses and side-effects of hydrocortisone, which is often the preferred corticosteroid. It should be noted that cortisone is of no value for topical application. See hydrocortisone, page 250 and Table 36.
colestipol An exchange resin used in hyperlipidaemia that acts by binding with bile salts in the gut and preventing their reabsorption, and so indirectly lowers the plasma level of cholesterol.
Dose: 10-30g daily. May interfere with the absorption of many drugs. (Colostid). See page 146 and Table 20.
colfoseeril A pulmonary surfactant used in the respiratory distress syndrome of the new-born. (Exosurf). See beractant.
colistin An antibiotic used mainly for bowel sterilization.
Dose: 4.5-9 mega-units daily. In systemic gram-negative infections 2 mega-units 8-hourly by injection have been used, but less toxic antibiotics are now preferred. Colonlycin).
collodion When applied to the skin, it dries to form a flexible film, and is used as a vehicle for the extended local application of drugs such as salicylic acid.
co-phenotrope tablets of diphenoxylate
and atropine. (Lomotil; Tropergen).
co-prenozide Tablets of oxprenolol and cyclopenthiazide. (Trasidex).
co-proxamol Tablets  and paracetamol. (Distalgesic).
corticosteroids Hormones secreted by the cortex of the suprarenal gland. The principal hormone is hydrocortisone but more potent synthetic derivatives such as dexamethasone are also in use.
co-tenidone Tablets of atenolol and chlorthaliclone. (Tenoretic).
co-triamterzide Tablets of hydrochlorothiazide and triannerine. (Diazide).
co-trimoxazole A mixture of trimethoprini and sulpliaiiietlioxazole. Trimethoprim, like the sulphonamides, interferes with the folic acid cycle of bacterial metabolism, but at a different point, and the mixture has an increased antibacterial action. It was once widely used, but is now advised only for Prieunjocystis carinii pneumonia. Occasionally given in acute bronchitis and urinary infections when no other drug is acceptable.
Dose: 120 nig/kf; daily lot- 14 days; 960 ing 12-hourly by i.v. infusion. (Bactrin); Septrin).
coumarins Compounds that depress the formation in the liver of prothrombin and other blood coagulation factors. See warfarin and phenindione.
counter-irritants Substances, also referred to as rubifacients, that, when applied to the skin, produce a mild, local irritation and inflammation, and give symptomatic relief in painful conditions of the muscles and joints. Creams and liniments containing methyl salicylate, turpentine, capsicum resin and menthol are examples of rubifacients.
crisantaspase Asparagine is an aminoacid essential for the development of some malignant cells. Crisantaspase is an enzyme, also known as asparaginase, that breaks down asparagine, and so has an indirect cytotoxic action. It is used to induce remission in acute lymphoblastic leukaemia in children.
Dose: (after pre-treatment with other drugs): 1000 units/kg by slow i.v. injection daily for 10 days. Side-effects include anaphylactic reactions, and skin tests to detect hypersensitivity
are essential before initial and re-treatment. (Erwinase).
crotamiton An ascaricide and antipruritiL. Used by local application as cream or lotion (10%) in the treatment of scabies and itching conditions. (Eurax).
crystal violet A dyestuffwith a selective action against Gram-positive organisms and yeasts. Used as a 0.5% solution for infected skin conditions, and for skin
preparation.
cyanocobalamin The anti-anaemic factor present III liver. It is specific in the treatment of pernicious anaemia and its neurological complications, and of value in some other anaernias due to nutritional deficiencies.
Dose: in pernicious anaemia, I Ing by i.m. injection at monthly intervals. It has been largely replaced by hydroxocobalamin, which has a more prolonged action. (Cytanien). See page 112 and’I'able 3.
cyclizine An antihistamine, used mainly in I ravel sickness and nausea generally. Also useful in vertigo.
Dose: 100-150 mg daily. Side-effects include dryness of the mouth, headache and drowsiness. (%Ialoid).
cyclopenthiazide A thiazide diuretic with the actions, uses and side-effects of bend roll tiazide.
Dose: I mg initially, 250-500mg daily or on alternate days, in the morning, according to need. (Navidrex). See page 148 and Table 21.
cyclopentolate An anticholinergic agent use(] to produce cycloplegia and mydriasis. The action is more rapid and less prolonged than atropine, particularly in children. (Mydrilate).
cyclophosphamide A widely used alkylating
cytotoxic agent, active orally and by injec-
tion. Used in I lodgkin’s disease, chronic
lymphocytic leukaemia and lymphomas. Dose: 100-300 Ing daily, orally or i.v., or 300 mg-1 g weekly. A high fluid intake is necessary, as a metabolite may cause hacm- ( )rrhagic cystitis, and it is sometimes used with mesna to reduce the risk of such cystitis. Nausea and vomiting are common side-effects, as is epilation with high doses. (Endoxana). See page 122 and Table 8.
cyclopropane An inhalation anaesthetic of high potency with which induction and recovery are rapid. It causes some respiratory depression and cardiac irregularities, and its administration requires care. It is used with closed-circuit apparatus as it forms an explosive mixture with air and oxygen. Supplied in orange-coloured cylinders.
cycloserine An antibiotic used in
pulmonary tuberculosis when standard drugs are ineffective. Occasionally used in urinary infections.
Dose: 250-750 mg daily. Side-effects include drowsiness, vertigo and rash. See page 170 and Table 31.
cyclosporin An antibiotic with a powerful inuininosuppressant action. It is used under expert control to prevent graft rejection in organ and bone marrow transplantation, and in the prevention of graft-versus-host disease (GVI-ID). Prolonged therapy over some months may be required. Side-effects may include tremor, gastrointestinal disturbance, hypertrichosis and nephrotoxicity (Neural; Sandinimun).
cyproheptadine A compound with antihistamine and antiserotonin properties. Sonic allergic reactions are due not only to histamine, but also to serotonin, and cyproheptadine is useful in conditions not responding completely to an antihistamine. Dose: 4-20 ing daily. It has been used as an appetile stimulant in doses of 12 mg daily and in refractory migraine. (11criactin). See page 110 and Table 2.
cyproterone An anti-androgen used to reduce libido in sexual deviants. Dose: 50-100 nig daily. It is also used in the palliative treatment of prostatic carcinoma, particularly in advanced cases that have become resistant to other therapy. Dose: 300 mg daily.