Drugs

Finasteride (Propecia)

Finasteride is used to treat androgenic alopecia. Finasteride – instructions for use, doses, side effects. Benefits of using Finasteride and the effectiveness of the drug.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

How many of your patients chronically take non-steroidal anti-inflammatory drugs (NSAIDs)? In a recent Saskatchewan survey, approximately 13% of the general population had filled a prescription for an NSAID during the preceding year. In British Columbia these drugs accounted for 6.4% of total claims and 9.8% of drug cost to the Pharmacare Program.

Non-steroidal Anti-inflammatory Drugs: Gastrointestinal Effects

The gastrointestinal effects of non-steroidal anti-inflammatory drugs range from dyspepsia to gastric ulceration, hemorrhage, and perforation. Minor symptoms of gastrointestinal discomfort are reported in 10% to 40% of patients using non-steroidal anti-inflammatory drugs.

Opioid overdose: Class

Morphine, the prototype opioid, is derived from opium, a crude material obtained from the seed pod of the opium poppy plant. The chemical structure of morphine is shown in Figure Structure-activity relationships of opioids. Many other derivatives of the opium plant (opiates) and other drugs with similar effects (opioids) have been discovered or synthesized.

Psychotropic Drugs in Children: Imipramine (Tofranil)

Prescribing Information for Imipramine (Tofranil). Concurrent Treatment and Alternatives.

Requip Relieves Restless Legs

The first double-blind, placebo-controlled study of Requip in patients with restless legs syndrome (RLS) showed the drug led to significant improvement in the periodic leg movements (PLMS) of sleep. The primary outcome measure was to determine whether the number of leg movements per hour in NREM sleep was reduced in patients treated with Requip vs. placebo-treated patients. Patients with primary RLS (n=31) were started on 0.25 mg/dose of Requip administered in the evening, and then maintained at that dosage for 2 weeks.

Medications that Zap Your Cholesterol

If you have too much cholesterol in your blood stream, you are at risk for getting heart disease and stroke. In some people, it may be difficult to lower cholesterol levels through diet and lifestyle changes alone.

Psychotropic Drugs in Children: Thioridazine (Mellaril)

Prescribing Information for Thioridazine (Mellaril): Optimum Dosage, Drug Interactions, Contra-indications.

Opioid overdose

An 18-year-old man is brought into the emergency department after being found on the street unresponsive. He is lethargic and does not answer questions.

NSAIDs

A 16-year-old female comes to the physician’s office because of menstrual cramps. Her menses lasts for 4-5 days, and she has 28-day cycles. For the first 2-3 days of her menses she states that she has very bad cramping.

Opioid overdose: Questions – Answers

Opioid agonists bind to G-protein-coupled receptors to reduce adenylyl cyclase activity, to reduce prejunctional calcium conductance, which results in a decrease in neurotransmitter release, and to enhance postjunctional potassium conductance, which results in decreased responsiveness to excitatory neurotransmitters. Meperidine is metabolized to normeperidine that may result in seizures. Morphine is metabolized to morphine-6 glucuronide.

Ergot alkaloids

You are called to see a 24-year-old G3P3 woman who approximately 1 hour ago underwent a vaginal delivery of an 8 lb infant. The nurse is concerned that the patient is continuing to bleed more than would be expected, and that her uterine fundus does not feel firm.

SSRIs Safe for Cardiac Patients

A study has found that paroxetine (Paxil/ SmithKline Beecham) effectively reduced depression in patients without affecting cardiac function. The patients in the study were administered either paroxetine, an SSRI, nortriptyline or placebo. Of the 41 patients taking nortriptyline, heart rates increased by 11% and 7 of the patients dropped out of the study because of potentially serious cardiovascular side effects, such as angina and sinus tachycardia.

Non-steroidal Anti-inflammatory Drugs (NSAIDs): Hematologic problems

Blood dyscrasias related to non-steroidal anti-inflammatory drug (NSAID) therapy are clinically important, although rare. In the Danish study, one third of reported deaths associated with NSAIDs had hematologic causes. All blood cell lines can be affected, resulting in red cell aplasia, hemolytic anemia, agranulocytosis, thrombocytopenia, and aplastic anemia.

Proscar Reduces Need for Surgery

A four-year study confirms that finasteride (Proscar/Merck) reduces by half the need for surgery in men who are experiencing acute urinary retention. The study of 3,040 men showed that those taking the drug were 55% less likely to need prostate surgery; men who did not have acute urinary retention were 57% less likely to develop the condition than men who were not taking the drug. The drug “clearly alters the progression of BPH,” said Dr.

COX-2 Drugs Curb Ocular Herpes

The herpes simplex type 1 virus, which can reside in the body for decades, is responsible for more than 500,000 cases of ocular herpes each year. Ocular herpes is a common cause of corneal blindness.

The Statins and the Heart

A new class of lipid-lowering agents is proving to be effective for preventing both first and second heart attacks in patients with hypercholesterolemia. These agents reduce cholesterol levels by inhibiting the activity of the hepatic enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. Blocking this enzyme increases the hepatic production of cholesterol receptors, and these receptors, in turn, pull cholesterol out of the bloodstream.

Viadur: Drug for Prostate Cancer

This year, more than 180,000 new cases of prostate cancer will be diagnosed in the US. In patients with advanced prostate cancer, decreasing the production of the hormone testosterone often reduces prostate cancer growth and relieves symptoms, such as pain and problems urinating.

Psychotropic Drugs in Children: Methylphenidate (Ritalin)

Prescribing Information for Methylphenidate (Ritalin).

Non-steroidal Anti-inflammatory Drugs (NSAIDs): Renal problems

Four types of renal problems can occur with non-steroidal anti-inflammatory drugs (NSAIDs). Acute renal dysfunction has been reported; it rarely progresses to tubular necrosis.