DOCSLIB.ORG

COMPARISON CHART for CONSTIPATION Meds

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
COMPARISON CHART for CONSTIPATION Meds COMPARISON CHART FOR CONSTIPATION MEDs Class of agent, Examples Mechanism of Contraindications, Administration & Onset of Action Action Precautions & SE Instructions Bulk-forming Agents: -Retain H2O in -NOT FOR pt w/ -Do not take within 2 Psyllium (Metamucil & stool & increase esophageal strictures, hrs of other Rx or Prodiem) stool bulk which GI ulcerations, effect of other Rx is Methylcellulose (Citrucel) stimulates stenosis or possible reduced Polycarbophil (Fiber-Con) intestinal motility obstruction -Do not prepare Sterculia gum (Normacol) -Use sugar-free mixture in advance Benefiber (wheat dextrin) version for diabetics -Take w/ 250ml H2O Onset: 12-72 hrs SE: flatulence, or juice diarrhea, bloating, -Increase fluids abdominal pain Hyper-osmotic Agents: -Pulls fluid into -*diabetics ? -Use water-soluble Lactulose GI tract by -Avoid antacids w/ lubricant to Sorbitol 70% solution osmosis & this lactulose administer supp & Onset: (24-48 hrs) increases pressure SE: flatulence, have pt turn & Glycerin suppository which stimulates cramps, bloating, remain on L side. Onset: (15-30min) GI motility diarrhea PEG powder can be Polyethylene glycol 3350 (Supp-local irritant) mixed w/ H2O, juice, (Miralax, PEG) (0.5-1hr) tea, coffee or soda Lubricants: -Coats & softens -DO NOT administer -use with extreme Mineral oil the stool & w/ stool softeners d/t caution d/t risk of Onset: 6-8 hrs prevents increased absorption aspiration pneumonia reabsorption of of mineral oil -Use only for short H2O into colon -Decreased periods absorption of fat -DO NOT give at soluble Vits (ADEK) bedtime, to prevent SE: rectal seepage, aspiration irritation Osmotic-Saline Agents: -Draw H2O into -Caution in elderly & -Caution in pts at risk Magnesium Hydroxide stool by osmosis, renal pts since Mg is of dehydration (MoM) increasing eliminated by -MoM has antacid Magnesium Citrate pressure & kidneys: increased properties so give 2 (Citro-Mag) stimulating Mg can cause CNS hrs apart from: Onset: 0.5-3 hrs intestinal motility depression, muscle ketoconazole, weakness, decreased itraconazole, BP & ECG changes tetracyclines & SE: diarrhea, quinolones abdominal pain Stool Softeners: -Decrease surface -Insignificant Na for -Take w/ lots of H2O Ducosate Na (Colace) tension & allow Na–restricted diets to improve Ducosate Ca (Surfak) fat & H2O into (HTN, CHF) effectiveness Onset: 12-72 hrs stools to soften SE: stomach upset -do not give w/ them mineral oil T. Broda, RN[EC], BScN, NP-PHC, CDDN Solution-s Class of agent & Mechanism of Contraindications, Administration Examples action Precautions & SE Instructions Stimulants: -Increase -DO NOT give to -Bisacodyl: do not Senna (Senekot) intestinal motility pregnant women as take with milk Bisacodyl (Dulcolax) by direct action may induce -Bisacodyl (EC) tabs Cascara sagrada on the smooth contractions should not be chewed Onset: 6-12 hrs muscle of the -Do not give to pt w/ or crushed to prevent Bisacodyl supp intestine appendicitis d/t risk contractions in Onset: 0.5-1hr -May also of rupture stomach & small stimulate SE: flatulence, intestine secretion of H2O griping, diarrhea, -Bisacodyl must be & electrolytes excessive diarrhea given 1-2 hrs apart into colon may lead to from antacids, H2- -Bisacodyl causes electrolyte loss & antagonists & PPI’s, contractions of dehydration as they will dissolve entire colon. (EC) (Senna & Cascara- EC => cramping! discolor urine: red, pink, brown, black) **Long term use may lead to cathartic colon, but may be necessary for pts on opiods long-term Enemas : -Various SE: mechanical -NOT for < 2 yrs (onset: 5-15 min) mechanisms of trauma to rectal 1. Tap H2O: action wall 1. Warm H2O 500 ml PR 1. H2O 2. Avoid 2. Na+ Phosphate intoxication prolonged (Fleet): 120ml PR & hypoNa+ retention 3. Mineral oil: 2. hypophospha 100-250ml PR temia & hypocalcemia 3. incontinence *Lactulose: indicated in Patient Self-Care, 2nd ed. (2010, p.269) that it CAN be used by diabetics but taste is ++ sweet & is NOT for pts who should not take galactose BUT bottle of Lactulose clearly indicates diabetic patients should consult MD before using (because it contains lactose & galactose). SE: side effects T. Broda, RN[EC], BScN, NP-PHC, CDDN Solution-s .
Load more

Recommended publications
  • Chemicals Used for Chemical Manufacturing Page 1 of 2
    Chemicals used for Chemical Manufacturing Page 1 of 2 Acetic Acid (Glacial, 56%) Glycol Ether PMA Acetone Glycol Ether PNB Acrylic Acid Glycol Ether PNP Activated Carbon Glycol Ether TPM Adipic Acid Glycols Aloe Vera Grease Aluminum Stearate Gum Arabic Aluminum Sulfate Heat Transfer Fluids Amino Acid Heptane Ammonium Acetate Hexane Ammonium Bicarbonate Hydrazine Hydrate Ammonium Bifluoride Hydrochloric Acid (Muriatic) Ammonium Chloride Hydrogen Peroxide Ammonium Citrate Hydroquinone Ammonium Hydroxide Hydroxylamine Sulfate Ammonium Laureth Sulfate Ice Melter Ammonium Lauryl Sulfate Imidazole Ammonium Nitrate Isobutyl Acetate Ammonium Persulfate Isobutyl Alcohol Ammonium Silicofluoride Calcium Stearate Dipropylene Glycol Isopropanolamine Ammonium Sulfate Carboxymethylcellulose Disodium Phosphate Isopropyl Acetate Antifoams Caustic Potash D'Limonene Isopropyl Alcohol Antifreeze Caustic Soda (All Grades) Dodecylbenzene Sulfonic Acid Isopropyl Myristate Antimicrobials Caustic Soda (Beads, Prills) (DDBSA) Isopropyl Palmitate Antimony Oxide Cetyl Alcohol Dowfrost Itaconic Acid Aqua Ammonia Cetyl Palmitate Dowfrost HD Jojoba Oil Ascorbic Acid Chlorine, Granular Dowtherm SR-1 Keratin Barium Carbonate Chloroform Dowtherm 4000 Lactic Acid Barium Chloride Chromic Acid EDTA Lanolin Beeswax Citric Acid (Dry and Liquid) EDTA Plus Lauric Acid Bentonite Coal Epsom Salt Lauryl Alcohol Benzaldehyde Cocamide DEA Ethyl Acetate Lecithin Benzoic Acid Copper Nitrate Ethyl Alcohol (Denatured) Lime Benzyl Alcohol Copper Sulfate Ethylene Glycol Linoleic Acid Bicarbonate
    [Show full text]
  • Potassium-Magnesium Citrate Is an Effective Prophylaxis Against Recurrent Calcium Oxalate Nephrolithiasis
    0022-5347/97/1586-2069$03.00/0 JOURNAL OF UROLOGY Vol. 158,2069-2073, December 1997 Copyright Q 1997 by AMERICANUROLOGICAL ASS~CIATION, INC. Printed in U.S.A. POTASSIUM-MAGNESIUM CITRATE IS AN EFFECTIVE PROPHYLAXIS AGAINST RECURRENT CALCIUM OXALATE NEPHROLITHIASIS BRUCE ETTINGER,* CHARLES Y. C. PAK, JOHN T. CITRON, CARL THOMAS, BEVERLEY ADAMS-HIJET AND ARLINE VANGESSEL From the Diuision of Research, Kaiser Permanente Medical Care Program, Oakland, California, the Department of Mineral Metabolism, Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, Department of Medicine, Kaiser Permanente Medical Center, Walnut Creek, California, Department of Urology, Kaiser Permanente Medical Center, San Francisco, California, and Kaiser Foundation Research Institute, Kaiser Foundation Hospitals, Oakland, California ABSTRACT Purpose: We examined the efficacy of potassium-magnesium citrate in preventing recurrent calcium oxalate kidney calculi. Materials and Methods: We conducted a prospective double-blind study of 64 patients who were randomly assigned to receive placebo or potassium-magnesium citrate (42 mEq. potassium, 21 mEq. magnesium, and 63 mEq. citrate) daily for up to 3 years. Results. New calculi formed in 63.6%of subjects receiving placebo and in 12.9%of subjects receiving potassium-magnesiumcitrate. When compared with placebo, the relative risk of treat- ment failure for potassium-magnesium citrate was 0.16 (95%confidence interval 0.05 to 0.46). potassium-magnesium citrate had a statistically significant effect (relative risk 0.10,95%confi- dence interval 0.03 to 0.36) even after adjustment for possible confounders, including age, pretreatment calculous event rate and urinary biochemical abnormalities.
    [Show full text]
  • Polyethylene Glycol (PEG) 3350
    Polyethylene Glycol (PEG) 3350 Polyethylene glycol is a laxative sold under the trade names MiraLAX®, ClearLax®, GaviLAX®, GlycoLax® and Purelax®. You do not need a doctor’s prescription to buy PEG 3350. It is available over-the-counter. PEG 3350 is an osmotic laxative, which means it increases the water content of stool and is effective in treating or preventing constipation. The body cannot absorb or digest this laxative. PEG 3350 is typically taken once a day by mouth, but the dose may be adjusted higher. It comes as a powder which you will have to mix with liquid. How do I prepare the medication? The standard dose is 17 grams of powder mixed into 8 ounces of liquid. The bottle has a measuring cap that is marked with a line. 1. Pour the powder into the cap up to the marked line. 2. Add the powder in the cap to a full glass (8 ounces) of water, juice, soda, coffee or tea. o If you are over 65, have kidney disease or have liver disease, please only use water. 3. Mix powder well and drink the solution. How do I take PEG 3350? You can take this medication on a full or empty stomach. PEG 3350 doesn’t have any known drug interactions but you should not take other medications at the same time that you take PEG 3350. Other medications may not be digested and absorbed as well. Always drink plenty of decaffeinated liquids with this medication. Michigan Bowel Control Program -1- What are possible side effects? Call your doctor immediately if you have any of the following side-effects: diarrhea severe bloating difficulty breathing painful swelling of the itching of the skin stomach hives vomiting skin rash Other side-effects that usually do not require immediate medical attention are: bloating cramps lower abdominal (stomach) nausea discomfort passing extra gas Some of these symptoms will decrease over time.
    [Show full text]
  • Laxatives for the Management of Constipation in People Receiving Palliative Care (Review)
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by UCL Discovery Laxatives for the management of constipation in people receiving palliative care (Review) Candy B, Jones L, Larkin PJ, Vickerstaff V, Tookman A, Stone P This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2015, Issue 5 http://www.thecochranelibrary.com Laxatives for the management of constipation in people receiving palliative care (Review) Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 2 OBJECTIVES ..................................... 4 METHODS ...................................... 4 RESULTS....................................... 7 Figure1. ..................................... 8 Figure2. ..................................... 9 Figure3. ..................................... 10 DISCUSSION ..................................... 13 AUTHORS’CONCLUSIONS . 14 ACKNOWLEDGEMENTS . 14 REFERENCES ..................................... 15 CHARACTERISTICSOFSTUDIES . 17 DATAANDANALYSES. 26 ADDITIONALTABLES. 26 APPENDICES ..................................... 28 WHAT’SNEW..................................... 35 HISTORY....................................... 35 CONTRIBUTIONSOFAUTHORS . 36 DECLARATIONSOFINTEREST . 36 SOURCESOFSUPPORT . 36 DIFFERENCES
    [Show full text]
  • HISTORY of WESTERN OIL SHALE HISTORY of WESTERN OIL SHALE
    / _... i';C4 - SHELF , Historyof Western Oil Shale Paul L. Russell . " The Center for Professional Advancement Paul Russell received his degree from the University of Arizona. After working for Industry for five years, he began his involvement with oil shale in 1948 when he joined the U.S. Bureau of Mines and was assigned to Rifle, Colorado, to work at Anvil Points. During the middle fifties, he was assigned to the Atomic Energy Com­ mission to study the extraction of ura­ nium from the Chattanooga Shales in Tennessee. He became Research Director of the U.S. Bureau ofMines in 1967 and served in this capacity until he retired in 1979. During these years his involvement with oil shale intensified. Currently, he is an engineering consultant. ISBN: 0-86563-000-3 ,._-------_._.. V.D.ALLRED 6016 SOUTH BANNOCK LI7TLETON. COLO. 80120 ....~ ...........~..... This compelling history spans 65 years of western oil shale development from its begin­ ning to the present day. These were the years in which most of the present-day retorting pro­ cesses were invented and devel­ oped,leading to present studies of in-situ retorting, and to the resumption of leasing of fed­ eral oil shale lands. The many excellent illustra­ tions and contemporary photo­ graphs in themselves provide a pictorial record of an era when the United States was "wild over oil"-an era when Gov­ ernment estimates of billions of barrels of oil in western oil shales were used to advan­ tage for questionable-if not fraudulent-stock promotions designed to raise capital for development, or to fatten the promoters' pockets.
    [Show full text]
  • Jbscreen Membrane 1 (PEG 400 to PEG 2000 MME Based) Cat.-No.: CS-301L
    JBScreen Membrane 1 (PEG 400 to PEG 2000 MME based) Cat.-No.: CS-301L No. Precipitant Precipitant 2 Buffer Additive A1 15 % w/v Polyethylene glycol 400 15 % w/v Glycerol 100 mM HEPES; pH 7.5 200 mM Calcium chloride A2 20 % w/v Polyethylene glycol 400 100 mM Sodium chloride 100 mM tri-Sodium citrate; pH 5.6 20 mM Magnesium chloride A3 25 % w/v Polyethylene glycol 400 none 50 mM Sodium acetate; pH 4.6 50 mM Magnesium acetate A4 30 % w/v Polyethylene glycol 400 50 mM Sodium sulfate 50 mM TRIS; pH 8.5 50 mM Lithium sulfate A5 48 % w/v Polyethylene glycol 400 none 100 mM HEPES; pH 7.5 200 mM Calcium chloride A6 20 % w/v Polyethylene glycol monomethyl ether 550 none 10 mM TRIS; pH 7.5 none A7 30 % w/v Polyethylene glycol monomethyl ether 550 none 50 mM TRIS; pH 8.5 100 mM Magnesium chloride A8 35 % w/v Polyethylene glycol 600 none none none A9 28 % w/v Polyethylene glycol 1,000 10 % w/v Glycerol 100 mM TRICINE; pH 8.0 350 mM Sodium chloride A10 10 % w/v Polyethylene glycol 1,500 5 % w/v Ethanol none 100 mM Magnesium chloride, 100 mM Sodium chloride A11 30 % w/v Polyethylene glycol 1,500 none none none A12 5 % w/v Polyethylene glycol 2,000 none none none B1 10 % w/v Polyethylene glycol 2,000 none 100 mM TRIS; pH 8.5 500 mM Magnesium chloride B2 15 % w/v Polyethylene glycol 2,000 none none none B3 15 % w/v Polyethylene glycol 2,000 none none 100 mM Lithium chloride B4 15 % w/v Polyethylene glycol 2,000 none 100 mM Sodium Phosphate; pH 6.2 20 mM tri-Sodium citrate B5 15 % w/v Polyethylene glycol 2,000 none 100 mM Sodium Phosphate; pH 6.8 500 mM
    [Show full text]
  • Crest ® Pro-Health™ Advanced Sensitive & Enamel Shield
    CREST PRO-HEALTH ADVANCED SENSITIVE AND ENAMEL SHIELD- stannous fluoride paste, dentifrice The Procter & Gamble Manufacturing Company Disclaimer: Most OTC drugs are not reviewed and approved by FDA, however they may be marketed if they comply with applicable regulations and policies. FDA has not evaluated whether this product complies. ---------- Crest ® Pro-Health™ Advanced Sensitive & Enamel Shield Drug Facts Active ingredient Stannous fluoride 0.454% (0.16% w/v fluoride ion) Purposes Anticavity, antigingivitis, antisensitivity toothpaste Uses aids in the prevention of cavities helps prevent gingivitis helps interfere with the harmful effects of plaque associated with gingivitis helps control plaque bacteria that contribute to the development of gingivitis builds increasing protection against painful sensitivity of the teeth to cold, heat, acids, sweets or contact Warnings When using this product do not use for sensitivity longer than four weeks unless recommended by a dentist. Stop use and ask a dentist if the sensitivity problem persists or worsens. Sensitive teeth may indicate a serious problem that may need prompt care. Keep out of reach of children. If more than used for brushing is accidentally swallowed, get medical help or contact a Poison Control Center right away. Directions adults and children 12 yrs. & older: apply at least a 1-inch strip of the product onto a soft bristle toothbrush. Brush teeth thoroughly for at least 1 minute twice a day (morning and evening) or as recommended by a dentist. Make sure to brush all sensitive
    [Show full text]
  • Polyethylene Glycols: Carefully the Calibration Table of the Molecular Weight Distribution Introduce 25.0 Ml of the Phthalic Anhydride Solution Into a Software
    Accessed from 128.83.63.20 by nEwp0rt1 on Tue Nov 29 23:26:06 EST 2011 NF 30 Official Monographs / Polyethylene 1901 pump Mobile phase through the column at this flow rate NMT 112.5% of the labeled nominal value if the labeled for at least 1 h before the first injection. Check the flow nominal value is more than 7000. It may contain a suitable gravimetrically, and adjust it if necessary. Reduce the flow antioxidant. rate to about 0.1 mL/min when the system is not in use.] Injection size: 50 µL ASSAY System suitability • AVERAGE MOLECULAR WEIGHT Sample: Standard solution Phthalic anhydride solution: Place 49.0 g of phthalic anhy- Chromatograph five replicate injections of the Standard dride into an amber bottle, and dissolve in 300 mL of pyri- solution, allowing 15 min between injections, and record dine from a freshly opened bottle or pyridine that has been the retention times of the components of the Standard freshly distilled over phthalic anhydride. Shake vigorously solution. until completely dissolved. Add 7 g of imidazole, swirl care- Insert the average retention time along with the molecular fully to dissolve, and allow to stand for 16 h before using. weight of each component in the Standard solution into Sample solution for liquid Polyethylene Glycols: Carefully the calibration table of the molecular weight distribution introduce 25.0 mL of the Phthalic anhydride solution into a software. Check the regression results for a cubic fit of the dry, heat-resistant pressure bottle. Add an amount of the calibration points, and obtain a correlation coefficient, R, specimen equivalent to its expected average molecular for the line.
    [Show full text]
  • Mineral Oil (Medium Viscosity)
    MINERAL OIL (MEDIUM VISCOSITY) Prepared at the 76th JECFA, published in FAO JECFA Monographs 13 (2012), superseding specifications for Mineral oil (Medium and low viscosity), class I prepared at the 59th JECFA (2002), published in FNP 52 Add 10 (2002) and republished in FAO JECFA Monographs 1 (2005). An ADI of 0-10 mg/kg bw was established at the 59th JECFA for mineral oil (medium and low), class I. At the 76th JECFA the temporary ADI and the specifications for mineral oils (Medium and low viscosity), class II and class III were withdrawn. SYNONYMS Liquid paraffin, liquid petrolatum, food grade mineral oil, white mineral oil, INS No. 905e DEFINITION A mixture of highly refined paraffinic and naphthenic liquid hydrocarbons with boiling point above 200°; obtained from mineral crude oils through various refining steps (eg. distillation, extraction and crystallisation) and subsequent purification by acid and/or catalytic hydrotreatment; may contain antioxidants approved for food use. C.A.S. number 8012-95-1 DESCRIPTION Colourless, transparent, oily liquid, free from fluorescence in daylight; odourless FUNCTIONAL USES Release agent, glazing agent CHARACTERISTICS IDENTIFICATION Solubility (Vol. 4) Insoluble in water, sparingly soluble in ethanol, soluble in ether Burning Burns with bright flame and with paraffin-like characteristic smell PURITY Viscosity, 100° 8.5-11 mm2/s See description under TESTS Carbon number at 5% Not less than 25 distillation point The boiling point at the 5% distillation point is higher than: 391°. See description under TESTS Average molecular 480-500 weight See description under TESTS Acidity or alkalinity To 10 ml of the sample add 20 ml of boiling water and shake vigorously for 1 min.
    [Show full text]
  • Cycle Stability and Hydration Behavior of Magnesium Oxide and Its Dependence on the Precursor-Related Particle Morphology
    nanomaterials Article Cycle Stability and Hydration Behavior of Magnesium Oxide and Its Dependence on the Precursor-Related Particle Morphology Georg Gravogl 1,2, Christian Knoll 2,3 , Jan M. Welch 4, Werner Artner 5, Norbert Freiberger 6, Roland Nilica 6, Elisabeth Eitenberger 7, Gernot Friedbacher 7, Michael Harasek 3 , Andreas Werner 8, Klaudia Hradil 5, Herwig Peterlik 9, Peter Weinberger 2 , Danny Müller 2,* and Ronald Miletich 1 1 Department of Mineralogy and Crystallography, University of Vienna, Althanstraße 14, 1090 Vienna, Austria; [email protected] (G.G.); [email protected] (R.M.) 2 Institute of Applied Synthetic Chemistry, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria; [email protected] (C.K.); [email protected] (P.W.) 3 Institute of Chemical, Environmental & Biological Engineering, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria; [email protected] 4 Atominstitut, TU Wien, Stadionallee 2, 1020 Vienna, Austria; [email protected] 5 X-ray Center, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria; [email protected] (W.A.); [email protected] (K.H.) 6 RHI-AG, Magnesitstraße 2, 8700 Leoben, Austria; [email protected] (N.F.); [email protected] (R.N.) 7 Institute of Chemical Technologies and Analytics, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria; [email protected] (E.E); [email protected] (G.F.) 8 Institute for Energy Systems and Thermodynamics, TU Wien, Getreidemarkt 9, 1060 Vienna, Austria; [email protected] 9 Faculty of Physics, University of Vienna, Boltzmanngasse 5, 1090 Vienna, Austria; [email protected] * Correspondence: [email protected]; Tel.: +43-1-5880-1163-740 Received: 31 August 2018; Accepted: 2 October 2018; Published: 7 October 2018 Abstract: Thermochemical energy storage is considered as an auspicious method for the recycling of medium-temperature waste heat.
    [Show full text]
  • Salicylic Acid
    Treatment Guide to Common Skin Conditions Prepared by Loren Regier, BSP, BA, Sharon Downey -www.RxFiles.ca Revised: Jan 2004 Dermatitis, Atopic Dry Skin Psoriasis Step 1 - General Treatment Measures Step 1 - General Treatment Measures Step 1 • Avoid contact with irritants or trigger factors • Use cool air humidifiers • Non-pharmacologic measures (general health issues) • Avoid wool or nylon clothing. • Lower house temperature (minimize perspiration) • Moisturizers (will not clear skin, but will ↓ itching) • Wash clothing in soap vs detergent; double rinse/vinegar • Limit use of soap to axillae, feet, and groin • Avoid frequent or prolonged bathing; twice weekly • Topical Steroids Step 2 recommended but daily bathing permitted with • Coal Tar • Colloidal oatmeal bath products adequate skin hydration therapy (apply moisturizer • Anthralin • Lanolin-free water miscible bath oil immediately afterwards) • Vitamin D3 • Intensive skin hydration therapy • Limit use of soap to axillae, feet, and groin • Topical Retinoid Therapy • “Soapless” cleansers for sensitive skin • Apply lubricating emollients such as petrolatum to • Sunshine Step 3 damp skin (e.g. after bathing) • Oral antihistamines (1st generation)for sedation & relief of • Salicylic acid itching give at bedtime +/- a daytime regimen as required Step 2 • Bath additives (tar solns, oils, oatmeal, Epsom salts) • Topical hydrocortisone (0.5%) for inflammation • Colloidal oatmeal bath products Step 2 apply od-tid; ointments more effective than creams • Water miscible bath oil • Phototherapy (UVB) may use cream during day & ointment at night • Humectants: urea, lactic acid, phospholipid • Photochemotherapy (Psoralen + UVA) Step 4 Step 3 • Combination Therapies (from Step 1 & 2 treatments) • Prescription topical corticosteroids: use lowest potency • Oral antihistamines for sedation & relief of itching steroid that is effective and wean to twice weekly.
    [Show full text]
  • Immediate Hypersensitivity Reactions Caused by Drug Excipients: a Literature Review Caballero ML, Quirce S
    REVIEWS Immediate Hypersensitivity Reactions Caused by Drug Excipients: A Literature Review Caballero ML, Quirce S Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain J Investig Allergol Clin Immunol 2020; Vol. 30(2): 86-100 doi: 10.18176/jiaci.0476 Abstract The European Medicines Agency defines excipients as the constituents of a pharmaceutical form apart from the active substance. Immediate hypersensitivity reactions (IHRs) caused by excipients contained in the formulation of medications have been described. However, there are no data on the prevalence of IHRs due to drug excipients. Clinical manifestations of allergy to excipients can range from skin disorders to life-threatening systemic reactions. The aim of this study was to review the literature on allergy to pharmaceutical excipients and to record the IHRs described with various types of medications, specifically reactions due to the excipients contained in their formulations. The cases reported were sorted alphabetically by type of medication and excipient in order to obtain a list of the excipients most frequently involved for each type of medication. Key words: Allergy. Drug immediate hypersensitivity reaction. Excipient. Pharmaceutical excipients. Resumen La Agencia Europea de Medicamentos define los excipientes como los componentes de una forma farmacéutica diferenciados del principio activo. Se han descrito reacciones de hipersensibilidad inmediata causadas por los excipientes contenidos en la formulación de medicamentos. Sin embargo, no hay datos sobre la prevalencia de dichas reacciones. Las manifestaciones clínicas de la alergia a los excipientes pueden ir desde trastornos de la piel hasta reacciones sistémicas que ponen en peligro la vida. El objetivo de este estudio fue realizar una revisión de la literatura sobre la alergia a los excipientes farmacéuticos y recopilar las reacciones inmediatas descritas con diferentes tipos de medicamento, debido solo a excipientes contenidos en sus formulaciones.
    [Show full text]