DOCSLIB.ORG

Medications with Fall Risk Precautions

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Medications with Fall Risk Precautions Medications with Fall Risk Precautions Antipsychotic Drugs Factors Contributing to Fall Risk Typical Antipsychotics (First Generation) Drowsiness, dizziness, confusion, hypotension (low Chlorpromazine (Thorazine®), Fluphenazine (Prolixin®), blood pressure), orthostatic hypotension (sudden drop Haloperidol (Haldol®), Loxapine (Loxitane®), Perphenazine in blood pressure when upright), syncope (fainting), (Trilafon®), Prochlorperazine ( Compazine®), Thioridazine ataxia (gait disturbance), blurred vision, disorientation, (Mellaril®), Thiothixene (Navane®), Trifluoperazine abnormal involuntary movements of the body, slowed (Stelazine®) body movements, tremors, muscle rigidity, muscle Atypical Antipsychotics (Second Generation) spasms, seizure risk, heart rate irregularities, risk of Aripiprazole (Abilify®), Asenapine (Saphris®), Clozapine delirium (Clozaril®), Iloperidone (Fanapt®), Lurasidone (Latuda®), Olanzapine (Zyprexa®), Paliperidone (Invega®), Quetiapine (Seroquel®), Risperidone (Risperdal®), Ziprasidone (Geodon®) Anti-Anxiety Drugs Factors Contributing to Fall Risk Long-acting Benzodiazepines Drowsiness, dizziness, weakness, confusion, Chlordiazepoxide (Librium®), Clorazepate (Tranxene®), orthostatic hypotension (sudden drop in blood pressure Diazepam (Valium®), Flurazepam (Dalmane®), Clonazepam when upright), disorientation, blurred vision, (Klonopin®) unsteadiness, ataxia (gait disturbance), tremor, risk of Intermediate to Short-acting Benzodiazepines seizures (with abrupt discontinuation), blurred vision, Alprazolam (Xanax®), Lorazepam (Ativan®), Oxazepam worsening of respiratory depression, risk of delirium (Serax®) Other Anxiolytics Buspirone (Buspar®), Meprobamate (Equanil®; Miltown®) Sedative Hypnotic Drugs Factors Contributing to Fall Risk Short-acting Benzodiazepines Daytime drowsiness, dizziness, confusion, orthostatic Alprazolam (Xanax®), Estazolam (Prosom®), Lorazepam hypotension (sudden drop in blood pressure when (Ativan®), Oxazepam (Serax®), Temazepam (Restoril®), upright), ataxia (gait disturbance), hangover effect, Triazolam (Halcion®) disorientation, syncope (fainting), blurred vision, tremor, Non-benzodiazepines agitation, bizarre behavior, worsening of respiratory Diphenhydramine (Benadryl®; Sominex®; Nytol®), Doxylamine depression, risk of delirium (Unisom®), Eszopiclone (Lunesta®), Zaleplon (Sonata®), Zolpidem (Ambien®; Intermezzo®) Antidepressant Drugs Factors Contributing to Fall Risk Tricyclics (TCAs) Drowsiness, dizziness, confusion, hypotension (low Amitriptyline (Elavil®), Clomipramine (Anafranil®), Desipramine blood pressure), orthostatic hypotension (sudden drop (Norpramin®), Doxepin (Sinequan®), Imipramine (Tofranil®), in blood pressure when upright), disorientation, Nortriptyline (Pamelor®) syncope (fainting), blurred vision, unsteadiness, Tetracyclics numbness in the extremities, weakness, fatigue, Maprotiline (Ludiomil®), Mirtazapine (Remeron®) agitation, restlessness, risk of delirium, risk for Selective Serotonin Reuptake Inhibitors (SSRIs) hyponatremia (low blood sodium, fall risk) Citalopram (Celexa®), Fluvoxamine (Luvox®), Fluoxetine (Prozac®), Paroxetine (Paxil®; Pexeva®), Sertraline (Zoloft®) TCAs have highest fall risk compared to other Serotonin-norepinephrine Reuptake Inhibitors (SNRIs) antidepressants. TCA special precautions: cardiac Desvenlafaxine (Pristiq®), Duloxetine (Cymbalta®), arrhythmias, tachycardia (increased heart rate), risk of Venlafaxine (Effexor®) stroke, cognitive impairment, seizure risk (with TCAs Other Antidepressants and Bupropion). Bupropion (Wellbutrin®; Zyban®), Nefazodone (Serzone®), SSRIs pose greatest fall risk during the first 2 weeks of Trazodone (Desyrel®; Oleptro®), Vilazodone (Viibryd®) initiation. Created by DADS Pharmacists January 2014. References: Drugs.com/professionals (FDA Professional Monograph) 1 Medications with Fall Risk Precautions Antimanic/Anticonvulsant Drugs Factors Contributing to Fall Risk Carbamazepine (Tegretol®), Ethosuximide (Zarontin®), Drowsiness, dizziness, unsteadiness, confusion, Gabapentin (Neurontin®), Lamotrigine (Lamictal®), Lithium blurred vision, some drugs may require periodic lab Carbonate (Eskalith®; Lithobid®), Levetiracetam (Keppra®), work to monitoring for toxic levels, hyponatremia (low Phenobarbital, Phenytoin (Dilantin®), Pregabalin (Lyrica®), blood sodium, fall risk) and electrolyte imbalances Primidone (Mysoline®), Tiagabine (Gabitril®), Topiramate (Topamax®), Valproic Acid/Divalproex Sodium (Depakene®; Some drugs may cause irregular heartbeat. Depakote®), Zonisamide (Zonegran®) Pain Relievers (Opioids & Synthetic Analgesics) Factors Contributing to Fall Risk Buprenorphine (Butrans® patch), Butalbital (Esgic®; Fioricet®; Sedation, drowsiness, confusion, disorientation, Fiorinal®), Butorphanol (Stadol® nasal spray), Codeine (various dizziness, fatigue, hypotension (low blood pressure), pain relievers/cough medicines in tablet and liquid forms), syncope (fainting), shortness of breath (more Fentanyl (Actiq®; Duragesic® patches), Hydrocodone (Lorcet®; noticeable in ambulatory individuals), opioid dose- Lortab®; Norco®; Vicodin®; Vicoprofen®), Hydromorphone related respiratory depression & irregular breathing (Dilaudid®; Exalgo®), Methadone (Dolophine®; Methadose®), with possible hypoxia (reduced blood oxygen) Morphine ( various tablet and liquid forms; Avinza®; Kadian®; MS Contin®; Oramorph®; Roxanol®), Oxycodone (OxyContin®; Tramadol may increase the risk of seizures. Percodan®; Percocet®; Tylox®), Oxymorphone (Opana®), Pentazocine (Talacen®; Talwin®), Tapentadol (Nucynta ER®), Some drugs may cause cardiac arrhythmias (e.g. Tramadol (Ultram®; Ultracet®) methadone). Muscle Relaxants Factors Contributing to Fall Risk Baclofen (Lioresal®), Carisoprodol (Soma®), Chlorzoxazone Sedation, drowsiness, dizziness, fatigue, weakness, (Parafon Forte®), Cyclobenzaprine (Flexeril®), Metaxalone impaired functional ability, confusion, hypotension (low (Skelaxin®), Methocarbamol (Robaxin®), Orphenadrine blood pressure), syncope (fainting), some have (Norflex®; Norgesic®), Tizanidine (Zanaflex®) seizure risk Anticholinergic/Antimuscarinic/Antispasmodic Drugs Factors Contributing to Fall Risk Antihistamines (Anti-itch and Anti-nausea/vertigo) Drowsiness, dizziness, sedation, fatigue, hypotension Dimenhydrinate (Dramamine®), Diphenhydramine (Benadryl®), (low blood pressure), disturbed coordination, Hydroxyzine (Atarax®;Vistaril®), Meclizine (Antivert®; Bonine®; confusion, disorientation, blurred vision, nervousness, Dramamine II®), Scopolamine (Transderm Scop®) restlessness, agitation, palpitations, increased risk of Drugs for Various Gastrointestinal Disorders delirium Atropine, Belladonna Alkaloids (Donnatal®), Cyproheptadine (Periactin®), Dicyclomine (Bentyl®), Diphenoxylate/Atropine Drugs with strong anticholinergic and antimuscarinic (Lomotil®), Glycopyrrolate (Robinul®), Hyoscyamine activity will have additive effects with other drug (Anaspaz®; Levbid®; Levsin®; NuLev®), Metoclopramide classes that have CNS (central nervous system) (Reglan®), Prochlorperazine (Compazine®; Compro® action. suppositories), Promethazine (Phenergan®), Trimethobenzamide (Tigan®) Drugs to Treat Movement Disorders (e.g. Parkinson’s or EPS) Benztropine (Cogentin®), Trihexyphenidyl (Artane®) Drugs to Treat Over-active Bladder Disorders Darifenacin (Enablex®), Fesoterodine (Toviaz®), Flavoxate (Urispas®), Mirabegron (Myrbetriq®), Oxybutynin (Ditropan®; Oxytrol® patch), Solifenacin (VESIcare®), Tolterodine (Detrol®), Trospium (Sanctura®) Created by DADS Pharmacists January 2014. References: Drugs.com/professionals (FDA Professional Monograph) 2 Medications with Fall Risk Precautions Diuretics (Drugs Treating Fluid Retention/blood Pressure) Factors Contributing to Fall Risk Carbonic Anhydrase Inhibitors Excessive diuresis leading to dehydration, electrolyte Acetazolamide (Diamox®), Methazolamide (Neptazane®) depletion, blood volume reduction with circulatory Loop Diuretics collapse Bumetanide (Bumex®), Furosemide (Lasix®), Torsemide (Demadex®) These medications require periodic lab work to monitor Potassium-sparing Diuretics for electrolyte imbalances. Watch for signs of weakness, Amiloride (Midamor®), Spironolactone (Aldactone®), drowsiness, dizziness, muscle cramps, muscular Triamterene (Dyrenium®) fatigue, hypotension (low blood pressure), orthostatic Thiazide Diuretics hypotension (sudden drop in blood pressure when Chlorothiazide (Diuril®), Hydrochlorothiazide (HydroDIURIL®; upright), tachycardia (increased heart rate) or Microzide®; Esidrix®), Indapamide (Lozol®), Methyclothiazide arrhythmias, blurred vision, vertigo. (Enduron®), Metolazone (Zaroxolyn®) Antihypertensives (Blood Pressure Lowering Drugs) Factors Contributing to Fall Risk Alpha-adrenergic Receptor Antagonists (Central Acting) Hypotension (low blood pressure), orthostatic Clonidine (Catapres®), Guanfacine (Tenex®), Methyldopa hypotension (sudden drop in blood pressure when (Aldomet®) upright), lightheadedness, syncope (fainting), vertigo, Alpha-adrenergic Receptor Antagonists (Peripherally Acting) fatigue, weakness, possible tachycardia (increased Doxazosin (Cardura®), Prazosin (Minipress®), Terazosin heart rate), possible arrhythmias, palpitations, (Hytrin®) bradycardia (slowed heart rate), numbness or tingling in Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors) the extremities, blurred vision Benazepril (Lotensin®), Captopril (Capoten®), Enalapril (Vasotec®), Fosinopril (Monopril®), Lisinopril (Prinivil®; Some drugs in this category will require periodic lab Zestril®),
Load more

Recommended publications
  • With LAMOTRIGINE IN
    were independent of seizure type. Cardiac abnormalities occurring in epilepsy with GTCS may potentially facilitate sudden cardiac death (SUDEP). ETHOSUXIMIDE, VALPROIC ACID, AND LAMOTRIGINE IN CHILDHOOD ABSENCE EPILEPSY Efficacy, tolerability, and neuropsychological effects of ethosuximide, valproic acid, and lamotrigine in children with newly diagnosed childhood absence epilepsy were compared in a double-blind, randomized, controlled clinical trial performed at six centers in the US and organized as a Study Group. Drug doses were incrementally increased until freedom from seizures or highest tolerable dose was reached, Primary outcome was freedom from treatment failure after 16 weeks therapy, and secondary outcome was attentional dysfunction. In a total of 453 children, the freedom-from-failure rates after 16 weeks were similar for ethosuximide (53%) and valproic acid (58%), and higher than the rate for lamotrigine (29%) (P<0.001). Attentional dysfunction was more common with valproic acid (49%) than with ethosuximide (33%) (P=0.03). (Glauser TA, Cnaan A, Shinnar S, et al. Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. N Engl J Med March 4 2010;362:790-799). (Reprints: Dr Tracy A Glauser, Cincinnati Children's Hospital, 3333 Burnett Ave, MLC 2015, Cincinnati, OH 45229. E- mail: [email protected]). COMMENT. "Older is better," is the conclusion of Vining EPG, in an editorial (N Engl J Med 2010;362:843-845). As generally accepted in US practice and confirmed by the above controlled trial, ethosuximide from the 1950s is the optimal initial therapy for childhood absence epilepsy without GTCS. Ethosuximide is equal to valproic acid in seizure control and superior in effects on attention.
    [Show full text]
  • The Effects of Oral Administration of the Novel Muscarinic Receptor
    Choi et al. BMC Urology (2020) 20:41 https://doi.org/10.1186/s12894-020-00611-8 RESEARCH ARTICLE Open Access The effects of oral administration of the novel muscarinic receptor antagonist DA- 8010 on overactive bladder in rat with bladder outlet obstruction Jin Bong Choi1, Seung Hwan Jeon2, Eun Bi Kwon3, Woong Jin Bae4, Hyuk Jin Cho2, U-Syn Ha2, Sung-Hoo Hong2, Ji Youl Lee2 and Sae Woong Kim4* Abstract Background: DA-8010 is a novel compound developed for the treatment of overactive bladder (OAB) and urinary incontinence. The aims of this study were to investigate the effects of DA-8010 on OAB in a rat model. Methods: Study animals were divided into the following five groups of seven animals each: a sham-operated control group, a control group with partial bladder outlet obstruction (BOO) (OAB group), and three DA-8010 (doses of 0.3 mg/kg/day, 1 mg/kg/day, and 3 mg/kg/day, respectively) with partial BOO groups. Oral administration of the drugs was continued for 14 days after 2 weeks of partial BOO. After 4 weeks of partial BOO, cystometrography was performed in all groups. Additionally, pro-inflammatory cytokines, Rho-kinases, and histology of the bladder were analyzed. Results: There was a significant increase in the contraction interval and a decrease in contraction pressure in the 3 mg/kg/day DA-8010 group versus those in the OAB group. Rho kinase was also significantly decreased in the DA- 8010 3 mg/kg/day dosage treatment group. The increased ratio of collagen to smooth muscle after partial BOO was significantly attenuated in the DA-8010 3 mg/kg/day dosage group.
    [Show full text]
  • Therapeutic Class Overview Anticonvulsants
    Therapeutic Class Overview Anticonvulsants INTRODUCTION Epilepsy is a disease of the brain defined by any of the following (Fisher et al 2014): ○ At least 2 unprovoked (or reflex) seizures occurring > 24 hours apart; ○ 1 unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after 2 unprovoked seizures, occurring over the next 10 years; ○ Diagnosis of an epilepsy syndrome. Types of seizures include generalized seizures, focal (partial) seizures, and status epilepticus (Centers for Disease Control and Prevention [CDC] 2018, Epilepsy Foundation 2016). ○ Generalized seizures affect both sides of the brain and include: . Tonic-clonic (grand mal): begin with stiffening of the limbs, followed by jerking of the limbs and face . Myoclonic: characterized by rapid, brief contractions of body muscles, usually on both sides of the body at the same time . Atonic: characterized by abrupt loss of muscle tone; they are also called drop attacks or akinetic seizures and can result in injury due to falls . Absence (petit mal): characterized by brief lapses of awareness, sometimes with staring, that begin and end abruptly; they are more common in children than adults and may be accompanied by brief myoclonic jerking of the eyelids or facial muscles, a loss of muscle tone, or automatisms. ○ Focal seizures are located in just 1 area of the brain and include: . Simple: affect a small part of the brain; can affect movement, sensations, and emotion, without a loss of consciousness . Complex: affect a larger area of the brain than simple focal seizures and the patient loses awareness; episodes typically begin with a blank stare, followed by chewing movements, picking at or fumbling with clothing, mumbling, and performing repeated unorganized movements or wandering; they may also be called “temporal lobe epilepsy” or “psychomotor epilepsy” .
    [Show full text]
  • Pharmacokinetic Drug–Drug Interactions Among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients
    International Journal of Molecular Sciences Review Pharmacokinetic Drug–Drug Interactions among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients Marta Kara´zniewicz-Łada 1 , Anna K. Główka 2 , Aniceta A. Mikulska 1 and Franciszek K. Główka 1,* 1 Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 60-781 Pozna´n,Poland; [email protected] (M.K.-Ł.); [email protected] (A.A.M.) 2 Department of Bromatology, Poznan University of Medical Sciences, 60-354 Pozna´n,Poland; [email protected] * Correspondence: [email protected]; Tel.: +48-(0)61-854-64-37 Abstract: Anti-epileptic drugs (AEDs) are an important group of drugs of several generations, rang- ing from the oldest phenobarbital (1912) to the most recent cenobamate (2019). Cannabidiol (CBD) is increasingly used to treat epilepsy. The outbreak of the SARS-CoV-2 pandemic in 2019 created new challenges in the effective treatment of epilepsy in COVID-19 patients. The purpose of this review is to present data from the last few years on drug–drug interactions among of AEDs, as well as AEDs with other drugs, nutrients and food. Literature data was collected mainly in PubMed, as well as google base. The most important pharmacokinetic parameters of the chosen 29 AEDs, mechanism of action and clinical application, as well as their biotransformation, are presented. We pay a special attention to the new potential interactions of the applied first-generation AEDs (carba- Citation: Kara´zniewicz-Łada,M.; mazepine, oxcarbazepine, phenytoin, phenobarbital and primidone), on decreased concentration Główka, A.K.; Mikulska, A.A.; of some medications (atazanavir and remdesivir), or their compositions (darunavir/cobicistat and Główka, F.K.
    [Show full text]
  • Mechanisms of Action of Antiepileptic Drugs
    Review Mechanisms of action of antiepileptic drugs Epilepsy affects up to 1% of the general population and causes substantial disability. The management of seizures in patients with epilepsy relies heavily on antiepileptic drugs (AEDs). Phenobarbital, phenytoin, carbamazepine and valproic acid have been the primary medications used to treat epilepsy for several decades. Since 1993 several AEDs have been approved by the US FDA for use in epilepsy. The choice of the AED is based primarily on the seizure type, spectrum of clinical activity, side effect profile and patient characteristics such as age, comorbidities and concurrent medical treatments. Those AEDs with broad- spectrum activity are often found to exert an action at more than one molecular target. This article will review the proposed mechanisms of action of marketed AEDs in the US and discuss the future of AEDs in development. 1 KEYWORDS: AEDs anticonvulsant drugs antiepileptic drugs epilepsy Aaron M Cook mechanism of action seizures & Meriem K Bensalem-Owen† The therapeutic armamentarium for the treat- patients with refractory seizures. The aim of this 1UK HealthCare, 800 Rose St. H-109, ment of seizures has broadened significantly article is to discuss the past, present and future of Lexington, KY 40536-0293, USA †Author for correspondence: over the past decade [1]. Many of the newer AED pharmacology and mechanisms of action. College of Medicine, Department of anti epileptic drugs (AEDs) have clinical advan- Neurology, University of Kentucky, 800 Rose Street, Room L-455, tages over older, so-called ‘first-generation’ First-generation AEDs Lexington, KY 40536, USA AEDs in that they are more predictable in their Broadly, the mechanisms of action of AEDs can Tel.: +1 859 323 0229 Fax: +1 859 323 5943 dose–response profile and typically are associ- be categorized by their effects on the neuronal [email protected] ated with less drug–drug interactions.
    [Show full text]
  • Chapter 25 Mechanisms of Action of Antiepileptic Drugs
    Chapter 25 Mechanisms of action of antiepileptic drugs GRAEME J. SILLS Department of Molecular and Clinical Pharmacology, University of Liverpool _________________________________________________________________________ Introduction The serendipitous discovery of the anticonvulsant properties of phenobarbital in 1912 marked the foundation of the modern pharmacotherapy of epilepsy. The subsequent 70 years saw the introduction of phenytoin, ethosuximide, carbamazepine, sodium valproate and a range of benzodiazepines. Collectively, these compounds have come to be regarded as the ‘established’ antiepileptic drugs (AEDs). A concerted period of development of drugs for epilepsy throughout the 1980s and 1990s has resulted (to date) in 16 new agents being licensed as add-on treatment for difficult-to-control adult and/or paediatric epilepsy, with some becoming available as monotherapy for newly diagnosed patients. Together, these have become known as the ‘modern’ AEDs. Throughout this period of unprecedented drug development, there have also been considerable advances in our understanding of how antiepileptic agents exert their effects at the cellular level. AEDs are neither preventive nor curative and are employed solely as a means of controlling symptoms (i.e. suppression of seizures). Recurrent seizure activity is the manifestation of an intermittent and excessive hyperexcitability of the nervous system and, while the pharmacological minutiae of currently marketed AEDs remain to be completely unravelled, these agents essentially redress the balance between neuronal excitation and inhibition. Three major classes of mechanism are recognised: modulation of voltage-gated ion channels; enhancement of gamma-aminobutyric acid (GABA)-mediated inhibitory neurotransmission; and attenuation of glutamate-mediated excitatory neurotransmission. The principal pharmacological targets of currently available AEDs are highlighted in Table 1 and discussed further below.
    [Show full text]
  • Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017
    Q UO N T FA R U T A F E BERMUDA PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 BR 111 / 2017 The Minister responsible for health, in exercise of the power conferred by section 48A(1) of the Pharmacy and Poisons Act 1979, makes the following Order: Citation 1 This Order may be cited as the Pharmacy and Poisons (Third and Fourth Schedule Amendment) Order 2017. Repeals and replaces the Third and Fourth Schedule of the Pharmacy and Poisons Act 1979 2 The Third and Fourth Schedules to the Pharmacy and Poisons Act 1979 are repealed and replaced with— “THIRD SCHEDULE (Sections 25(6); 27(1))) DRUGS OBTAINABLE ONLY ON PRESCRIPTION EXCEPT WHERE SPECIFIED IN THE FOURTH SCHEDULE (PART I AND PART II) Note: The following annotations used in this Schedule have the following meanings: md (maximum dose) i.e. the maximum quantity of the substance contained in the amount of a medicinal product which is recommended to be taken or administered at any one time. 1 PHARMACY AND POISONS (THIRD AND FOURTH SCHEDULE AMENDMENT) ORDER 2017 mdd (maximum daily dose) i.e. the maximum quantity of the substance that is contained in the amount of a medicinal product which is recommended to be taken or administered in any period of 24 hours. mg milligram ms (maximum strength) i.e. either or, if so specified, both of the following: (a) the maximum quantity of the substance by weight or volume that is contained in the dosage unit of a medicinal product; or (b) the maximum percentage of the substance contained in a medicinal product calculated in terms of w/w, w/v, v/w, or v/v, as appropriate.
    [Show full text]
  • Title 16. Crimes and Offenses Chapter 13. Controlled Substances Article 1
    TITLE 16. CRIMES AND OFFENSES CHAPTER 13. CONTROLLED SUBSTANCES ARTICLE 1. GENERAL PROVISIONS § 16-13-1. Drug related objects (a) As used in this Code section, the term: (1) "Controlled substance" shall have the same meaning as defined in Article 2 of this chapter, relating to controlled substances. For the purposes of this Code section, the term "controlled substance" shall include marijuana as defined by paragraph (16) of Code Section 16-13-21. (2) "Dangerous drug" shall have the same meaning as defined in Article 3 of this chapter, relating to dangerous drugs. (3) "Drug related object" means any machine, instrument, tool, equipment, contrivance, or device which an average person would reasonably conclude is intended to be used for one or more of the following purposes: (A) To introduce into the human body any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (B) To enhance the effect on the human body of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (C) To conceal any quantity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; or (D) To test the strength, effectiveness, or purity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state. (4) "Knowingly" means having general knowledge that a machine, instrument, tool, item of equipment, contrivance, or device is a drug related object or having reasonable grounds to believe that any such object is or may, to an average person, appear to be a drug related object.
    [Show full text]
  • Therapeutic Drug Monitoring of Antiepileptic Drugs by Use of Saliva
    REVIEW ARTICLE Therapeutic Drug Monitoring of Antiepileptic Drugs by Use of Saliva Philip N. Patsalos, FRCPath, PhD*† and Dave J. Berry, FRCPath, PhD† INTRODUCTION Abstract: Blood (serum/plasma) antiepileptic drug (AED) therapeu- Measuring antiepileptic drugs (AEDs) in serum or tic drug monitoring (TDM) has proven to be an invaluable surrogate plasma as an aid to personalizing drug therapy is now a well- marker for individualizing and optimizing the drug management of established practice in the treatment of epilepsy, and guidelines patients with epilepsy. Since 1989, there has been an exponential are published that indicate the particular features of epilepsy and increase in AEDs with 23 currently licensed for clinical use, and the properties of AEDs that make the practice so beneficial.1 recently, there has been renewed and extensive interest in the use of The goal of AED therapeutic drug monitoring (TDM) is to saliva as an alternative matrix for AED TDM. The advantages of saliva ’ fl optimize a patient s clinical outcome by supporting the man- include the fact that for many AEDs it re ects the free (pharmacolog- agement of their medication regimen with the assistance of ically active) concentration in serum; it is readily sampled, can be measured drug concentrations/levels. The reason why TDM sampled repetitively, and sampling is noninvasive; does not require the has emerged as an important adjunct to treatment with the expertise of a phlebotomist; and is preferred by many patients, AEDs arises from the fact that for an individual patient
    [Show full text]
  • Tetracaine and Oxymetazoline
    PATIENT & CAREGIVER EDUCATION Tetracaine and Oxymetazoline This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider. What is this drug used for? It is used before dental care to numb the area. What do I need to tell the doctor BEFORE my child takes this drug? If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had. If your child has thyroid disease, talk with the doctor. If your child has high blood pressure. If your child has methemoglobinemia. If your child is taking certain drugs used for depression like isocarboxazid, phenelzine, or tranylcypromine, or drugs used for certain other health problems like selegiline or rasagiline. If your child is taking or has recently taken any drugs for mental or mood problems like depression. There are many drugs that Tetracaine and Oxymetazoline 1/7 must not be taken with this drug. Talk with your child’s doctor if you are not sure. If your child is taking any of these drugs: Nadolol, penbutolol, pindolol, propranolol, sotalol, or timolol. If your child has used another drug in the last 24 hours that has the same drug in it. If your child is using another drug in the nose. If your child weighs less than 88 pounds (40 kilograms). This drug is not for use in children who weigh less than 88 pounds (40 kilograms).
    [Show full text]
  • New Drug Evaluation Monograph Template
    Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-947-5220 | Fax 503-947-1119 © Copyright 2012 Oregon State University. All Rights Reserved Month/Year of Review: January 2014 Date of Last Review: January 2012 PDL Classes: Beta Blockers Source Document: OSU College of Pharmacy Current Status of PDL Class: Preferred Agents: ACEBUTOLOL HCL, ATENOLOL, CARVEDILOL, LABETALOL HCL, METOPROLOL TARTRATE, NADOLOL, PROPRANOLOL HCL Non-Preferred Agents: BETAXOLOL, BISOPROLOL, METOPROLOL SUCCINATE, NEBIVOLOL (BYSTOLIC®), PENBUTOLOL (LEVABUTOL®), PINDOLOL, TIMOLOL Previous Conclusions and Recommendation: In patients with mild-moderate HF, bisoprolol, carvedilol or metoprolol succinate (ER) reduce mortality. In patients with severe HF, carvedilol or metoprolol succinate (ER) reduce mortality. In patients with recent MI, acebutolol, carvedilol, metoprolol tartrate (IR), propranolol, or timolol reduce mortality. It is important that at least one of these drugs be included in the PDL. All of the β-Blockers reviewed are effective in the treatment of hypertension, but there is no evidence of differences between β-blockers for blood pressure control, survival, or quality of life. All of the β-Blockers reviewed except carteolol reduced anginal attacks in patients in short-term studies that did not allow mortality evaluation. Because of their effectiveness in rate control for atrial fibrillation at least one of either atenolol, bisoprolol, carvedilol, metoprolol succinate (ER), nadolol, pindolol, or propranolol should be included in the PDL. The current evidence does not distinguish a difference among these beneficial β−Blockers that were tested for preventing recurrence and diminishing the severity of migraine headaches: atenolol, bisoprolol, metoprolol tartrate (IR), metoprolol succinate (ER), propranolol, propranolol LA nadolol, or timolol.
    [Show full text]
  • Pharmacy and Poisons Act 1979
    Q UO N T FA R U T A F E BERMUDA PHARMACY AND POISONS ACT 1979 1979 : 26 TABLE OF CONTENTS PART I PRELIMINARY 1 Short title 2 Interpretation PART II THE PHARMACY COUNCIL 3 The Pharmacy Council 4 Membership of the Council 4A Functions of the Council 4B Protection from personal liability 4C Annual Report 5 Proceedings of the Council, etc PART III REGISTRATION OF PHARMACISTS 6 Offence to practise pharmacy if not registered 7 Registration as a pharmacist 7A Re-registration as non-practising member 7AA Period of validity of registration 8 Code of Conduct 9 Pharmacy Profession Complaints Committee 10 Investigation of complaint by Committee 10A Inquiry into complaint by Council 10B Inquiry by Council of its own initiative 11 Surrender of registration 12 Restoration of name to register 1 PHARMACY AND POISONS ACT 1979 13 Proof of registration 14 Appeals 14A Fees 14B Amendment of Seventh Schedule 15 Regulations for this part PART IV REGISTRATION OF PHARMACIES 16 Register of pharmacies 17 Registration of premises as registered pharmacies 18 Unfit premises: new applications 19 Unfit premises: registered pharmacies 20 Appeals 21 When certificates of unfitness take effect 22 Regulations for this Part PART V CONTROL OF PRESCRIPTIONS AND IMPORTATION 23 Prescriptions to be in a certain form 23A Validity of a prescription 24 Supply by registered pharmacist of equivalent medicines 25 Restrictions on the importation of medicines 26 Declaration relating to imported medicines [repealed] PART VI CONTROL OF DRUGS 27 Certain substances to be sold on prescription
    [Show full text]