Propranolol 10Mg, 40Mg, 80Mg and 160Mg Tablets
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Optum Essential Health Benefits Enhanced Formulary PDL January
PENICILLINS ketorolac tromethamineQL GENERIC mefenamic acid amoxicillin/clavulanate potassium nabumetone amoxicillin/clavulanate potassium ER naproxen January 2016 ampicillin naproxen sodium ampicillin sodium naproxen sodium CR ESSENTIAL HEALTH BENEFITS ampicillin-sulbactam naproxen sodium ER ENHANCED PREFERRED DRUG LIST nafcillin sodium naproxen DR The Optum Preferred Drug List is a guide identifying oxacillin sodium oxaprozin preferred brand-name medicines within select penicillin G potassium piroxicam therapeutic categories. The Preferred Drug List may piperacillin sodium/ tazobactam sulindac not include all drugs covered by your prescription sodium tolmetin sodium drug benefit. Generic medicines are available within many of the therapeutic categories listed, in addition piperacillin sodium/tazobactam Fenoprofen Calcium sodium to categories not listed, and should be considered Meclofenamate Sodium piperacillin/tazobactam as the first line of prescribing. Tolmetin Sodium Amoxicillin/Clavulanate Potassium LOW COST GENERIC PREFERRED For benefit coverage or restrictions please check indomethacin your benefit plan document(s). This listing is revised Augmentin meloxicam periodically as new drugs and new prescribing LOW COST GENERIC naproxen kit information becomes available. It is recommended amoxicillin that you bring this list of medications when you or a dicloxacillin sodium CARDIOVASCULAR covered family member sees a physician or other penicillin v potassium ACE-INHIBITORS healthcare provider. GENERIC QUINOLONES captopril ANTI-INFECTIVES -
Comparing the Effect of Venlafaxine and the Combination of Nortriptyline and Propranolol in the Prevention of Migraine
Comparing the Effect of Venlafaxine and the Combination of Nortriptyline and Propranolol in the Prevention of Migraine Arash Mosarrezaii1, Mohammad Reza Amiri Nikpour1, Ata Jabarzadeh2 1Department of Neurology, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran, 2Medical Student, Urmia University of Medical Sciences, Urmia, Iran Abstract Background: Migraine is a debilitating neurological condition, which can be categorized into episodic and chronic groups based on its clinical pattern. Avoiding the risk factors exacerbating migraine is not enough to reduce the frequency and severity of migraine headaches, and in the case of non-receiving proper drug treatment, episodic migraines have the potential to become chronic, which increases the risk of cardiovascular complications RESEARCH ARTICLE and leaves great impact on the quality of life of patients and increasing the health-care costs. The objective of this research was to compare the effects of venlafaxine (VFL) and nortriptyline and propranolol in preventing migraines. Methods: This research is an interventional study performed on 60 patients with migraine admitted to the neurological clinic. Patients were visited at 3 time intervals. In each stage, the variables of headache frequency, headache severity, nausea, vomiting, and drowsiness were recorded. Data were analyzed using SPSS 23 software. Results: VFL drug with a daily dose of 37.5 mg is not only more tolerable in the long term but also leaves better effect in reducing the frequency and severity of headaches compared to the combination of nortriptyline and propranolol. Conclusion: VFL is an appropriate, effective, and tolerable alternative to migraine treatment. Key words: Migraine, nortriptyline, propranolol, venlafaxine INTRODUCTION Patients with CM are less likely to have full-time job than patients with episodic type, and they are at risk of job igraine is known as a common incapacity, anxiety, chronic pain, and depression 2 times neurological disorder and causes more than patients with episodic migraine. -
Schizophrenia Care Guide
August 2015 CCHCS/DHCS Care Guide: Schizophrenia SUMMARY DECISION SUPPORT PATIENT EDUCATION/SELF MANAGEMENT GOALS ALERTS Minimize frequency and severity of psychotic episodes Suicidal ideation or gestures Encourage medication adherence Abnormal movements Manage medication side effects Delusions Monitor as clinically appropriate Neuroleptic Malignant Syndrome Danger to self or others DIAGNOSTIC CRITERIA/EVALUATION (PER DSM V) 1. Rule out delirium or other medical illnesses mimicking schizophrenia (see page 5), medications or drugs of abuse causing psychosis (see page 6), other mental illness causes of psychosis, e.g., Bipolar Mania or Depression, Major Depression, PTSD, borderline personality disorder (see page 4). Ideas in patients (even odd ideas) that we disagree with can be learned and are therefore not necessarily signs of schizophrenia. Schizophrenia is a world-wide phenomenon that can occur in cultures with widely differing ideas. 2. Diagnosis is made based on the following: (Criteria A and B must be met) A. Two of the following symptoms/signs must be present over much of at least one month (unless treated), with a significant impact on social or occupational functioning, over at least a 6-month period of time: Delusions, Hallucinations, Disorganized Speech, Negative symptoms (social withdrawal, poverty of thought, etc.), severely disorganized or catatonic behavior. B. At least one of the symptoms/signs should be Delusions, Hallucinations, or Disorganized Speech. TREATMENT OPTIONS MEDICATIONS Informed consent for psychotropic -
Selective Labeling of Serotonin Receptors Byd-[3H]Lysergic Acid
Proc. Nati. Acad. Sci. USA Vol. 75, No. 12, pp. 5783-5787, December 1978 Biochemistry Selective labeling of serotonin receptors by d-[3H]lysergic acid diethylamide in calf caudate (ergots/hallucinogens/tryptamines/norepinephrine/dopamine) PATRICIA M. WHITAKER AND PHILIP SEEMAN* Department of Pharmacology, University of Toronto, Toronto, Canada M5S 1A8 Communicated by Philip Siekevltz, August 18,1978 ABSTRACT Since it was known that d-lysergic acid di- The objective in this present study was to improve the se- ethylamide (LSD) affected catecholaminergic as well as sero- lectivity of [3H]LSD for serotonin receptors, concomitantly toninergic neurons, the objective in this study was to enhance using other drugs to block a-adrenergic and dopamine receptors the selectivity of [3HJISD binding to serotonin receptors in vitro by using crude homogenates of calf caudate. In the presence of (cf. refs. 36-38). We then compared the potencies of various a combination of 50 nM each of phentolamine (adde to pre- drugs on this selective [3H]LSD binding and compared these clude the binding of [3HJLSD to a-adrenoceptors), apmo ie, data to those for the high-affinity binding of [3H]serotonin and spiperone (added to preclude the binding of [3H[LSD to (39). dopamine receptors), it was found by Scatchard analysis that the total number of 3H sites went down to 300 fmol/mg, compared to 1100 fmol/mg in the absence of the catechol- METHODS amine-blocking drugs. The IC50 values (concentrations to inhibit Preparation of Membranes. Calf brains were obtained fresh binding by 50%) for various drugs were tested on the binding of [3HLSD in the presence of 50 nM each of apomorphine (A), from the Canada Packers Hunisett plant (Toronto). -
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role of CALCIUM CHANNEL BLOCKERS in HYPERTENSION KEY POINTS ThIAZIDES ARE APPROPRIATE INITIAL THERAPY FOR MOST PEOPLE WITH HYPERTENSION Thiazides are appropriate initial therapy for most ▪ There is limited evidence of superiority of one antihypertensive people with hypertension. over another but evidence suggests that for most patients, ▪ Choice of other antihypertensives is decided by diuretics can be considered first, based on their effectiveness, individual patient factors. safety and low cost. ▪ Factors which potentially favour use of calcium channel blockers include arrhythmia (verapamil CHOICE OF ADDITIONAL ANTIHYPERTENSIVES only), angina, older age and high risk of stroke. IS DECIDED BY INDIVIDUAL PATIENT FACTORS ▪ Factors which may weigh against the use of Other agents may be chosen for individual patients based calcium channel blockers include potential drug on concurrent medical conditions, patient tolerability and interactions, and diltiazem and verapamil are drug interactions. Indications for treatment with different contraindicated in heart block and heart failure. antihypertensive agents are discussed in BPJ 6 (June 2007). ▪ Choice between the different calcium channel blockers depends on patient tolerability, co- morbidity and drug interactions. FACTORS FOR AND AGAINST THE USE OF CALCIUM chANNEL BLOCKERS Factors that potentially favour the use of calcium channel Factors favouring use of calcium channel blockers include arrhythmia (verapamil only), angina, or high blockers: risk of stroke. Verapamil can also be used post myocardial infarction if beta blockers are contraindicated or not tolerated. ▪ Hypertension with co-morbid angina In addition, calcium channel blockers may be more suitable than other agents for elderly people and those of African ▪ Hypertension with co-morbid arrhythmia 1 (verapamil only) descent. -
Alcoholism Pharmacotherapy
101 ALCOHOLISM PHARMACOTHERAPY JOSEPH R. VOLPICELLI SUCHITRA KRISHNAN-SARIN STEPHANIE S. O’MALLEY Alcoholism remains one of the most common and signifi- PHARMACOLOGIC TREATMENTS FOR cant medical problems in the United States and internation- ALCOHOL DETOXIFICATION ally. For example, in the United States, over 4% of the general population is alcohol dependent and another 5 to The first step in the pharmacologic treatment of alcoholism 10 million people drink hazardously at least several times is to help patients safely detoxify from alcohol. Although per month (1). The economic and medical costs of alcohol- historically, alcohol detoxification has occurred in inpatient ism and alcohol abuse continue to escalate. Most recent setting, increasingly alcohol detoxification is being con- figures put the economic costs of alcohol-related expenses ducted in ambulatory settings. Except in the case of medical at $176 billion annually in the United States (2). This in- or psychiatric emergencies, outcome studies generally show cludes the economic costs of increased health care expenses, that successful detoxification can safely and effectively be lost productivity at work, and legal expenses. Similarly, al- carried out in ambulatory setting using medications such though there have been some reductions in the number of as benzodiazepines (5,6). In addition, the use of anticonvul motor vehicle deaths attributed to excessive alcohol drink- sants has received recent interest. ing, the overall number of alcohol-related annual deaths is 105,000 in the United States (3). Benzodiazepines Current psychosocial approaches to alcohol addiction are moderately effective, with perhaps as many as half the pa- Benzodiazepines are �-aminobutyric acid (GABA) agonists tients receiving treatment becoming abstinent or signifi- that metaanalysis of placebo-controlled double-blind studies cantly reducing episodes of binge drinking (4). -
Antiparasitic Properties of Cardiovascular Agents Against Human Intravascular Parasite Schistosoma Mansoni
pharmaceuticals Article Antiparasitic Properties of Cardiovascular Agents against Human Intravascular Parasite Schistosoma mansoni Raquel Porto 1, Ana C. Mengarda 1, Rayssa A. Cajas 1, Maria C. Salvadori 2 , Fernanda S. Teixeira 2 , Daniel D. R. Arcanjo 3 , Abolghasem Siyadatpanah 4, Maria de Lourdes Pereira 5 , Polrat Wilairatana 6,* and Josué de Moraes 1,* 1 Research Center for Neglected Diseases, Guarulhos University, Praça Tereza Cristina 229, São Paulo 07023-070, SP, Brazil; [email protected] (R.P.); [email protected] (A.C.M.); [email protected] (R.A.C.) 2 Institute of Physics, University of São Paulo, São Paulo 05508-060, SP, Brazil; [email protected] (M.C.S.); [email protected] (F.S.T.) 3 Department of Biophysics and Physiology, Federal University of Piaui, Teresina 64049-550, PI, Brazil; [email protected] 4 Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand 9717853577, Iran; [email protected] 5 CICECO-Aveiro Institute of Materials & Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; [email protected] 6 Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand * Correspondence: [email protected] (P.W.); [email protected] (J.d.M.) Citation: Porto, R.; Mengarda, A.C.; Abstract: The intravascular parasitic worm Schistosoma mansoni is a causative agent of schistosomiasis, Cajas, R.A.; Salvadori, M.C.; Teixeira, a disease of great global public health significance. Praziquantel is the only drug available to F.S.; Arcanjo, D.D.R.; Siyadatpanah, treat schistosomiasis and there is an urgent demand for new anthelmintic agents. -
Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss
Supplemental Material can be found at: /content/suppl/2020/12/18/73.1.202.DC1.html 1521-0081/73/1/202–277$35.00 https://doi.org/10.1124/pharmrev.120.000056 PHARMACOLOGICAL REVIEWS Pharmacol Rev 73:202–277, January 2021 Copyright © 2020 by The Author(s) This is an open access article distributed under the CC BY-NC Attribution 4.0 International license. ASSOCIATE EDITOR: MICHAEL NADER Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss Antonio Inserra, Danilo De Gregorio, and Gabriella Gobbi Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada Abstract ...................................................................................205 Significance Statement. ..................................................................205 I. Introduction . ..............................................................................205 A. Review Outline ........................................................................205 B. Psychiatric Disorders and the Need for Novel Pharmacotherapies .......................206 C. Psychedelic Compounds as Novel Therapeutics in Psychiatry: Overview and Comparison with Current Available Treatments . .....................................206 D. Classical or Serotonergic Psychedelics versus Nonclassical Psychedelics: Definition ......208 Downloaded from E. Dissociative Anesthetics................................................................209 F. Empathogens-Entactogens . ............................................................209 -
Guideline- Management of Migraine and Cluster Headache
Hull & East Riding Prescribing Committee Guideline- Management of Migraine and Cluster Headache 1. BACKGROUND Headache is a common neurological condition which accounts for 4.4% of primary care consultations and 30% of neurology appointments. Primary headache disorders include migraine, tension-type and cluster headache. Twice as many women as men are affected by headache disorder. This is thought to be due to changes in hormone levels during the menstrual cycle, which can be more pronounced at puberty and menopause. Recommendations within this guideline are based on best evidence and national/international guidelines. They are followed by consultants and specialist nurses working within the neurology department. Some recommendations may be for medicines prescribed outside their product license i.e. off label. It is noted in the guideline when the medicine is off label and relevant guidelines should be followed when prescribing medicines off label. A number of British Association for the Study of Headache (BASH) leaflets have been linked in this guidance; these can be given to patients and cover the off license use of medicines and information about duration of prophylactic treatments. The colours on the drug names in this guidance refer to the classification in the joint formulary i.e. Red – specialist prescriber only Amber – prescribed in accordance with approved shared care framework Blue - Guideline Led prescribed on advice of specialist or in line with national / local guideline Green – other items listed on formulary suitable for initiation and prescribing by any prescriber If printed in black and white please refer to joint formulary for classification of medicines. Migraine Migraine is often underdiagnosed, misdiagnosed and undertreated. -
Migraine Headache Prophylaxis Hien Ha, Pharmd, and Annika Gonzalez, MD, Christus Santa Rosa Family Medicine Residency Program, San Antonio, Texas
Migraine Headache Prophylaxis Hien Ha, PharmD, and Annika Gonzalez, MD, Christus Santa Rosa Family Medicine Residency Program, San Antonio, Texas Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and headache-related distress. Preventive therapy may also improve quality of life and prevent the progression to chronic migraines. Some indications for preventive therapy include four or more headaches a month, eight or more headache days a month, debilitating headaches, and medication- overuse headaches. Identifying and managing environmental, dietary, and behavioral triggers are useful strategies for preventing migraines. First-line med- ications established as effective based on clinical evidence include divalproex, topiramate, metoprolol, propranolol, and timolol. Medications such as ami- triptyline, venlafaxine, atenolol, and nadolol are probably effective but should be second-line therapy. There is limited evidence for nebivolol, bisoprolol, pindolol, carbamazepine, gabapentin, fluoxetine, nicardipine, verapamil, nimodipine, nifedipine, lisinopril, and candesartan. Acebutolol, oxcarbazepine, lamotrigine, and telmisartan are ineffective. Newer agents target calcitonin gene-related peptide pain transmission in the migraine pain pathway and have recently received approval from the U.S. Food and Drug Administration; how- ever, more studies of long-term effectiveness and adverse effects are needed. The complementary treatments petasites, feverfew, magnesium, and riboflavin are probably effective. Nonpharmacologic therapies such as relaxation training, thermal biofeedback combined with relaxation training, electromyographic feedback, and cognitive behavior therapy also have good evidence to support their use in migraine prevention. (Am Fam Physician. 2019; 99(1):17-24. -
DBL™ Promethazine Hydrochloride Injection BP
DBL™ Promethazine Hydrochloride Injection BP 1. NAME OF THE MEDICINE Promethazine hydrochloride 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each mL of the solution contains 25.0 mg promethazine hydrochloride, 0.10 mg disodium edetate, 1.30 microlitre glacial acetic acid, 27.2 mg sodium acetate and 1.32 mg sodium metabisulfite in water for injections. Excipient(s) with known effect Sodium metabisulfite For the full list of excipients, see section 6.1 List of Excipients. 3. PHARMACEUTICAL FORM Solution for injection. DBL™ Promethazine Hydrochloride Injection BP is a clear, colourless solution of pH 5.0 to 6.0. 4. CLINICAL PARTICULARS 4.1 Therapeutic Indications DBL™ Promethazine Hydrochloride Injection BP is indicated for the following conditions: Treatment of allergic reactions such as: uncomplicated allergic conditions of the immediate type, e.g., pruritus, urticaria and angioedema, when oral therapy is impossible or contraindicated. Treatment and prevention of vomiting including: motion sickness; drug induced nausea; prevention and control of nausea and vomiting associated with certain types of anaesthesia and surgery, such as procedures with a high incidence of post-operative vomiting (e.g., gynaecological surgery, strabismus or middle ear surgery, and electroconvulsive therapy); in patients with a past history of motion sickness or post- operative vomiting; and in patients in whom avoidance of vomiting is crucial (e.g., neurosurgery and eye surgery). Page 1 of 10 Promethazine has sedative effects and it is also used in: pre-operative, post-operative and obstetric (during labour) sedation. 4.2 Dose and Method of Administration Dosage Allergic conditions Adults: 25 mg to 50 mg by deep intramuscular injection or slow intravenous injection; may be repeated within two hours if necessary. -
Effect of Amitriptyline Antidotes on Repetitive Extrasystole Threshold
Effect of amitriptyline antidotes on repetitive extrasystole threshold The effect ofamitriptyline that leads to ventricular tachycardia was evaluated hy the repetitive extrasystole threshold (RET) technique in 18 dogs. The RET was 28.8 ± 7.9 mamp before and 8.2 ± 5.3 mamp after amitriptyline. p < 0.001. Physostigmine. propranolol. sodium bicarbonate, and left stellate ganglionectomy reversed the effect of amitriptyline on RET. We conclude that amitriptyline overdose predisposes to sudden death by lowering the ventricular fibrillation threshold. This cardiotoxic effect is mediated partly through the central nervous system and can be inhibited by increased plasma binding (bicarbonate), cholinergic stimulation (physostigmine), beta adrenergic blockade (propranolol), and sympathetic denervation (left stellate ganglionectomy). Jonathan M. Tobis, M.D., and Wilbert S. Aronow, M.D. Irvine, Calif. Cardiology Section and Medical Service, University of California, Irvine, and Long Beach Veterans Administration Medical Center The mechanism of tricylic antidepressant ac tyline on the repetinve extrasystole threshold tion is not established. The cardiotoxic proper (RET), Matta et al." have shown that the RET ties have been established.?- II, 14 The most was a good marker of the ventricular fibrillation common serious clinical arrhythmia is ventricu threshold in 91% of the animals they studied. A lar tachycardia." Several antidotes have been single repetitive extrasystole occurred when reported as successful in reversing the central 66% of the fibrillation current was delivered, nervous system and cardiac manifestations oftri and repeated extrasystoles were induced at 82% cyclic antidepressant overdose, i.e., physo of the fibrillation current. stigmine, propranolol, and sodium bicarbon We then explored the effect of several poten ate,3-5, 10.