Antispasmodics (To Help with Muscle Spasms/Cramping) Antidiarrheals

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Antispasmodics (To Help with Muscle Spasms/Cramping) Antidiarrheals

Laxatives (to increase bowel function) Agent Examples of Brand Names Methylcellulose Citrucel Psyllium Metamucil, Konsyl Polycarbophil Fiberall, FiberCon, Equalactin Magnesium hydroxide Uromag, Milk of Magnesia Magnesium citrate Citroma Sodium phosphate Fleet Phospho Soda, K Phos Neutral Tablets Lactulose Enulose, Cephulac, Kristalose, Duphalac Polyethylene glycol MiraLax Sorbitol solution (70%) Cystosol, Minilax, Resulax, Sorbilax Cascara sagrada Nature's Remedy Tablets Senna Perdiem, Senokot Ricinoleic acid Castor oil Bisacodyl Dulcolax, Correctol Docusates Colace Mineral oil Fleet Mineral Oil Antispasmodics (to help with muscle spasms/cramping) Agents Examples of Brand Names Dicyclomine Bentyl, Bemote Hyoscyamine Levsin, NuLev, Levbid Propanthiline bromide Pro-Banthine Clinidium + chlordiazepoxide hydrochloride (Librium) Librax, Clindex Hyoscyamine + scopalamine, atropine, phenobarbital Donnatal Peppermint Oil Elanco (Enteric coated), Peppermint Spirits Antidiarrheals (to prevent or stop diarrhea) Agents Examples of Brand Names Diphenoxylate Lomotil, Lomocot Loperamide Immodium, PeptoDiarrhea Bile Acid Binder (Cholestyramine) Questran, Cholybar Antidepressants (used to help with pain) Agents Examples of Brand Names Desipramine Norpramin Amitriptyline Elavil Nortriptyline Pamelor Fluoxetine Prozac Citalopram Celexa Paroxetine Paxil Sertraline Zoloft Specific Serotonin Receptors Agents Examples of Brand Names Alosetron (Blocks a hormone involved in sensation Lotronex and movement of the intestines) Probiotics (contain good bacteria for the intestines) Found in: Bifidobacterium Align, Bifantis, Dannon’s Activia, other yogurts/supplements Lactobacillus Dannon’s DanActive, other yogourts or supplements Combination of 8 healthy bacteria VSL #3 Other Medications Agents Examples of Brand Names Activated charcoal (Absorbs gases/toxins, may Charco Caps, Charcoal Plus relieve stomach pain/cramping) Lubiprostone (Chloride channel activator; helps with Amitiza chronic idiopathic constipation) .

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Appendix a Common Abbreviations Used in Medication
UNIVERSITY OF AMSTERDAM MASTERS THESIS Impact of Medication Grouping on Fall Risk Prediction in Elders: A Retrospective Analysis of MIMIC-III Critical Care Database Student: SRP Mentor: Noman Dormosh Dr. Martijn C. Schut Student No. 11412682 – SRP Tutor: Prof. dr. Ameen Abu-Hanna SRP Address: Amsterdam University Medical Center - Location AMC Department Medical Informatics Meibergdreef 9, 1105 AZ Amsterdam Practice teaching period: November 2018 - June 2019 A thesis submitted in fulfillment of the requirements for the degree of Master of Medical Informatics iii Abstract Background: Falls are the leading cause of injury in elderly patients. Risk factors for falls in- cluding among others history of falls, old age, and female gender. Research studies have also linked certain medications with an increased risk of fall in what is called fall-risk-increasing drugs (FRIDs), such as psychotropics and cardiovascular drugs. However, there is a lack of consistency in the definitions of FRIDs between the studies and many studies did not use any systematic classification for medications. Objective: The aim of this study was to investigate the effect of grouping medications at different levels of granularity of a medication classification system on the performance of fall risk prediction models. Methods: This is a retrospective analysis of the MIMIC-III cohort database. We created seven prediction models including demographic, comorbidity and medication variables. Medica- tions were grouped using the anatomical therapeutic chemical classification system (ATC) starting from the most specific scope of medications and moving up to the more generic groups: one model used individual medications (ATC level 5), four models used medication grouping at levels one, two, three and four of the ATC and one model did not include med- ications.
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Table 2. 2012 AGS Beers Criteria for Potentially
Table 2. 2012 AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults Strength of Organ System/ Recommendat Quality of Recomm Therapeutic Category/Drug(s) Rationale ion Evidence endation References Anticholinergics (excludes TCAs) First-generation antihistamines Highly anticholinergic; Avoid Hydroxyzin Strong Agostini 2001 (as single agent or as part of clearance reduced with e and Boustani 2007 combination products) advanced age, and promethazi Guaiana 2010 Brompheniramine tolerance develops ne: high; Han 2001 Carbinoxamine when used as hypnotic; All others: Rudolph 2008 Chlorpheniramine increased risk of moderate Clemastine confusion, dry mouth, Cyproheptadine constipation, and other Dexbrompheniramine anticholinergic Dexchlorpheniramine effects/toxicity. Diphenhydramine (oral) Doxylamine Use of diphenhydramine in Hydroxyzine special situations such Promethazine as acute treatment of Triprolidine severe allergic reaction may be appropriate. Antiparkinson agents Not recommended for Avoid Moderate Strong Rudolph 2008 Benztropine (oral) prevention of Trihexyphenidyl extrapyramidal symptoms with antipsychotics; more effective agents available for treatment of Parkinson disease. Antispasmodics Highly anticholinergic, Avoid Moderate Strong Lechevallier- Belladonna alkaloids uncertain except in Michel 2005 Clidinium-chlordiazepoxide effectiveness. short-term Rudolph 2008 Dicyclomine palliative Hyoscyamine care to Propantheline decrease Scopolamine oral secretions. Antithrombotics Dipyridamole, oral short-acting* May
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Chlorthalidone Is Superior to Potassium Citrate in Reducing Calcium Phosphate Stones and Increasing Bone Quality in Hypercalciuric Stone-Forming Rats
BASIC RESEARCH www.jasn.org Chlorthalidone Is Superior to Potassium Citrate in Reducing Calcium Phosphate Stones and Increasing Bone Quality in Hypercalciuric Stone-Forming Rats Nancy S. Krieger,1 John R. Asplin,2 Ignacio Granja,2 Felix M. Ramos,1 Courtney Flotteron,1 Luojing Chen,1 Tong Tong Wu,3 Marc D. Grynpas,4 and David A. Bushinsky1 1Division of Nephrology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; 2Litholink Corporation, Laboratory Corporation of America Holdings, Chicago, Illinois; 3Department of Biostatistics and Computational Biology, University of Rochester School of Medicine, Rochester, New York; and 4Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada ABSTRACT Background The pathophysiology of genetic hypercalciuric stone-forming rats parallels that of human idiopathic hypercalciuria. In this model, all animals form calcium phosphate stones. We previously found that chlorthalidone, but not potassium citrate, decreased stone formation in these rats. Methods To test whether chlorthalidone and potassium citrate combined would reduce calcium phos- phate stone formation more than either medication alone, four groups of rats were fed a ﬁxed amount of a normal calcium and phosphorus diet, supplemented with potassium chloride (as control), potassium citrate, chlorthalidone (with potassium chloride to equalize potassium intake), or potassium citrate plus chlorthalidone. We measured urine every 6 weeks and assessed stone formation and bone quality at 18 weeks. Results Potassium citrate reduced urine calcium compared with controls, chlorthalidone reduced it fur- ther, and potassium citrate plus chlorthalidone reduced it even more. Chlorthalidone increased urine citrate and potassium citrate increased it even more; the combination did not increase it further.
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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.
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The Importance of Minerals in the Long Term Health of Humans Philip H
The Importance of Minerals in the Long Term Health of Humans Philip H. Merrell, PhD Technical Market Manager, Jost Chemical Co. Calcium 20 Ca 40.078 Copper 29 Cu 63.546 Iron Magnesium 26 12 Fe Mg 55.845 24.305 Manganese Zinc 25 30 Mn Zn 55.938 65.380 Table of Contents Introduction, Discussion and General Information ..................................1 Calcium ......................................................................................................3 Copper .......................................................................................................7 Iron ...........................................................................................................10 Magnesium ..............................................................................................13 Manganese ..............................................................................................16 Zinc ..........................................................................................................19 Introduction Daily intakes of several minerals are necessary for the continued basic functioning of the human body. The minerals, Calcium (Ca), Iron (Fe), Copper (Cu), Magnesium (Mg), Manganese (Mn), and Zinc (Zn) are known to be necessary for proper function and growth of the many systems in the human body and thus contribute to the overall health of the individual. There are several other trace minerals requirements. Minimum (and in some cases maximum) daily amounts for each of these minerals have been established by the Institute of
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Drugs to Avoid in Patients with Dementia
Detail-Document #240510 -This Detail-Document accompanies the related article published in- PHARMACIST’S LETTER / PRESCRIBER’S LETTER May 2008 ~ Volume 24 ~ Number 240510 Drugs To Avoid in Patients with Dementia Elderly people with dementia often tolerate drugs less favorably than healthy older adults. Reasons include increased sensitivity to certain side effects, difficulty with adhering to drug regimens, and decreased ability to recognize and report adverse events. Elderly adults with dementia are also more prone than healthy older persons to develop drug-induced cognitive impairment.1 Medications with strong anticholinergic (AC) side effects, such as sedating antihistamines, are well- known for causing acute cognitive impairment in people with dementia.1-3 Anticholinergic-like effects, such as urinary retention and dry mouth, have also been identified in drugs not typically associated with major AC side effects (e.g., narcotics, benzodiazepines).3 These drugs are also important causes of acute confusional states. Factors that may determine whether a patient will develop cognitive impairment when exposed to ACs include: 1) total AC load (determined by number of AC drugs and dose of agents utilized), 2) baseline cognitive function, and 3) individual patient pharmacodynamic and pharmacokinetic features (e.g., renal/hepatic function).1 Evidence suggests that impairment of cholinergic transmission plays a key role in the development of Alzheimer’s dementia. Thus, the development of the cholinesterase inhibitors (CIs). When used appropriately, the CIs (donepezil [Aricept], rivastigmine [Exelon], and galantamine [Razadyne, Reminyl in Canada]) may slow the decline of cognitive and functional impairment in people with dementia. In order to achieve maximum therapeutic effect, they ideally should not be used in combination with ACs, agents known to have an opposing mechanism of action.1,2 Roe et al studied AC use in 836 elderly patients.1 Use of ACs was found to be greater in patients with probable dementia than healthy older adults (33% vs.
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Some Drugs Are Excluded from Medicare Part D, but Are Covered by Your Medicaid Benefits Under the Healthpartners® MSHO Plan (HMO)
Some drugs are excluded from Medicare Part D, but are covered by your Medicaid benefits under the HealthPartners® MSHO Plan (HMO). These drugs include some over‐the‐counter (OTC) items, vitamins, and cough and cold medicines. If covered, these drugs will have no copay and will not count toward your total drug cost. For questions, please call Member Services at 952‐967‐7029 or 1‐888‐820‐4285. TTY members should call 952‐883‐6060 or 1‐800‐443‐0156. From October 1 through February 14, we take calls from 8 a.m. to 8 p.m., seven days a week. You’ll speak with a representative. From February 15 to September 30, call us 8 a.m. to 8 p.m. Monday through Friday to speak with a representative. On Saturdays, Sundays and holidays, you can leave a message and we’ll get back to you within one business day. Drug Description Strength 3 DAY VAGINAL 4% 5‐HYDROXYTRYPTOPHAN 50 MG ABSORBASE ACETAMINOPHEN 500 MG ACETAMINOPHEN 120MG ACETAMINOPHEN 325 MG ACETAMINOPHEN 650MG ACETAMINOPHEN 80 MG ACETAMINOPHEN 650 MG ACETAMINOPHEN 160 MG/5ML ACETAMINOPHEN 500 MG/5ML ACETAMINOPHEN 160 MG/5ML ACETAMINOPHEN 500MG/15ML ACETAMINOPHEN 100 MG/ML ACETAMINOPHEN 500 MG ACETAMINOPHEN 325 MG ACETAMINOPHEN 500 MG ACETAMINOPHEN 80 MG ACETAMINOPHEN 100.00% ACETAMINOPHEN 80 MG ACETAMINOPHEN 160 MG ACETAMINOPHEN 80MG/0.8ML ACETAMINOPHEN‐BUTALBITAL 50MG‐325MG ACNE CLEANSING PADS 2% ACNE TREATMENT,EXTRA STRENGTH 10% ACT ANTI‐CAVITY MOUTH RINSE 0.05% Updated 12/01/2012 ACTICAL ACTIDOSE‐AQUA 50G/240ML ACTIDOSE‐AQUA 15G/72ML ACTIDOSE‐AQUA 25G/120ML ACTIVATED CHARCOAL 25 G ADEKS 7.5 MG
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Nomination Background: Ketamine Hydrochloride (CASRN: 1867-66-9)
KETAMINE Nomination TABLE OF CONTENTS Page 1.0 BASIS OF NOMINATION 1 2.0 BACKGROUND INFORMATION 1 3.0 CHEMICAL PROPERTIES 2 3.1 Chemical Identification 2 3.2 Physico-Chemical Properties 3 3.3 Purity and Commercial Availability 4 4.0 PRODUCTION PROCESSES AND ANALYSIS 6 5.0 PRODUCTION AND IMPORT VOLUMES 7 6.0 USES 7 7.0 ENVIRONMENTAL OCCURRENCE 7 8.0 HUMAN EXPOSURE 7 9.0 REGULATORY STATUS 7 10.0 CLINICAL PHARMACOLOGY 7 11.0 TOXICOLOGICAL DATA 13 11.1 General Toxicology 13 11.2 Neurotoxicology 14 12.0 CONCLUSIONS 15 APPENDIX A 17 APPENDIX B 23 APPENDIX C 27 1 KETAMINE 1.0 BASIS OF NOMINATION Ketamine, a noncompetitive NMDA receptor blocker, has been used extensively off - label as a pediatric anesthetic for surgical procedures in infants and toddlers. Recently, Olney and coworkers have demonstrated severe widespread apoptotic degeneration throughout the rapidly developing brain of the 7-day-old rat after ketamine administration. Recent research at FDA has confirmed and extended Olney’s observations. These findings are cause for concern with respect to ketamine use in children. The issue of whether the neurotoxicity found in this animal model (rat) has scientific and regulatory relevance for the pediatric use of ketamine relies heavily upon confirmation of these findings that may be obtained from the conduct of an appropriate study in non-human primates. 2.0 BACKGROUND INFORMATION The issue of potential ketamine neurotoxicity in children surfaced as a result of FDA’s reluctance to approve an NIH pediatric clinical trial using this compound because of its documented neurotoxic effects in young rats (published in several papers over the last ten years by Olney and co-workers).
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The Anticholinergic Toxidrome
Poison HOTLINE Partnership between Iowa Health System and University of Iowa Hospitals and Clinics July 2011 The Anticholinergic Toxidrome A toxidrome is a group of symptoms associated with poisoning by a particular class of agents. One example is the opiate toxidrome, the triad of CNS depression, respiratory depression, and pinpoint pupils, and which usually responds to naloxone. The anticholinergic toxidrome is most frequently associated with overdoses of diphenhydramine, a very common OTC medication. However, many drugs and plants can produce the anticholinergic toxidrome. A partial list includes: tricyclic antidepressants (amitriptyline), older antihistamines (chlorpheniramine), Did you know …… phenothiazines (promethazine) and plants containing the anticholinergic alkaloids atropine, hyoscyamine and scopolamine (Jimson Weed). Each summer, the ISPCC receives approximately 10-20 The mnemonic used to help remember the symptoms and signs of this snake bite calls, some being toxidrome are derived from the Alice in Wonderland story: from poisonous snakes (both Blind as a Bat (mydriasis and inability to focus on near objects) local and exotic). Red as a Beet (flushed skin color) Four poisonous snakes can be Hot as Hades (elevated temperature) found in Iowa: the prairie These patients can sometimes die of agitation-induced hyperthermia. rattlesnake, the massasauga, Dry as a Bone (dry mouth and dry skin) the copperhead, and the Mad as a Hatter (hallucinations and delirium) timber rattlesnake. Each Bowel and bladder lose their tone (urinary retention and constipation) snake has specific territories Heart races on alone (tachycardia) within the state. ISPCC A patient who has ingested only an anticholinergic substance and is not specialists have access to tachycardic argues against a serious anticholinergic overdose.
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3 Drugs That May Cause Delirium Or Problem Behaviors CARD 03 19 12 JUSTIFIED.Pub
Drugs that May Cause Delirium or Problem Behaviors Drugs that May Cause Delirium or Problem Behaviors This reference card lists common and especially problemac drugs that may Ancholinergics—all drugs on this side of the card. May impair cognion cause delirium or contribute to problem behaviors in people with demena. and cause psychosis. Drugs available over‐the‐counter marked with * This does not always mean the drugs should not be used, and not all such drugs are listed. If a paent develops delirium or has new problem Tricyclic Andepressants Bladder Anspasmodics behaviors, a careful review of all medicaons is recommended. Amitriptyline – Elavil Darifenacin – Enablex Be especially mindful of new medicaons. Clomipramine – Anafranil Flavoxate – Urispas Desipramine – Norpramin Anconvulsants Psychiatric Oxybutynin – Ditropan Doxepin – Sinequan Solifenacin – VESIcare All can cause delirium, e.g. All psychiatric medicaons should be Imipramine – Tofranil Tolterodine – Detrol Carbamazepine – Tegretol reviewed as possible causes, as Nortriptyline – Aventyl, Pamelor Gabapenn – Neuronn eﬀects are unpredictable. Trospium – Sanctura Anhistamines / Allergy / Leveracetam – Keppra Notable oﬀenders include: Insomnia / Sleep Valproic acid – Depakote Benzodiazepines e.g. Cough & Cold Medicines *Diphenhydramine – Sominex, ‐Alprazolam – Xanax *Azelasne – Astepro Pain Tylenol‐PM, others ‐Clonazepam – Klonopin *Brompheniramine – Bromax, All opiates can cause delirium if dose *Doxylamine – Unisom, Medi‐Sleep ‐Lorazepam – Avan Bromfed, Lodrane is too high or
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Colonoscopy Instructions Using Miralax and Gatorade, with Magnesium Citrate
Procedure Locations: The Vancouver Clinic Ambulatory Surgery Center 700 NE 87th Ave Suite 320 Vancouver, WA 98664 Legacy Salmon Creek Hospital Patient Name:_________________________ 2211 NE 139th St. Vancouver, WA 98686 Appointment Date:_____________________ (2nd floor, Surgery Patient Check-in) Arrival Time:__________________________ Peacehealth SW Medical Center 400 NE Mother Joseph Place Provider:______________________________ Vancouver, WA 98664 (5th Street entrance, Short Stay Unit) Please call our office at (360) 397-3805 with any questions Colonoscopy instructions using Miralax and Gatorade, with magnesium citrate. Bowel preparation (cleansing) is needed to perform a high-quality colonoscopy. Any stool remaining in the colon can hide important findings and result in the need to repeat the procedure. It is critical that you follow the instructions as directed. It is important that you follow the prep instructions as below, and not those located on the prep kit packaging. Prior to and during the procedure you will receive sedation (unless you request otherwise) through and IV. The sedation interferes with forming memories, so most patients do not even remember the procedure. Your physician will discuss any findings of your procedure with you in the recovery room. If biopsies are taken or polyps removed, you will receive a letter or MyChart message in 2-3 weeks detailing the final results and recommendations. If your results require a change in your current treatment plan, you may receive a phone call from the office. We make every effort to keep your appointment at the scheduled time, however unexpected delays may occur and your wait time prolonged. Please note that you may be asked to come in earlier than your scheduled time to accommodate changes that occur in the schedule.
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Magnesium Citrate Preparation
Division of Gastroenterology COLONOSCOPY PREPARATION INSTRUCTIONS Magnesium Citrate Preparation WHAT IS A COLONOSCOPY? • Your physician has recommended that you have a colonoscopy. This test is a visual examination of the lining of the large intestine. During the test, a colonoscope, which is a long, flexible instrument that has a light and a camera at the tip, will be passed through the rectum and around the colon. Your doctor will view the colonoscopy on a television screen and look for any abnormalities that may be present. • Colonoscopy usually is performed to evaluate and treat colon cancer, polyps, gastrointestinal bleeding and diarrhea. If necessary, biopsies (tiny tissue samples) may be taken painlessly during the examination and sent for laboratory analysis. Polyps (abnormal growths of tissue) also may be removed and bleeding areas may be identified and treated. PREPARING FOR A COLONOSCOPY Food and Drink • In order for your doctor to perform an adequate and safe examination, the colon must be clear. You will be given a laxative solution to drink prior to the examination. Follow the instructions carefully. • You should be on a modified diet the entire day before your colonoscopy. You may continue to have clear fluids the day of your procedure, up to three (3) hours prior to your examination. A clear fluid diet includes jello, coffee (please do not add milk), tea (please do not add milk), soft drinks, ices, clear soups, sports drinks such as Gatorade or Powerade and apple or white grape juice. Please avoid red or purple drinks, jello or popsicles for the 24 hours prior to the examination.
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