Drugs Contraindicated in Pregnancy
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Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications
International Journal of Molecular Sciences Review Folic Acid Antagonists: Antimicrobial and Immunomodulating Mechanisms and Applications Daniel Fernández-Villa 1, Maria Rosa Aguilar 1,2 and Luis Rojo 1,2,* 1 Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; [email protected] (D.F.-V.); [email protected] (M.R.A.) 2 Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, 28029 Madrid, Spain * Correspondence: [email protected]; Tel.: +34-915-622-900 Received: 18 September 2019; Accepted: 7 October 2019; Published: 9 October 2019 Abstract: Bacterial, protozoan and other microbial infections share an accelerated metabolic rate. In order to ensure a proper functioning of cell replication and proteins and nucleic acids synthesis processes, folate metabolism rate is also increased in these cases. For this reason, folic acid antagonists have been used since their discovery to treat different kinds of microbial infections, taking advantage of this metabolic difference when compared with human cells. However, resistances to these compounds have emerged since then and only combined therapies are currently used in clinic. In addition, some of these compounds have been found to have an immunomodulatory behavior that allows clinicians using them as anti-inflammatory or immunosuppressive drugs. Therefore, the aim of this review is to provide an updated state-of-the-art on the use of antifolates as antibacterial and immunomodulating agents in the clinical setting, as well as to present their action mechanisms and currently investigated biomedical applications. Keywords: folic acid antagonists; antifolates; antibiotics; antibacterials; immunomodulation; sulfonamides; antimalarial 1. -
Prevention and Management of Intravesical BCG-Related Lower Urinary Tract Symptoms with Prophylactic Pentosan Polysulphate In
Prevention and Management of Intravesical BCG-related Lower Urinary Tract Symptoms with Prophylactic Pentosan Polysulphate in Patients with Non-Muscle-Invasive Bladder Cancer: A Randomized Controlled Trial Samer Shamout, Simon Tanguay, Maurice Anidjar, Lysanne Campeau CQI Research Grant 2017 INTRODUCTION METHODS / INTERVENTIONS PATIENT IMPACT Study Design • Bacillus Calmette-Guerin (BCG) remains the most effective • Phase 2, double-blind, randomized, placebo-controlled, parallel-group • Improve patient experience by identifying predictor markers prophylactic treatment of intermediate and high-risk non- study rendering patients at higher risk of developing BCG-related muscle invasive bladder cancer. • Multicentre trial involving two partner sites: (Jewish General Hospital, LUTS. McGill University Health Centre) • 30 to 60% of bladder cancer patients experienced systemic • This will guide patient counselling before treatment to inform Outcomes them about associated risks and benefits of the BCG and local adverse events of variable severity following Primary outcomes (change from baseline to end of treatment): treatment. intravesical BCG therapy • Mean change in number of urgency episodes/24hr (3-day bladder diary) • Only 16 to 29% of patients completed all the three-year BCG • Mean change in ICIQ-LUTSqol score • We will determine the role of prophylactic PPS to prevent these treatment regimen. • Mean change in OAB-V8 score LUTS from occurring, particularly if patients are considered at Secondary outcomes (change from baseline to end of treatment): higher risk, and therefore improve patient experience. • Guidelines recommend medications, such as oxybutynin • Mean change in VAS score only phenazopyridine, and propantheline bromide for short term • Mean change in urinary inflammatory markers (TRAIL, IFN, IL-2, IL-10) • The improvement measurements are validated in the symptomatic relief. -
CASODEX (Bicalutamide)
HIGHLIGHTS OF PRESCRIBING INFORMATION • Gynecomastia and breast pain have been reported during treatment with These highlights do not include all the information needed to use CASODEX 150 mg when used as a single agent. (5.3) CASODEX® safely and effectively. See full prescribing information for • CASODEX is used in combination with an LHRH agonist. LHRH CASODEX. agonists have been shown to cause a reduction in glucose tolerance in CASODEX® (bicalutamide) tablet, for oral use males. Consideration should be given to monitoring blood glucose in Initial U.S. Approval: 1995 patients receiving CASODEX in combination with LHRH agonists. (5.4) -------------------------- RECENT MAJOR CHANGES -------------------------- • Monitoring Prostate Specific Antigen (PSA) is recommended. Evaluate Warnings and Precautions (5.2) 10/2017 for clinical progression if PSA increases. (5.5) --------------------------- INDICATIONS AND USAGE -------------------------- ------------------------------ ADVERSE REACTIONS ----------------------------- • CASODEX 50 mg is an androgen receptor inhibitor indicated for use in Adverse reactions that occurred in more than 10% of patients receiving combination therapy with a luteinizing hormone-releasing hormone CASODEX plus an LHRH-A were: hot flashes, pain (including general, back, (LHRH) analog for the treatment of Stage D2 metastatic carcinoma of pelvic and abdominal), asthenia, constipation, infection, nausea, peripheral the prostate. (1) edema, dyspnea, diarrhea, hematuria, nocturia, and anemia. (6.1) • CASODEX 150 mg daily is not approved for use alone or with other treatments. (1) To report SUSPECTED ADVERSE REACTIONS, contact AstraZeneca Pharmaceuticals LP at 1-800-236-9933 or FDA at 1-800-FDA-1088 or ---------------------- DOSAGE AND ADMINISTRATION ---------------------- www.fda.gov/medwatch The recommended dose for CASODEX therapy in combination with an LHRH analog is one 50 mg tablet once daily (morning or evening). -
Pyrimethamine
Canterbury District Health Board Neonatal Services PYRIMETHAMINE Trade Name Daraprim (GlaxoSmithKlyne) Class Antiparasitic/antimalarial agent Mechanism of Action Inhibits parasitic dihydrofolate reductase resulting in inhibition of tetrahydrofolic acid synthesis Indications Congenital toxoplasmosis (Used in combination with sulfadiazine) Contraindications Known megaloblastic anaemia Supplied As Pyrimethamine suspension 1mg/mL (prepared by pharmacy) Dilution None required Dosage 1mg/kg/dose If the patient has difficulty tolerating pyrimathamine give each dose with a feed to reduce the incidence of vomiting Interval Once daily for the first 6 months, then Three times a week for the second 6 months Administration Oral Compatible With N/A Incompatible With N/A Interactions Pyrimethamine reduces the anti-epileptic effect of phenytoin Antifolate effects are increased when pyrimethamine is given in combination with sulphonamides, trimethoprim, zidovudine or methotrexate. Folic Acid may reduce the anti-parasitic effect of pyrimethamine and also increase the risk of pyrimethamine induced bone marrow suppression , for these reasons folinic acid is used to counteract the antifolate effect of pyrimethamine. Avoid brands of sunblock that contain PABA as this may reduce the effectiveness of sulfadiazine. Monitoring Full blood count Stability 30 days at 2 – 8 oC Storage In the fridge Adverse Reactions Skin rash (including Stevens Johnson Syndrome), nausea, vomiting, diarrhoea, blood dyscrasias, raised AST, sensory neuropathy Metabolism 15-40% metabolised by liver, approx 60% of dose excreted as Pyrimethamine Printed copies are not controlled and may not be the current version in use Ref.236799 Authorised by: Clinical Director Neonatal Page 1 of 2 March 2016 Canterbury District Health Board Neonatal Services unchanged drug by kidneys. -
Information for the User ZYTIGA 500 Mg Film-Coated Tablets Abiraterone
Package leaflet: Information for the user ZYTIGA 500 mg film-coated tablets abiraterone acetate Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or pharmacist. - This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours. - If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4. What is in this leaflet: 1. What ZYTIGA is and what it is used for 2. What you need to know before you take ZYTIGA 3. How to take ZYTIGA 4. Possible side effects 5. How to store ZYTIGA 6. Contents of the pack and other information 1. What ZYTIGA is and what it is used for ZYTIGA contains a medicine called abiraterone acetate. It is used to treat prostate cancer in adult men that has spread to other parts of the body. ZYTIGA stops your body from making testosterone; this can slow the growth of prostate cancer. When ZYTIGA is prescribed for the early stage of disease where it is still responding to hormone therapy, it is used with a treatment that lowers testosterone (androgen deprivation therapy ). When you take this medicine your doctor will also prescribe another medicine called prednisone or prednisolone. This is to lower your chances of getting high blood pressure, having too much water in your body (fluid retention), or having reduced levels of a chemical known as potassium in your blood. -
2021 National Formulary 3Rd Quarter Edition
2021 National Formulary 3rd Quarter Edition Last Revised: 08/18/2021 Version 2021Q3c Table of Contents OVERVIEW 4 CARDIOVASCULAR (HEART) DRUGS 14 Alpha & Beta Blockers 14 COVERAGE LIMITATION 4 Antihypertensive Combinations 14 Calcium Channel Blockers (CCBs) 14 COMPOUNDED DRUGS 4 ACE Inhibitors without & with Diuretics 15 DRUG PLACEMENT DETERMINATION 4 ACE Inhibitors / CCB Combinations 15 ARBs without & with Diuretics 15 PREFERRED BRAND PRODUCTS 5 ARB Combinations 15 Naprilysin Inhibitors 15 GENERIC SUBSTITUTION 5 Diuretics 15 Renin Inhibtors 16 SINGLE & DUAL SOURCE GENERICS 5 Antiarrhythmics/Anti-Ischemic 16 Cardiac Glycosides 16 PRIOR AUTHORIZATIONS, STEP EDITS & QTY LIMITS 6 Vasodilators, Coronary, Nitrates/Vasodilators, Sympatholytics 16 EXCLUDED DRUGS 6 Other Drugs 16 NON-LISTED DRUGS & DRUG CATEGORIES 7 ANTIHYPERLIPIDEMIC (CHOLESTEROL) DRUGS 17 Statins & Statin/CCB Combinations 17 FORMULARY MODIFICATIONS & CHANGES 7 Bile Acid Sequestrants, Liver Drugs 17 Fibrates 17 BIOSIMILARS 7 ACL Inhibitors 17 Other Drugs 17 MAJOR CHANGES TO THE PDL 7 PANCREATIC DRUGS 18 ANTIBIOTICS 8 Penicillins & Cephalosporins 8 KIDNEY & URINARY / UROLOGICAL DRUGS 18 Tetracyclines 8 Benign Prostate Hyperplasia 18 Macrolides & Clindamycins 8 Urologic Drugs / Other Drugs 18 Sulfonamides, Sulfones & Ketolides 8 Erectile Dysfunction Drugs 18 Quinolones 8 Gout Drugs – Purine Inhibitors 19 Miscellaneous Antibiotics 8 Urinary Ph Modifiers 19 Potassium & Electrolytes 19 ANTI-VIRALS 9 Phosphorus/Calcium/Electrolyte Depleters 19 General Antivirals 9 HIV Antiviral Drugs 9 OSTEOPOROSIS (BONE) DRUGS 20 HIV Pre-Exposure Propylaxis Drugs 9 ANTI-INFLAMMATORY / ANALGESIC (PAIN) DRUGS 20 ANTI-INFECTIVES 10 Anti-Inflammatory Drugs (NSAIDS) 20 Anaerobic Anti-Infectives 10 COX-II Drugs 21 Antiparasitics 10 Analgesics, Narcotics (Opioids) 21 Antimalarials & Antiprotozoals 10 Analgesics, Salicylates, Non-Salicylates, Other 21 Antihelmintic Drugs 10 CENTRAL NERVOUS SYSTEM DRUGS 22 ANTIEMETICS 10 Anti-Anxiety Drugs (Benzodiazepines) 22 Sedative/Sleeping Drugs 22 NEUROLOGIC DRUGS 11 A.D.D. -
COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone During SARS-Cov-2 Infection
pharmaceuticals Review COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone during SARS-CoV-2 Infection Katarzyna Kotfis 1,* , Kacper Lechowicz 1 , Sylwester Drozd˙ zal˙ 2 , Paulina Nied´zwiedzka-Rystwej 3 , Tomasz K. Wojdacz 4, Ewelina Grywalska 5 , Jowita Biernawska 6, Magda Wi´sniewska 7 and Miłosz Parczewski 8 1 Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; [email protected] 2 Department of Pharmacokinetics and Monitored Therapy, Pomeranian Medical University, 70-111 Szczecin, Poland; [email protected] 3 Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland; [email protected] 4 Independent Clinical Epigenetics Laboratory, Pomeranian Medical University, 71-252 Szczecin, Poland; [email protected] 5 Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland; [email protected] 6 Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland; [email protected] 7 Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; [email protected] 8 Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, 71-455 Szczecin, Poland; [email protected] * Correspondence: katarzyna.kotfi[email protected]; Tel.: +48-91-466-11-44 Abstract: In March 2020, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was declared Citation: Kotfis, K.; Lechowicz, K.; a global pandemic by the World Health Organization (WHO). The clinical course of the disease is Drozd˙ zal,˙ S.; Nied´zwiedzka-Rystwej, unpredictable but may lead to severe acute respiratory infection (SARI) and pneumonia leading to P.; Wojdacz, T.K.; Grywalska, E.; acute respiratory distress syndrome (ARDS). -
Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals
Journal of Clinical Medicine Review Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals Carlotta Cocchetti 1, Jiska Ristori 1, Alessia Romani 1, Mario Maggi 2 and Alessandra Daphne Fisher 1,* 1 Andrology, Women’s Endocrinology and Gender Incongruence Unit, Florence University Hospital, 50139 Florence, Italy; [email protected] (C.C); jiska.ristori@unifi.it (J.R.); [email protected] (A.R.) 2 Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, 50139 Florence, Italy; [email protected]fi.it * Correspondence: fi[email protected] Received: 16 April 2020; Accepted: 18 May 2020; Published: 26 May 2020 Abstract: Introduction: To date no standardized hormonal treatment protocols for non-binary transgender individuals have been described in the literature and there is a lack of data regarding their efficacy and safety. Objectives: To suggest possible treatment strategies for non-binary transgender individuals with non-standardized requests and to emphasize the importance of a personalized clinical approach. Methods: A narrative review of pertinent literature on gender-affirming hormonal treatment in transgender persons was performed using PubMed. Results: New hormonal treatment regimens outside those reported in current guidelines should be considered for non-binary transgender individuals, in order to improve psychological well-being and quality of life. In the present review we suggested the use of hormonal and non-hormonal compounds, which—based on their mechanism of action—could be used in these cases depending on clients’ requests. Conclusion: Requests for an individualized hormonal treatment in non-binary transgender individuals represent a future challenge for professionals managing transgender health care. For each case, clinicians should balance the benefits and risks of a personalized non-standardized treatment, actively involving the person in decisions regarding hormonal treatment. -
Abiraterone Acetate for Chemotherapy-Naive
Fan et al. BMC Urology (2018) 18:110 https://doi.org/10.1186/s12894-018-0416-6 RESEARCHARTICLE Open Access Abiraterone acetate for chemotherapy- naive metastatic castration-resistant prostate cancer: a single-centre prospective study of efficacy, safety, and prognostic factors Liancheng Fan†, Baijun Dong†, Chenfei Chi†, Yanqing Wang†, Yiming Gong†, Jianjun Sha, Jiahua Pan, Xun Shangguan, Yiran Huang, Lixin Zhou* and Wei Xue* Abstract Background: To evaluate the efficacy and safety of abiraterone acetate (AA) plus prednisone compared with prednisone alone in Asian patients with chemotherapy-naive metastatic castration-resistant prostate cancer (mCRPC), and to identify predictive factors. Methods: We reviewed the medical records of 60 patients with chemotherapy-naive mCRPC at Renji Hospital who were treated with AA plus prednisone (n = 43) or prednisone alone (n = 17). All patients were assessed for prostate- specific antigen (PSA) response, PSA progression-free survival (PSA PFS), radiographic progression-free survival (rPFS), and overall survival (OS). The ability of several parameters to predict PSA PFS, rPFS, and OS was studied. Results: The median follow-up time was 14.0 months (range 7.0–18.5 months), at which time 19 death events had been reported: 11 in the AA + prednisone group and 8 in the prednisone group. The AA + prednisone group had significantly longer median PSA PFS (10.3 vs 3.0 months, P < 0.001), rPFS (13.9 vs 3.9 months, P < 0.001), and OS (23. 3 vs 17.5 months, P = 0.016) than the prednisone-alone group. The most frequently reported grade 3 or 4 adverse event in both the AA + prednisone and prednisone-alone groups was elevated alanine aminotransferase level in 5 of 43 patients (11.6%) and 2 of 17 patients (11.8%), respectively. -
Dentistry and Basic Non- Opioid Prescribing in Pain Dmitry M
Dentistry and Basic Non- Opioid Prescribing in Pain Dmitry M. Arbuck, MD President, Indiana Polyclinic Clinical Associate Professor of Psychiatry and Pain Management, Marian University College of Osteopathic Medicine Clinical Assistant Professor of Psychiatry and Medicine, IU School of Medicine www.IndianaPolyclinic.com Version May 2020 1 Disclosures No disclosures currently (May 7, 2020) 2 Disclaimer ISDH Oral Health Program Disclaimer for courses or presentations: The information provided in this course or presentation does not, and is not intended to, constitute dental, medical, or legal advice; instead, all information, content, and materials available in this course or presentation are for general informational purposes only. You should contact an outside dentist, physician, or attorney to obtain dental, medical, or legal advice and prior to acting, or refraining from acting, on the basis of information contained in this course or presentation. All liability with respect to actions taken or not taken based on the contents of this course or presentation are hereby expressly disclaimed. 3 Goals of Pain Management • Decrease pain • Increase function • Utilize medications that limit unacceptable side effects, including addiction 4 Goals of This Presentation • Gain knowledge of appropriate use of NSAIDs and acetaminophen for pain management in dentistry • Improve insight into benefits and adverse effects of various NSAIDs • Learn appropriate alternatives to opioid use for pain management 5 Opioids: Use with Caution • Use of opioids for -
Impact of Tamsulosin, Tolterodine and Drug-Combination On
African Journal of Urology (2017) 23, 28–32 African Journal of Urology Official journal of the Pan African Urological Surgeon’s Association web page of the journal www.ees.elsevier.com/afju www.sciencedirect.com Original article Impact of Tamsulosin, Tolterodine and drug-combination on the outcomes of lower urinary tract symptoms secondary to post-ureteroscopy ureteral stent: A prospective randomized controlled clinical study a b,∗ a a O. Abdelkader , K. Mohyelden , M.H. Sherif , A.H. Metwaly , b c d a H. Aldaqadossi , A. Shelbaya , H. Khairy , A. Elnashar a Department of Urology, Suez Canal University, Ismailia, Egypt b Department of Urology, Fayoum University, Fayoum, Egypt c Student Hospital, Cairo University, Cairo, Egypt d Department of Urology, Cairo University, Cairo, Egypt Received 17 March 2016; received in revised form 23 June 2016; accepted 23 June 2016 Available online 18 November 2016 KEYWORDS Abstract Anticholinergics; Objectives: To compare the role of alpha-blocker (Tamsulosin) monotherapy, anticholinergic (Tolterodine) ␣-Adrenergic blockers; monotherapy or combination of both drugs versus analgesics in improving post-ureteroscopy (URS) lower Ureter stent; urinary tract symptoms related to double-J ureteral stent. Ureteroscopy Patients and methods: Between January 2009 and June 2013, 160 consecutive patients with ureteric stones were included in this study at 2 tertiary care centers’. Patients were randomized into 4 groups; group A (n = 40) received 0.4 mg Tamsulosin once a day, group B (n = 40) received 4 mg Tolterodine once a day, group C (n = 40) received Tamsulosin 0.4 mg and Tolterodine 4 mg once a day and group D (n = 40) as a control group, received placebo once a day. -
Phenazopyridine | Memorial Sloan Kettering Cancer Center
PATIENT & CAREGIVER EDUCATION Phenazopyridine 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. Brand Names: US AZO Urinary Pain Relief [OTC]; Baridium [OTC] [DSC]; Pyridium; Urinary Pain Relief [OTC] Brand Names: Canada Phenazo; Pyridium What is this drug used for? It is used to ease pain from a bladder infection. It is used to treat signs of urinary problems. What do I need to tell my doctor BEFORE I take this drug? If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had. If you have any of these health problems: Kidney disease or liver disease. This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Phenazopyridine 1/5 Do not start, stop, or change the dose of any drug without checking with your doctor. What are some things I need to know or do while I take this drug? Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists. This drug is not to be used instead of an antibiotic.