Hydroxyzine Prescribing Information
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NH Healthy Families Preferred Drug List (PDL) Is the List of Covered Drugs
Pharmacy Program NH Healthy Families is committed to providing appropriate, high quality, and cost effective drug therapy to all NH Healthy Families members. NH Healthy Families works with providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. NH Healthy Families covers prescription medications and certain over-the-counter (OTC) medications when ordered by a practitioner. The pharmacy program does not cover all medications. Some medications require prior authorization (PA) or have limitations on age, dosage, and maximum quantities. Preferred Drug List The NH Healthy Families Preferred Drug List (PDL) is the list of covered drugs. The PDL applies to drugs members can receive at retail pharmacies. The NH Healthy Families PDL is continually evaluated by the NH Healthy Families Pharmacy and Therapeutics (P&T) Committee to promote the appropriate and cost- effective use of medications. The Committee is composed of the NH Healthy Families Medical Director, NH Healthy Families Pharmacy Director, and several New Hampshire physicians, pharmacists, and other healthcare professionals. Pharmacy Benefit Manager NH Healthy Families works with Envolve Pharmacy Solutions to process pharmacy claims for prescribed drugs. Some drugs on the NH Healthy Families PDL may require PA, and Envolve Pharmacy Solutions is responsible for administering this process. Envolve Pharmacy Solutions is our Pharmacy Benefit Manager (PBM). Specialty Drugs NH Healthy Families contracts with a number of specialty pharmacies, such as AcariaHealth Specialty Pharmacy, to ensure members have adequate access to the specialty drugs they require. Specialty drugs, such as biopharmaceuticals and injectables, may require PA to be approved for payment by NH Healthy Families. -
Medications and Alcohol Craving
Medications and Alcohol Craving Robert M. Swift, M.D., Ph.D. The use of medications as an adjunct to alcoholism treatment is based on the premise that craving and other manifestations of alcoholism are mediated by neurobiological mechanisms. Three of the four medications approved in the United States or Europe for treating alcoholism are reported to reduce craving; these include naltrexone (ReVia™), acamprosate, and tiapride. The remaining medication, disulfiram (Antabuse®), may also possess some anticraving activity. Additional medications that have been investigated include ritanserin, which has not been shown to decrease craving or drinking levels in humans, and ondansetron, which shows promise for treating early onset alcoholics, who generally respond poorly to psychosocial treatment alone. Use of anticraving medications in combination (e.g., naltrexone plus acamprosate) may enhance their effectiveness. Future studies should address such issues as optimal dosing regimens and the development of strategies to enhance patient compliance. KEY WORDS: AOD (alcohol and other drug) craving; anti alcohol craving agents; alcohol withdrawal agents; drug therapy; neurobiological theory; alcohol cue; disulfiram; naltrexone; calcium acetylhomotaurinate; dopamine; serotonin uptake inhibitors; buspirone; treatment outcome; reinforcement; neurotransmitters; patient assessment; literature review riteria for defining alcoholism Results of craving research are often tions (i.e., pharmacotherapy) to improve vary widely. Most definitions difficult to interpret, -
Medicines That Affect Fluid Balance in the Body
the bulk of stools by getting them to retain liquid, which encourages the Medicines that affect fluid bowels to push them out. balance in the body Osmotic laxatives e.g. Lactulose, Macrogol - these soften stools by increasing the amount of water released into the bowels, making them easier to pass. Older people are at higher risk of dehydration due to body changes in the ageing process. The risk of dehydration can be increased further when Stimulant laxatives e.g. Senna, Bisacodyl - these stimulate the bowels elderly patients are prescribed medicines for chronic conditions due to old speeding up bowel movements and so less water is absorbed from the age. stool as it passes through the bowels. Some medicines can affect fluid balance in the body and this may result in more water being lost through the kidneys as urine. Stool softener laxatives e.g. Docusate - These can cause more water to The medicines that can increase risk of dehydration are be reabsorbed from the bowel, making the stools softer. listed below. ANTACIDS Antacids are also known to cause dehydration because of the moisture DIURETICS they require when being absorbed by your body. Drinking plenty of water Diuretics are sometimes called 'water tablets' because they can cause you can reduce the dry mouth, stomach cramps and dry skin that is sometimes to pass more urine than usual. They work on the kidneys by increasing the associated with antacids. amount of salt and water that comes out through the urine. Diuretics are often prescribed for heart failure patients and sometimes for patients with The major side effect of antacids containing magnesium is diarrhoea and high blood pressure. -
)&F1y3x PHARMACEUTICAL APPENDIX to THE
)&f1y3X PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE )&f1y3X PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 3 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABAMECTIN 65195-55-3 ACTODIGIN 36983-69-4 ABANOQUIL 90402-40-7 ADAFENOXATE 82168-26-1 ABCIXIMAB 143653-53-6 ADAMEXINE 54785-02-3 ABECARNIL 111841-85-1 ADAPALENE 106685-40-9 ABITESARTAN 137882-98-5 ADAPROLOL 101479-70-3 ABLUKAST 96566-25-5 ADATANSERIN 127266-56-2 ABUNIDAZOLE 91017-58-2 ADEFOVIR 106941-25-7 ACADESINE 2627-69-2 ADELMIDROL 1675-66-7 ACAMPROSATE 77337-76-9 ADEMETIONINE 17176-17-9 ACAPRAZINE 55485-20-6 ADENOSINE PHOSPHATE 61-19-8 ACARBOSE 56180-94-0 ADIBENDAN 100510-33-6 ACEBROCHOL 514-50-1 ADICILLIN 525-94-0 ACEBURIC ACID 26976-72-7 ADIMOLOL 78459-19-5 ACEBUTOLOL 37517-30-9 ADINAZOLAM 37115-32-5 ACECAINIDE 32795-44-1 ADIPHENINE 64-95-9 ACECARBROMAL 77-66-7 ADIPIODONE 606-17-7 ACECLIDINE 827-61-2 ADITEREN 56066-19-4 ACECLOFENAC 89796-99-6 ADITOPRIM 56066-63-8 ACEDAPSONE 77-46-3 ADOSOPINE 88124-26-9 ACEDIASULFONE SODIUM 127-60-6 ADOZELESIN 110314-48-2 ACEDOBEN 556-08-1 ADRAFINIL 63547-13-7 ACEFLURANOL 80595-73-9 ADRENALONE -
Safety and Efficacy of a Continuous Infusion, Patient Controlled Anti
Bone Marrow Transplantation, (1999) 24, 561–566 1999 Stockton Press All rights reserved 0268–3369/99 $15.00 http://www.stockton-press.co.uk/bmt Safety and efficacy of a continuous infusion, patient controlled anti- emetic pump to facilitate outpatient administration of high-dose chemotherapy SP Dix, MK Cord, SJ Howard, JL Coon, RJ Belt and RB Geller Blood and Marrow Transplant Program, Oncology and Hematology Associates and Saint Luke’s Hospital of Kansas City, Kansas City, MO, USA Summary: and colleagues1 described an outpatient BMT care model utilizing intensive clinic support following inpatient admin- We evaluated the combination of diphenhydramine, lor- istration of HDC. This approach facilitated early patient azepam, and dexamethasone delivered as a continuous discharge and significantly decreased the total number of i.v. infusion via an ambulatory infusion pump with days of hospitalization associated with BMT. More patient-activated intermittent dosing (BAD pump) for recently, equipped BMT centers have extended the out- prevention of acute and delayed nausea/vomiting in patient care approach to include administration of HDC in patients receiving high-dose chemotherapy (HDC) for the clinic setting. Success of the total outpatient care peripheral blood progenitor cell (PBPC) mobilization approach is dependent upon the availability of experienced (MOB) or prior to autologous PBPC rescue. The BAD staff and necessary resources as well as implementation of pump was titrated to patient response and tolerance, supportive care strategies designed to minimize morbidity and continued until the patient could tolerate oral anti- in the outpatient setting. emetics. Forty-four patients utilized the BAD pump Despite improvements in supportive care strategies, during 66 chemotherapy courses, 34 (52%) for MOB chemotherapy-induced nausea and vomiting continues to be and 32 (48%) for HDC with autologous PBPC rescue. -
Adverse Reactions to Hallucinogenic Drugs. 1Rnstttutton National Test
DOCUMENT RESUME ED 034 696 SE 007 743 AUTROP Meyer, Roger E. , Fd. TITLE Adverse Reactions to Hallucinogenic Drugs. 1rNSTTTUTTON National Test. of Mental Health (DHEW), Bethesda, Md. PUB DATP Sep 67 NOTE 118p.; Conference held at the National Institute of Mental Health, Chevy Chase, Maryland, September 29, 1967 AVATLABLE FROM Superintendent of Documents, Government Printing Office, Washington, D. C. 20402 ($1.25). FDPS PRICE FDPS Price MFc0.50 HC Not Available from EDRS. DESCPTPTOPS Conference Reports, *Drug Abuse, Health Education, *Lysergic Acid Diethylamide, *Medical Research, *Mental Health IDENTIFIEPS Hallucinogenic Drugs ABSTPACT This reports a conference of psychologists, psychiatrists, geneticists and others concerned with the biological and psychological effects of lysergic acid diethylamide and other hallucinogenic drugs. Clinical data are presented on adverse drug reactions. The difficulty of determining the causes of adverse reactions is discussed, as are different methods of therapy. Data are also presented on the psychological and physiolcgical effects of L.S.D. given as a treatment under controlled medical conditions. Possible genetic effects of L.S.D. and other drugs are discussed on the basis of data from laboratory animals and humans. Also discussed are needs for futher research. The necessity to aviod scare techniques in disseminating information about drugs is emphasized. An aprentlix includes seven background papers reprinted from professional journals, and a bibliography of current articles on the possible genetic effects of drugs. (EB) National Clearinghouse for Mental Health Information VA-w. Alb alb !bAm I.S. MOMS Of NAM MON tMAN IONE Of NMI 105 NUNN NU IN WINES UAWAS RCM NIN 01 NUN N ONMININI 01011110 0. -
Acute Migraine Treatment
Acute Migraine Treatment Morris Levin, MD Professor of Neurology Director, Headache Center UCSF Department of Neurology San Francisco, CA Mo Levin Disclosures Consulting Royalties Allergan Oxford University Press Supernus Anadem Press Amgen Castle Connolly Med. Publishing Lilly Wiley Blackwell Mo Levin Disclosures Off label uses of medication DHE Antiemetics Zolmitriptan Learning Objectives At the end of the program attendees will be able to 1. List all important options in the acute treatment of migraine 2. Discuss the evidence and guidelines supporting the major migraine acute treatment options 3. Describe potential adverse effects and medication- medication interactions in acute migraine pharmacological treatment Case 27 y/o woman has suffered ever since she can remember from “sick headaches” . Pain is frontal, increases over time and is generally accompanied by nausea and vomiting. She feels depressed. The headache lasts the rest of the day but after sleeping through the night she awakens asymptomatic 1. Diagnosis 2. Severe Headache relief Diagnosis: What do we need to beware of? • Misdiagnosis of primary headache • Secondary causes of headache Red Flags in HA New (recent onset or change in pattern) Effort or Positional Later onset than usual (middle age or later) Meningismus, Febrile AIDS, Cancer or other known Systemic illness - Neurological or psych symptoms or signs Basic principles of Acute Therapy of Headaches • Diagnose properly, including comorbid conditions • Stratify therapy rather than treat in steps • Treat early -
5-HT3 Receptor Antagonists in Neurologic and Neuropsychiatric Disorders: the Iceberg Still Lies Beneath the Surface
1521-0081/71/3/383–412$35.00 https://doi.org/10.1124/pr.118.015487 PHARMACOLOGICAL REVIEWS Pharmacol Rev 71:383–412, July 2019 Copyright © 2019 by The Author(s) This is an open access article distributed under the CC BY-NC Attribution 4.0 International license. ASSOCIATE EDITOR: JEFFREY M. WITKIN 5-HT3 Receptor Antagonists in Neurologic and Neuropsychiatric Disorders: The Iceberg Still Lies beneath the Surface Gohar Fakhfouri,1 Reza Rahimian,1 Jonas Dyhrfjeld-Johnsen, Mohammad Reza Zirak, and Jean-Martin Beaulieu Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Laval University, Quebec, Quebec, Canada (G.F., R.R.); Sensorion SA, Montpellier, France (J.D.-J.); Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran (M.R.Z.); and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada (J.-M.B.) Abstract. ....................................................................................384 I. Introduction. ..............................................................................384 II. 5-HT3 Receptor Structure, Distribution, and Ligands.........................................384 A. 5-HT3 Receptor Agonists .................................................................385 B. 5-HT3 Receptor Antagonists. ............................................................385 Downloaded from 1. 5-HT3 Receptor Competitive Antagonists..............................................385 2. 5-HT3 Receptor -
Effect of Naltrexone and Ondansetron on Alcohol Cue–Induced Activation of the Ventral Striatum in Alcohol-Dependent People
ORIGINAL ARTICLE Effect of Naltrexone and Ondansetron on Alcohol Cue–Induced Activation of the Ventral Striatum in Alcohol-Dependent People Hugh Myrick, MD; Raymond F. Anton, MD; Xingbao Li, MD; Scott Henderson, BA; Patrick K. Randall, PhD; Konstantin Voronin, MD, PhD Context: Medication for the treatment of alcoholism is double-blind randomly assigned daily dosing with 50 mg currently not particularly robust. Neuroimaging tech- of naltrexone (n=23), 0.50 mg of ondansetron hydro- niques might predict which medications could be use- chloride (n=23), the combination of the 2 medications ful in the treatment of alcohol dependence. (n=20), or matching placebos (n=24). Objective: To explore the effect of naltrexone, ondanse- Main Outcome Measures: Difference in brain blood tron hydrochloride, or the combination of these medi- oxygen level–dependent magnetic resonance when view- cations on cue-induced craving and ventral striatum ac- ing alcohol pictures vs neutral beverage pictures with a tivation. particular focus on ventral striatum activity comparison across medication groups. Self-ratings of alcohol craving. Design: Functional brain imaging was conducted dur- ing alcohol cue presentation. Results: The combination treatment decreased craving for alcohol. Naltrexone with (P=.02) or without (P=.049) Setting: Participants were recruited from the general ondansetron decreased alcohol cue–induced activation community following media advertisement. Experimen- of the ventral striatum. Ondansetron by itself was simi- tal procedures were performed in the magnetic reso- lar to naltrexone and the combination in the overall analy- nance imaging suite of a major training hospital and medi- sis but intermediate in a region-specific analysis. cal research institute. -
An Insidious Onset of Symptoms Neetu Sakkari, MD, and Tracey Criss, MD
Cases That Test Your Skills An insidious onset of symptoms Neetu Sakkari, MD, and Tracey Criss, MD Ms. S’s depression and anxiety have been well controlled by How would you medication, but after several months, she develops tremors, poor handle this case? Answer the challenge concentration, and confusion. What is causing her symptoms? questions at MDedge.com/ psychiatry and see how your colleagues responded CASE Tremors, increasing anxiety presentation and similarity to other syn- Ms. S, age 56, has a history of depression and dromes such as NMS, serotonin syndrome anxiety. Previously, she tried several selec- often is undiagnosed.5 tive serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibi- tors (SNRIs), which failed to treat her symp- TREATMENT Discontinue fluoxetine toms. Ms. S is switched from duloxetine, 120 Several months after the fluoxetine increase, mg/d, to fluoxetine, 20 mg/d, while continu- Ms. S’s physical symptoms emerge. Several ing bupropion, 150 mg/d, and gabapentin, weeks later, she notices significant hyper- 600 mg/d. She tolerates fluoxetine well, but 5 tension of 162/102 mm Hg by checking her months later, she requests a dosage increase blood pressure at home. She had no history because her depressive and anxious symp- of hypertension before taking fluoxetine. toms re-emerge. Fluoxetine is increased to She then tells her psychiatrist she has been 40 mg/d. experiencing confusion, shakiness, loss of balance, forgetfulness, joint pain, sweating, and fatigue, along with worsening anxiety. The authors’ observations The treatment team makes a diagnosis of The incidence of serotonin syndrome has serotonin syndrome and recommends dis- increased because of increasing use of sero- continuing fluoxetine and starting cyprohep- tonergic agents.1-3 Although the severity tadine, 4 mg initially, and then repeating the could range from benign to life-threatening, cyproheptadine dose in several hours if her the potential lethality combined with dif- symptoms do not resolve. -
Paper Clip—High Risk Medications
You belong. PAPER CLIP—HIGH RISK MEDICATIONS Description: Some medications may be risky for people over 65 years of age and there may be safer drug choices to treat some conditions. It is recommended that medications are reviewed regularly with your providers/prescriber to ensure patient safety. Condition Treated Current Medication(s)-High Risk Safer Alternatives to Consider Urinary Tract Infections (UTIs), Nitrofurantoin Bactrim (sulfamethoxazole/trimethoprim) or recurrent UTIs, or Prophylaxis (Macrobid, or Macrodantin) Trimpex/Proloprim/Primsol (trimethoprim) Allergies Hydroxyzine (Vistaril, Atarax) Xyzal (Levocetirizine) Anxiety Hydroxyzine (Vistaril, Atarax) Buspar (Buspirone), Paxil (Paroxetine), Effexor (Venlafaxine) Parkinson’s Hydroxyzine (Vistaril, Atarax) Symmetrel (Amantadine), Sinemet (Carbidopa/levodopa), Selegiline (Eldepryl) Motion Sickness Hydroxyzine (Vistaril, Atarax) Antivert (Meclizine) Nausea & Vomiting Hydroxyzine (Vistaril, Atarax) Zofran (Ondansetron) Insomnia Hydroxyzine (Vistaril, Atarax) Ramelteon (Rozerem), Doxepin (Silenor) Chronic Insomnia Eszopiclone (Lunesta) Ramelteon (Rozerem), Doxepin (Silenor) Chronic Insomnia Zolpidem (Ambien) Ramelteon (Rozerem), Doxepin (Silenor) Chronic Insomnia Zaleplon (Sonata) Ramelteon (Rozerem), Doxepin (Silenor) Muscle Relaxants Cyclobenazprine (Flexeril, Amrix) NSAIDs (Ibuprofen, naproxen) or Hydrocodone Codeine Tramadol (Ultram) Baclofen (Lioresal) Tizanidine (Zanaflex) Migraine Prophylaxis Elavil (Amitriptyline) Propranolol (Inderal), Timolol (Blocadren), Topiramate (Topamax), -
Non-Clinical Review(S) Department of Health and Human Services Public Health Service Food and Drug Administration Center for Drug Evaluation and Research
CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 209830Orig1s000 NON-CLINICAL REVIEW(S) DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE FOOD AND DRUG ADMINISTRATION CENTER FOR DRUG EVALUATION AND RESEARCH PHARMACOLOGY/TOXICOLOGY NDA REVIEW AND EVALUATION Application number: 209830 Supporting document/s: 1, 4, 9, 19 Applicant’s letter date: 8/31/17, 11/6/17, 11/22/17, 3/12/18 CDER stamp date: 8/31/17, 11/6/17, 11/22/17, 3/12/18 Product: ARISTADA INITIO Aripiprazole lauroxil NanoCrystal® Dispersion (AL-NCD, aripiprazole lauroxil nano and ALKS 9072N) Indication: As a starting dose to initiate ARISTADA® (aripiprazole lauroxil) treatment for schizophrenia (b) (4) Applicant: Alkermes, Inc. Review Division: Psychiatry Products Reviewer: Amy M. Avila, PhD Supervisor/Team Leader: Aisar Atrakchi, PhD Division Director: Mitchell Mathis, MD Project Manager: Kofi Ansah, PharmD Template Version: September 1, 2010 Disclaimer Except as specifically identified, all data and information discussed below and necessary for approval of NDA 209830 are owned by Alkermes or are data for which Alkermes has obtained a written right of reference. Any information or data necessary for approval of NDA 209830 that Alkermes does not own or have a written right to reference constitutes one of the following: (1) published literature, or (2) a prior FDA finding of safety or effectiveness for a listed drug, as reflected in the drug’s approved labeling. Any data or information described or referenced below from reviews or publicly available summaries of a previously approved application is for descriptive purposes only and is not relied upon for approval of NDA 209830.