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Interactions Pharmacokinetics Profile Profile Profile Adverse Effects And Ammonium 1541 15. Bos JD, et al. Allergic contact dermatitis to amyl nitrite ('poppers'). r i has been suggested for each gram of resin. It should not be Contact Dermatitis 1985; 12: 109. P.r.�P.�_ ?l ()_n.�................. ................... given in fruit juices that have a high potassium content. 16. Foroozan M, et al. Dermatose faciale aux poppers. Ann Dermatol Venereal Proprietary Preparations (details are given in Volume B) 2009; 136: 298-9. When oral administration is difficult, calcium poly­ Single-ingredient Preparations, Jpn: Kremezin; Kyucal. styrene sulfonate may be given rectally as an enema. The usual daily dose is 30 g given as a suspension in 150 mL of Handling and storage. Amyl nitrite is very flammable water or glucose 10%, or IOOmL of 2% methylcellulose and must not be used where it may be ignited. It should plus 100 mL of water, and retained, if possible, for at least 9 be protected from light. Atipamezole {BAN, USAN, r/NN) hours. Initial therapy may involve both oral and rectal At tparilezoi: Arl pametoium; MPV·l248: AT•ma· routes. Following retention of the enema the colon should Pregnancy. Licensed product information warns that Atipq_m· ezoil2; Melon · be irrigated to remove the resin. maternal use of amyl nitrite during pregnancy reduces .. For doses in children, see below. blood pressure in the mother and blood flow across the placenta. Administration in children. Calcium polystyrene sulfonate is used in neonates and children to enhance potassium Interactions excretion in the treatment of hyperkalaemia associated with anuria or severe oliguria, and in dialysis patients. Use Like organic nitrates, amyl nitrite and other inhaled volatile is not recommended in neonates with reduced gut moti­ nitrites may potentiate the hypotensive effects of phospho­ Atipamezole Hydrochloride {BANM, r/NNM) lity. It may be given orally as a suspension or paste, or diesterase type-5 inhibitors, see Interactions, under oe: rectally; calcium polystyrene sulfonate to be given rectally Sildenafil, p. 2366.3. Atipamets<;ilillydrokfor\di: . Atlpamezol, hidroclorum Atipam.ezole, .Chtdrhydrate d': Atl pamezolhydroklorid; is mixed with water or glucose 5 or 10%, diluted in the same ratio as that for adults, see above. Care is needed Alip<Jrilez:oli. Hyoro<:h!bridum; Hidrodoruro de atipamezol; with rectal use in children as excessive dosage or inade­ Pharmacokinetics A.m naMe30J1a. rwijpol\119PV\!l. quate dilution can result in impaction of the resin; how­ >.;Ni,flC!o;24 8:8 Amyl nitrite is absorbed via the skin, lungs, mucous C ,4H ever, the oral route is not recommended in neonates. membranes, and the gastrointestinal tract. Therapeutic CA S � 1o4075'4S-t , Licensed product information recommends a dose of effects are seen within l minute of inhalation. It is UN/I - 2W42795l li( I g/kg daily in divided doses, reduced to a maintenance metabolised rapidly in the liver by hydrolytic denitration dose of 500 mg/kg daily in divided doses. The BNFC sug­ and excreted as both metabolites and unchanged drug in the Profile gests the same doses (to a daily maximum of 60 g orally, urine. or 30 to 40 g rectally). Atipamezole is a selective alphaz-adrenergic receptor r r ti antagonist that is used as the hydrochloride in veterinary P. �p�_ ':l ?.n.�... medicine to reverse the sedative effects of medetomidine. Adverse Effects and Precautions Proprietary Preparations (details are given in Volume B) References. As for Sodium Polystyrene Sulfonate, p. 1575.3. Sodium Mulfi·ingredient Preparations. S.Afr. : Tripac-Cyano; USA: Cya­ l. Pertovaara A, et a!. Pharmacological properties, central nervous system overloading is not a problem with calcimn polystyrene effects, and potential therapeutic applications of atipamezole, a selective sulfonate, but calcium overloading and hypercalcaemia may nide Antidote Package; Emergent-Ez. 11: alpha2-adrenoceptor antagonist. CNS Drug Rev 2005; 273-88. occur. It should therefore be avoided in patients with Homoeopathic Preparations. Austral. : Hot Flush & Menopause conditions such as hyperparathyroidism, multiple myel­ Relief; Hot Flush & Menopause Relief; Canad.: Menopause. oma, sarcoidosis, or metastatic carcinoma. Patients should Bixalomer {USAN, riNN) be monitored for electrolyte disturbances, especially Pharmacopoeial Preparations •l\Sf" l>lxalp re; Bixat6merQ: Bixatomerum; hypokalaerniaand hypercalcaemia. USP 36: Amyl Nitrite Inhalant. /I.Mei22>; 15�; �. &i-1KCaJf0Mep, . · • . •. ·· . .. Intestinal necrosis has N,N",N',N( :tefraki$'(3-aminoprop• yl)butane-1,4- diamlne polyc Effects on the gastroinlestinal tract. been reported after oral use of calcium polystyrene sulfo- rner.with o(chloromethyl)oxirane:·· Asoxime Chloride l, nate in a patient with acute colonic pseudo-obstruction,1 (GioH,oN0),;(\:lH;Cl0}, 1 and after oral and rectal use in a uraemic patient;2 neither Asoxirna, cloru(o Chiorek AzoksyrruJ; � de; Hl-6. CAS .:..,· 8S(373- 13·;t patient was given sorbitol. 1 ·({[4·(Aminocarbor;y0pyridinio]methoxy)methyl)�2 -[{hydro­ I. Goutorbe P, et a!. Intestinal necrosis associated with orally administered xyimino)methyi]pyridinium dichloride, calcium polystyrene sulfonate without sorbitol. Ann Pharmacother 2011; C,.H,6Cl,N,Or359.2 45: 278. 1845 - 34433"3h3. 2. Joo M, et a!. Colonic mucosal necrosis following administration of Bixalomer is a phosphate binder used for hyperphospha­ calcium polystryrene [sic] sulfonate (Kalimate) in a uremic patient. 1 UNit - HIJV88P6SJS. Korean Med Sci 2009; 24: 1207-l l. taemia (p. 1776.3) in patients with chronic renal failure. It is ', given orally. Profile Effects on thelungs. An elderly man who died from car­ r r ti diac arrest was found at autopsy to have bronchopneu­ Asoxime chloride is a cholinesterase reactivator that has P.. �P.�. �_ ?.n.�.... ... .......................................... ........................ monia associated with inhalation of calcium polystyrene been tried in the treatment of poisoning by organophos­ Proprietary Preparations (details are given in Volume B) sulfonate; 1 the resin had been given orally to treat hyper­ phorus pesticides and related compounds, including nerve kalaemia. Single-ingredient Preparations. Jpn: Kiklin. agents. I. Chaplin AJ, Millard PR. Calcium polystyrene sulphonate: an unusual cause of inhalation pneumonia. BMJ 1975; 3: 77-8. References. I. JovanoviC D, et al. A case of unusual suicidal poisoning by the organophosphorus insecticide dimethoatc. Hum Exp Toxicol 1990; 9: 49- Interactions 5!. 2. KuSiC R, et al. H -6 in man: efficacy of the oxime in poisoning by As for Sodium Polystyrene Sulfonate, p. 1576.1. organophosphorusl insecticides. Hum Exp Toxicol 1991; 10: I 13-18. 3. Lundy PM, et al. Development of the bisquaternary oxime HI-6 toward r i clinical use in the treatment of organophosphate nerve agent poisoning. P.r.�P.�. �_l ()_n.� Toxicol Rev 2006; 25: 23I-43. Proprietary Preparations (details are given in Volume B) Single-ingredient Preparations. Arg.: Resincalcio; RIC Calcio; Austral.: Calcium Resonium; Austria: CPS Pulver; Sorbisterit; AST- 120 Pharmacopoeias. In Br. and Jpn. Belg.: Kayexalate; Sorbisterit; Braz. : Sorcal; Canad.: Resonium ); CAS 90597-58�3. BP 2014: (Calcium Polystyrene Sulfonate). A cream to light Calcium; Chile: Sorbisterit; China: Calcium Resonium (.W.fU1:. brown, fine powder. The calcium content is not less than Cz.: Calcium Resonium; Resical; Denm.: Resonium Calcium; 6.5% and not more than 9.5%, calculated with reference to Sorbisterit; Fin.: Sorbisterit; Fr.: Calcium-Sorbisteritt; Resikali; Ger.: Calcium Resoniumt; CPS Pulver; Elutit-Calcium; Sorbis· Profile the dried substance. Each g exchanges not less than terit; Gr.: Calcium Resonium; Hong Kong: Calcium Resonium; l.3mmol and not more than 2.0mmol of potassium, AST-120 is a form of activated charcoal (p. 1537.3) India: Calcium Resonium; K-Bind; Kapstat; Indon.: Kalitake; consisting of spherical microcrystalline carbonaceous calculated with reference to the dried substance. Practically Irl. : Calcium Resonium; Sorbisteritt; Jpn: Kalimate; Malaysia: particles with oxygen complex including surface oxides. It insoluble in water and in alcohol. Store in airtight Kalimate; Neth.: Sorbisterit; Norw.: Resonium Calcium; NZ: is given orally as an adsorbent to delay the progression of containers. Calcium Resonium; Philipp.: Kalimate; Pol. : Calcium chronic renal failure by removing uraemic toxins and their Resonium; Port.: Resical; Spain: Resincaldo; Sorbisterit; Swed.: precursors from the gastrointestinal tract. It is also under Uses and Administration Resonium Calcium; Sorbisterit; Switz. : Sorbisterit; Thai.: Kali­ investigation in hepatic encephalopathy and gastrointest­ mate; Resincalcio; Turk.: Anti-potasium; UK: Calcium Calcium polystyrene sulfonate, the calcium salt of inal disorders. Resonium; Sorbisterit. sulfonated styrene polymer, is a cation-exchange resin References. that exchanges calcium ions for potassium ions and other l. Takahashi N, et al. Therapeutic eftects of long-term administration of an cations in the gastrointestinal tract. It is used similarly to oral adsorbent in patients with chronic renal failure: two-year study. Tnt sodium polystyrene sulfonate (p. 1575.2) to enhance Deferasirox rusAN, riNN! J Uro/ 2005; 12: 7-1 1. potassium excretion in the treatment of hyperkalaemia 2. Ueda H, et al. AST-120, an oral adsorbent, delays the initiation of dialysis CGP�72670: Deferasiraks: Dek'rasirox; Def.,rasiroX\tm; iCL- in patients v.ith chronic kidney diseases. Ther Apher Dia/ 2007; 11: 189- (p. 1777.1) associated with anuria
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