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WELLBUTRIN SR Safely and Effectively
HIGHLIGHTS OF PRESCRIBING INFORMATION psychosis, hallucinations, paranoia, delusions, homicidal ideation, These highlights do not include all the information needed to use aggression, hostility, agitation, anxiety, and panic, as well as suicidal WELLBUTRIN SR safely and effectively. See full prescribing ideation, suicide attempt, and completed suicide. Observe patients information for WELLBUTRIN SR. attempting to quit smoking with bupropion for the occurrence of such symptoms and instruct them to discontinue bupropion and contact a WELLBUTRIN SR (bupropion hydrochloride) sustained-release tablets, healthcare provider if they experience such adverse events. (5.2) for oral use • Initial U.S. Approval: 1985 Seizure risk: The risk is dose-related. Can minimize risk by gradually increasing the dose and limiting daily dose to 400 mg. Discontinue if WARNING: SUICIDAL THOUGHTS AND BEHAVIORS seizure occurs. (4, 5.3, 7.3) See full prescribing information for complete boxed warning. • Hypertension: WELLBUTRIN SR can increase blood pressure. Monitor blood pressure before initiating treatment and periodically during • Increased risk of suicidal thinking and behavior in children, treatment. (5.4) adolescents and young adults taking antidepressants. (5.1) • Activation of mania/hypomania: Screen patients for bipolar disorder and • Monitor for worsening and emergence of suicidal thoughts and monitor for these symptoms. (5.5) behaviors. (5.1) • Psychosis and other neuropsychiatric reactions: Instruct patients to contact a healthcare professional if such reactions occur. (5.6) --------------------------- INDICATIONS AND USAGE ---------------------------- • Angle-closure glaucoma: Angle-closure glaucoma has occurred in WELLBUTRIN SR is an aminoketone antidepressant, indicated for the patients with untreated anatomically narrow angles treated with treatment of major depressive disorder (MDD). (1) antidepressants. -
Concomitant Drugs Associated with Increased Mortality for MDMA Users Reported in a Drug Safety Surveillance Database Isaac V
www.nature.com/scientificreports OPEN Concomitant drugs associated with increased mortality for MDMA users reported in a drug safety surveillance database Isaac V. Cohen1, Tigran Makunts2,3, Ruben Abagyan2* & Kelan Thomas4 3,4-Methylenedioxymethamphetamine (MDMA) is currently being evaluated by the Food and Drug Administration (FDA) for the treatment of post-traumatic stress disorder (PTSD). If MDMA is FDA-approved it will be important to understand what medications may pose a risk of drug– drug interactions. The goal of this study was to evaluate the risks due to MDMA ingestion alone or in combination with other common medications and drugs of abuse using the FDA drug safety surveillance data. To date, nearly one thousand reports of MDMA use have been reported to the FDA. The majority of these reports include covariates such as co-ingested substances and demographic parameters. Univariate and multivariate logistic regression was employed to uncover the contributing factors to the reported risk of death among MDMA users. Several drug classes (MDMA metabolites or analogs, anesthetics, muscle relaxants, amphetamines and stimulants, benzodiazepines, ethanol, opioids), four antidepressants (bupropion, sertraline, venlafaxine and citalopram) and olanzapine demonstrated increased odds ratios for the reported risk of death. Future drug–drug interaction clinical trials should evaluate if any of the other drug–drug interactions described in our results actually pose a risk of morbidity or mortality in controlled medical settings. 3,4-Methylenedioxymethamphetamine (MDMA) is currently being evaluated by the Food and Drug Adminis- tration (FDA) for the treatment of posttraumatic stress disorder (PTSD). During the past two decades, “ecstasy” was illegally distributed and is purported to contain MDMA, but because the market is unregulated this “ecstasy” may actually contain adulterants or no MDMA at all1. -
Kava (Piper Methysticum) and Its Methysticin Constituents Protect Brain Tissue Against Ischemic Damage in Rodents
5 Refs: Arletti R et al, Stimulating property of Turnera diffusa and Pfaffia paniculata extracts on the sexual-behavior of male rats. Psychopharmacology 143(1), 15-19, 1999. Berger F, Handbuch der drogenkunde . Vol 2, Maudrich, Wien, 1950. Martinez M, Les plantas medicinales de Mexico . Cuarta Edicion Botas Mexico , p119, 1959. Tyler VE et al, Pharmacognosy , 9 th edition, Lea & Febiger, Philadelphia, 1988. KAVA ( Piper methysticum ) - A REVIEW The Kava plant (Piper methysticum) is a robust, well-branching and erect perennial shrub belonging to the pepper family (Piperaceae). The botanical origin remains unknown, although it is likely that early Polynesian explorers brought the plant with them from island to island. Numerous varieties of Kava exist, and today it is widely cultivated in several Pacific Island countries both for local use as well as the rapidly growing demand for pharmaceutical preparations. The dried rhizomes (roots) are normally used. The first description to the western world of the ceremonial use of an intoxicating beverage prepared from Kava was made by Captain James Cook following his Pacific voyage in 1768. The drink, prepared as an infusion in an elaborate manner after first chewing the root, is consumed on formal occasions or meetings of village elders and chiefs, as well as in reconciling with enemies and on a more social basis. It remains an important social custom in many Pacific Island countries today. Most of the islands of the Pacific possessed Kava prior to European contact, particularly those encompassed by Polynesia, Melanesia and Micronesia. After drinking the Kava beverage a pleasantly relaxed and sociable state develops, after which a deep and restful sleep occurs. -
Alternative Treatments for Depression and Anxiety
2019 PCB Conference: Strickland Benzodiazepines (BZDs), Herbal and Alternative Treatments for Anxiety & Depression BZD Learning Objectives • List at least three uses for benzodiazepines • Discuss at least two risk factors associated with benzodiazepine prescriptions Craig Strickland, PhD, Owner Biobehavioral Education and Consultation https://sites.google.com/site/bioedcon 1 2 BZD Pharmacokinetics Clinical Uses of BZDs Generic Name Trade Name Rapidity ½ Life Dose (mg) • Treat a variety of anxiety disorders alprazolam Xanax Intermediate Short 0.75-4 • Hypnotics • Muscle relaxants chlordiaze- Librium Intermediate Long 15-100 poxide • To produce anterograde amnesia clonazepam Klonopin Intermediate Long 0.5-4 • Alcohol & other CNS depressant withdrawal • Anti-convulsant therapy diazepam Valium Rapid Long 4-40 triazolam Halcion Intermediate Very short 0.125-0.5 temazepam Restoril Short Short 7.5-30 3 4 1 2019 PCB Conference: Strickland Issues with BZDs Herbal Medication and Alternative Therapies Used in the Treatment of Depression and Anxiety • Addictive potential • Confusion between “anti-anxiety” effects and the “warm-fuzzy) • Large dose ranges • Comparison of BZDs with medications like Buspar, etc. • They work, they work well and they work quickly 5 6 Alternative Tx. Learning Objectives Background Information on herbals: Natural does not necessarily mean “safe” • List several amino acid treatments for depression • Side-effects and adverse reactions • List at least three of the most common herbal – Herbal medications are “drugs” although -
Chapter 3 Drug/Alcohol Facilitated Sexual Assault
Chapter 3 Drug/Alcohol Facilitated Sexual Assault “No drug, not even alcohol, causes the fundamental ills of society. If we’re looking for the source of our troubles, we shouldn’t test people for drugs, we should test them for stupidity, ignorance, greed and love of power.” ~ P.J. O’Rourke (1947- ) American humorist & journalist OBJECTIVES FOR THIS CHAPTER . Increase awareness and knowledge about alcohol, drugs and sexual assault . Understand the link between alcohol and sexual assault . Know the appropriate actions to take if a drugging is suspected ALCOHOL, DRUGS AND SEXUAL ASSAULT: AN INTRODUCTION1, 2 “I woke up and I wasn’t in my bed. I had no idea how I had got there, or if I have been with someone. I wondered what had happened to me, and I wondered why I couldn’t remember…” Alcohol and drugs are often weapons used by perpetrators to facilitate sexual assault. With all the news about predatory drugs, we sometimes forget that alcohol is the most common drug associated with sexual assault. Since alcohol is cheap, readily and legally available, and common among adolescents and young adults, it is important to understand the connection between alcohol and sexual assault. Note: Alcohol does not cause sexual violence nor does it give an offender an excuse to commit a sex crime. 1 Quinn, Kathleen M. “Drugs and Sexual Assault: A Dangerous Mix.” Illinois Coalition Against Sexual Assault Fall 2002 Coalition Commentary (Fall 2002.) Web. 23 September 2010. 2Predatory Drugs: Don’t Let Your Guard Down. Saint Louis Park, MN: Bacchus & Gamma. 2002. Print. -
I. Antihistamines Seunghoon Han* Department of Clinical Pharmacology and Therapeutics, Seoul St
2014;22(1):13-18 TCP Translational and Clinical Pharmacology http://dx.doi.org/10.12793/tcp.2014.22.1.13 Clinical Pharmacology Review for Primary Health Care Providers: I. Antihistamines Seunghoon Han* Department of Clinical Pharmacology and Therapeutics, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 137-701, Korea *Correspondence: S. Han; Tel: +82-2-2258-7326, Fax: +82-2-2258-7876, E-mail: [email protected] Received 31 May 2014 Primary health care providers play a critical role in maintaining public health, and the appropri- Accepted 31 May 2014 ate use of pharmaceutical products is one of the major parts of their practice. This series of articles, pISSN: 2289-0882 entitled ‘Clinical Pharmacology Review for Primary Health Care Providers,’ is intended to help pri- mary health care providers select more appropriate prescriptions for frequently used drugs based on up-to-date information. We expect that this effort will contribute to improvements in public health and diminish unnecessary drug use. Introduction tion on the H1 receptor.[8] THERAPEU Antihistamines include some of the most frequently prescribed drugs in the primary health care environment for the symp- Generations and Classes tomatic relief of allergic diseases, the common cold, urticaria, Many primary health care providers are well-informed about T and insomnia.[1-5] The importance of antihistamines has been the different ‘generations’ of antihistamines but not about the ICS TU emphasized as the prevalence of target diseases increases.[6,7] different ‘classes’ characterized according to chemical structure. However, the appropriate use, clinical effectiveness, and target [1] This discrepancy seems reasonable because ‘inter-generation’ T populations for prescription of antihistamines are still a matter differences are more prominent than ‘inter-class’ differences. -
A Date Rape Drug
MOJ Toxicology Short Communication Open Access A contemporary facet on rohypnol: a date rape drug Abstract Volume 4 Issue 1 - 2018 Rohypnol is the common name for a drug called Flunitrazepam, the slang term used Priyanshu Jain, Navjot Kaur Kanwal is roofies. Rohypnol is believed to be most commonly used drug in commission of drug Department of Criminology and Forensic Science, Dr. H.S Gour assisted Sexual assaults in the United States, the United Kingdom, and throughout Europe, Central University, India Asia and South America and very popular in clubs and rave parties. This drug being colourless, odourless and flavourless is simply slipped in a drink, or mixed in any food Correspondence: Navjot Kaur Kanwal, Department of supplement without being suspected and is used to robe, rape or harm people therefore Criminology and Forensic Science Dr. H.S Gour Central infamously called as Date rape drugs. It is a strong hypnotic, a sedative ; an anticonvulsant; University, Sagar, India, Email [email protected] an anxiolytic ; an amnestic ; and skeletal muscle relaxant. Present paper concisely states about the effects of such drugs, scenarios, attempts to explore various analytical methods Received: December 04, 2017 | Published: January 08, 2018 available & challenges regarding its analysis posed before the toxicologist and law enforcing authorities. This communication has been sourced from scientific literature available in electronic databases and traditional literature available. Keywords: rohypnol, hypnotic, sedative, central nervous system, toxicologist Introduction One of the infamous drug among Date rape drugs, a Benzodiazepine which is a central nervous system depressant. Roche (a healthcare and Date Rape drugs usually applies to the drugs that renders us pharmaceutical company) started selling flunitrazepam (Rohypnol) in incapable of saying no, it causes sedation, impaired motor skills, 1975. -
Medication Conversion Chart
Fluphenazine FREQUENCY CONVERSION RATIO ROUTE USUAL DOSE (Range) (Range) OTHER INFORMATION KINETICS Prolixin® PO to IM Oral PO 2.5-20 mg/dy QD - QID NA ↑ dose by 2.5mg/dy Q week. After symptoms controlled, slowly ↓ dose to 1-5mg/dy (dosed QD) Onset: ≤ 1hr 1mg (2-60 mg/dy) Caution for doses > 20mg/dy (↑ risk EPS) Cmax: 0.5hr 2.5mg Elderly: Initial dose = 1 - 2.5mg/dy t½: 14.7-15.3hr 5mg Oral Soln: Dilute in 2oz water, tomato or fruit juice, milk, or uncaffeinated carbonated drinks Duration of Action: 6-8hr 10mg Avoid caffeinated drinks (coffee, cola), tannics (tea), or pectinates (apple juice) 2° possible incompatibilityElimination: Hepatic to inactive metabolites 5mg/ml soln Hemodialysis: Not dialyzable HCl IM 2.5-10 mg/dy Q6-8 hr 1/3-1/2 po dose = IM dose Initial dose (usual): 1.25mg Onset: ≤ 1hr Immediate Caution for doses > 10mg/dy Cmax: 1.5-2hr Release t½: 14.7-15.3hr 2.5mg/ml Duration Action: 6-8hr Elimination: Hepatic to inactive metabolites Hemodialysis: Not dialyzable Decanoate IM 12.5-50mg Q2-3 wks 10mg po = 12.5mg IM CONVERTING FROM PO TO LONG-ACTING DECANOATE: Onset: 24-72hr (4-72hr) Long-Acting SC (12.5-100mg) (1-4 wks) Round to nearest 12.5mg Method 1: 1.25 X po daily dose = equiv decanoate dose; admin Q2-3wks. Cont ½ po daily dose X 1st few mths Cmax: 48-96hr 25mg/ml Method 2: ↑ decanoate dose over 4wks & ↓ po dose over 4-8wks as follows (accelerate taper for sx of EPS): t½: 6.8-9.6dy (single dose) ORAL DECANOATE (Administer Q 2 weeks) 15dy (14-100dy chronic administration) ORAL DOSE (mg/dy) ↓ DOSE OVER (wks) INITIAL DOSE (mg) TARGET DOSE (mg) DOSE OVER (wks) Steady State: 2mth (1.5-3mth) 5 4 6.25 6.25 0 Duration Action: 2wk (1-6wk) Elimination: Hepatic to inactive metabolites 10 4 6.25 12.5 4 Hemodialysis: Not dialyzable 20 8 6.25 12.5 4 30 8 6.25 25 4 40 8 6.25 25 4 Method 3: Admin equivalent decanoate dose Q2-3wks. -
(Orion) 5 Mg Tablets Buspirone (Orion) 10 Mg Tablets
NEW ZEALAND DATA SHEET 1. PRODUCT NAME Buspirone (Orion) 5 mg tablets Buspirone (Orion) 10 mg tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 5 mg buspirone hydrochloride. Each tablet contains 10 mg buspirone hydrochloride. Excipient with known effect: 5 mg tablet: Each tablet contains 59.5 mg lactose (as monohydrate) 10 mg tablet: Each tablet contains 118.9 mg lactose (as monohydrate). For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Tablet. 5 mg tablet: White or almost white, oval tablets debossed with ‘ORN 30’ on one side and a score on the other side. The tablet can be divided into equal doses. 10 mg tablet: White or almost white, oval tablets debossed with ‘ORN 31’ on one side and a score on the other side. The tablet can be divided into equal doses. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Buspirone hydrochloride is indicated for the management of anxiety with or without accompanying depression in adults. Buspirone hydrochloride is indicated for the management of anxiety disorders or the short- term relief of symptoms of anxiety with or without accompanying depression. 4.2 Posology and method of administration The usual starting dose is 5 mg given three times daily. This may be titrated according to the needs of the patient and the daily dose increased by 5 mg increments every two or three days depending upon the therapeutic response to a maximum daily dose of 60 mg. After dosage titration the usual daily dose will be 20 to 30 mg per day in divided doses. -
MODERN INDICATIONS for the USE of OPIPRAMOL Krzysztof Krysta1, Sławomir Murawiec2, Anna Warchala1, Karolina Zawada3, Wiesław J
Psychiatria Danubina, 2015; Vol. 27, Suppl. 1, pp 435–437 Conference paper © Medicinska naklada - Zagreb, Croatia MODERN INDICATIONS FOR THE USE OF OPIPRAMOL Krzysztof Krysta1, Sławomir Murawiec2, Anna Warchala1, Karolina Zawada3, Wiesław J. Cubała4, Mariusz S. Wiglusz4, Katarzyna Jakuszkowiak-Wojten4, Marek Krzystanek5 & Irena Krupka-Matuszczyk1 1Department of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland 2“Dialogue” Therapy Centre, Warsaw, Poland 3Department of Pneumonology, Medical University of Silesia, Katowice, Poland 4Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland 5Department of Rehabilitation Psychiatry, Medical University of Silesia, Katowice, Poland SUMMARY Opipramol is considered as a pharmacological agent that does not fit the classification taking into account the division of antidepressants, antipsychotics and anxiolytics. It has a structure related to tricyclic antidepressants but it has a different mechanism of action, i.e. binding to sigma1 and to sigma2 sites. It has been regarded as an effective drug in general anxiety disorders together with other agents like SSRI`s, SNRI`s, buspirone and pregabalin for many years. It can however also be indicated in other conditions, e.g. it may be used as a premedication in the evening prior to surgery, positive results are also observed in psychopharmacological treatment with opipramol in somatoform disorders, symptoms of depression can be significantly reduced in the climacteric syndrome. The latest data from literature present also certain dangers and side effects, which may result due to opipramol administration. Mania may be induced not only in bipolar patients treated with opipramol, but it can be an adverse drug reaction in generalized anxiety disorder. This analysis shows however that opipramol is an important drug still very useful in different clinical conditions. -
(Methadone Hydrochloride Oral Concentrate USP) and Methadose
NDA 17-116/S-021 Page 3 Methadose™ Oral Concentrate (methadone hydrochloride oral concentrate USP) and Methadose™ Sugar-Free Oral Concentrate (methadone hydrochloride oral concentrate USP) dye-free, sugar-free, unflavored CII Rx only FOR ORAL USE ONLY Deaths have been reported during initiation of methadone treatment for opioid dependence. In some cases, drug interactions with other drugs, both licit and illicit, have been suspected. However, in other cases, deaths appear to have occurred due to the respiratory or cardiac effects of methadone and too-rapid titration without appreciation for the accumulation of methadone over time. It is critical to understand the pharmacokinetics of methadone and to exercise vigilance during treatment initiation and dose titration (see DOSAGE AND ADMINISTRATION). Patients must also be strongly cautioned against self- medicating with CNS depressants during initiation of methadone treatment. Respiratory depression is the chief hazard associated with methadone hydrochloride administration. Methadone's peak respiratory depressant effects typically occur later, and persist longer than its peak analgesic effects, particularly in the early dosing period. These characteristics can contribute to cases of iatrogenic overdose, particularly during treatment initiation and dose titration. Cases of QT interval prolongation and serious arrhythmia (torsades de pointes) have been observed during treatment with methadone. Most cases involve patients being treated for pain with large, multiple daily doses of methadone, NDA -
Recommended Methods for the Identification and Analysis of Fentanyl and Its Analogues in Biological Specimens
Recommended methods for the Identification and Analysis of Fentanyl and its Analogues in Biological Specimens MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES Laboratory and Scientific Section UNITED NATIONS OFFICE ON DRUGS AND CRIME Vienna Recommended Methods for the Identification and Analysis of Fentanyl and its Analogues in Biological Specimens MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES UNITED NATIONS Vienna, 2017 Note Operating and experimental conditions are reproduced from the original reference materials, including unpublished methods, validated and used in selected national laboratories as per the list of references. A number of alternative conditions and substitution of named commercial products may provide comparable results in many cases. However, any modification has to be validated before it is integrated into laboratory routines. ST/NAR/53 Original language: English © United Nations, November 2017. All rights reserved. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. Mention of names of firms and commercial products does not imply the endorse- ment of the United Nations. This publication has not been formally edited. Publishing production: English, Publishing and Library Section, United Nations Office at Vienna. Acknowledgements The Laboratory and Scientific Section of the UNODC (LSS, headed by Dr. Justice Tettey) wishes to express its appreciation and thanks to Dr. Barry Logan, Center for Forensic Science Research and Education, at the Fredric Rieders Family Founda- tion and NMS Labs, United States; Amanda L.A.