FF #314 Mirtazapine
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THE USE of MIRTAZAPINE AS a HYPNOTIC O Uso Da Mirtazapina Como Hipnótico Francisca Magalhães Scoralicka, Einstein Francisco Camargosa, Otávio Toledo Nóbregaa
ARTIGO ESPECIAL THE USE OF MIRTAZAPINE AS A HYPNOTIC O uso da mirtazapina como hipnótico Francisca Magalhães Scoralicka, Einstein Francisco Camargosa, Otávio Toledo Nóbregaa Prescription of approved hypnotics for insomnia decreased by more than 50%, whereas of antidepressive agents outstripped that of hypnotics. However, there is little data on their efficacy to treat insomnia, and many of these medications may be associated with known side effects. Antidepressants are associated with various effects on sleep patterns, depending on the intrinsic pharmacological properties of the active agent, such as degree of inhibition of serotonin or noradrenaline reuptake, effects on 5-HT1A and 5-HT2 receptors, action(s) at alpha-adrenoceptors, and/or histamine H1 sites. Mirtazapine is a noradrenergic and specific serotonergic antidepressive agent that acts by antagonizing alpha-2 adrenergic receptors and blocking 5-HT2 and 5-HT3 receptors. It has high affinity for histamine H1 receptors, low affinity for dopaminergic receptors, and lacks anticholinergic activity. In spite of these potential beneficial effects of mirtazapine on sleep, no placebo-controlled randomized clinical trials of ABSTRACT mirtazapine in primary insomniacs have been conducted. Mirtazapine was associated with improvements in sleep on normal sleepers and depressed patients. The most common side effects of mirtazapine, i.e. dry mouth, drowsiness, increased appetite and increased body weight, were mostly mild and transient. Considering its use in elderly people, this paper provides a revision about studies regarding mirtazapine for sleep disorders. KEYWORDS: sleep; antidepressive agents; sleep disorders; treatment� A prescrição de hipnóticos aprovados para insônia diminuiu em mais de 50%, enquanto de antidepressivos ultrapassou a dos primeiros. -
Histamine and Antihistamines
ACTA FACULTATIS MEDICAE NAISSENSIS UDC: 615.218 DOI: 10.1515/afmnai-2015-0001 Review article Histamine and Antihistamines Nikola Stojković1, Snežana Cekić2, Milica Ristov3, Marko Ristić1, Davor Đukić1, Maša Binić1, Dragan Virijević1 1University of Niš, Faculty of Medicine, PhD student, Serbia 2Institute of Physiology, University of Niš, Faculty of Medicine , Serbia 3Doctor of Medicine SUMMARY In recent years, there has been a steady increase in the prevalence of allergic diseases. Allergic immune response represents a complex network of cellular events involving numerous immune cells and mediators. It represents the interaction of innate and acquired immune response. The key role in the immune cascade is taken by histamine, a natural component of the body, which in the allergic inflammatory response is releasesd by the mast cells and basophils. The aim of this study was to highlight the role of histamine in allergic immunological events, their effect on Th1 and Th2 subpopulation of lymphocytes and the production of the corresponding cytokines, as well as the role of histamine blockers in the treatment of these conditions. Histamine achieves its effect by binding to the four types of its receptors, which are widely distributed in the body. Histamine blockers block a numerous effects of histamine by binding to these receptors. As a highly selective second-generation antihistamine, cetirizine not only achieves its effects by binding to H1 receptors, but also attenuates numerous events during the inflammatory process. Knowledge of the effects -
Mirtazapine (Remeron)
What is most important to remember? If you have questions: Strong Internal Medicine • It may take a few weeks for you to see the benefits of taking this Ask your doctor, nurse or pharmacist for medicine more information about mirtazapine (Remeron®). • Do not suddenly stop taking mirtazapine; you could have unpleasant withdrawal symptoms. Talk with your doctor about how to slowly discontinue this medicine • Seek help from a doctor or pharmacist if you have thoughts of suicide or hurting yourself • This medication may impair your thinking or reactions. Be careful if Strong Internal Medicine you drive or do anything that 601 Elmwood Avenue requires you to be alert. Ambulatory Care Facility, 5th Floor Rochester, NY 14642 • Do not start any new medications, Phone: (585) 275 -7424 over-the-counter drugs or herbal Mirtazapine (Remeron®): remedies without talking to your Visit our website at: Important Patient Information www.urmc.rochester.edu/medicine/ - doctor general-medicine/patientcare/ • If you think there has been an overdose, call your poison control center or get medical care right away What does mirtazapine (Remeron®) do? What side effects could occur with mirtazapine What are some things that I need to be aware of when • It is in a class of medications called antidepressants. It (Remeron®)? taking mirtazapine (Remeron®)? works by increasing certain types of activity in the brain • Lightheaded, dizzy, or sleepy • Tell your doctor or pharmacist if you are allergic to mirtazapine, any other medicines, foods, or substances to maintain mental balance • Blurred eyesight or a change in thinking clearly • It may take a few weeks for you to see the benefits of taking • It is used to treat depression (low mood) • Constipation, dry mouth, and weight gain this medicine. -
Download Large Text CMI (PDF)
Children's Paedamin Antihistamine Oral Liquid Decongestant and Antihistamine Children 6-12 years Consumer Medicine Information What is in this leaflet? • Itchy, watery eyes Before you give • Nasal congestion Children's Paedamin This leaflet answers some common Children's Paedamin Decongestant Decongestant and questions about Children's and Antihistamine contains Antihistamine Paedamin® Decongestant and Diphenhydramine Hydrochloride Antihistamine. and Phenylephrine Hydrochloride. When you must not give it It does not contain all the available Diphenhydramine Hydrochloride Do not use Children's Paedamin information. It does not take the belongs to a group of medicines Decongestant and Antihistamine if place of talking to your doctor or called 'antihistamines'. you/ your child have an allergy to: pharmacist. Antihistamines help reduce allergic All medicines have risks and symptoms, such as sneezing, runny • any medicine containing benefits. Your doctor or pharmacist nose or itchy, watery eyes, by Diphenhydramine has weighed the risks of you/your preventing the effects of a substance Hydrochloride or other child taking Children's Paedamin called histamine. Histamine is antihistamines Decongestant and Antihistamine produced by the body in response to • any medicine containing against the benefits they expect it foreign substances that the body is Phenylephrine Hydrochloride will have for you. allergic to. • any of the ingredients listed at If you have any concerns about Phenylephrine Hydrochloride the end of this leaflet taking this medicine, ask your belongs to a group of medicines Some of the symptoms of an doctor or pharmacist. called decongestants. allergic reaction may include: Keep this leaflet with the It works by reducing congestion in • shortness of breath medicine. -
OTC DOSING GUIDE Benadryl
OTC DOSING GUIDE Benadryl Our Dosing Guide gives dosages for common over-the-counter medications used in children. These medications are dosed according to weight. To calculate your child’s dose, look up his or her weight in the Dosing Guide and read across to the proper dose for each medicine listed. If you do not know your child’s weight and if your child is too young to stand on bathroom scales, a simple way to determine his or her weight is to first weigh both you and your child as you hold him. Then weigh yourself alone. Subtracting these two numbers will give you a fairly accurate weight for your child. The doses listed in the Dosing Chart are standard doses which are safe for your child. In some situations we recommend doses of these medications which may be slightly higher or lower than the doses recommended on the packaging of the medication. This should not concern you. If our advice calls for doses which are dramatically different, please ask us the reason for this. Abbreviations: mg=milligram tsp=teaspoon ml=milliliter cc=cubic centimeter dppr=dropperful 1 cc=1 ml 1 tsp=5 cc If your child takes an overdose of any medication, call Poison Control right away. The phone number is 1-800-376-4766 or 686-6161. CHILDREN’S BENADRYL ALLERGY LIQUID (Generic Name: Diphenhydramine) (Antihistamine) NEVER GIVE TO INFANTS LESS THAN 6 MONTHS OLD. DO NOT GIVE TO CHILDREN LESS THAN 2 YEARS OLD UNLESS ADVISED BY A PHYSICIAN. Dosage: Every 4 -6 hours. -
Doxylamine Succinate-Pyridoxine Hydrochloride
Doxylamine succinate-pyridoxine hydrochloride This sheet is about exposure to doxylamine succinate-pyridoxine hydrochloride in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare providers. What is doxylamine succinate-pyridoxine hydrochloride? The combination of 10mg of doxylamine succinate and 10mg of pyridoxine hydrochloride is a medication used to treat nausea and vomiting of pregnancy (NVP), also called “morning sickness.” For more information on NVP, please see the MotherToBaby fact sheet Nausea and Vomiting of Pregnancy (https://mothertobaby.org/fact-sheets/nausea-vomiting-pregnancy-nvp/pdf/). Doxylamine succinate is an antihistamine. Antihistamines lessen the symptoms of allergic reactions and colds and help to treat insomnia (hard time sleeping). Pyridoxine hydrochloride is a form of vitamin B6. In the United States, the combination of doxylamine and pyridoxine has been sold under the name Diclegis® since 2013. In Canada, it has been sold under the brand name Diclectin®. Diclegis® and Diclectin® are delayed-release tablets available by prescription. Delayed-release means that the tablet coating prevents the ingredients from being absorbed too quickly by the body. Doxylamine succinate and/or pyridoxine hydrochloride may also be available as over-the- counter medicines. I take doxylamine succinate-pyridoxine hydrochloride. Can it make it harder for me to get pregnant? Based on the data available, it is not known if doxylamine succinate-pyridoxine hydrochloride can make it harder to become pregnant. I just found out I am pregnant. Should I stop taking doxylamine succinate-pyridoxine hydrochloride? Talk with your healthcare providers before making any changes to how you take your medication(s). -
Doxylamine/Pyridoxine
BonjestaTM (doxylamine/pyridoxine) – New Drug Approval • On November 7, 2016, the FDA approved Duchesnay’s Bonjesta (doxylamine/pyridoxine) for the treatment of nausea and vomiting of pregnancy in women who do not respond to conservative management. — Bonjesta has not been studied in women with hyperemesis gravidarum. • Bonjesta is a fixed dose combination product containing an antihistamine (doxylamine) and a vitamin B6 analog (pyridoxine). The exact mechanism of Bonjesta is not known. — Doxylamine/pyridoxine is also available as Diclegis®, which contains 10 mg of doxylamine and 10 mg of pyridoxine as delayed-release tablets for the same indication. • There have been no efficacy and safety trials for Bonjesta. However, a placebo-controlled study was conducted to support the safety and efficacy of 10 mg doxylamine succinate and 10 mg pyridoxine hydrochloride tablets (a different formulation and dosage strength than Bonjesta) in the treatment of nausea and vomiting of pregnancy. • Bonjesta is contraindicated in women with known hypersensitivity to doxylamine, other ethanolamine derivative antihistamines, or pyridoxine or any inactive ingredient in the formulation; monoamine oxidase (MAO) inhibitors intensify and prolong the adverse central nervous system effects of Bonjesta. • Warnings and precautions of Bonjesta include somnolence and concomitant medical conditions. • The most common adverse event (≥ 5% and exceeding placebo) with combination 10 mg doxylamine and 10 mg pyridoxine tablets was somnolence. • The recommended dose of Bonjesta is one tablet orally at bedtime on day 1. If the dose adequately controls symptoms the next day, the patient may continue taking one tablet daily at bedtime only. However, if symptoms persist on day 2, the dose may be increased to one tablet in the morning and one tablet at bedtime. -
Doxepin (Dox-E-Pin) Description: Tricyclic Antidepressant; Antihistamine Other Names for This Medication: Sinequan®, Silenor® Common Dosage Forms: Veterinary: None
Prescription Label Patient Name: Species: Drug Name & Strength: Directions (amount to give how often & for how long): Prescribing Veterinarian's Name & Contact Information: Refills: [Content to be provided by prescribing veterinarian] Doxepin (dox-e-pin) Description: Tricyclic Antidepressant; Antihistamine Other Names for this Medication: Sinequan®, Silenor® Common Dosage Forms: Veterinary: None. Human: 3 mg, 6 mg, 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, & 150 mg capsules; 10 mg/mL oral liquid concentrates. This information sheet does not contain all available information for this medication. It is to help answer commonly asked questions and help you give the medication safely and effectively to your animal. If you have other questions or need more information about this medication, contact your veterinarian or pharmacist. Key Information When used as an antihistamine, doxepin should be used on a regular, ongoing basis in animals that respond to it. This drug works better if used before exposure to an allergen (eg, pollens). When used for behavior modification, it may take several days to weeks to determine if doxepin is effective. May be given with or without food. If your animal vomits or acts sick after receiving the drug on an empty stomach, try giving the next dose with food or a small treat. If vomiting continues, contact your veterinarian. Most common side effects are sleepiness, dry mouth, and constipation. Be sure your animal always has access to plenty of fresh, clean water. Rare side effects that can be serious (contact veterinarian immediately) include abnormal bleeding, lack of an appetite, seizures, collapse, or profound sleepiness. -
Histamine and Antihistamines Sites of Action Conditions Which Cause Release Aron H
Learning Objectives I Histamine Pharmacological effects Histamine and Antihistamines Sites of action Conditions which cause release Aron H. Lichtman, Ph.D. Diagnostic uses Associate Professor II Antihistamines acting at the H1 and H2 receptor Pharmacology and Toxicology Pharmacological effects Mechanisms of action Therapeutic uses Side effects and drug interactions Be familiar with the existence of the H3 receptor III Be able to describe the main mechanism of action of cromolyn sodium and its clinical uses Histamine Pharmacology First autacoid to be discovered. (Greek: autos=self; Histamine Formation akos=cure) Synthesized in 1907 Synthesized in mammalian tissues by Demonstrated to be a natural constituent of decarboxylation of the amino acid l-histidine mammalian tissues (1927) Involved in inflammatory and anaphylactic reactions. Local application causes swelling redness, and edema, mimicking a mild inflammatory reaction. Large systemic doses leads to profound vascular changes similar to those seen after shock or anaphylactic origin Histamine Stored in complex with: Heparin Chondroitin Sulfate Eosinophilic Chemotactic Factor Neutrophilic Chemotactic Factor Proteases 1 Conditions That Release Histamine 1. Tissue injury: Any physical or chemical agent that injures tissue, skin or mucosa are particularly sensitive to injury and will cause the immediate release of histamine from mast cells. 2. Allergic reactions: exposure of an antigen to a previously sensitized (exposed) subject can immediately trigger allergic reactions. If sensitized by IgE antibodies attached to their surface membranes will degranulate when exposed to the appropriate antigen and release histamine, ATP and other mediators. 3. Drugs and other foreign compounds: morphine, dextran, antimalarial drugs, dyes, antibiotic bases, alkaloids, amides, quaternary ammonium compounds, enzymes (phospholipase C). -
2021 Formulary List of Covered Prescription Drugs
2021 Formulary List of covered prescription drugs This drug list applies to all Individual HMO products and the following Small Group HMO products: Sharp Platinum 90 Performance HMO, Sharp Platinum 90 Performance HMO AI-AN, Sharp Platinum 90 Premier HMO, Sharp Platinum 90 Premier HMO AI-AN, Sharp Gold 80 Performance HMO, Sharp Gold 80 Performance HMO AI-AN, Sharp Gold 80 Premier HMO, Sharp Gold 80 Premier HMO AI-AN, Sharp Silver 70 Performance HMO, Sharp Silver 70 Performance HMO AI-AN, Sharp Silver 70 Premier HMO, Sharp Silver 70 Premier HMO AI-AN, Sharp Silver 73 Performance HMO, Sharp Silver 73 Premier HMO, Sharp Silver 87 Performance HMO, Sharp Silver 87 Premier HMO, Sharp Silver 94 Performance HMO, Sharp Silver 94 Premier HMO, Sharp Bronze 60 Performance HMO, Sharp Bronze 60 Performance HMO AI-AN, Sharp Bronze 60 Premier HDHP HMO, Sharp Bronze 60 Premier HDHP HMO AI-AN, Sharp Minimum Coverage Performance HMO, Sharp $0 Cost Share Performance HMO AI-AN, Sharp $0 Cost Share Premier HMO AI-AN, Sharp Silver 70 Off Exchange Performance HMO, Sharp Silver 70 Off Exchange Premier HMO, Sharp Performance Platinum 90 HMO 0/15 + Child Dental, Sharp Premier Platinum 90 HMO 0/20 + Child Dental, Sharp Performance Gold 80 HMO 350 /25 + Child Dental, Sharp Premier Gold 80 HMO 250/35 + Child Dental, Sharp Performance Silver 70 HMO 2250/50 + Child Dental, Sharp Premier Silver 70 HMO 2250/55 + Child Dental, Sharp Premier Silver 70 HDHP HMO 2500/20% + Child Dental, Sharp Performance Bronze 60 HMO 6300/65 + Child Dental, Sharp Premier Bronze 60 HDHP HMO -
Harmful Interactions with Alcohol and Medication
May cause DROWSINESS. ALCOHOL may intensify this effect. USE CARE when operating a car or dangerous machinery. alcohol Harmful medicines mixing with Interactions May cause DROWSINESS. ALCOHOL USE CARE or dangerous machinery. may intensify this effect. when operating a car Harmful interactions You’ve probably seen this warning on medicines you’ve taken. The danger is real. Mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing. In addition to these dangers, alcohol can make a medication less effective or even useless, or it may make the medication harmful or toxic to your body. Some medicines that you might can result. The list gives the brand never have suspected can react with name by which each medicine is alcohol, including many medications commonly known (for example, which can be purchased “over-the- Benadryl®) and its generic name or counter”—that is, without a prescription. active ingredient (in Benadryl®, this Even some herbal remedies can is diphenhydramine). The list have harmful effects when combined presented here does not include all with alcohol. the medicines that may interact This pamphlet lists medications harmfully with alcohol. Most im- that can cause harm when taken with portant, the list does not include all alcohol and describes the effects that the ingredients in every medication. 1 Medications typically are safe and effective when used appropriately. Your pharmacist or other health care provider can help you determine which medications interact harmfully with alcohol. -
Allergy, Depression and Tricyclic Antidepressants
Allergy, Depression and Tricyclic Antidepressants A. Hoffer, M.D., Ph.D.1 INTRODUCTION causes a variety of symptoms of which mood Psychiatrists have been very reluctant to disorder is one. The patient with asthma is not accept the idea that depressions, which they depressed because it is hard to breathe—the know so well, may be caused by allergies to depression and the difficulty in breathing are common environmental molecules such as both expressions of an allergic reaction to one foods, airborne particles, and chemicals in or more foreign types of molecules. water. When patients were depressed and Many years ago allergists recognized that it anxious, and at the same time suffered from was possible to be allergic to foods as well as diseases accepted as allergic, psychosomatic to pollens or dusts, and described the mood explanations were used. This usually meant symptoms which were also present. The that a psychological explanation for the depression and anxiety was recognized as a presence of the allergic reactions was invoked. reaction to the allergen, but prime emphasis The mood disorder was looked upon as a was given to the non-psychiatric symptoms. natural reaction to the discomfort of the Clinical allergists who are now practicing allergic reaction. Asthma for a long time was clinical ecology went one step further when one of the seven major psychosomatic they recognized that allergic reactions could diseases. Most psychiatrists still believe cause depression and anxiety as the main schizophrenic patients can not be allergic, at symptom with minimal somatic reactions. least not when they are ill, but it was accepted Dr.