Amitriptyline (Elavil): Important Patient Information
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Drug and Alcohol Abuse Prevention Handbook FOREWARD
Drug and Alcohol Abuse Prevention Handbook FOREWARD Grayson College recognizes that the illicit use of drugs and/or the abuse of alcohol are a persistent health problem of major proportion affecting our society physically, mentally, and socially. Illicit drug use and /or alcohol abuse can adversely affect an individual’s personal life, safety, health, and mental and physical performance. It is the intent of GC to provide employees and students pertinent information related to illicit drug use and/or alcohol abuse in an effort to prevent such harm. GC is committed to promoting and maintaining a work and academic environment that is free from illegal alcohol and drug use and abuse, in accordance with all federal, state, and local laws. Students, employees, and visitors are prohibited from possessing, consuming, manufacturing, dispensing, or being under the influence of alcohol/illegal drugs or engaging in improper self- medication while on college property or college business. Any member of the college community who violates this policy is subject to both prosecution and punishment under federal, state, and local laws to disciplinary proceedings by the college. This alcohol/drug policy is not designed to punish people for seeking rehabilitation. All information about those individuals who voluntarily avail themselves of drug or alcohol counseling or rehabilitation will not be used as a basis for disciplinary action or be used against an individual in any way. College employees and students who violate the alcohol/drug policy shall be informed about and referred to services to assist them in determining whether they are abusing drugs and alcohol or are chemically dependent. -
Medication: Amitriptyline 10 Mg
Amitriptyline (Elavil) COMPLEX CHRONIC DISEASES PROGRAM Medication Handout Date: May 15, 2018 Medication: Amitriptyline 10 mg What is Amitriptyline? Amitriptyline belongs to a group of medications called tricyclic antidepressants (TCAs) that were first used to treat depression. It works by altering the levels of certain neuro- transmitters in the brain such as noradrenalin and serotonin. They have since been found to be effective for many different uses such as: pain, helping with sleep quality (but is not a sleeping pill), irritable bowel syndrome (with diarrhea), migraine prevention, and interstitial cystitis. Expected Benefit: Usually takes several weeks to notice a benefit You may not notice a benefit until you get to a dose of 25 mg Watch for possible side effects: This list of side effects is important for you to be aware of; however, it is also important to remember that not all side effects happen to all people. Many of these less serious side effects will improve over the first few days of taking the medications. If you have problems with these side effects talk with your doctor or pharmacist: Dry mouth – this is the most common side; the others are much less frequent Hangover effect – too sleepy in the morning Blurred vision Urinary retention, trouble with urination Tiredness, dizziness that is more than usual Diarrhea or constipation Stopping the medication: Do NOT stop taking this medication suddenly without asking your doctor – this medication is usually decreased slowly (at higher doses) before it is stopped completely How to use this medication: Take this medication with or without food Dosing Schedule: Start with 5 mg (½ tablet) 2 hrs before bed Increase dose according to table below Many patients can only tolerate 20 or 30 mg If you don’t have dry mouth or side effects, you can continue slowly increasing the dose to a maximum of 70 mg You can stay at a lower dose (stop increasing) if you get side effects (usually dry mouth). -
Kiwiherb Valerian Oral Liquid Valerian Root Extract
PATIENT INFORMATION LEAFLET: stress and to aid sleep, exclusively based on long standing use. 2. Before you take this product DO NOT TAKE this product if you are: • Allergic to Valerian or any other ingredients in this product (see section 6) • Under 18 years of age • Pregnant or breast feeding • Taking medicines known to interact with alcohol (e.g. metronidazole) • Already taking a medicine for sleep or Kiwiherb Valerian Oral Liquid anxiety Valerian Root Extract Taking other medicines Tell your healthcare professional, e.g. a doctor or pharmacist, if you are taking any other medicines Read all of this leaflet carefully because it contains including herbal medicines or medicines that did important information for you. not require a prescription. This medicine is available without prescription. Driving and using machines However you still need to use Kiwiherb Valerian carefully to get the best results from it. This product may cause drowsiness. If affected, do not drive or operate machinery Keep this leaflet. You may want to read it again. Take Special Care with this product Ask your healthcare professional, e.g. a doctor or pharmacist, if you need more information or This product contains alcohol (45% ethanol), i.e. advice. up to 2.25 ml per 5 ml dose, (equivalent to 45 ml beer or 18.8 ml wine), and may be harmful to If the condition worsens or symptoms do not those suffering from alcoholism. improve after 2 weeks, a qualified healthcare professional, e.g. a doctor or pharmacist, should be To be taken into account in pregnant or consulted. -
Neurological Complications of Nitrous Oxide Abuse
Katherine Shoults, MD Case report: Neurological complications of nitrous oxide abuse A patient who presented with limb paresthesia and B12 deficiency was eventually diagnosed with subacute combined degeneration neuropathy secondary to nitrous oxide abuse. Case data ABSTRACT: A 34-year-old female ary to nitrous oxide (“laughing gas”) A 34-year-old female presented with with a history of alcohol and crystal abuse that had affected B12 activa- a 2-week history of progressive bilat- methamphetamine abuse presented tion. The patient was continued on eral limb paresthesia and tenderness, to the emergency department with B12 therapy, neurology follow-up as well as an inability to balance. She limb paresthesia and difficulty walk- was arranged, and addiction coun- had been well previously, although ing. At a primary care visit a week seling services were recommended. she did have a history of alcohol and earlier her progressive neurological Unfortunately, the patient was lost crystal methamphetamine abuse. She compromise had been viewed in the to follow-up after discharge from the had abstained from crystal metham- context of anemia and she was start- hospital. Physicians should be aware phetamine for 5 years and from alco- ed on daily B12 injections. Further that nitrous oxide is easy to acquire hol for 2 months. She was working as a investigations in hospital revealed in the form of commercially available care aid and denied using illegal drugs diminished proprioception, hyperal- cartridges or whipped cream canis- currently, but reported she had been gesia with pinprick and temperature ters called “whippits” and abuse of inhaling nitrous oxide (“laughing tests, a wide-based high-steppage nitrous oxide is increasingly com- gas”) for 6 months, with an escalation gait, elevated levels of B12 and ho- mon. -
SAD.002 Alcohol and Drugs
ALCOHOL AND DRUG POLICY Southern Oregon University is committed to promoting an environment that supports the health and well-being of every member of the campus community. Since drug and alcohol abuse can seriously impair an individual’s personal and academic functioning, the University helps campus members make responsible decisions about drugs and alcohol. It is Southern’s obligation, therefore, to provide pertinent drug and alcohol information, educational opportunities, prevention-related activities, individual support and referral services, and enforcement of University rules regarding the use of alcohol and illegal drugs. In keeping with this policy and the intent of Public Law 101-226, Section 22: Drug-Free Schools and Campuses, it is our obligation and responsibility to inform you of the health risks associated with the use of various illicit drugs, nicotine, and the abuse of alcohol. Please note that any substance used through needle-sharing increases the risk of contracting AIDS and hepatitis B. Controlled Substances: Type of Drug and Possible Health Risks 1. Stimulants – speed up action of central nervous system • Amphetamines (speed). Hallucinations; heart problems; malnutrition; dependency; paranoid psychosis; death. Affects fetal development. • Cocaine (coke, crack) — Classified as a narcotic. Confusion; depression; convulsions; damaged nasal membranes; lung lesions; dependency; coma; paranoid psychosis; death. Affects fetal development. • MDMA (ecstasy). Short-term: euphoria; dehydration; loss of inhibition. Long-term: danger to cognitive learning and memory impairment. 2. Depressants – relax central nervous system • Barbiturates (downers). Tranquilizers and methaqualone (ludes). Confusion; loss of coordination; tolerance; dependency; seizures; coma; death. • Especially dangerous in combination with alcohol. 3. Cannabis – alters perception and mood • Marijuana and hashish. -
PRODUCT MONOGRAPH ELAVIL® Amitriptyline Hydrochloride Tablets
PRODUCT MONOGRAPH ELAVIL® amitriptyline hydrochloride tablets USP 10, 25, 50 and 75 mg Antidepressant AA PHARMA INC. DATE OF PREPARATION: 1165 Creditstone Road Unit #1 August 29, 2018 Vaughan, ON L4K 4N7 Control No.: 217626 1 PRODUCT MONOGRAPH ELAVIL® amitriptyline hydrochloride tablets USP 10, 25, 50, 75 mg THERAPEUTIC CLASSIFICATION Antidepressant ACTIONS AND CLINICAL PHARMACOLOGY Amitriptyline hydrochloride is a tricyclic antidepressant with sedative properties. Its mechanism of action in man is not known. Amitriptyline inhibits the membrane pump mechanism responsible for the re-uptake of transmitter amines, such as norepinephrine and serotonin, thereby increasing their concentration at the synaptic clefts of the brain. Amitriptyline has pronounced anticholinergic properties and produces EKG changes and quinidine-like effects on the heart (See ADVERSE REACTIONS). It also lowers the convulsive threshold and causes alterations in EEG and sleep patterns. Orally administered amitriptyline is readily absorbed and rapidly metabolized. Steady-state plasma concentrations vary widely and this variation may be genetically determined. Amitriptyline is primarily excreted in the urine, mostly in the form of metabolites, with some excretion also occurring in the feces. INDICATIONS AND CLINICAL USE ELAVIL® (amitriptyline hydrochloride) is indicated in the drug management of depressive illness. ELAVIL® may be used in depressive illness of psychotic or endogenous nature and in selected patients with neurotic depression. Endogenous depression is more likely to be alleviated than are other depressive states. ELAVIL® ®, because of its sedative action, is also of value in alleviating the anxiety component of depression. As with other tricyclic antidepressants, ELAVIL® may precipitate hypomanic episodes in patients with bipolar depression. These drugs are not indicated in mild depressive states and depressive reactions. -
Alcohol Hangover Headache
Headache ISSN 0017-8748 C 2007 the Authors doi: 10.1111/j.1526-4610.2006.00694.x Journal compilation C 2007 American Headache Society Published by Blackwell Publishing Expert Opinion Alcohol Hangover Headache Case History submitted by Randolph W. Evans, MD Expert opinion submitted by Christina Sun, MD; Christine Lay, MD Key words: alcohol hangover headache, migraine (Headache 2007;47:277-279) In his 1954 first novel, “Lucky Jim,” Sir Kingsley she has no ill effects. She is healthy with no history of Amis describes the delayed effects of drinking port significant headaches. on the titular history lecturer upon awakening in the morning. “Dixon was alive again. Consciousness was QUESTIONS upon him before he could get out of the way; not for What is the prevalence and cause of alcohol hang- him the slow, gracious wandering from the halls of over headache (AHH)? What are the latency, features, sleep, but a summary, forcible ejection. ... The light and duration of the headache? Is the risk of develop- did him harm, but not as much as looking at things ment of AHH related to the type or amount of alcohol did; he resolved, having done it once, never to move consumed? How can you distinguish between AHH his eyeballs again. A dusty thudding in his head made and migraine triggered by alcohol? Are there any ef- the scene before him beat like a pulse. ...he sat up a fective interventions or treatments for AHH? little, and what met his bursting eyes roused to a frenzy the timpanist in his head.” EXPERT COMMENTARY Alcohol hangover, or “veisalgia,” is a well-known CASE and common phenomenon that generally occurs af- A few hours after drinking 3 glasses of any type ter heavy consumption of alcohol. -
Problematic Use of Nitrous Oxide by Young Moroccan–Dutch Adults
International Journal of Environmental Research and Public Health Article Problematic Use of Nitrous Oxide by Young Moroccan–Dutch Adults Ton Nabben 1, Jelmer Weijs 2 and Jan van Amsterdam 3,* 1 Urban Governance & Social Innovation, Amsterdam University of Applied Sciences, P.O. Box 2171, 1000 CD Amsterdam, The Netherlands; [email protected] 2 Jellinek, Department High Care Detox, Vlaardingenlaan 5, 1059 GL Amsterdam, The Netherlands; [email protected] 3 Amsterdam University Medical Center, Department of Psychiatry, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands * Correspondence: [email protected] Abstract: The recreational use of nitrous oxide (N2O; laughing gas) has largely expanded in recent years. Although incidental use of nitrous oxide hardly causes any health damage, problematic or heavy use of nitrous oxide can lead to serious adverse effects. Amsterdam care centres noticed that Moroccan–Dutch young adults reported neurological symptoms, including severe paralysis, as a result of problematic nitrous oxide use. In this qualitative exploratory study, thirteen young adult Moroccan–Dutch excessive nitrous oxide users were interviewed. The determinants of problematic nitrous oxide use in this ethnic group are discussed, including their low treatment demand with respect to nitrous oxide abuse related medical–psychological problems. Motives for using nitrous oxide are to relieve boredom, to seek out relaxation with friends and to suppress psychosocial stress and negative thoughts. Other motives are depression, discrimination and conflict with friends Citation: Nabben, T.; Weijs, J.; van or parents. The taboo culture surrounding substance use—mistrust, shame and macho culture— Amsterdam, J. Problematic Use of frustrates timely medical/psychological treatment of Moroccan–Dutch problematic nitrous oxide Nitrous Oxide by Young users. -
PERPHENAZINE and AMITRIPTYLINE HYDROCHLORIDE- Perphenazine and Amitriptyline Hydrochloride Tablet, Film Coated Mylan Pharmaceuticals Inc
PERPHENAZINE AND AMITRIPTYLINE HYDROCHLORIDE- perphenazine and amitriptyline hydrochloride tablet, film coated Mylan Pharmaceuticals Inc. ---------- WARNING Increased Mortality in Elderly Patients with Dementia-Related Psychosis Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug- treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Perphenazine and amitriptyline hydrochloride is not approved for the treatment of patients with dementia- related psychosis (see WARNINGS). Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of perphenazine and amitriptyline or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. -
Doxepin (Sinequan)
8/31/2017 Doxepin Uses, Side Effects & Warnings - Drugs.com doxepin (Sinequan) Generic Name: doxepin (Sinequan) (DOX e pin) Brand Name: What is doxepin (Sinequan)? This medication guide provides information about the use of doxepin (Sinequan or other generic names) to treat depression or anxiety. Silenor is another brand of doxepin that is not covered in this medication guide. Doxepin is a tricyclic antidepressant that affects chemicals in the brain that may be unbalanced. Doxepin (Sinequan or other generic name) is used to treat symptoms of depression and/or anxiety associated with alcoholism, psychiatric conditions, or manic-depressive conditions. Doxepin may also be used for purposes not listed in this medication guide. What is the most important information I should know about doxepin (Sinequan)? You should not take doxepin if you have glaucoma or problems with urination. Do not use if you are allergic to doxepin or to similar antidepressants. Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Do not give this medicine to anyone under 18 years old without the advice of a doctor. Doxepin is not approved for use in children. What should I discuss with my healthcare provider before taking doxepin (Sinequan)? You should not use doxepin if you are allergic to it, or if you have: glaucoma; urination problems; or an allergy to similar antidepressants such as amitriptyline, amoxapine, clomipramine, desipramine, imipramine, nortriptyline, protriptyline, or trimipramine. -
The Use of Psychedelic Drugs in the Treatment of Problematic Drug and Alcohol Use
Tripping up addiction: The use of psychedelic drugs in the treatment of problematic drug and alcohol use Short Title: Illicit drugs in the treatment of addiction Celia Morgan 1,3, Amy McAndrew1, Tobias Stevens1, David Nutt2, Will Lawn1,3 1. Psychopharmacology and Addiction Research Centre, University of Exeter, UK 2. Centre for Neuropsychopharmacology, Imperial College London, UK 3. Clinical Psychopharmacology Unit, University College London, UK Address Corrrespondence to: Celia Morgan Psychopharmacology and Addiction Research Centre Washington Singer Laboratory University of Exeter Perry Road, Exeter Devon UK EX4 4QG Key words: addiction, psychedelics, ketamine, ibogaine, ayahuasca, LSD , psilocybin, neurogenesis, 1 Highlights: Psilocybin may reduce alcohol and tobacco use in addicted samples. Ibogaine and ayahuasca have shown promise in the treatment of various addictions through observational studies. Ketamine has been used to treat alcohol dependence and reduces cocaine self- administration in the human laboratory. Randomised controlled trials are greatly needed to further test the efficacy of all of these compounds. Psychedelic drugs may have their therapeutic qualities due to anti-depressant effects, stimulating neuroplasticity and long-term psychological changes. 2 Abstract Psychedelic drugs have been used as treatments in indigenous cultures for thousands of years. Yet, due to their legal status, there has been limited scientific research into the therapeutic potential of these compounds for psychiatric disorders. In the absence of other effective treatments however, researchers have begun again to systematically investigate such compounds and there is now evidence pointing to the use of psychedelic drugs in the treatment of addiction. In this review we focus on human evidence for the effectiveness of preparations used by indigenous cultures in the Amazon (ayahausca) and Africa (ibogaine) and worldwide (psilocybin), and more recently synthetised drugs such as the serotonergic hallucinogen LSD and the dissociative anaesthetic ketamine. -
Enflurane Buffer Solution—Prepare a Solution of 0.05 M Monobasic Po- Tassium Phosphate
Accessed from 128.83.63.20 by nEwp0rt1 on Thu Nov 24 01:18:27 EST 2011 3038 Enalaprilat / Official Monographs USP 35 Table 1 Relative Retention Limit Component Time (minutes) (w/w, %) Enalaprilat heat degradation product 0.6 vs enalaprilat 0.5 Enalaprilat 1 vs enalaprilat — Benzyl alcohol 1 vs benzyl alcohol — Benzyl alcohol related unknown impurity 1 1.2 vs benzyl alcohol — Benzoic acid 1.4 vs benzyl alcohol — Benzyl alcohol related unknown impurity 2 1.7 vs benzyl alcohol — Benzaldehyde 2.1 vs benzyl alcohol — Enalapril maleate 4.7 vs enalaprilat 0.25 Enalaprilat related impurity A 5.1 vs enalaprilat 1.0 Any other unspecified individual impurity — 0.10 Total impurities — 2.0 ProcedureÐProceed as directed in the Assay. Calculate the the label claim, of enalaprilat (C 18H24N2O5) in the portion of percentage of benzyl alcohol, based on the label claim, in the Injection taken by the formula: volume of Injection taken by the formula: 100(CS / CU)(rU / rS) 100(CS /CU)(rU / rS) in which CS is the concentration, in mg per mL, of USP in which CS is the concentration, in mg per mL, of USP Benzyl Enalaprilat RS in the Standard preparation; CU is the concentra- Alcohol RS in the Standard solution; CU is the concentration, in tion, in mg per mL, of enalaprilat in the Assay preparation, mg per mL, of benzyl alcohol in the Test solution; and rU and rS based on the label claim; and rU and rS are the peak responses are the benzyl alcohol peak responses obtained from the Test obtained from the Assay preparation and the Standard prepara- solution and the Standard solution, respectively: between 75.0% tion, respectively.