Medications

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Treatment of enterococcal infections - UpToDate
Treatment of enterococcal infections - UpToDate
Learn about the antimicrobial agents and approaches for different clinical syndromes caused by enterococci, such as urinary tract infections, bacteremia, endocarditis, and meningitis. Find out how to distinguish E. faecalis and E. faecium, and how to test for beta-lactamase and vancomycin
Treatment of enterococcal infections - UpToDate
The clinical heterogeneity of drug-induced myoclonus: an illustrated review
The clinical heterogeneity of drug-induced myoclonus: an illustrated review
A wide variety of drugs can cause myoclonus. To illustrate this, we first discuss two personally observed cases, one presenting with generalized, but facial-predominant, myoclonus that was induced by amantadine; and the other presenting with propriospinal ...
The clinical heterogeneity of drug-induced myoclonus: an illustrated review
Trospium | Side Effects, Dosage, Uses, and More
Trospium | Side Effects, Dosage, Uses, and More
Trospium oral tablet is a prescription medication that’s used to treat overactive bladder (OAB). It can help relieve symptoms such as urinary urgency, urinary frequency, and urine leaks. It’s available only as a generic drug. It doesn’t have a brand-name version. Learn about side effects, warnings, dosage, and more.
Trospium | Side Effects, Dosage, Uses, and More
Going Off Antidepressants - Harvard Health Publishing - Harvard Health
Going Off Antidepressants - Harvard Health Publishing - Harvard Health
People who have been taking antidepressants for some time may wish to stop taking them due to unpleasant side effects. This can be accomplished, but it is best to taper the dosage slowly and be awa...
bupropion (Wellbutrin) 21 hours 4.4 days
Going Off Antidepressants - Harvard Health Publishing - Harvard Health
Venlafaxine: Dosage, Mechanism/Onset of Action, Half-Life - Medicine.com
Venlafaxine: Dosage, Mechanism/Onset of Action, Half-Life - Medicine.com
Includes Venlafaxine indications, dosage/administration, pharmacology, mechanism/onset/duration of action, half-life, dosage forms, interactions, warnings, adverse reactions, off-label uses and more.
Urine (~87%;
Extended release: Venlafaxine: 6.3 ± 2.3 hour
10.7 ± 3.2 hours (extended-release
Venlafaxine: Dosage, Mechanism/Onset of Action, Half-Life - Medicine.com
Venlafaxine (Oral Route) Precautions - Mayo Clinic
Venlafaxine (Oral Route) Precautions - Mayo Clinic
may cause hyponatremia (low sodium
results of some tests may be affected by this medicine.
Venlafaxine may increase your risk for bleeding problems.
low amount of fluid in the body
trouble concentrating, memory problems, confusion, weakness, or feel unsteady when standing
Venlafaxine (Oral Route) Precautions - Mayo Clinic
Trospium: Dosage, Mechanism/Onset of Action, Half-Life - Medicine.com
Trospium: Dosage, Mechanism/Onset of Action, Half-Life - Medicine.com
Includes Trospium indications, dosage/administration, pharmacology, mechanism/onset/duration of action, half-life, dosage forms, interactions, warnings, adverse reactions, off-label uses and more.
MetFORMIN: May decrease the serum concentration of Trospium. Monitor therapy
Opioid Agonists: Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Monitor therapy
Ophthalmic: Dry eye syndrome
confusion
hallucination
back pain,
CNS effects: May cause drowsiness, confusion, dizziness, hallucinations, and/or blurred vision, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (
morphine
Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors.
antagonizes the effects of acetylcholine on muscarinic receptors in cholinergically innervated organs
Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron
Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Avoid combination
Trospium: Dosage, Mechanism/Onset of Action, Half-Life - Medicine.com
Alternative Choices to Oxybutynin: When, Why, and How Much?
Alternative Choices to Oxybutynin: When, Why, and How Much?
tolterodine (Detrol), and trospium (Sanctura)
tolterodine (Detrol), and trospium (Sanctura)
tolterodine and trospium are significantly less expensive, at about $2 per pill,
anticholinergic, trospium
does not readily cross the blood brain barrier
trospium
Alternative Choices to Oxybutynin: When, Why, and How Much?
These highlights do not include all the information needed to use Trospium Chloride Tablets safely and effectively. See full prescribing information for Trospium Chloride Tablets. Trospium Chloride Tablets, for oral use Initial U.S. Approval: 2004
These highlights do not include all the information needed to use Trospium Chloride Tablets safely and effectively. See full prescribing information for Trospium Chloride Tablets. Trospium Chloride Tablets, for oral use Initial U.S. Approval: 2004
creatinine clearance ranging from 30 to 80 mL/min
moderate and severe hepatic impairment.
increase in heart rate that correlates with increasing plasma concentrations.
500 mg metformin immediate release tablets twice daily reduced the steady-state systemic exposure of trospium by approximately 29% for mean
have an eye problem called "uncontrolled narrow-angle glaucoma"
These highlights do not include all the information needed to use Trospium Chloride Tablets safely and effectively. See full prescribing information for Trospium Chloride Tablets. Trospium Chloride Tablets, for oral use Initial U.S. Approval: 2004
Adverse Effects of Antipsychotic Medications
Adverse Effects of Antipsychotic Medications
The use of antipsychotic medications entails a difficult trade-off between the benefit of alleviating psychotic symptoms and the risk of troubling, sometimes life-shortening adverse effects. There is more variability among specific antipsychotic medications than there is between the first- and second-generation antipsychotic classes. The newer second-generation antipsychotics, especially clozapine and olanzapine, generally tend to cause more problems relating to metabolic syndrome, such as obesity and type 2 diabetes mellitus. Also, as a class, the older first-generation antipsychotics are more likely to be associated with movement disorders, but this is primarily true of medications that bind tightly to dopaminergic neuroreceptors, such as haloperidol, and less true of medications that bind weakly, such as chlorpromazine. Anticholinergic effects are especially prominent with weaker-binding first-generation antipsychotics, as well as with the second-generation antipsychotic clozapine. All antipsychotic medications are associated with an increased likelihood of sedation, sexual dysfunction, postural hypotension, cardiac arrhythmia, and sudden cardiac death. Primary care physicians should understand the individual adverse effect profiles of these medications. They should be vigilant for the occurrence of adverse effects, be willing to adjust or change medications as needed (or work with psychiatric colleagues to do so), and be prepared to treat any resulting medical sequelae.
older first-generation antipsychotics are more likely to be associated with movement disorders, but this is primarily true of medications that bind tightly to dopaminergic neuroreceptors,
such as haloperidol,
less true of medications that bind weakly
such as chlorpromazine.
All antipsychotic medications are associated with an increased likelihood of sedation, sexual dysfunction, postural hypotension, cardiac arrhythmia, and sudden cardiac death.
hyperprolactinemia
Includes decrease in muscle mass
Antipsychotic medications should be used with caution in older adults because of the risk of increased mortality from sudden cardiac death and cerebrovascular accidents.
terms “low-potency” and “high-potency,” not to indicate their clinical effectiveness, but rather to indicate their potency in binding to this dopamine D2 neuroreceptor
new anti-psychotics were considered atypical because they targeted neuroreceptors other than only dopamine
Risperidone (Risperdal) 1994 3 to 6 mg
Aripiprazole (Abilify) 2002 10 to 30 mg
likely that the adverse effect profile of Invega will be similar to that of risperidone
McK ER doctor thought Invega was more problematic than Latuda.
Many patients become tolerant to the sedative effect over time
Somnolence can be alleviated by lowering the dosage, changing to a single bedtime dose, or switching to a less sedating medication.
constipation, urinary retention
dry mouth
cognitive impairment
tardive dyskinesia
(inc. grimacing)
acute dystonia
involuntary maintained contraction of agonist and antagonist muscles yielding abnormal posturing, twisting and repetitive movements, or tremulous and can be initiated or worsened by attempted movement. Dystonia is a dynamic disorder that changes in severity based on the activity and posture.
shuffling gait
rigidity in the arms and shoulders,
behavioral difficulties
Adverse Effects of Antipsychotic Medications
Alpha-linolenic acid
Alpha-linolenic acid
Learn about Alpha-linolenic acid or find a doctor at Mount Sinai Health System.
Alpha-linolenic acid
Prospective, Randomized Comparison of Intravenous and Oral Ciprofloxacin with Intravenous Ceftazidime in the Treatment of Nosocomial Pneumonia
Prospective, Randomized Comparison of Intravenous and Oral Ciprofloxacin with Intravenous Ceftazidime in the Treatment of Nosocomial Pneumonia
OBJECTIVE: To compare the efficacy of intravenous and oral ciprofloxacin and intravenous ceftazidime in the treatment of nosocomial pneumonia.DESIGN: Randomized, nonblinded, multicentre comparative trial.SETTING: Seven Canadian university hospitals.POPULATION: Adult patients with moderate to severe pneumonia developing 72 h or longer after hospitalization.METHODS: After informed consent was obtained, patients were randomized to receive intravenous ciprofloxacin 300 mg every 12 h or ceftazidime 2 g every 8 h. After three days, patients in the ciprofloxacin arm could be switched to oral cipro...
Prospective, Randomized Comparison of Intravenous and Oral Ciprofloxacin with Intravenous Ceftazidime in the Treatment of Nosocomial Pneumonia