cS

Omalizumab ref.: Davis's Drug Guide

Omalizumab (o-ma-liz-u-mab)
Xolair
Classification
Therapeutic: antiasthmatics
Pharmacologic: monoclonal antibodies
Pregnancy Category B








Indications
Moderate to severe asthma not controlled by inhaled corticosteroids.

Action
Inhibits binding of IgE to receptors on mast cells and eosinophils; preventing the release of mediators of the allergic response. Also decreases amount of IgE receptors on basophils. Therapeutic
Effects: Decreased incidence of exacerbations of asthma.

Pharmacokinetics
Absorption: 62% absorbed slowly from subcut sites.
Distribution: Enters breast milk. Metabolism and Excretion: Degraded similarly to IgG via binding degradation, reticuloendothelial system and the liver.
Half-life: 26 days.

ROUTE: Subcut

ONSET: within 1 hr

PEAK: unknown

DURATION: up to 1 yr

Contraindications/Precautions
Contraindicated in: Hypersensitivity; Acute bronchospasm.

Use Cautiously in: Chronic use of inhaled corticosteroids;
OB: Use in pregnancy only if clearly needed; enroll pregnant women with at least one exposure to omalizumab in the Xolair Pregnancy
Exposure Registry (1-866-496-5247); Lactation:
Safety not established; Pedi: Children 12 yr
(safety not established).

Adverse Reactions/Side Effects
Local: injection site reactions. Misc: allergic reactions including ANAPHYLAXIS,qrisk of malignancy.
Interactions
Drug-Drug: None noted.
Route/Dosage
Subcut (Adults and Children 12 yr): 150– 375 mg every 2–4 wk (determined by pretreatment serum IgE level and body weight).

Availability
Powder for injection: 150 mg/vial.

NURSING IMPLICATIONS
Assessment
  • Assess lung sounds and respiratory function prior to and periodically during therapy.
  • Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically throughout therapy.
  • Assess for allergic reactions (urticaria, tongue and/or throat edema) within 2 hr of first or subsequent injections. Observe patient following injection. Epinephrine, diphenhydramine, and corticosteroids should be available in case of anaphylaxis.
  • Monitor for injection site reactions (bruising, redness, warmth, burning, stinging, itching, hives, pain, induration, mass, inflammation). Usually occur within 1 hr of injection, last 8 days, and decrease in frequency with subsequent dosing.
  • Lab Test Considerations: Serum IgE levels will increase following administration and may persist for up to 1 year following discontinuation. Serum total IgE levels obtained <1 year following discontinuation may not reflect steady state free IgE levels and should not be used to reassess the dosing regimen.
Potential Nursing Diagnoses
Ineffective airway clearance
Implementation
  • Doses of inhaled corticosteroids may be gradually decreased with supervision of health care professional; do not discontinue abruptly.

Meclizine Ref.: Davis's Drug Guide

Meclizine
(mek-li-zeen)
Antivert, Bonamine, Bonine, Dramamine Less Drowsy Formula

Classification
Therapeutic: antiemetics, antihistamines
Pregnancy Category B

Indications
Management/prevention of: Motion sickness, Vertigo.



Action
Has central anticholinergic, CNS depressant, and antihistaminic properties. Decreases excitability of the middle ear labyrinth and depresses conduction in middle ear vestibular-cerebellar pathways.
Therapeutic Effects: Decreased motion sickness. Decreased vertigo from vestibular pathology.
Pharmacokinetics
Absorption: Absorbed after oral administration.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: 6 hr.

TIME/ACTION PROFILE (antihistaminic
effects)

ROUTE: PO 
ONSET: 1 hr 
PEAK: unknown
DURATION 8–24 hr

Contraindications/Precautions
Contraindicated in: Hypersensitivity; OB: Has caused congenital malformations (cleft palate) in animal studies.
Use Cautiously in: Prostatic hyperplasia; Angleclosure glaucoma; Lactation: Occasional use may be acceptable; prolonged use may expose infant to drug effects or may interfere with milk supply;
Pedi: Children <12 yr (safety not established);
Geri: increase sensitivity and risk of adverse reactions.

Adverse Reactions/Side Effects
CNS: drowsiness, fatigue. EENT: blurred vision.
GI: dry mouth.

Interactions
Drug-Drug: Additive CNS depression with other CNS depressants, including alcohol, other antihistamines, opioid analgesics, and sedative/ hypnotics. Additive anticholinergic effects with other drugs possessing anticholinergic properties, including some antihistamines, antidepressants, atropine, haloperidol, phenothiazines, quinidine, and disopyramide.


Cyclobenzaprine Ref.: Davis's Drug Guide

Cyclobenzaprine
(sye-kloe-ben-za-preen)
Amrix, Flexeril


Classification:
Therapeutic: skeletal muscle relaxants (centrally
acting)
Pregnancy Category B

Indications:
Management of acute painful musculoskeletal conditions associated with muscle spasm.
Unlabeled Use: Management of fibromyalgia.



Action:
Reduces tonic somatic muscle activity at the level of the brainstem. Structurally similar to tricyclic antidepressants. Therapeutic Effects: Reduction in muscle spasm and hyperactivity without loss of function.

Pharmacokinetics
Absorption: Well absorbed from the GI tract.
Distribution: Unknown.
Protein Binding: 93%.
Metabolism and Excretion: Mostly metabolized by the liver.
Half-life: 1–3 days.

TIME/ACTION PROFILE (skeletal muscle
relaxation)

ROUTE: PO
ONSET: within 1 hr
PEAK:  3–8 hr
DURATION: 12–24 hr

Full effects may not occur for 1–2 wk

Contraindications/Precautions
Contraindicated in: Hypersensitivity; Should not be used within 14 days of MAO inhibitor therapy; Immediate period after MI; Severe or symptomatic cardiovascular disease; Cardiac conduction disturbances; Hyperthyroidism.

Use Cautiously in: Cardiovascular disease; Geri: Appears on Beers list. Poorly tolerated due to anticholinergic effects; OB, Lactation, Pedi: Pregnancy, lactation, and children 15 yr (safety not established).

Adverse Reactions/Side Effects
CNS: dizziness, drowsiness, confusion, fatigue,
headache, nervousness.
EENT: dry mouth, blurred vision. CV: arrhythmias. GI: constipation,
dyspepsia, nausea, unpleasant taste. GU: urinary retention.

Interactions
Drug-Drug: Additive CNS depression with other
CNS depressants, including alcohol, antihistamines, opioid analgesics, and sedative/ hypnotics. Additive anticholinergic effects with drugs possessing anticholinergic properties, including antihistamines, antidepressants, atropine, disopyramide, haloperidol, and phenothiazines. Avoid use within 14 days of MAO inhibitors (hyperpyretic crisis, seizures, and death may occur). Drug-Natural Products: Concomitant use of kava-kava, valerian, chamomile, or hops can increase CNS depression.

Route/Dosage
PO (Adults): Acute painful musculoskeletal conditions—10 mg 3 times daily (range 20–40 mg/day in 2–4 divided doses; not to exceed 60 mg/day) or extended-release, 15–30 mg once daily. Fibromyalgia—5–40 mg at bedtime (unlabeled).

Availability (generic available)
Tablets: 5 mg, 10 mg. Cost: Generic—5 mg, 10 mg. Extended-release capsules (Amrix): 15 mg, 30 mg.

NURSING IMPLICATIONS

Assessment
  • Assess patient for pain, muscle stiffness, and range of motion before and periodically throughout therapy.
  • Geri: Assess geriatric patients for anticholinergic effects (sedation and weakness).
Potential Nursing Diagnoses
Acute pain (Indications)
Impaired physical mobility (Indications)
Risk for injury (Side Effects)

Implementation
  • Do not confuse cyclobenzaprine with cyproheptadine.
  • PO: May be administered with meals to minimize gastric irritation.
  • Swallow extended-release capsules whole; do not open, crush, or chew.
Patient/Family Teaching
  • Instruct patient to take medication as directed; do not take more than the prescribed amount.
  • Taken missed doses within 1 hr of time ordered; otherwise, return to normal dose schedule.
Do not double doses.
  • Medication may cause drowsiness, dizziness, and blurred vision. Caution patient to avoid driving or other activities requiring alertness until response to drug is known. Advise patient to avoid concurrent use of alcohol or other CNS depressants with this medication.
  • If constipation becomes a problem, advise patient that increasing fluid intake and bulk in diet and stool softeners may alleviate this condition.
  • Advise patient to notify health care professional if symptoms of urinary retention (distended abdomen, feeling of fullness, overflow incontinence, voiding small amounts) occur. Inform patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may help relieve dry mouth.
Evaluation/Desired Outcomes
  • Relief of muscular spasm in acute skeletal muscle conditions. Maximum effects may not be evident for 1–2 wk. Use is usually limited to 2–3 wk; however, has been effective for at least 12 wk in the management of fibromyalgia.

Benifits of Sex

Sexual Health

  • When you're in the mood, it's a sure bet that the last thing on your mind is boosting your immune system or maintaining a healthy weight. Yet good sex offers those health benefits and more. That's a surprise to many people, says Joy Davidson, PhD, a New York psychologist and sex therapist. "Of course, sex is everywhere in the media," she says. "But the idea that we are vital, sexual creatures is still looked at in some cases with disgust or in other cases a bit of embarrassment. So to really take a look at how our sexuality adds to our life and enhances our life and our health, both physical and psychological, is eye-opening for many people."
  • Sex does a body good in a number of ways, according to Davidson and other experts. The benefits aren't just anecdotal or hearsay -- each of these health benefits of sex is backed by scientific scrutiny.


Sex Relieves Stress

A big health benefit of sex is lower blood pressure and overall stress reduction, according to researchers from Scotland who reported their findings in the journal Biological Psychology. They studied 24 women and 22 men who kept records of their sexual activity. Then the researchers subjected them to stressful situations -- such as speaking in public and doing verbal arithmetic -- and noted their blood pressure response to stress. Those who had intercourse had better responses to stress than those who engaged in other sexual behaviors or abstained.




Sex Lowers Blood Pressure

Another study published in Biological Psychology found that frequent intercourse was associated with lower diastolic blood pressure (the lower, or second, number in a blood pressure reading). This study focused on people living with their sex partner.
Still further research found a link between partner hugs and lower blood pressure in women.
Elevated blood pressure is a risk factor for coronary artery disease, heart attack, kidney disease, and stroke.









Sex Boosts Immunity

Good sexual health may mean better physical health. Having sex once or twice a week has been linked with higher levels of an antibody called immunoglobulin A or IgA, which can protect you from getting colds and other infections. Scientists at Wilkes University in Wilkes-Barre, Pa., took samples of saliva, which contain IgA, from 112 college students who reported the frequency of sex they had.
Those in the "frequent" group -- once or twice a week -- had higher levels of IgA than those in the other three groups -- who reported being abstinent, having sex less than once a week, or having it very often, three or more times weekly.






Sex Counts As Exercise

"Sex is a great mode of exercise," says Patti Britton, PhD, a Los Angeles sexologist and president of the American Association of Sexuality Educators and Therapists. It takes work, from both a physical and psychological perspective, to do it well, she says.
The benefits of sex as a form of exercise are many - sex can improve your cardiovascular fitness, strength, flexibility, and balance, not to mention your emotional health.

Sex Burns Calories

Thirty minutes of sex burns 85 calories or more. It may not sound like much, but it adds up: 42 half-hour sessions will burn 3,570 calories, more than enough to lose a pound. The number of calories burned during sex is about the same as the number burned by walking at 2 miles per hour.
Doubling up on the 30 minute sessions, you could drop that pound in 21 hour-long sessions.

Sex Improves Cardiovascular Health

While some older folks may worry that the efforts expended during sex could cause a stroke, that's not so, according to researchers from England. In a study published in the Journal of Epidemiology and Community Health, scientists found that the frequency of sex was not associated with stroke in the 914 men they followed for 20 years.
And the heart health benefits of sex don't end there. The researchers also found that having sex twice or more a week reduced the risk of fatal heart attack by half for the men, compared with those who had sex less than once a month.

Sex Boosts Self-Esteem

Boosting self-esteem was one of 237 reasons people have sex, collected by University of Texas researchers and published in the Archives of Sexual Behavior.
That finding makes sense to Gina Ogden, PhD, a sex therapist and marriage and family therapist in Cambridge, Mass., although she finds that those who already have self-esteem say they sometimes have sex to feel even better. "One of the reasons people say they have sex is to feel good about themselves," she tells WebMD. "Great sex begins with self-esteem, and it raises it. If the sex is loving, connected, and what you want, it raises it."

Sex Strengthens Your Well-Being

Sex, like any activity that fosters a close and loving connection to your partner, not only raises self-esteem, but strengthens your overall sense of well-being. Studies have shown that people with strong social support networks (which includes lovers) are healthier and happier than their less-connected peers.


Sex Improves Intimacy

Having sex and orgasms increases levels of the hormone oxytocin, the so-called love hormone, which helps us bond and build trust. Researchers from the University of Pittsburgh and the University of North Carolina evaluated 59 premenopausal women before and after warm contact with their husbands and partners ending with hugs. They found that the more contact, the higher the oxytocin levels.
"Oxytocin allows us to feel the urge to nurture and to bond," Britton says.
Higher oxytocin has also been linked with a feeling of generosity. So if you're feeling suddenly more generous toward your partner than usual, credit the love hormone.

Sex Reduces Pain

As the hormone oxytocin surges, endorphins increase, and pain declines. So if your headache, arthritis pain, or PMS symptoms seem to improve after sex, you can thank those higher oxytocin levels.


Oxytocin – The Love Hormone

A study published in the Bulletin of Experimental Biology and Medicine examined the response of the “love hormone” oxytocin on pain perception in an experiment with 48 volunteers. Study participants inhaled oxytocin vapor and then had their fingers pricked. Those who had inhaled oxytocin lowered their pain threshold by more than half.

Sex Reduces Prostate Cancer Risk

Frequent ejaculations, especially in 20-something men, may reduce the risk of prostate cancer later in life, Australian researchers reported in the British Journal of Urology International. When they followed men diagnosed with prostate cancer and those without, they found no association of prostate cancer with the number of sexual partners as the men reached their 30s, 40s, and 50s.
But they found men who had five or more ejaculations weekly while in their 20s reduced their risk of getting prostate cancer later by a third.
Another study, reported in the Journal of the American Medical Association, found that frequent ejaculations, 21 or more a month, were linked to lower prostate cancer risk in older men, as well, compared with less frequent ejaculations of four to seven monthly.

Sex Strengthens Pelvic Floor Muscles

For women, doing a few pelvic floor muscle exercises known as Kegel exercises during sex offers a couple of benefits. You will enjoy more pleasure, and you'll also strengthen the area and help to minimize the risk of incontinence later in life.
To do a basic Kegel exercise, tighten the muscles of your pelvic floor, as if you're trying to stop the flow of urine. Count to three, then release.


Additional Benefits of Kegel Exercises

Kegel exercises have a number of proven health benefits in addition to making sex more enjoyable. The strengthening of the pelvic floor muscles can help prevent prolapse (a slipping out of position) of the vagina, uterus, and bladder. Pelvic floor muscles may be weakened later in life as a result of childbearing, being overweight, and aging. Kegel exercises help offset the consequences of weakened pelvic floor muscles.

Sex Helps You Sleep Better

The oxytocin released during orgasm also promotes sleep, according to research.
And getting enough sleep has been linked with a host of other good things, such as maintaining a healthy weight and blood pressure. Something to think about, especially if you've been wondering why your guy can be active one minute and snoring the next.

Sex As Physical Exercise Also Promotes Sleep

The physical exercise component of sex can also help you relax and sleep better, in addition to the hormonal effects. People who get regular exercise tend to sleep better and have more restful sleep. Moreover, as we have seen in the earlier part of this slideshow, sex is a great way to get some exercise.

Summary

Take note that sex is good for you in ways you may never have imagined and that the health benefits extend well beyond the bedroom.



source..

Propecia

Finasteride (generic name)
Propecia (brand name)


Finasteride Oral tablet [Benign Prostatic Hyperplasia] 

What is this medicine?

  • FINASTERIDE (fi NAS teer ide) is used to treat benign prostatic hyperplasia (BPH) in men. This is a condition that causes you to have an enlarged prostate. This medicine helps to control your symptoms, decrease urinary retention, and reduces your risk of needing surgery. When used in combination with certain other medicines, this drug can slow down the progression of your disease.
  • This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:

  •     Liver disease
  •     An unusual or allergic reaction to finasteride, other medicines, foods, dyes, or preservatives
  •     Pregnant or trying to get pregnant
  •     Breast-feeding

How should I use this medicine?

  • Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take this medicine with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on the advice of your doctor or health care professional.
  • Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: 

  • If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: 
  • This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

  • If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

  • Male hormones like testosterone
  • This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Share

Twitter Delicious Facebook Digg Stumbleupon Favorites