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  • [::..archive..::]
    07/20/2003 - 07/27/2003 07/27/2003 - 08/03/2003 08/03/2003 - 08/10/2003 08/10/2003 - 08/17/2003 08/24/2003 - 08/31/2003 08/31/2003 - 09/07/2003 09/07/2003 - 09/14/2003 09/14/2003 - 09/21/2003 09/21/2003 - 09/28/2003 11/09/2003 - 11/16/2003 03/21/2004 - 03/28/2004
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    :: Tuesday, August 12, 2003 ::

    antacids

    aluminium hydroxide gel (amphogel, alternaGel)
    aluminium carbonate gel (basaljel)
    bismuth subsalicylate (pepto-bismol)
    calcium carbonate (tums)

    magnesium hydroxide (milk of magnesia, MOM)
    misoprostol (cytotec)
    sulcralfate (carafate)


    description
    react with gastric acid to produce neutral salts or salts of low acidity
    inactivate pepsin and enhance mucosal protection but do not coat the ulcer crater to protect it from teh acid and pepsin.
    used for peptic ulcer disease and gastroesophageal reflux disease.
    should be taken on a regular schedule
    are usually administered severn times a day, 1 and 3 hourws after each meal and at bedtime
    to provide maximum benefit, treatement should elevate the gastric pH above 5
    antacid tablets should be chewed thoroughly and followed with a glass of water or milk.
    liquid preparations should be taken before dispensing.
    interactions with other medications can be minimized by allowing one hour between antacid administraiton and administration of other medications.
    can interfere with the action of sucralfate (carafate) and to minimize this interaction, the medications should be administered 1 hour apart from each other.

    sucralfate (carafate)

    creates a protective barrier against acid and pepsin.
    administered orally; should be taken on an empty stomach
    administer atleast 60 minutes apart from an antacid
    may cause constipation
    may impede absorption of warfarin sodium (coumadin), phenytoin (dilantin), theophylline, digoxin (lanoxin) and some antibiotics and should be administered atleast 2 hours apart from these medications.

    misoprostol (cytotec)

    used to prevent gastric ulcers caused by long term therapy with nonsteroidal antiinflammatory drugs (NSAIDS)
    suppresses secretion of gastric acid
    promotes secretion of bicarbonate and cytoprotective mucous.
    maintains submucosal blood flow by promoting vasodilation
    administered with meals.
    causes diarrhea and abdominal pain
    contraindicated for use in pregnancy.

    magnesium hydroxide

    rapid acting
    also referred to as milk of magnesia
    most prominent side effect is diarrhea
    usually administered in combination with aluminium hydroxide; an antacid that assists in preventing diarrhea.
    contraindicated in clients with intestinal obstruction, appendicitis, or clients with undiagnosed abdominal pain.
    in clients with renal impariment, magnesium can accumulate to high levels, causing signs of toxicity.

    aluminium hydroxide gel (amphogel, alternagel)

    slow acting
    contains significant amounts of sodium
    used with caution in clients with hypertension and heart failure
    most common side effect is constipation
    can reduce teh effect of tetracyclines, warfarin sodium (coumadin), and digoxin (lanoxin)
    can reduce phosphate absorption and thereby cause hypophosphatemia.

    calcium carbonate (tums)
    rapid acting
    common side effect is constipation

    sodium bicarbonate

    rapid onset
    liberates carbon dioxide, increases intraabdominal pressure and flatulence.
    used in caution with clients with hypertension and heart failure
    can cause systemic alkalosis in clients with renal impairment
    in useful for treating acidosis and elevating urinary pH to promote excretion of acidic medications after overdose.

    histamine H-2 receptor aganoists

    cimetidine (tagamet)
    famotidine (pepcid)
    nizatidine (axid)
    ranitidine (zantac)
    ranitidine bismuth citrate (tritec)


    description

    suppress secretions of gastric acid
    alleviate symptoms of heartburn and assist in preventing complications of peptic culcer disease
    prevent stress ulcers and reduce the recurrence of all ulcers
    promotes healing in GERD
    contraindicated in hypersensitivity
    used with caution in clients with impaired renal or hepatic function.

    cimetidine (tagamet)

    can be administered orally (IV); intramuscularly (IM), or intravenously (IV)
    food reduces the rate of absorption if taken with meals, absorption will be slowed.
    antacids can decrease the absorption of cimetidine
    cimetidine and antacids should be administered atleast one hour apart from each other
    passes the blood brain barrier, and central nervous system side effects can occur.
    may cause mental confusion, agitation, psychosis, depression, anxiety and disorientation.
    dosage should be reduced in clients with renal impairment.
    IV administration can cause hypotension and dysrhythmias
    if administered with warfarin sodium (coumadin), phenytoin (dilantin), theophylline or lidocaine (xylocaine), the dosages of these medications should be reduced.

    ranitidine (zantac)


    can be administered orally, IM, IV
    side effects are uncommon
    unlike cimetidine, ranitidine (zantac) does not penetrate the blood-brain barrier.
    zantac is not affected by food.

    famotidine (pepcid) and nizatidine (axid)

    similar to zantac and tagamet
    do not need to be administered with food.

    ranitidine bismuth citrate (tritec)

    used to treat active duodenal ulcers associated with helicobacter pylori
    administered with the antibiotic clarithromycin (biaxin)

    :: Sindhu's Medical News @ 12:38 AM [+]

    ...
    :: Sunday, August 10, 2003 ::
    hormonal medications and enzymes

    androgens

    testolactone (teslac)
    fluoxymesterone (halotestin)

    hormonal antagonists, enzymes


    aminoglutethimide (Cytadren)
    asparaginase (elspar)
    diethylstilbestrol (stilphostrol)
    flutamide (Eulexin)
    goserelin acetate (zoladex)

    megesterol acetate (megace)
    mitotane (lysodren)
    tamoxifen citrate (nolvadex
    )

    description

    suppress the immune system and block normal hormones in hormone sensitive tumors
    change teh hormonal balance and slow the growth rate of certain tumors.

    side effects

    anorexia, nausea and vomiting
    leukopenia
    impaired pancreatic function with asparaginase (elspar)
    gynecomastia
    breast swelling
    hot flashes
    weight gain
    hemorrhagic cystitis, hypouricemia, and hypercholesterolemia with mitotane (lysodren)
    hypertension
    thromboembolytic disorders
    edema
    sex characteristic alterations
    electrolyte imbalances
    tamoxifen citrate (nolvadex) may cause edema, and elevated cholesterol and triglyceride levels and decreases the effect of estrogen.
    diethylstilbestrol (stilphostrol) may cause impotence and gynecomastia in mena and may alter effects of insulin, oral anticoagulants, and oral hypoglycemic agents.

    implementation

    monitor vital signs
    ask the client about the medications currently taking
    monitor serum calcium levels with androgens
    monitor for signs of alterations in sexual characteristics
    montir pancreatic functionwith asparaginase
    encourage an oral intake of 2 to 3 liters of fluids per day
    monitor uric acid and cholesterol levels
    monitor for signs of hemorrhagic cystitis.

    immunotherapy: biological response modifiers

    colony stimulating factors (CSF)


    granulocyte/macrophage colony stimulating factor(gm-csf)

    sargramostim (leukine, prokine)

    granulocyte stimulating factors (g-csf)


    filgastrim (neupogen)

    erythropoietin (EPO)

    epotin alfa (epogen
    )

    description

    stimulate the immune system to recognize cancer cells and take action to eliminate or destroy them.
    interleukins: help different immune system cells to recognize and destroy abnormal body cells.
    interferons: slow down tumor cells division; stimulate proliferation and activiation of natural killer cells; and help cancer cells resume a more normal appearance and revert to their previous characteristics.

    colony stimulating factors: induce more rapid bone marrow recovery after suppression by chemotherapy

    :: Sindhu's Medical News @ 11:06 PM [+]

    ...
    vinca (plant) alkaloids

    etoposide (vepesid)
    paclitaxel (taxol)
    docetaxel (taxotere
    )
    teniposide (Vumon)
    vinblastine sulphate (velban
    )
    vincristine sulphate (oncovin)
    vindesine (eldisine)
    vinorelbine (navelbine)


    description

    prevent mitosis, causing cell death
    mitotic inhibitor that prevents cell division
    cell cycle phase specific and act on the M phase

    side effects

    leukopenia
    neurotoxicity with vincristine sulfate (oncovin) manifested as numbness and tingling in the fingers and toes.
    ptosis
    hoarseness
    motor instability
    anorexia, nausea, and vomiting
    constipation
    peripheral neuropathy
    alopecia
    stomatitis
    hyperuricemia
    phlebitis at IV site

    implementation

    monitor vital signs
    monitor WBC, CBC, uric acid, and platelet counts
    monitor for hoarseness
    check the eye for ptosis
    monitor motor stability and initate safety precautions as necessary
    monitor for neurotoxicity with vincristine sulfate (oncovin) manifested as numbness and tingling in the fingers and toes.

    :: Sindhu's Medical News @ 9:47 PM [+]

    ...

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