Paxil

The most important information about Paxil 

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are a child or young adult. Talk with your doctor about this risk. While you are taking Paxil you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.
Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself. Paxil may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Paxil, do not stop taking the medication without first talking to your doctor. Do not take Paxil together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

What is Paxil

Paxil is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paxil affects chemicals in the brain that may become unbalanced.

Paxil is used to treat depression, obsessive-compulsive disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Paxil may also be used for purposes other than those listed in this medication guide.

What to discuss with your doctor before taking Paxil

You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are a child or young adult. Talk with your doctor about this risk. While you are taking Paxil you will need to be monitored for worsening symptoms of depression and/or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks.
Do not use Paxil if you are using pimozide (Orap), thioridazine (Mellaril), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with Paxil. You must wait at least 14 days after stopping an MAO inhibitor before you can take Paxil. After you stop taking Paxil, you must wait at least 14 days before you start taking an MAOI.

Before taking Paxil, tell your doctor if you are allergic to any drugs, or if you have:

liver or kidney disease;

seizures or epilepsy;

bipolar disorder (manic depression), or a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may not be able to use Paxil, or you may need a dosage adjustment or special tests.
FDA pregnancy category D. Paxil may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Paxil, do not stop taking the medication without first talking to your doctor. Paxil can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How to take Paxil

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.
Do not crush, chew, or break a controlled-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. Shake the liquid form of Paxil well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. It may take 4 weeks or longer before you start feeling better. Do not stop using Paxil without first talking to your doctor. Store Paxil at room temperature away from moisture and heat.

What happens in case of missing a dose

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.
What happens if I overdose with Paxil?
Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a Paxil overdose may include nausea, vomiting, tremor, sweating, decreased urination, blurred vision, rapid heartbeat, confusion, aggression, seizures, and coma.

What to avoid while taking Paxil

Avoid drinking alcohol, which can increase some of the side effects of Paxil.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, other medication for depression or anxiety). They can add to sleepiness caused by Paxil.
Paxil can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

The possible side effects of Paxil

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

seizure (convulsions);

tremors, shivering, muscle stiffness or twitching;

problems with balance or coordination; or

agitation, confusion, sweating, fast heartbeat.

Other less serious side effects are more likely to occur, such as:

feeling nervous, restless, or unable to sit still;

drowsiness, dizziness, weakness;

sleep problems (insomnia);

nausea, constipation, loss of appetite;

weight changes;

decreased sex drive, impotence, or difficulty having an orgasm; or

dry mouth, yawning, or ringing in your ears.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Paxil?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Paxil may cause you to bruise or bleed easily.

Before taking Paxil, tell your doctor if you are using any of the following medicines:

atomoxetine (Strattera), cimetidine (Tagamet), lithium (Lithobid, Eskalith), risperidone (Risperdal), St. John's wort, tramadol (Ultram), or tryptophan (also called L-tryptophan);

heart rhythm medication such as flecainide (Tambocor) or propafenone (Rhythmol);

a blood thinner such as warfarin (Coumadin);

any other antidepressants such as amitriptyline (Elavil), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or sertraline (Zoloft);
a phenothiazine such as prochlorperazine (Compazine), chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), and others; or

almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).

If you are using any of these drugs, you may not be able to use Paxil, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Paxil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Accutane

The most important information about Accutane

Accutane can cause severe, life-threatening birth defects if the mother takes the medication during pregnancy. Even one dose of Accutane can cause major birth defects of the baby's ears, eyes, face, skull, heart, and brain. Never use Accutane if you are pregnant.
Women of child-bearing potential must agree in writing to use two specific forms of birth control and have regular pregnancy tests before, during, and after taking Accutane. Unless you have had a total hysterectomy or have been in menopause for at least a year, you are considered to be of child-bearing potential.

Accutane is available only under a special program called iPLEDGE. You must be registered in the program and sign agreements to use birth control and undergo pregnancy testing as required by the program. Read all program brochures and agreements carefully.

It is dangerous to try and purchase Accutane on the Internet or from vendors outside of the United States. The sale and distribution of Accutane outside of the iPLEDGE program violates the regulations of the U.S. Food and Drug Administration for the safe use of this medication.

What is Accutane

Accutane is a form of vitamin A. It reduces the amount of oil released by oil glands in your skin, and helps your skin renew itself more quickly.

Accutane is used to treat severe nodular acne. It is usually given after other acne medicines or antibiotics have been tried without successful treatment of symptoms.

Accutane may also be used for purposes other than those listed in this medication guide.


What to discuss with your doctor before taking Accutane

Do not use this medication if you are allergic to Accutane or to parabens, or if you are pregnant or may become pregnant.
Before taking Accutane, tell your doctor if you are allergic to any foods or drugs, or if you have:

a personal or family history of depression or mental illness;

heart diease, high cholesterol or triglycerides;

osteoporosis or other bone disorders;

diabetes;

asthma;

an eating disroder (anorexia nervosa); or

liver disease.
If you have any of these conditions, you may not be able to use Accutane, or you may need a dosage adjustment or special tests during treatment.

Accutane can cause severe, life-threatening birth defects if the mother takes the medication during pregnancy. Even one dose of Accutane can cause major birth defects of the baby's ears, eyes, face, skull, heart, and brain. Never use Accutane if you are pregnant.
For Women: Unless you have had your uterus and ovaries removed (total hysterectomy) or have been in menopause for at least 12 months in a row, you are considered to be of child-bearing potential.

Even women who have had their tubes tied are required to use birth control while taking Accutane.

You must have a negative pregnancy test 30 days before you start taking Accutane. A pregnancy test is also required before each prescription is refilled, right after you take your last dose of Accutane, and again 30 days later. All pregnancy testing is required by the iPLEDGE program.

You must agree in writing to use two specific forms of birth control beginning 30 days before you start taking Accutane and ending 30 days after you stop taking it. Both a primary and a secondary form of birth control must be used together.

Primary forms of birth control include:

tubal ligation (tubes tied);

vasectomy of the male sexual partner;

an IUD (intrauterine device);

estrogen-containing birth control pills (not mini-pills); and

hormonal birth control patches, implants, injections, or vaginal ring.

Secondary forms of birth control include:

a male latex condom plus spermicidal foam or gel;

a diaphragm plus spermicidal foam or gel;

a cervical cap plus spermicidal foam or gel; and

a vaginal sponge containing spermicide.

Do not take St. John's wort, an herbal supplement, if you are using any type of hormonal birth control, including pills, patches, implants, injections, or a vaginal ring. Breakthrough bleeding may occur.
Stop using Accutane and call your doctor at once if you have unprotected sex, if you quit using birth control, if your period is late, or if you think you might be pregnant.

It is not known whether Accutane passes into breast milk. Do not take Accutane without first talking to your doctor if you are breast-feeding a baby.

How to take Accutane

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Each prescription of Accutane must be filled within 7 days of the date it was prescribed by your doctor. You will receive no more than a 30-day supply of Accutane at one time.

Always take Accutane with a full glass of water to prevent the capsule from melting in your esophagus (food pipe), causing irritation. Do not chew or suck on the capsule. Swallow it as quickly as possible. Take Accutane with food or milk. Take this medication for the entire length of time prescribed by your doctor. Your acne may seem to get worse at first, but should then begin to improve.
To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled visits to your doctor.

Never share this medicine with another person, even if they have the same symptoms you have. Store Accutane at room temperature away from moisture, heat, and light.

In case of missing a dose

Skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.


In case of overdosing

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of an Accutane overdose include headache, dizziness, vomiting, stomach pain, warmth or tingling under the skin, swelling of the lips, and loss of balance or coordination.

What to avoid while taking Accutane

Do not take vitamin supplements containing vitamin A while you are taking Accutane.
Accutane can weaken bones. Avoid sports or activities that may result in injury or bone fracture.

Do not donate blood while taking Accutane and for at least 30 days after you stop taking it. Donated blood that is later given to pregnant woman could lead to birth defects in her baby if the blood contains any level of Accutane.
Do not use wax hair removers or have dermabrasion or laser skin treatments while you are taking Accutane and for at least 6 months after you stop taking it. Scarring may result.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Accutane can make your skin more sensitive to sunlight and sunburn may result. Accutane can cause side effects that may impair your vision, especially at night. Be careful if you drive or do anything that requires you to see clearly.

The possible side effects of Accutane

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Accutane and call your doctor at once if you have any of these serious side effects:
depressed mood, trouble concentrating, sleep problems, crying spells, aggression or agitation, changes in behavior, hallucinations, thoughts of suicide or hurting yourself;

sudden numbness or weakness, especially on one side of the body;

blurred vision, sudden and severe headache or pain behind your eyes, sometimes with vomiting;

hearing problems, hearing loss, or ringing in your ears;

seizure (convulsions);

severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

severe diarrhea, rectal bleeding, black, bloody, or tarry stools;

fever, chills, body aches, flu symptoms, purple spots under your skin, easy bruising or bleeding; or

joint stiffness, bone pain or fracture.

Continue taking Accutane and talk to your doctor if you have any of these less serious side effects:

discomfort with contact lenses;

joint pain, back pain;

feeling dizzy, drowsy, or nervous;

dryness of the lips, mouth, nose, or skin; or

cracking or peeling skin, itching, rash, changes in your fingernails or toenails.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Accutane

Before taking Accutane, tell your doctor if you are also taking:

steroids (prednisone and others);

seizure medication such phenytoin (Dilantin); or

a tetracycline antibiotic such as demeclocycline (Declomycin), doxycycline (Doryx, Vibramycin), minocycline (Minocin), or tetracycline (Brodspec, Sumycin, Tetracap).

If you are using any of these drugs, you may not be able to use Accutane, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Accutane. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Ventolin

Composition, structure and packing

Aerosol metered dose for inhalation as a suspension of white or nearly white. 1 dose of salbutamol sulphate 120.5 mg which corresponds to the content of salbutamol 100 micrograms. Excipients: propellant 1,1,1,2-tetrafluoroethane (HFA 134a) does not contain chlorofluorocarbons. .

Clinico-pharmacological group: bronchodilators product - beta2-adrenomimetics.

Pharmacological action

Selective beta2-adrenomimetics. At therapeutic doses, acts on the β2-adrenergic receptors of smooth muscles of the bronchi, providing little effect on β1-adrenergic receptors infarction. Salbutamol inhibits the release of mast cell histamine, leukotrienes, prostaglandin D2, and other biologically active substances for a long time. Inhibits early and late bronchial reactivity. Has pronounced bronchodilatory effect, preventing or kupiruya bronchospasm, reduces the resistance in the airways. Increases vital capacity.

Increases mucociliary clearance (with chronic bronchitis and 36%), stimulates mucus secretion, activates the function of ciliated epithelium. Hinders release of inflammatory mediators from mast cells and basophils, in particular the release of histamine induced by antibodies to immunoglobulin E, eliminates the suppression of antigen mucocilliary transport and separation factor of chemotaxis of neutrophils.

Prevents the development of allergen-induced bronchospasm. Can lead to a decrease in the number of β1-adrenergic receptors, including on lymphocytes. It has a number of metabolic effects: reduces the concentration of potassium in the plasma affects glycogenolysis and insulin release, has a hyperglycemic (especially in patients with bronchial asthma) and the lipolytic effect, increases the risk of acidosis.

Pharmacokinetics

Absorption and metabolism

After inhalation of salbutamol 10-20% of the dose reaches the lower respiratory tract. The remainder of the dose remains in the inhaler, or deposited in the oropharynx and then swallowed.

The fraction deposited in the airways, absorbed in the lung tissue and blood, but is not metabolized in the lungs. Swallowed portion of an inhalation dose is absorbed from the gastrointestinal tract and is subjected to intensive metabolism in the "first pass" through the liver, becoming inactive 4'-O-sulphate (phenolic sulphate).

Distribution

Linking calbutamola to plasma proteins is 10%.

Withdrawal

When i / in the introduction of T1 / 2 of salbutamol is 4-6 hours Unchanged salbutamol and conjugate are excreted primarily in urine. Since feces displayed only a fraction of the administered dose of salbutamol. Most of the dose of salbutamol, introduced in the body in / in, inside, or by inhalation displayed within 72 hours

Statement

Asthma:
relief of asthma attacks, including during exacerbation of asthma severe course;
preventing attacks of bronchospasm associated with exposure to an allergen or due to physical activity;
used as a component for long-term maintenance treatment of bronchial asthma.

Chronic obstructive pulmonary disease (COPD), accompanied by reversible airway obstruction, including chronic bronchitis and emphysema of the lungs.

Dosage regimen

Metered Aerosol Ventolin is intended only for inhalation. To solve the issue of increasing the dose or frequency of use of the drug can only be a doctor. Not recommended for use Ventolin often 4 times / day. The need for frequent use Ventolin in the maximum doses or in a sudden increase in dose indicates deteriorating course of the disease. Adults (including elderly patients). Cupping bronchospasm: the recommended dose is 100-200 mcg (1-2 inhalations).

Preventing attacks of bronchospasm associated with exposure to an allergen or caused by physical stress: the recommended dose is 200 mcg (2 inhalations) for 10-15 minutes before exposure to a provoking factor. Long-term maintenance therapy: The recommended dose is 200 mcg (2 inhalations) 4 times / day. Ventolin, you can enter through the spacer Volyumatik.

Children cupping bronchospasm: the recommended dose is 100-200 mcg (1-2 inhalations). Preventing attacks of bronchospasm associated with exposure to an allergen or caused by physical stress: the recommended dose is 100-200 mcg (1-2 inhalations) for 10-15 minutes before exposure to a provoking factor. Long-term maintenance therapy: The recommended dose is 200 mg (2 inhalations) 4 times / day. Ventolin, you can enter through the spacer Bebihaler or Volyumatik.

Side effect

Allergic reactions: seldom - angioedema, urticaria.
From the side of the central nervous system: often - tremor, headache, and very rarely - hyperactivity.
Since the cardiovascular system: often - tachycardia is very rare - arrhythmia, supraventricular tachycardia, extrasystoles, increased peripheral vascular diseases.
On the part of the respiratory system: very rarely - bronchospasm.
On the part of the digestive system: rarely - irritation of the mucous membrane of the oral cavity and pharynx.
On the part of the musculoskeletal system: rarely - muscle cramps.
On the part of metabolism: rarely - hypokalemia.

Contraindications
management of preterm labor;
threatened abortion;
Children under 2 years
Hypersensitivity to any component of the drug.

Pregnancy and lactation

During pregnancy and lactation drug prescribed only in cases where the expected benefit to the mother than any possible risk to the fetus. Salbutamol is likely to penetrate into breast milk.

Data to know whether present in breast milk salbutamol harmful effect on the newborn, no. Cautions should instruct the patient about the proper use of inhaler Ventolin. Bronchodilators should not be the sole or main component of bronchial asthma or severe unstable flow.

If the action is the usual dose of Ventolin becomes less effective or less long (drug effect persists at least 3 h), the patient should consult a doctor. Increasing demand for use of inhaled β2-adrenoceptor agonist with a short duration of action for the control of asthma symptoms reflecting the worsening of the disease. In such cases, should review the treatment plan.

Sudden and progressive deterioration of bronchial asthma may pose a threat to the patient's life, so in these situations need to urgently address the issue of the appointment or increasing the dose of GCS. In such patients is recommended for daily monitoring of peak velocity of exhalation. With careful use the drug in patients with thyrotoxicosis. Therapy β2-adrenoceptor agonists, especially when they are introduced parenterally or by nebulizer, can lead to hypokalaemia.

Particular caution should be exercised when treating severe asthma attacks, because in these cases, the hypokalemia may be exacerbated by the simultaneous application of xanthine derivatives, SCS, diuretics, and also due to hypoxia. In such situations need to monitor potassium levels in blood serum.

Effects on ability to drive vehicles and management mechanisms

Data on the effect on the ability to drive motor vehicles and / or other mechanisms are absent.

Overdose

Symptoms: possible hypokalemia.

Treatment: for suspected overdose should monitor the level of potassium in the blood serum. Antidotes are cardioselective beta-blockers. However, β-adrenoceptor blockers should be used with caution in patients with a history of attacks of bronchospasm.

Drug Interactions

It is not recommended to use both salbutamol and nonselective β-adrenoceptor blockers such as propranolol. Salbutamol is not contraindicated in patients who are receiving MAO inhibitors.

Terms and conditions of storage

The drug should be stored at a temperature below 30 ° C. Shelf life - 2 years. Inhaler should not be frozen and exposed to direct sunlight.