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Lab tests may include complete blood count with differential, electrolytes, renal and liver functions, thyroid studies, urine drug screen, etc treatment hospitalization and esidrix. First, followed by some of the common proprietary trade ; names. Drugs shown with underlining are not available under the Pharmaceutical Benefits Schemes [PBS] in Australia, i.e., they are not available at a subsidised price ; . Antipsychotics Amisulpride Solian ; Chlorpromazine Largactil ; Escitalopram Lexapro ; Fluphenazine Modecate ; Haloperidol Haldol, Serenace ; Moclobemide Auroix ; Olanzapine Zyprexa ; Promazine Promazine ; Quetiapine Seroquel ; Risperidone Risperdal ; Sulpiride Dolmatil, Sulparex, Sulpitil ; Trifluoperazine Stelazine ; Zuclopenthixol Clopixol ; Antidepressants Amitriptyline Endep ; Citalopram Cipramil, also Celapram, Ciazil, Talam, Talohexal ; Dothiepin Prothiaden, also Dothep ; Doxepin Sinequan, also Deptran ; Fluoxetine Prozac, also Lovan, Auscap, Fluohexal, Fluoxebell, Zactin ; Fluvoxamine Faverin, also Movax, Luvox, Voxam ; Imipramine Tofranil, also Tolerade ; Mirtazipine Avanza, Axit, Mirtazon, Remeron ; Nortriptyline Allegron ; Paroxetine Aropax, Paxtine, Oxetine ; Reboxetine Edronax ; Sertraline Zoloft, Xydep, Eleva, Concorz ; Venlafaxine Efexor ; Mood stabilisers Lithium carbonate Lithicarb, Quilonum ; Anxiety-relieving drugs Alprazolam Xanax, also Alprax, Kalma, Zamahexal ; Buspirone Buspar ; Diazepam Valium also Antenex, Valpam, Ducene.
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Adapted from Fick DM et al., Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, Archives of Internal Medicine, December 8 22, 2003, Drug Category Common Brand Name generic name ; Adderall amphetamine mixture ; Bontril phendimetrazine ; Desoxyn methamphetamine ; Dexedrine dextroamphetamine ; Didrex benzphetamine ; Ionamin phentermine ; Meridia sibutramine ; Tenuate diethylpropion ; Android Virilon Testred methyltestosterone ; Cordarone amiodarone ; Norpace and Norpace CR disopyramide ; Prozac fluoxetine daily ; Elavil amitriptyline ; Triavil amitriptyline-perphenazine ; Limbitrol amitriptyline-chlordiazepoxide ; Sinnequan doxepin ; Diabinese chlorpropamide ; Tigan trimethobenzamide ; Benadryl diphenhydramine ; Chlor-Trimeton chlorpheniramine ; Periactin cyproheptadine ; Phenergan promethazine ; Polaramine dexchlorpheniramine ; Tripelennamine Atarax Vistaril hydroxyzine ; Adalat Procardia nifedipine short acting ; Hylorel guanadrel ; Ismelin guanethidine ; Aldomet methyldopa ; Aldoril methyldopa-hydrochlorothiazide ; Macrodantin nitrofurantoin ; Ticlid ticlopidine ; Mellaril thioridazine ; Serentil mesoridazine ; Miltown meprobamate ; Butisol butabarbital ; Nembutal pentobarbital ; Seconal secobarbital ; Key A A A F&G H I J K Drug Category Common Brand Name generic name ; Doral quazepam ; Librium chlordiazepoxide ; Paxipam halazepam ; Tranxene chlorazepate ; Valium diazepam ; Dalmane flurazepam ; Librium Librax Limbitrol chlordiazepoxide, chlordiazepoxide-clindium, chlordiazepoxideamitriptyline ; Ativan lorazepam ; 3mg Halcion triazolam ; 0.25mg Restoril temazepam ; 15mg Serax oxazepam ; 60mg Xanax alprazolam ; 2mg Bentyl dicyclomine ; Donnatal and others belladona alkaloids ; Levsin Levsinex hyoscyamine ; Pro-Banthine propantheline ; Librax clindium-chlordiazepoxide ; Cascara Aromatic cascara sagrada ; Dulcolax bisacodyl ; Neoloid castor oil ; Mineral Oil Norflex orphenadrine ; Ditropan oxybutynin regular release ; Flexeril cyclobenzaprine ; Parafon Forte DSC chlorzoxazone ; Robaxin methocarbamol ; Skelaxin metaxalone ; Soma carisoprodol ; Talwin pentazocine ; Demerol meperidine ; Anaprox Aleve naproxen sodium ; Daypro oxaprozin ; Feldene piroxicam ; Indocin and Indocin SR indomethacin ; Naprosyn naproxen ; Toradol ketorolac ; Key G G G G&U W W W X Thyroid See Reference Key for Specific Concerns Armour Thyroid dessicated thyroid ; Replacement Identified as one of the top 25 potentially inappropriate medications prescribed in Greater Genesee County as identified by Health Plan claim data. Please note that this list does not attempt to identify all potentially inappropriate medications, nor are these medications inappropriate in every older adult. The prescribing physician must determine the appropriateness of the medications chosen for patients. 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Feeling of Well-Being Score Treatment by DM yielded significantly P .025 ; better scores in the double-blind phase compared with placebo or the pretreatment period in all patients Fig. 1, middle column ; . The five patients patients 1, 4, and 79 ; who reverted to the open study, although they reported low feelings of well-being 40 ; during the double-blind study Fig. 1 ; , self-rated their well-being 70 P .05 ; during the open-phase study Table 3 ; . The low scores 21 3 ; of patient 2's feeling of well-being during the double-blind phase reflected her pain perception see previously these represented the only untoward side effect reported by the patients during either study phase. The 3-Month Treatment Phase and the Poststudy Follow-Up Data None of the patients withdrew from the study, and all continued treatment with the identified best drug regimen for 3 months, noting satisfaction with it on their self-rated reports Table 3 ; . Pain intensity, sedation, and subjective well-being scores at the end of the 1-month time that followed the cessation of DM treatments were slightly lower but did not reach statistical significance compared with those rated during the time pain was satisfactorily controlled either during the double-blind or open-study phase ; in seven of the patients Table 3 ; . Three patients patients 1, 3, and 8 ; reported intensification in pain sensation P .05 ; , although it was still significantly P .05 ; below pretreatment scores; at this time, patients 1 and 8 resumed the use of NSAIDs. No side effects were recorded for any of the patients throughout drug treatment and during the 1-month follow-up and microzide.
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Dosage and Administration. For most patients with illness of mild to moderate severity. a starting daily dose of 75 mg is recommended Dosage may subsequently be increased or decreased at appropriate intervals and according to individual response. The usual optimum dose range is 75 mg day to 150 mg day In more severely ill patients higherdoses may be required with subsequentgradual increaseto 300 mg day if necessary. Additional therapeutic effect is rarely to be obtained by exceeding a dose of 300 mg day. In patients with very mild symptomatology or emotional symptoms accompanying organic disease. lower doses may suffice Some ofthese patients have been controlled on doses as low as 25-50 mg day. The total daily dosage of SINEQUAN doxepin HCI ; may be given on a divided or oncea.day dosage schedule If the once-a-day schedule is employed the maximum recommended dose is 150 mg day This dose maybe given at bedtime The 15Omgcpiul rsngthisIntsndsdf inaintinance therapy only and is not recommsndd for inftlation of tratmsnt. Antianxiety effect is apparent before the antidepressant effect Optimal antidepressant effect may not be evident for two to three weeks Overdosag. A Signs and Symptoms 1 Mild Drowsiness, stupor, blurred vision, excessive dryness of mouth. 2 Severe Respiratory depression, hypotension, coma, convulsions, cardiac arrhythmias and tachycardias. Also: urinary retention bladder atonyl, decreased gastrointestinal motility paralytic ileus ; . hyperthermia or hypothermia ; , hypertension, dilated pupils, hyperactive reflexes. B Management and Treatment 1 Mild Observation and supportive therapy is all that is `isually necessary. 2. Severe Medical management of severe SINEQUAN overdosage consists of aggressive supportive therapy. If the patient is conscious, gastric lavage, with appropriate precautions to prevent pulmonary aspiration. should be performed even though SINEQUAN is rapidly absorbed. The use of activated charcoal has been recommended. as has been continuous gastric lavage with saline for 24 hours or more. An adequate airway should be established in comatose patients and assisted ventilation used if necessary. EKG monitoring may be required for several days. since relapse after apparent recovery has been reported. Arrhythmias should betreated withthe appropriate antiarrhythmic agent. It has been reported that many ofthe cardiovascular and CNS symptoms of tricyclic antidepressant poisoning in adults may be reversed by the slow intra. venous administration of 1 mg to 3 mg of physostigmine salicylate Because physostigmine is rapidly metabolized, the dosage should be repeated as required Convulsions may respond to standard anticonvulsant therapy; however. barbiturates may potentiate any respiratory depression. Dialysis and forced diuresis generally are not of value in the management of overdosage due to high tissue and protein binding of SINEQUAN. Supply SINEQUAN is available as capsules containing doxepin HClequivalentto: 10 mg, 75 mg, and 100 mg doxepin: bottles of 100, 1000, and unit-dose packages of 100 110 x 10's ; . 25 mg and 50 mg doxepin: bottles of 100, 1000, 5000, and unitdose packages of 100 1 0 x 10's ; . 10mg doxepin bottles of 50, 500. and unit-dose packages of 100 10 a lOs ; . SINEQUAN Oral Concentrate 10 mg mI ; isavailable in 120 ml bottles with anaccompanying dropper calibrated at 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg Each ml contains doxepin HCI equivalent to 10mg doxepin Just prior to administration, SINEQUAN Oral Concentrate should be diluted with approximately 120 ml of water. whole or skimmed milk. or orange, grapefruit. tomato. prune or pineapple luice. SINEQUAN Oral Concentrate is not physically compatible with a number of carbonated beverages For those patients requiring antidepressant therapy who are on methadone maintenance, SINEQUAN Oral Concentrate and methadone syrup can be mixed together with Gatorade, lemonade, orange luice, sugar water, Tango, or water; but not with grape tuice Preparation and storage of bulk dilutions is not recommended.
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Over the past 18 months there has been wide-ranging public discussion on the potential medical uses of marijuana, particularly smoked marijuana. To contribute to the resolution of the debate, the National Institutes of Health NIH ; held a 2-day scientific meeting on February 19-20, 1997, to review the scientific data concerning the potential therapeutic uses for marijuana and the need for and feasibility of additional research. Central to the current debate about the therapeutic uses of marijuana is the claim that smoked marijuana offers therapeutic advantages over the currently available oral form dronabinol capsules ; of its most active ingredient, delta-9-tetrahydrocannabinol 9-THC ; , for a wide variety of conditions. As the therapeutic claims surrounding marijuana are wide-ranging, 10 separate NIH Institutes with interest in the relevant areas ; selected a group of eight experts with broad experience in clinical studies and therapeutics and none of whom had a predetermined position on the medical utility of marijuana ; to examine the data from the published scientific literature presented by speakers in the various therapeutic fields. The Ad Hoc Group of Experts also considered public comments including those of patients and advocacy groups as well as written material submitted to the Group after the meeting. The Expert Group was asked to focus on four questions: Question 1 - What research has been done previously and what is currently known about the possible medical uses of marijuana? Question 2 - What are the major unanswered scientific questions? Question 3 - What are the diseases or conditions for which marijuana might have potential as a treatment and that merit further study? Question 4 - What special issues have to be considered in conducting clinical trials of the therapeutic uses of marijuana? Each presentation of data by a speaker was followed by a question-and-answer session by the Expert Group. There was no requirement that individuals on the Group agree or express a consensus view, although they were free to do so they so desired. A second day was provided for public comment and further discussion by the Expert Group. This report is a compilation of the opinions of the Expert Group. Speakers reviewed the literature on the potential efficacy of cannabinoids, including smoked marijuana, in the areas of analgesia, neurological and movement disorders, nausea and vomiting associated with cancer chemotherapy, glaucoma, and appetite stimulation cachexia. A review of selected aspects of the general clinical pharmacology of marijuana precedes the disorder-specific commentary. The discovery of receptors in the central nervous system CNS ; for cannabinoid compounds, and the presence of an endogenous ligand for these receptors, is of importance to the debate concerning the potential therapeutic uses of marijuana. This discovery supports a recommendation for more basic research to discover the functional roles of the cannabinoid 1 and vibramycin. MEDICATION INSTRUCTIONS STOP A MINIMUM OF 7 DAYS BEFORE TESTING NASAL SPRAYS: Afrin, Vancenase, Beconase, Nasalide, Nasalcrom, Flonase, Nasonex, Astelin EYE DROPS: Patanol, Optivar ANTIHISTAMINES: Claritin, Allegra, Zyrtec, ChlorTrimeton, Dimetane, Percodin, Phenergan, Antivert, Benadryl, Clarinex, Singulair STOP 72 HOURS BEFORE MISCELLANEOUS DRUGS: Tussi-12, Tylenol PM, Hydroxyzine HCL, Atarax, Vistaril, Doxepin HCL, Adapin, Sineqaun ; ANTIDEPRESSANTS: Paxil, Elavil, Zoloft, Celexa, Effexor SHORT ACTING ANTIHISTAMINES: Chlor-Trimeton, Rynatan, Ryna-12, Dimetane, Phenergan, Antivert, Meclizine, Benadryl ASPIRIN PRODUCTS: Aspirin, Advil, Motrin, Ibuprofen, Nuprin, Naprosyn, Voltaren, Vioxx, Celebrex, Percodan ULCER MEDICATIONS: Reflux medications: Zantac, Pepcid, Prevacid, Axis, Tagamet, Nexium, Prilosec ALL OVER THE COUNTER MEDICATIONS Please ask the nurse regarding specific medications. STOP 48 HOURS BEFORE: Consult your physician before stopping any steroids. STEROIDS: Medrol dosepak, Prednisone, Prednisolone, Cortone, Prednisol, Haldron, Aristocort ADVAIR IS OKAY. This work was supported by grants to R.C.F. from the National Institute of Allergy and Infectious Diseases grant AI49174 ; and the Fogarty International Center grant TW00976 ; , and to Y.A. from the British Columbia Lung Association and the TB Veterans Association. Y.A. is a Canadian Institute of Health Research Foundation-BC Lung Association Scholar. We thank Koen De Smet for kindly providing the pALACE shuttle plasmid.

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