What is Pleural Effusion and Symptomes

Pleural effusion definition

Pleural effusion is one of the critical problem. A pleural effusion is a buildup of fluid in the pleural space, an area between the layers of tissue that line the lungs and the chest cavity. It may also be referred to as effusion or pulmonary effusion. The type of fluid that forms a pleural effusion may be categorized as either transudate or exudate. Transudate is usually composed of ultrafiltrates of plasma due to an imbalance in vascular hydrostatic and oncotic forces in the chest (heart failure, cirrhosis), while exudate is typically produced by inflammatory conditions (lung infection, malignancy). Exudative pleural effusions are usually more serious and difficult to treat.

Causes of pleural effusion:

There are many causes of pleural effusions. The following is a list of some of the major causes:

• Congestive heart failure
• Kidney failure
• Infection
• Malignancy
• Pulmonary embolism
• Hypoalbuminemia
• Cirrhosis
• Trauma

The development of a pleural effusion occurs from fluid seeping into the pleural space, a thin area between the visceral and pleural membranes in the chest cavity, which normally contains a small amount of fluid to facilitate smooth lung movement. Fluid under pressure, malignant cells, and infectious agents can occasionally enter this space and What are the signs and symptoms of pleural effusion?

Some Common symptoms associated with pleural effusion may include the following:

• chest pain,
• difficulty breathing,
• painful breathing (pleurisy), and
• cough (either a dry cough or a productive cough).

Deep breathing typically increases the pain. Symptoms of fever, chills, and loss of appetite often accompany pleural effusions caused by infectious agents.

Risk factors for pleural effusion:

Pleural effusions are caused by the underlying medical problems listed previously, therefore the presence of any of these medical problems are risk factors for the development of pleural effusions. It is important to note, however, that not all individuals with these medical problems will develop pleural effusions. Congestive heart failure is the most common cause of transudative pleural effusions, while infection (pneumonia) and malignancy are the most common causes of exudative pleural effusions.

How is pleural effusion diagnosed?

Mainly depend on patient condition and history . The patient's history and physical exam may indicate a presumptive diagnose of pleural effusion. For example, a patient with a history of congestive heart failure or cirrhosis with symptoms of cough, difficulty breathing, and pleuritic chest pain may have a pleural effusion. Findings from the physical exam, such as dullness to percussion of the lung area (when tapping the area of the lung with a finger, the percussion or sound is dull - if no fluid exists in the area the sound will be lighter - please see this for an informational video by the Stanford School of Medicine on percussion of the chest), decreased vibration (decreased tactile fremitus), and asymmetrical chest expansion (the lungs do not inflate or deflate equally - please see this for an informational YouTube video about asymmetrical chest expansion) may also be evidence of a pleural effusion. Other physical exam findings detected with a stethoscope may include reduced or inaudible breath sounds on the affected side, egophony (patient voices the letter "e," but when listening [auscultation] it sounds like "a"), and a friction rub (if there is fluid in the pleural area, the heart will rub against the inflamed or fluid filled space). To hear what a friction rub sounds like please see this informational YouTube video.
Chest X-ray can detect pleural effusions, as they usually appear as whitish areas at the lung base, and they may occur on only one side (unilateral) or on both sides (bilateral). If a person lies on their side for a few minutes, most pleural effusions will move and layer out along that side of the chest cavity which is positioned downward (because of the effects of gravity). This movement of the pleural effusion can be seen on an X-ray taken with the person lying on their side (a lateral decubitus X-ray).
Other imaging tests, such as CT scan, may be ordered to further identify the possible cause and the extent of the pleural effusion.
Diagnosing the cause(s) of a pleural effusion often begins with determining whether the fluid is transudate or exudate. This is important because the results of this fluid analysis may provide a diagnosis and determine the course of treatment. Thoracentesis (a procedure to remove the fluid from the pleural space) followed by laboratory analysis of the fluid can differentiate between transudate and exudate. The results from the fluid obtained from the thoracentesis are compared to certain blood tests (for example, LDH, glucose, protein, pH, cholesterol and others). Additional testing of the pleural fluid may also include a cell count, cytology, and cultures. Criteria are then used to differentiate exudate from transudate. Exudate has the following characteristics:

• Pleural fluid LDH > 0.45 of the upper limits of normal blood values
• Pleural fluid protein level > 2.9g/dL
• Pleural fluid cholesterol level > 45mg/dL

Other health care professionals may use different criteria to determine the presence of exudate, such as the ratio of pleural fluid to serum protein levels > 0.5, LDH ratio > 0.6 and LDH ratio > 2/3 the upper limits of normal. Other pleural fluid test results (cytology or amylase, for example) may also reveal the source of the effusion.

Posted by Unknown 5:04 AM 0 comments

Naproxen USP(NSAID) TradeName :Napro-A.Naprox,Sonap,Naprosyn,Servinaprox

TradeName :Napro-A.Naprox,Sonap,Naprosyn,Servinaprox(BD)

Naproxen USP

Naproxen USP is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory and antipyretic properties. Naproxen is a propionic acid derivative related to the arylacetic acid class of drugs. The chemical name of naproxen is (+)-6-methoxyalpha- methyl-2-naphthaleneacetic acid. Naproxen has been shown to have striking anti-inflammatory properties when tested in human clinical studies and classical animal test systems. In addition, it has marked analgesic and antipyretic actions. It inhibits synthesis of prostaglandins.

Posted by Unknown 6:27 AM 3 comments

Naproxen+Esomeprazole (NSAID) Information Use Indication Dosage and Side Effects

 

Naproxen+Esomeprazole Consists of an immediate release Esomeprazole Magnesium layer & an enteric coated Naproxen core. As a result Esomeprazole is released first into the stomach, prior to the dissolution of Naproxen in the small intestine. Naproxen is a NSAID with analgesic & antipyretic properties. The mechanism of action of Naproxen is to inhibit the prostaglandin synthesis. Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H+/k+ –ATP ase in the gastric parietal cell by acting specifically on the proton pump, Esomeprazole blocks the final step in acid production, thus reducing gastric acidity.

Dosage and Administration

Carefully consider the potential benefits & risks of Naproxen+Esomeprazole & other treatment options before deciding to use Naprosyn-Plus®. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals. If a dose of Esomeprazole lower than a total daily dose of 40 mg is more appropriate, a different treatment should be considered. Rheumatoid Arthritis, Osteoarthritis, Ankylosing Spondylitis Do not split, chew, crush or dissolve the tablet. Naprosyn plus is to be taken at least 30 minutes before meals. Elderly patients: Studies indicate that although total plasma concentration of naproxen is unchanged, the unbound plasma fraction of naproxen is increased in the elderly. Use caution when high doses are required & some adjustment of dosage may be required in elderly patients. As with other drugs used in the elderly use the lowest effective dose. Patients with Moderate to severe Renal impairment: Naproxen-containing products are not recommended for use in patients with moderate to severe or severe renal impairment (creatinine clearance <30 ml/min). Hepatic insufficiency: Monitor patients with mild to moderate hepatic impairment closely & consider a possible dose reduction based on the Naproxen component of Naprosyn-Plus®. Naproxen+Esomeprazole is not recommended in patients with severe hepatic impairment because Esomeprazole dosage should not exceed 20 mg daily in these patients. Children: Dosage in children less than 18 years has not been established.

. Side Effects

In general, Naproxen+Esomeprazole is well tolerated. The most common adverse reactions in clinical trials (>5%): erosive gastritis, dyspepsia, gastritis, diarrhea, gastric ulcer, upper abdominal pain, nausea etc.

Contraindications

• Known hypersensitivity to any component of Naproxen+Esomeprazole or substituted benzimidazoles
• History of asthma, urticaria or other allergic–type reactions after taking aspirin or other NSAIDs
• Use during the peri-operative period in the setting of coronary artery bypass graft (CABG) surgery
• Late pregnancy

In pregnancy:
Pregnancy category C. In late pregnancy, it should be avoided because it may cause premature closure of the ductus arteriosus.

In lactation:
Naproxen+Esomeprazole should not be used in nursing mothers due to the Naproxen component

Drug Interaction
• Concomitant use of NSAIDs may reduce the antihypertensive effect of ACE inhibitors, diuretics & beta-blockers
• Concomitant use of Naproxen+Esomeprazole and warfarin may result in increased risk of bleeding complication.
• Esomeprazole inhibits gastric acid secretion & may interfere with absorption of drugs where gastric pH is an important determinant of bioavailability (eg. Ketoconazole, iron salts and digoxin).

Over Dosage

There is no clinical data on overdosage with Naprosyn-Plus®.
Overdose of Naproxen: Significant naproxen overdosage may be characterized by lethargy, drowsiness, epigastric pain, abdominal discomfort, heartburn, indigestion, nausea, transient alteration in liver function, hypoprothrombinemia, renal dysfunction, metabolic acidosis, apnea, vomiting etc. Overdose of Esomeprazole: The major signs of acute toxicity were reduced motor activity, changes in respiratory frequency, tremor and intermittent clonic convulsions etc.

Commercial Pack

Dinovo,Naprox Plus, Naprosyn-Plus,Napro-a Plus Naproxen+Esomeprazole Tablet : Each box contains 375mg Naproxen Plus 20 mg Esomeprazole,
  And  Dinovo,Naprox Plus, Naprosyn-Plus,Napro-a Plus Naproxen+Esomeprazole Tablet : Each box contains 500mg Naproxen Plus 20 mg Esomeprazole

Posted by Unknown 8:27 AM 3 comments

Gastroenteritis (Problem Stomach Flu) part-3

How is gastroenteritis treated?

Maximum people with gastroenteritis require no formal treatment. The key to a rapid and safe recovery at home (home remedy) is proper hydration. Home treatment consists of adequate fluid intake so dehydration is prevented. Clear fluids are recommended (Pedialyte especially for young children, Gatorade, PowerAde and other sports drinks), but not fruit juices or milk as they may prolong the symptoms. If dehydration occurs, the patient should be evaluated by a doctor. Many health care professionals choose to begin IV fluids, the treatment of choice for rapid rehydration.
Other medications may be prescribed to reduce the symptoms of gastroenteritis. To reduce vomiting, promethazine (Phenergan), prochlorperazine (Compazine), or ondansetron (Zofran) are often used. Some physicians suggest using these agents only as a suppository or rapidly disintegrating tablet on the tongue since patients may vomit the pills up. Others may prescribe diphenoxylate and atropineomotil (Lomotil) or lopermadine (Imodium) to slow diarrhea while others do not as they may prolong the disease. Many doctors recommend no medical treatment for gastroenteritis symptoms as all of the drugs have side effects and if the patient stays well hydrated, the symptoms usually stop soon anyway.
As the gastroenteritis symptoms abate, especially vomiting, doctors may recommend a BRAT diet (bananas, rice, apples and toast) for a day or two before returning to the patient's regular diet.
Patients who have more serious symptoms or other symptoms in addition to gastroenteritis need to be evaluated, diagnosed, and treated by a physician because the patient will likely have a specific disease that will need treatment. The treatment will depend on the cause of the illness (for example, salmonellosis or Clostridium difficile toxin). Antibiotics and other treatments may not be recommended for some of these diseases so an accurate diagnosis of the disease is important. For Clostridium difficile infected patients, antibiotic sensitivity testing may need to be done to determine the most effective antibiotics to use.

When should I call my doctor for gastroenteritis?

If gastroenteritis symptoms last more than about 5 days, increase in severity (fever of 101 F or 38.33C or higher), or bloody diarrhea develops, dehydration, constant abdominal pain or other symptoms, a patient should see a physician. The patient may have some gastroenteritis symptoms but may have a disease more serious than self-limiting gastroenteritis. Signs and symptoms of dehydration may include decreased or no urine production, dry mucus membranes, dry mouth or skin, no tears, weakness, lightheadedness and low blood pressure, while children may show little or no urination, become lethargic, have skin that "tents up" when pinched. Signs of dehydration in anyone are good reasons to see a doctor immedia
What are complications of gastroenteritis?

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Most patients who get gastroenteritis have no complications and will completely recover. The major complication for some patients is dehydration; infants, children, the elderly and immunosuppressed are at higher risk for this complication. In many third world countries, hydration of infants is difficult at best so there are many infant deaths worldwide due to dehydration caused by gastroenteritis.

Can gastroenteritis be prevented?

In general, there are some actions people can do to prevent or reduce the chance of getting gastroenteritis, including:

• Hand washing, especially before eating and after any close association with an infected person or items (clothing, bedding, toys) they have touched
• Launder items daily that infected persons wear
• Avoid direct contact with infected individuals when possible
• Do not eat undercooked foods, especially meats
• Do not eat or drink raw foods or untreated water
• Do not drink untreated or unpasteurized fluids, especially milk
• Thoroughly wash any produce, especially in third world countries, before eating
• While traveling, avoid all raw foods and ice; drink only from sealed bottled products and use bottled water for tooth brushing

In addition, there is a vaccine available against rotavirus that has reduced this infection in children. Also, there is a vaccine available against cholera-causing bacteria (Vibrio), but it is not widely available. Research is ongoing; in 2013 a clinical trial of a Norovirus vaccine was done with some success. It is likely in the near future commercial vaccines against some causes will be available.

What is the prognosis for gastroenteritis?

The prognosis (outlook) for complete recovery is excellent in most people infected with viral and bacterial caused gastroenteritis, as long as the person keeps well hydrated. Because infants, children, pregnant women, and adults that are elderly or immunosuppressed, usually dehydrate faster than healthy adults and sometimes are more difficult to rehydrate orally, their prognosis can range from excellent to poor. Their prognosis depends on how dehydrated they become and how effective are the attempts to rehydrate the patient.
The prognosis for those patients that develop gastroenteritis symptoms as part of a specific disease process (for example, shigellosis) vary from good to poor, depending on the severity of the specific disease process.
REFERENCES:

MedscapeReference. Bacterial Gastroenteritis.

MedscapeReference. Emergent Treatment of Gastroenteritis.

MedscapeReference. Viral Gastroenteritis Clinical Presentation.

Posted by Unknown 8:13 AM 0 comments

Gastroenteritis (Problem Stomach Flu) Part 2

Is gastroenteritis contagious?

Maximum and large majority of causes (viral and bacterial) of gastroenteritis are contagious, usually through food or water contamination; in addition, they can be transferred person-to-person. A few causes are not contagious such as food allergies or the side effects of medications.

Who is at risk for gastroenteritis?

Every one at risk for gastroenteritis. Gastroenteritis is a common, worldwide disease and almost everyone suffers from it a few times in their life because it is almost impossible to avoid contact with some of the viral and bacterial causes.

• People living in crowded conditions (military, cruise ships, dorms) are at higher risk, as are people living in developing countries who often have a diet that contains contaminated food or water.
• Infants, children and some adults (elderly, immunosuppressed) are at higher risk because of immature or depressed immune systems and also because they can become dehydrated faster than older children and adults.
• Some patients taking antibiotics are at higher risk because the antibiotics depress the normal GI microbes and allow bacteria or viruses like Clostridium diffficile to predominate and cause disease.
• People who do not practice good hygiene and hand washing techniques are at higher risk, as are those who eat under cooked and/or unwashed foods or drink from potentially contaminated fluid sources (rivers, streams, unpasteurized milk, for example).

How is gastroenteritis transmitted?

Majority of all patients can transfer most viral and bacterial causative agents to other people by direct and indirect contact, usually by the fecal – oral route. Direct contact could involve an infant's hand touching feces-contaminated surfaces and then touching a sibling or relative; indirect contact would be like touching a door knob or railing on a cruise ship or in a dorm that is contaminated and the person touches the contaminated surface and transfers the agent by touching their mouth. Another common way to get gastroenteritis is drinking or eating contaminated foods and liquids.

How does food become contaminated with gastroenteritis bacteria or viruses?

About most instances, food and drinks come into contact with feces contaminated with the infecting agent. This can happen in the fields, or in transport, storage, and processing of food and drinks. In processed foods and drinks, this contamination is relatively rare, but when it occurs, an outbreak of the disease is often traced back to faulty equipment, human errors in the processing and/or a breakdown of quality-control procedures.

How is gastroenteritis diagnosed?

Mainly diagnosed by sign and symptoms. Gastroenteritis is most often presumptively diagnosed by the symptom(s) it produces (mainly diarrhea). Because gastroenteritis is usually a self-limited disease, the large majority of people are never seen or diagnosed by a doctor. There are no specific tests for gastroenteritis. However, during outbreaks like those seen on cruise ships, viral and bacterial cultures or PCR and other immunologically-based tests can eventually identify the causative pathogen. By the time this identification occurs, most of the patients with gastroenteritis have begun to recover. When gastroenteritis symptoms become severe, most public health officials and health care professionals run such tests to identify the causative agent of a specific disease, based on all of the patient's history, physical exam, and symptoms. In addition, patients with similar histories of recent food or drink they had in common with others often helps to discover the source of the disease (for example, people who got diarrhea had salads from the same food provider).

Posted by Unknown 8:10 AM 0 comments

Gastroenteritis (Problem Stomach Flu)

What is gastroenteritis

Stomach Flu is very critical problem for all.Gastroenteritis (often referred to as the "stomach flu," however, it is not related to the influenza virus) is a nonspecific term for various problems in the gastrointestinal tract with the most common symptoms and signs of diarrhea, nausea, vomiting, and abdominal pains.
Its not associated with previously mentioned, although it is not caused by influenza viruses, it is commonly referred to as the "stomach flu" because most people have acute symptoms that last a day or so, and then begin to resolve, like the more benign flu strains. In the U.S., less than 2% of the estimated 100 million persons with symptoms per year ever require hospitalization, but in developing countries it is a leading cause of death, mainly due to dehydration. Severe gastroenteritis can cause dehydration. Also, people with symptoms of diarrhea, bloody diarrhea, fever greater than 101 F (38.33 C) for longer than 5 days, or have severe infection (sepsis), and other problems will be considered to have another disease (for example, shigellosis). Not all doctors agree on the nonspecific term of gastroenteritis so for this article, the parameters are presented.

The causes gastroenteritis:-

Maximum infectious agents such as bacteria and viruses are the most frequent causes of gastroenteritis in the US and worldwide. Infections cause diarrhea and other symptoms by causing inflammation of the gastrointestinal (GI) tissue. The infections increase the fluid content in the intestines and colon by changing the gastrointestinal tract's ability to absorb water and by increasing the speed of transit (motility) for things you ingest. This, in turn, causes diarrhea. Infectious agents may physically damage intestinal cells directly or indirectly with secreted toxins.

Most common causes of gastroenteritis :-

Their most prevalent cause of gastroenteritis in the U.S. and the world is Norovirus. It causes about 50% to 70% of viral gastroenteritis while Rotavirus, Astrovirus, Adenovirus, and Sapovirus strains cause most of the other viral gastroenteritis infections. In 2013, Norovirus was also listed as the leading cause of gastroenteritis in children under 5 years old according to the Centers for Disease Control (CDC).
Bacterial causes of gastroenteritis that occur worldwide are Salmonella, Shigella, Campylobacter Aeromonas, and Escherichia coli (E. coli) strains of bacteria. Other bacteria like Clostridium, Vibrio, Campylobacter, and Yersinia spp can cause outbreaks occasionally.
Parasites such as Giardia, Cryptosporidium, and Entamoeba infections can cause gastroenteritis and occasionally, other parasites have outbreaks such as the Cyclospora outbreak that occurred in 2012 to 2013 in the U.S.
There are many other less frequent causes of gastroenteritis such as food allergies, antibiotics, and toxins. Gastroenteritis symptoms are frequently listed as possible side effects of many medicines.

Symptoms of gastroenteritis:-

Most or approximately primary symptom of gastroenteritis is diarrhea (non-bloody). Nausea, vomiting, and some abdominal cramping may accompany the diarrhea; mild fever (about 100 F or 37.77 C), chills, headache, and muscle aches along with feeling tired may occur in some individuals. Vomiting is occasional and the symptoms usually last about 2 to 5 days and begin to resolve. Severe gastroenteritis means the person has signs of dehydration: this is a medical emergency.
Children with gastroenteritis usually have diarrhea, but may have other symptoms, sometimes conflicting, of refusing to eat or drink or are very thirsty, either increased or low or no urine output. Weight loss, lethargy, and pinched skin that does not rapidly go back to normal are signs of dehydration, along with decreased fluid intake

Posted by Unknown 7:37 AM 0 comments

Diclofenac+Misoprostol, NSAID

Uses and Indication:-

Diclofenac is used to relieve pain, swelling (inflammation), and joint stiffness caused by arthritis. Reducing these symptoms helps you do more of your normal daily activities. Diclofenac is known as a nonsteroidal anti-inflammatory drug (NSAID). Misoprostol protects the stomach from diclofenac's irritating effects. This combination medication is used to treat arthritis in people at high risk of developing stomach ulcers and serious complications such as bleeding.
If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.
OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
This medication may also be used to treat gout attacks.

Posted by Unknown 1:22 AM 0 comments

Hypothyroidism Medicine Levothyroxine, Dosage information, Side Effects, Pregnancy and Breastfeeding Warnings Levothyroxine

Levothyroxine

Levothyroxine is a replacement for a hormone normally produced by your thyroid gland to regulate the body's energy and metabolism. Levothyroxine is given when the thyroid does not produce enough of this hormone on its own.

Levothyroxine treats hypothyroidism (low thyroid hormone). It is also used to treat or prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation treatment, surgery, or cancer.

Information about levothyroxine

You may not be able to take levothyroxine if you have certain medical conditions. Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack.

Levothyroxine should not be used to treat obesity or weight problems. Dangerous side effects or death can occur from the misuse of levothyroxine, especially if you are taking any other weight-loss medications or appetite suppressants.

Taking Before levothyroxine

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Levothyroxine Side Effects

Along with its needed effects, levothyroxine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking levothyroxine:
Less common

• Chest pain or discomfort
• decreased urine output
• difficult or labored breathing
• difficulty with swallowing
• dilated neck veins
• extreme fatigue
• fainting
• fast, slow, irregular, pounding, or racing heartbeat or pulse
• fever
• heat intolerance
• hives or welts
• increased blood pressure
• increased pulse
• irregular breathing
• irritability
• menstrual changes
• nausea
• pain or discomfort in the arms, jaw, back, or neck
• shortness of breath
• skin itching, rash, or redness
• sweating
• swelling of the eyes, face, lips, throat, or tongue
• tightness in the chest
• tremors
• troubled breathing

Rare

Posted by Unknown 7:34 AM 0 comments

Levothyroxine Dosage information

Usual Adult Dose for Hypothyroidism

Oral:
The initial dose is 12.5 to 50 mcg orally once a day. The dosage can be increased in 12.5 to 25 mcg/day increments every 2 to 4 weeks. In older patients or in younger patients with a history of cardiovascular disease, the dosage should be increased in 12.5 to 25 mcg increments every 3 to 6 weeks.
Few patients require doses higher than 200 mcg. Inadequate response to doses higher than 200 mcg is rare and may suggest malabsorption, poor patient compliance and/or drug interactions.
Parenteral: The usual IV or IM dose is 50 to 75% of the oral dose.

Usual Adult Dose for TSH Suppression

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Anticonvulsant (Carbamazepine) dose and use in pregnancy

Usual Adult Dose for Epilepsy

Initial dose: 200 mg orally twice a day (immediate and extended release) or 100 mg orally 4 times a day (suspension).
Increase dose at weekly intervals in 200 mg/day increments using a twice daily regimen of extended release or a three times a day or four times a day regimen of the other formulations.
Maintenance dose: 800 to 1200 mg/day.
Dosage generally should not exceed 1200 mg/day.
However, doses up to 1600 mg/day have been used in rare instances.

Usual Adult Dose for Trigeminal Neuralgia

Initial dose: 100 mg orally twice a day (immediate or extended release) or 50 mg orally 4 times a day (suspension).
May increase by up to 200 mg/day using increments of 100 mg every 12 hours (immediate or extended release), or 50 mg four times a day. (suspension), only as needed to achieve freedom from pain. Do not exceed 1200 mg/ day.
Maintenance dose: 400 to 800 mg/day.
Some patients may be maintained on as little as 200 mg/day while others may require as much as 1200 mg/day. At least once every 3 months throughout the treatment period, attempts should be made to reduce the dose to the minimum effective level or to discontinue the drug.

Usual Adult Dose for Bipolar Disorder

Initial dose: 200 mg orally in tablet or capsule form every 12 hours or 100 mg of oral solution 4 times a day.

Tablets and solution:
Following autoinduction, higher doses will be necessary to maintain drug levels within the therapeutic range of 6 to 12 mcg/mL. The daily dose should be increased in 100 to 200 mg increments at 1 to 2 week intervals.

Maintenance dose: up to 1200 mg daily in 3 or 4 divided doses may be necessary to maintain plasma levels in the therapeutic range.

Extended release capsules:
The dose should be adjusted in 200 mg daily increments (increase by 100 mg twice daily) to achieve optimal clinical response. Doses higher than 1600 mg per day have not been studied.

Usual Adult Dose for Diabetic Neuropathy

Initial dose: 100 mg orally in tablet form every 12 hours or 50 mg of oral solution 4 times a day.

The daily dose should be increased in 100 mg increments at 1 to 2 week intervals.

Maintenance dose: 600 to 1200 mg daily in 3 or 4 divided doses may be necessary to maintain plasma levels in the therapeutic range.

Posted by Unknown 10:19 PM 2 comments

Anticonvulsant Carbamazepine Use indication

Trade Name: carbazine,valex,valex CR,Tegretol CR

Carbamazepine

Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain.
Carbamazepine is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. It is also used to treat bipolar disorder.
Carbamazepine may also be used for purposes not listed in this medication guide.

Important information

You should not take carbamazepine if you have a history of bone marrow suppression, if you are also taking nefazodone, or if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).
Treatment for bipolar disorder is getting better every day and there are things you can start doing right away.
This medication may cause severe or life-threatening skin rash. Your doctor may recommend a blood test before you start the medication to determine your risk.
Do not start or stop taking carbamazepine during pregnancy without your doctor's advice. Carbamazepine may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking carbamazepine for seizures.
TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make carbamazepine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

When taking carbamazepine

Do not use carbamazepine if you also take nefazodone, or if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.
You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), doxepin (Sinequan, Silenor), imipramine (Tofranil), or nortriptyline (Pamelor).
Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk.
To make sure carbamazepine is safe for you, tell your doctor if you have any of these conditions:

·         heart disease, high blood pressure, high cholesterol or triglycerides;

·         liver or kidney disease;

·         glaucoma;

·         a thyroid disorder;

·         lupus;

·         porphyria; or

·         a history of mental illness, psychosis, or suicidal thoughts or actions.

You may have thoughts about suicide while taking carbamazepine. Tell your doctor if you have symptoms of depression or suicidal thoughts. Your family or other caregivers should also be alert to changes in your mood or symptoms.
FDA pregnancy category D. Do not start or stop taking carbamazepine during pregnancy without your doctor's advice. Carbamazepine may cause harm to an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking carbamazepine for seizures. Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) to prevent pregnancy while taking this medicine.
Carbamazepine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using this medicine.

How should I Use carbamazepine?

Take carbamazepine exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.
Do not crush, chew, break, or open a carbamazepine extended-release tablet or capsule. Swallow the pill whole. Breaking the pill would cause too much of the drug to be released at one time.
You may open the extended-release capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow right away without chewing. Do not save the mixture for later use. Discard the empty capsule.
Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-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.
The chewable tablet must be chewed before you swallow it.
It may take up to 4 weeks before your symptoms improve. Keep using carbamazepine as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures.
While using carbamazepine, you may need frequent blood tests at your doctor's office.
Do not stop using carbamazepine without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using carbamazepine suddenly.
Store carbamazepine at room temperature away from moisture, heat, and light.

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