Type of Drug:Human antidiuretic hormone (ADH).

How the Drug Works:

A hormone which makes the kidneys reabsorb (retain) water and increases the concentration/activity of certain blood factors necessary for normal blood clotting.

Uses:

DDA VP: As antidiuretic hormone replacement therapy in the management of central cranial diabetes insipidus and for temporary excessive urination and excessive thirst following head injury or surgery in the pituitary region. This will allow return to a more normal lifestyle with decreased urinary frequency and nighttime urination.

To treat nighttime bed-wetting (nasal solution only). May be used alone or in combination with behavioral conditioning or other non medicinal intervention.

To control bleeding in hemophilia A patients during and after surgery, and to stop spontaneous or trauma-induced bleeding in hemophilia A patients (injection only).

To control bleeding in patients with mild to moderate von Willebrand disease (Type I) during and after surgery, and to stop spontaneous or trauma-induced bleeding in patients with von Willebrand disease (injection only).

Stimate: To stop spontaneous or trauma-induced bleeding in patients with hemophilia A or mild to moderate von Willebrand disease (Type I).

Unlabeled Uses:

Nasal solution - To treat chronic autonomic failure (eg, nighttime bed­wetting, over-night weight loss and morning dizziness or lightheadedness when rising from a sitting or lying position).

Water intoxication: Very young and elderly patients should drink only enough fluids to satisfy thirst in order to decrease the potential occurrence of water intoxication (over-load) and salt depletion in the blood.

Long-term use: There have been reports of reduced responsiveness or duration of effect in patients using the drug for more than 6 months. Consult your doctor if such changes occur.

Precautions:

Pregnancy: Studies in pregnant women or in animals have been judged not to show a risk to the fetus. However, no drug should be used during pregnancy unless clearly needed.

Breastfeeding: It is not known if desmopressin acetate appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Infants and children need careful fluid intake restrictions to prevent possible salt depletion in the blood and water intoxication (over­load). Nasal solution has been used safely and is modestly effective for short-term use (4 to 8 weeks) in children 6 years of age and older for the treatment of nighttime bed-wetting. Do not use injection in children under 3 months of age or the nasal solution in children under 11 months of age in the treatment of hemophilia A or von Willebrand disease. Safety and effectiveness have not been established in children under 12 years of age (injection) or under 3 months of age (nasal solution) with diabetes insipid us. Decompressing tablets have been used safely in children 4 years of age and older for periods of up to 44 months.

Lab tests may be necessary to monitor therapy. Be sure to keep appointments.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to

take any over-the-counter or prescription medications or dietary supplements while taking this medicine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with this medicine.

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

DDA VP nasal solutions - Headache; runny nose; nausea; stomach cramps; vaginal pain; high blood pressure; facial flushing; nosebleed; sore throat; cough; difficulty breathing.

DDA VP injection - Redness, swelling or burning at injection site; head­ache; runny nose; nausea; stomach cramps; vaginal pain; high blood pressure; facial flushing.

Stimate nasal solution - Sleepiness; dizziness; itchy or light-sensitive eyes; sleeplessness; chills; warm feeling; pain; chest pain; palpitations (pounding in the chest); fast heartbeat; indigestion; fluid retention; vomiting; agitation; genital inflammation; difficulty breathing.

Guidelines for Use:

• Read and follow patient instructions carefully and use exactly as prescribed.
• If a dose is missed, take or use it as soon as Possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose in order to “catch up” (unless advised to do so by your doctor). If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• If bleeding is not controlled or worsens, contact your doctor.
• Contact your doctor if headache, shortness of breath, heartburn, nausea, stomach cramps or vaginal pain OCcurs.
• Nasal solutions - For nasal use only. Use one spray per nostril. If used before surgery, administer 2 hours before the scheduled procedure.
• Stimate Spray pump must be primed before the first use. To prime the pump, press down 4 times. The pump will stay primed for 1 week if refrigerated. Repair the pump after 1 week if not used. Discard any solution remaining after 25 doses since the amount delivered thereafter may be less than the required dose. Do not transfer the remaining solution to another bottle.
• Storage- Refrigerate nasal solutions and injection at 36° to 46°F. When travel­ling, closed nasal solution containers may be kept at room temperature (72°F) for up to 3 weeks. Store tablets at room temperature (59° to 86°F) protected from heat and light.

Type of Drug:A blood glucose (sugar) elevating agent.

How the Glucagon Products Works:

Glucagon is a natural hormone that is released from the pancreas. It elevates blood sugar in a variety of ways (eg, inhibition of glucogen synthesis, enhanced formation of glucose from noncarbohydrates and fat, increased hydrolysis of glucogen to glucose).

Uses of The Glucagon:

Used to treat severe hypoglycemia (low blood glucose levels). Because patients with type 1 diabetes may have less of an increase in blood glucose levels compared with a stable type 2 diabetes patient, a supplementary carbohydrate should be given as soon as possible, especially to a pediatric patient.

Used as a diagnostic aid in the x-ray examination of the stomach, duodenum, small intestine, and colon when decreased intestinal motility is desired.

Unlabeled Uses: Occasionally doctors may prescribe glucagon for treatment of an overdose of propranolol and in cardiovascular emergencies (eg, severely reduced heart rates).

Precautions:

Do not use in the following situations: Allergy to glucagon or any of its ingredients.

Use with caution in the following situations: pheochromocytoma, active or history of tumor of the pancreas, history of Hypoglycemia (low blood sugar levels): Although glycogen may be used for emergency treatment of low blood sugar levels, notify your doctor so that adjustments in insulin dose and dietary factors can be made. In addition, patients should be given food after they become conscious and alert. Frequently self monitor blood glucose so that blood sugar levels are not allowed to get too low.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if glycogen appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness for use in the treatment of hypoglycemia in children have been established.

Lab Tests: Lab tetras will be required to monitor therapy. Tests include blood glucose levels.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over- the-counter or prescription medications or dietary supplements while taking glucagon. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. Oral anticoagulants (eg, warfarin) interact with glucagon.

Side Effects of Glucagon:

Every drug is capable of producing side effects. Many glucagon users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include: Nausea; vomiting; hives; low blood pressure; difficulty breathing.

Guidelines for Use:

• Carefully read the patient instructions provided with the product.
• All patients with. diabetes should have a Glucagon Emergency Kit. Low blood sugar (conscious patent)- Consume fast-acting sugars (eg, B-D Glucose, Glutose).
• Low blood sugar (unconsciouspati.ent) Intravenous (IV; into a vein) glucose use is encouraged, if available and feasible. If not, glucagon is the treatment of choice. Instruct friends, coworkers, and family members of patients with diabetes how to administer glucagon. Prompt treatment is essential.
• The patient will usually awaken within 15 minutes of glucagon use. If not, repeat the dose. Upon awakening, give the patient food (eg, a carbohydrate) as soon as possible and follow the usual dietary regimen.
• The glucagon emergency kit has a diluting fluid in a.unit (one) dose syringe. This diluting fluid is injected into a vial of the glucagon Crystals. The vial is then shaken and the contents brought back into the syringe. The glucagon crystals now in the diluting fluid are given IV, intra­muscularly (IM; into a muscle), or subcutaneous (SG; undertheskin).
• Notify your doctor if you experience a hypoglycemic reaction $0 that your treatment regimen may be adjusted if necessary.
• Lab tests will be required. Be sure to keep appointments.
• Store at controlled room temperature (68° to 77° F) before mixing with the diluting fluid.
• Use glucagon immediately after it has been mixed with the diluting fluid because the drug is stable for only a short time. Discard any unused portion.

Type of Drug:Topical anti-inflammatory, anti-itching agents; anti-inflammatory steroids.

How the Corticosteroids, Topical Works:

Topical adrenocortical steroids reduce skin inflammation (eg, redness, swelling), itching, and irritation. The exact manner in which the drug works is not fully understood. The effectiveness of the drug depends on many factors, including: The extent of absorption of the drug, the potency of the drug, the size of the area treated, and the dose form (eg, cream, ointment).

Uses of The Corticosteroids, Topical:

To treat inflammation and itching caused by corticosteroid-responsive skin disorders.

OTC Hydrocortisone: To treat minor skin irritation, itching, and rashes due to eczema; insect bites; poison ivy, oak, or sumac; allergic inflammation from soaps, detergents, cosmetics, or jewelry; itchy genital and anal areas; psoriasis; seborrheic dermatitis; or other minor skin irritations

Precautions:

Do not use in the following situations: acne allergy to corticosteroids or any of their ingredients bacterial infections of the skin, single therapy for cellulitus facial, groin, or armpit areas (high potency agents only) prolonged use near eyes or eye­lids rosacea

Use with caution in the following situations: blistered, raw, or oozing areas of skin diaper dermntosis skin infection

Absorption into the body: Absorption into the body of topical corticosteroids has produced manifestations of Cushing’s syndrome, reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, and increased blood and urine sugar. This is more likely to occur with application to large body surfaces, use of occlusive dressings, and with the more potent steroids. Patients at higher risk include young children.

Side effects may include growth retardation, delayed weight gain, low plasma cortisol levels and absence of response to ACTH stimulation, including bulging “soft spots,” headaches, and bilateral papilledema.

Alcohol-containing preparations: Alcohol-containing preparations may cause drying, burning, or irritation of open lesions.

Formulations: Corticosteroids are specially formulated to maximize their release and potency. Mixing these products with other products is discouraged because it may affect potency and effectiveness.

Occlusive vehicles: A transparent plastic wrap or other vehicles that will not allow air to pass through to the treated area will enhance absorption at least 10 times. These kinds of dressings are not generally recommended (eg, when using clobetasol or halobetasol, when treating children).

Greasy ointment bases are more occlusive and are preferred for dry, scaly lesions. Gels are less occlusive. The aerosols, lotions and solutions are best suited for hairy areas.

Skin atrophy: Skin atrophy may occur in 3 to 4 weeks if the most potent corticosteroids are employed. Skin atrophy occurs most readily at sites where absorption through the skin is highest.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus. Do not use large doses or for prolonged periods of time if you are pregnant.

Breastfeeding: It is not known if topical corticosteroids appear in breast milk. Oral corticosteroids appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Limit therapy to the lowest possible dosage because children may be more susceptible to topical corticosteroid-induced side effects. Safety and effectiveness of alclometasone in children less than 1 year of age have not been established. Clobetasol is not recommended in children less than 12 years of age. Safety and effectiveness of hydrocortisone probutate in children less than 18 years of age have not been established.

Lab tests may be required to monitor therapy. Tests may include urinary­free cortisol, ACTH stimulation, and early morning plasma cortisol test.

Side Effects of Corticosteroids Topical:

Every drug is capable of producing side effects. Many topical corticosteroid users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Skin: Burning; itching; irritation; redness; dryness; allergic inflammation; acne; decreased pigmentation in the area being treated; streaks in skin; skin atrophy; infection; stinging; cracking; rash; tingling; scalp pustules (scalp application only); unusual hair growth.

Other: Elevated blood or urine sugar; cataracts and glaucoma (prolonged use near eyes); numbness of fingers; worsening of condition being treated.

Also consider all side effects for oral corticosteroids..

Guidelines for Use:

• Dosage is individualized.
• Application frequency and duration of therapy are dependent on the condition treated, its location, the potency of the drug, and the vehicle employed. For assistance in product-specific drug selection and dos­age guidelines, consult your doctor or pharmacist.
• Wash hands before and after application.
• Wash or soak the affected area before application. This may increase drug penetration.
• Apply sparingly as a thin film. Rub in lightly until the medication disappears.
• For external use only. Avoid contact with the eyes.
• Avoid prolonged use, especially near the eyes, on the face, on genital and rectal areas, and in skin folds.
• The treated area should not be bandaged, covered, or wrapped to be occlusive, unless advised to do so by your doctor.
• Do not use tight-fitting diapers or plastic pants on children treated with topical corticosteroids in the diaper area. Such garments function as occlusive dressings.
• Skin infections may worsen. It may be necessary to stop the corticosteroid and treat the infection.
• Do not use these agents to treat acne, the lesions of rosacea, skin inflammation near the mouth, or for any disorder other than that for which it was prescribed.
• Allergic reactions may Occur. Contact your doctor if the condition being treated worsens or irritation, burning, redness, swelling, or stinging persists. Do not reapply the drug.
• If you do not notice improvement within 2 weeks (or 1 week when using aTC hydrocortisone), consult your doctor.
• Aerosol/Spray - Take care to cover the eyes while spraying close to the face. Avoid inhalation. Spray the affected area for 3 seconds or less at a time and at a distance of at least 6 inches between the nozzle and skin.
• Scalp application - Apply to the affected scalp areas twice daily, once in the morning and once at night. Do not use more than 50 week. Treatment must be limited to 2 consecutive weeks.
• Tape - Skin should be clean and dry before the tape is applied. Tape should always be cut, never torn. Replacement of the tape every 12 hours produces the lowest incidence of side effects, but it may be left in place for 24 hours if it is well­tolerated and adheres well. When replacing the tape, cleanse the skin and allow to dry for 1 hour before applying new tape. When necessary, the tape may be used at night only and removed during the day. If the ends of the tape loosen prematurely, they may be trimmed off and replaced with fresh tape.
• Lab tests may be required to monitor therapy. Bo sure to keep appointments.
• Store at controlled room temperature (59 to 86 F),protect solution and lotions from freezing.

Type of Drug:Synthetic hormone closely related to the natural hormone somatostatin (growth hormone inhibitor).

How the Octreotide Acetate Works:

Octreotide reduces blood levels of a variety of hormones (eg, growth hormone) and chemical messengers (eg, gastrin).

Uses of the Octreotide Acetate

To reduce the blood levels of growth hormone and IGF-I in patients with acromegaly who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation and bromocriptine mesylate at maximally tolerated doses. The goal is to achieve normalization of growth hormone and IGF-I levels.

To treat symptoms of patients with metastatic carcinoid tumors where it suppresses or inhibits severe diarrhea and flushing episodes.

Treatment of the profuse watery diarrhea associated with vasoactive intestinal peptide (VIP) tumors.

Unlabeled Uses: Occasionally doctors may prescribe this medicine to reduce output from gastrointestinal or pancreatic sores; treat variceal bleeding, diarrheal states associated with a variety of conditions, irritable bowel syndrome, dumping syndrome, enteric fistula, pancreatitis, pan creatic surgery, glucagonoma, insulinoma, gastrinoma (Zollinger-Ellison syndrome), intestinal obstruction, local radiotherapy, thyrotropin and TSH-secreting tumors; for chronic pain management, antineoplastic (anti-cancer) therapy or to decrease insulin requirements in diabetes mellitus.

Precautions:

Do not use in the following situations: Sensitivity to any component of this medicine.

Use with caution in the following situations: diabetes kidney disease

Pregnancy: Studies in pregnant women or in animals have been judged not to show a risk to the fetus. However, no drug should be used during pregnancy unless clearly needed.

Breastfeeding: It is not known if octreotide appears in breast milk. Consult your doctor before begin breastfeeding.

Elderly: Lower doses may be necessary

Lab tests may be required to monitor therapy. Lab tests may include blood tests and thyroid function tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking this medicine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes may interact with this medicine.

Side Effects of Octreotide Acetate:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility. Possible side effects include:

Digestive Tract: Diarrhea; loose stools; nausea; stomach pain; vomiting; gas; bloating; constipation.

Nervous System: Headache; dizziness; tiredness; weakness; depression. Circulatory System: Slow or irregular heart rate.

Skin: Injection site pain or bruising; swelling; itching; hair loss; bruising; flushing.

Other: Gallbladder problems, especially stones or biliary sludge; back or joint pain; cold or flu symptoms; visual problems; blurred vision; frequent urination; urinary tract infection; changes in blood sugar levels; under active thyroid; goiter.

Guidelines for Use:

• Use exactly as prescribed.
• Follow the injection procedures taught to you by your health care provider. Use proper technique; inject deep under the skin, not into muscle. Rotate injection sites.
• If a dose is missed, inject it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose in order to “catch up” (unless advised to do so by your doctor). If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Diabetics - Insulin requirements may increase or decrease. Be prepared to monitor blood sugar more often.
• May cause dizziness. Use caution when driving or performing other tasks requiring alertness, coordination or physical dexterity.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Visually inspect solution for particles or discoloration before use.
• Ampules - Open just prior to administration. Discard any unused portion.
• Vials - Discard any unused portion within 14 days of first use.
• Store at room temperature (70 to 86°F) away from light, for up to 14 days. For prolonged storage, store in the refrigerator (36 to 46°F) away from light. Solution may be warmed to room temperature naturally. Do not warm artificially.

Content in the table above is given per serving of capsule, tablet, or teaspoon (5 milliliters). Products containing the greatest amount of Vitamin B 1 are listed first.

Type of Drug:

Vitamin combinations.

Uses:

Dietary supplement

Guidelines for Use:

• Dosage will be individualized.
• Do not exceed the recommended dose, unless advised to do so by your doctor.
• Most people on regular diets do not need vitamin supplements.
• Sotre at controlled room temperature (59 degree to 86 degree F). Protect from moisture.

Doses:

Type of Drug:

Ovulation stimulant.

How the Clomiphene Works:

Clomiphene produces a “false signal” that estrogen levels are low. The body responds by increasing the secretion of hormones (eg, gonadotropins) from the pituitary gland. These hormones stimulate the ovaries, causing the ovarian follicle to mature, resulting in ovulation (release of the egg). Clomiphene is not a steroid.

Effectiveness is documented but unpredictable. In clinical trials, pregnancy occurred in approximately 30% of women with ovulation problems who received clomiphene.

Uses of The Clomiphene:

To treat female ovulatory dysfunction (infertility) when the patient desires pregnancy, the sexual partner is fertile and potent, and the patient has normal liver function and normal estrogen levels.

Ovulatory dysfunction due to thyroid or adrenal conditions will not respond to clomiphene.

Unlabeled Uses: Occasionally doctors may prescribe clomiphene citrate for male infertility.

Before therapy: A complete pelvic examination is mandatory prior to treatment and repeated before each course. Clomiphene is not used in the presence of an ovarian cyst; further enlargement may occur. Other lab tests may also be required.

Multiple births: The risk of a multiple pregnancy is increased approximately 6 times when clomiphene is given. In 2369 pregnancies associated with clomiphene therapy, 92.1 % were single and 6.9% wore twins. The remainder resulted in triplets or more. Of the multiple pregnoncios, 96% to 99% were live births.

Eyes: Blurring or other visual symptoms, such as spots or flashes may occur. Use caution while driving or operating machinery, especially in variable light. If visual symptoms occur, discontinue treatment and call your doctor about a complete eye evaluation.

Over stimulation of the ovary: The lowest effective dose is used to reduce the risk of abnormal ovarian enlargement. Mild to moderate ovarian enlargement, with or without bloating or stomach pain, may occur and generally goes away within 2 or 3 weeks after discontinuing this medicine. All patients who experience bloating or stomach pain should be examined for ovarian enlargement. If significant ovarian enlargement occurs after ovulation, do not engage in sexual intercourse.

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit. Consult your doctor if pregnancy is suspected. Clomiphene may be linked to birth defects.

Breastfeeding: It is not known if clomiphene appears in breast milk. How­ever, it may reduce lactation. Consult your doctor before you begin breastfeeding ..

Side Effects of Clomiphene:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Eyes or Ocular: Blurred vision; spots or flashes of light; sensitivity to light; double vision.

Digestive Tract: Nausea; vomiting; diarrhea; stomach pain.

Nervous System: Headache; dizziness; light-headedness; nervousness; feeling of whirling motion (vertigo); sleeplessness.

Other: Multiple pregnancy; pregnancy; hot flushes; flushing; abnormal uterine bleeding; breast tenderness; ovarian enlargement; pelvic discomfort; distention or bloating; weight gain.

Guidelines for Use:

• Dosage is individualized. Use exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Each course of clomiphene should be started on or about the fifth day of the menstrual cycle. Wait 30 days between courses.
• Properly timed intercourse is important for good results.
• Intercourse should be prohibited in patients in whom significant ovarian enlargement occurs after ovulation.
• Notify your doctor immediately if you experience bloating, stomach or pelvic pain, blurred vision, weight gain, yellowing of skin or eyes, hot flushes, breast discomfort, headache, difficulty breathing, decreased uri­nation, nausea, or vomiting.
• May cause dizziness, light-headedness, and visual disturbances. Use caution while driving or performing tasks requiring alertness, coordination, or physical dexterity, particularly in variable lighting.
• Multiple pregnancy is possible and poses potential hazards.
• The likelihood of conception diminishes with each succeeding course of therapy. If pregnancy has not been achieved after three courses of treatment, further treatment is not recommended. Long-term cyclic therapy is not recommended.
• Do not use this medicine if you are pregnant or think you might be pregnant. A reliable pregnancy test should be administered before starting therapy to avoid taking this medicine during early pregnancy.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature (59 0 to 86°F) away from heat, light, and moisture.

Type of Drug:Enzyme replacement therapy.

How the Imiglucerase Drug Works:

An enzyme used long-term to break down glucocerebroside into glucose and ceramide. This prevents the accumulation of glucocerebroside in disease.

Uses Imiglucerase:

For long-term enzyme replacement therapy for type I Gaucher disease that results in one or more of the following problems: anemia, low platelet counts, bone disease and deterioration, enlargement of the liver or spleen.

Precautions:

Do not use in the following situations: Allergy to imiglucerase or any of its ingredients.

Use with caution in the following situations: Pulmonary hypertension.

Hypersensitivity: Approximately 15% of patients have developed antibodies reactive with imiglucerase during the first year of therapy. Approximately 46% of those patients experienced allergic reactions.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if imiglucerase appears in breast milk.

Consult your doctor before you begin breastfeeding.

Side Effects of Imiglucerase:

Every drug is capable of producing side effects. Many imiglucerase users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Nervous System: Headache; fever; chills; fatigue; dizziness.

Other: Nausea; vomiting; stomach discomfort; diarrhea; back pain; chest discomfort; swelling; difficulty breathing; low blood pressure; rapid heart rate; injection site burning, itching, and swelling; rash; itching; flushing; skin discoloration

Guidelines for Use:

• This drug is prepared and administered intravenously (IV; into a vein) by your health care provider in a medical setting.
• Dosage is individualized and may be administered as frequently as 3 times per week or as infrequently as once every 2 weeks depending on disease severity.
• Contact your doctor immediately if you experience any symptoms of allergic reaction (eg, rash, difficulty breathing).

Type of Drug:Synthetic hormones (anabolic steroids) closely related to the androgen testosterone (male sex hormone).

How the Drugs Works:

Anabolic steroids promote body tissue-building processes and reverse destructive tissue-depleting processes. They also decrease normal testosterone production by the testicles.

Uses :

Nandrolone and oxymetholone - To treat certain types of anemia.

Oxandrolone - To treat weight loss due to severe illness, following extensive surgery, and in some patients who, without definite reasons, fail to gain or maintain normal weight. To relieve bone pain caused by osteoporosis (brittle bones). To prevent the breakdown of protein associated with prolonged corticosteroid (eg, prednisone) use.

Stanozolol - To decrease the frequency and severity of hereditary angioedema attacks.

Unlabeled Uses: Occasionally doctors may prescribe oxandrolone for alcoholic hepatitis, short stature associated with Turner syndrome, HIV wasting syndrome, and HIV-associated musclo weakness.

Precautions:

Athletic performance: Anabolic steroids have not been shown to enhance athletic ability. An athlete’s motivation to use steroids includes: Increased muscle mass and strength; decreased muscle recovery time, allowing more frequent weight training; decreased healing time after muscle injury; increased aggressiveness. The increase in muscle size and weight gain is partially attributed to increased sodium and water retention. The serious health hazards associated with anabolic steroids minimize any real or perceived gain in performance. Effects of these agents may persist for up to 6 months after the last dose. Adverse effects may be serious and irreversible.

Benzyl alcohol: Some of these products contain benzyl alcohol, which has been associated with fatal “gasping syndrome” in premature infants. Consult your doctor or pharmacist.

Edema: Edema (swelling), with or without congestive heart failure, may occur. Use with caution in patients with heart, kidney, or liver disease; epilepsy; migraine; or other conditions that may be aggravated by fluid retention. In addition to discontinuation of the drug, diuretic therapy may be required.

High serum cholesterol: Anabolic steroids may lower high-density lipoprotein (HDL) (”good” cholesterol) and raise low-density lipoprotein (LDL) (”bad” cholesterol). This effect may increase the risk of arteriosclerosis (hardening of the arteries) and coronary artery disease.

Leukemia: Leukemia has been observed in patients with plastic anemia treated with oxyacetylene, but the role of oxyacetylene is unclear.

Liver disease: Liver cysts and tumors have occurred during treatment with anabolic steroids. They are often not recognized until a life-threatening condition develops. Stopping the medicine usually results in shrinking or complete disappearance of the lesions.

Mnlos after puberty: Anabolic steroids may inhibit function of the testes, Iggravato acne, decrease sperm count, promote development of breast cantus the testes to shrink, and lead to impotence.

Women: Anabolic steroids may produce irreversible vitalization (eg, deepening of voice, unusual hair growth, enlargement of the clitoris) in females. Women should be carefully monitored and drug therapy stopped at the first sign of virilization (eg, menstrual irregularities).

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit. Anabolic steroids may cause masculinization of the female fetus.

Breastfeeding: It is not known if anabolic steroids appear in breast milk.

Because of the potential for serious adverse effects, decide whether to discontinue nursing or the drug. Consult your doctor before you begin breastfeeding.

Children: The adverse effects of use in young children are not fully under­stood. Anabolic steroids may interfere with growth to normal adult height. Use with caution.

Elderly: Anabolic steroids may increase risk of prostate enlargement or prostate cancer. Use with caution.

Lab tests may be required to monitor therapy. Tests may include liver function, blood calcium levels, cholesterol levels, and hemoglobin tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking an anabolic steroid. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. Anticoagulants (eg, warfarin) interact with anabolic steroids.

Side Effects:

Every drug is capable of producing side effects. Many anabolic steroid users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Males (before puberty): Increased size of penis; increased frequency of erections.

Males (after puberty): Breast enlargement; changes in sex drive; impotence; persistent, painful erections; shrinking of testes; decreased semen volume; bladder irritation; inhibition of testicular function.

Females: Excessive growth of body hair; hoarseness or deepening of the voice; enlargement of the clitoris; changes in sex drive; changes in menstruation; male pattern baldness.

Digestive Tract: Nausea; vomiting; diarrhea.

Nervous System: Sleeplessness; dependency; depression; excitability Skin: Yellowing of the skin or eyes; acne.

Other: Fluid retention; ankle swelling; electrolyte imbalance;abnormal cholestrol lvels;abnormal lab test ;liver disease;elevated blood sugar.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not change the dose or stop taking, unless advised by your doctor.
• The inject able form of nandrolone will usually be prepared and administered by your health care provider in a medical setting.
• May cause nausea or gastrointestinal upset.
• Diabetic patients _ Glucose tolerance may be altered. Monitor blood sugar closely and report any changes to your doctor.
• Seizure disorders _ Epileptic patients may note an increase in seizure frequency; notify your doctor if this occurs.
• Notify your doctor if you experience nausea, vomiting, yellowing of skin color, or ankle swelling.
• Female patients should notify their doctor if they experience hoarse- ness, deepening of the voice, changes in body hair growth, menstrual changes, malepattern baldness, or acne .
• Male patients should notify their doctor if they experience too frequent or persistent erections of the penis or development or worsening of acne.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Do not use to enhance physical appearance or athletic performance.
• Effects of anabolic steroids may persist for up to 6 months after the last dose; some adverse effects are irreversible.
• Maximum benefit may not be reached for several months.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store tablets at controlled room temperature (59° to 86°F).

Type of Drug:

Thyroid hormones.

How the Thyroid Hormones Works:

The natural thyroid hormone products (eg, desiccated thyroid and ) are obtained from beef and pork. They are economical, but standardization of iodine content is difficult. The synthetic products, including love thyroxin, Lithuanian and liotrix are generally preferred due to more uniform potency.

Thyroid hormones increase the metabolic rate of body tissues. This involves many varied functions such as oxygen use, respiratory rate, body temperature, heart rate, metabolism of foods, enzyme activity and growth and development of the skeletal and nervous system. Thyroid hormones influence every organ system of the body.

Uses of The Thyroid Hormones:

To treat hypothyroidism (low thyroid hormone Production).

To treat thyroid nodules, chronic lymphocytic thyroiditis (Hashimoto disease), multinodular goiter and thyroid cancer.

To treat thyrotoxicosis (excessive thyroid hormone production). Used with an antithyroid drug to prevent hypothyroidism.

Precautions:

Do not use in the following situations: allergy to thyroid hormones heart attack, recent obesity, treatment thyroid deficiency (hypothyroidism) and hypoadrenalism (Addison disease) together thyroid gland, overactive (thyrotoxicosis)

Use with caution in the following situations: Addison disease heart disease angina (chest pain) infertility diabetes insipid us kidney disease diabetes mellitus myxedema (swelling due to elderly hypothroidism)

Pregnancy: This drug appears to be safe for use during pregnancy. Do not discontinue thyroid replacement therapy in hypothyroid (decreased thyroid activity) women during pregnancy.

Breastfeeding: Very small amounts of thyroid hormones appear in breast milk. Use with caution during breastfeeding. The mother and nursing infant should be checked periodically.

Children: Thyroid replacement therapy in children may lead to partial hair loss in the first few months of therapy. This is a temporary condition. Normal hair growth and distribution returns.

Lab Tests: Lab tests will be required to monitor therapy. Be sure to keep appointments.

Tartrazine: Some of these products may contain the dye tartrazine (FD&C Yellow No.5) which can cause allergic reactions in certain individuals. Check package label when available or consult your doctor or pharmacist.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary Supplements while taking this medicine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with ‘his medicine:

Side Effects of Thyroid Hormones:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility.

Side effects other than those indicating too much thyroid due to excessive dosage or too rapid dosage increase are rare. Symptoms of too much thyroid include:

Digestive Tract: Diarrhea; vomiting.

Nervous System: Tremors; headache; nervousness; sleeplessness. Circulatory System: Increased heart rate; palpitations (pounding in the chest); irregular heartbeat; angina (chest pain); cardiac arrest.

Other: Weight loss; menstrual irregularities; sweating; heat intolerance; fever.

Guidelines for Use:

• Use exactly as prescribed.
• Take as a single daily dose on an empty stomach, preferably before breakfast.
• Brand interchange - Do not change from one brand of this drug to another without consulting your pharmacist or doctor. Products manufactured by different companies may not be equally effective.
• Replacement therapy is usually taken for life.
• Do not discontinue medication except on advice of your doctor.
• Notify your doctor if headache, nervousness, sleeplessness diarrhea, excessive sweating, heat intolerance, chest pain, increased heart rate, irregular heartbeat or any unusual event occurs.
• Partial loss of hair may be experienced by children in the first few months of thyroid therapy, but this is usually only temporary.
• Do not use this medication to treat obesity. Thyroid hormones are not effective for weight reduction. Large doses of thyroid medications may produce serious or even life-threatening conditions, especially when taken with appetite suppressants.
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose In order to “catch up” (unless advised to do so by your doctor). If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Dosage is individualized to approximate the deficit in thyroid secretion. Your response is evaluated by your doctor with lab tests. Store at room temperature away from moisture and light.

Bisphosphonates Drug - How does Bisphosphonates Works?

Type of Drug:

Bisphosphonates.

How the Bisphosphonates Works:

Bisphosphonates help preserve bone mass by inhibiting normal and abnormal bone loss due to resorption (bone tissue loss). Some of these drugs also help control the balance of calcium in bones and blood in certain cancers.

Uses of The Bisphosphonates:

To treat Paget disease of bone (alendronate, etidronate, pamidronate, rise- dronate, tiludronate only).

To treat osteoporosis bone metastases of breast cancer and osteolytic bone losions of multiple myeloma in conjuction with standard antineoplastic thorapy (pamidronate only).

To treat high calcium blood levels in combination with adequate hydration (pamidronate,zoledronic acid only) and bone lesions (pamidronate only) caused by cancer.

To treat osteoporosis in men and postmenopausal women; to prevent osteoporosis in postmenopausal women; to treat glucocorticoid­induced osteoporoses in men and women (alendronate, risedronate only).

To prevent and treat heterotopic ossification (unwanted bone calcification) following total hip replacement or due to spinal cord injury (oral etidronate only).

Unlabeled Uses: To treat osteoporosis in postmenopausal women (etidronate, pamidronate, risedronate only). To prevent osteoporosis in post­menopausal women (risedronate, etidronate only). To treat hyperparathyroidism, high calcium blood levels associated with immobilization; to reduce bone pain in patients with prostatic cancer (pamidronate only). To prevent glucocorticoid-induced osteoporosis (etidronate, pamidronate only).

Precautions:

Do not use in the following situations: allergy to the bisphosphonate or any of its ingredients clinically overt bone softening (osteomalacia) (etidronate only) esophagus abnormalities (alendronate only) inability to stand or sit upright for at least 30 minutes (alendronate, risedronate only)

Use with caution in the following situations: asthma liver disease (zoledronic acid bone fractures only) digestive system disorders low calcium blood levels kidney disease

Pregnancy: There are no adequate or well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if these drugs appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children have not been established. Lab tests will be required periodically during treatment. Tests may include blood exams and kidney function tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-­the-counter or prescription medications or dietary supplements with a bisphosphonate. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with bisphosphonates:

Side Effects:

Every drug is capable of producing side effects. Many bisphosphonate users experience no, or minor, side effects. The frequency or severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Inflammation of the stomach, nausea; vomiting; diarrhea; constipation; gas; heartburn; indigestion; ulcers; stomach pain; acid regurgitation; difficulty swallowing; bloating; appetite loss; stomach bleeding; taste changes; dental disorder; mouth sores; inflammation of the colon.

Circulatory System: High blood pressure; fainting; rapid heartbeat; irregular heartbeat; anemia; decreased white blood cell and platelet count; abnormal blood tests.

Nervous System: Headache; fatigue; dizziness; drowsiness; weakness; vertigo (feeling of whirling motion); confusion; anxiety; nervousness; sleep disorders; sleeplessness; hallucinations; amnesia; depression; convulsions.

Respiratory System: Difficulty breathing; runny nose; sore throat; sinus infection; coughing; bronchitis; upper respiratory infections.

Skin: Rash; itching; redness, swelling, hardness, or pain at injection site (pamidronate, zoledronic acid only); fungal infections; sweating; flushing; hair loss.

Other: Urinary tract infection; flu-like symptoms; infection; fracture; vitamin D deficiency; fever; general swelling; joint, muscle, chest, neck, leg, back, or bone pain; involuntary muscle contractions; muscle or leg romps; abnormal skin sensations (eg, burning, prickling, tingling); catamcts; glaucoma; eye inflammation.

Guidelines for Use:

• Pamidronate and zoledronic acid are prepared and administered by your health care provider in a medical setting.
• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose unless directed by your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• These medications may cause upset stomach, nausea, or diarrhea.
• Take supplemental calcium and vitamin 0 as advised by your doctor if dietary intake is inadequate.
• Avoid nicotine and alcohol, which deplete calcium from the bones.
• Consider weight-bearing exercises to increase the calcium density of bones.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store tablets at controlled room temperature (59° to 86°F) in a tightly sealed container. Do not remove tiludronate tablets from foil strip until they are to be used ..
• Alendronate and risedronate _ Take each tablet first thing in morning with a full glass of water (6 to 8 oz) at least 30 minutes before the first food, beverage, or medication of the day. Taking with mineral water, fruit juices, or coffee can decrease its effectiveness. Do not lie down for at least 30 minutes following administration and until after the first food of the day. Discontinue use and notify your physician if you experience new or worsening heartburn or difficult or painful swallowing.

Etidronate-

• Take tablets with a full glass of water (6 to 8 oz) on an empty stomach, at least 2 hours before meals. Take tablets as a single dose. If stomach upset occurs, divide the dose. Do not eat foods (such as milk or dairy products), vitamins, mineral supplements, or antacids that are high in calcium within 2 hours of taking.