Miscellaneous
Antidote, Ethylene Glycola
Fomepizole (Antizol)
This is indicated for the treatment of acute ingestion of ethylene glycol (the main ingredient in antifreeze) whether due to suicidal or accident.. The mechanism of action is to inhibit alcohol dehydrogenase which converts the ethylene glycol to glycolic and oxalic acids, which are toxic metabolites.
Diabetic Patients
Regranex (Becaplermin)
This new topically applied agent represents a significant advance in the treatment of skin ulcers commonly seen in diabetic patients. It consists of platelet-derived growth factor which promotes granulation in the ulcer and significantly increase the rate of healing. It should be used in conjunction with and not in place of good ulcer care.
Male Baldness
Finasteride (Propecia)
This is a newly released (and only) oral drug for the treatment of male pattern baldness. Based on before and after photographs, approximately 35-40% of patients who took this medication in clinical trials showed some hair gain compared with 7% taking placebo. On average the hair gain was 10-15% in a 1 inch circle on the top of the head. Hair growth was observed in frontal, mid-area and vertex areas of the scalp. It requires a minimum of several months of treatment for effects to be noticed. Side effects are rare. However, since this is a testosterone antagonist, occasionally the side effects of decreased libido may occur.
Male Impotence
Alprostadil (Muse)
This is the second drug in the class of agents for the treatment of male impotence. This drug is inserted intraurethrally compared with the other agent which is injected into the penis. It appears to be effective in producing a satisfactory erection in approximately 60% of users irrespective of the cause of the impotence (diabetes). The main side effect is burning and mild penile pain on insertion. Occasionally, female partners may experience vaginal itching which can be prevented by the use of a condom (male or female).
Organ Rejection
Zenapax (Daclizumab)
This intravenously administered drug is indicated to prevent acute organ rejection in patients receiving kidney transplants. This drug is a monoclonal antibody which prevents the activaton of lymphocytes, a step leading to organ rejection. It can be used with other supressors of organ rejection without any additive side effects.
Paget's Disease
Tiludronate (Skelid)
This drug was approved for the treatment of Paget's disease of the bone. It should be used along with supplemental calcium therapy.
Prostatic Hypertrophy
Tamsulosin (Flomax)
This drug is indicated in alleviating the difficulty in urination associated with prostatic hypertrophy. When compared with placebo, there was a significant increase in overall symptom score (irritative and obstructive symptoms) and an increase in peak urine flow rate. The improvement is maintained for at least 13 weeks. Side effects include dizziness upon arising from sitting or lying positions, runny nose, and a change in ejaculation behavior (8-18%) depending on dose.
Psoriasis
Tazarotene (Tazorac)
this is a new topical retinoid preparation which is the first retinoid approved for the treatment of stable plaque psoriasis. As with any retinoid, burning and excessive peeling may occur. It is contraindicated in pregnancy and should be used with caution in women attempting to get pregnant.
Urinary Disorders
Detrol (Tolterodine)
Detrol is a drug taken by mouth. It is indicated for those with symptoms of an overactive bladder such as urinary frequency, urgency, or incontinence. In clinical studies, the three meaured parameters, number of micturations/24 h, number of episodes of incontinence, and volume voided all showed signnificant improvement in the Detrol groups. Most side effects were similar to those observed with a placebo however this drug, since it is a cholinergic agonist, should be used with caution in patients with narrow angle glaucoma and those predisposed to urinary and gastric retention.
Vitamin B12 Deficiency
Cyanocobalamin for Nasal Use (Nascobal)
This preparation which is given once weekly is designed to replace the reliance on injectable cyanocobalamin in patients with vitamin B12 deficiency.
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