Archive | November 2014

Disulfiram (Antabuse)

Category:

Alcohol-abuse deterrent—

Indications

Accepted

Alcoholism (treatment)—Disulfiram is used to help maintain sobriety in the treatment of chronic alcoholism in conjunction with supportive and psychotherapeutic measures.

Mechanism of action/Effect:

Produces irreversible inhibition of the enzyme responsible for oxidation of the ethanol metabolite acetaldehyde. {01} {28} The resultant accumulation of acetaldehyde may be responsible for most of the signs and symptoms occurring after ethanol ingestion in disulfiram-treated patients. {01} {28} The hypotensive response may be due to inhibition of norepinephrine synthesis by the major disulfiram metabolite diethyldithiocarbamate.

Even small amounts of alcohol can produce unpleasant symptoms while Antabuse is in your body. These symptoms include:

  • flushing (warmth, redness, or tingly feeling);
  • sweating, increased thirst, swelling, rapid weight gain;
  • nausea, severe vomiting;
  • neck pain, throbbing headache, blurred vision;
  • chest pain, shortness of breath (even with mild exertion);
  • fast or pounding heartbeats or fluttering in your chest;
  • confusion, weakness, spinning sensation, feeling unsteady; or
  • a light-headed feeling, like you might pass out.

More severe symptoms may occur when Antabuse and large amounts of alcohol are used together, such as severe chest pain spreading to your jaw or shoulder, slow heart rate, weak pulse, seizure, fainting, weak or shallow breathing, or slow breathing (breathing may stop). A disulfiram-alcohol reaction can be fatal.

http://www.drugs.com/mmx/disulfiram.html

http://www.drugs.com/antabuse.html

Status asthmaticus

status asthmaticus is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators (inhalers) and steroids.[1] Symptoms include chest tightness, rapidly progressive dyspnea (shortness of breath), dry cough, use of accessory respiratory muscles, labored breathing, and extreme wheezing. It is a life-threatening episode of airway obstruction and is considered a medical emergency. Complications include cardiac and/or respiratory arrest.

http://en.wikipedia.org/wiki/Acute_severe_asthma

Midodrine

Midodrine (brand names Amatine, ProAmatine, Gutron) is a vasopressor/antihypotensive agent for the treatment of dysautonomia and orthostatic hypotension.

Midodrine is a prodrug which forms an active metabolite, desglymidodrine, which is an α1-receptor agonist and exerts its actions via activation of the alpha-adrenergic receptors of the arteriolar and venous vasculature, producing an increase in vascular tone and elevation of blood pressure.

After oral administration, midodrine is rapidly absorbed. The plasma levels of the prodrug peak after about half an hour, and decline with a half-life of approximately 25 minutes, while the metabolite reaches peak blood concentrations about 1 to 2 hours after a dose of midodrine and has a half-life of about 3 to 4 hours.

It can reduce dizziness and faints by about a third, but can be limited by troublesome goose bumps.[5] Small studies have also shown that midodrine can be used to prevent excessive drops in blood pressure in people requiring dialysis.[6]

Contraindications

Midodrine is contraindicated in patients with severe organic heart disease, acute renal disease, urinary retention, pheochromocytoma or thyrotoxicosis. Midodrine should not be used in patients with persistent and excessive supine hypertension.

Side effects

Headache; feeling of pressure/fullness in the head, vasodilation/flushing face, confusion/thinking abnormality, dry mouth; nervousness/anxiety and rash

http://en.wikipedia.org/wiki/Midodrine