Category Drugs_Medicines

Lactulose Syrup

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Lactulose is a synthetic sugar used to treat constipation. It is broken down in the colon into products that pull water out from the body and into the colon. This water softens stools. Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body.

How should Lactulose be used?

Lactulose comes as liquid to take by mouth. It usually is taken once a day for treatment of constipation and three or four times a day for liver disease. Your prescription label tells you how much medicine to take at each dose. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lactulose exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

What special precautions should I follow?

Before taking lactulose,

tell your doctor and pharmacist if you are allergic to lactulose or any other drugs.

tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antacids, antibiotics including neomycin (Mycifradin), and other laxatives.

tell your doctor if you have diabetes or require a low-lactose diet.

tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking lactulose, call your doctor.

if you are having surgery or tests on your colon or rectum, tell the doctor that you are taking lactulose.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Lactulose may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

diarrhea

gas

nausea

If you have any of the following symptoms, stop taking lactulose and call your doctor immediately:

stomach pain or cramps

vomiting

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach.

What other information should I know?

Keep all appointments with your doctor.

To improve the taste of lactulose, mix your dose with one-half glass of water, milk, or fruit juice.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names

Cholac®

Constilac® Syrup

Constulose®

Enulose®

Evalose® Syrup

Generlac®

Heptalac®

Kristalose®

Laxilose®

Portalac®

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Omeprazole

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Omeprazole is used alone or with other medications to treat the symptoms of conditions in which the stomach produces too much acid such as Zollinger-Ellison syndrome, Peptic ulcer disease, gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus.

Omeprazole is used to treat damage from GERD in adults and children 1 month of age and older. Prescription omeprazole is used to allow the esophagus to heal and prevent further damage to the esophagus in adults and children 1 year of age and older with GERD.

Prescription omeprazole is also used to treat conditions in which the stomach produces too much acid such as Zollinger-Ellison syndrome in adults.

Prescription omeprazole is also used to treat ulcers (sores in the lining of the stomach or intestine) and it is also used with other medications to treat and prevent the return of ulcers caused by a certain type of bacteria (H. pylori) in adults.

Nonprescription (over-the-counter) omeprazole is used to treat frequent heartburn (heartburn that occurs at least 2 or more days a week) in adults. Omeprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

Omeprazole Dosage and Prescription

Prescription omeprazole comes as a delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) capsule, and packets of delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) granules for suspension (to be mixed with liquid) to take by mouth or give through a feeding tube.

Nonprescription (over-the-counter) omeprazole comes as a delayed-release tablet to take by mouth. Prescription omeprazole is usually taken once a day before a meal but may be taken twice a day when used with other medications to eliminate H. pylori, or up to three times a day, before meals when used to treat conditions in which the stomach produces too much acid.

The nonprescription delayed-release tablets are usually taken once a day in the morning at least 1 hour before eating for 14 days in a row. If needed, additional 14-day treatments may be repeated, not more often than once every 4 months. To help you remember to take omeprazole, take it at around the same time(s) every day. Follow the directions on your prescription label or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take omeprazole exactly as directed.

Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor or stated on the package.

If you are taking the delayed-release tablets, swallow them whole with a full glass of water. Do not split, chew, or crush them or crush and mix them into food.

Swallow the delayed-release capsules whole. If you have difficulty swallowing the delayed-release capsules, place one tablespoon of soft, cool applesauce in an empty bowl. Open the delayed-release capsule and carefully empty all the granules inside the capsule onto the applesauce. Mix the granules with the applesauce and swallow the mixture immediately with a glass of cool water. Do not chew or crush the granules. Do not store the applesauce/granule mixture for future use.

Do not take nonprescription omeprazole for immediate relief of heartburn symptoms. It may take 1 to 4 days for you to feel the full benefit of the medication. Call your doctor if your symptoms get worse or do not improve after 14 days or if your symptoms return sooner than 4 months after you finish your treatment. Do not take nonprescription omeprazole for longer than 14 days or treat yourself with omeprazole more often than once every 4 months without talking to your doctor.

Continue to take prescription omeprazole even if you feel well. Do not stop taking prescription omeprazole without talking to your doctor. If your condition does not improve or gets worse, call your doctor.

What special precautions should I follow?

Before taking omeprazole,

tell your doctor and pharmacist if you are allergic to omeprazole, dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), any other medications, or any of the ingredients in the omeprazole product you will be taking. Ask your pharmacist or check the package label for a list of the ingredients.

tell your doctor if you are taking rilpivirine (Edurant, in Cabenuva, Complera, Odefsey). Your doctor will probably tell you not to take omeprazole if you are taking this medication.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Jantoven), atazanavir (Reyataz, in Evotaz), cilostazol, citalopram (Celexa), clopidogrel (Plavix), cyclosporine (Gengraf, Neoral, Sandimmune), dasatinib (Sprycel), diazepam (Valium, Valtoco), digoxin ( Lanoxin), disulfiram, diuretics (‘water pills’), erlotinib (Tarceva), iron supplements, itraconazole (Sporanox, Tolsura), ketoconazole, methotrexate (Trexall, Xatmep), mycophenolate mofetil (Cellcept, Myfortic), nelfinavir (Viracept), nilotinib (Tasigna), phenytoin (Dilantin, Phenytek), rifampin (Rifadin, Rimactane), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), tacrolimus (Astagraf, Envarsus, Prograf), and voriconazole (Vfend). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

tell your doctor what herbal products you are taking, especially St. John’s wort. Your doctor may tell you not to take St. John’s wort while taking omeprazole.

if you plan to take nonprescription omeprazole, tell your doctor if your heartburn has lasted 3 months or longer, if you have taken nonprescription omeprazole for a longer period of time than stated on the package, or if you have experienced any of the following symptoms: lightheadedness, sweating, or dizziness along with your heartburn; chest pain or shoulder pain; shortness of breath or wheezing; pain that spreads to your arms, neck, or shoulders; unexplained weight loss; nausea; vomiting, especially if the vomit is bloody; stomach pain; difficulty swallowing food or pain when you swallow food; or black or bloody stools. You may have a more serious condition that cannot be treated with nonprescription medication.

tell your doctor if you are of Asian descent and if you have or have ever had a low level of magnesium, calcium, or potassium in your blood; hypoparathyroidism (condition in which the body does not produce enough parathyroid hormone [PTH; a natural substance needed to control the amount of calcium in the blood]); low levels of vitamin B12 in your body; osteoporosis (a condition in which the bones become thin and weak and break easily); an autoimmune disease (condition in which the body attacks its own organs, causing swelling and loss of function) such as systemic lupus erythematosus; or liver disease.

What side effects can Omeprazole cause?

Omeprazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

constipation

gas

nausea

diarrhea

vomiting

headache

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately, or get emergency medical help:

blisters, peeling, or bleeding skin; sores on the lips, nose, mouth, or genitals; swollen glands; shortness of breath; fever; or flu-like symptoms

rash; hives; itching; swelling of the eyes, face, lips, mouth, throat, or tongue; difficulty breathing or swallowing; or hoarseness

irregular, fast, or pounding heartbeat; muscle spasms; uncontrollable shaking of a part of the body; excessive tiredness; lightheadedness; dizziness; or seizures

severe diarrhea with watery stools, stomach pain, or fever that does not go away

new or worsening joint pain; rash on cheeks or arms that is sensitive to sunlight

increased or decreased urination, blood in urine, fatigue, nausea, loss of appetite, fever, rash, or joint pain

People who take proton pump inhibitors such as omeprazole may be more likely to fracture their wrists, hips, or spine than people who do not take one of these medications. People who take proton pump inhibitors may also develop fundic gland polyps (a type of growth on the stomach lining). These risks are highest in people who take high doses of one of these medications or take them for one year or longer. Talk to your doctor about the risk of taking omeprazole.

Symptoms of overdose may include the following:

confusion

drowsiness

blurred vision

fast or pounding heartbeat

nausea

vomiting

sweating

flushing (feeling of warmth)

headache

dry mouth

What other information should I know about Omeprazole?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain laboratory tests before and during your treatment.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking omeprazole.

Do not let anyone else take your medication. If you are taking prescription omeprazole, ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Insulin Therapy

Drugs_Medicines
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Insulin is a hormone produced by the pancreas to help the body use and store glucose. Glucose is a source of fuel for the body.

With diabetes, the body cannot regulate the amount of glucose in the blood (called glycemia or blood sugar). Insulin therapy can help some people with diabetes maintain their blood sugar levels.

Information

Carbohydrates from food are broken down into glucose and other sugars. Glucose is absorbed from the digestive tract into the bloodstream. Insulin lowers blood sugar by allowing it to move from the bloodstream into muscle, fat, and other cells, where it can be stored or used as fuel. Insulin also tells the liver how much glucose to produce when you are fasting (have not had a recent meal).
People with diabetes have high blood sugar because their body does not make enough insulin or because their body does not respond to insulin properly.

 

With type 1 diabetes the pancreas produces little to no insulin.

With type 2 diabetes the fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. Over time, the pancreas stops making as much insulin.

Insulin Doses and Types

Insulin therapy replaces the insulin the body would normally make. People with type 1 diabetes must take insulin every day.

People with type 2 diabetes need to take insulin when other treatments and medicines fail to control blood sugar levels.

Insulin doses are given in two main ways

Basal dose – provides a steady amount of insulin delivered all day and night. This helps maintain blood glucose levels by controlling how much glucose the liver releases (mainly at night when the time between meals is longer).

Bolus dose – provides a dose of insulin at meals to help move absorbed sugar from the blood into muscle and fat. Bolus doses can also help correct blood sugar when it gets too high. Bolus doses are also called nutritional or meal-time doses.

There are several types of insulin available. Insulin types are based on :

Onset – how quickly it starts working after injection

Peak – time when the dose is the strongest and most effective

Duration – total time the insulin dose stays in the bloodstream and lowers blood sugar

Types of insulin:

Rapid-acting or fast-acting insulin starts working within 15 minutes, peaks in 1 hour, and lasts for 4 hours. It is taken right before or just after meals and snacks. It is often used with longer-acting insulin.

Regular or short-acting insulin reaches the bloodstream 30 minutes after use, peaks within 2 to 3 hours, and lasts 3 to 6 hours. This is taken a half-hour before meals and snacks. It is often used with longer-acting insulin.

Intermediate-acting insulin starts working within 2 to 4 hours, peaks in 4 to 12 hours, and lasts 12 to 18 hours. This is taken mostly either twice a day or once at bedtime.

Long-acting insulin starts to work a few hours after injection and works for about 24 hours, sometimes longer. It helps control glucose throughout the day. It is often combined with rapid- or short-acting insulin as needed.

Premixed or mixed insulin is a combination of 2 different types of insulin. It has both a basal and bolus dose to control glucose after meals and throughout the day.

Inhaled insulin is a rapid-acting breathable insulin powder that starts working within 15 minutes of use. It is used just before meals.

One or more types of insulin may be used together to help control your blood sugar. You also may use insulin along with other diabetes medicines. Your health care provider will work with you to find the right combination of medications for you.

Your provider will tell when and how often you need to take insulin.

Your dosing schedule may depend on:

Your weight

Type of insulin you take

How much and what you eat

Level of physical activity

Your blood sugar level

Other health conditions

Your provider can calculate the insulin dose for you. Your provider will also tell you how and when to check your blood sugar and time your doses during the day and night.

Ways to Take Insulin

Insulin cannot be taken by mouth because stomach acid destroys insulin. It is most often injected under the skin into fatty tissue. There are different insulin delivery methods available:

Insulin syringe – insulin is drawn from a vial into a syringe. Using the needle, you inject the insulin under the skin.

Insulin pump – a small machine worn on the body pumps insulin under the skin throughout the day. A small tube connects the pump to a small needle inserted into the skin.

Insulin pen – disposable insulin pens have prefilled insulin delivered under the skin using a replaceable needle.

Inhaler – a small device you use to inhale insulin powder through your mouth. It is used at the start of meals.

Injection port – a short tube is inserted into the tissue under the skin. The port containing tube is adhered to skin using adhesive tape. Fast-acting insulin is injected into the tube using a syringe or pen. This allows you to use the same injection site for 3 days before rotating to a new site.

You can talk with your health care provider about your preferences when deciding on an insulin delivery method.

Insulin is injected into these sites on the body:

Abdomen

Upper arm

Thighs

Hips

Your provider will teach you how to give an insulin injection or use an insulin pump or other device. It is important not to always use the same site as this can decrease how effective the insulin is for you.

Points to Remember

You need to know how to adjust the amount of insulin you are taking:

When you exercise

When you are sick

When you will be eating more or less food

When you are traveling

Before and after surgery

When to Call the Doctor

If you are taking insulin, contact your provider if:

You think you may need to change your insulin routine

You have any problems taking insulin

Your blood sugar is too high or too low and you don’t understand why

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