• Anxiety,
• tension,
• symptoms of acute alcohol withdrawal,
• partial seizures,
• fatigue,
• agitation,
• irritable bowel syndrome,
• and panic attacks.

General Information of the drug

• Clorazepate dipotassium is a benzodiazepine, which directly affect the brain. This drug is a central-nervous-system depressant, and can relax you and make you more tranquil or sleepier, or they can slow nervous system transmissions in such a way as to act as an anticonvulsant.
• Many doctors prefer benzodiazepines to other drugs that can be used to similar effect because they tend to be safer, have fewer side effects.
• Clorazepate may increase blood levels of digoxin and the chances of digoxin toxicity.
• Don’t mix it with alcohol, other sedatives, narcotics, barbiturates, monoamine oxidase inhibitor and other antidepressants, and antihistamines.
• Taking clorazepate with other similar effects drugs may result in excessive depression, tiredness, sleepiness, breathing difficulties, or related symptoms.
• Combining clorazepate with phenytoin may increase phenytoin blood concentrations and the chances of phenytoin toxicity.
• Smoking may reduce clorazepate’s effectiveness by increasing the rate at which it is broken down by the body.
• Clorazepate’s effects may be prolonged when it is mixed with cimetidine, contraceptive drugs, disulfiram, fluoxetine, isoniazid, ketoconazole, metoprolol, probenecid, propoxyphene, propranolol, rifampin, or valproic acid.
• If you have to take Tranxene for a prolong period of time, your doctor will need to monitor your blood counts and liver function to be sure of your health state.
• Theophylline may reduce clorazepate’s sedative effects.
• If you take antacids, separate them from your clorazepate dose by at least 1 hour to prevent them from interfering with the absorption of clorazepate into the bloodstream.
• The effect of levodopa + carbidopa may be decreased if it is taken together with clorazepate.

Cautions ( This drug may be addictive ! )

• Clorazepate may be addictive. It should be used with caution in people with a history of drug dependence.
• Do not take clorazepate if you are allergic or sensitive to any of its ingredients or to another benzodiazepine drug, including clonazepam.
• Clorazepate can aggravate narrow-angle glaucoma, but you may take it if you have open-angle glaucoma and are receiving therapy for it.
• Clorazepate should not be taken by psychotic patients because it is not effective for them and can trigger unusual excitement, stimulation, and rage.
• Clorazepate is not intended to be used for more than 3-4 months at a time. Your doctor should reassess your condition before continuing your prescription beyond that time.
• Your dosage should always be reduced gradually to prevent drug withdrawal symptoms, which may develop if you stop taking it after as few as 4 weeks of regular use but is more likely after longer use.
• Drug withdrawal symptoms may start with anxiety and progress to tingling in the hands or feet, sensitivity to bright light, sleep disturbances, cramps, tremors, muscle tension or twitching, poor concentration, flu-like symptoms, fatigue, appetite loss, sweating. and changes in mental state.
• Other conditions in which clorazepate should be avoided are: severe depression, severe lung disease, sleep apnea (intermittent cessation of breathing during sleep), liver disease, drunkenness, and kidney disease. In each of these conditions, the depressive effects of clorazepate may be enhanced or could be detrimental to your overall condition.

Note

• This drug is for Adult Only ! It is not recommended for child.
• Clorazepate is best taken on an empty stomach, but if it upsets your stomach then it may be taken with food. Consult your doctor on this.
• Clorazepate can cause tiredness, drowsiness, inability to concentrate, or similar symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.
• People taking clorazepate for more than 3 or 4 months at a time may develop drug withdrawal reactions if the medication is stopped suddenly (see “Cautions” section above). Do not stop taking clorazepate or increase or decrease your dosage without first consulting your doctor.
• Do not take a double dose. If you forget a dose of clorazepate, take it as soon as you remember. If it is almost time for your next dose, skip the dose you forgot and continue with your regular schedule.

Pregnancy/Breast-feeding period :

• Clorazepate may cause birth defects if taken during the first 3 months of pregnancy.
• Avoid this drug if you are or might be pregnant, as Clorazepate may pass into breast milk. Nursing mothers who must take clorazepate should switch to use infant formula.

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• Nausea and vomiting associated with cancer chemotherapy,
• appetite stimulation and weight-loss prevention in people with acquired immunodeficiency syndrome (AIDS).

General Information

• Dronabinol is a legal form of marijuana. The psychoactive chemical in marijuana is delta-9-THC. Dronabinol has all of the psychological effects of marijuana and is therefore considered to be a highly abusable drug.
• Dronabinol increases the effects of alcohol, sleeping pills, sedatives, and other depressants.
• Dronabinol also enhances the effects of psychoactive drugs including tricyclic antidepressants, amphetamines, cocaine, and other stimulants.
• This drug is known to be potential cause of personality changes, feelings of detachment, hallucinations, and euphoria (feeling “high”).
• Younger adults have reported a greater success rate with dronabinol, probably because they are better able to tolerate these effects.
• Most people start taking dronabinol while in the hospital so their response to the drug and its possible adverse effects can be monitored.
• Dronabinol has also been studied as a glaucoma treatment. ( More information to be researched in this field )
• Dronabinol may increase the effects of fluoxetine and disulfiram.
• The effects of theophylline drugs are reduced by dronabinol.
• Combining dronabinol and antihistamines or anticholinergic drugs may cause either rapid heartbeat or excessive drowsiness.

Cautions ( This drug has serious effects ! )

• Do not take dronabinol if you are allergic or sensitive to any of its ingredients, to marijuana. or to sesame oil.
• Dronabinol should be used with caution in those with a history of seizure disorders or substance abuse.
• Dronabinol should be used with caution by people with heart disease or high blood pressure.
• Dronabinol has a profound effect on mental states, as it will impair your ability to operate complex equipment or engage in any activity that requires intense concentration, sound judgment, or coordination—such as driving a car.
• Dronabinol should not be used to treat nausea and vomiting caused by anything other than cancer chemotherapy.
• Dronabinol produces withdrawal symptoms when the drug is stopped. These may develop within 12 hours of the drug’s discontinuation and include restlessness, sleeplessness, and irritability.
• Within a day after the drug has been stopped, symptoms like stuffy nose, hot flashes, sweating, loose stools, hiccups, or appetite loss may occur. These symptoms usually subside within a few days.
• Dronabinol should be used with caution by people with a manic-depressive or schizophrenic history because it may aggravate the underlying disease.

Note :-

• Avoid alcohol and other central nervous system (CNS) depressants.
• The capsules must be stored in the refrigerator.
• Be careful when driving or performing any task that requires concentration.
  Dronabinol may cause acute psychiatric or psychological side effects. Call your doctor for advise.

Common Side Effects of the drug :-

• drowsiness,
• depression,
• loss of muscle coordination,
• unsteadiness,
• paranoia,
• depersonalization,
• disorientation,
• euphoria,
• dizziness,
• weakness,
• sluggishness,
• nausea and vomiting,
• headache,
• a separation in time and space,
• confusion,
• rapid heartbeat.
• hallucinations,
• memory lapses,
• anxiety,
• muddled thinking,
• perceptual difficulties,
• poor coordination,
• irritability,
• dizziness when rising from a sitting or lying position.

Unlikely Side Effects :-

• difficulty talking or slurred speech,
• facial flushing
• loss of bowel control,
• excessive perspiration,
• fainting,
• diarrhea,
• nightmares,
• ringing or buzzing in the ears,
• muscle pain

Usual Dose Intake ( Do not take a double dose )

1. Antiemetic :

• 5 mg 1-3 hours before starting chemotherapy treatment and repeated every 2-4 hours after treatment, for a total of 4-6 doses a day.
• Dosage may be increased up to 15 mg per dose if needed; psychiatric side effects increase greatly at higher dosages.

2. Appetite Stimulant:

• 2.5 mg before lunch or dinner, or 2.5 mg at bedtime. Dosage may be increased to 20 mg a day.

Over Dosage Effect(s)

• Overdose symptoms may occur at usual dosages or at higher dosages if the drug is being abused.
• The primary symptoms of overdose are the psychological symptoms listed above (see “Side Effects lists above”).
• In some cases, overdose may lead to panic reactions or seizure.

Pregnancy/Breast-feeding period :

• Dronabinol is known to be passes into breast milk. Nursing mothers who must take this drug should use infant formula. Animal laboratory studies have shown adverse effects on the fetus.

• Generalized Anxiety Disorder Treatment with Clorazepate ( Tranxene )
• Using Entacapone in Parkinson’s Disease Treatment
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• Drugs Usage during Critical Medical Emergencies – Synopsis of Important Principles
• Angiotensin-Converting Enzyme Inhibitor – Vasotec Enalapril
• Pathophysiology of Circulatory Failure and Cardiopulmonary Resuscitation
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Parkinson’s disease

• Chronic (persistent) disorder of part of the brain, which affects the way the brain co-ordinates the movements of the muscles in various parts of the body.

General Information of the drug
Entacapone is always used in combination with levodopa + carbidopa. It is prescribed For Parkinson’s disease patients for whom levodopa + carbidopa loses its effectiveness between doses.

Entacapone enhances the effect of levodopa + carbidopa by reversing the action of an enzyme known as catechol-O-methyltransferase (COMT), which is primarily responsible for breaking down levodopa in the body.

Some patients experience signs and symptoms of an end-of-dose “wearing-off” effect with these drugs.

Cautions

• If you are allergic or sensitive to any of its ingredients -> Do not take entacapone !
• People with liver disease should use entacapone with caution as they may accumulate twice as much of this drug in their blood as people with normal liver function.
• Entacapone may cause kidney toxicity.
• Entacapone may increase the risk of dizziness or fainting when rising from a sitting or lying down position.
• Do not take entacapone with phenelzine or tranyleypromine -> Serious reaction may occur.
• Hallucinations have been reported with other Parkinson’s disease drugs.
• Entacapone has been rarely associated with the formation of fibrous tissues in unusual places such as the urinary tract and lungs. It has also caused fluid in the lungs.

Intake and Dosage

• Adult Dose Intake :- 200 mg with each levodopa + carbidopa dose, up to 1600 mg a day.
• Entacapone may be taken with or without food. However, Do Not Mix entacapone with the monoamine oxidase inhibitor (MAGI) antidepressants phenelzine or tranylcypromine.
• Entacapone may be taken with the MA01 selegiline.
• Other drugs broken down by COMT will also be affected by entacapone.
• lsoproterenol, epinephrine, ephedrine, norepinephrine, isoetharine, and others will interact with entacapone, even when taken by inhalation. The result may be increased heart rate, arrhythmias, and excessive changes in blood pressure.
• Cholestyramine, probenecid, erythromycin, rifampin, ampicillin, and chioramphenicol may interfere with the elimination of entacapone from the body.
• Entacapone may enhance the effects of sedatives and other nervous system depressants.
• Although there have been no reports of significant entacapone overdose as of publcation. But theoretically, a massive entacapone overdose could prove lethal by completely inhibiting COMT throughout the body.
• Doses up to 800 mg have been taken and side effects were mainly abdominal pain and loose stools.
• Other effects that might be expected include difficulty breathing, loss of muscle coordination, reduced level of activity, and convulsions.
• Overdose victims should be taken to a hospital emergency room as soon as possible ( ALWAYS bring along the prescription bottle or container. )
  

Important Note

• This drug can cause dizziness, nausea, sweating, or fainting when rising quickly from a sitting or lying position, especially at the beginning of treatment.
• Always take your entacapone dose together with your levodopa + carbidopa dose. If you forget a dose. take it as soon as you remember. ( If it is within 2 hours of your next dose. skip the dose you forgot and continue with your regular schedule. )
• If you experience an increased body movements and twitching, twisting, or uncontrolled tongue, lip, face, arm, or leg movement, consult your doctor as he may need to adjust your dose of levodopa + carbidopa.
• Until your body has become accustomed to the effects of entacapone, it’s highly advisable to be caution when performing tasks, such as driving, that require coordination and concentration.
• Gradually reducing the dose of entacapone decreases some drug side effects.
• Patients who stop using entacapone should be monitored as rapid withdrawal of the drug can cause high fever, sweating, unstable blood pressure, stupor, and muscular rigidity.
• If your urine to turn a brownish-orange color after taking Entacapone,  it is usually harmless.

Possible Side Effects

Most of the common effects after taking this drugs are :-

• difficulty performing voluntary muscle functions,
• excessive muscle activity,
• nausea,
• urine discoloration,
• diarrhea,
• reduced muscle activity,
• dizziness,
• fatigue,
• constipation,
• abdominal pain.

Less common side effects or rarely occurs side effects ( Consult your doctor immediately ) :-

• low blood pressure and fainting ( especially when rising from a sitting or lying position ),
• hallucinations,
• anxiety,
• agitation,
• gastritis or other stomach disorders,
• dry mouth,
• vomiting,
• increased sweating,
• back pain,
• taste changes,
• shortness of breath,
• easy bruising,
• weakness,
• bacterial infection,
• muscle damage or death,
• high fever,
• confusion.

Pregnancy/Breast-feeding period :

• When this drug is considered crucial by your doctor, its potential benefits must be weighed against its risks.
• Entacapone causes birth defects, miscarriage and abortion in pregnant animals. It has been known that Entacapone passes into the breast milk of animals, but at the moment if publication, there is no information on humans is available. Nursing mothers who must take this drug should use infant formula.

• Generalized Anxiety Disorder Treatment with Clorazepate ( Tranxene )
• Treating Diabetes Type2 with Miglitol ( Glyset, Acarbose, Precose )
• Treatments Usage and Effects of Dronabinol Drug (Or Marinol )
• Angiotensin-Converting Enzyme Inhibitor – Vasotec Enalapril
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• Fosfomycin – Urinary anti-infection drug