In case of overdose, priorities are the reestablishment of a patent and protected airway and institution of assisted or controlled ventilation, if needed. Employ other supportive measures including oxygen and vasopressors in the management of circulatory shock and pulmonary edema as indicated. Cardiac arrest or arrhythmias will require advanced life-support techniques. What Are Warnings and Precautions for Tolterodine? Methylprednisolone may make you dizzy. not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Cut back on sodium and salty foods: Lots of sodium can raise calcium levels in your urine. And that can cause stones to form.
Cordarone, Pacerone dofetilide Tikosyn disopyramide Norpace procainamide Procan, Pronestyl quinidine Quin-G or sotalol Betapace. To prevent needle-stick injuries, needles should not be recapped, purposely bent, or broken by hand. Elderly patients aged 65 years or older may have increased sensitivity to meperidine. In general, use caution when selecting a dosage for an elderly patient, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy. Adults: The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously, 30 to 90 minutes before the beginning of anesthesia. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.
Individually titrate Demerol Injection to a dose that provides adequate analgesia and minimizes adverse reactions. Demerol Injection contains meperidine, a Schedule II controlled substance. You need to get the condition treated. If your bladder can't empty, that can lead to infections and other problems. Caution is advised when using Detrol LA extended-release capsules in CHILDREN; they may be more sensitive to its effects, especially an increased risk for urinary tract infection and behavior or attention problems.
It may rarely harm an unborn baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for a long time may have problems. The half-life of meperidine is 2 to 5 hours, and the half-life of normeperidine is 15 to 30 hours. The major hazards of meperidine, as with other opioid analgesics, are respiratory depression and, to a lesser degree, circulatory depression; respiratory arrest, shock, and cardiac arrest have occurred. Mental or physical problems such as or prevent you from getting to the bathroom in time. Detrol LA extended-release capsules may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Detrol LA extended-release capsules with caution.
This medication is not recommended for use in children younger than 1 year due to increased risk of side effects. Tell your doctor if your condition persists or worsens. It is readily soluble in water and has a neutral reaction and a slightly bitter taste. The solution is not decomposed by a short period of boiling. Demerol Injection is indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. Take this medication with water. Allergic. Pruritus, urticaria, other skin rashes, wheal and flare over the vein with intravenous injection. Accumulation of normeperidine as in chronic use or possibly following introduction of a concomitant CYP3A4 inducer presents as excitatory syndrome including hallucinations, tremors, muscle twitches, dilated pupils, hyperactive reflexes, and convulsions.
Other. Pain at injection site; local tissue irritation and induration following subcutaneous injection, particularly when repeated; antidiuretic effect. If any of these effects persist or worsen, notify your doctor or promptly. Once you have passed the stone, the doctor will have it analyzed to figure out what it was made of. You also might need to collect your pee for 24 hours to have it tested. Tolterodine may cause a condition that affects the heart rhythm QT prolongation. Drinking alcohol can increase some of the side effects of tolterodine. The safety and effectiveness of meperidine in pediatric patients has not been established. Literature reports indicate that meperidine has a slower elimination rate in neonates and young infants compared to older children and adults. Neonates and young infants may also be more susceptible to the effects, especially the respiratory depressant effects. If meperidine use is contemplated in neonates or young infants, any potential benefits of the drug need to be weighed against the relative risk of the patient. Demerol Injection is contraindicated in patients with known or suspected gastrointestinal obstruction, including paralytic ileus. Both tolerance and physical dependence can develop during chronic opioid therapy. Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia in the absence of disease progression or other external factors. Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects. Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome. Available data with Demerol Injection are insufficient to inform a drug-associated risk for major birth defects and miscarriage. Formal animal reproduction studies have not been conducted with meperidine. isoxsuprine
The dose should be titrated to the needs of the patient and will depend on the premedication and type of anesthesia being employed, the characteristics of the particular patient, and the nature and duration of the operative procedure. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely. Follow patients for signs and symptoms of respiratory depression and sedation. Then, if needed, she will order tests to get pictures of your kidneys and urinary tract. Swallow Detrol LA extended-release capsules whole. Do not break, crush, or chew before swallowing. Medications, electrical stimulation, or surgery. Doctors sometimes prescribe medicines that block the of an overactive bladder. Electrical stimulation of the bladder nerves helps in some cases. Surgery is reserved for severe cases. It aims to increase the amount of urine your bladder can store. Opioids may also obscure the clinical course in a patient with a head injury. Avoid the use of Demerol Injection in patients with impaired consciousness or coma. Long-term studies in animals to evaluate the carcinogenic potential of meperidine have not been conducted. While serious, life-threatening, or fatal respiratory depression can occur at any time during the use of Demerol Injection, the risk is greatest during the initiation of therapy or following a dosage increase. Monitor patients closely for respiratory depression, especially within the first 24 to 72 hours of initiating therapy with and following dosage increases of Demerol Injection.
Carpuject are packaged in a Slim-Pak tamper detection package. Note that a needle is not included. There is a relationship between increasing meperidine plasma concentration and increasing frequency of dose-related opioid adverse reactions such as nausea, vomiting, CNS effects, and respiratory depression. The findings cannot be clearly attributed to maternal toxicity. Drug addiction is a cluster of behavioral, cognitive, and physiological phenomena that develop after repeated substance use and includes a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal. Methylprednisolone can make you more likely to get infections or may worsen any current infections. Therefore, well to prevent the spread of infection. DEMEROL meperidine hydrochloride, USP Injection is an opioid agonist, available for intramuscular, intravenous, or subcutaneous administration. If any of these effects persists or worsens, tell your doctor or promptly. Side Effects List Detrol LA side effects by likelihood and severity. This information should not be used to decide whether or not to take Detrol LA extended-release capsules or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Detrol LA extended-release capsules. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Detrol LA extended-release capsules. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Detrol LA extended-release capsules. Do not crush, chew, break, or open a controlled-release capsule. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time. This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment. Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. Catheter. Some people use a catheter to make sure their bladder is emptied. It's a thin plastic tube that you insert in your urethra. A doctor or nurse can teach you how to insert it for yourself. Do not start, stop, or change the dosage of any medicines without your doctor's approval. zyprexa printable discount coupons
In severe overdose, particularly by the intravenous route, apnea, circulatory collapse, cardiac arrest, and death may occur. Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Demerol Injection is achieved. Similarly, discontinuation of a CYP3A4 inducer, such as rifampin, carbamazepine, and phenytoin, in DEMEROL-Injection treated patients may increase meperidine plasma concentrations and prolong opioid adverse reactions. Do NOT change your dose of Detrol LA extended-release capsules without checking with your doctor. Symptoms can vary and can range in severity. If you miss a dose of Detrol LA extended-release capsules, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Use Detrol LA extended-release capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions. Meperidine causes a reduction in motility associated with an increase in smooth muscle tone in the antrum of the stomach duodenum. Digestion of food in the small intestine is delayed and propulsive contractions are decreased. Propulsive peristaltic waves in the colon are decreased, while tone may be increased to the point of spasm, resulting in constipation. Other opioid-induced effects may include a reduction in biliary and pancreatic secretions, spasm of sphincter of Oddi, and transient elevations in serum amylase. UpToDate: "Nutrition and Dietary Interventions in Adults with Inflammatory Bowel Disease. While many dieters swear by high-, eating large amounts of can also cause a stone to form. How should I take tolterodine Detrol LA? Check with your pharmacist about how to dispose of unused medicine. First, she will get a medical history and examine you. MAO inhibitors those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue. Do not use Demerol Injection in patients taking MAOIs or within 14 days of stopping such treatment. Intravenous hydrocortisone or prednisolone have been used to treat severe reactions, with the addition of intravenous chlorpromazine in those cases exhibiting hypertension and hyperpyrexia. The usefulness and safety of narcotic antagonists in the treatment of these reactions is unknown. The safety and efficacy of Demerol Injection in patients less than 18 years of age have not been established.
What is the most important information I should know about tolterodine Detrol? Acute overdose with Demerol Injection can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, and, in some cases, pulmonary edema, bradycardia, hypotension, partial or complete airway obstruction, atypical snoring, and death. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. If your symptoms do not improve or if they become worse, check with your doctor. Serious, life-threatening, or fatal respiratory depression may occur with use of Demerol Injection. Drink plenty of water: You should drink at least 64 ounces of water each day. Some of that liquid can be orange juice, lemonade, or limeade. What happens if I miss a dose Detrol? Demerol Injection should not be used for treatment of chronic pain. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day. Physical dependence results in withdrawal symptoms after abrupt discontinuation or a significant dosage reduction of a drug. It repositions the urethra to help reduce leakage. Do not use Demerol Injection in patients taking MAOIs or within 14 days of stopping such treatment. This drug may make you dizzy. not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit beverages. This medication contains tolterodine. Do not take Detrol or Detrol LA if you are allergic to tolterodine or any ingredients contained in this drug. Hold the squeeze for 10 seconds, then rest for 10 seconds. galantamine purchase online mastercard europe
This may occur within the recommended dosage range. How does your doctor know if you really do have a kidney stone? For certain products of this drug, an empty tablet shell may appear in your stool. This is harmless. Even if you have a kidney stone, you may not have any symptoms -- that is, until the stone goes on the move. Chronic use of opioids may influence the hypothalamic-pituitary-gonadal axis, leading to androgen deficiency that may manifest as low libido, impotence, erectile dysfunction, amenorrhea, or infertility. Meperidine is contraindicated in patients who are receiving monoamine oxidase MAO inhibitors or those who have recently received such agents. Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally fatal reactions in patients who have received such agents within 14 days. The mechanism of these reactions is unclear, but may be related to a preexisting hyperphenylalaninemia. Some have been characterized by coma, severe respiratory depression, cyanosis, and hypotension, and have resembled the syndrome of acute narcotic overdose. Serotonin syndrome with agitation, hyperthermia, diarrhea, tachycardia, sweating, tremors and impaired consciousness may also occur. In other reactions the predominant manifestations have been hyperexcitability, convulsions, tachycardia, hyperpyrexia, and hypertension. What are the possible side effects of tolterodine Detrol LA? The dosage is based on your medical condition and response to treatment.
Pfizer also has programs that provide eligible patients with insurance, support assistance, and medicines at a savings. Contact Pfizer RxPathways for details 844-989-7284. Opioids have been shown to have a variety of effects on components of the immune system in in vitro and animal models. The clinical significance of these findings is unknown. Overall, the effects of opioids appear to be modestly immunosuppressive. Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately. Tell your doctor if your condition does not improve or if it worsens. Avoid contact with people who have recently received live such as inhaled through the nose. About FAERS: The FDA Adverse Event Reporting System FAERS is used by FDA for activities such as looking for new safety concerns that might be related to a marketed product, evaluating a manufacturer's compliance to reporting regulations and responding to outside requests for information. Reporting of adverse events is a voluntary process, and not every report is sent to FDA and entered into FAERS. Because of these risks, reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate. The potential for these risks should not, however, prevent the proper management of pain in any given patient. Patients at increased risk may be prescribed opioids such as Demerol Injection, but use in such patients necessitates intensive counseling about the risks and proper use of Demerol Injection along with intensive monitoring for signs of addiction, abuse, and misuse. If concomitant use is necessary, consider dosage reduction of Demerol Injection until stable drug effects are achieved. Monitor patients for respiratory depression and sedation at frequent intervals. Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. The dose of Demerol Injection should be proportionately reduced usually by 25 to 50 percent when administered concomitantly with phenothiazines and many other tranquilizers since they potentiate the action of Demerol Injection. MD, assistant professor of medicine, director, IBD Center, Georgetown University Hospital, Washington DC; expert, Crohn's amp; Colitis Foundation of America. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. It is important to continue taking this medication even if you feel well. Most people with not feel sick. Symptoms may include difficulty breathing; difficulty urinating; dilated pupils; dry mouth; excitation; fast heartbeat; hallucinations; seizures. epogen
Using corticosteroid for a long time can make it more difficult for your body to respond to physical stress. The most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. These effects seem to be more prominent in ambulatory patients and in those who are not experiencing severe pain. In such individuals, lower doses are advisable. Some adverse reactions in ambulatory patients may be alleviated if the patient lies down. The concomitant use of Demerol Injection with all cytochrome P450 3A4 inhibitors may result in an increase in meperidine plasma concentrations, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression. In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in meperidine plasma concentration. Where can I get more information? The treatment takes about an hour, and you can usually go home about an hour later. Pfizer also has programs that provide eligible patients with insurance support, copay assistance, and medicines for free. The onset of symptoms generally occurs within several hours to a few days of concomitant use, but may occur later than that. Discontinue Demerol Injection if serotonin syndrome is suspected. Infants exposed to Demerol Injection through breast milk should be monitored for excess sedation and respiratory depression. Withdrawal symptoms can occur in breastfed infants when maternal administration of an opioid analgesic is stopped, or when breast-feeding is stopped. HCl, and it has the following chemical structure. What is the most important information I should know about tolterodine Detrol LA? Before you take tolterodine, tell your doctor if you have kidney or liver disease, glaucoma, myasthenia gravis, or a personal or family history of "Long QT syndrome. Other medications can affect the removal of from your body, which may affect how methylprednisolone works. Prescription drug abuse is the intentional non-therapeutic use of a prescription drug, even once, for its rewarding psychological or physiological effects. Limit dosage and duration to the minimum required.
Consult your doctor before -feeding. Oro Valley, AZ 85755. November 17, 2015. Tolterodine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. It may be taken with or without food. The dosage is based on your medical condition and response to therapy. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously when pain becomes regular, and may be repeated at 1- to 3-hour intervals. This may interfere with certain laboratory tests such as possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Discontinue Demerol Injection if serotonin syndrome is suspected. Overdose symptoms may include dry mouth, blurred vision, and fast heartbeat. Adrenal insufficiency: Cases of adrenal insufficiency have been reported with opioid use, more often following greater than one month of use. Gastrointestinal. Dry mouth, constipation, biliary tract spasm. Meperidine should therefore be used with caution in patients with renal impairment. Titrate the dosage of Demerol Injection slowly in patients with renal impairment and monitor closely for signs of central nervous system and respiratory depression. pharmacy zestoretic online
This means you have any two types of the condition. Many women have both stress and urge incontinence. Store Detrol LA extended-release capsules at room temperature, between 68 and 77 degrees F 20 and 25 degrees C. Brief storage at temperatures between 59 and 86 degrees F 15 and 30 degrees C is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Detrol LA extended-release capsules out of the reach of children and away from pets. Although may be used to prevent problems or treat people who have problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking candesartan. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine. The meperidine in Demerol Injection may increase the frequency of seizures in patients with seizure disorders, and may increase the risk of seizures occurring in other clinical settings associated with seizures. Monitor patients with a history of seizure disorders for worsened seizure control during Demerol Injection therapy. Respiratory depression is the chief risk for elderly patients treated with opioids, and has occurred after large initial doses were administered to patients who were not opioid-tolerant or when opioids were co-administered with other agents that depress respiration. Talk to your doctor or about lifestyle changes that might benefit you. Discuss the risks and benefits with your doctor. Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. Warn patients of the symptoms of serotonin syndrome and to seek medical attention right away if symptoms develop. If you are taking this once daily and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Drowsiness and confusion can increase the risk of falling. If Demerol Injection is abruptly discontinued in a physically-dependent patient, a withdrawal syndrome may occur. Some or all of the following can characterize this syndrome: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other signs and symptoms also may develop, including: irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate. Marked mydriasis rather than miosis may be seen due to hypoxia in overdose situations. Ask your pharmacist about the safe use of those products. Take this medication by mouth with or without food as directed by your doctor, usually once a day. Swallow the medication whole with a full glass of liquid. Do not crush or chew the medication. Doing so can destroy the long action of the drug and may increase side effects. Tell your doctor if your condition does not improve or if it worsens such as your remain high or increase.
Flecainide can affect your heart's rhythm. Other drugs can have the same effect. This medication may lower your ability to fight infections. This may make you more likely to get a serious rarely fatal infection or make any infection you have worse. See "What Are Side Effects Associated with Using Tolterodine? With this type, urine leaks due to weakened pelvic floor muscles and tissues. The stones can be brown or yellow, and smooth or rough. For these reasons, FAERS case reports cannot be used to calculate incidence or estimates of risk for a particular product or compare risks between products. The use of Demerol Injection in patients with acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment is contraindicated. If necessary, meperidine may be given intravenously, but the injection should be given very slowly, preferably in the form of a diluted solution. Rapid intravenous injection of narcotic analgesics, including meperidine, increases the incidence of adverse reactions; severe respiratory depression, apnea, hypotension, peripheral circulatory collapse, and cardiac arrest have occurred. Meperidine should not be administered intravenously unless a narcotic antagonist and the facilities for assisted or controlled respiration are immediately available. When meperidine is given parenterally, especially intravenously, the patient should be lying down. If you get a kidney stone, you are in danger of getting more later in life. In clinical studies reported in the literature, changes in several pharmacokinetic parameters with increasing age have been observed. The initial volume of distribution and steady-state volume of distribution may be higher in elderly patients than in younger patients. The free fraction of meperidine in plasma may be higher in patients over 45 years of age than in younger patients. Inadvertent injection about a nerve trunk may result in sensory-motor paralysis which is usually, though not always, transitory. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Meperidine produces respiratory depression by direct action on brain stem respiratory centers. The respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to both increases in carbon dioxide tension and electrical stimulation. PREGNANCY and BREAST-FEEDING: If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Detrol LA extended-release capsules while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking Detrol LA extended-release capsules. What are the possible side effects of tolterodine Detrol? lunt.info glimepiride
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If the level of pain increases after dosage stabilization, attempt to identify the source of increased pain before increasing the Demerol Injection dosage. If unacceptable opioid-related adverse reactions are observed, consider reducing the dosage. Adjust the dosage to obtain an appropriate balance between management of pain and opioid-related adverse reactions. Your doctor will pass the scope through your bladder and ureter into your kidney. She uses a small basket to remove small stones. If the stones are larger, the doctor will pass a laser through the scope to break them up. Typically, you are able to go home on the same day.
Demerol Injection may cause severe hypotension including orthostatic hypotension and syncope in ambulatory patients. Abuse and addiction are separate and distinct from physical dependence and tolerance. Health care providers should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of opioids can occur in the absence of true addiction. Reserve concomitant prescribing of Demerol Injection and benzodiazepines or other CNS depressants for use in patients for whom alternative treatment options are inadequate. Phenytoin: The hepatic metabolism of meperidine may be enhanced by phenytoin.
Consult your doctor for specific advice. Elevated serum levels have been reported to cause central nervous system excitatory effects. Meperidine should therefore be used with caution in patients with hepatic impairment. Titrate the dosage of Demerol Injection slowly in patients with hepatic impairment and monitor closely for signs of central nervous system and respiratory depression. This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest.
Detrol LA extended-release capsules works best if it is taken at the same time each day. Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Shock wave lithotripsy: This is the most common procedure for kidney stones in the United States. It uses shock waves, which can blast the stone into little pieces. Then, the smaller pieces can more easily be passed in your urine. When a patient who has been taking Demerol Injection regularly and may be physically dependent no longer requires therapy with Demerol Injection, taper the dose gradually, by 25% to 50% every 2 to 4 days, while monitoring carefully for signs and symptoms of withdrawal. If the patient develops these signs or symptoms, raise the dose to the previous level and taper more slowly, either by increasing the interval between decreases, decreasing the amount of change in dose, or both.