Endocrine Dep of TMC

20/10/2017

2
في البوست هادا حنحكوا ع مسكنات الالم و خافضات الحراره
عندك 3 انواع من الادوية الي حتصرفها لتسكين الالم و تخفيض الحراره وحتكون متوفره في الصيدليات وهي كالاتي :
1_Acetaminophen (paracetamol)
2_ nonsteroidal antinflmatory drugs
3_opoids

بالاضافة للكمادات الطبيه لتخفيض الحراره
طبعا في ادوية ثانيه بس التقسيمه للادوية المتوفره في صيدلياتنا التقسيمه توريك كيف تخدم بالموجود عندك يعني لو تبي كلام كتابات عندك النت ودور
1_Acetaminophen (paracetamol) _adol _calpol
طبعا هادا اشهر دواء لتسكين الالم و تخفيض الحراره طبعا الكل عارفه باسم بنادول
و هو يعتبر أكثر دواء أمن للجسم من عمر يوم من الولاده
طريقة عمله:
هادا يخدم على هيبوتلامس لتنقيص الحراره
و ليه دور في تسكين الالم من خلال
Block pain impulse generation at peripherally and block prostaglandin syenthesis in the cns
الاشكال الدوائية المتوفره منه:
حبوب : 500 او 1000مج معروف بالبنادول او حبوب الراس
فوار باسم efffergan :تركيزه اما 330 او 500 او حتى 1000 الناس تعرفه باسم الفوار التونسي فوار صداع
شراب : بتركيزات اما 125 او 250 مج لكل 5 ملي باسماءadol or calpol or panadol
في الوريد : اما 500 او 1000 طبعا مايستحقش اختبار حساسيه و في الوصفه تلقاه مكتوب باسم perfergan or paracetamol or panadol iv
لو بتعطيه في الوريد لبيبي يفضل ببطء هلبه و ماتعطيشي اكثر من 50 ملي فقط فقط
بس في الكبار عادي
زرابيط: 80 125 150 250 300 500mg
في العضل : شركة ام الربيع نزلت منه بس شكله مشروعه فاشل

جرعته : 15 مج لكل كيلو تنعطى جرعه كل 4 او 6 ساعات طبعا زي ماقولنا ينعطى لبيبي من عمر يوم
اما بالنسبه للكبار الاغلب يوصفوا فيه حبتين 500 جميع كل 8 ساعات
اهم شي جرعة ماتفوتش 4 جرامات يوميات و الجرعة السميه منه هيا 8 جرامات
بالله عليكم اهم شي توقظوا الاهل انه زرابيط حراراه نفس تركيبة شروبوا حراره مش يعطيه زوز في نفس الوقت في الي تلقاه يعطيله في زوز جميع
لو بيبي حرارته فوق 38 و نص او يرجع يفضل زرابيط خير من شراب

مضاعفاته : يعتبر امن بس لو جرعة تفوت الحد المسموح بيه ضر الكبد
في ناس صارتلهم منه حساسيه
لا يعطى في المرضى المصابين بمشاكل حاده في الكبد
توا نعطوا ع مثال كيف نعطوه للبيبيات
مثلا بيبي عمره سنتين و جاك بوه يقولي نبي خافض حراره
طبعا حاول تشرحله انه يشوف دكتور احسن 😂😂😂صاحب صيدليه احتمال يلزك
مهم ماعلينا انت بتصرفله
نجوا نحسبوه وزنه
2×2+8=12kg
توا بتحسب قداش يبي مج من بنادول لكل جرعه
12*15=180mg per dose
يعني بيبي يبي 180 مج من بنادول لكل جرعه تقدر تعطيها ليه زرابيط او شروبو
لو بتعطيه شروبو بتحول 180 للمليات مش تعرف قداش ملي بتعطيه
في الصيدليه عندك زوز تركيزات اما 125 مج او 250 مج لكل 5 ملي
180×5/125= 7.2 ml
يعني بيبي بتعطيه 7 ملي كل 4 او 6 ساعات
لو بتعطيه تركيز 250
180×5/250=3.6ml
يعني تعطيه تركيز 250 اوفر ليه

توا هنا بنحكوا ع انواع بنادول الحبوب المتوفره و المخلطه مع تركيبات اخرى :
1 البنادول الازرق فيه منه تونسي و ايرلندي الفرق في عدد الحبات اسمه advance
وهادا بنادول صافي مامعاشي شي ثاني و السبر يقول امن للحامل كمسكن لوجع زي السوسه و لمرضى الضغط لانه مافيشي كافيين
2 البنادول الاحمر الاكسترا paracetamol +caffeine

هادا يفضل ماينعطاش للحامل و لمرضى الضغط
3 بنادول البنفسجيpanadol night
paracetamol 500mg +diphenhydramin 25 mg antihistamin
يستعمل كمساعد للنوم وايضا حتى للحساسيه
4 بنادول اخضرcold and flu يرقد: للصداع paracetamol500
+chlorphenarmin 2mg للعطس anti histamin
+pseudophedrin 30 mg للاحتقان decongested

ﻳﻌﺘﺒﺮ ﻫﻮ ﺍﻟﺒﻨﺎﺩﻭﻝ ﺍﻷﺳﺎﺳﻲ ﻳﺴﺘﺨﺪﻡ ﻟﻌﻼﺝ ﺍﻟﺒﺮﺩ ﻭﺍﻻﺣﺘﻘﺎﻥ

لا يعطى لمرضى الضغط و الحوامل
تقدر تعطيهم مياه وملح للاحتقان
ماينعطاش لسواقين الطانطات يرقد ترزيه في روحه و في غيره ﻧﻈﺮﺍ ﻻﺣﺘﻮﺍﺋﻪ ﻋﻠﻰ ﻣﻀﺎﺩﺍﺕ ﺍﻟﻬﺴﺘﺎﻣﻴﻦ
5بنادول الاصفر cold and flu : النهاري لانه مايرقدش

Paracetamol 500
+
Phenylephrine للاحتقان 5mg
+caffeine
ﻳﺨﺘﻠﻒ ﻋﻦ ﺍﻟﺒﻨﺎﺩﻭﻝ ﺍﻷﺧﻀﺮ ﻓﻰ ﻛﻮﻧﻪ ﻳﺤﺘﻮﻯ ﻋﻠﻰ ﻓﻴﺘﺎﻣﻴﻦ C .
ﻛﻤﺎ ﺍﻧﻪ ﻻ ﻳﺤﺘﻮﻯ ﻋﻠﻰ ﻣﻀﺎﺩﺍﺕ ﺍﻟﺤﺴﺎﺳﻴﺔ ﻟﻬﺬﺍ ﻻ ﻳﺴﺒﺐ ﺍﻟﻨﻌﺎﺱ ﻭﻣﻜﻦ ﺍﺳﺘﺨﺪﺍﻣﻪ ﻧﻬﺎﺭﺍ ﺩﻭﻥ ﻗﻠﻖ ﻭﻓﻰ ﺍﻭﻗﺎﺕ ﺍﻟﻌﻤﻞ ﻭﻳﻮﺟﺪ ﻣﻨﻪ ﺃﻗﺮﺍﺹ ﺍﻭ ﺑﻮﺩﺭ .
ﻭﻳﻮﺟﺪ ﻣﻨﻪ ﻧﻮﻉ ﺍﺧﺮ ﻭﻫﻮ ﺑﻨﺎﺩﻭﻝ ﻛﻮﻟﺪ ﺍﻧﺪ ﻓﻠﻮ ﺑﺎﻟﻠﻴﻤﻮﻥ ﻭﺍﻟﻌﺴﻞ ﺍﻟﺴﺎﺧﻦ ﻭﻫﻮ ﻋﻠﻰ ﺷﻜﻞ ﺑﻮﺩﺭ ﻭﻳﺘﻤﻴﺰ ﺑﺨﺼﺎﺋﺺ ﺍﻟﻌﺴﻞ ﻭﺍﻟﻠﻴﻤﻮﻥ ﺍﻟﻤﺰﻳﻠﺔ ﻟﻼﺣﺘﻘﺎﻥ ﻭﺍﻟﻤﻘﻮﻳﺔ ﻟﺠﻬﺎﺯ ﺍﻟﻤﻨﺎﻋﺔ

لايعطى للحامل و مريض الضغط تقدر تعطيه لسواق طانطا مايرقدش

6بنادول البرتقاليall in one
ﺍﻟﺒﻨﺎﺩﻭﻝ ﺍﻟﺒﺮﺗﻘﺎﻟﻲ ﻳﺴﺘﻌﻤﻞ ﺃﻳﻀﺎً ﻟﻌﻼﺝ ﻧﺰﻻﺕ ﺍﻟﺒﺮﺩ ﻭﺍﻻﻧﻔﻠﻮﻧﺰﺍ ﻭﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻚ ﻳﺤﺘﻮﻱ ﻋﻠﻰ ﻣﻀﺎﺩ ﻟﻠﺴﻌﺎﻝ ‏( ﺍﻟﻜﺤﺔ ‏) ' ﻭﻻ ﻳﺴﺒﺐ ﺍﻟﻨﻌﺎﺱ ﻳﺤﺘﻮﻱ ﻋﻠﻰ :
Paracetamol 250mg + guiaphenesin100mg للكحه + phenylephrine tab 5mg للعطس

7بنادول جيوب الانفيه panadol sinus
Paracetamol +pseudophedrineللاحتقان

8بنادول actifast رصاصي :
ﻳﺴﺘﻐﺮﻕ ﺍﻣﺘﺼﺎﺹ ﺑﺎﻧﺎﺩﻭﻝ ﺃﻛﺘﻴﻔﺎﺳﺖ ﻧﺼﻒ ﺍﻟﻮﻗﺖ ﺍﻟﻤﺴﺘﻐﺮﻕ ﻓﻲ ﺍﻣﺘﺼﺎﺹ ﺃﻗﺮﺍﺹ ﺑﺎﻧﺎﺩﻭﻝ ﺍﻟﻌﺎﺩﻳﺔ ، ﻣﻤﺎ ﻳﺴﺎﻋﺪﻙ ﻋﻠﻰ ﺍﻟﻌﻮﺩﺓ ﻟﺤﻴﺎﺗﻚ ﺍﻟﻄﺒﻴﻌﻴﺔ ﺑﺸﻜﻞ ﺃﺳﺮﻉ
Paracetamol + sodium 173mg

9بنادول المفاصل panadol joint :
Paracetamol 665
ﺑﺎﻧﺎﺩﻭﻝ ﺟﻮﻳﻨﺖ ﺗﺮﻛﻴﺒﺔ ﻣﻤﺘﺪﺓ ﺍﻟﻤﻔﻌﻮﻝ ﺫﺍﺕ ﻣﻔﻌﻮﻝ ﻣﺴﻜﻦ ﻳﺪﻭﻡ ﻃﻮﻳﻼ ﻵﻻﻡ ﺍﻟﻤﻔﺎﺻﻞ - ﻛﺘﻠﻚ ﺍﻟﻤﺼﺎﺣﺒﺔ ﻟﻠﻔﺼﺎﻝ ﺍﻟﻌﻈﻤﻲ . ﻗﺪ ﻳﻜﻮﻥ ﺑﺎﻧﺎﺩﻭﻝ ﺟﻮﻳﻨﺖ ﺍﻟﺨﻴﺎﺭ ﺍﻟﻤﻨﺎﺳﺐ ﻻﺣﺘﻮﺍﺋﻪ ﻋﻠﻰ ﻣﺎﺩﺓ ﺍﻟﺒﺎﺭﺍﺳﻴﺘﺎﻣﻮﻝ ﺑﺸﻜﻞ ﺃﻛﺒﺮ ﻣﻨﻪ ﻓﻲ ﺃﻗﺮﺍﺹ ﺑﺎﻧﺎﺩﻭﻝ ﺍﻟﻌﺎﺩﻱ . ﻳﺘﻤﻴﺰ ﺑﺎﻧﺎﺩﻭﻝ ﺟﻮﻳﻨﺖ ﺑﻤﻔﻌﻮﻟﻪ ﺍﻟﻤﺴﻜﻦ ﻟﻶﻻﻡ ﻭﺍﻟﺬﻱ ﻳﺴﺘﻤﺮ ﺣﺘﻰ ٨ ﺳﺎﻋﺎﺕ

الانواع 9 حبتين جميع كل 8 ساعات للاعمار فوق 12 سنه
دهشنا البنادول سامحونا ع التعطيل بس باعتباره اكثر شي حتعاملوا معاه في الصيدليه

20/10/2017

1

حيكون الكورس ع عدة بوستات بمعدل بوست كل يومين او ثلاته ع حسب الفضوه

اغلب دكاتره البشري خدموا في صيدليات و تعلموا فيها الصيدليه ليها دور كبير في المساعده في مشوار الطبيب بدأت الي يبوا يتخصصوا ميديسن و بيديا و جلديه و العيون الجراحه و اناستيزيا و قايني مش هلبه حيستحقوها
بالاضافة للمردود العلمي في حاجتين مهمات توفرهم ليك الصيدليه المردود المادي بدأت في الوقت هادا كيف متخرج ع الصفر و تساعدك في فهم تركيبة المرضى و الي حتواجهم كل يوم في حياتك كطبيب و كيفية معاملتهم

في قواعد ضروري تفهمهم :

ماديريش روحك فالح خط مافهمتاش و دواء مش متأكد منه ماتصرفاش خلي يقول عليك ماتفهمش خير ماتصرف دواء و يطلع غلط والله مافي حد حيرحمك بعدها لو طلع غلط

_ كيفية حساب وزن البيبيات التقريبي حتى عمر 12 سنه تقريبيا
العمر اقل من سنه = العمر بالشهور +٩÷٢
العمر من سنه ل 8 سنوات = العمر بالسنه *٢+٨
العمر من 9 سنوات ل 12 سنه = العمر بالسنه *٢+٩

الاشكال الدوائية :
Inhaler بخاخة فم
Nebulizer بخار
Nasal spray بخاخة انف
Im حقن في العضله
Iv حقن في الوريد
subcuatanous SCحقن تحت الجلد
Sachet زروف
Oral nasal ear eye drops قطرات كل حسب مكانها
Cap tab كبسولات و حبوب
Syrupشروبوات
Cream كريم
Ointment مرهم
Foam رغوه
Re**al or vaginal Suppository تحاميل او زرابيط
E***a ترومبا
Vaginal douch غسول مهبلي
Lotion غسول
Mouth washمضمضة فم
Oral gel جيل فموي
Vaginal gel جل مهبلي
patchesلاصقات
sublingual S/Lتحت اللسان
تركيبة الوصفه ضروري تحتوي على الاتي :
اسم المريض وعمره و جنسه و توقيع الطبيب و التاريخ
اسم الدواء تجاري و علمي
شكل الدواء حبوب او شروبو او ايباري
جرعة الدواء
عدد مرات اخذه يوميا
مدة العلاج
ملاحظات حول طريقة اخذ الدواء وعلاقته بالاكل او ادوية اخرى

ولو تكون قاري شوي و تحاول تزبط اي انتراكشن بين الادوية يكون الطبيب متلخبط فيهم تكون ساعدت المريض بجد

هكي نكونوا كملنا الحلقه الاولى
الحلقة الثانيه حتكون عن المسكنات

05/09/2017

9-year-old pediatric patient getting a new heart. ❤️

05/09/2017

قائمه بالأدوية ذات المحاذير العاليه👇🏻💊💉 High alert medications

05/09/2017

What is Ventavis (iloprost)?

Ventavis is a medicine used to treat adults with certain kinds of Pulmonary Hypertension.

🚨How is Ventavis taken👀?
Ventavis is inhaled through a special system called the I-neb AAD System ( ultrasonic nebulizer or Mesh nebulizer)🌬

What is the I-neb AAD? The I-neb AAD is a special system that is used to inhale Ventavis. AAD stands for Adaptive Aerosol Delivery.

Ventavis Dosage and Administration

Contraindications and Cautions for VENTAVIS

🚨VENTAVIS side effect Be aware of that 🚨

05/09/2017

This is a classic presentation of a disease known as Necrotising enterocolitis (shortly, NEC).

05/09/2017

This is a real eye from a 55-year-old woman who suffered from glaucoma for a long time.

03/06/2017

Causes of an elevated troponin are:  Trauma  Cardioversion  Rhabdomyolysis  Pulmonary embolism  Pulmonary hypertension  Hypertension  Hypotension, especially with arrhythmias  HOCM  Myocarditis including Kawasaki's disease  Sepsis  Burns  Subarachnoid haemorrhage and stroke  Infiltrative/autoimmune disorders: including sarcoidosis, amyloidosis, haemochromatosis and scleroderma.  Drugs: including Adriamycin, Herceptin and 5-fluorouracil.

03/06/2017

Long QT1 - usually associated with exertional syncope, often swimming.  Long QT2 - often associated with syncope occurring following emotional stress, exercise or auditory stimuli e.g. doorbell or telephone ring.  Long QT3 - events often occur at night or at rest.  Sudden cardiac death.  Diagnosis is based upon the QTc (corrected QT interval), although this may be within the normal range at rest; hence Holter ECG monitoring is recommended.  Identification of an LQTS genetic mutation confirms the diagnosis. However, a negative result on genetic testing is of limited diagnostic value because only approximately 50% of patients with LQTS have known mutations. The remaining half of patients with LQTS may have mutations of yet unknown gene.
-ree

07/05/2017

28/04/2017

A 66-year-old retired sheep farmer presents with a persistent cough, dating from a
cold some nine months ago. He has become more short of breath on exercise, and
he wheezes occasionally, although he dismisses these symptoms as being due to his
increasing weight following retirement. On examination, he is short, stocky and
overweight. His breathing is somewhat noisy but his chest is clear on auscultation.
Neurological examination is normal. There is no fatigability.
Full blood count and electrolytes are normal. ESR 7 mm/h. Static and dynamic
lung volumes are normal (FEV1 2.8 l). PEFR 200 l/min.
1. Which of the following pathologies best fits this clinical scenario?
a) Hypersensitivity pneumonitis
b) Chronic obstructive pulmonary disease
c) Obstructive sleep apnoea
d) Multinodular goitre
2. Choose the three initial investigations most likely to be helpful:
a) Plain chest radiograph
b) Flow-volume loop
c) Serum precipitins
d) Serum IgE
e) Serial peak flows
f) CT chest/neck
g) Bronchoscopy
h) Polysomnography

28/04/2017

14/04/2017

intra-operative brain photo demonstrates the structure of the arachnoid, which resembles a spider web-like appearance.

18/03/2017

. Drug-induced hyperkalemia (with renal insufficiency) A. Potassium-sparing diuretics (amiloride, triamterene, spironolactone) B. Trimethoprim C. Pentamidine D. ACE-Is and ARBs E. Nonsteroidal anti-inflammatory drugs F. Cyclosporine and tacrolimus

08/12/2016

Hope all of you are well .

04/10/2016

Hutchinson–Gilford progeria syndrome

16/05/2016

A 60-year-old woman was admitted with a 2-day history of dysuria, loin pain and rigors.

On admission, she was unwell and confused. She was also febrile and tachycardic. She was transferred to the medical high-dependency unit for invasive monitoring.

Which set of haemodynamic values is most likely to be hers?

mean arterial
pressure
(mmHg) mean
right
atrial
pressure
(mmHg) mean
pulmonary
arterial
pressure
(mmHg) mean
pulmonary
arterial wedge
pressure
(mmHg) mean
cardiac
output
(L/min)
normal 85 3 15 9 5.0
A 80 8 22 20 3.0
B 110 18 20 11 4.0
C 85 6 16 8 2.5
D 66 20 22 20 2.0
E 60 2 15 8 4.5
Answers
A:
B:
C:
D:
E:

Sultan Saby

16/05/2016

A 53-year-old man presented with a 2-week history of diarrhoea associated with cramping abdominal pain. He was passing up to 15 very loose and watery stools per day. He had no blood in his stools. He had undergone a heart transplant 2 years previously, and his medication comprised ciclosporin, prednisolone, aspirin and ramipril.

Investigations:

haemoglobin 110 g/L (130–180)
white cell count 12.5 × 109/L (4.0–11.0)

serum urea 14.4 mmol/L (2.5–7.0)
serum creatinine 135 µmol/L (60–110)
serum C-reactive protein 35 mg/L (

16/05/2016

Question 1
A 67-year-old woman was referred with a 3-month history of painful legs, malaise and weight loss. She had had type 2 diabetes mellitus and hypertension for 18 years. Her medication was gliclazide 160 mg twice daily, ramipril 2.5 mg daily and atorvastatin 20 mg daily.

On examination, her blood pressure was 145/90 mmHg. There was some tenderness over her spine and legs.

Investigations:

serum sodium 138 mmol/L (137–144)
serum potassium 5.5 mmol/L (3.5–4.9)
serum creatinine 240 µmol/L (60–110)
serum corrected calcium 1.80 mmol/L (2.20–2.60)
serum phosphate 1.6 mmol/L (0.8–1.4)
plasma parathyroid hormone 22.2 pmol/L (0.9–5.4)
What therapy is most likely to correct the calcium and parathyroid hormone concentrations?

A: alendronic acid
B: alfacalcidol
C: calcitonin
D: cinacalcet
E: ergocalciferol

Sultan Saby

10/03/2016

Side effects of common chemotherapeutic agents Chemo man

10/03/2016

Novo Nordisk Receives FDA Approval for Tresiba® (insulin degludec injection) for Adults with Type 1 and Type 2 Diabetes
Tresiba® marks the first new basal insulin molecule to be approved by the FDA in 10 years

How to prescribe Tresiba® FlexTouch®
Rx Prescription
Recommended starting dose for insulin-naïve adults with type 2 diabetes is 10 units once daily
• Individualize and titrate the dose of Tresiba® based on patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal
• The recommended days between dose increases is 3 to 4 days
Recommended starting dose for insulin-naïve adults with type 1 diabetes is approximately one-third to one-half of total daily insulin dose
• The remainder of total daily insulin dose should be administered as short-acting insulin and divided between each daily meal
• As a general rule, 0.2 to 0.4 units of insulin per kilogram of body weight can be used to calculate initial total daily insulin dose in insulin-naïve patients with type 1 diabetes
Prescribe Tresiba® U-200 FlexTouch®
• Up to 160 units in a single injection
• Pen contains 600 total units
• Once opened, lasts 8 weeks at room temperature (below 86°F). Do not refrigerate once in use

After opening, Tresiba® may be used for up to 8 weeks at room temperature vs 4 weeks for insulin glargine 100 units/mL1,2,a,b

aTresiba® may be stored at room temperature (below 86°F) for 8 weeks once in use. In use, Tresiba® should not be stored in a refrigerator.1

bOpened (in-use) Lantus® SoloSTAR® device must be discarded 4 weeks after being opened.2
Video: Step by step instructions on how to use Tresiba® FlexTouch®

See an instructional video with step-by-step instructions to show your patients how to use Tresiba® FlexTouch®.

Watch U-100 video

Watch U-200 video

Introducing Tresiba® U-200 FlexTouch®
The only basal insulin with a 160-unit maximum-dose pen1
Graphic showing features of Tresiba® U-200 FlexTouch® l prefilled basal insulin pen

Tresiba® U-100 FlexTouch®
Find out more about how your patients should use Tresiba® U-200 FlexTouch®, and view the Instructions For Use.

Administering Tresiba®

Add Tresiba® FlexTouch® to your ePrescribing system
Add Tresiba® U-200 FlexTouch® to your ePrescribing system banner

Form/Strength: 200 units/mL

Quantity: 9 mL (3 x 3 mL)

Dosage Form: Solution

NDC: 0169-2550-13

Tresiba® U-200 FlexTouch® is the first prefilled basal insulin pen that can dose up to 160 units in a single injection.
Add Tresiba® U-100 FlexTouch® to your ePrescribing system banner

Form/Strength: 100 units/mL

Quantity: 15 mL (5 x 3 mL)

Dosage Form: Solution

NDC: 0169-2660-15

Tresiba® U-100 FlexTouch® doses up to 80 units in a single injection.
Selected Important Safety Information
Contraindications

Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients

Warnings and Precautions

Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens
Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed
Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening

Indications and Usage

Tresiba® (insulin degludec injection) is indicated to improve glycemic control in adults with diabetes mellitus.
Limitations of Use

Tresiba® is not recommended for treating diabetic ketoacidosis.
Important Safety Information
Contraindications

Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients

Warnings and Precautions

Never Share a Tresiba® FlexTouch® Pen Between Patients, even if the needle is changed. Sharing poses a risk for transmission of blood-borne pathogens
Monitor blood glucose in all patients treated with insulin. Changes in insulin may affect glycemic control. These changes should be made cautiously and under medical supervision. Adjustments in concomitant oral anti-diabetic treatment may be needed
Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment
Accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors, always instruct patients to check the insulin label before each injection
Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including Tresiba®
As with all insulins, Tresiba® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Closely monitor potassium levels in patients at risk of hypokalemia and treat if indicated
Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Tresiba®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered

Adverse Reactions

Adverse reactions commonly associated with Tresiba® are hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, and weight gain

Drug Interactions

Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and close monitoring of blood glucose. The signs and symptoms of hypoglycemia may be reduced or absent in patients taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine)

Please click here for Prescribing Information.



Needles are sold separately and may require a prescription in some states.



References:

Tresiba [package insert]. Plainsboro, NJ: Novo Nordisk Inc; September 2015.
Lantus [package insert]. Bridgewater, NJ: sanofi-aventis US LLC; August 2015.

27/12/2015

TOXICOLOGY

27/12/2015

Kayser-Fleischer ring (arrow)

in a patient with advanced neuropsychiatric Wilson disease.

27/12/2015

HAND FOOT SKIN REACTION (HFSR) -

side effect of tyrosine kinase inhibitors like imatinib, sorafenib, sunitinib

20/10/2015

info 5-5
🔘6 Blood Test In
《Addisonś dz》🔻
🔹Eosinophilia + Lymphocytosis
🔹Hyponatremia
🔹Hypoglycemia
🔹Hyperkalemia
🔹Hypercalcemia
🔹Metabolic acidosis

20/10/2015

info 4-5
🔘Give 3《Endocrine》Causes Of
《Carpal Tunnel
Syndrome》🔻🔻🔻
1📘DM
2📘Acromegaly
3📘Hypothyrodism

20/10/2015

info 3-5
🔘Give 4《 Infection》 Common In
《DM》🔻
1■Mucormycosis
2■Malignant otitis externa
3■Emphysematous pyelonephritis
4■Genital candidiasis

20/10/2015

info
2-5

🔘Give 5 《Endocrine 》Causes Of《 DM 》🔻🔻🔻🔻🔻
1💬Cushing syndrome
2💬Hyperthyroidism
3💬Acromegaly
4💬Pheochromocytoma
5💬Glucagonoma

20/10/2015

5 info
1-1
🔘4 Causes Of Fall Potassium During Rx Of DKA:
◼Insulin therapy
◼Correct of acidosis
◼Ongoing urinary loss
◼Dilutional effect of rehydration