Type of Drug:Enzyme replacement therapy.

How the Imiglucerase Drug Works:

An enzyme used long-term to break down glucocerebroside into glucose and ceramide. This prevents the accumulation of glucocerebroside in disease.

Uses Imiglucerase:

For long-term enzyme replacement therapy for type I Gaucher disease that results in one or more of the following problems: anemia, low platelet counts, bone disease and deterioration, enlargement of the liver or spleen.

Precautions:

Do not use in the following situations: Allergy to imiglucerase or any of its ingredients.

Use with caution in the following situations: Pulmonary hypertension.

Hypersensitivity: Approximately 15% of patients have developed antibodies reactive with imiglucerase during the first year of therapy. Approximately 46% of those patients experienced allergic reactions.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if imiglucerase appears in breast milk.

Consult your doctor before you begin breastfeeding.

Side Effects of Imiglucerase:

Every drug is capable of producing side effects. Many imiglucerase users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Nervous System: Headache; fever; chills; fatigue; dizziness.

Other: Nausea; vomiting; stomach discomfort; diarrhea; back pain; chest discomfort; swelling; difficulty breathing; low blood pressure; rapid heart rate; injection site burning, itching, and swelling; rash; itching; flushing; skin discoloration

Guidelines for Use:

• This drug is prepared and administered intravenously (IV; into a vein) by your health care provider in a medical setting.
• Dosage is individualized and may be administered as frequently as 3 times per week or as infrequently as once every 2 weeks depending on disease severity.
• Contact your doctor immediately if you experience any symptoms of allergic reaction (eg, rash, difficulty breathing).

Type of Drug:Synthetic hormones (anabolic steroids) closely related to the androgen testosterone (male sex hormone).

How the Drugs Works:

Anabolic steroids promote body tissue-building processes and reverse destructive tissue-depleting processes. They also decrease normal testosterone production by the testicles.

Uses :

Nandrolone and oxymetholone - To treat certain types of anemia.

Oxandrolone - To treat weight loss due to severe illness, following extensive surgery, and in some patients who, without definite reasons, fail to gain or maintain normal weight. To relieve bone pain caused by osteoporosis (brittle bones). To prevent the breakdown of protein associated with prolonged corticosteroid (eg, prednisone) use.

Stanozolol - To decrease the frequency and severity of hereditary angioedema attacks.

Unlabeled Uses: Occasionally doctors may prescribe oxandrolone for alcoholic hepatitis, short stature associated with Turner syndrome, HIV wasting syndrome, and HIV-associated musclo weakness.

Precautions:

Athletic performance: Anabolic steroids have not been shown to enhance athletic ability. An athlete’s motivation to use steroids includes: Increased muscle mass and strength; decreased muscle recovery time, allowing more frequent weight training; decreased healing time after muscle injury; increased aggressiveness. The increase in muscle size and weight gain is partially attributed to increased sodium and water retention. The serious health hazards associated with anabolic steroids minimize any real or perceived gain in performance. Effects of these agents may persist for up to 6 months after the last dose. Adverse effects may be serious and irreversible.

Benzyl alcohol: Some of these products contain benzyl alcohol, which has been associated with fatal “gasping syndrome” in premature infants. Consult your doctor or pharmacist.

Edema: Edema (swelling), with or without congestive heart failure, may occur. Use with caution in patients with heart, kidney, or liver disease; epilepsy; migraine; or other conditions that may be aggravated by fluid retention. In addition to discontinuation of the drug, diuretic therapy may be required.

High serum cholesterol: Anabolic steroids may lower high-density lipoprotein (HDL) (”good” cholesterol) and raise low-density lipoprotein (LDL) (”bad” cholesterol). This effect may increase the risk of arteriosclerosis (hardening of the arteries) and coronary artery disease.

Leukemia: Leukemia has been observed in patients with plastic anemia treated with oxyacetylene, but the role of oxyacetylene is unclear.

Liver disease: Liver cysts and tumors have occurred during treatment with anabolic steroids. They are often not recognized until a life-threatening condition develops. Stopping the medicine usually results in shrinking or complete disappearance of the lesions.

Mnlos after puberty: Anabolic steroids may inhibit function of the testes, Iggravato acne, decrease sperm count, promote development of breast cantus the testes to shrink, and lead to impotence.

Women: Anabolic steroids may produce irreversible vitalization (eg, deepening of voice, unusual hair growth, enlargement of the clitoris) in females. Women should be carefully monitored and drug therapy stopped at the first sign of virilization (eg, menstrual irregularities).

Pregnancy: Do not use during pregnancy. The risk of use in a pregnant woman clearly outweighs any possible benefit. Anabolic steroids may cause masculinization of the female fetus.

Breastfeeding: It is not known if anabolic steroids appear in breast milk.

Because of the potential for serious adverse effects, decide whether to discontinue nursing or the drug. Consult your doctor before you begin breastfeeding.

Children: The adverse effects of use in young children are not fully under­stood. Anabolic steroids may interfere with growth to normal adult height. Use with caution.

Elderly: Anabolic steroids may increase risk of prostate enlargement or prostate cancer. Use with caution.

Lab tests may be required to monitor therapy. Tests may include liver function, blood calcium levels, cholesterol levels, and hemoglobin tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements while taking an anabolic steroid. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. Anticoagulants (eg, warfarin) interact with anabolic steroids.

Side Effects:

Every drug is capable of producing side effects. Many anabolic steroid users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Males (before puberty): Increased size of penis; increased frequency of erections.

Males (after puberty): Breast enlargement; changes in sex drive; impotence; persistent, painful erections; shrinking of testes; decreased semen volume; bladder irritation; inhibition of testicular function.

Females: Excessive growth of body hair; hoarseness or deepening of the voice; enlargement of the clitoris; changes in sex drive; changes in menstruation; male pattern baldness.

Digestive Tract: Nausea; vomiting; diarrhea.

Nervous System: Sleeplessness; dependency; depression; excitability Skin: Yellowing of the skin or eyes; acne.

Other: Fluid retention; ankle swelling; electrolyte imbalance;abnormal cholestrol lvels;abnormal lab test ;liver disease;elevated blood sugar.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not change the dose or stop taking, unless advised by your doctor.
• The inject able form of nandrolone will usually be prepared and administered by your health care provider in a medical setting.
• May cause nausea or gastrointestinal upset.
• Diabetic patients _ Glucose tolerance may be altered. Monitor blood sugar closely and report any changes to your doctor.
• Seizure disorders _ Epileptic patients may note an increase in seizure frequency; notify your doctor if this occurs.
• Notify your doctor if you experience nausea, vomiting, yellowing of skin color, or ankle swelling.
• Female patients should notify their doctor if they experience hoarse- ness, deepening of the voice, changes in body hair growth, menstrual changes, malepattern baldness, or acne .
• Male patients should notify their doctor if they experience too frequent or persistent erections of the penis or development or worsening of acne.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• Do not use to enhance physical appearance or athletic performance.
• Effects of anabolic steroids may persist for up to 6 months after the last dose; some adverse effects are irreversible.
• Maximum benefit may not be reached for several months.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store tablets at controlled room temperature (59° to 86°F).

Type of Drug:

Thyroid hormones.

How the Thyroid Hormones Works:

The natural thyroid hormone products (eg, desiccated thyroid and ) are obtained from beef and pork. They are economical, but standardization of iodine content is difficult. The synthetic products, including love thyroxin, Lithuanian and liotrix are generally preferred due to more uniform potency.

Thyroid hormones increase the metabolic rate of body tissues. This involves many varied functions such as oxygen use, respiratory rate, body temperature, heart rate, metabolism of foods, enzyme activity and growth and development of the skeletal and nervous system. Thyroid hormones influence every organ system of the body.

Uses of The Thyroid Hormones:

To treat hypothyroidism (low thyroid hormone Production).

To treat thyroid nodules, chronic lymphocytic thyroiditis (Hashimoto disease), multinodular goiter and thyroid cancer.

To treat thyrotoxicosis (excessive thyroid hormone production). Used with an antithyroid drug to prevent hypothyroidism.

Precautions:

Do not use in the following situations: allergy to thyroid hormones heart attack, recent obesity, treatment thyroid deficiency (hypothyroidism) and hypoadrenalism (Addison disease) together thyroid gland, overactive (thyrotoxicosis)

Use with caution in the following situations: Addison disease heart disease angina (chest pain) infertility diabetes insipid us kidney disease diabetes mellitus myxedema (swelling due to elderly hypothroidism)

Pregnancy: This drug appears to be safe for use during pregnancy. Do not discontinue thyroid replacement therapy in hypothyroid (decreased thyroid activity) women during pregnancy.

Breastfeeding: Very small amounts of thyroid hormones appear in breast milk. Use with caution during breastfeeding. The mother and nursing infant should be checked periodically.

Children: Thyroid replacement therapy in children may lead to partial hair loss in the first few months of therapy. This is a temporary condition. Normal hair growth and distribution returns.

Lab Tests: Lab tests will be required to monitor therapy. Be sure to keep appointments.

Tartrazine: Some of these products may contain the dye tartrazine (FD&C Yellow No.5) which can cause allergic reactions in certain individuals. Check package label when available or consult your doctor or pharmacist.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary Supplements while taking this medicine. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with ‘his medicine:

Side Effects of Thyroid Hormones:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy and individual susceptibility.

Side effects other than those indicating too much thyroid due to excessive dosage or too rapid dosage increase are rare. Symptoms of too much thyroid include:

Digestive Tract: Diarrhea; vomiting.

Nervous System: Tremors; headache; nervousness; sleeplessness. Circulatory System: Increased heart rate; palpitations (pounding in the chest); irregular heartbeat; angina (chest pain); cardiac arrest.

Other: Weight loss; menstrual irregularities; sweating; heat intolerance; fever.

Guidelines for Use:

• Use exactly as prescribed.
• Take as a single daily dose on an empty stomach, preferably before breakfast.
• Brand interchange - Do not change from one brand of this drug to another without consulting your pharmacist or doctor. Products manufactured by different companies may not be equally effective.
• Replacement therapy is usually taken for life.
• Do not discontinue medication except on advice of your doctor.
• Notify your doctor if headache, nervousness, sleeplessness diarrhea, excessive sweating, heat intolerance, chest pain, increased heart rate, irregular heartbeat or any unusual event occurs.
• Partial loss of hair may be experienced by children in the first few months of thyroid therapy, but this is usually only temporary.
• Do not use this medication to treat obesity. Thyroid hormones are not effective for weight reduction. Large doses of thyroid medications may produce serious or even life-threatening conditions, especially when taken with appetite suppressants.
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose In order to “catch up” (unless advised to do so by your doctor). If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Dosage is individualized to approximate the deficit in thyroid secretion. Your response is evaluated by your doctor with lab tests. Store at room temperature away from moisture and light.

Bisphosphonates Drug - How does Bisphosphonates Works?

Type of Drug:

Bisphosphonates.

How the Bisphosphonates Works:

Bisphosphonates help preserve bone mass by inhibiting normal and abnormal bone loss due to resorption (bone tissue loss). Some of these drugs also help control the balance of calcium in bones and blood in certain cancers.

Uses of The Bisphosphonates:

To treat Paget disease of bone (alendronate, etidronate, pamidronate, rise- dronate, tiludronate only).

To treat osteoporosis bone metastases of breast cancer and osteolytic bone losions of multiple myeloma in conjuction with standard antineoplastic thorapy (pamidronate only).

To treat high calcium blood levels in combination with adequate hydration (pamidronate,zoledronic acid only) and bone lesions (pamidronate only) caused by cancer.

To treat osteoporosis in men and postmenopausal women; to prevent osteoporosis in postmenopausal women; to treat glucocorticoid­induced osteoporoses in men and women (alendronate, risedronate only).

To prevent and treat heterotopic ossification (unwanted bone calcification) following total hip replacement or due to spinal cord injury (oral etidronate only).

Unlabeled Uses: To treat osteoporosis in postmenopausal women (etidronate, pamidronate, risedronate only). To prevent osteoporosis in post­menopausal women (risedronate, etidronate only). To treat hyperparathyroidism, high calcium blood levels associated with immobilization; to reduce bone pain in patients with prostatic cancer (pamidronate only). To prevent glucocorticoid-induced osteoporosis (etidronate, pamidronate only).

Precautions:

Do not use in the following situations: allergy to the bisphosphonate or any of its ingredients clinically overt bone softening (osteomalacia) (etidronate only) esophagus abnormalities (alendronate only) inability to stand or sit upright for at least 30 minutes (alendronate, risedronate only)

Use with caution in the following situations: asthma liver disease (zoledronic acid bone fractures only) digestive system disorders low calcium blood levels kidney disease

Pregnancy: There are no adequate or well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if these drugs appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children have not been established. Lab tests will be required periodically during treatment. Tests may include blood exams and kidney function tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-­the-counter or prescription medications or dietary supplements with a bisphosphonate. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with bisphosphonates:

Side Effects:

Every drug is capable of producing side effects. Many bisphosphonate users experience no, or minor, side effects. The frequency or severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Inflammation of the stomach, nausea; vomiting; diarrhea; constipation; gas; heartburn; indigestion; ulcers; stomach pain; acid regurgitation; difficulty swallowing; bloating; appetite loss; stomach bleeding; taste changes; dental disorder; mouth sores; inflammation of the colon.

Circulatory System: High blood pressure; fainting; rapid heartbeat; irregular heartbeat; anemia; decreased white blood cell and platelet count; abnormal blood tests.

Nervous System: Headache; fatigue; dizziness; drowsiness; weakness; vertigo (feeling of whirling motion); confusion; anxiety; nervousness; sleep disorders; sleeplessness; hallucinations; amnesia; depression; convulsions.

Respiratory System: Difficulty breathing; runny nose; sore throat; sinus infection; coughing; bronchitis; upper respiratory infections.

Skin: Rash; itching; redness, swelling, hardness, or pain at injection site (pamidronate, zoledronic acid only); fungal infections; sweating; flushing; hair loss.

Other: Urinary tract infection; flu-like symptoms; infection; fracture; vitamin D deficiency; fever; general swelling; joint, muscle, chest, neck, leg, back, or bone pain; involuntary muscle contractions; muscle or leg romps; abnormal skin sensations (eg, burning, prickling, tingling); catamcts; glaucoma; eye inflammation.

Guidelines for Use:

• Pamidronate and zoledronic acid are prepared and administered by your health care provider in a medical setting.
• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose unless directed by your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• These medications may cause upset stomach, nausea, or diarrhea.
• Take supplemental calcium and vitamin 0 as advised by your doctor if dietary intake is inadequate.
• Avoid nicotine and alcohol, which deplete calcium from the bones.
• Consider weight-bearing exercises to increase the calcium density of bones.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store tablets at controlled room temperature (59° to 86°F) in a tightly sealed container. Do not remove tiludronate tablets from foil strip until they are to be used ..
• Alendronate and risedronate _ Take each tablet first thing in morning with a full glass of water (6 to 8 oz) at least 30 minutes before the first food, beverage, or medication of the day. Taking with mineral water, fruit juices, or coffee can decrease its effectiveness. Do not lie down for at least 30 minutes following administration and until after the first food of the day. Discontinue use and notify your physician if you experience new or worsening heartburn or difficult or painful swallowing.

Etidronate-

• Take tablets with a full glass of water (6 to 8 oz) on an empty stomach, at least 2 hours before meals. Take tablets as a single dose. If stomach upset occurs, divide the dose. Do not eat foods (such as milk or dairy products), vitamins, mineral supplements, or antacids that are high in calcium within 2 hours of taking.