Sources:    Research References/Bibliography
- Choline Magnesium Trisalicylate
- Choline Salicylate
Cortisone, Dexamethasone, Prednisone, Prednisolone, Hydrocortisone, Methylprednisolone, Flunisolide, Fluticasone, Betamethasone, Mudesonide, Betamethasone
Coverage of Drug-Induced Nutrient Depletion, Drug Brand Names, Contraindications, Warnings/Precautions, Adverse Reactions, Overdose/Toxicology, etc.
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Choline Magnesium Trisalicylate
Analgesics: acetaminophen, aspirin, ibuprofen, helps to relieve aches and pains and reduce fever, by themselves, colds do not usually cause significant fever, allowing a low grade fever to run its course may be beneficial, an elevated temperature is a way the body fights infection, if you have a fever of 102 or higher, chances are that something other than the cold is causing it, it may be a sign of a developing bacterical infection somewhere in the body that requires treatment, dy reducing fever, analgesics may mask this sign
Antihistamines: decrease nasal secretions by blocking the action of histamine, a body chemical that causes swelling of small blood vessels, which results in smeezing and runny nose. These products can make you drowsy. In addition, it is better to allow the secretions that contain the virus to flow out of the body rather than trying to block them.
Cough medicines: expectorants (make cough more productive by increasing the amount of phelgm and decreasing its thickness, helps remove irritants from the airway) and antitussives (reduce the frequency of coughing) because coughing is the body's way to clear secretions from the lungs, its probably best not to suppress it
Decongestants: shinrk nasal blood vessels to relieve swelling and congestion, cause side effects including jitteriness, insomnia, and fatigue
Usually infection will resolve in 4-7 days with or without treatment
Headache, sore throat, sinus pain, feverishness - aspirin, paracetamol, ibuprofen, aspirin not recommended for use in hilcdren under 12 yars of age except on medical advice, aspirin and ibuprofen are more likely to cause gastric disturbance than paracetamol and should not be used in patients with peptic ulcer or those who are sensitive to aspirin or ibuporfen
Blocked nose: Nasal sprays containing xylometazoline or oxymetazoline, oral decongestants - pseudoephedrine and phenylpropanolamine are not as effective as the nasal sprays in treating nasal congestion, they are hlepful when used with pain killers, oral decongestants should be used with caution by patients with a history of any heart disease or high blood pressure, for infants and children under six - products containing menthol and essential oils, decongestants not recommended for this age group
runny nose, sneezing: antihistamines such as chlorpheniramine and doxylamine
Cough: many cough medicines contain dextromethorphan and codeine there is very little evidence to support their effectiveness in treating cough associated with common cold, some relief can be obtained from the dry cough associated with the common cold with hot drinks and lozenges contianing menthol and essential oilds
Hot drinks: provide relief from sore throat and cough, slightly bitter flavors such as lemon and citric acid are particularly beneficial, spicy foods and hot soups are also beneficials as they promote airway secretions which have a claming action on an inflmared throat, hot drinks in combination with paracetamol provide long lasting relif from pain related symptoms and fecer
Folic Acid, Iron, Potassium, Sodium, Vitamin C
U.S. Brand Names:Tricosal®, Trilisate®
Use: Management of osteoarthritis, rheumatoid arthritis, and other arthritis; salicylate salts may not inhibit platelet aggregation and, therefore, should not be substituted for aspirin in the prophylaxis of thrombosis
Pregnancy Risk Factor and Implications: C
Contraindications:Bleeding disorders; hypersensitivity to salicylates or other NSAIDs; tartrazine dye hypersensitivity, asthma
Alcohol: Combination causes GI irritation, possible bleeding; avoid or limit alcohol. Patients at increased risk include those prone to hypoprothrombinemia, vitamin K deficiency, thrombocytopenia, thrombotic thrombocytopenia purpura, severe hepatic impairment, and those receiving anticoagulants.
Food: May decrease the rate but not the extent of oral absorption. Drug may cause GI upset, bleeding, ulceration, perforation. Take with food or large volume of water or milk to minimize GI upset.
Folic acid: Hyperexcretion of folate; folic acid deficiency may result, leading to macrocytic anemia. Supplement with folic acid necessary.
Iron: With chronic use at doses of 3-4 g/day, iron deficiency anemia may result; supplement with iron if necessary.
Magnesium: Hypermagnesemia resulting from magnesium salicylate; avoid or use with caution in renal insufficiency.
Sodium: Hypernatremia resulting form buffered aspirin solutions or sodium salicylate containing high sodium content. Avoid or use with caution in CHF or any condition where hypernatremia would be detrimental.
Curry powder, paprika, licorice, Benedictine liqueur, prunes, raisins, tea and gherkins: Potential salicylate accumulation. These foods contain 6 mg salicylate/ 100g. An ordinary American diet contains 10-200 mg/day of salicylate. Foods containing salicylates may contribute to aspirin hypersensitivity. Patients at greatest risk of aspirin hypersensitivity include those with asthma, nasal polyposis, or chronic urticaria.
Warnings/Precautions:Use with caution in patients with impaired renal junction, erosive gastritis, or peptic ulcer; avoid use in patients with suspected varicella or influenza (salicylates have been associated with Reye's syndrome in children less than 16 years of age when used to treat symptoms of chickenpox or the flu). Tinnitus or impaired hearing may indicate toxicity; discontinue use 1 week prior to surgical procedures.
Elderly are a high-risk population for adverse effects from nonsteroidal anti-inflammatory agents. As much as 60% of elderly can develop peptic ulceration and /or hemorrhage asymptomatically. Use lowest effective dose for shortest period possible. Tinnitus may be a difficult and unreliable indication of toxicity due to age-related hearing loss or eighth cranial nerve damage. CNS adverse effects may be observed in the elderly at lower doses than younger adults.
Adverse Reactions:Greater than 10%experience:
Gastrointestinal: Nausea, heartburn, stomach pains, dyspepsia, epigastric discomfort
1% to 10% experience:
Central nervous system: Fatigue
Gastrointestinal: Gastrointestinal ulceration
Hermatologic: Hemolytic anemia
Neuromuscular & skeletal: Weakness
Miscellaneous: Anaphylactic shock
Less than 1% experience: Insomnia, nervousness, jitters, occult bleeding, prolongation of bleeding time, leukopenia, thrombocytopenia, iron deficiency anemia, hepatotoxicity, impaired renal function, bronchospasm
Overdose/Toxicology:Symptoms of overdose include tinnitus, vomiting, acute renal failure, hyperthermia, irritability, seizures, coma, and metabolic acidosis. For acute ingestion, determine serum salicylate levels 6 hours after ingestion. Nomograms, such as the "Done" nomogram, may be helpful for estimating the severity of aspirin poisoning and directing treatment using serum salicylate levels. Treatment is based upon symptomatology.
Nutrients Depleted: Folic Acid, Iron, Potassium, Sodium, Vitamin C.
U.S. Brand Names: Arthropan® [OTC].
Canadian Brand Names: Teejel®
Use: Temporary relief of pain of rheumatoid arthritis, rheumatic fever, osteo-arthritis, and other conditions for which oral salicylates are recommended; usejul in patients in which there is difficulty in administering doses in a tablet or capsule dosage form, because of the liquid dosage form.
Pregnancy Risk Factor and Implications: C
Contraindications: Hypersensitivity to salicylates or any component or other nonacetylated salicylates.
Warnings/Precautions: Use with caution in patients with impaired renal function, erosive gastritis, or peptic ulcer; avoid use in patients with suspected varicella or influenza (salicylates have been associated with Reye's syndrome in children less than 16 years of age when used to treat symptoms of chickenpox or the flu).
Greater than 10%: Gastrointestinal: Nausea, heartburn, stomach pains, dyspepsia, epigastric discomfort.
1% to 10%: Central nervous system: Fatigue
Gastrointestinal: Gastrointestinal ulceration
Hematologic: Hemolytic anemia
Neuromuscular & skeletal: Weakness
Miscellaneous: Anaphylactic shock
Less than 1%: Insomnia, nervousness, jitters, occult bleeding, prolongation of bleeding time, leukopenia, thromboctytopenia, iron deficiency anemia, hepatotoxicity, impaired renal function, bronchospasm.
Overdose/Toxicology: Sumptoms of overdose include tinnitus, vomiting, acute renal failure, hyperthermia, irritability, seizures, coma, metabolic acidosis.
For acute ingestions, determine serum salicylate levels 6 hours after ingestion; the "Done" nomogram may be helpful for estimating the severity of aspirin poisoning and directing treatment using serum salicylate levels. Treatment can also be based upon symptomatology.
Nutrients Depleted: Calcium, Folic Acid, Magnesium, Potassium, Selenium, Vitamin C, Vitamin D, Zinc.
U.S. Brand Names: Acticort 100®; Adlone® Injection; AeroBid®-M Oral Aerosol Inhaler; AeroBid® Oral Aerosol Inhaler; Aeroseb-Dex®; Aeroseb-HC®; A-hydroCort®; AK-Dex®; AK-Pred® Ophthalmic; Ala-Cort®; AlaScalp®; Alba-Dex®; Alphatrex®; Amcort®; A-methaPred® Injection; Anucort-HC® Suppository; Anuprep HC® Suppository; Anusol® HC-1 [OTC]; Anusol®; HC-2.5%[[OTC]; Anusol-HC®; Suppository; Aristocort®; Aristocort®A; Aristocort®Forte; Aristocort® Intralesional; Aristospan® Intra-Articular; Aristospan® Intralesional; Articulose-50® Injection; Atolone® Azmacort; Baldex®; Betatrex®; Beta-Val®; CaldeCORT®; CaldeCORT® Anti-Itch Spray; Celestone®; Celestone® Soluspan®; Cel-U-Jec®; Cetacort®; Clocort® Maximum Strength; CortaGel® [OTC]; Cortaid® Maximum Strength [OTC]; Cortaid® With Aloe [OTC]; Cort-Dome®; Cortef®; Cortef® Feminine Itch; Cortenema®; Cortifoam®; Cortizone® -5 [OTC]; Cortizone® -10 [OTC]; Cortone® Acetate; Cutivate; Dalalone L.A.®; Decaderm®; Decadron®; Decadron® -LA; Decadron® Turbinaire®; Decaject-L.A.®; Decaspray®; Dekasol-L.A.®; Delcort®; Delta-Cortef® Oral; Deltasone®; Delta-Tritex®; depMedalone® Injection; Depoject® Injection; Depo-Medrol® Injection; Depopred® Injection; Dermacort®; Dermarest Dricort®; DermiCort®; Dermolate® [OTC]; Dermtex® HC With Aloe; Dexair®; Dexasone L.A.®; Dexone®; Dexone L.A.®; Dezone® Deprolene®; Deprolene®AF; Diprosone®; D-Med® Injection; Duralone® Injection; Econopred® Ophthalmic; Econopred® Plus Ophthalmic; Eldecort®; Elocon® Topical; Flonase®; Flovent®; Flutex®; Gynecort® [OTC]; Hemril-HC® Uniserts®; Hexadrol®; Hi-Cor-1.0®; Hi-Cor 2.5®; Hydrocort®; Hydrocortone® Acetate; Hydrocortone® Phosphate; HydroSKIN®; Hydro-Tex® [OTC]; Hytone®; I-Methasone®; Inflamase® Forte Ophthalmic; Inflamase® Mild Ophthalmic; Kenacort®;Kenaject-40®; Kenalog®; Kenalog-10®; Kenalog-40®; Kenalog® H; Kenalog® in Orabase®; Kenonel®; Key-Pred® Injection; Key-Pred-SP® Injection; LactiCare-HC®; Lanacort® [OTC]; Liquid Pred®; Locoid®; Maxidex®; Maxivate®; Medralone® Injection; Medrol® Oral; Methylone®; Meticorten®; Metreton® Ophthalmic; M-Prednisol® Injection; Nasacort®; Nasacort®AQ; Nasalide® Nasal Aerosol; Nasarel; Nutracort®; Ocu-Dex®; Orabase® HCA; Orasone®; Pandel®; Pediapred® Oral; Penecort®; Predair®; Predaject®; Predalone T.B.A.®; Pred Forte® Ophthalmic; Pred Mild® Ophthalmic; Prednicen-M®; Prednisol® TBA Injection; Prelone® Oral; Procort® [OTC]; Proctocort; Psorion® Cream; Pulmicort Turbuhaler®; Rhinocort®; Scalpicin®; Solu-Cortef®; Solu-Medrol® Injection; Solurex L.A.®; S-T Cort®; Sterapred®; Synacort®; Tac-40; Tegrin®-HC [OTC]; Teladar®; Triacet; Triam-A®; Triam Forte®; Triderm®; Tri-Kort®; Trilog®; Trilone®; Tristoject®; U-Cort; Valisone®; Westcort®.
Canadian Brand Names: Apo® -Prednisone; Betnesol® [Disodium Phosphate]; Bronalide®; Diprolene® Glycol [Dipropionate]; Elocom; Entocort®; Jaa-Prednisone®; Novo-Prednisolone; Novo-Prednisone; Occlucort®; Pulmicort®; Rhinalar®; Rhinaris®-F; Rhoprolene; Rhoprosone; Syn-Flunis-olide; Taro-Sone; Topilene; Topisone; Wimpred.
Use: Adrenocortical hormone replacement insufficiency; used in rheumatic, autoimmune, dermatologic, collagen-vascular and other inflammatory diseases. Used in the treatment of hypercalcemia, as immunosuppressive agents including use in organ transplantation. Management of respiratorydiseases including asthma, neoplastic diseases, and allergic disorders. Selected agents have been used in postherpetic neuralgia, meningitis, alcoholic hepatitis, and adult respiratory distress syndrome.
Pregnancy Risk Factor and Implications: B; Some corticosteroids are known to enter breast milk/use caution.
Contraindications: Hypersensitivity to individual corticosteroid agents or formulation, fungal infections, serious infections (Note: There are specific exceptions to this general contraindication such as bacterial meningitis in selected patients).
Warnings/Precautions: Withdrawal of therapy must be done gradually, use may retard bone growth, use with caution in patients with hypothyroidism, cirrhosis, hypertension, congestive heart failure, diabetes mellitus, ulcerative colitis, thromboembolic disorders, and patients at risk for peptic ulcer disease. Use the lowest possible dose for the shortest possible period of time. Adverse effects may be particularly common in the elderly.
Adverse Reactions: Signs and symptoms of systemic hypercorticism and suppression of the adrenal-hypothalamic-pituitary axis may occur when used for prolonged periods. Cushingoid appearance, muscle weakness, and osteoporosis may result. Individual corticosteroids may vary in their potential to cause specific adverse effects. The listing below provides only a general indication of the spectrum and frequency of adverse reactions to corticosteroids.
Greater than 10%:
Central nervous system: Insomnia, nervousness
Gastrointestinal: Increased appetite, indigestion.
1% to 10%:
Endocrine & metabolic: Diabetes mellitus
Ocular: Cataracts, glaucoma
Neuromuscular & skeletal: Arthralgia
Less than 1%: Edema, hypertension, vertigo, seizures, psychoses, pseudotumor cerebri, headache, mood swings, delirium, hallucination, euphoria, acne, skin atrophy, bruising, hyperpigmentation, Cushing's syndrone, pituitary-adrenal axis suppression, growth suppression, glucose intolerance, hypokalemia, alkalosis, amenorrhea, sodium and water retention, hyperglycemia, peptic ulcer, nausea, vomiting, abdominal distention, ulcerative esophagitis, pancreatitis, muscle weakness, osteoporosis, fractures, muscle wasting, hypersensitivity reactions.
Overdose/Toxicology: Symptoms of intoxication include cardiac disturbances, CNS toxicity, bronchospasm, hypoglycemia, and hyperkalemia. The most commn cardiac symptoms include hypotension and bradycardia. Atrioventricular block, intraventricular conduction disturbances, cardiogenic shock, and asystole may occur with severe overdose, especially with membrane-depressant drugs (eg, propranolol). CNS effects include convulsions and coma. Respiratory arrest (commonly seen with propranolol and other membrane-depressant and lipid-soluble drugs). Treat symptomatically. Cardiac and hemodynamic monitoring may be necessary.