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Phenylephrine And Diabetes

Are Cough And Cold Products Safe For People With Diabetes?

Are Cough And Cold Products Safe For People With Diabetes?

It's that time of year again. Stuffy noses, scratchy throats, upset tummies, and splitting headaches can send even the most stoic among us to the local drugstore for a magic pill to take away the pain. The fluorescent aisles of brightly colored bottles promising fast relief can seem daunting. Are all over-the-counter cold and flu meds safe for people with diabetes? Many over-the-counter cough, cold, and flu remedies list diabetes as an underlying condition that may indicate you should leave the medication on the shelf. The warnings are clear: "Ask a doctor before use if you have: heart disease, high blood pressure, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy. Most experts agree that most people with diabetes can feel free to select whatever over-the-counter (OTC) product works best for them, so long as the medication is taken as directed. At the same time, everyone is different so it's important to shop smartly to ensure a quick and safe recovery from this season's infections. Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too. Ask the Pharmacist Don't just wander around the drugstore dazed and confused. "When making these choices, this is a time to utilize a pharmacist…This is what they are trained for…Tell the pharmacist all your symptoms, what other medicines you are taking,” says Jerry Meece, RPh, FACA, CDE, director of clinical services at the Plaza Pharmacy and Wellness Center in Gainesville, Texas." Meter/Monitor Accuracy There's been concern that certain OTC medications can cause false blood glucose readings. "Ten years ago, as companies were changing the process by which they mon Continue reading >>

Phenylephrine Hydrochloride

Phenylephrine Hydrochloride

asthma; cerebral arteriosclerosis (in adults); corneal epithelial damage; darkly pigmented iris is more resistant to pupillary dilatation and caution should be exercised to avoid overdosage; diabetes (avoid eye drops in long standing diabetes); mydriasis can precipitate acute angle-closure glaucoma in a few patients, usually over 60 years and hypermetropic (long-sighted), who are pre-disposed to the condition because of a shallow anterior chamber (in adults); mydriasis can precipitate acute angle-closure glaucoma in the very few children who are predisposed to the condition because of a shallow anterior chamber (in children); neonates are at an increased risk of systemic toxicity (in neonates); ocular hyperaemia coronary disease; coronary vascular thrombosis; diabetes; elderly (in adults); extravasation at injection site may cause necrosis; following myocardial infarction; hypercapnia; hyperthyroidism; hypoxia; mesenteric vascular thrombosis; peripheral vascular thrombosis; Prinzmetals variant angina; uncorrected hypovolaemia Phenylephrine has a longer duration of action than noradrenaline (norepinephrine), and an excessive vasopressor response may cause a prolonged rise in blood pressure. blurred vision; conjunctivitis on prolonged administration; coronary artery spasm; extrasystoles; hyperaemia on prolonged administration; local irritation on prolonged administration; myocardial infarction (usually after use of 10% strength in patients with pre-existing cardiovascular disease); oedema on prolonged administration; photophobia; raised intraocular pressure; transient stinging angle-closure glaucoma; anorexia; anxiety; bradycardia (also reflex bradycardia); confusion; dyspnoea; headache; hypoxia; insomnia; nausea; peripheral ischaemia; psychosis; tremor; urinary retentio Continue reading >>

Phenylephrine Disease Interactions

Phenylephrine Disease Interactions

There are 4 disease interactions with phenylephrine: Sympathomimetics (Includes Phenylephrine) Cardiovascular Disease Severe Potential Hazard, High plausibility Applies to: Cardiovascular Disease, Cerebrovascular Insufficiency, Hyperthyroidism, Pheochromocytoma Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension. Covington TR, Lawson LC, Young LL, eds. "Handbook of Nonprescription Drugs. 10th ed." Washington, DC: American Pharmaceutical Association (1993): Horowitz JD, Lang WJ, Howes LG, Fennessy MR, Christophidis N, Rand MJ, Louis WJ "Hypertensive responses induced by phenylpropanolamine in anorectic and decongestant preparations." Lancet 1 (1980): 60-1 Frewin DB "Phenylpropanolamine. How safe is Continue reading >>

Responsiveness Of Vascular Alpha1-adrenoceptors Of Diabetic Rat Knee Joint To Phenylephrine In Acute Inflammation.

Responsiveness Of Vascular Alpha1-adrenoceptors Of Diabetic Rat Knee Joint To Phenylephrine In Acute Inflammation.

Responsiveness of vascular alpha1-adrenoceptors of diabetic rat knee joint to phenylephrine in acute inflammation. Hajizadeh S, et al. J Basic Clin Physiol Pharmacol. 2005. Department of Physiology, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran. [email protected] J Basic Clin Physiol Pharmacol. 2005;16(4):301-9. In diabetic angiopathy, responsiveness of alphal-adrenoceptors in blood vessels increases. The aim of this study was to investigate the vasoconstrictor response of knee joint blood vessels to phenylephrine (a 1-adrenoceptor agonist) in diabetes and acute inflammation. Acute knee joint inflammation was induced by the intraarticular injection of a 3% kaolin/3% carrageenan suspension. Diabetes was induced by the intravenous injection of alloxan (70 mg/kg). Male albino rats weighing 70 to 90 g each were divided into the following 4 groups: untreated controls, diabetic, inflammatory, and diabetic inflammatory. The blood flow of the knee joint was measured using the laser Doppler flowmetry (LDF) technique. Vasoconstriction of the articular microvascular was measured in response to the topical application of different concentrations (10(-7) to 10(-3) mol) phenylephrine. The results of this study show that (a) increased knee joint diameter and circumference due to inflammation and the knee joint basal blood flow were significantly lower in diabetic than in control rats; (b) the responsiveness of alphal-adrenoceptors decreased in kaolin/carrageenan-induced acute inflammation; (c) carrageenan-induced acute inflammation did not decrease the responsiveness of alphal-adrenoceptors in diabetic rats. We conclude that diabetes inhibits the reductive effect of acute inflammation on the responsiveness of alpha1-adrenoceptors in rats. Continue reading >>

Effects Of Streptozotocin-induced Diabetes On The Pharmacology Of Rat Conduit And Resistance Intrapulmonary Arteries

Effects Of Streptozotocin-induced Diabetes On The Pharmacology Of Rat Conduit And Resistance Intrapulmonary Arteries

Effects of streptozotocin-induced diabetes on the pharmacology of rat conduit and resistance intrapulmonary arteries Gurney and Howarth; licensee BioMed Central Ltd.2009 Poor control of blood glucose in diabetes is known to promote vascular dysfunction and hypertension. Diabetes was recently shown to be linked to an increased prevalence of pulmonary hypertension. The aim of this study was to determine how the pharmacological reactivity of intrapulmonary arteries is altered in a rat model of diabetes. Diabetes was induced in rats by the -cell toxin, streptozotocin (STZ, 60 mg/kg), and isolated conduit and resistance intrapulmonary arteries studied 34 months later. Isometric tension responses to the vasoconstrictors phenylephrine, serotonin and PGF2, and the vasodilators carbachol and glyceryl trinitrate, were compared in STZ-treated rats and age-matched controls. STZ-induced diabetes significantly blunted the maximum response of conduit, but not resistance pulmonary arteries to phenylephrine and serotonin, without a change in pEC50. Agonist responses were differentially reduced, with serotonin (46% smaller) affected more than phenylephrine (32% smaller) and responses to PGF2 unaltered. Vasoconstriction caused by K+-induced depolarisation remained normal in diabetic rats. Endothelium-dependent dilation to carbachol and endothelium-independent dilation to glyceryl trinitrate were also unaffected. The small resistance pulmonary arteries are relatively resistant to STZ-induced diabetes. The impaired constrictor responsiveness of conduit vessels was agonist dependent, suggesting possible loss of receptor expression or function. The observed effects cannot account for pulmonary hypertension in diabetes, rather the impaired reactivity to vasoconstrictors would counteract the d Continue reading >>

Sneezes And Wheezes: Seasonal Allergies And Diabetes

Sneezes And Wheezes: Seasonal Allergies And Diabetes

Spring is really starting to burst out here in Massachusetts. The tulips are blooming and leaves and buds are popping out on the trees. As pretty and welcoming as this is, many of you (about 50 million!) are probably bracing yourself for all of the pollen that is soon to follow, and suffering through the misery that it can bring. Thanks to the mild winter that we had in the Northeast, plants are pollinating earlier than usual. As if that weren’t bad enough, having seasonal allergies can also affect your blood sugar control. Seasonal allergies: do you have them? Seasonal allergies are sometimes called hay fever or, more technically, seasonal allergic rhinitis. You might be wondering if your symptoms are due to a cold, flu, or allergies. While there can be some overlap, the following symptoms are usually indicative of allergies: • Itchy eyes • Watery eyes • Dark circles under the eyes • Sneezing • Runny nose • Stuffy nose • Sore throat You might also feel a little bit tired. You won’t get a fever from allergies, however. These symptoms can linger for weeks unless they’re treated. Treating allergies There are a number of remedies for seasonal allergies, including oral medications, nasal sprays, and eye drops. It’s important that you not only choose the right one for your symptoms, but that you also are aware of how these medicines might affect your blood sugars. The following types of allergy medicines may affect your blood glucose levels or how you manage them: Antihistamines. These medicines can reduce sneezing, runny nose, and itchy and watery eyes. Common antihistamines include diphenhydramine (Benadryl), loratidine (Alavert, Claritin), cetirizine (Zyrtec Allergy), and fexofenadine (Allegra Allergy). Antihistamines might be combined with a deconge Continue reading >>

Otc Cold Remedies: Phenylephrine And Diabetes

Otc Cold Remedies: Phenylephrine And Diabetes

OTC cold remedies: Phenylephrine and diabetes My wife has come down with the killer cold that is going around lately. She also has RA (taking Methotrexate) and recently was diagnosed with type 2 diabetes (Metformin 500mg). Most of the "dayquil" type cold and flu OTC gel tablets have phenylephrine in them. The included instructions warn to check with a Dr or pharmacist before using with diabetes. When I was at the store I asked the pharmacist on duty but she only spoke to the amount of sugar in the liquid medications, not the liquid gel tablets. She didn't seem familiar with the contraindications on the package. I'm not finding much else on why phenylephrine is contraindicated with diabetes. Hopefully you might have a little more experience with this than the pharmacist at the drug store. Chlorpheniramine Maleate - 2 mgAntihistamine , Acetaminophen (325 mg)Pain Reliever/Fever Reducer , Dextromethorphan HBr - 10 mgCough Suppressant , Phenylephrine HCl - 5 mgNasal Decongestant Nighttime: Corn Starch , FD&C Blue #1 Aluminum Lake , FD&C Blue #2 Aluminum Lake , Sodium Starch Glycolate , Daytime: Corn Starch , Croscarmellose Sodium , Crospovidone , Flavor , Magnesium Stearate , Microcrystalline Cellulose , Polyethylene Glycol , Polyvinyl Alcohol , Povidone , Silica Gel , Stearic Acid , Sucralose , Talc , Titanium Dioxide Continue reading >>

Drug Interactions With Diabetes

Drug Interactions With Diabetes

Patients with diabetes often receive many other medications in addition to their oral or injectable diabetes agents. If confronted with a loss of glycemic control, providers should investigate whether or not concomitant drug therapy may be contributing. This is of particular consideration when starting a new medication or increasing dosages. The theorized mechanisms for these interactions include decreased peripheral insulin sensitivity, decreased insulin secretion and/or increased gluconeogenesis. This article summarizes information on a core group of medications to be suspected in cases of decreased glycemic control. Corticosteroids The route of administration and the dose are factors that determine the impact of this class on blood glucose. Lower risk is associated with inhaled and topical formulations vs. oral formulations. The effect on blood glucose may be dramatic and prolonged, requiring dose increases in diabetes medications to achieve glycemic control during concomitant therapy. Atypical antipsychotics These medications have been frequently reported to be associated with significant increases in weight, diabetes (even diabetic ketoacidosis) and may have an adverse effect on lipids. The weight gain appears to be rapid, within the first few months of therapy, but may not plateau for as long as one year after treatment initiation. The increase in weight is widely variable (2 to 10 kg) and is reportedly due to an increase in body fat, suggesting insulin resistance as the mechanism. The relative risk of hyperglycemia and weight gain varies between agents within this class. Clozapine (Clozaril, Novartis) and olanzepine (Zyprexa, Eli Lilly) appear to be ranked highest. Switching patients to the lowest risk agents aripiprazole (Abilify, Otsuka America/Bristol-Myers Sq Continue reading >>

Cold Medicines That Are Safe For Diabetes

Cold Medicines That Are Safe For Diabetes

Searching for relief for your runny nose, sore throat, or cough? Many over-the-counter cough, cold, and flu remedies list diabetes as an underlying condition that may indicate you should leave the medication on the shelf. The warnings are clear: "Ask a doctor before use if you have: heart disease, high blood pressure, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy. Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too. Simple Is Best for Cold Medicines Keep it simple by choosing an over-the-counter medication based on the types of ingredients proven to relieve your particular symptoms. Often a medication with just one ingredient is all you need to treat your symptoms rather than agents with multiple ingredients. "To choose the correct medication, take time to speak to a pharmacist," says Jerry Meece, R.Ph., CDE, of Gainesville, Texas. "The proper remedies may not only make you feel better, but also cut the length of the illness and possibly save you a trip to the doctor." Oral cold and flu pills are often a better choice than syrups with the same ingredients because the pills may contain no carbohydrate. If you decide to use a syrup, look for one that is sugar-free. If you can't find one, the small amount of sugar in a syrup will likely affect your blood sugar less than the illness itself, Meece says. Safe OTC Cold Medicines Various over-the-counter medications are designed to treat specific symptoms. Many pharmacists recommend these products for people with diabetes. Symptom: Cough Best option: Anti-tussive dextromethorphan (Delsym, Diabetic Tussin NT [includes acetaminophen, diphenhydramine]) Sympt Continue reading >>

Phenylephrine

Phenylephrine

Ah-Chew D, Dimetapp Cold Drops, Lusonal, Nasop, Nasop12, PediaCare Children's Decongestant, Phenyl-T, Sudafed PE, Sudafed PE Children's Nasal Decongestant, Sudafed PE Quick Dissolve, Sudogest PE, Triaminic Thin Strips Cold What is the most important information I should know about phenylephrine? Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. You should not use this medication if you are allergic to phenylephrine. Do not use phenylephrine if you have used linezolid (Zyvox) or procarbazine (Matulane), or if you have taken a monoamine oxidase inhibitor (MAOI) such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) in the last 14 days. Serious, life-threatening side effects can occur if you take phenylephrine before these other drugs have cleared from your body. Before you take phenylephrine, tell your doctor if you are allergic to any decongestants, or if you have heart disease, heart rhythm disorder, high blood pressure, circulation problems, diabetes, glaucoma, a thyroid disorder, kidney disease, an enlarged prostate or urination problems, anxiety, sleep problems, bipolar disorder or other mental illness. Phenylephrine may interact with heart or blood pressure medications, antidepressants, diabetes medications, migraine headache medications, and other decongestants. Never take more of the medicine than directed on the label or prescribed by your doctor. Call your doctor if your symptoms do not improve after 7 days of using phenylephrine, or if they get worse and your also have a fever. Phenylephrin Continue reading >>

Phenylephrine - Side Effects, Dosage, Interactions - Drugs

Phenylephrine - Side Effects, Dosage, Interactions - Drugs

Phenylephrine is a nasal decongestant that provides relief from nasal discomfort caused by colds, allergies , and hay fever. It belongs to a class of drugs called vasopressors , and it works by reducing swelling of the blood vessels in the nose. Phenylephrine relieves symptoms but doesnt treat the cause of the symptoms or speed recovery. Its the active ingredient in dozens of generic products, including childrens cough medications and over-the-counter (OTC) drugs. Some of the most commonly used medications that contain phenylephrine include Neo-Synephrine, Sudafed PE, Vicks Sinex Nasal Spray, and Suphedrine PE. In 2011, the Food and Drug Administration (FDA) issued a safety alert about certain unapproved prescription cough, cold, and allergy products containing phenylephrine in combination with other drugs. These products are not currently approved by the FDA for safety, effectiveness, and quality. The FDA asked drug companies to stop shipping many of these products for sale in the United States due to concerns about improper use in young children, potentially risky combinations of phenylephrine, and reports of overuse through time-release products. You should not use medicines that contain phenylephrine if you have used a monoamine oxidase inhibitor (MAOI) in the past 14 days because of a potentially dangerous drug interaction. You should also ask a doctor if phenylephrine is safe to use if you have the following conditions: If you become pregnant while using phenylephrine, let your doctor know immediately. If your symptoms do not get better within 7 days of starting phenylephrine, or if you develop a fever, discontinue phenylephrine and call your doctor. Nonprescription cough and cold combination products, including those that contain phenylephrine, can cause serious Continue reading >>

The Effects Of Phenylephrine 2.5% Versus Phenylephrine 10% On Pupillary Dilation In Patients With Diabetes.

The Effects Of Phenylephrine 2.5% Versus Phenylephrine 10% On Pupillary Dilation In Patients With Diabetes.

The effects of phenylephrine 2.5% versus phenylephrine 10% on pupillary dilation in patients with diabetes. Kresge Eye Institute, Detroit, Michigan 48201, USA. PURPOSE: A prospective, double-blind study was conducted to compare the clinical efficacy of a combination of 1% tropicamide and 2.5% phenylephrine and a combination of 1% tropicamide and 10% phenylephrine for pupillary dilation in patients with diabetes. METHODS: Either 2.5% phenylephrine in one eye and 10% phenylephrine in the other eye, 2.5% phenylephrine in both eyes, or 10% phenylephrine in both eyes was administered to 127 consecutive patients with diabetes. All patients received 1% tropicamide in both eyes. RESULTS: There was no statistically significant difference in the amount of pupillary dilation between the three groups. CONCLUSION: As 2.5% phenylephrine may produce a lower incidence of side effects than the 10% concentration, we advise the use of the lower concentration, particularly among patients with diabetes, who already exhibit a higher prevalence of vascular disease and autonomic dysfunction. Continue reading >>

Voice Of The Diabetic

Voice Of The Diabetic

by Sarah Johnston Miller, Pharm.D., BCNSP (Note from Dr. Wes Wilson: Looking at this question, I felt it would be wise to refer it to a pharmacist who is actively involved in both patient care and in teaching students about such problems. Dr. Sarah Miller is Professor of Clinical Pharmacy at the University of Montana, and is also a consultant at St. Patrick Hospital in Missoula, Montana. Her answer should be helpful.) Q: Which nonprescription drug products for treatment of common cold symptoms should a person with diabetes avoid? A: There is some concern about the effect some nonprescription (over-the-counter) medications may have on blood sugar control. The diabetic patient should always remember that, in general, "sick days" may be associated with fluctuations in blood sugar. This may be related to the stress of being sick, or to changes in dietary intake during illness. Your nonprescription medications may not be at fault at all--but it pays to know. A severe bout of the common cold (a viral illness) could certainly produce "sick days," elevated blood sugars--without any effects from your nonprescription or other medications. When you're sick, test your blood more often. Textbooks may list quite a few classes of potentially-problematic medications, though many of these are in reality not very significant. Regardless, the diabetic patient should always contact their health care provider (physician, diabetes educator, or pharmacist) prior to taking any new nonprescription medication. This includes "lternative"remedies purchased at the health food store or elsewhere; "natural" does not mean "safe from interactions!" You should be cautious that many nonprescription medications, including those targeting symptoms of the common cold, contain multiple ingredients. Another Continue reading >>

Phenylephrine - An Overview | Sciencedirect Topics

Phenylephrine - An Overview | Sciencedirect Topics

Phenylephrine is a noncatecholamine, direct-acting receptor agonist that does not possess any significant receptor activity. Robert L Stamper MD, ... Michael V Drake MD, in Becker-Shaffer's Diagnosis and Therapy of the Glaucomas (Eighth Edition) , 2009 Phenylephrine hydrochloride is a potent synthetic sympathomimetic agent that differs from epinephrine in that it lacks a hydroxyl group on the 4 position of the benzene ring (see Fig. 24-1). The drug acts predominantly on 1-adrenergic receptors and is used topically in concentrations of 0.12510% to induce vasoconstriction or mydriasis or to break posterior synechiae. Following instillation of topical phenylephrine, mydriasis reaches a maximum in 6090minutes with recovery by 6 hours. Phenylephrine can produce mydriasis even in patients treated with strong miotics. The drug is often used in combination with, or as a diluent for, echothiophate to prevent the development of cysts of the iris pigment epithelium.55 Phenylephrine produces a slight fall in IOP but is of little use in the chronic therapy of glaucoma. Occasionally topical phenylephrine administration produces an increase in IOP from the release of iris pigment particles.56 This phenomenon may be more common in patients with the pigment dispersion syndrome or pigmentary glaucoma. Phenylephrine also has the capability of triggering an attack of acute angle closure in susceptible eyes. Daniel J. Ford, ... Mark Denton, in Therapy in Nephrology & Hypertension (Third Edition) , 2008 Phenylephrine is a specific -adrenoreceptor agonist that is used in some ICUs to treat hypotension associated with septic shock. There is currently very little evidence of its use in patients with renal failure. Krejci and colleagues142 showed that phenylephrine increases RBF more than norep Continue reading >>

Treating The Common Cold And Type 2 Diabetes

Treating The Common Cold And Type 2 Diabetes

It is that time of year again and as a Pharmacist/Certified Diabetes Educator one of the most common questions over the fall, the holiday’s and winter months is “What do you have to treat my cold?” or simply “Can you make me feel better?” Well there is no cure and we cannot wave our “therapeutic” wand and make symptoms disappear but there are a variety of products to help with the symptoms of cough and cold. If the patient is relatively healthy it may be a bit of a hit or miss scenario but usually the product will ease the symptoms until the cold runs its course over 7 to 10 days. The picture becomes less clear when the patient is taking other medications, has medical conditions such as kidney disease, blood pressure, or they have diabetes. Assisting our patient choose an appropriate product that will not worsen their existing medical conditions, and lessen the symptoms that make them feel miserable is key. Diabetes is a condition that requires some adjusting to choose the right product. It is not always a “Sugar free”, “Natural”, or alternative product that is best, as active ingredients may have issues. These include raising blood sugars, raising blood pressure or stressing the kidneys (common issues with diabetes). Usually after a brief discussion to educate the patient, a product can be chosen to help both their symptoms and minimally impact their diabetes and blood sugars. The discussion that follows is a practical approach on how to decide what a person with diabetes can use so that they understand why we avoid certain classes of products due to a their existing medical conditions. Blood Sugars Can Rise when Ill It is important to realize that when a person with diabetes is “fighting” a cold it produces stresses on the body as a whole and Continue reading >>

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