Selegiline Wikipedia. Selegiline. Clinical data. Pronunciations LEJ i leen. Trade names. Pill form is generic and available under many brand names 1transdermal patch is called Emsam. Visual Studio 2010 Express C# Tutorial Pdf there. AHFSDrugs. com. Monograph. Medline. Plusa. 69. License data. Pregnancycategory. AU B2. US C Risk not ruled outRoutes ofadministration. Oral, transdermal, buccal. ATC code. Legal status. Legal status. Pharmacokinetic data. Bioavailability. 4. VDotHCP2.gif' alt='Thyroid Transdermal Patch' title='Thyroid Transdermal Patch' />Fentanyl Transdermal Patch learn about side effects, dosage, special precautions, and more on MedlinePlus. Find patient medical information for Nicoderm CQ Transdermal on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Forskolin Thyroid Treatment Medical Articles 10 Day Sugar Detox Menu Detoxing Your Body Heal Anxiety Smoothie Detox Cleanse. INDICATION. DURAGESIC is A strong prescription pain medicine that contains an opioid narcotic that is used to manage pain severe enough to require daily around. Find patient medical information for Estradiol Transdermal Patch on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Thyroid Transdermal Patch' title='Thyroid Transdermal Patch' />Protein binding8. Metabolism. Extensive in liver. Metabolites. N desmethylselegiline, L amphetamine and L methamphetamine. Biological half life. Excretion. Urine main routeIdentifiersR N methyl N 1 pheny lpropan 2 ylprop 1 yn 3 amine. CAS Number. Pub. Chem. CIDIUPHARBPSDrug. Bank. Chem. Spider. UNIIKEGGCh. EBICh. EMBLECHA Info. Card. Airport Planning And Management 6Th Edition. Chemical and physical data. Formula. C1. 3H1. NMolar mass. 18. 7. D model JSmolCCCNCHCc. CCIn. Ch. I1. SC1. H1. 7Nc. 1 4 1. H,1. H2,2 3. H3t. 12 m. YKey MEZLKOACVSPNER GFCCVEGCSA N Y  verifySelegiline, also known as L deprenyl, is a substituted phenethylamine. At normal clinical doses, it is a selective irreversible MAO B inhibitor. In larger doses it loses its specificity and also inhibits MAO A. It is available in pill form under many brand names1 and is used to reduce symptoms in early stage Parkinsons disease. A transdermal patch brand name, Emsam is used to treat depression. Medical useseditFor all human uses and all forms, selegiline is pregnancy category C,23 meaning that caution is in order because studies in pregnant laboratory animals have shown an adverse effect on the fetus and there are no adequate and well controlled studies in humans, but that the drugs potential benefits may nonetheless warrant use of the drug in some pregnant women. Parkinsons diseaseeditIn its pill form, selegiline is used to treat symptoms of Parkinsons disease. It can be used on its own or in a combination with another agent, most often L DOPA. Selegiline delays the time point when the L DOPA levodopa treatment becomes necessary from about 1. The rationale for adding selegiline to levodopa is to decrease the required dose of levodopa and thus reduce the motor complications of levodopa therapy. DepressioneditSelegiline is also delivered via a transdermal patch in this form it is used as a treatment for major depressive disorder. A quantitative review published in 2. The number needed to harm inverse of the NNT, a high number here is better ranged from 3. With regard to the likelihood to be helped or harmed LHH, the analysis showed that the selegiline patch was 3. LHH for remission vs. LHH for remission vs. The LHH for remission vs insomnia and sexual dysfunction were both very low. Adverse effectseditSide effects of the pill form include, in decreasing order of frequency, nausea, hallucinations, confusion, depression, loss of balance, insomnia, increased involuntary movements, agitation, arrhythmia, slow heart rate, delusions, hypertension, new or increased angina pectoris, and syncope. The main side effects of the patch form for depression included application site reactions, insomnia, diarrhea, and sore throat. The selegiline transdermal patch for depression carries a black box warning about the risk of suicide, especially for young people,3 as do all antidepressants since 2. InteractionseditBoth forms of the drug carry strong warnings against combining selegiline with drugs that could produce serotonin syndrome, which include SSRIs and the cough medicine, dextromethorphan. Selegiline in combination with the opioid analgesic pethidine is not recommended as it can lead to severe adverse effects. Several other synthetic opioids such as tramadol and methadone, dextromethorphan, and various triptans are contraindicated due to potential for serotonin syndrome. Both forms of the drug carry warnings about food restrictions, to avoid hypertensive crisis that are associated with MAO inhibitors. The patch form of the drug was created in part to overcome the issues with food restrictions the clinical trials did not include food restrictions, and no hypertensive crisis during the course of them. Additionally, in post marketing surveillance from April 2. October 2. 01. 0, only 1. The lowest dose of the patch method of delivery, 6 mg2. Higher doses of the patch and oral formulations, whether in combination with the older non selective MAOIs or in combination with the reversible MAO A inhibitormoclobemide, require a low tyramine diet. PharmacologyeditProtein bindingeditSelegiline is a selective inhibitor of MAO B MAO B metabolizes dopamine and phenylethylamine. Selegiline also inhibits CYP2. A6 and can increase the effects of nicotine as a result. Selegiline appears to activate 1 receptors with a relatively high affinity of approximately 4. M. 1. 51. 6Pharmacokinetics of the pill formeditSelegiline has a low oral bioavailability, which increases to moderate when ingested together with a high fat meal, the molecule being fat soluble. Selegilines oral bioavailability is drastically increased in females taking oral contraceptives 1. This could lead to loss of MAO B selectivity, with inhibition of both MAO A and MAO B, which would make patients susceptible to the usual risks of unselective MAOIs such as tyramine induced hypertensive crisis and serotonin toxicity when combined with serotonergics such as SSRIs. Pharmacokinetics of the patch formeditFollowing application of the patch to humans, 2. Transdermal dosing results in significantly higher exposure to selegiline with significantly lower exposure for all metabolites when compared to oral dosing, due to extensive first pass metabolism for the pill form and low first pass metabolism for the patch form. The site of application is not a significant factor in how the drug is distributed. In humans, selegiline does not accumulate in the skin nor is it metabolized in the skin. When radiolabeled selegiline is given transdermally to laboratory animals, the drug is rapidly distributed to all body tissues and rapidly penetrates the bloodbrain barrier. MetaboliteseditDesmethylselegilineeditN Desmethylselegiline may have neuroprotective antiapoptotic properties. A large multicenter study suggests a decrease in the disease progression of Parkinsonism but may have reflected other symptomatic response. Desmethylselegiline is metabolized by CYP2. C1. 9. 1. 9Levoamphetamine and levomethamphetamineeditSelegiline is partly metabolized to levomethamphetamine L methamphetamine, one of the two enantiomers of methamphetamine, in vivo. While these metabolites may contribute to the drugs ability to inhibit reuptake of the neurotransmitters dopamine and norepinephrine, they have also been associated with orthostatic hypotension and hallucinations in some people. A newer antiparkinson MAO B inhibitor, rasagiline, metabolizes into 1R aminoindan which has no amphetamine like characteristics. This metabolic pathway may cause persons taking selegiline to test positive for amphetamine or methamphetamine on drug screening tests. ChemistryeditSelegiline belongs to a class of drugs called phenethylamines. Selegiline is an L methamphetamine derivative with a propargyl group attached to the nitrogen atom. This detail is borrowed from pargyline, an older phenethylamine MAO B inhibitor. Duragesic fentanyl Uses, Dosage, Side Effects. Generic Name fentanyl transdermal skin patch FEN ta nil trans DERM alBrand Names Duragesic. What is Duragesic Duragesic is a skin patch containing fentanyl, an opioid pain medication. An opioid is sometimes called a narcotic. Duragesic is used to treat moderate to severe chronic pain around the clock. Duragesic is not for treating mild or occasional pain or pain from surgery. Important information. Fentanyl can slow or stop your breathing. MISUSE OF DURAGESIC CAN CAUSE DEATH, especially in a child who gets a hold of the skin patch and places it in the mouth or on the skin. Fentanyl may be habit forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Do not use a Duragesic skin patch if you have a breathing problem, a blockage in your stomach or intestines, or if you are NOT already being treated with a similar opioid narcotic pain medicine and are tolerant to it. You may not be able to use Duragesic if you also use certain antibiotics, antifungal medications, heart or blood pressure medications, or medicines to treat HIV or AIDS. Avoid sources of heat while you are wearing a Duragesic skin patch. Heat can increase the amount of drug your skin absorbs. Before taking this medicine. Fentanyl may be habit forming, and the Duragesic transdermal skin patch contains a high concentration of this medicine. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away fentanyl is against the law. Do not use a Duragesic skin patch if you are allergic to fentanyl, or if you have a severe breathing problem such as asthma attacks a blockage in your digestive tract stomach or intestines orif you are NOT already being treated with a similar opioid narcotic pain medicine and are tolerant to it. Some medicines can cause unwanted or dangerous effects when used with fentanyl. You may not be able to use Duragesic if you also use certain antibiotics, antifungal medications, heart or blood pressure medications, or medicines to treat HIV or AIDS. Tell your doctor about all medicines you use. Some medicines can interact with fentanyl and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinsons disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications. To make sure Duragesic is safe for you, tell your doctor if you have any type of breathing problem or lung disease a history of head injury, brain tumor, mental illness, alcoholism or drug addiction urination problems liver or kidney disease orproblems with your gallbladder, pancreas, or thyroid. Do not put a Duragesic skin patch on any child who does not have a personal prescription for this medicine. It is not known whether this medicine will harm an unborn baby. If you use fentanyl while you are pregnant, your baby could become dependent on the drug. This can cause life threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant. Fentanyl can pass into breast milk and may cause withdrawal symptoms in a nursing infant. Do not breast feed while using Duragesic. The Duragesic skin patch may burn your skin if you wear the patch during an MRI magnetic resonance imaging. Remove the patch before undergoing such a test. How should I use Duragesic Use Duragesic exactly as prescribed by your doctor. Follow all directions on your prescription label. Never use fentanyl in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain. Do not use a skin patch if it has been cut or damaged, or you could receive a fatal overdose of fentanyl. MISUSE OF DURAGESIC CAN CAUSE HARMFUL SIDE EFFECTS OR DEATH, especially in a child who gets a hold of the skin patch and places it in the mouth or on the skin. Do not use this medicine on a child who does not have a prescription to use Duragesic. When placing a skin patch on a young child, choose a wearing area where the child cannot easily remove the patch unsupervised. A Duragesic skin patch is for use only on the skin. Avoid touching the sticky side of a skin patch. Do not allow the medicine to come into contact with your eyes, nose, mouth, or lips. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions. Avoid sources of heat while you are wearing the Duragesic patch. Do not use a heating pad or electric blanket, a waterbed heater, tanning bed or sauna. Zyxel Nas Starter Utility Mac more. Do not sit in hot water, sunbathe, or raise your body temperature with vigorous activity. Heat can increase the amount of drug you absorb through your skin and may cause an overdose or death. Remove and replace the Duragesic patch every 7. Apply the new patch to a different skin area on the chest, back, side, or upper arm. After removing a skin patch fold it in half firmly with the sticky side in, and flush the patch down the toilet right away. Do not place a used skin patch into a trash can. Do not keep any unused skin patches. Ask your pharmacist where to locate a drug take back disposal program. If there is no take back program, flush the unused patches in the same folded manner described above. Do not flush the foil pouch or patch liners place them in a trash container out of the reach of children and pets. Keep both used and unused Duragesic skin patches out of the reach of children or pets. The amount of fentanyl in a used skin patch could be fatal to a child or pet who accidentally chews, sucks on, or swallows the patch. Seek emergency medical attention if this happens. Store the Duragesic skin patches at room temperature. Keep each patch in its foil pouch until you are ready to use it. Keep track of how many skin patches have been used from each new package. Fentanyl is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription. Dosage Information comprehensiveWhat happens if I miss a dose If you are using the skin patches on a schedule, apply the missed patch as soon as you remember. Continue wearing the patch for up to 7. Do not wear extra patches to make up a missed dose. What happens if I overdose Seek emergency medical attention or call the Poison Help line at 1 8. A fentanyl overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting. What should I avoid while using a Duragesic patchFentanyl may impair your thinking or reactions. Do not drive or operate machinery until you know how fentanyl will affect you. Dizziness or severe drowsiness can cause falls or other accidents. Do not drink alcohol or dangerous side effects and death could occur. Check your food and medicine labels to be sure these products do not contain alcohol. Avoid wearing a Duragesic skin patch on a part of your body where a child could reach or remove the patch from your skin.