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At present, the structure of this website should be characterized as follows .:

1. We present the patterns of pharmacological treatment of chosen, ' most common medical situations ' - first by compilation of rather exhaustive list of groups of medicaments, which can be used in the course of the treatment. This list quote so called
Recommended International Nonproprietary Names ( rINN ) of the medicaments and give examples of drugs, named by 'proprietary names'

2. We present also ( under http://salve.slam.katowice.pl/treatment1.htm )  another kind of the 'patterns of treatment'. They are examples of set of medicaments prescribed simultaneously often as a necessary ' therapeutic complex '. These patterns are formulated using only rINN. We formulated these patterns according to real practices encountered in UK in NHS hospitals.
 

At present, the ' exhaustive list of groups of medicaments ', which can be used in the course of the treatment of the particular syndroms - mentioned under point 1 are related to the following clinical situations.:

1. Pharmacological Treatment of Coronary Heart Disease ( CHD )
2. Pharmacological Treatment of Hypertension - supplement to CHD treatment
3. Pharmacological Treatment of HF - supplement to (1) hypertension and (2) CVD
4. Pain Management ( Analgesia )
5. Infections - Antibiotics
6. Treatment of Insulin Dependent Diabetes Mellitus (IDDM)
7. Management of the goiter ( thoroid gland diseases )

8. Hodgkin's lymphoma
9. Non - Hodgkin's lymphoma's
10. CCL - Chronic lymphocytic leukemia
11. CML - Chronic myelotic leukemia
12. Plasmocytoma
 

Cholesterol-lowering medications

  Statins

       Lovastatin

         Lovastatinum (Argon) 20 mg

       Simvastatin

         Zocor (Merck Sharo) 10,20,40,80 mg

         Cardin ( Schwartz Pharma ) 5,10,20,40 mg

       Pravastatin

         Lipostat ( Bristol Mayers Squibb) 20 mg

       Fluvastatin

         Lescol (Novartis ) 20, 40, XL 80 mg

       Atorvastatin

         Sortis ( Parke Davis ) 10,20,40 mg  

  Bile Acid Sequestrants ( Leki wiazace kwasy zolciowe )

       Cholestyramina

       Kolestypol

         Colestid ( Pharmacia ) - granulat

  Nicotinic Acid

  Fibrates

       Benzafibrat

       Gemfibrozil

       Fenofibrat

         Fenoratio ( Radiopharm ) 100 mg

         Lipanthyl ( Fournier ) 100, 200, 267 mg 

       Ciprofibrat

         Lipanor ( Sanofi ) 100 mg

  Anticoagulants

  Aspirin

       Acard (  ( Polfa ) 75 mg

       Aspirin Protect ( Bayern ) 100 mg

        Agrenox 

  Other antiplatelet medications

      Ticlo ( Schwartz  Pharma )  250 mg

      Aclotin ( Polfa ) 250 mg   

    Glycoprotein IIb-IIIa inhibitors

Heparin

ACE inhibitors

     Captopril

     Enalapril

     Lizynopril

            Diroton ( Richter Geodeon )  2,5,   5 ,  10 mg

     Perindopril

            Prestarium ( Servier ) 4 mg 

     Ramipril

            Tritace ( Aventis ) 1,25   2,5   5 mg

     Chinapril

            Accupro ( Goedecke- Parke-Davis ) 5, 10 , 20 mg

     Benazapril

            Lotensin ( Novartis ) 5, 10 , 20 mg

     Cilazapril

             Inhibace ( Roche )  0,5  1   2,5   mg 

     Fosinopril

             Monopril ( Bristol - Myers Squibb )  10  , 20 mg

     Trandolapril

             Gopten ( Abbott ) 0,5, 2,0  mg

     Moeksipril

             Cardiotensin ( Schwarz Pharma ) 7,5  , 15  mg

Beta-blockers

     Non - selective

         Oksyprenolol

             Coretal ( Polfa )

         Propranolol

             Propranolol

         Sotalol

             Sotahexal (Hexal ) 80, 160 mg

     Selective

          Metoprolol

              Metocard ( Polpharma ) 50, 100 mg ; prolongatum 200 mg

              Betaloc  ZOK ( Astra Zeneca ) 25,  50,  100  mg

              Metoxehal ( Hexal ) 50, 100 mg

          Atenolol

              Atenolol ( Sanofi ) 25, 50, 100 mg

          Acebutol

               Sectral ( Polfa )  200 , 400 mg

               Abutol ( Schwarz Pharma ) 200 mg, .. Long 400 mg

          Betaksolol

          Bisoprolol

                Concor ( Merck ) 5, 10, COR 1,25,   2,5 ,   5   mg

          Celiprolol

                 Celipres ( Ranbaxy ) 100, 200 mg

          Nebivolol

                Nebilet ( Berlin - Chemie ) 5 mg

      α-  and β-   adronolithics

          Labetalol

          Carvedilol

Calcium channel blockers

      Amlodypina

          Amlozek ( Adamet) 5, 10 mg

          Norvarc (Pfizer )  5 , 10 mg

      Felodypina

          Plendil (Astra-Zeneca ) 5 mg, 10 mg

      Isradypina

          Lomir SRO ( Novartis ) 5 mg

      Nifedipina

          Cordafen ( Polpharma )  10 mg

          Cordipin retard ( Krka )  20 mg

      Nitrendypina

          Nitrendipina ( Anpharm ) 10, 20 mg

      Lacydypina

         Lacipil ( Glaxo ) 2, 4 mg 

Nitrates

  Nitroglicerinum (  Triazotan glicerolu )   

         Nitroglicerinum ( Argon ) 0,5 mg

         Nitroglicerinum prolongatum ( Argon ) 2,6 i 6,4 mg

         Nitrocard - ointment,

         Nitromint - aerozol , Trimonit ( Sanofi )

         Nitroderm TTS 5, TTS 10  ( Novartis - transdermal )

  Long-acting nitrates

     Diazotan izosorbidu  ( Isosorbide Dinitrate )           

         Sorbonit ( Argon )  5, 10 mg; prolongatum 20, 40 mg

         Cardonit prolongatum  ( Polfa )  40, 60, 80 mg 

         Iso-Mack Retard ( H.Mack ) 20, 40, 60 mg   

         Isodinit ( Pharmachin - Holding )  10, 20 mg        

         Isoket , Isoket Retard ( Schwarz Pharma ) 5 mg, retard 20, 40, 120 mg

         Isoket - aerozol

         Aerosonit - aerosol ( Glaxo )

     Monoazotan izosorbidu  ( Isosorbide Mononitrate )

         Effox ( Schwarz Pharma ) 10, 20, 40 mg long 50, 75 mg

         Izonit ( Argon ) 10, 20 mg; prolongatum 40 mg

         Monocard ( Synteza) 10, 20 mg

         Mononit ( Sanofi ) 10, 20, 40 mg, retard 60, 80, 100 mg

         Mono Mack  Depot ( H.Mack ) 100 mg

         Olicard retard ( Solvay ) 40, 60 mg

   Tetraazotan pentaerytritolu

         Pentaerythritol ( Galena ) 100, 200 mg     

Thrombolytics

       Abbokinase ( Urokinase (yoor-oh-KIN-ace)

       Activase( Alteplase, Recombinant (AL-te-plase) )

       Eminase ( Anistreplase (a-NISS-tre-place) )

       Retavase ( Reteplase, Recombinant (RE-te-plays) )

       Streptase ( Streptokinase (strep-toe-KIN-ace) )

Anticoagulants
 

    Aspirin
    Acard ( ( Polfa ) 75 mg
    Aspirin Protect ( Bayern ) 100 mg
    Agrenox

   Other antiplatelet medications

   Ticlo ( Schwartz Pharma ) 250 mg
   Aclotin ( Polfa ) 250 mg
   Plavix ( Bristol - Myers Squibb ) 0,075

   Glycoprotein IIb-IIIa inhibitors

   Abciximab
      Reopro ( Eli Lilly )
          For prevention of blood clots during percutaneous coronary intervention. Initial dose: 250 micrograms
          (mcg) per kilogram (kg) of body weight injected 10 to 60 minutes before the procedure.
    Tinofiban
    Agrostat ( MSD ()
    Integrillin

Heparin

 

Diuretics

   Thiazide diuretics

            Hydrochlorothiazidum ( Polpharm ) 12,5 ; 25 mg

            Disalunil ( Berli9n - Chemie ) 25 mg

       Thizide - like

          Klopamid

             Clopamid ( Polfa ) 20 mg   

          Chortalidon

             Hygroton  ( Novartis ) 50 mg              

          Indapamid 

             Indapsan ( Sanofi - Winthrop ) 2,5 mg

             Tertensif SR  1,5 mg

              Noliprel  2 mg    

   Loop diuretics

        Sulphonamides

              Furosemide

                  Lasix ,  40 mg

              Torasemide

                  Trifas ( Berlin - Chemie ) 10 mg, 200 mg 

                  Demadex

   Potassium - sparing diuretics

             Amiloride ( Midamor )

             Tiamterene ( Dyrenium )

   Aldosterone - receptor blocers

         Spironolakton ( Aldactone )

             Spironol 25 , 100 mg

             Verospiron ( Richter ) 25, 50, 100 mg

             Eplerenone ( Inspra )

 β  - blockers  - vide treatment  of CHD

 β - blockers with intrinsic sympathomimetic activity

.....Acebutol ( Sectral ) , Pindolol ( Visken ) , Penbutolol ( Levatol ) - vide tr.CHD

Combined    α - and β - blockers

     Carvedilol ( Coreg )

     Labetalol  ( Normodyne )

α - blockers 

    Doxasosin

        Cardura

    Prazosin ( Minipress )

    Terazosin ( Hytrin )

Central   agonists and other centrally  acting drugs  

         Clonidine  ( Catapresan ,   100 mg,  )

         Methyldopa ( Aldomet , 250 mg )

         Reserpine    0.05 mg

         Guanfacine  0.5 mg

Direct vasodilatators   

         Hydralazin ( Apresoline, 25 mg  )

         Minoxidil  ( Loniten 2.5 mg )

        Inotropic agents

               Glycosides ('gl aj-ke-"sajds  )

                 Digoxin

                        Digoxin  0,1 mg , 0,250 mg

                        Lanoxin

                        Lanoxicaps

                 Methyldigoxin

                        Bemecor  0,1 mg

             Dobutamine  ( Hexal, Polfa ) 0,25 g /5 ml - fiolka

                        Dobutrex           0.5 mcg/kg/min i.v.         

             Dopamine

                        Intropin              5 mcg/kg/min   i.v.

                        Dopaminum ( Polfa 1% lub 4 % - 0,04 g/ml-  5ml )

      Phosphodieesterase inhibitors  (PDIs )  ( in-'hi-b&-t&r )           

             Milrinone

                       Primacor  50 mcg/kg i.v.  bolus +  0.25-1.0 mcg/kg/min

                       Corotrope - solutio - i.v.

             Amrinone

                        Inocor

       Prostaglandyny

             Alprostadil

                        Prostavasin (Schwarz )

             Crataegus

                        Cardiplant ( Dr Willmar Schwabe )

             Ubidekarenon

                        Envit

             Trimatazydyna

                         Preductal (Servier ) 20 mg

     Human B-type natiuretic peptides  ( hBNPs)         

             Nesiritide ( Natrecor ) 2 mcg/kg i.v. - bolus over 60 sec;

                 follow by 0.01 mcg/kg/min continuous infusion

Opioids

  Morphine        

            Doltard - tablets - prolonged action ( Nycomed )  10, 30, 60, 100 mg

            Morphini sulfas ( Polfa )  amp.- 10 mg/ml , 20 mg /ml

  Codeine  ('kO-"dEn )  

            Dihydrocodeine

                DHC Continus  ( Polfa )    0,06 ; 0,09 ; 0,12

  Meperidine ( Demerol )  100 mg  i.v.

Phenylopiperidins

    Petydyna

            Dolargan ( Chinoin )

    Fentanyl

            Durogesic - transdermal system -  25, 50 , 75 , 100 μg/h

    Alfentanil

            Rapifen ( Janssen solutio 0,5 mg /ml amp a 2 , 10 ml )        

    Diphenylpropylamina

           Methadone hydrochroride ( Molteni ) syrup - 5mg/5ml, 10mg/10 ml ..

    Bezomorfan - Pentazocin

           Fortral ( Krka )  - tablets 50 mg 

           Pentazocinum ( Polfa )  solutio - 30 mg/ml

    Buprenorphine

           Transtec ( Grunenthal ) - transdermal system -  35, 52 , 70 μg/h

Tramadol

           Tramal ( Grunenthal )  50, 100 mg  

Salicilic acid .... - and derivates

            Aspirin ( Bayer ) 325 mg, 500 mg

            Laspal

Pirozalon - Metamizol

            Pyralginum ( Glaxo )

Anilids

            Paracetamol

                 Codipar ( Glaxo ) 500mg

                 Panadol ( Smith ) 500mg  

            Nefopam

                 Nefopam ( Jelfa )  30 mg

Non - steroid - anti - inflammation drugs '   ( "in-fl&-'mA-sh&n )

     Butylpirazolidine derivates    

          Phenylbutazone

              Butapirazol ( GlaxoSmith Kline )

          Propyphenazone

              Saridon ( Roche) .. mix.-paracetamol + propyphenazone + coffeine

   Acetaminophen,  650 mg, 1 g

    Acetic acid derivates

        Indometacine

              Medindol  ( Glaxo Smith )

              Metindol ( Polfa ) 0,025   

       Diclofenac

            Voltaren ( Novartis ) .... 

            Dicloberl  ( Berlin Chemie ) ....

            Cataflam ( Novartis ) 50 mg

            Diclofenac (  ( GlaxoSmith )  50, 100 mg

            Olfen ( Mepha ) 50 mg, 100 mg

    Propionic acid derivates

       Ibuprofen

            Bolinet ( Bristol Mayers )  0,2

            Nurofen ( Boots Health Care International )  Active 0,2;   Forte 0,4 ;

                                    Menstrual 0,3; Ultrafast 0,2

            Ibuprofen ( Polfa ) 0,2

        Ketoprofen

               Bi-profenid ( Aventis ) ' tablets slow release 0,150

               Profenid ( Aventis ) 0,1; 02

        Dex - ketoprofen

              Dexak ( Berlin - Chemie ) 0,025   

        Naproxen

              Aleve ( Roche ) 0,220

              Naproxen ( GlaxoSmith ) 250, 500 mg

   Tiaprophenic acid

              Surgam ( Roussel ) 300 mg

   Mephenamic acid

              Mefacit ( Polfa ) 0,250 mg

              Apo- Mefen ( Apotex ) 250 mg  

   Acemetacin

            Randudil , forte, retard ( Bayer ) 0,06 ; 0,09

   Oxykamy

        Piroxicam

               Piroxicam ( Glaxo Smith ) 10 mg,  20 mg

        Meloxycam

                Movalis ( Boeringer ) 7,5,  15 mg     

    Etofenamate

              Rheumon ( Bayer ) - creme -

              Traumon ( Bayer )  - aerozol 

   Benzydamine ( indazol - derivate )

             Benalgin ( Sanofi )

             Tantum ( Angelini )  - gel ; Rosa ,  Verde  - aerozol -  for .. mouth

  COX-2 inhibitors 

    Celecoxib ; Rofecoxib

              Celebrex ( Pharmatia co. ) caps. -  0,1 ; 02  ;

              Vioxx ( Merck ) 12,5; 25 mg

    Nabumeton

              Relifex ( Smith - Kline ) 500 mg

              Coxalgan ( Anpharm ) 500 mg

    Nimesulid

              Aulin ( Medicom ) 0,1 - granulat - p.os.

Pen·i·cil·lin  ( "pe-n&-'si-l&n )

  Benzylpenicillinum

         Penicillinum cristalisatum  ( 600 000 u. - > 1-2 - 5 billion u. )

  Aminopennicilins  ( Broader spectrum )

          Am·pi·cil·lin ( "am-p&-'si-l&n )

         Ampicillin ( Pharmachin ),tablets,  500 mg x3,

     Amox·i·cil·lin ( &-"mäk-sE-'si-l&n  )

                 Duomox ( Yamanouchi ) , e.g. 500 mg x 3

                 Novamox ( Hexal ), e.g. 500 mg x 3

                 Ospamox ( Biochemie  e.g. 500 mg  x 3

                 Hiconcil ( Krka )     e.g. 500 mg  x 3

          Amoxicillin with enzyme inhibator

                 Augmentin ( SmithKline ..) e.g. 375 mg x 3 ; 625 mg x 2 ;  1,0

                 Ramoclay (  Ranbaxy ) e.g. 375 mg x 3

          Clox·a·cil·lin  (  "kläk-s&-'si-l&n )

         Syntarpen ( Polfa ) e.g. 0,5

   Carboxy- penicillines

          Azlocylin

                  Securopen D amp. 0,5; 2,0; 5,0

          Carbenicylin

                  Geopen  ( Pfizer ) tabl. 0,25

          Piperacylin

                  Pipril amp. 2,0; 4,0

          Ticarcilin       

                  Timentin ( Smith-Kline..) amp. 1,6; 3,2

Other β - lactame anybiotics

        Carbapenemes

            Imipenem

                 Tienam  ( Merck  ) amp. 0,5 ; 1,0

         Monobactames

            Astreonam

                 Azactam ( Bristol ) amp. 0,5 ; 1,0

Tet·ra·cy·cline  ( "te-tr&-'sI-"klEn )

     Doxy·cy·cline (  "däk-s&-'sI-"klEn )  - a broad-spectrum tetracycline antibiotic

                            C₂₂H₂₄N₂O₈ with potent antibacterial activity that is often taken orally as

                            a prophylactic against diarrhea by travelers

                  Unidox ( Yamanouchi ) , 100 mg x 1

                  Supracylin  ( Grunenthal ) , 100 mg x 1    

Ceph·a·lo·spo·rin  ( "se-f&-l&-'spOr-&n )

    Ceph·a·lex·in  (  "se-f&-'lek-s&n )  ( I gener.)

         Keflex ( Eli Lilly  ) e.g. 500 mg x 3

    Cefazolinum ( I gener.)

         Kefzol ( Eli Lilly ) amp. a 0,5  ; 1,0

   Cephadroxil  ( I gener.)

       Duracef ( Bristol-Myers Squibb ) e.g. 500 mg x2

    Cephuroxim   ( II gener. )

       Zinacef ( Glaxo ) 1,5 x 1-2 injections

       Zinnat ( Glaxo )e.g.  250 mg x 3

       Biofuroxim ( Bioton ) e.g. 500 mg - 1,5 injections

       Bioracef ( Bioton ) e.g. 500 mg 2 x

   Cefaclor  ( II gener. )

       CEK 250,500,100 ( Hexal ) e.g. 250; 0,5; 1,0

       Serviclor ( Biochemie )  amp.

       Vercef  ( Ranbaxy ) amp...; caps. 250; 500 mg

       Ceclor ( POlfa ) amp.; kaps e.g. 500 mg

   Cefamandole ( II gen. )

       Mandol ( Eli Lilly )   

   Ceftazidime  ( III gener. )

       Fortum ( Glaxo ) e.g. amp. 0,5;1,0; 2,0 for injections

       Biotum ( Bioton ) amp. 0,5; 1,0  

   Ceph-triaxon  ( III gener. )

       Rocephin ( Roche ) e.g. 250 mg - 1,0 injections

       Biotrakson ( Bioton ) e.g. 500 mg 1,0 injections

       Oftramax ( Ranbaxy ) 1,0 injections

       Tartriakson ( Polfa ..)

  Ceph - ...

       Tarcevis ( Polfa ) e.g. 250 mg, 500 mg 2 x

       Cedax ( Schering - Plough ) 400mg - injectins

       Cefzil ( Bristol - ) 250, 500 mg 2x

  Cefepime ( IV gener.)

       Maxipime( Bristol-Myers Squibb) amp.a 0,5;1,0;2,0

Macrolides

   Erythromycinum

       Davercin, tablets 250 mg

       Erythromycinum, tablets 250 mg

   Spiramicinum

       Rovamycin ( Rhhone - Poulenc )tabl.:1,5;3billions units

   Roxytromycinum

       Rulid ( Roussel - Uclaf ) tabl e.g. 150 mg, 2 x

   Claritromycinum

       Klacid ( Abbott ) 250, 500 mg, 2  x

       Klacid UNO ( Abbot ) 500 mg

   Azitromycinum

       Sumamed ( Pliva ) 500 mg,1 x, 2 or 3 days 

Lincozamides

   Clindamycinum

       Dalacin C ( Pharmacia ) e.g. 150 mg , 2x

       Clindacin ( Lanacher ) caps. 300 mg

       Clindo ( Hexal ) caps. 300 mg , amp. 0,15/ml;0,6/4ml

   Lincomycinum

       Lincocin 500 mg , 2 x

Aminoglicosides

   Streptomycinum

       Streptomycinum 

   Gentamycinum

       Garamycin ( Schering - Plough ) 0,040;

   Neomycinum

       Neomycinum 

   Amikacinum

       Biodacyna ( Bioton ), 250 mg; 500 mg/2 ml; 1 g/4 ml

   Tobramycin

       Nebecin amp. 0,01 ; 004

   Netilmicin

       Netromycine ( Schering - Plough ) amp. 0,005; 0,1; 02

Glicopeptides

   Vancomycin  

       Vancococin ( Eli Lilly ) amp. 0,5 ; 1,0

Chinolony

 Fluorochinolony

   Ofloksacyna

      Tarivid ( Hoechst Marion Roussel ),200 mg

      Zanocin ( Ranbaxy ),  200 mg

   Ciprofloksacyna

    Cifran ( Ranbaxy ) 250 mg,  500 mg

    Ciprobay ( Bayer ) 250 mg, 500 mg, Uro 100 mg

    Ouintor ( Torrent Pharmaceuticals ) 250 mg,  500 mg

   Pefloksacyna

    Abaktal ( Lek )400 mg Lek Polska

   Norfloksacyna

     Nolicin ( Krka ) 400 mg

     Norbactin ( Ranbaxy ) 400 mg

    Lewofloksacyna

     Tavanic (Hoechst Marion Roussel ), 500 mg

   Moksyfloksacyna

     Avelox ( Bayer ), 400 mg

Other

Sulfonamines

   Sulfametoksazol + trimetoprim

     Bactrim ( Roche ) tabl.480 mg; 960 mg

     Biseptol ( Polfa ) tabl.120mg; 480; 960

     Septrin ( Glaxo )  tabl.480 mg

Pipemidinic acid derivate

    Palin( Lek ) caps. 200 mg

Derivates of imidazolum

  Metronidazol

      Metronidazol ( Polpharma )  250 mg

      Metronidazol ( Glaxo ) 500 mg ; 1 g

      Flagyl ( May & Baker ) amp. a 20 ml 

  Tynidazol

      Tinidazolum ( Polpharma ) tabl. 500 mg

      Fasygin ( Krka ) tabl., 0,5

Derivates of  nitrofuran

   Furaginum ( Adamed ) tabl. 50 mg

   Nitrofurantoina

       Nifuratio retard: -kaps. (700 mg), Ratiopharm

       Siraliden ( medana ) 50 mg/5 ml

Fosfonion Acid derivates

  Fosfomycine 

     Monural ( Zambon ) sachete a 3 g

Oxazolidines

  Linezolid

     Zyvoxid ( Pharmacia ) tabl. a 600 mg amp. i.v. 0,002/ml

a. Types ( species )  of insulin .:  

b. Insulin dosing

   Quotation from William Skach et al. .: " Handbook of medical treatment " ( Johnes Medical Publications )  :

["...

    a. Average total replacement dose  of insulin  in patients with IDDM ranges from  0.4 - 0.8 units/ kg  ( 70 kg x  0.6 =  42  units / day  !!! ) depending on diet and exercise.

   b. Conventional insulin therapies prescribe divided doses of insulin ... as approximately

2/3 total daily  insulin requirement to be given  before breakfast

( often  2 : 1 intermediate - acting : short acting )  and 1/3 top be given before the evening  

meal ( again 2:1 intermediate - acting  : short - acting ).

   c.  Divided dosing  is indicated  for all type I  diabetics reqiring  > 40 units insulin /day ..

[... It is usually good to split the daily insulin requirement into 2 or 3 doses, administated  before meals...]

  By measuring preprandial blood glucose levels, appropriate adjustments in the insulin dosage can be made gradually and further improvements in glycemic control can be achieved by adjusting feedings and   exercise.  .. " ]

C. Patter nr 1  - conventional therapy

     ( 1 ) Before  breakfast  :

             Insulin Mixtard  HM  Penfill  30      24 j .

     (2)  Before the evening meal :

             Insulin Mixtard HM Penfill 30        12 u

                                             .......................     

                                    Sum                             36 u

     
Patter nr 2  - conventional therapy

             ( 1 ) Before  breakfast  :

             Insulin Humulin M3                        30 u.

             (2)  Before the evening meal :

               Insulin Humulin N                      18 u

                                               ......................                

                                    Sum                        48 u

   Pattern 3  - Divided dosing 

         ( 1 ) Before  breakfast  :

             Insulin Acrapid  HM              12  u.

         ( 2 ) Before  lunch  :

             Insulin Acrapid  HM             12  u.

         ( 3 )  Before the evening meal :

             Insulin Actrapid  HM             8 u

         (4)  Beefore sleep

               Insulin  Insulatard HM      12 u

                                             .......................   .

                                        Sum            44  u  

[ Fragments of the text quoted bellow were taken from http://www.emedicine.com/med/topic916.htm ; another data were acquired from the manual : H.P. Wolff, T.R. Weihrauch - Internal medicine therapy   ] 

[" The non - toxic goiter { Synonyms and related keywords: goiter, multinodular goiter, adenomatous goiter, endemic goiter, sporadic goiter, nodular hyperplasia, diffuse or nodular enlargement of the thyroid gland, follicular epithelial hyperplasia, diffuse goiter, focal hyperplasia, thyroid-stimulating hormone, TSH, sporadic nontoxic goiter, cretinism, dyshormonogenesis }

Background.: A nontoxic goiter is a diffuse or nodular enlargement of the thyroid gland that does not result from an inflammatory or neoplastic process and is not associated with abnormal thyroid function. Endemic goiter is defined as thyroid enlargement that occurs in more than 10% of a population, and sporadic goiter is a result of environmental or genetic factors that do not affect the general population. ...   The thyroid gland is controlled by thyrotropin (TSH), secreted from the pituitary gland, which, in turn, is influenced by the thyrotropin-releasing hormone (TRH) from the hypothalamus. Thyrotropin permits growth, cellular differentiation, and thyroid hormone production and secretion by the thyroid gland via action on TSH receptors. Serum thyroid hormones levothyroxine and triiodothyronine feed back to the pituitary, regulating TSH production. Interference with this TRH-TSH thyroid hormone axis causes changes in the function and structure of the thyroid gland. Stimulation of the TSH receptors of the thyroid by TSH, TSH-receptor antibodies or TSH receptor agonists, such as chorionic gonadotropin, may result in a diffuse goiter. When a small group of thyroid cells, inflammatory cells, or malignant cells metastatic to the thyroid is involved, a thyroid nodule may develop.

A deficiency in thyroid hormone synthesis or intake leads to increased TSH production. Increased TSH causes increased cellularity and hyperplasia of the thyroid gland in an attempt to normalize thyroid hormone levels. If this process is sustained, a goiter is established. Causes of thyroid hormone deficiency include inborn errors of thyroid hormone synthesis, iodine deficiency, and goitrogens.

Goiter may result from a number of TSH receptor agonists. TSH receptor stimulators include TSH receptor antibodies, pituitary resistance to thyroid hormone, adenomas of the hypothalamus or pituitary gland, and tumors producing human chorionic gonadotropin....] 

 [ ... Medical Care: Small benign euthyroid goiters do not require treatment. The effectiveness of medical treatment using thyroid hormone for benign goiters is controversial. Large and complicated goiters may require medical and surgical treatment. Malignant goiters require medical and surgical treatment.

• The size of a benign euthyroid goiter may be reduced with levothyroxine suppressive therapy. The patient is monitored to keep serum TSH in a low but detectable range to avoid hyperthyroidism, cardiac arrhythmias and osteoporosis. The patient has to be compliant with monitoring. Some authorities suggest suppressive treatment for a definite time period instead of indefinite therapy. Patients with Hashimoto's thyroiditis respond better.

• Treatment of hypothyroidism or hyperthyroidism often reduces the size of a goiter.

• Thyroid hormone replacement is often required following surgical and radiation treatment of a goiter. Use of radioactive iodine for the therapy of nontoxic goiter has been disappointing and is controversial.

• Medical therapy of autonomous nodules with thyroid hormone is not indicated.

• Ethanol infusion into benign thyroid nodules has not been approved in the United States, but it is used elsewher

        Surgical Care: Surgery is reserved for the following situations:

• Large goiters with compression

• Malignancy

• When other forms of therapy are not practical or ineffective

Consultations: An endocrinologist should assess a patient at least once, and assessment should be even more frequently if the goiter is complicated by thyroid dysfunction or malignancy or if the patient is being considered for surgical management.

Diet: Nutrition plays a role in the development of endemic goiters. Dietary factors include iodine deficiency, goitrogens, protein malnutrition, and energy malnutrition. Often these factors occur concurrently.

• Iodine: If it is practical, treat endemic goiters in iodine-deficient regions with iodine supplementation in the diet and avoidance of goitrogens. Treatment with iodine supplementation or levothyroxine may reduce goiter size.

• Goitrogens

• Cyanoglucosides are naturally occurring goitrogens that are digested to release cyanide, which is converted to thiocyanate. Thiocyanate inhibits iodide transport in the thyroid and, at higher levels, inhibits organification. Foods that contain cyanoglucosides include cassava, lima beans, maize, bamboo shoots, and sweet potatoes.

• Thioglucosides are natural goitrogens found in the Cruciferae family of vegetables and weeds eaten by animals. When digested, they release thiocyanate and isothiocyanate, which have thionamidelike properties and are passed to humans via milk ingestion....]

[ ...Toxic nodular goiter (TNG) is the second most common cause of hyperthyroidism after Graves disease in the Western world. In areas of endemic iodine deficiency, it ranks first. TNG was originally described by Henry Plummer in 1913 and is also known as Plummer disease.  Pathophysiology: TNG represents a spectrum ranging from a single hyperfunctioning nodule within a thyroid that contains other nonfunctioning nodules to multiple areas of hyperfunction throughout the gland. In the latter case, distinguishing nonfunctioning nodules from extranodular thyroid tissue may not be possible.  The natural history of a multinodular goiter involves variable growth of individual nodules, with some resulting in hemorrhage and degeneration, followed by healing with fibrosis. Calcification may be found in areas of previous hemorrhage. The nodules are not encapsulated. Autonomously functioning nodules may become toxic in 10% of patients. Hyperthyroidism predominantly occurs in nodules larger than 3 cm in diameter. Signs and symptoms of TNG are similar to those of other types of hyperthyroidism....] 

Medicaments:

Potassium Iodid

    Jodid ( Merck )  100, 200, 500  ( 130,8 μg potassium iodid ; 216 μg ... )

    Iodox ( Berlin Chemie )  200  μg

    Jodostin ( Polpharma ) 100, 200

Synthetic thyroid hormone

Levothyroxine sodium

        Synthetic thyroxine is converted to the active form, triiodothyronine, in the pituitary

        by 5'-deiodinase. Inhibits production of thyrotropin, which is the main growth factor

        for the thyroid gland.

    Eltroxin ( Glaxo -UK )  50, 100  μg

    Euthyrox ( Merck ) 25,50,75,100,125,150,175,200,300  μg

    Eferox  ( Hexal ) 25,50,75,100,125,150 μg

    Letrox  ( Berlin - Chemie ) 25,50,100,150 μg

    Levoroxin  ( Polfa ) 100 μg

    Synthroid,

    Levoxyl,

    Levothroid

Liothyronine

    Thybon ( henning ) 20 , 100 μg

    Trijodothyronin BC 50  μg

Mixture of L-T₄ + L-T₃

    Novothyral  ( Merck ) 75, 100    μg

Thyreostatic medicaments- Antithyroid agents

 Tiamazol

      Thyrozol ( Merck )  5, 10, 20 mg

      Metizol  ( Polfa )       5 mg 

      [ Thiamazol inject  i.v.  ( Henning  )

         Favistan i.v. ]

 Karbimazol

      Methimazole ( Tapazole )  5, 10 mg

 Propylotiouracyl

     Propicil ( Solvay )  5 mg

     Thyrosan ( Sun Farm )  5 mg

 Sodium perchlorate 

     Irenat  ( Bayer ) drops 0,3 g / ml - 40 ml

MOPP (Mustargen [ie, mechlorethamine], Oncovin (ie, vincristine), procarbazine, and prednisone) is a 4-drug regimen developed by DeVita et al at the National Cancer Institute (NCI) in the mid 1960s. It was the first curative combination chemotherapy for HD.

ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine) was developed in Italy by Bonadonna et al in the early 1970s. This combination has now become the standard chemotherapy regimen for HD because it is associated with a very low incidence of sterility and leukemia, and it has been shown to be superior in terms of disease-free survival (DFS) in a head-to-head comparison with MOPP.

Alternating regimens (MOPP/ABVD) and hybrid regimens (MOPP/ABV) have been tested but were not found to be superior to ABVD.

Stanford V is a multidrug regimen developed at Stanford University consisting of doxorubicin, vinblastine, mustard, bleomycin, vincristine, etoposide, and prednisone. The drugs are administered weekly, alternating myelosuppressive and nonmyelosuppressive agents, for 12 weeks. Involved-field radiotherapy at the conclusion of the 12-week regimen is considered part of this regimen.

BEACOPP includes the following chemotherapeutic drugs: bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone. A dose-intensified version of BEACOPP, with higher doses of etoposide, Adriamycin, and cyclophosphamide and the addition of granulocyte colony-stimulating factor (G-CSF) for neutrophil support, also has been developed (escalated BEACOPP).     Although preliminary studies have shown encouraging results, both of these regimens, BEACOPP and escalated BEACOPP, are associated with a higher incidence of sterility and leukemogenesis.  Third-generation regimens (eg, Stanford V, BEACOPP) may improve the outcome of patients with advanced HD. Many investigators have advocated these more aggressive chemotherapy regimens.

Intermediate- and high-grade lymphomas  - Aggressive NHL

CHOP

Cyclophosphamide                 750 mg/m²/day i.v.          1 - day        21-  day

Doxorubicin (Adriamycin)        50 mg/m²/day i.v.          1 - day        21-  day

Vincristine                                1,4 mg/m²/day i.v.          1 - day        21-  day

Prednisone                               100 mg/day      p.o.         1- 5 day

Low-grade lymphomas -  Indolent NHL

Chlorambucile / Prednisone ( Knospe )

Cyclophosphamide/ Prednisone

Bendamustine

Fludarabine

Fludarabine/ Cyclophosphamide

Rituximab ( monoclonal antibody anti - CD20 )

Chlorambucil / Prednisone ( Knospe )

     Chlorambucile ( Leukeran ) 0,002 ( GlaxoSithKline )  18mg/m²  - 1 day

     Prednisone  75 mg , 50 mg, 25 mg  - 1, 2 , 3 day  -  repeated any 3 week

Hydroxycarbamidum

     Hydroxyurea medac (  Medac ) 0,5 g  [ 20 - 40 mg/ kg/ day ]

Interferon alfa (Interferon alfa-2a (Roferon-A) or alfa-2b (Intron A)  

Glivec

Melfalan

     Alkeran    0,25mg/kg     1-2-3-4 day

     Prednisolone   2 mg/kg  1-2-3-4 day

This Internet website will be developed !!!  

see also: examples of set of medicaments prescribed simultaneously often as a necessary ' therapeutic complex '

http://salve33.webpark.pl/treatment1.htm

Autor witryny:
 

prof. dr hab. n. med. Andrzej Brodziak