Long-term treatment of asthma. It may be used to prevent breathing problems in certain patients, including patients with night-time asthma, or breathing problems caused by exercise. It may be used for long-term treatment of chronic obstructive pulmonary disease (COPD). It may also be used for other conditions as determined by your doctor.
Salmeterol is a long-acting beta-agonist bronchodilator. It widens the airways in the lungs, which helps you breathe more easily.
Do NOT use Salmeterol if:
you are allergic to any ingredient in Salmeterol
you are using another medicine that has a long-acting beta-agonist (eg, fluticasone/salmeterol, formoterol) in it
you are having an asthma attack (eg, sudden severe onset or worsening of asthma symptoms such as chest tightness, cough, shortness of breath, wheezing)
Contact your doctor or health care provider right away if any of these apply to you.
Before using Salmeterol :
Some medical conditions may interact with Salmeterol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
if you are pregnant, planning to become pregnant, or are breast-feeding
if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you have had a severe allergic reaction to milk protein
if you have a history of liver problems, diabetes, heart problems (eg, fast or irregular heartbeat, heart blood vessel problems), high blood pressure, low blood potassium levels, seizures, an adrenal gland tumor (pheochromocytoma), or an overactive thyroid
if you have recently been to an emergency room for asthma, have a history of frequent hospitalizations for asthma, or have ever had a life-threatening asthma attack
if you have had an unusual reaction to a sympathomimetic medicine (eg, albuterol, pseudoephedrine), such as fast or irregular heartbeat, overexcitement, or severe trouble sleeping
if you are taking a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) or a tricyclic antidepressant (eg, amitriptyline) or you have taken any of these medicines within the last 14 days
Some MEDICINES MAY INTERACT with Salmeterol. Tell your health care provider if you are taking any other medicines, especially any of the following:
Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood potassium or irregular heartbeat may be increased
Catechol-O-methyltransferase (COMT) inhibitors (eg, entacapone), long-acting beta-agonists (eg, fluticasone/salmeterol, formoterol), MAOIs (eg, phenelzine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of Salmeterol 's side effects
Beta-blockers (eg, propranolol) because they may decrease Salmeterol 's effectiveness or worsen your condition
This may not be a complete list of all interactions that may occur. Ask your health care provider if Salmeterol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Salmeterol :
Use Salmeterol as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Salmeterol comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Salmeterol refilled.
Always activate and use this device in a level, horizontal position. Do NOT try to use a spacer device with Salmeterol.
To prepare the device for use, open the protective foil pouch and remove the inhaler device. Hold the device in one hand. Use the thumb of the opposite hand to push the thumbgrip as far away from you as it will go. The mouthpiece will appear and snap into position.
Hold the device in a level, flat position with the mouthpiece towards you. Use your thumb to slide the lever away from you as far as it will go. You should hear a click. The device is now ready for use.
Do NOT close or tilt the device, play with the lever, or move the lever more than once. You may accidentally release or waste a dose.
To use a dose of Salmeterol , hold the inhaler level and away from your mouth. Breathe out fully. Do NOT exhale into the device for any reason. Put the mouthpiece to your lips. Breathe in quickly and deeply through your mouth and hold your breath. Remove the inhaler from your mouth. Continue to hold
your breath for 10 seconds or as long as possible. Then, breathe out
slowly.
Close the device when you are finished taking a dose. Slide the thumbgrip back towards you as far as it will go. The device will click shut, and the lever will return to its original position.
Salmeterol delivers your dose as a very fine powder. Most, but not all, patients can taste or feel it. Even if you cannot feel it, do not use more than the recommended dose. If you are not sure if you are receiving your dose, contact your doctor or pharmacist.
If you are using Salmeterol to prevent breathing problems caused by exercise, use it at least 30 minutes before you start to exercise. Do not use another dose for at least 12 hours. If you already use Salmeterol twice daily on a regular basis, do NOT take an extra dose before you exercise.
Discard the inhaler 6 weeks after removing it from the protective foil pouch or after all the blisters have been used, whichever comes first.
The dose indicator on the device will tell you how many doses are left. The dose indicator will read "0" when all the blisters have been used.
Never wash the mouthpiece or any other part of the inhaler. Keep it dry and always store it in a dry place.
Do NOT try to take the unit apart.
Continue to use Salmeterol even if you feel well. Do not miss any doses.
If you miss a dose of Salmeterol , skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Salmeterol.
Important safety information:
Salmeterol may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Salmeterol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
Salmeterol will not stop an asthma attack once it has already started. Be sure to carry a short-acting bronchodilator with you at all times to treat any breathing problems that may occur between doses of Salmeterol (eg, severe or sudden onset of wheezing or shortness of breath). If you have any
questions about which medicines stop asthma attacks, check with your
doctor or pharmacist.
If you have been regularly using a short-acting bronchodilator inhaler (eg, albuterol), talk with your doctor about how to use it with Salmeterol. Short-acting bronchodilators are normally only used with Salmeterol to treat breathing problems that may occur between doses.
The risk of serious heart problems (eg, irregular heartbeat) may be greater if you use Salmeterol in high doses. Do NOT use more than the recommended dose or use more often than prescribed.
If your symptoms do not get better within 1 week of starting Salmeterol , or if they get worse, contact your doctor right away.
Tell your doctor at once if you notice that your short-acting bronchodilator inhaler does not work as well, if you need to use it often (eg, 4 or more times a day for more than 2 days in a row; more than 1 canister in 8 weeks), or if you have a decrease in your peak flow meter results.
Contact your doctor or seek medical care right away if you have breathing problems that worsen quickly, or if you use your short-acting bronchodilator and do not get relief.
Salmeterol is not to be used in place of a corticosteroid. If you are using a corticosteroid medicine for asthma, do not stop or reduce the dose unless your doctor tells you to.
Talk with your doctor or pharmacist about all of your asthma medicines and how to use them. Do not start, stop, or change the dose of any asthma medicine unless your doctor tells you to.
Salmeterol may sometimes cause severe breathing problems right after you use a dose. If this happens, use your short-acting bronchodilator. Contact your doctor or seek other medical care at once.
Diabetes patients - Salmeterol may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
Lab tests, including lung function tests and blood pressure, may be performed while you use Salmeterol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
Use Salmeterol with caution in the ELDERLY; they may be more sensitive to its effects, especially effects on the heart.
Salmeterol should be used with extreme caution in CHILDREN younger than 4 years old; safety and effectiveness in these children have not been confirmed.
PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Salmeterol while you are pregnant. It is not known if Salmeterol is found in breast milk. If you are or will be breast-feeding while you use Salmeterol , check with your
doctor. Discuss any possible risks to your baby.
Possible side effects of Salmeterol :
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, tongue, or throat; unusual hoarseness); chest pain; choking; fast or irregular heartbeat; fever; new or worsening asthma symptoms (eg, increased chest tightness, coughing, shortness of breath, or wheezing); overexcitement; severe or persistent
headache or dizziness; severe or persistent muscle pain or cramps.
What is the shelf life of the pills?
The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.
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Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity.
Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.
Erectile dysfunction was once a taboo subject, but more men are seeking help. Doctors are gaining a better understanding of what causes erectile dysfunction and are finding new and better treatments.
This Website discusses all about erectile dysfunction, physiology of the normal erection and the pathophysiology, and treatment of ED.
What is Erectile Dysfunction?
Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.
The causes may be physiological or psychological. Psychological impotence can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.
Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.
The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.
Signs and symptoms:
Erectile dysfunction is characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland).
Here are some causes of Erectile Dysfunction:
* Arousal: The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts.
* Nervous system response: The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.
* Blood vessel response:. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.
Physiology of normal erections:
Penile erections involve an integration of complex physiologic processes involving the CNS, peripheral nervous system, and hormonal and vascular systems. Any abnormality involving these systems, whether from medication or disease, has a significant impact on the ability to develop and sustain an erection, ejaculate, and experience orgasm. Tumescence, the vascular filling of the cavernous bodies, relies on neural and hormonal mechanisms operating at various levels of the neural axis. This is unique among visceral functions because it requires central neurological input.
Andersson et al summarized some of the information related to the pathways involved in erectile function. The degree of contraction of corpus cavernosal smooth muscle determines the functional state of the penis. The balance between contraction and relaxation is controlled by central and peripheral factors that involve many transmitters and transmitter systems. At the cellular level, smooth muscle relaxation occurs following the release of acetylcholine from the parasympathetic nerves.
Pathophysiology of erectile dysfunction:
Erectile Dysfunction is essentially a vascular disease. It is often associated with other vascular diseases and conditions such as diabetes, hypertension, and coronary artery disease. Other conditions associated with Erectile Dysfunction include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypertension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in arterial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders.
Treatment:
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