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methacholine chloride
Overview
What is Provocholine?
Provocholine is a parasympathomimetic (cholinergic) bronchoconstrictor agent to be administered in solution only, by inhalation, for diagnostic purposes. Each 20 mL vial contains 100 mg of methacholine chloride powder which is to be reconsituted with 0.9% sodium chloride injection or 0.9% sodium chloride injection containing 0.4% phenol (pH 7.0). See DOSAGE AND ADMINISTRATION for dilution procedures, concentrations and schedule of administration.
What does Provocholine look like?
What are the available doses of Provocholine?
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What should I talk to my health care provider before I take Provocholine?
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How should I use Provocholine?
Provocholine is indicated for the diagnosis of bronchial airway hyperreactivity in subjects who do not have clinically apparent asthma.
Before Provocholine Inhalation challenge is begun, baseline pulmonary function tests must be performed. A subject to be challenged must have an FEV of at least 70% of the predicted value.
100 MG: DILUTION SEQUENCE-MULTIPLE PATIENT TESTING (2-5 PATIENTS)
[Requires 2 vials of Provocholine)
100 MG: DILUTION SEQUENCE SINGLE PATIENT TESTING
Dilutions A through D should be stored at 36° to 46°F (2° to 8°C) in a refrigerator and can be stored for not more than 2 weeks. [The unreconstituted powder should be stored at 59°F to 86°F (15° to 30°C)]. After this time, discard the vials and prepare new dilutions. Freezing does not affect the stability of dilutions A through D. Vial E must be prepared on the day of challenge.
A Sterile bacterial-retentive filter (porosity 0.22µm) should be used when transferring a solution from each vial (at least 2mL) to a nebulizer.
Procedure:
The challenge is performed by giving a patient ascending serial concentrations of Provocholine. At each concentration, five breaths are administered by a nebulizer that permits intermittent delivery time of 0.6 seconds by a breath-actuated timing device (dosimeter).
At each of five inhalations of a serial concentration, the patient begins at functional residual capacity (FRC) and slowly and completely inhales the dose delivered. Within 5 minutes, FEV values are determined. The procedure ends either when there is a 20% or greater reduction in FEV compared with the baseline sodium chloride solution value (i.e., a positive response) or if 188.88 total cumulative units have been administered (see table below) and the FEV has been reduced by 14% or less (i.e., a negative response). If there is a reduction of 15% to 19% in the FEV compared with baseline, either the challenge may be repeated at that concentration or a higher concentration may be given as long as the dosage administered does not result in total cumulative units exceeding 188.88.
The following is a suggested schedule for the administration of Provocholine. Cumulative units are calculated by multiplying the number of breaths by the concentration administered.
Total cumulative units is the sum of cumulative units for each concentration administered.
An inhaled beta-agonist may be administered after Provocholine challenge to expedite the return of the FEV to baseline and to relieve the discomfort of the patient. Most patients revert to normal pulmonary function within 5 minutes following bronchodilators or within 30 to 45 minutes without any bronchodilator.
What interacts with Provocholine?
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What are the warnings of Provocholine?
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What are the precautions of Provocholine?
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What are the side effects of Provocholine?
Sorry No records found
What should I look out for while using Provocholine?
Provocholine is contraindicated in patients with known hypersensitivity to this drug or to other parasympathomimetic agents.
Inhalation challenge should not be performed in patients receiving any beta-adrenergic blocking agent because in such patients responses to methacholine chloride can be exaggerated or prolonged, and may not respond as readily to accepted modalities of treatment (see WARNINGS box).
What might happen if I take too much Provocholine?
Provocholine is to be administered only by inhalation. When administered orally or by injection, overdosage with methacholine chloride can result in a syncopal reaction, with cardiac arrest and loss of consciousness. Serious toxic reactions should be treated with 0.5 mg to 1 mg of atropine sulfate, administered IM or IV.
50
How should I store and handle Provocholine?
Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from moisture. Keep this and all medication out of the reach of children.Repackaged by Preferred Pharmaceuticals, Inc.Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from moisture. Keep this and all medication out of the reach of children.Repackaged by Preferred Pharmaceuticals, Inc.Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from moisture. Keep this and all medication out of the reach of children.Repackaged by Preferred Pharmaceuticals, Inc.Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from moisture. Keep this and all medication out of the reach of children.Repackaged by Preferred Pharmaceuticals, Inc.Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from moisture. Keep this and all medication out of the reach of children.Repackaged by Preferred Pharmaceuticals, Inc.Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]Protect from moisture. Keep this and all medication out of the reach of children.Repackaged by Preferred Pharmaceuticals, Inc.Overbagged with 10 tablets per bag, NDC 55154-7638-0StorageStore montelukast 4-mg chewable tablets, 5-mg chewable tablets and 10-mg film-coated tablets at 25°C (77°F), excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. Protect from moisture and light. Store in original package.Overbagged with 10 tablets per bag, NDC 55154-7638-0StorageStore montelukast 4-mg chewable tablets, 5-mg chewable tablets and 10-mg film-coated tablets at 25°C (77°F), excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. Protect from moisture and light. Store in original package.Overbagged with 10 tablets per bag, NDC 55154-7638-0StorageStore montelukast 4-mg chewable tablets, 5-mg chewable tablets and 10-mg film-coated tablets at 25°C (77°F), excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. Protect from moisture and light. Store in original package.
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
Methacholine chloride is the ß-methyl homolog of acetylcholine and differs from the latter primarily in its greater duration and selectivity of action. Bronchial smooth muscle contains significant parasympathetic (cholinergic) innervation.
Non-Clinical Toxicology
Provocholine is contraindicated in patients with known hypersensitivity to this drug or to other parasympathomimetic agents.Inhalation challenge should not be performed in patients receiving any beta-adrenergic blocking agent because in such patients responses to methacholine chloride can be exaggerated or prolonged, and may not respond as readily to accepted modalities of treatment (see WARNINGS box).
Drug Interactions:
Adverse reactions associated with 153 inhaled methacholine chloride challenges include one occurrence each of headache, throat irritation, light headedness and itching.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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