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· Antiperspirants Cure for hyperhidrosis |
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Benztropine (Cogentin) -- Blocks receivers of cholinergic of striatal; can help cholinergic of equilibrium and activity of dopaminergic plantar hyperhidrosis in the striatum.
The adult Dose1-2 EVEN mg/D; not to exceed 6 mg/D
The pediatric Dose did not recommend
The counter-indications They documented the ultrasensibilidad to the product or products related; colitis of ulcerative; glaucoma of narrow-angle; the tract obstruction illness of GI or urinary tract; atony intestinal of older people or patients weakened; gravis of miastenia; megacolon toxic; the unstable cardiovascular adjustment in the sharp hemorrhage
The interactions They diminish the effects of levodopa; concurrent antacids diminish the effects; disopyramide concurrent, TCAs, phenothiazides, the corticosteroids, atenolol, digoxin, bretylium, or other drugs with the toxicity of the increase of the activity of anticholinergic; can diminish the efficacy of phenothiazides
The embarrassment C - the Security for the use during the embarrassment has not been established.
The precautions They notify in renal, CNS, or the liver illness; the care in patients and geriatric patients with the syndrome of Down; can cause the urinary retention, the arrhythmia, dysfunction of CNS, plantar hyperhidrosis the visual changes, xerostomia, the constipation, or intolerance of heat
The confusion can occur in geriatric patients; diarrhea can be the early symptom of incomplete intestinal obstruction (in this case, the processing with propantheline would be outside of place and possibly damaging); autonomous neuropathy can occur; the care in the concomitant administration of alkaloids of nightshade, of agents of anticholinergic of synthetic/semisynthetic, of analgesic narcotics, of the type 1 antiarrhythmics, of the antihistamínicos, of phenothiazines, of TCAs, or of other drugs additional adverse effects include heart failure congestiva, heart illness of coronary, the liver or renal illness, rupture of hiatal associate esophagitis of reflux, the hypertension, and the hipertiroidismo
Drug the Name
Oxybutynin (Ditropan) -- Inhibits the action of acetylcholine in the smooth muscle and has the direct antispasmodic effect in smooth muscles.
The adult Dose5 offering/tid of PAIR of mg; not to exceed 5 qid of mg
Pediatric dose<5 years: Done not it establish
>5 years: 5 offering/tid of mg
The counter-indications They documented the ultrasensibilidad to the product or products related; colitis of ulcerative; glaucoma of narrow-angle; the tract obstruction illness of GI or urinary tract; atony intestinal of older people or patients weakened; gravis of miastenia; megacolon toxic; the unstable cardiovascular adjustment in the sharp hemorrhage
The Effects of interactions diminish with concurrent antacids; disopyramide concurrent, TCAs, phenothiazides, the corticosteroids, atenolol, digoxin, bretylium, or other drugs with the toxicity of the increase of the activity plantar hyperhidrosis of anticholinergic; can diminish the efficacy of phenothiazides
The embarrassment B - Generally sure but the benefits should they weigh more than the risks.
The precautions They notify in renal, CNS, or the liver illness; the care in patients and geriatric patients with the syndrome of Down; can cause the urinary retention, the arrhythmia, dysfunction of CNS, the visual changes, xerostomia, the constipation, or intolerance of heat
The confusion can occur in geriatric patients; diarrhea can be the early symptom of incomplete intestinal obstruction (in this case, the processing with propantheline would be outside of place and possibly damaging); autonomous neuropathy can occur; the care in the concomitant administration of alkaloids of nightshade, of agents of anticholinergic of synthetic/semisynthetic, of analgesic narcotics, of the type 1 antiarrhythmics, of the antihistamínicos, of phenothiazines, of TCAs, or of other drugs additional adverse effects include heart failure congestiva, heart illness of coronary, the liver or renal illness, rupture of hiatal associate esophagitis of reflux, the hypertension, and the hipertiroidismo
Drug the Category: The agents to block of Neuromuscular -- These agents inhibit the nerve impulses broadcast in the junction of neuromuscular of skeletal muscle and/or autonomous ganglions.
Drug the Name
Toxin of toxin botulínica A (BOTOX®) -- Prevents the calcium-dependent liberation of acetylcholine and produces a state of denervation in the junction of neuromuscular and postganglionic nice nerves of cholinergic in the glands hyperhidrosis treatments.
Each injection produces an area of anhydrosis approximately 1,2 cm of diameter. Has as a result to last of anhydrosis 4-12 mo (Shelley, 1998).
The toxin toxin injections botulínica should be repeated in varying intervals to maintain the long-term results.
Hyperhidrosis adult of Obvious Dose:50 injections of subepidermal of 2 OR by palm (totals 100 OR by palm)
Axillary hyperhidrosis: 50 OR of intradermally of toxin of toxin botulínica each axilla
The pediatric Dose did not establish
The counter-indications They documented the ultrasensibilidad
The interactions Aminoglycosides or the drugs that intervene with the broadcast of neuromuscular can promote the effects
The embarrassment C - the Security for the use during the embarrassment has not been established.
The precautions They do not exceed the dose and the frequencies recommended of the administration; the presence of antibodies to the toxin of the toxin botulínica types A can reduce the effects of the therapy; the weakness of thumb and weakness of temperate transitory muscle in toxin-treated places can occur but they can be resolved inside 2-5 sem.
The Secciónde SEGUIMIENTO8 of 10 Click for here go to the prior section in this Click of the theme for here go to the top of this Click of page for here go to the next section in this theme
Write Clinical Differential Monitoring Information Introduction of Medicine of Processing of Workup Various Bibliography
The additional Impatient Care:
* Sympathectomy requires an impatient one remains.
The additional plantar hyperhidrosis Care of the outpatient:
* Many of the options of the processing require they repeat the visits to the dermatologist to continue the care (p.and., repeated injections of toxin botulínica, they fill the prescriptions) and for evaluate the therapeutic progress.
The complications:
* The Severe cases of hyperhidrosis can affect adversly the quality of patient of the life causing great emotional grief, the social confusion, and the incapacity of work-related (due to hyperhidrosis of palmoplantar).
* To Sweat of Palmoplantar can have as a result irritation of the skin affected, ultimately carrying to be grazed.
* Hyperhidrosis of Axillary can be smelly, causing the social confusion.
The forecast:
* Hyperhidrosis is difficult to treat really.
* With the newest modalities of the now available processing, the patient has numerous options and is offered a better forecast.
The patient Education:
* Patient they should be educated considering all the options of the processing, inclusive their complications and corresponding costs.
* For excellent patient resources of education, visit the Center of Procedures of eMedicine. Also, it sees patient article of education of eMedicine BOTOX® Injections.
The SecciónVARIADA9 of 10 Click for here go to the prior section in this Click of the theme for here go to the top of this Click of page for here go to the next section in this theme
Write Clinical Differential Monitoring Information Introduction of Medicine of Processing of Workup Various Bibliography
Medical/legal traps:
* The failure to seek for causes sistémicas for the hyperhidrosis with a plantar hyperhidrosis beginning then in life is a trap.
* The failure to seek for causes sistémicas of hyperhidrosis generalized is a trap.
* The failure to recognize the conditions that fundamental is a trap that can have as a result the unnecessary patient inconvenience and the ineffective processing. The correction of fundamental conditions can be resolved hyperhidrosis.
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