Advair Diskus 250/50 and Physostigmine Salicylate

• Generic Name: fluticasone / salmeterol
• Dosage Forms: aerosol, metered
• Other Brand Names: Advair Diskus, Advair HFA, AirDuo RespiClick, Wixela Inhub

Fluticasone and salmeterol is a combination of two medicines that are used to help control the symptoms of asthma and improve breathing. It is used when a patient's asthma has not been controlled sufficiently on other asthma medicines, or when a patient's condition is so severe that more than one medicine is needed every day. This medicine will not relieve an asthma attack that has already started.

This medicine is also used to treat air flow blockage and reduce the worsening of chronic obstructive pulmonary disease (COPD). This includes chronic bronchitis and emphysema.

Inhaled fluticasone belongs to the family of medicines known as corticosteroids or steroids (cortisone-like medicines). It works by preventing certain cells in the lungs and breathing passages from releasing substances that cause asthma symptoms.

Inhaled salmeterol is a long-acting bronchodilator. Bronchodilators are medicines that are breathed in through the mouth to open up the bronchial tubes (air passages) in the lungs. It relieves cough, wheezing, shortness of breath, and troubled breathing by increasing the flow of air through the bronchial tubes.

This medicine must be used with a short-acting medicine (eg, albuterol) for an asthma attack or asthma symptoms that need attention right away.

This medicine is available only with your doctor's prescription.

• Generic Name: physostigmine
• Dosage Forms: n.a.
• Other Brand Names: Antilirium

Carefully weigh risks and potential benefits of physostigmine therapy when making individual decisions about its use since serious adverse effects (including seizures and asystole) may occur with physostigmine therapy.

The manufacturers state that physostigmine is used to reverse CNS effects resulting from clinical or toxic dosages of drugs (e.g., some antihistamines, antimuscarinics, antiparkinsonian agents, phenothiazines) capable of producing anticholinergic syndrome and from intoxication with certain plants (e.g., Atropa belladonna [deadly nightshade], Brugmansia species [angels’ trumpet], Datura stramonium [jimsonweed, thorn apple, locoweed], Lantana camara). However, routine use not recommended because of potentially serious adverse effects (e.g., seizures, bronchospasm, bradycardia, asystole); many clinicians advise to reserve use for treatment of severe or life-threatening symptoms (e.g., extensive delirium or agitation, hallucinations, hyperthermia, severe sinus or supraventricular tachycardia, seizures) in patients who fail to respond to alternative therapy.

Has also been used successfully in the treatment of tricyclic antidepressant-induced anticholinergic toxicity, but currently is rarely used because of potentially serious adverse effects (seizures, bronchospasm, bradycardia, asystole). Precise role controversial; most clinicians advise against the routine use of physostigmine in tricyclic intoxication, and some clinicians recommend to reserve use only for life-threatening anticholinergic symptoms refractory to other treatment.

Treatment to reverse anticholinergic effects (e.g., delirium, prolonged somnolence) produced by atropine and/or scopolamine preanesthetic medications.

Has been used with variable results in the treatment of dementia of the Alzheimer’s type (Alzheimer’s disease), alone or combined with lecithin.

Has been used for the treatment of Friedreich’s ataxia and other hereditary ataxias (spinocerebellar degenerations) (designated an orphan drug by FDA for these uses).