Deferoxamine Mesylate and Insulin glulisine Subcutaneous

• Generic Name: deferoxamine
• Dosage Forms: n.a.
• Other Brand Names: Desferal

Adjunctive therapy for acute iron intoxication.

Not a substitute for standard measures generally used, including GI decontamination (e.g., induction of emesis, gastric lavage, whole-bowel irrigation), suction and maintenance of airway, correction of acidosis, and control of shock with IV fluids, blood, oxygen, and vasopressors.

Recommended for patients with severe manifestations of iron intoxication (e.g., metabolic acidosis, repetitive vomiting, lethargy, coma, seizures, hypotension, GI bleeding, signs of shock) or serum iron concentration >500 mcg/dL; less serious ingestions may be treated with supportive care alone.

Treatment of chronic iron overload resulting from multiple transfusions in patients with thalassemia or other chronic anemias.

Long-term therapy may have beneficial effects on the liver (i.e., slow accumulation of hepatic iron, retard or eliminate progression of hepatic fibrosis).

In patients with thalassemia, long-term therapymay have beneficial effects on the heart (e.g., delay and/or prevent development of iron-associated cardiac disease, improve left ventricular function in patients with subclinical cardiac dysfunction, improve cardiac function in at least some patients with symptomatic cardiac disease ) and improve survival.

Initiate therapy early in the course of thalassemia (i.e., some clinicians recommend initiation of chelation therapy when serum ferritin concentrations reach 1000 ng/mL or child reaches the age of 3 years [see Pediatric Use under Cautions]) and monitor compliance closely; noncompliance with chelation regimen and failure to initiate therapy prior to development of irreversible tissue damage are associated with cardiac disease.

Diagnosis or treatment of aluminum-associated neurotoxicity and/or bone abnormalities in patients with chronic renal failure undergoing dialysis.

Has been used with some success for treatment of iron overload secondary to primary hemochromatosis. Phlebotomy is the method of choice for removal of excess iron; however, deferoxamine may be beneficial when phlebotomy is contraindicated.

Has been studied as a chelating agent for aluminum and its potential beneficial effects in patients with Alzheimer’s disease; not currently recommended for this use since existing evidence to support such use is weak and long-term chelation therapy may be associated with potentially serious adverse effects.

• Generic Name: insulin glulisine
• Dosage Forms: n.a.
• Other Brand Names: Apidra, Apidra OptiClik Cartridge, Apidra SoloStar Pen

Insulin glulisine is a fast-acting type of insulin. Insulin is one of many hormones that help the body turn the food we eat into energy. This is done by using the glucose (sugar) in the blood as quick energy. Also, insulin helps us store energy that we can use later. When you have diabetes mellitus, your body cannot make enough insulin or does not use insulin properly. So, you must take additional insulin to regulate your blood sugar and keep your body healthy. This is very important as too much sugar in the blood can be harmful to your health.

Insulin glulisine starts to work faster than some other types of insulin, and its effects do not last as long. It should act more like the insulin your body would normally produce. Because the effects of insulin glulisine are short-acting, your doctor may also prescribe a longer-acting insulin for you to use.

Insulin glulisine is available only with your doctor's prescription.