Glucosamine Chondroitin Advanced MSM and Norepinephrine Bitartrate

• Generic Name: chondroitin / glucosamine / methylsulfonylmethane
• Dosage Forms: n.a.
• Other Brand Names: Glucosamine & Chondroitin with MSM, Glucosamine Chondroitin Advanced, Osteo Bi-Flex Advanced, Osteo Bi-Flex Plus MSM, Glucosamine Chondroitin MSM Complex, Duraflex

Chondroitin is a naturally occurring substance formed of sugar chains. Chondroitin is believed to help the body maintain fluid and flexibility in the joints.

Glucosamine is a naturally occurring substance that is believed to help develop and renew cartilage (the hard connective tissue mainly located on bones near joints in the body), and keep it lubricated for better joint movement and flexibility.

Methylsulfonylmethane (MSM) is a naturally occurring form of sulfur that helps support muscles and tendons in the body.

Chondroitin, glucosamine, and MSM is a combination medicine that has been used in alternative medicine as a possibly effective aid in treating osteoarthritis, muscle damage caused by exercise, and other inflammatory joint disorders.

It is not certain whether chondroitin, glucosamine, and MSM is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. This product should not be used in place of medication prescribed for you by your doctor.

Chondroitin, glucosamine, and MSM is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Chondroitin, glucosamine, and MSM may also be used for purposes not listed in this product guide.

• Generic Name: norepinephrine
• Dosage Forms: n.a.
• Other Brand Names: Levophed, Levophed Bitartrate

Used as adjunctive therapy to produce vasoconstriction and maintain BP in the management of certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, MI, septicemia, blood transfusion, drug reactions).

Pressor therapy is not a substitute for replacement of blood, plasma, fluids, and/or electrolytes. Correct blood volume depletion as fully as possible before administration.

The Surviving Sepsis Campaign International Guidelines for Management of Sepsis and Septic Shock recommend norepinephrine as the vasopressor of choice in adults with septic shock; if adequate BP not achieved, vasopressin or epinephrine may be added. Vasopressin also may be given in conjunction with norepinephrine to reduce dosage requirements of norepinephrine.

Also used to provide vasopressor support in other types of shock (e.g., cardiogenic, hemorrhagic), generally as a temporary measure until underlying cause can be treated.

In patients who are hypotensive from blood volume deficits, manufacturer states to use norepinephrine only as an emergency measure to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed.

Early revascularization is standard of care in patients with cardiogenic shock; individualize use of vasopressors in this setting.

Has been used to treat hypotension during spinal anesthesia; however, other vasopressors with a longer duration (e.g., phenylephrine) more commonly used.

Used adjunctively in the management of cardiac arrest to restore and maintain adequate BP after an effective heartbeat and ventilation have been established by other means.

High-quality CPR and defibrillation are the only proven interventions to increase survival to hospital discharge in ACLS. Other resuscitative efforts, including drug therapy, are considered secondary and should be performed without compromising the quality and timely delivery of chest compressions and defibrillation.

Principal goal of pharmacologic therapy during cardiac arrest is to facilitate the return of spontaneous circulation (ROSC), and epinephrine is the drug of choice for this use. Vasoactive drugs such as norepinephrine may be used for hemodynamic support following resuscitation.