Hyoscyamine Sulfate and Oritavancin Diphosphate

• Generic Name: hyoscyamine
• Dosage Forms: n.a.
• Other Brand Names: Anaspaz, Cystospaz, Hyosyne, Levbid, Levsin, Levsinex, NuLev, Symax, Ed Spaz, Symax SR, Levsin SL, Cystospaz-M, Levsinex SR, Symax SL, A-Spas S/L, Donnamar, Hyosol, NuLev, Spasdel, IB-Stat, Hyospaz, Symax Duotab, Symax FasTab, HyoMax SL, HyoMax SR, HyoMax FT, HyoMax DT, HyoMax, Oscimin, A-Spaz, Levsin/SL, Colidrops, Symax FasTabs

Adjunct in the treatment of peptic ulcer disease; however, no conclusive data that it aids in the healing, decreases the rate of recurrence, or prevents complications of peptic ulcers. In patients with gastric ulcer, antimuscarinics may delay gastric emptying and result in antral stasis.

Adjunct in the treatment of functional GI disorders such as irritable bowel syndrome; however, efficacy is limited. Use only if other measures (e.g., diet, sedation, counseling, amelioration of environmental factors) have been of little or no benefit. Also has been used in combination with phenobarbital in the treatment of irritable bowel syndrome; however, such combined therapy lacks substantial evidence of efficacy.

Use with caution, if at all, in the treatment of hypermotility and diarrhea associated with GI disorders such as ulcerative colitis, dysentery, shigellosis, and Clostridium difficile-associated diarrhea and colitis (also known as antibiotic-associated pseudomembranous colitis).

Adjunctive therapy in the management of hypermotility disorders of the lower urinary tract. May provide symptomatic relief, but the underlying cause should be determined and specifically treated.

With the exception of uninhibited or reflex neurogenic bladder, there is generally little evidence to support use of antimuscarinics in the treatment of various GU disorders.

Treatment of infant colic; however, minimal evidence of efficacy with antimuscarinics. Infant colic is considered a benign, self-limiting condition that tends to resolve spontaneously and not require medical treatment.

Has been used to inhibit salivation and excessive secretions of the respiratory tract; however, current surgical practice (e.g., using thiopental [no longer commercially available in the US], halothane, or similar general anesthetics that do not stimulate salivary and tracheobronchial secretions) has reduced the need to control excessive respiratory secretions during surgery.

Has been used prophylactically to reduce volume and acidity of gastric secretions and to prevent acid-aspiration pneumonitis during surgery; however, antimuscarinics not shown to be effective for this use.

May be used to block cardiac vagal inhibitory reflexes during induction of anesthesia and intubation, thus preventing cholinergic effects during surgery (e.g., cardiac arrhythmias, hypotension, bradycardia) secondary to visceral traction (resulting in vagal stimulation), carotid sinus stimulation, or concomitant drugs (e.g., succinylcholine).

Used to block adverse muscarinic effects of anticholinesterase agents that are used after surgery to terminate curarization.

Used parenterally as an antidote in the treatment of cholinesterase inhibitor toxicity.

Also used orally or sublingually in the treatment of cholinesterase inhibitor toxicity.

Concomitantly with a cholinesterase reactivator (pralidoxime chloride) to reverse muscarinic effects associated with toxic exposure to anticholinesterase compounds (e.g., organophosphate pesticides). However, other antimuscarinics (principally atropine) are used more commonly.

Facilitation of endoscopy or hypotonic duodenography by reducing GI motility; however, glucagon appears to be more effective and generally is preferred.

Has been used to increase visualization of the urinary tract in excretion urography.

Do not rely on antimuscarinics for relief of biliary tract disorders (e.g., combined with opiates for biliary colic) because of weak biliary antispasmodic action.

Has been used to reduce pain and hypersecretion in pancreatitis; however, there is little, if any, evidence that antimuscarinics improve the prognosis of the disease.

Has been used as a drying agent in the relief of symptoms of acute rhinitis.

Adjunctive therapy in the treatment of parkinsonian syndrome to reduce rigidity and tremors and to control associated sialorrhea and hyperhidrosis.

Has been used in conjunction with morphine or other opiates for the symptomatic relief of renal colic.

May be useful in some patients in the treatment of partial heart block associated with vagal activity.

• Generic Name: oritavancin
• Dosage Forms: n.a.
• Other Brand Names: Orbactiv

Treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible Staphylococcus aureus (including methicillin-resistant S. aureus [MRSA; also known as oxacillin-resistant S. aureus or ORSA] and methicillin-susceptible S. aureus), Streptococcus pyogenes (group A β-hemolytic streptococci, GAS), S. agalactiae (group B streptococci, GBS), S. dysgalactiae, S. anginosus group (includes S. anginosus, S. intermedius, and S. constellatus), or vancomycin-susceptible Enterococcus faecalis.