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Q: Diseases requiring daily injections ( Answered,   0 Comments )
Question  
Subject: Diseases requiring daily injections
Category: Reference, Education and News
Asked by: mrsmith5678-ga
List Price: $30.00
Posted: 31 Jan 2003 10:53 PST
Expires: 02 Mar 2003 10:53 PST
Question ID: 155706
I'm looking for a list of diseases who's sufferers require daily (or
frequent)injections of non refrigerated medication.

Request for Question Clarification by pafalafa-ga on 31 Jan 2003 12:25 PST
There appear to be a few (not many) that fall into this category, but
it's near impossible to be comprehensive in an answer.  How many
diseases/medicine would you consider an acceptable answer?  Can you
live with some uncertainity that not all diseases meeting your
description may have been listed?

Request for Question Clarification by knowledge_seeker-ga on 31 Jan 2003 12:31 PST
One further question --

By "daily injections" do you mean long-term and/or life-long?  

Or would diseases that need short-term treatment apply to your answer?
For example, some therapies may require daily injections for say, 10
days.

Let us know -

Thanks - K~

Request for Question Clarification by librariankt-ga on 31 Jan 2003 12:39 PST
Also, do you just want the name of the disease, or the disease with
the name of the injected medication?  I am not clear on what
medications must be refrigerated versus what do not have to be, so
would be tempted to give you records that include both.  And they
would look like this:

Venous thromboembolism (venous thrombosis & pulmonary embolism) -
heparin
Diabetes mellitus - insulin

There are also a number of experimental cancer treatments that involve
daily injections of drugs - are these of interest? What about daily
injections of hormones (such as human growth hormone) for people who
are deficient?


librariankt

Clarification of Question by mrsmith5678-ga on 03 Feb 2003 07:15 PST
I would prefer diseases that are either long term or life long as
opposed to short term.  Also - please include experiemtal treatments,
and any other condition or circumstance that would require daily or
frequent injections over a long term (over 6-12 months).

If it isn't possible to separate refrigerated vs non, I can live with
that.  I am most interested in identifying the conditions, but if the
information about the medications (hormones, etc) is there, it would
certainly be helpful.
Answer  
Subject: Re: Diseases requiring daily injections
Answered By: pafalafa-ga on 05 Feb 2003 08:48 PST
 
Mrs. Smith,

Thank you for a very intriguing question.  

I must admit to a growing sense of curiosity as to why you specified
the three conditions you did – long term illness, daily injections,
and non-refrigerated medicine.  The last, in particular, is unusual,
but it also makes the question answerable, as it narrows the field
considerably out of the thousands of medications available for
long-term therapies.

Most injectable medicines that are being stored for the long term come
with recommendations that they be refrigerated.  However, a small
number of such medicines can be stored without refrigeration and some
must expressly not be refrigerated, as the cold can damage the
medication.

A caution is in order.  I am not a doctor, nor have I verified the
reliability of the sites and the information I have found.  Please do
not base any medical decisions on the information here, without
consulting a doctor first.
  
Here are the few descriptions I found that seem to meet your criteria.
 All text is taken directly from the website, expect for bracketed
text [ ] which is my own comments:


-----
http://onsopcontent.ons.org/PDFs/images/Library/ons_publications/cjon/2002/May_June_2002/175-176.pdf

Amifostine as a Radioprotectant

Amifostine is used as a radioprotectant in patients undergoing
postoperative radiation therapy for head and neck cancer, where the
radiation port includes a substantial portion of the parotid glands to
reduce or prevent acute or late xerostomia.  Amifostine also is used
in conjunction with chemotherapy to decrease the incidence or severity
of neurotoxicity, nephrotoxicity, and hematologic toxicity.

Route and dosage: For patients undergoing radiation therapy for
squamous cell carcinoma of the head and neck, amifostine is given as a
daily injection 15–30 minutes prior to radiotherapy every day at a
dose of 200 mg/m2.

Stability: Amifostine can be stored at room temperature prior to
reconstitution.
Once reconstituted, it is stable up to five hours at room temperature
or up to 24 hours refrigerated.

-----

http://www.thepvd.org/shows/evolving%20role%20of%20lysis.pdf

The Evolving Role of Pharmacologic Lysis

This program reviews the utilization of antithrombotic and
thrombolytic agents, including newer recombinantly derived
pharmacologics, for the management of peripheral arterial occlusion
(PAO), deep vein thrombosis (DVT), pulmonary embolism (PE), and
vascular access devices and grafts.

Tenecteplase is supplied as a sterile, preservative-free, lyophilized
power in a 50-mg vial under partial vacuum.  Each 50-mL vial is
packaged with one 10-mL vial of sterile water for injection (USP) for
reconstitution.  Because tenecteplase contains no antibacterial
preservatives, it should be reconstituted immediately before use.  If
the reconstituted product is not used immediately, the vial should be
refrigerated at 2 to 8C (36 to 46F) and used within 8 hours.

[note: this is a drug being used experimentally for treatment of the
above diseases.  Prior to reconstitution, it does not require
refrigeration.  In the experimental setting, the drug is administered
intravenously, but it could be administered via injection in the
future].

-----
http://drugs.medbroadcast.com/ASP/DrugInfo.asp?BrandNameID=1450

Jectofer 
 
iron - sorbitol - citric acid 
 
Iron supplements belong to a class of drugs known as anemia therapy.
Iron is important for the production of red blood cells. It helps red
blood cells to carry much needed oxygen to the various parts of the
body.   Iron supplements can also be used during times when the body
needs extra iron. Pregnancy, bleeding problems, burns, and certain
stomach problems are examples of conditions where a person might need
extra iron.

Usually iron supplements are taken in pill or liquid form by mouth.
Iron - sorbitol -citric acid is an injectable form of iron that is
used only when a person with iron deficiency cannot take iron by mouth
or would not be sufficiently helped by taking it by mouth...

...The single daily injection of more than 2 mL of iron sorbitol is
not recommended. The vials should be stored at room temperature and
not refrigerated.

-----
http://healthanswers.telstra.com/drugdata/appco/00097611.asp

Humalog: Insulin lispro

This Lilly human insulin analogue differs from other insulins because
it has a unique structure, a very quick onset of action and a shorter
duration of activity. Humalog and Humalog Mix25 should be given
immediately (up to 15 minutes) before a meal.

Humalog vials and cartridges can be kept at ambient temperature below
30̊C and away from direct heat and light for 28 days while in
use. Humalog Mix25 cartridges can be kept at ambient temperature below
30̊C and away from direct heat and light for 28 days while in
use. The reusable cartridge pen combination should not be
refrigerated....  Humalog preparations should be stored in a
refrigerator between 2̊ and 8̊C. They should not be frozen
or exposed to excessive heat or sunlight.
-----
http://www.bccancer.bc.ca/HPI/DrugDatabase/DrugIndexALPt/Octreotide.htm

Octreotide (ok-TREE-oh-tide) is a hormone drug that is used to treat
some kinds of cancer. It is a clear liquid that is usually injected
under the skin (daily injection) or into a muscle (monthly
injection)...Store octreotide out of the reach of children, in the
refrigerator (do not freeze), and protected from light. Daily
injections can be kept at room temperature for up to two weeks.
-----
www.lubbockmsaasupportgroup.50megs.com/ news_articles.htm

Betaseron was the first therapy approved in the United States to treat
relapsing-remitting MS. People with this form of MS typically have
mild to moderate disability with EDSS scores of 0-5.5....  In January
2002, the FDA approved a new room-temperature formulation of
Betaseron. Betaseron is the first and only therapy available as a
room-temperature formulation (25̊C/77̊F) for
relapsing-remitting MS, providing a convenient option for MS patients
in the United States. Injections of this formulation should be
administered immediately after preparation. If the injection is
delayed, the solution should be refrigerated and injected within a
three-hour time period.

-----
http://my.diabetovalens.com/diab_kids/insulin.asp 

Get to know your Insulin treatment better 

[includes a detailed description of different insulin types available
for frequent injection in the treatment of diabetes]

Insulin is stable at room temperature for at least 4 weeks, if the
temperatures are not extreme (below 0̊C or over 25̊C). 
Unused vials, cartridges or pre-filled syringes should be stored in
the refrigerator at 2-8?C.  Insulin should never be exposed to direct
sunlight or be frozen.
-----

http://www.fda.gov/bbs/topics/ANSWERS/ANS00836.html 

NEW BIOTECH PRODUCT APPROVED TO REDUCE NEED FOR CHEMOTHERAPY-RELATED
PLATELET TRANSFUSIONS

FDA today approved interleukin eleven (IL-11), a new bioengineered
product that can reduce the need for frequent platelet transfusions
following high-dose chemotherapy.  Patients who have required platelet
transfusions after chemotherapy in the past may benefit most from this
new product.  IL-11 belongs to a family of human growth factors which
stimulate the growth of cells.  It is administered as a daily
injection under the skin when chemotherapy is completed.  The
genetically engineered version will be marketed under the trade name
Neumega...

Platelet transfusions, while very safe, carry small risks of
infectious disease transmission, as do other blood products.  In
addition, since platelets must be stored at room temperature, there is
a small risk of bacterial contamination.
-----
http://www.newswise.com/articles/2002/4/MSPREFIL.FHK.html 

COPAXONE(r) is indicated for the treatment of relapsing-remitting MS. 
Its pre-filled syringe was the first one approved by the FDA in the
United States.  Most MS therapies require time-intensive preparation,
including mixing the drug with sterile water for injection to provide
the proper dose.  With the new COPAXONE(r) pre-filled syringe, people
living with MS will find self-injecting more manageable.  The
pre-filled syringe is expected to replace the previous mixable form of
COPAXONE(r), and it will have the same efficacy and proven
tolerability.  It can be stored at room temperature for up to seven
days.
-----

[below is an excerpt from a report on medicines of the future.  I
thought it might be of interest as the authors emphasize the need for
medicines that don’t need refrigeration, since much of the world’s
poor do not have refrigerators]

www.un.org/events/wssd/pressconf/020831conf3.htm 
World Summit on Sustainable Development

Academy for Future Science [is reporting on ] needleless insulin and
HIV therapy"

"Dr. Hurtak then introduced a new patented technique of administering
standard medical treatment on a daily basis, developed by Biophysix,
Inc, based on research from the University of Illinois, which would be
a "boon to those in need of daily injection therapy". The new
technique, based on polymer packages that allowed for loading several
medicines, would spray medicine under the tongue, so that it would be
assimilated without damage to cell walls and cell membranes. It was a
"revolutionary new means of delivering drugs".... Another benefit was
that the containers did not need to be refrigerated.

-----

I hope this is the information you need.  I strive to give the best
answers possible, but if you feel additional information is needed,
please post a "Request for Clarification" before rating this answer.



search strategy:  ("daily injection" OR "frequent injection")
refrigerated
                  ("daily injection" OR "frequent injection") “room
temperature”
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