Please help

[shannyn]

I'm a student nurse and would like to help my friend who has got some sort of disease but she can't remember the name. Does anyone know what the name of this disease is: it lines the outside of the blood vessels and causes pain (my friends syptoms are pain radiating from the knee to the hips and starting in the hand, she can't sleep at night with pain and has to keep moving in the day or she seizes up).

She's on diaphene but doesn't find it any help. Plus one of our friends, her best friend is having his 21st saturday and she wants to drink. (She does not normally drink but i think she wants to escape and forget for a night. She's usually very happy person but she's very down even though she's trying not to show it). I told her she can't since she's on diaphene but she says she going to go off it for the night. I have told her she shouldn't do that either.

As i'm only 2nd year student nurse i'm not all that familiar with the side effects of drugs. I know diaphene is a strong drug. Does anyone know how i can educate her on the drug and convince her not to do it. It's harder cause it's a friend and not a patient.

I really could do with some help or advice on what the disease is? (If you ever heard of it, maybe symptoms too broad), any cure for it? (Again if you have ever heard of it) or how i prevent her drinking on diaphene or going off it for night? Any help would be much appreciated and thank you for taking the time to read my question.

[texasnursingstudent]

www.rxlist.com or http://www.nih.gov/

go there try the rxlist.com first- and type in the generic/brand- you may have to try both. also, i recommend looking in davis drug guide or one of the nursing drug guides. usually each drug has a section labeled something along the lines of "nursing implications." patient teaching a long with a few nursing diagnoses are usually listed under this section.....

BTW, i got curious about what "diaphene" is..and did a quick search for it at ask.com and google..and got nothing back. in fact, it kept trying to change my "diaphene" to "diaphane." are you sure that is the name of the drug? let me know...im' really curious now!

[TazziRN, RN]

Not much you can do if she's being stubborn. You should get her doctor involved and let him know what's happening, maybe she'll listen to him/her.

[Diahni]

Not much you can do if she's being stubborn. You should get her doctor involved and let him know what's happening, maybe she'll listen to him/her.

TazziRN,

Please tell me what "second star to the right" means! I'm curious!

Diahni

[TazziRN, RN]

From Peter Pan?

[Ann RN]

salicylanilides

important compounds

niclosamide, oxyclozanide, clioxanide, rafoxanide, brotianide, bromoxanide, closantel, resorantel.

synonyms

niclosamide: mansonil-p, lintex-m, mansonil-m, yomesan, bayluscid, cestocid, devermin, fenasal, radeverm, sagimid, tredemine, vermitin.

oxyclozanide: 3,3',5,5',6-pentachloro-2'-hydroxysalicylanilide, zanil, diplin, metiljin.

clioxanide: 2-acetoxy-4'-chloro-3,5-diiodobenzanilide, tremerad.

rafoxanide: 3'-chloro-4'-(p-chlorophenoxy)-3,5-diiodosalicylanilide, mk-990, bovanide, duofas, flukanide, ranide, ursovermid.

brotianide: 3,4'-dibromo-5-chlorothiosalicylanilide acetate, bay 4059, dirian.

bromoxanide: none

closantel: flukiver, seponver.

resorantel: resorcylan, terenol.

clinical relevance

the first salicylanilide niclosamide was discovered in 1958 and introduced in the early 60's as anticestodal drug. the fasciolicidal activity of diaphene was discovered in 1963.

niclosamide exerts anticestodal activity. it was the drug of choice in cestodiasis before the discovery of praziquantel. it has high curative efficacy against taenia saginata, taenia solium, diphyllobothrium latum, hymenolepis nana, [color=#0f7f20]mesocestoides spp., and dipylidium spp., but only low activity against echinococcus granulosus. its absorption from the intestinal tract is poor (only 2%–25% absorption in the first four days), and it is not accumulated in any organ. more than 70% of the drug are excreted via feces and the excretion is completed within 1–2 days. resorantel, another salicylanilide, exhibits anticestodal activity against [color=#0f7f20]moniezia expansa in ruminants.

in general, the antitrematodal activities are the main actions of salicylanilides. niclosamide exerts activity against immature paramphistomes. it is regarded as the most effective and safe compound for the control of an outbreak of paramphistomiasis ([color=#0f7f20]table 1). however, it has no effectivity against adult paramphistomes in ruminants. in general, drugs with high efficacy against the adult flukes are not active enough for elimination of pasture contamination. furthermore niclosamide has activities against intestinal flukes (fasciolopsis, metagonimus, heterophyes, echinostoma, gastrodiscoides, watsonius, nanophyetes) ([color=#0f7f20]table 2), but it is not active against fasciola hepatica.

diaphene is a mixture of 3,4,5'-tribromosalicylanilide (tribromsalane), the main component and fasciolicidal compound, and 4',5-dibromosalicylanilide used as a germicide. tribromsalane was a new lead structure in the 1960's for a variety of salicylanilides such as oxyclozanide, clioxanide, rafoxanide, brotianide, bromoxanide and closantel. salicylanilides show an increased potency against adult and particularly also against immature flukes. they possess a greater therapeutic index between 4 and 6 compared to the halogenated phenols with a therapeutic index between 1 and 4. with salicylanilides mass treatment of sheep and cattle is possible for the first time, because they have good activity against 4–6 week old immature flukes.

resorantel, a 4'-bromo-γ-resorcylanilide-derivative, is a specific and the most effective drug against immature and adult paramphistomes in sheep, goats, and cattle with slightly erratic, but good efficacy. in addition it has some activity against gastrodiscoides ([color=#0f7f20]table 2).

oxyclozanide is probably the most suitable drug for the control of an outbreak of acute intestinal paramphistomes in calves, especially in concurrent fasciola-infections.

besides their anticestodal and antitrematodal activity, salicylanilides are also active against some nematodes. thus, rafoxanide and closantel are active against the blood-ingesting nematode haemonchus contortus ([color=#0f7f20]table 1).

molecular interactions

the mechanism of the anticestodal action of niclosamide is the uncoupling of oxidative phosphorylation from electron transport in cestodes ([color=#0f7f20]fig. 4). thereby, protons are translocated through the inner mitochondrial membrane. there is a measurable decrease of atp synthesis in [color=#0f7f20]ascaris muscle mitochondria. the selective toxicity of niclosamide is explained by its poor absorption from the host intestine resulting in a protection of host cells against the uncoupling properties of this drug.

the fasciolicidal salicylanilides possess highly lipophilic groups like iodine, chlorophenoxy, tert-butyl-substituents which are responsible for prolonged plasma half-lifes between 2–4 days. rafoxanide and bromoxanide have even longer half-lifes of 5–6 days. moreover, there is slow excretion resulting in persistent drug residues. therefore, several weeks of withdrawal periods before slaughter are necessary and most of the phenol-type fasciolicides are not used for treatment of milk-producing ruminants.

for rafoxanide, oxyclozanide and closantel there is more direct evidence for an uncoupling action within the fluke ([color=#0f7f20]fig. 4). an increased end-product formation by 32% and decreased atp-synthesis by 29% by rafoxanide can be detected. furthermore, there is an increased glucose uptake, decreased [color=#0f7f20]glycogen content, enhanced end-product formation (succinate), increased mitochondrial atpase activity, reduced atp levels by closantel. a probable correlation between death of the flukes and reduced atp levels is discussed. a deformation of mitochondria in many fluke tissues is observable. the [color=#0f7f20]golgi apparatus in the tegumental and gastrodermal cells is reduced in size and contains vacuolated cisternae. the basal infolds of the [color=#0f7f20]tegument are swollen and ion pumps associated with the tegumental membranes are inhibited. there is as a result a general induction of rapid spastic paralysis of the adult flukes by the action of the presumptive uncoupler-type fasciolicides such as rafoxanide, oxyclozanide, nitroxynil.

[color=#0f7f20] fig. 4. action of anthelmintics by uncoupling of oxidative phosphorylation.

resistance

a selection of resistant strains of fasciola hepatica in australia has occurred by prolonged use of rafoxanide and closantel. there is cross-resistance between salicylanilides and the halogenated phenol nitroxynil. the resistance is manifest against immature but rarely against adult flukes. there is no side-resistance in rafoxanide- and closantel-resistant liver flukes to oxyclozanide. it is assumed that selection for resistance in the case of rafoxanide and closantel is favoured by possible differences in the mode of action and pharmacokinetic properties between oxyclozanide on the one hand and rafoxanide/closantel on the other hand. thus, quick peak concentrations in the blood and quick elimination are seen with oxyclozanide in contrast to the strong binding to plasma proteins with rafoxanide and closantel resulting in long-lasting persistance in the blood at therapeutic concentrations for more than 90 days.

[herecomestrouble]

Second star to the right and straight on til morning--directions to Neverland

Sorry to say I don't know the answer to the original question.Does that say something about my nursing skills?

[angel's RN]

Good website to get education on the drug is WebMD.com. It actually has a place that you can print out "patient education" on meds, diseases, ect. Your friend SHOULD NOT drink taking this med, and just "stopping it Saturday night" will not take care of it. The med is in her system, and missing one dose won't remove it from her system.

Thant's my 2-cents. 's RN

[tvccrn, ASN, RN]

Second star to the right and straight on til morning--directions to Neverland

Sorry to say I don't know the answer to the original question.Does that say something about my nursing skills?

It took me a bit to figure out the question to Tazzi was about her location and had nothing to do with the OP at all. So I don't blame you for being confused.

tvccrn

[TazziRN, RN]

That's okay.....the question was directed at me and I wondered what she was talking about for a few seconds!!!