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it may slow down raising blood glucose 130.(c) Hydroxocobalamin, an active ingredient
concentrations after eating meals. found in Cyanokit, is cobinamide dihydroxide
dihydrogen phosphate (ester). It is the hydroxylated
It is indicated for the treatment of diabetes active form of vitamin B12 and is a large molecule in
mellitus. The recommended dose is 25 mg to 100 which a trivalent cobalt ion is coordinated in four
mg, three times daily at the start (with the first bite) positions by a tetrapyrrole (or corrin) ring.
of each main meal.
It is indicated for the treatment of known or
Abdominal pain, diarrhea, flatulence, liver toxicity suspected cyanide poisoning.
and hypoglycemia (only when combined with other
antidiabetic agents) are principal side effects of the The starting dose of hydroxocobalamin for adults is
drug. 5 grams administered as an intravenous (IV)
infusion over 15 minutes. Depending upon the
128.(c) Precose (Acarbose) should not cause severity of the poisoning and the clinical response, a
hypoglycemia since it does not stimulate insulin second dose of 5 grams may be administered by IV
secretion from beta cells of the pancreas, but infusion for a total dose of 10 g. The rate of infusion
lowers the rate of blood glucose formation. If for the second dose may range from 15 minutes to
hypoglycemia occurs, patients should be advised to two hours, as clinically indicated.
take glucose (dextrose or I.V. glucose) since Precose
may inhibit the breakdown of sucrose (table sugar) 131.(b) Pancrelipase enzyme preparations may help
into glucose and fructose. converting complex carbohydrates to glucose. Thus,
they reduce the effect of Precose (Acarbose).
129.(a) Precose (Acarbose) may elevate an AST
level when given in a dose of 150 mg to 300 mg per 132.(c) Zaroxolyn (Metolazone) is classified as a
day. An aspartate aminotransferase (AST) test thiazide diuretic. Zaroxolyn is indicated for the
measures the amount of this enzyme in the blood. treatment of salt and water retention including:
AST is normally found in red blood cells, liver, heart,
muscle tissue, pancreas, and kidneys. AST formerly 1. Edema accompanying congestive heart failure;
was called serum glutamic oxaloacetic transaminase 2. Edema accompanying renal diseases, including
(SGOT). the nephrotic syndrome and states of diminished
renal function.
Low levels of AST are normally found in the blood.
When body tissue or an organ such as the heart or Zaroxolyn is also indicated for the treatment of
liver is diseased or damaged, additional AST is hypertension, alone or in combination with other
released into the bloodstream. The amount of AST antihypertensive drugs of a different class. Mykrox
in the blood is directly related to the extent of the tablets, a more rapidly available form of
tissue damage. After severe damage, AST levels rise Metolazone, are intended for the treatment of new
in 6 to 10 hours and remain high for about 4 days. patients with mild to moderate hypertension. A
The normal range for an AST is 10 to 34 IU/L where dose titration is necessary if Mykrox tablets are to
IU/L stands for international units per liter. be substituted for Zaroxolyn in the treatment of
hypertension.
The AST test may be done at the same time as a test
for alanine aminotransferase, or ALT. The ratio of A patient should not interchange Zaroxolyn tablets
AST to ALT sometimes can help determine whether and other formulations of Metolazone.
the liver or another organ has been damaged. Both Formulations bioequivalent to Zaroxolyn and
ALT and AST levels can test for liver damage. formulations bioequivalent to Mykrox should not be
interchanged for one another.

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