SYNCROSTIM 500

Indications

• Autism Spectrum Disorders
• Attention Deficit Hyperactivity Disorder (ADHD)
• Post-Traumatic Stress Disorder (PTSD)
• Anxiety Disorders
• Depression
• Cerebral Palsy
• Physical Rehabilitation

Dosage

Children: Refer to the specific therapeutic regimen determined by a healthcare professional, as equine therapy is individualized based on patient needs.

Adults: Refer to the specific therapeutic regimen determined by a healthcare professional, as equine therapy is individualized based on patient needs.

Mechanism of action

Equine therapy operates on several levels. The physical interaction with horses can enhance gross motor skills and encourage physical fitness. Psychologically, the bond formed between horse and human can foster emotional healing, reduce anxiety, and build confidence. The rhythmic motion of riding has been shown to have a calming effect on individuals, mimicking similar movements to those experienced in a therapeutic setting. Moreover, the social interaction involved in caring for and riding horses may improve communication skills and socialization.

Pharmacodynamics

Equine therapy itself does not involve pharmacological agents; however, it may influence the psychobiological pathways in the body. The interactions evoke hormonal responses that can alter levels of cortisol and adrenaline, enhancing relaxation and reducing stress. The therapeutic environment can also promote the release of endorphins, contributing to a sense of well-being and happiness.

Pharmacokinetics

As equine therapy does not involve drugs, pharmacokinetics is not applicable. However, the effects on the body can vary based on individual patient characteristics, the specific condition treated, and the duration and frequency of the therapy sessions. Factors such as age, physical condition, and psychological state can influence therapeutic outcomes.

Pregnancy

Equine products should be used with caution during pregnancy, as there is limited data on their safety. Consultation with a healthcare professional is recommended.

Breast-feeding

Safety during breastfeeding is not well established; therefore, caution is advised when using equine products in nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Anovulation
• Infertility
• Hypogonadism
• Assisted reproductive technology (ART)
• Ovarian stimulation

Dosage

Children: Refer to the BNF for Children for dosing information as it varies according to the specific clinical scenario and individual patient

Adults: Dosing regimens vary based on the specific gonadotrophin and clinical indication. Refer to specific guidelines or the relevant BNF for detailed dosing information.

Mechanism of action

Gonadotrophins act by binding to specific receptors on the surface of gonadal cells. FSH primarily promotes the growth and maturation of ovarian follicles in females and spermatogenesis in males. LH triggers ovulation and promotes the secretion of sex steroids, such as estrogen and testosterone, from the gonads. This action is mediated through the activation of adenylate cyclase, leading to increased cyclic AMP levels and subsequent activation of protein kinase A.

Pharmacodynamics

The pharmacodynamics of gonadotrophins involves the regulation of reproductive hormones and the reproductive cycle. FSH stimulates the development of ovarian follicles and the production of estrogen, while LH is responsible for triggering ovulation and supporting luteal function through progesterone secretion. Their synergistic action is crucial for normal reproductive function and fertility.

Pharmacokinetics

Gonadotrophins are administered via injection, as they are not effective orally due to degradation in the gastrointestinal tract. They have a variable half-life depending on the specific type of gonadotrophin used, with FSH typically having a half-life of 3-4 hours and LH having a shorter half-life. The pharmacokinetics may also be influenced by the formulation (e.g., recombinant versus urinary-derived). The gonadotrophins are metabolized in the liver and excreted via the kidneys.

Contra-indications

• Hypersensitivity to gonadotrophins or any of their excipients
• Tumors of the pituitary gland or hypothalamus
• Ovarian cysts or enlarged ovaries not caused by polycystic ovary syndrome
• Primary ovarian insufficiency

Adverse effects

• Ovarian hyperstimulation syndrome (OHSS)
• Multiple pregnancies
• Headache
• Nausea
• Abdominal pain
• Injection site reactions
• Mood swings
• Breast tenderness

Interactions

• Corticosteroids may reduce the effectiveness of gonadotrophins
• Other hormone treatments may interact with gonadotrophins

Precautions

• Monitor for signs of OHSS
• Use with caution in patients with a history of thromboembolic disorders
• Careful consideration in patients with liver or kidney disease

Pregnancy

Gonadotrophins are contraindicated in pregnancy due to the potential for inducing ovarian hyperstimulation syndrome and promoting multiple gestations.

Breast-feeding

There is limited data on the excretion of gonadotrophins in breast milk; caution is advised when administering to breastfeeding mothers.

Storage

Store in a refrigerator (2-8°C). Protect from light. Do not freeze.

Formulations

• Human chorionic gonadotropin (hCG)
• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Recombinant gonadotrophins

Indications

• Diagnostic blood tests
• Assessment of organ function
• Evaluation of electrolyte balance
• Monitoring of therapeutic drug levels
• Detection of antibodies or infectious agents

Dosage

Children: Dosage is not applicable as serum is a biological fluid used for diagnostic purposes and not an administered drug.

Adults: Dosage is not applicable as serum is a biological fluid used for diagnostic purposes and not an administered drug.

Mechanism of action

Serum itself does not have a specific mechanism of action as it is a biological fluid. However, its components, particularly proteins such as albumin and immunoglobulins, contribute to homeostasis, transport, and immune response. Albumin helps in maintaining oncotic pressure and transporting various substances, while immunoglobulins play a vital role in the immune response.

Pharmacodynamics

The pharmacodynamics of serum are closely related to its composition. The proteins in serum, including enzymes, hormones, and antibodies, exert various physiological effects. For example, serum albumin helps maintain blood volume and pressure, while globulins are involved in immune function. Changes in serum composition can affect the pharmacodynamics of drugs, influencing their distribution, metabolism, and elimination.

Pharmacokinetics

Serum does not follow a traditional pharmacokinetic profile, as it is a complex mixture rather than a single drug. However, the elimination and distribution of substances within the serum can be influenced by factors such as protein binding, blood flow, and the physiological state of the individual. The half-life of any drugs or substances present in serum will depend on their specific characteristics and interactions with serum components.

Adverse effects

• Allergic reactions
• Infection at the injection site
• Fever
• Rash
• Joint pain

Precautions

• Use with caution in individuals with a history of allergic reactions
• Monitor for signs of infection
• Assess for any history of autoimmune conditions

Pregnancy

Consult healthcare provider. Safety in pregnancy is not well established.

Breast-feeding

Consult healthcare provider. Limited information is available regarding excretion in breast milk.

Storage

Store at 2 to 8 degrees Celsius. Do not freeze. Protect from light.

Formulations

• Intravenous solution
• Subcutaneous injection