goodduck

lactulose 
[mechanism]
1. colon bacteria degrade -> acid pH -> convert ammonia to ammonium ion -> poor absorb
2. GI ammnoia decrease -> blood  amonia diffuse to GI -> in GI with acid pH, converted to ammonium ion
3. osmotic laxative
[use]
1. oral: control 2~4 soft stool/day
2. enema: 300mL lactulose dilute to 700 mL with water


[mechanism] non-selective beta-blocker

Inderal (propranolol)
 onset: 1~2 hrs
 duration: 6 hrs (short term)

Corgard (Nadolol)
 peak:2~4 hrs
 duration:17~24 hrs (long term)

Cornor (Bisoprolol)
 onset:1~2 hrs
 duration: ??

[steriod]
[sort-tomedium]                                [long]
cortisol                      1.0                      Dexamethasone   30
cortisone                   0.8                     Betamethasone     25~40
predisone                 4.0
prednisolone           5.0
methylpredisone     5.0

1. Who needs taper?
2. How to taper steroid?