Friday, June 20, 2008

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posted by Jason Walker @ 11:12 PM   3 comments links to this post

Monday, May 19, 2008

Prescription Drug: Tramadol (Ultram)

Generic Name: Tramadol

Brand name: Ultram, Ultram ER

Class of drug: Narcotic (opioid) analgesic.

Mechanism of action: Most likely produces analgesia by binding to opioid receptors. Also inhibits reuptake of norepinephrine and serotonin.

Indications/dosage/route: Oral only.
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posted by Jason Walker @ 7:46 AM   3 comments links to this post

Thursday, May 15, 2008

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posted by Jason Walker @ 7:05 AM   3 comments links to this post

What is Generic Viagra?



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posted by Jason Walker @ 7:02 AM   3 comments links to this post

Wednesday, April 09, 2008

Commonly prescribed antibiotic is not effective against bronchitis

Physicians in the U.S. commonly prescribe the antibiotic azithromycin (Zithromax) for the treatment of acute bronchitis. However, research has not yielded conclusive evidence that azithromycin is effective in treating acute bronchitis. As an antibiotic, azithromycin has the ability to kill bacteria, but most cases of bronchitis are caused by viruses rather than bacteria. This means that whether you take an antibiotic or not, you'll get better when the illness runs its course, though you can take cough medicine to relieve symptoms in the meantime.In an article recently published in The Lancet , researchers reported that azithromycin was no more effective than a placebo (inactive) pill in treating acute bronchitis.
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posted by Jason Walker @ 2:42 PM   1 comments links to this post

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Pronunciation
(az ith roe MYE sin)

U.S. Brand Names
Zithromax®

Synonyms
Azithromycin Dihydrate; Zithromax® TRI-PAK™; Zithromax® Z-PAK®

Generic Available
No

Canadian Brand Names
Zithromax®

Azithromycin Use
Treatment of acute otitis media due to H. influenzae , M. catarrhalis , or S. pneumoniae ; pharyngitis/tonsillitis due to S. pyogenes ; treatment of mild-to-moderate upper and lower respiratory tract infections, infections of the skin and skin structure, community-acquired pneumonia, pelvic inflammatory disease (PID), sexually-transmitted diseases (urethritis/cervicitis), pharyngitis/tonsillitis (alternative to first-line therapy), and genital ulcer disease (chancroid) due to susceptible strains of C. trachomatis , M. catarrhalis , H. influenzae , S. aureus , S. pneumoniae , Mycoplasma pneumoniae , and C. psittaci ; acute bacterial exacerbations of chronic obstructive pulmonary disease (COPD) due to H. influenzae, M. catarrhalis, or S. pneumoniae ; acute bacterial sinusitis
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posted by Jason Walker @ 2:35 PM   1 comments links to this post

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What is the most important information I should know about azithromycin?

Do not use azithromycin if you have ever had an allergic reaction to this medicine or similar drugs such as erythromycin (E-Mycin, Ery-Tab, E.E.S.), clarithromycin (Biaxin), or other macrolide antibiotics.

There are many other medicines that can interact with azithromycin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Azithromycin will not treat a viral infection such as the common cold or flu. Take azithromycin on an empty stomach 1 hour before or 2 hours after meals. Do not take azithromycin at the same time as taking an antacid that contains aluminum or magnesium. This includes Rolaids, Maalox, Mylanta, Milk of Magnesia, Pepcid Complete, and others. These antacids can make azithromycin less effective when taken at the same time.
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posted by Jason Walker @ 2:14 PM   0 comments links to this post

Saturday, April 05, 2008

Migraine: Abortive Drug Therapy

Almost all migraineurs who experience at least occasional attacks of moderate or severe headache are candidates for treatment with an abortive agent. Some general caveats for the use of abortive drug therapy follow.

1. Use a therapeutic dose at the appropriate time: An adequate dose of aspirin or acetaminophen (say, 975 mg, especially taken in conjunction with a caffeinated beverage) administered early in a migraine attack may be more effective than a "powerful" opioid (narcotic) taken too late. When patients tell us that "simple" analgesics have failed in the past, we are careful to ask them what dosage was used and at what point in the attack the medication was taken. Especially with over-the-counter (OTC) medications, the "recommended" doses often are insufficient to terminate acute migraine.
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posted by Jason Walker @ 12:36 PM   0 comments links to this post

The Pharmacologic Treatment of Migraine

For the past two years our increasing knowledge of migraine's biogenesis has been paralleled by an explosion of new therapies  unprecedented in their biologic selectivity and clinical effectiveness. While these medications provide us with a potent arsenal of  weaponry for combating migraine, all possess at least some imperfections, and their inappropriate use may make a bad situation worse. In this article, we will discuss the issues of acute migraine treatment, prevention of migraine attacks and suppression of chronic migraine, emphasizing the use of medications.
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posted by Jason Walker @ 12:21 PM   0 comments links to this post

Headache for History Buffs [Part 3]

During the next two centuries, physicians described many different factors that could influence the development of headaches: diet, underlying psychological difficulties, fluctuations of ovarian function and gastrointestinal disturbances. In 1873 Dr. Edward Liveing wrote On Megrim, Sick-Headache, and Some Allied Disorder, describing in detail the faulty habits of life that caused the illness. He recommended an improved diet, restoration of general health through rest and good personal hygiene and the use of sedatives such as belladonna, "tonics," iron, and quinine.
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posted by Jason Walker @ 11:32 AM   0 comments links to this post

Headache for History Buffs [Part 2]

The Navaho people today still employ ancient ceremonies to cure disease. They believe that the sufferer needs to restore harmony with nature, and they emphasize the inclusion of family and friends to achieve this end. The cause of illness may be a broken taboo or some other offense against the gods, and during a typical ceremony, the gods are petitioned to forgive the transgression. Purgatives, emetics, and sweat baths are physical treatments utilized, while the gods hear chants and view the sand paintings offered as appeasement for misdeeds. This method demonstrates well an example of "holistic" medicine, involving the simultaneous treatment of both body and mind.
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posted by Jason Walker @ 10:52 AM   0 comments links to this post

Headache for History Buffs [Part 1]


That so many theories to explain the origins of headache have been advanced and rejected over the centuries indicates both its long enduring impact on society's health and wellbeing and man's determination to understand the condition  and so rid himself of its burden. Happily, we no longer bore holes into the skulls of headache sufferers so as to release the evil spirits, humors, or vapors accumulated within, and our therapies today are considerably more effective as well as less invasive. The path from "there to here" is a fascinating one; the personalities of the individuals who have shaped headache theory often have been as brilliantly compelling as their theories have been wrong-headed. In this chapter we will trace that path.

Even today, individuals with chronic headache too often are informed that their pain is due to "stress," anxiety, depression, or some less well-defined deficiency of personality, mood, or behavior. It understandably is difficult for headache sufferers to accept the erroneous notion that "it's all in their heads," especially when lying in bed in a dark room and desperately trying not to vomit. Many explanations for the cause of headache have been advanced in the past, and it is interesting to speculate whether those actually experiencing the symptom have accepted these frequently wild-eyed heories.

Primitive medicine originated from magical and religious beliefs. Early medical treatments applied not to mind or body alone, but always to both. Ceremonies, prayers, chants, and sacred dances were coupled with massage, sweat baths, purgatives, and incense inhalants to relieve both psychological and physical symptoms. Drugs were believed to derive their healing power from
the incantations that accompanied their administration; adding a physical manipulation was felt to offer an even greater chance of success. Such interventions were utilized to treat headache.

Headache clearly has existed as long as mankind.  The first written descriptions of head pain date from Mesopotamian tablets inscribed around 4000 BC. Demons commonly were thought to be the bearers of headache, and an early description of the evil headache spirit, Ti'u, chasing a victim through the desert, demonstrates vividly the eerie power attributed to this symptom.

Headache roameth over the desert, blowing like the
wind,
Flashing like lightning, it is loosed above and below;
It cutteth off him who feareth not his god like a reed, Like a stalk of henna it shitteth his Chews.
It wastes the flesh of him who hath no protecting
goddess,
Flashing like a heavenly star, it cometh, like the dew;
It standeth hostile against the wayfarer, scorching him
like the day,
This man it hath struck and
Like one with heart disease he staggereth,
Like one bereft of reason he is broken,
Like that which has been cast into the fire he is
shriveled,
Like a wild ass . . . his eyes are full of cloud,
On himself he feedeth, bound in death;
Headache whose course like the dread windstorm
none knoweth,
None knoweth its full time or its bond.
An exorcism was definitely in order for the unfortunate soul who had so angered the gods. In combination with an ointment of human bone reduced to ashes and mixed with cedar oil, the priest-physician would use charms and amulets to enact the ritual. Unpleasant substances also were applied, all in hopes of placating the spirits and releasing the headache to move elsewhere.
Other ancient descriptions are more reminiscent of modern headache classifications. One may have been referring to a variant of cluster: "a man's brain contains fire, and myalgia afflicts the temples and smites the eyes, his eyes are afflicted with dimness, cloudiness, a disturbed appearance, with the veins blood-shot, shedding tears." Another appears to speak to migraine: "when his brow pains a man and he vomits and is sick, his eyes being inflamed." In this case the cause of headache is thought to be the "hand of a ghost."

The Egyptians of old were not unaware of headache. Gods such as Horus and Ra were known to suffer the disorder, and the goddess Isis treated Ra with a potion of coriander, wormwood, juniper, honey, and opium. A dancing girl in Pharaoh's court is mentioned in the Eber's papyrus as having been afflicted with unilateral (onesided) headaches accompanied by vomiting and malaise,
symptoms highly suggestive of migraine. Headache treatments employed by Egyptian physicians included trephining, which involved boring a hole in the skull such "that the evil air may breathe out." Less invasive remedies including application of wet, cold mortar pressed to the scalp, or of clay crocodiles bearing the names of the gods, bound firmly to the patient's head with linen strips.
Conceivably these clay totems compressed the superficial temporal arteries, the blood vessels of the temple that so often pound and ache during a migraine, and thus provided relief. Incredibly, to this day preindustrial societies still trephine skulls to relieve chronic headache.

In 400 BC the Greek physician, Hippocrates, was the first to suggest that the cause of headache was something other than the anger of the gods. He believed head pain occurred when the different elements of nature-blood, phlegm, and black bile-were out of harmony, an extension of the so-called humoral theory of illness. Pain supposedly resulted from vapors rising to the head from a bilious liver, and treatment consequently consisted of bloodletting or applying herbs to the scalp so as to drain the excess liquids. We give credit to Hippocrates for recognizing that there are different kinds of headaches, such as those associated with fever or infection as opposed to primary headaches. An example of the latter follows: "He seemed to see something shining before him like a light, usually in part of the right eye; at the end of a moment, a violent pain supervened in the right temple, then in all the head and neck. Vomiting, when it became possible, was able to divert the pain and render it more moderate." This patient appears to have had migraine, his symptoms including a visual aura immediately prior to headache onset.
Orignal From: Headache for History Buffs [Part 1]

posted by Jason Walker @ 10:10 AM   0 comments links to this post

Wednesday, March 26, 2008

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Friday, March 21, 2008

Ultracet® - (tramadol 37.5mg/acetaminophen 325mg) contraindications

ULTRACET® should not be administered to patients who have previously demonstrated hypersensitivity to tramadol, acetaminophen, any other component of this product or opioids. ULTRACET is contraindicated in any situation where opioids are contraindicated, including acute intoxication with any of the following: alcohol, hypnotics, narcotics, centrally acting analgesics, opioids or psychotropic drugs. ULTRACET may worsen central nervous system and respiratory depression in these patients.
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posted by Jason Walker @ 7:55 AM   0 comments links to this post

Ultracet® - (tramadol 37.5mg/acetaminophen 325mg) special populations

Renal:
The pharmacokinetics of ULTRACET® in patients with renal impairment have not been studied. Based on studies using tramadol alone, excretion of tramadol and metabolite M1 is reduced in patients with creatinine clearance of less than 30 mL/min, adjustment of dosing regimen in this patient population is recommended. (See DOSAGE AND ADMINISTRATION.) The total amount of tramadol and M1 removed during a 4-hour dialysis period is less than 7% of the administered dose based on studies using tramadol alone.

Hepatic:
The pharmacokinetics and tolerability of ULTRACET in patients with impaired hepatic function has not been studied. Since tramadol and acetaminophen are both extensively metabolized by the liver,  the use of ULTRACET in patients with hepatic impairment is not  recommended.

Geriatric:
A population pharmacokinetic analysis of data obtained from a clinical trial in patients with chronic pain treated with ULTRACET which included 55 patients between 65 and 75 years of age and 19 patients over 75 years of age, showed no significant changes in  pharmacokinetics of tramadol and acetaminophen in elderly patients with normal renal and hepatic function (see PRECAUTIONS, Geriatric
Use).

Gender:
Tramadol clearance was 20% higher in female subjects compared to males on four phase I studies of ULTRACET in 50 male and 34 female healthy subjects. The clinical significance of this difference is unknown.

Pediatric:
Pharmacokinetics of ULTRACET tablets have not been studied in pediatric patients below 16 years of age.
Orignal From: Ultracet® - (tramadol 37.5mg/acetaminophen 325mg) special populations

posted by Jason Walker @ 6:44 AM   1 comments links to this post