Health news blog

MASTERING MEDICATIONS FOR A HEALTHY HEART: NITROGLYCERIN AND NITRATES

admin — Wed, 02 Jun 2010 14:34:21 +0000

I have a deep and abiding respect for nitrates, since I believe these drugs kept me alive during my heart attack in 1978. I experienced that heart attack the night before my scheduled angiogram, and fortunately my cardiologist had put me on a high dosage of nitrates, which are designed to keep the arteries open. Without the effects of those drugs, my attack might very well have been worse.

The nitrates are used mainly for acute relief and prevention of angina pectoris. They work by relaxing the smooth muscle tissue of the blood vessels, resulting in dilation of both veins and arteries. This, in turn, yields increased blood flow and decreased oxygen consumption by the heart. Another effect may be a reduction in both systolic and diastolic blood pressure.

There are a number of ways to deliver nitrates, for either long-term or short-term benefits. Glyceryl trinitrate, more commonly known as nitroglycerin and which I’ll discuss in more detail in a moment, provides a quick burst of vasodilation, but the vessel-opening effect doesn’t last long. The long-term nitrates don’t have as dramatic an effect, but they keep the vessels open over a longer period of time. Your doctor may prescribe one or more of the nitrates, to be taken as tablets (swallow, don’t chew), ointment, skin patches or sprays.

Contraindications include severe anaemia, head trauma, cerebral haemorrhage, and hypersensitivity to nitrates. The drugs can result in postural hypotension, that is, dizziness which occurs when you change position suddenly, such as standing up from a seated position. Since alcohol makes this tendency worse, it’s best to avoid or limit drinking. Large nitrate dosage can produce headaches. Talk with your doctor if headache develops; often patients become more tolerant to nitrates.

If you experience angina pectoris, your doctor will very likely prescribe nitroglycerin, either alone or in addition to other nitrates. It enables the heart muscle to get more blood which, in turn, provides more oxygen and relieves the pain.

Unless instructed otherwise, place a nitroglycerin tablet under your tongue at the start of chest pain. You may experience a dull headache, one of the ways you know that the nitroglycerin has gotten into your bloodstream. If your chest pain doesn’t go away within five minutes, take another tablet. If pain still persists, after another five minutes take a third tablet. And if that doesn’t work, contact your physician. For severe or worsening pain, seek immediate medical attention.

Dr Nishi offers these tips regarding nitroglycerin usage:

Do not drink water with this pill, and don’t swallow it. Let it dissolve under your tongue.

It’s best to sit down or lie down when taking nitroglycerin, as it

may cause a temporary drop in blood pressure and resulting dizziness.

Don’t be concerned about normal side effects including headache, dizziness, a warm flushed feeling and a burning sensation under the tongue.

This medication can easily lose its potency. Don’t store in a hot or even very warm place, and keep it out of the sun. Keep nitroglycerin in its original, brown glass container. Studies have shown that even the heat generated by keeping the container in a shirt pocket next to the skin is enough to destroy nitroglycerin’s potency.

Replace opened bottles of nitroglycerin at least every six months. Properly stored, unopened bottles should be good until the expiration date on the label.

If you don’t get the dull headache that typically occurs when taking nitroglycerin, assume that the pills have lost their potency.

Keep the bottle top tightly closed.

As with all other medications, discuss nitroglycerin with your doctor or pharmacist. Dr Nishi recalls a patient who claimed he had no questions, and fully understood all his medications. Then the pharmacist spotted the patient’s nitroglycerin on a windowsill in direct sunlight. After mentioning that, a 15- to 20-minute discussion and Q&A session followed.

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Cardio & Blood/ Cholesterol

MASTERING MEDICATIONS FOR A HEALTHY HEART: ANTICOAGULANTS

admin — Wed, 02 Jun 2010 14:33:33 +0000

This category of drugs is also designed to prevent clotting. These medications are commonly referred to as “blood thinners”. The generic name is warfarin, with brand names Coumadin and Marevan. Warfarin, like aspirin and Persantin, lengthens clotting time. It does so by affecting clotting factors in the blood, while aspirin and Persantin act by affecting the function of blood platelets.

Warfarin is often given to patients with certain types of artificial heart valves to reduce the possibility of small clots forming on the valves.

The amount you take will be determined by the results of a “pro-time” blood test. Your doctor will prescribe a standard daily dose or may give you a specific dosage schedule to follow. Take your medication at the same time each day, and do not stop taking it without consulting your physician. You may be taking warfarin for some time, perhaps indefinitely.

If bleeding from a cut continues for several minutes, contact your doctor. Talk with him about signs of unusual bleeding as well, including black stool, pink or red urine, nose bleeds, or bruising with severe swelling.

Do not take aspirin or preparations containing aspirin while taking warfarin. If you have a headache, one of the non-aspirin pain relievers such as Tylenol or Panadol may be taken instead.

Do not drink excessive amounts of alcohol. More than one or two drinks, or drinking even that amount regularly, can alter the effect of your anticoagulant. Major changes in diet, such as eating unusually large amounts of fish or leafy green vegetables, can alter your response to the drug. Try to keep your diet regular, without binges or splurges.

While these precautions and warnings may sound severe to you now, remember that anticoagulants have been prescribed for many years for thousands of patients. They have major benefits your doctor wants you to get. In a short period of time you and your doctor will work out just the right dosage, and taking this medication will become second nature to you.

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Cardio & Blood/ Cholesterol

CHILD’S HEALTH/EAR, NOSE AND THROAT DISORDERS: EAR WAX

admin — Thu, 21 May 2009 07:11:54 +0000

Wax is normally secreted by glands which lie in the ear canal. When first secreted it is soft and colourless, but with exposure to air becomes hardened and acquires a brown colour. Its function is to act as a filter for the ear, trapping particles of dust and dirt when they enter the ear canal. Usually the actions of chewing and the constant renewal of the ear canal’s lining ensures that wax is moved outward. Sometimes a build up of wax can block the ear canal, and may cause discomfort or interfere with hearing. Earwax can be softened by placing 2 drops of paraffin oil in the ear for 3 consecutive nights. Never use a cotton bud to remove wax inside the ear canal, as this can easily cause damage by pushing the wax deeper inside the ear. Some children may have to use ear drops on a regular basis to prevent a build up of wax. The doctor may sometimes have to use a special syringe to flush out wax that is blocking the ear.

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THE NEWBORN BABY: RESPIRATORY DISTRESS SYNDROME (RDS)

admin — Tue, 19 May 2009 06:30:51 +0000

Respiratory distress syndrome refers to breathing difficulty experienced by many premature babies, due to underdevelopment of their lungs. The earlier a baby is born the more likely he is to suffer from RDS. Babies born at 28 weeks have a 70% chance of developing RDS. This figure drops to around 10% for babies born at 34 weeks gestation.

Cause

Because the lungs of premature babies are immature they do not produce a substance called surfactant, which lines the lung surface and prevents collapse of the smallest airways (alveoli) used for oxygen exchange. This substance starts being produced when the baby is around 28 weeks gestation.

Clinical features

A baby suffering from RDS will have difficulty breathing, having to work very hard with each breath. His chest may be drawn in and he will grunt when he tries to breathe out.

Investigations

Diagnosis of RDS is usually confirmed by chest X-ray.

Treatment

Babies with RDS require highly specialised treatment in a special care nursery. They will be nursed in a humidicrib and will require oxygen administered through a special hood. Sometimes they will require oxygen through a tube passed into their windpipe, and some babies may be hooked up to a special breathing machine (ventilator) for days or even weeks. Artificial surfactant is also now available, and this helps those babies with respiratory distress due to immature lungs.

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YOUR MARITAL HEALTH/THE MOST OFTEN ASKED QUESTION: WILL I, DOES ANYONE, GET OVER THE TERRIBLE SCARS OF THE

admin — Mon, 18 May 2009 12:59:21 +0000

ABUSE?

”When I read about sexual abuse, I knew it was the same for

me. Will I, does anyone, get over the terrible scars of the

abuse?”

ANSWER: No, nobody “gets over” them, but one learns to put them to work in favor of a new intimacy. Those who have suffered abuse learn the contrast between sharing and abusing, and they seem all the stronger for the pain, for they have seen both sides of the issue. They have felt the guilt, self-blame, and anger of sexual abuse and learned the contrast between that and the love, trust, and safety of sex in marriage. Just as someone who never has been really sick may never fully know what it is to be very healthy or at least fully appreciate and value health every day, so it is with sexual abuse. You have seen and felt the pain, so the joy and freedom is all the more valued.

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THE JOY OF PERFECT HEALTH: POLLUTION OF THE ENVIRONMENT

admin — Mon, 18 May 2009 09:25:42 +0000

Many species of birds, marsupials, mammals and other animals on our planet become extinct every year.

The main reason for their extinction is that their organisms cannot cope with the increasing levels of pollution in their food and their environment.

Nature gives us a fair warning. If we keep polluting our planet, it may soon be our turn.

So far into our “civilised evolution” we continue to develop more and more diseases, allergies etc. and have increasing difficulty maintaining good health.

However, when we understand the reasons for this, we have a choice. Rather than waiting for governments and the industry to do something about it, WE THE CONSUMERS should make a choice first.

No industry will produce articles consumers do not want.

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INFLUENZA – GREAT PANDEMIC

admin — Fri, 15 May 2009 09:33:57 +0000

There is some confusion about influenza and this may come about because many people talk about the flu when what they are referring to is the common cold or other mild respiratory infections.

Real influenza is certainly not a mild illness. Epidemics and pandemics (that is, a worldwide epidemic) of influenza have spread even in ancient times.

The great pandemic of 1918-1919 claimed an estimated 20 million people, more than died in the Great War.

Influenza is caused by a virus of which there are three sub-groubs, À, Â and Ñ. Ñ virus is rarely isolated and does not cause epidemic influenza. Â virus may cause epidemics which tend to be milder than those caused by A virus and it is this last which causes the pandemics.

The incubation is short, some two to three days. The onset of the infection is abrupt with fever, headache, malaise, shivering and severe aches and pains in the limbs and back.

This is followed by a dry cough, a sore throat and other symptoms of a respiratory infection.

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ANTIBIOTICS – GENERAL INFORMATION

admin — Fri, 15 May 2009 07:45:58 +0000

It can be taken every eight hours (three times a day) and, because this is easier, more people are likely to take it properly. Ampicillin is marketed as Penbritin and Austrapen, and amoxycillin as Mox-acin and Amoxil.

The tetracyclines are a group of bacteriostatic antibiotics produced from a number of moulds. They have a wide range of activity against many organisms which are insensitive to penicillin.

These drugs are also active against some of the larger viruses and related organisms which fall between bacteria and viruses in their characteristics.

Bacteria are organisms with a cell wall containing the active ingredients of the cell. They are capable of independent reproduction.

Viruses are smaller particles without a cell wall and consisting mainly of RNA or DNA, proteins which make up the nucleus of cells and which contain the genetic material.

Viruses can reproduce only inside cells of the host but bacteria can be grown in the test tube, if suitable nutrient is available. A virus can grow only in a suitable cell culture, where it reproduces itself inside a living cell.

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THE EMBRYONIC THEORY

admin — Fri, 08 May 2009 14:51:40 +0000

Could you be born with cells that have within them the possibility of growing into a full-blown case of endometriosis? In answering this question, researchers noted that many women do not have any classical symptoms of endometriosis while having the disease. Another dilemma involved women who had undergone abdominal surgery; there it was found that masses had developed that contained endometriosis like cells. That is, these patients appeared to have the disease, but in fact, they did not. How might this happen?

Noteworthy embryo logical studies uncovered some fascinating evidence. During intrauterine life, the fetal reproductive organs germinate from different types of cells. Vaginal tissue originates from a different set of genetic blueprints than uterine tissue, although both organs have the quality and capability of, for example, elasticity to accommodate childbearing. These embryonic studies went on to show that the tissue lining the ovaries, the endometrium, and the peritoneum—the smooth, transparent, and highly sensitive membrane that lines the pelvic and abdominal cavity—all originated from the same embryonic cell membrane.

It was then postulated that some of these cells could be transformed into endometrial cells or endometrial like cells through repeated irritation, such as pelvic infections, or by hormonal stimulation. In many cases, the physiological result is identical to having actual endometrial cells run wild and implant themselves: pain, cramps, and possible infertility. Thu mimicking of the disease posed some conclusions that interest scientists. The story that follows reveals why.

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SKIN INFECTIONS: BOILS

admin — Fri, 08 May 2009 14:22:18 +0000

Boils are deep infections, usually of hair follicles. They may occur at any age but are most common in adolescence. They can occur at any site except the palms and soles. Friction such as that often felt in the belt or collar areas may predispose to their development. Various diseases such as uncontrolled diabetes may aggravate boils, although very few people with boils have in fact got diabetes. The most common infective organism is the Staphylococcus.

A single boil may require no treatment other than careful washing with an antiseptic soap, causing it to spontaneously discharge. When there are multiple boils, or if one is in a potentially dangerous site, active treatment is necessary. Initially, a penicillinase-resistant semi-synthetic penicillin should be administered—such as Cloxacillin. The pus should be cultured, so that the most appropriate antibiotic can then be selected for further treatment. If boils recur, further investigations are necessary. Cultures should be taken from the infected lesion and from other sites such as the nostrils, normal skin, armpits and genital area. This will identity the reservoir or source of the infective organism. Occasionally cultures taken from other members of the immediate family may be helpful. Appropriate local treatment with an antibiotic cream can then be employed to eradicate the source. Treatment may be assisted by the taking of oral antibiotics and antiseptic baths. Further investigation to exclude possible concurrent diseases such as diabetes and immunological deficiencies may occasionally also be necessary.

Viruses are lengths of nucleic acid which carry enough information for their own replication only. They are therefore completely dependent on the host cells. Unlike bacteria, they do not grow by dividing; they assemble new virus particles by the addition of protein. There are a large number of viruses which affect man and, unfortunately, there are no antibiotics effective in their treatment.

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