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| Conventional Drugs / Information |
Last updated: May 12, 2008 |
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Conventional Drugs / Information |
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 Conventional Drugs / Information can help with the following: | |  | | | | Aging |  Alzheimer's Disease | Researchers found that clioquinol can almost stop the progression of Alzheimer’s disease. They believed that by absorbing the copper and zinc atoms that concentrate in the brains of Alzheimer's sufferers, clioquinol could stop the onset of dementia before it starts.
The finding came from a study conducted on 26 Alzheimer’s sufferers; half were given clioquinol while the other 13 were given a placebo. Researchers studied all 26 patients over a nine-month period of time and found that patients given the clioquinol retained more mental capacity than those who received the placebo. Research also showed patients who were given clioquinol had a 1.4 percent decrease in their mental capacity, whereas patients who were given the placebo had an 8.9 percent decrease in their mental capacity.
The study suggests that before dementia sets in in the brains of Alzheimer’s sufferers, clioquinol could prevent zinc from building up on the surface of the brain by absorbing the mineral’s atoms. The results of the study show that clioquinol could treat patients with Alzheimer’s twice as well as the latest Alzheimer’s drugs that are available.
Clioquinol has been around for 100 years and is currently used to treat athlete’s foot, ear infections and indigestion. [Archives of Neurology December, 2003;60(12):pp.1685-91]
In October 2003, the FDA finally approved memantine for the treatment of moderate to severe Alzheimer’s disease. Memantine is marketed in the US by Forest Laboratories under the trade name Namenda.
Memantine is an N-methyl- D-aspartate (NMDA) receptor antagonist that is neuroprotective by blocking glutamate, which can cause overstimulation of the nerves and become toxic to the nervous system. Memantine may benefit individuals with Alzheimer’s disease by improving cognition and overall functioning.
Jan 10, 2008. Newsmax reports that an "extraordinary new scientific study, which for the first time documents marked improvement in Alzheimer's disease within minutes of administration of a therapeutic molecule, has just been published in the Journal of Neuroinflammation."
Known as anti-TNF therapeutics, the drug used in the study is called Etanercept (trade name Enbrel) which is given by an injection into the spine. Improvement was said to have come came within minutes of the injection.
Sue Griffin, Ph.D., director of research at the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences (UAMS) in Little Rock and at the Geriatric Research and Clinical Center at the VA Hospital in Little Rock, said: "It is unprecedented that we can see cognitive and behavioral improvement in a patient with established dementia within minutes of therapeutic intervention."
To date other patients with mild to severe Alzheimer's have reportedly received the treatment and "all have shown sustained and marked improvement." |
Parkinson's Disease / Risk| | Conventional medical treatment relies heavily on l-dopa (levo-dihydroxy-phenylalanine), a dopamine precursor that can cross the blood-brain barrier and is converted to dopamine in the brain. L-dopa is now rarely used by itself, but rather in combination with carbidopa (Sinemet) or benserazide (Madopar) that protects it from breaking down before it reaches the brain tissue. As l-dopa must compete with other amino acids in crossing both from the gut to the blood stream and from the blood stream to the brain it is usually recommended that it be taken between meals rather than with meals.
Although l-dopa medications can bring significant relief from Parkinson's disease symptoms they become less effective with time. After four or five years of increasing dosages their effect becomes sporadic and unpredictable (the "on-off syndrome") and patients become increasingly helpless and depressed. There is also evidence that the use of l-dopa medications may lead to a deficiency of B-vitamins, especially niacin and vitamin B-6. Most Parkinson's disease experts now recommend that l-dopa therapy be started as late as possible after diagnosis of Parkinson's disease so as to postpone the day when it no longer works and to limit its many serious adverse effects.
Selegiline (Deprenyl, Eldepryl) is another drug used in Parkinson's disease therapy. It works by blocking the breakdown of dopamine in the brain. Trials have shown that starting Parkinson's disease patients on selegiline can extend the time period before they need l-dopa by about nine months. Combinations of l-dopa medications and selegiline have also been tried in early stage Parkinson's disease patients, but were found to have no advantage. A study concluded that the combination therapy increased mortality by about 50% when compared to Parkinson's disease patients treated with l-dopa medications alone.
However, a subsequent study found that Eldepryl (Selegiline, Deprenyl) can slow Parkinson's Disease safely. In patients with early Parkinson's disease, selegiline and other drugs in a class called monoamine oxidase type B inhibitors are cheap and effective treatments that reduce disability and the need for levodopa, researchers reported in the British Medical Journal. Their study findings also show that the drugs are not associated with increased mortality, as had been reported in an earlier study. [British Medical Journal, August 14, 2004]
Anticholinergenic drugs work by reducing the amount of acetylcholine produced in the brain and thereby redressing the imbalance between dopamine and acetylcholine. They are no longer recommended for older patients as they have serious neuropsychiatric side-effects. |
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Allergy |
 Allergic Rhinitis / Hay Fever| | Prescription Drugs
Nonsedating antihistamines may cause life-threatening irregular heartbeat and should not be taken with other drugs or if you have other liver or heart problems. Oral decongestants may have systemic side effects. Nasal corticosteroid sprays are effective if used properly; improvement takes 1 to 2 weeks. Systemic steroids are prescribed only for severe allergic rhinitis; generally prescribed for short amounts of time because of their many side effects.
Over-the-Counter
Antihistamines may cause drowsiness. Alpha-adrenergic topical sprays reduce congestion but there is a rebound effect if used for more than a few days. Cromolyn sodium is the only preventative drug choice; works as well as antihistamines but does not cause drowsiness; take continuously or it will not work effectively; it is virtually without side-effects.
The FDA (Food and Drug Administration, USA) has approved an allergy drug, Zyrtec-D (cetirizine HCl 5 mg and pseudoephedrine HCl 120 mg), for non-prescription use in children aged 12 and more and adults (Nov 2007). In other words, Zyrtec-D is now an OTC (over-the-counter) drug.
Zyrtec-D has been on the market since 2001, but only as a prescription medication. The latest approval applies to OTC status for the relief of hay fever and other upper-respiratory allergies, such as sneezing, itchy/watery eyes, runny nose, itchy nose, itchy throat, and nasal congestion. Zyrtec-D is also indicated for nasal passage swelling, sinus congestion/pressure relief, and for restoring freer breathing through the nose.
NOTE: Extended use of antihistamines or nasal sprays can make your allergic rhinitis worse. |
Post Nasal Drip| | Allergy medications: Histamines are naturally occurring chemicals released in response to an exposure to an allergen, and they are responsible for the congestion, sneezing, and runny nose typical of an allergic reaction. Antihistamines are drugs that block the histamine reaction. These medications work best when given prior to exposure. Antihistamines can be divided into two groups: 1) Sedating (Benadryl, ChlorTrimetron, Tavist), 2) Non- Sedating (Claritin, Hismanal). Sedating antihistamines should be avoided in those patients who need to drive or use dangerous equipment. Non-sedating antihistamines can have serious drug interactions.
Decongestants: These drugs temporarily reduce swelling of sinus and nasal tissues leading to an improvement of breathing and a decrease in obstruction. They may also stimulate the heart and raise the blood pressure and should therefore be avoided by patients who have high blood pressure, heart irregularity, glaucoma, thyroid problems, or difficulty in urination. The most common decongestant is pseudoephedrine (Sudafed).
Combinations: These drugs are made up of one or more anti-allergy medications. They are usually a combination of an antihistamine and a decongestant. Other common combinations include mucus thinning agents, anti-cough agents, aspirin, Advil, or tylenol. They help to simplify dosing and often will work either together for even more benefit or have side-effects that cancel each other out.
Allergy Shots (Immunotherapy): Allergy shots interfere with the allergic response. After identification of an allergen, small amounts of it is given back to the sensitive patient. Overtime the patient will develop blocking antibodies to the allergen, and they become less sensitive.
Steroids: These drugs (prednisone, medrol, hydrocortisone) are highly effective in allergic patients, however there is a potential for serious side effects when used over time. They are best used for the short term management of allergic problems, and must always be monitored by a physician.
Steroid nasal sprays: (Vancenase, Beconase, Flonase, Nasacort, Rhinocort) They reduce allergic or inflammatory inflammation, but do not have the side-effects of oral (systemic) steroids.
Nasalcrom: This spray helps to stabilize allergy cells (mast cells) by preventing release of allergy mediators, like histamine.
Decongestant sprays: (Afrin, Neosynpherine) They quickly reduce swelling of nasal tissues by shrinking the blood vessels. They will improve breathing and drainage over the short term, unfortunately if they are used for more than a few days they can become highly addictive (rhinitis metamentosa). Long term use can lead to serious damage.
Antihistamine sprays: It works like oral antihistamines but applied topically to the nasal membranes (Astelin).
Atrovent: It helps to control nasal drainage mediated by neural pathways. It will not treat an allergy, but it does decrease nasal drainage.
Mucus thinning agents: Mucus thinning agents are utilized to make secretions more thin and less sticky. They help to prevent pooling of secretions in the back of the nose and throat where they often cause choking. The thinner secretions pass more easily. Guaifenesin (Humibid, Fenesin) and organic Iodine (Organidin) are commonly used formulations. If a rash develops or there is swelling of the salivary glands they should be discontinued. |
Allergy / Intolerance to Foods (Hidden)| | Thirty-five children with atopic dermatitis were proven to be allergic to various foods by dietary elimination and challenge, radio-allergosorbent test (RAST) and human basophil degranulation test (HBDT). Oral sodium cromoglycate improved skin lesions in these patients and protected them from the effects of challenge with food allergens. This protective effect of oral sodium cromoglycate may be explained by the blocking of the immune response in the gut wall and of antigen entry. [Ann Allergy. 1981 Sep;47(3): pp.173-5] The initial dose was 100mg per day and was progressively raised to 200-600mg per day, depending on the response. |
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Autoimmune |
Addison's Disease| | If you receive an early diagnosis of Addison's disease, treatment may involve taking prescription corticosteroids. Because your body isn't producing sufficient steroid hormones, your doctor may have you take one or more hormones to replace the deficiency. Cortisol is replaced using hydrocortisone (Cortef), prednisone (Deltasone) or cortisone. Fludrocortisone (Florinef) replaces aldosterone, which controls your body's sodium and potassium needs and keeps your blood pressure normal.
You take these hormones orally in daily doses that mimic the amount your body normally would make, thereby minimizing side effects. If you're facing a stressful situation such as an operation, an infection or a minor illness, your doctor may suggest a temporary increase in your dosages. |
Hyperthyroidism| | Because of the importance of controlling hyperthyroidism and preventing it's effects (on bone loss, for example), the use of conventional drugs to accomplish this should be considered strongly. |
Myasthenia Gravis| | Conventional medicine can control myasthenia gravis. Some medications improve neuromuscular transmission and increase muscle strength, and some suppress the production of abnormal antibodies. These medications must be used with careful medical supervision because they may cause major side effects. |
Autoimmune Tendency| | Natural compounds derived from a sea anemone extract and a shrub plant have been found to block the autoimmune disease response in type-1 diabetes and rheumatoid arthritis, according to University of California, Irvine researchers.
The study shows both in human and animal tests how these compounds work to deter the effect of autoimmune T-cells, white blood cells that attack the body. The goal, according to UCI researchers, is to develop new treatments from these compounds that will target these destructive T-cells while allowing other white blood cells to fight disease and infection.
The study, led by UC Irvine School of Medicine researchers George Chandy and Christine Beeton, identifies how these compounds work against a type of white blood cells called effector memory T lymphocytes, which play a major role in autoimmunity. Both compounds block an ion channel in these cells that prevents the cells from proliferating and producing chemicals called cytokines that attack the body during autoimmune disease states.
"Autoimmune diseases affect millions of Americans, and any new therapies that can aid them will have great significance," Chandy said. "What's promising about this study is that we identified a protein target on the T-cells that promote autoimmune activity and the compounds that can selectively block the target and shut down the destructive cells."
White blood cells patrol the body to fight against cancer and infections, but if some of these cells turn against the body they are meant to protect, they cause autoimmune diseases. Millions of people worldwide are afflicted with disabling autoimmune disorders. Two examples of this large class of diseases are type 1 diabetes, in which white blood cells attack the pancreas, and rheumatoid arthritis, in which the joints are attacked.
In their study, the UCI researchers used modified compounds derived from the rue plant (PAP-1) and a Cuban sea anemone extract (SL5), both of which block the ion channel in the destructive T-cells. [Early Online Edition of the Proceedings of the National Academy of Sciences. Nov 6-10, 2006 |
Multiple Sclerosis / Risk| | A form of bacteria seems to be the organic cause of multiple sclerosis, claims a Dr. Hoekstra, MD. Its tentative name - not yet widely accepted by other microbiologists - is Borrelia mylophora, so named because its characteristics seem to resemble those of Borrelia burgdorferi, the bacteria believed responsible for Lyme disease. In cases of multiple sclerosis, the myelin sheath covering the nerves gets eaten away by the immune system, explains Dr. Hoekstra. "That is exactly like the hunters' torches setting fire to the forest. Most of the destruction of the myelin sheath takes place from actions of the white blood cells and their antibodies. But their primary target is not the myelin sheath at all. It's the Borrelia mylophora bacteria, running around in the nervous system. B. mylophora has an extremely high affinity for the myelin sheath. It loves it."
The successful use of doxycycline against B. mylophora was first verified by a physician in South Dakota who reasoned that the symptoms of MS (which he had) were suggestively similar to those of Lyme disease, which responds fairly well to doxycycline. After dosing himself for three months with the antibiotic, he was symptom free. However, the long-term use of antibiotics has many drawbacks, cautions Dr. Hoekstra. It seriously damages the ecology of intestinal microflora and can lead to a condition of microbial imbalance called dysbiosis. This in turn can be the foundation for numerous diseases. It can also facilitate the growth of more cell wall deficient forms. To counteract this, probiotic replacement is required.
Researchers from the Medical University of South Carolina have produced the first clinical evidence that statins can help in multiple sclerosis in an article in The Lancet (May 2004).
A group of 30 patients with MS given 80mg a day of Zocor, or simvastatin, had a 44 percent reduction in brain lesions after three months of treatment, their study showed. Brain lesions are areas of inflammation, and are markers of the progression and severity of MS -- a debilitating disease in which nerve cells lose their insulating sheath, leading to muscle weakness, fatigue, bladder problems and impaired vision.
Professor Chris Polman, an MS expert at the VU Medical Center in Amsterdam said more research was needed, including a large placebo-controlled clinical trial.
Tysabri was withdrawn in 2005 by Biogen Idec Inc. and Elan Corp. PLC, only months after it had been approved. The Food and Drug Administration has allowed testing to resume after the company said no more cases of the brain disease had emerged.
The new studies found that Tysabri alone or with standard interferon treatment cut the rate of relapse by as much as two-thirds after two years and reduced the number of people whose MS got worse, compared to those on a dummy treatment or interferon alone.
Tysabri was highly anticipated because it works in a different way than existing drugs, which offer only modest help. It blocks destructive immune cells from leaving the bloodstream and entering the brain to inflame and damage nerve tissue.
The studies "confirm that this drug is a significant advance for MS treatment," said Dr. Allan H. Ropper of Boston's Caritas St. Elizabeth's Medical Center, who wrote an editorial in the journal. [NEJM March 1, 2006] |
Ulcerative Colitis| | Mild symptoms of UC may respond to antidiarrheal medications and dietary changes. Prescription medications may be used to treat mild symptoms and keep the disease in remission. Usually, corticosteroids (such as hydrocortisone or prednisone) are given for a few weeks to control active disease. Once inflammation is under control, aminosalicylates (such as sulfasalazine or mesalamine) can be used to maintain remission.
Moderate to severe symptoms of UC usually require corticosteroids to control inflammation. The required dose of steroids may be higher than that necessary to treat mild colitis.
Canasa Rectal Suppositories contains 500mg of mesalamine. Sulfasalazine has been used in the treatment of ulcerative colitis for over 55 years. It is split by bacterial action in the colon into sulfapyridine (SP) and mesalamine (5-ASA). It is thought that the mesalamine component only is therapeutically active in ulcerative colitis.
Immunomodulator medications, such as azathioprine (AZA) or 6-mercaptopurine (6-MP), also may be needed for severe cases that cannot be controlled with aminosalicylates alone. These medications suppress the body's immune system to prevent inflammation, and may be needed to avoid the long-term use of steroids.
Using an epidermal growth factor (EGF) enema with oral medication is effective in treating the ulcers and inflammation that ulcerative colitis causes, a study shows. EGF is known to stimulate the healing process. The research shows that the stimulating properties in an EGF enema can help speed up the healing process of the ulcers, improve symptoms, and lead to more remissions.
To determine EGF's effectiveness, researchers split 24 volunteers into two groups and evaluated them at two-, four-, and 12-week intervals. Half of the patients were men. Each participant gave himself or herself an enema and retained the solution for more than 45 minutes per day for 14 days. One group had enemas containing EGF, but the comparison group did not. All of the volunteers also combined their treatment with the ulcerative colitis drug mesalamine, which was taken orally. At the start, all of them had common symptoms of ulcerative colitis, including: fatigue, weight loss, loss of appetite, rectal bleeding, and loss of body fluids and nutrients
At two weeks, the group taking the EGF enemas showed significant decreases in symptoms, and 10 out of 12 went into remission, compared with 1 out of 12 in the comparison group. Eight of the 12 in the EGF group remained in remission after 12 weeks.
Two patients in the comparison group left the study by the second week because their symptoms got worse. [NEJM, July 24, 2003]
Crohn's disease (CD) and ulcerative colitis (UC) are chronic-relapsing diseases, the clinical courses of which are characterized by periods of remission and periods of acute flare up, determining clinical symptoms which have a strong impact on the quality of life for patients. For many years, corticosteroids have represented the cornerstone of therapy for induction of remission in Inflammatory Bowel Disease (IBD); however, the side-effects emerging with long-term use exceeded the clinical benefits. Recently, Infliximab (IFX) has become an alternative choice in the treatment strategies for CD and UC. Some safety issues are associated with IFX use, mostly related to the development of adverse events (e.g. opportunistic infections, autoimmune disorders and infusion reactions). Major concerns are related to the reactivation of latent tuberculosis and development of malignancy, even if there is no clear evidence the use of IFX increases the incidence of solid cancers. The research published in issue 39 of World Journal of Gastroenterology and led by Renato Caviglia at University Campus Biomedico in Italy aimed to retrospectively evaluate the safety and efficacy of long-term therapy with IFX, reviewing the medical charts of 41 IBD patients who received, after a loading dose of 3 IFX infusions, scheduled retreatment every 8 weeks as maintenance protocol.
Centocor, Inc., Schering-Plough Corporation, and Mitsubishi Tanabe Pharma Corporation have announced (2007) that an estimated one million patients have now been treated with REMICADE (infliximab), the leading anti-tumor necrosis factor (TNF)-alpha therapy worldwide. In fact, REMICADE has been used to treat more patients worldwide than all other anti-TNF-alpha agents combined. REMICADE was the first anti-TNF-alpha treatment approved by the U.S. Food and Drug Administration (FDA), when it was indicated for the treatment of acute moderate to severe Crohn's disease in 1998. The indication for Crohn's disease was quickly followed by additional indications, such as rheumatoid arthritis.
REMICADE has been studied in more than 37 clinical trials, evaluating its use in a wide variety of diseases of the immune system and is approved for use in 88 countries. |
Lupus, SLE (Systemic Lupus Erythromatosis)| | Hydroxychloroquine (Plaquenil) is one of a number of drugs, like chloroquine or quinacrine, which have been used for many years in the treatment of malaria. It was discovered that these drugs often are helpful in the treatment of various rheumatic diseases, particularly systemic lupus erythematosus (SLE) and rheumatoid arthritis. Although chloroquine is sometimes used, the preferred antimalarial drug is hydroxychloroquine due to its greater safety. These can be used in combination also, sometimes with better success. |
Microscopic Colitis| | Conventional treatment is often started with sulfasalazine. Patients may improve with sulfasalazine, but they are not necessarily cured. For the many that don't tolerate sulfasalazine, Asacol (one brand of mesalamine or 5-aminosalicylic acid) is typically prescribed. These medicines are thought to act as anti-inflammatory agents in the intestine.
Anti-diarrheal medications such as Imodium and Lomotil are used for temporary relief, but tend to merely delay the diarrhea.
Studies done with prednisone (a corticosteroid) do not sound very promising for long-term use. Most patients do respond quickly to this agent, so it can be useful to stop a severe attack. However, the diarrhea routinely returns when prednisone is discontinued. Long-term use of prednisone is discouraged because the side effects (formation of cataracts, bone degeneration, high blood pressure, and a tendency toward diabetes) which can eventually be worse than the benefits.
Some people report excellent short-term results with certain antibiotics; however, the results generally are not long lasting.
A cholesterol-lowering drug called cholestyramine is helpful to some. Fiber in the form of psyllium hydrophilic mucilloid (like Metamucil) also helps some patients, but not others.
Low dose tricyclic antidepressants (such as Doxepin or Elavil) can sometimes help with the joint and muscle pain. |
 Ankylosing Spondylitis| | Sulfasalazine is a prodrug, that is, it is not active in its ingested form. It is broken down by bacteria in the colon into two products: 5-aminosalicylic acid (5ASA), and sulfapyridine. There is some controversy as to which of these two products are responsible for the activity of azulfidine. Whereas it is known that 5ASA has therapeutic benefit, it is not clear whether sulfapyridine adds any further benefit. In the colon, the products created by the breakdown of sulfasalazine work as anti-inflammatory agents for treating inflammation of the colon. The beneficial effect of sulfasalazine is believed to be due to a local effect on the bowel, although there may also be a beneficial systemic immune-suppressant effect as well. Following oral administration, 33% of the sulfasalazine is absorbed, all of the sulfapyridine is absorbed, and about 33% of the 5ASA is absorbed. Sulfasalazine was approved by the FDA in 1950.
Through a long line of firsts in the biotechnology industry, the history of REMICADE includes 15 FDA indications spanning across inflammatory diseases that include Crohn's disease (adult and pediatric), ulcerative colitis, rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis and psoriasis. (2007) |
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Childhood |
Cerebral Palsy| | There are many different drugs that can be and are commonly used for muscle relaxation in CP. |
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Circulation |
Congestive Heart Failure| | Prescription drugs are part of a program used to treat CHF. Such a program should consider:
- Reducing the workload of heart (limit activity level, reduce weight and control hypertension)
- Using diuretics (removal of retained salt and water) and restrict sodium (low salt diet)
- Using angiotensin-converting enzyme inhibitors (decreases afterload and retained salt and water)
- Using digitalis (positive inotropic effect on depressed heart)
- Using vasodilators (decreases preload & afterload)
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Chronic Venous Insufficiency (CVI)| | Daflon 500mg is an oral phlebotropic drug indicated in the treatment of venous disease, ie, chronic venous insufficiency (CVI) and hemorrhoidal disease (HD). It contains naturally occurring substances, but one of them has been modified for better absorption.
Daflon 500mg, micronized, purified flavonoid fraction (MPFF), is a semisynthetic phlebotropic drug whose active ingredients are micronized diosmin (90%) and hesperidin (10%). Hesperidin is extracted from a species of Rutaceae aurantieae of the citrus genus, a type of immature small orange harvested and dried in Spain, North Africa, and China. Diosmin, a member of the flavonoid family, is synthesized starting from this raw material.
Daflon is challenging to find in the USA, but can be ordered from some foreign pharmacies, including India and Malaysia. Some locations seem to be charging too much, so please shop around. Two capsules a day should cost around one US dollar. |
Lymphatic Congestion| | DAFLON 500 mg improves lymphatic drainage by increasing the frequency and intensity of lymphatic contractions, and by increasing the total number of functional lymphatic capillaries. Furthermore, DAFLON 500 mg decreases the diameter of lymphatic capillaries and the intralymphatic pressure. [Phlebology. 1994;(suppl 1): p.23-25, Lymphology. 1998;31(suppl): pp.12-16] |
Varicose Veins| | DAFLON 500 mg has a comprehensive and rigorously demonstrated mode of action, which enables it to fight simultaneously all the pathophysiological aspects of venous disease, affecting the veins, lymphatics, and microcirculation.
It prolongs the vasoconstrictor effect of noradrenaline on the vein wall, even under warm and acidotic conditions, increasing venous tone, and therefore reducing venous capacitance, distensibility, and stasis. This increases the venous return and reduces venous hyperpressure present in patients suffering from chronic venous insufficiency (CVI).
Daflon is challenging to find in the USA, but can be ordered from some foreign pharmacies, including India and Malaysia. Some locations seem to be charging too much, so please shop around. Two capsules a day should cost around one US dollar. |
Arrhythmias/Dysrhythmias| | In atrial fibrillation, medications are available to restore and maintain a normal heart rhythm. Additionally, blood thinning agents, such as Coumadin (warfarin), are prescribed to reduce the risk of clots forming or stroke. The results of a study were announced showing that an experimental orally administered anticoagulant, Ximelagatran (Exanta™, Exanta™, AstraZeneca) has been shown to be a highly effective alternative to well-controlled warfarin for stroke prevention in patients with non-valvular Atrial fibrillation, not only resulting in a greater reduction of strokes and systemic embolic events in these individuals, but also caused less bleeding while providing a safer, easier-to-administer agent without the need for monitoring. [Halperin JL., Am Heart J. September 2003;146(3): pp.431-8]
For PVCs, unless there is structural heart damage, no action may be required. If symptoms are troubling, a mild anxiolytic drugs or beta-adrenergic blockers may be helpful. Long-term treatment of ventricular tachycardia may require the use of oral anti-arrhythmic medications (such as procainamide, amiodarone, or sotalol). Anti-arrhythmic medications, however, may have severe side effects, and their use is currently decreasing in favor of other treatments. |
Phlebitis / Thrombophlebitis| | Subcutaneous (beneath the skin) injection of the original and less expensive form of the anticoagulant medication heparin is as effective and safe as subcutaneous administration of the newer and more expensive low-molecular-weight heparin for treatment of venous thromboembolism.
"We conclude that fixed-dose subcutaneous unfractionated heparin is as effective and safe as low-molecular-weight heparin for initial treatment of patients with venous thromboembolism and is suitable for treatment at home," they write. "In addition, the results of this study question the value of APTT monitoring in patients who are treated with currently recommended doses of unfractionated heparin." [JAMA. 2006;296: pp.935-942] |
Increased Risk of Stroke| | You can increase the chance of getting the preventive effects and decrease the chance of side effects effects of any medicine by choosing and using it wisely. When it comes to using aspirin to lower the risk of heart attack and stroke, choosing and using wisely means knowing the facts and working with your health professional.
There are many reasons to believe that the drug dipyridamole (300mg per day) will be far more effective in the prevention of heart attacks and strokes than aspirin. Moreover, dipyridamole has none of the harmful side effects of aspirin.
Dipyridamole, like aspirin, inhibits platelet adhesion, and thus tends to prevent the vascular thrombosis of heart attacks and strokes. In a trial referencing the poor response to aspirin, Dipyridamole was added to the treatment protocol and the results were outstanding. Over a two-year period, stroke deaths were decreased by 50%, deaths from myocardial infarction decreased by 38% and deaths from cancer by 25%. [ European Stroke Prevention Study, Lancet, December 12, 1987; pp. 1,371-4] |
Hypotension| | If simple measures don't alleviate the problem, you may need conventional medication. Although a wide range of drugs (including phenylpropanolamine, ephedrine and the nonsteroidal antiinflammatory drugs indomethacin and ibuprofen) have been used to treat hypotension, many of them are not consistently effective.
The following medications have proven effective in treating postural hypotension:
Fludrocortisone. Fludrocortisone is a mineralocorticosteroid that appears to be effective for most types of postural hypotension. It works by promoting sodium retention by the kidney, thereby causing fluid retention and some swelling, which is necessary to improve blood pressure. Its sparing effect on sodium is done at the expense of a concurrent loss of potassium. Therefore, when taking fludrocortisone, it's important to also take adequate amounts of potassium each day. Fludrocortisone has none of the anti-inflammatory properties of cortisone or prednisone and it is not a muscle-building agent.
Midodrine. Midodrine activates receptors on the arterioles and veins to produce an increase in blood pressure. Studies show that it is effective in improving standing blood pressure in those with postural hypotension related to nervous system dysfunction, such as in patients with Shy-Drager syndrome. |
Pericarditis| | In a study of nine patients with recurrent pericarditis resistant to traditional therapy it was found that all had a positive response with colchicine at a dose of one mg/day. These patients had experienced relapses despite treatment with indomethocin, acetylsalicylic acid, or prednisone. With colchicine treatment prednisone was discontinued in all patients between 2 to 6 weeks. The colchicine was continued. A mean follow-up of 24.3 months showed no recurrences in
any patient. These results are encouraging but due to the small sample in this study larger trials are warranted. [Circulation, 1990;82: pp.1117-1120] |
Sickle Cell Trait / Disease| | GenoMed, the Next Generation Disease Management company whose business is public healt, announced today that it has submitted a case report of a sickle cell patient whose pain disappeared with GenoMed's treatment approach, only to recur when GenoMed's treatment was stopped.
The patient is a middle-aged African American woman who for years required multiple pain pills every day to tolerate the pain of her sickle cell disease. Since beginning GenoMed's trial on Dec. 22, 2005, she experienced no pain until her trial medication ran out on February 6, 2006. Said her physician, who is lead author on the case report, "Prior to this experiment, for over two years, there has not been more than a day, at least during the winter months, when she has not required some Vicodin." [medicalnewstoday.com, 16, Sep 2006] |
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Digestion |
Constipation| | Research has found that a medication, tegaserod, is effective in treating nearly all symptoms associated with chronic constipation (CC), a common disorder of the gastrointestinal tract that affects approximately 15% of the Western population at any one time. Tegaserod is currently the only drug aside from laxatives found to be effective at treating such a wide variety of symptoms.
"Chronic constipation is a complex medical disorder and several bodily mechanisms are involved in its development," says Stefan Muller-Lissner, M.D., lead author of the study. "The positive results we have found from tegaserod treatment in relieving this array of symptoms could potentially benefit millions."
The long-term safety, efficacy and tolerability of tegaserod have been proven. Patients show no serious side-effects from long-term usage and maximal improvements were observed after approximately 6 months of further treatment and were sustained thereafter. [The American Journal of Gastroenterology, 27 Nov 2006]
Well, another drug bites the dust. The Food and Drug Administration (FDA) has requested that Novartis Pharmaceuticals Corporation of East Hanover, New Jersey, voluntarily discontinue marketing of Zelnorm (tegaserod) based on the recently identified finding of an increased risk of serious cardiovascular adverse events (heart problems) associated with use of the drug. Novartis has agreed to voluntarily suspend marketing of the drug in the United States.
Zelnorm is a prescription medicine approved in July 2002 for short-term treatment of women with irritable bowel syndrome whose primary symptom is constipation. It was subsequently approved in August 2004 for treatment of chronic constipation for men and women under age 65. Zelnorm is marketed in 55 countries.
FDA is currently advising patients who are using Zelnorm to contact their health care providers to discuss treatment alternatives. Patients who are taking Zelnorm should seek emergency medical care if they experience severe chest pain, shortness of breath, dizziness, sudden onset of weakness or difficulty walking or talking, or other symptoms of a heart attack or stroke.
"This decision reflects the FDA's commitment to continuously monitor approved drugs throughout their marketing life, and take action when we believe the risks exceed the benefits," said Dr. Douglas Throckmorton, Deputy Director for the Center for Drug Evaluation and Research. "Here, a potential risk of very serious harm to patients who have this non-life-threatening condition was recently identified, making this action necessary."
Throughout February and March 2007, Novartis reported to FDA the results of a new analysis of 29 short-term (1 - 3 months) randomized, controlled clinical trials of Zelnorm. FDA has concluded, based on these data that for most patients the benefits of this drug no longer outweigh the risks. |
Hemorrhoids| | In acute hemorrhoidal attacks, DAFLON 500mg is highly effective, right from the second day of treatment, in improving all signs and symptoms, such as bleeding, pain, discharge, tenesmus, and proctitis, thereby reducing the consumption of oral analgesics.
The efficacy of DAFLON 500 mg associated with fiber supplement has been superior to fiber supplement alone and equivalent to rubber-band ligation plus fiber supplement in stopping anal bleeding due to hemorrhoids.
DAFLON 500 mg combined with hemorrhoidectomy significantly reduces the risk of postoperative bleeding.
In long-term treatment for chronic hemorrhoidal disease, DAFLON 500mg has been proven to significantly reduce recurrence, duration, number, and severity of hemorrhoidal attacks. [Dis Col Rectum.2000;43: pp.66-69, Phlebology. 1992;7(suppl 2): pp.61-63] |
IBS (Irritable Bowel Syndrome)| | Please see the link between IBS and Antibiotics. |
Nausea, Vomiting| | Until recently, symptoms of nausea almost always were treated with promethazine (Phenergan) suppositories. Today's technology offers more choices, both commercially and through compounding.
A few OTC treatments are available that can be helpful in relieving nausea, vomiting, and dizziness. Dimenhydrinate (Dramamine) and meclizine (Bonine) are perennial favorites for treating symptoms associated with motion sickness. Emetrol (consisting of dextrose, fructose, and phosphoric acid), can be effective in treating nausea.
When OTC treatments fail to provide the needed relief, a prescription medication may be more appropriate. Commercially available options include dopamine-2 antagonists such as promethazine and prochlorperazine (Compazine), as well as 5-hydroxytryptamine-3 antagonists such as ondansetron (Zofran) and granisetron (Kytril). For motion sickness, scopolamine is a highly effective anticholinergic agent. Additional options include metoclopramide, chlorpromazine, and haloperidol.
Please keep in mind that other conventionally used medications you may be taking for other purposes can cause nausea and vomiting. |
Not recommended for:
 Heartburn / GERD| | If you are currently taking a proton pump inhibitor like Prilosec or Nexium you should not stop these drugs suddenly. That is one of their main dangers, in that while they relieve your symptoms they actually make the underlying condition worse and cause you to be dependent on them. Transition to an H2 receptor antagonist like Zantac at bedtime and then gradually wean off the Zantac. Zantac is much safer than these proton pump inhibitors. |
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Drug Side Effects |
Anticoagulant Use| | Continued anticoagulant use is recommended, although the dose may need to be reduced or even eliminated when taking natural anticoagulants. Lab test monitoring is necessary to make sure that the blood is not overly thinned. |
Not recommended for:
Prescription Drug Side-Effects| | As with so many things, the benefits of a medication must be balanced against any side effects. Some consequences require that the medication be discontinued. |
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Hormones |
Hypothyroidism| | Please see the link between Hypothyroidism and Thyroid Medications. |
Hyperprolactinemia| | Medications such as some blood pressure medications, anti-nausea drugs or antipsychotics may cause elevated prolactin levels.Here is a page where many men and women describe how much Dostinex has helped them. |
Elevated SHBG| | SHBG's may be lowered by two of the artificially generated progesterones, norgestrel and norethisterone. |
Hirsutism| | If you have seen a medical doctor about hirsutism, you’re probably taking birth control pills, possibly in combination with one or more other drugs. Drugs to retard hirsutism fall into three broad categories:
1. Androgen receptor blockers: Cyproterone, flutamide (Eulexin), and spironolactone (Aldactone).
2. Androgen-suppressing agents: GnRH agonists (Lupron), estroprogestins (birth control pills), corticosteroids, and insulin-sensitizing agents (metformin/Glucophage).
3. 5 alpha-reductase inhibitors: Finasteride (Proscar), eflornithine hydrochloride (Vaniqa).
All of these drugs work to some extent. They have helped some women see measurable reductions in androgen levels and unwanted hair growth. Most have side effects. All are recommended in conjunction with birth control pills, partly to control the side effects of these medications. |
Low HGH (Human Growth Hormone)| | Adding the medication mestinon (30-60 milligrams before exercise) may restore the normal rise in growth hormone release during exercise in fibromyalgia. |
Low Testosterone Level| | The most commonly used aromatase inhibitor in bodybuilding is aminoglutethimide (Cytadren). This drug also inhibits an enzyme (desmolase) necessary for synthesis of cortisol, but fortunately, aromatase can be inhibited with levels of drug that cause only limited inhibition of desmolase.
For an average male, a dose of 250mg per day (one tablet) appears optimal. The half-life is 8 hours, so the drug is better taken in divided doses. The best plan seems to be to take half a tablet on arising, and quarter tabs six and twelve hours later. This keeps levels generally fairly constant, but allows a small drop in the hours shortly before arising, which is then compensated for by the higher dose on arising. With this scheme, inhibition of cortisol production is generally too low to be noticed, and generally there is no rebound effect on discontinuance. However it is not a bad idea nonetheless to taper off, first omitting the midday quarter tab dose for a few days, then omitting both quarter tab doses, then reducing the initial dose to one quarter tab, and then ending completely. A week is sufficient for the taper.
Some people suffer a degree of lethargy or sedation from aminoglutethimide, even at this low dose, but most do not.
Anastrozole (Arimidex) is a superior aromatase inhibitor which does not have the above side effects. It is, however, very expensive. With moderate doses of testosterone it seems that 1mg perday is sufficient, and some have claimed half a tab to be sufficient. |
Low Adrenal Function / Adrenal Insufficiency| | The use of hydrocortisol to supplement low cortisol output by weak or failing adrenal glands is essential. |
Elevated DHEA| | Aldactone (spironolactone) decreases androgens like DHEA and testosterone and thus helps to decrease excess hair growth and acne. |
Low SHBG| | Selection of an OC formulation that maintains increases in SHBG may be important in minimizing androgenic effects in general, and especially important in hyperandrogenic women, who may benefit most from reductions in levels of free testosterone.
SHBG's may be lowered by two of the artificially generated progesterones, norgestrel and norethisterone. If you are a woman who may be susceptible to androgenetic alopecia, that is, hereditary hair loss (female pattern baldness), or you have a naturally low SHBG level, you should avoid any contraceptive pills or hormone replacement therapy that contains synthetic progesterone. |
Cushing's Syndrome / Hypercortisolism| | Please see the link between Cushing's and Surgery. |
Elevated Testosterone Level, Female| | Troglitazone and metformin lower biologically available testosterone levels by approximately 25% in women with PCOS. This testosterone lowering correlates with the reduction in insulin levels. Resumption of ovulation has been reported in women receiving these agents alone or in combination with clomiphene citrate (Clomid). |
Elevated Insulin Levels| | Metformin makes the body's tissues more sensitive to insulin and is one of the most common OHAs, or oral hypoglycemic agent, on the market. Its use can make weight loss easier too. |
Not recommended for:
Low Sex Drive| | The most common medications that put a damper on sex include antidepressants, which inhibit arousal and orgasm; anti-inflammatories, which also hamper orgasm; ulcer medications, which lessen desire; and birth control pills, which limit desire and decrease lubrication. Diuretics and anti-anxiety drugs may have this side-effect also. |
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Immunity |
AIDS / Risk| | Prednisone must be used cautiously by HIV-positive individuals because it is immunosuppressive and can increase the risk of getting opportunistic infections.
ATRIPLA contains 3 medicines, SUSTIVA (efavirenz), EMTRIVA (emtricitabine) and VIREAD (tenofovir disoproxil fumarate also called tenofovir DF) combined in one pill. EMTRIVA and VIREAD are HIV (human immunodeficiency virus) nucleoside analog reverse transcriptase inhibitors (NRTIs) and SUSTIVA is an HIV non-nucleoside analog reverse transcriptase inhibitor (NNRTI). VIREAD and EMTRIVA are the components of TRUVADA. ATRIPLA can be used alone as a complete regimen, or in combination with other anti-HIV medicines to treat people with HIV infection. ATRIPLA is for adults age 18 and over. |
Chronic Fatigue / Fibromyalgia Syndrome| | If prescriptions medications are needed to maximize sleep, Ambien, Desyrel, and Klonopin are more helpful than other sleep medications when CFS / Fibromyalgia is present. |
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Infections |
MRSA| | Vancomycin is one of the few antibiotics still effective against hospital strains of MRSA infection, although the drug is no longer effective in every case. Several drugs continue to work against CA-MRSA, but CA-MRSA is a rapidly evolving bacterium, and it may be a matter of time before it, too, becomes resistant to most antibiotics. |
HPV (Human Papilloma Virus)| | A conventional MD may offer you one of several ways to treat genital warts.
- Imiquimod, an immune response cream which you can apply to the affected area
- 20 % podophyllin anti-mitotic solution, which you can apply to the affected area and later wash off
- 0.5 % podofilox solution, applied to the affected area but shouldn’t be washed off
- 5 % 5-fluorouracil cream
- Trichloroacetic acid (TCA)
If you have small warts, the doctor can remove them by freezing (cryosurgery), burning (electrocautery), or laser treatment. Occasionally, the doctor will have to use surgery to remove large warts that have not responded to other treatment.
The antiviral drug alpha interferon is sometimes injected directly into the warts, to treat those which have returned after removal by traditional means.
If you are pregnant, you should not use podophyllin or podofilox because they are absorbed through the skin and may cause birth defects. 5-fluorouracil cream should be avoided also during this time.
While treatment can remove warts, the virus remains present and warts can appear again in the future. |
Sinusitis| | Please see the link between Sinusitis and Antibiotics. |
Shingles (Herpes Zoster)| | In a double-blind, randomized, crossover study, 58 patients with postherpetic neuralgia received 6-week courses of amitriptyline, 12.5 to 150 mg/d; lorazepam, 0.5 to 6 mg/d; or lactose placebo. Doses were titrated to the maximum level tolerated. Patients rated pain in a diary, using lists of verbal descriptors. Forty-seven percent of patients reported moderate or greater relief with amitriptyline, 16% with placebo, and 15% with lorazepam. Mean amitriptyline dose was 65 mg/d. Greater relief was associated with higher amitriptyline doses, up to the maxiumum dose of 150 mg/d, and with higher serum tricyclic levels. Lorazepam did not relieve pain and was associated with severe depressive reactions in four patients. [NEUROLOGY 1988;38:1427]
Based on evidence from randomized trials, tricyclic anti-depressants appear to be the only agents of proven benefit for established postherpetic neuralgia. |
Lyme Disease| | Please see the link between Lyme Disease and Antibiotics. |
Parasite, Eosinophilic Meningitis / Rat lung worm| | In severe cases steroids may help to reduce inflammation and symptoms. The worms generally die without treatment after a few weeks. Giving a patient anti-worm treatment can make their condition much worse by killing all worms present at the same time which results in even greater brain inflammation. |
Parasite, Pinworm Infection| | Pin-X (pinworm treatment containing pyrantel pamoate) is available over-the-counter as a single dose remedy. If you have side-effects after taking pyrantel, get advice from your health care provider before you take it again, especially if a skin rash occurs. |
Not recommended for:
Periodontal Disease - Gingivitis| | Some drugs, such as oral contraceptives, anti-depressants and certain heart medicines, can affect your oral health. |
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Inflammation |
Chronic Inflammation| | Although they are sometimes necessary, long-term use of the more dangerous antiinflammatory drugs, such as prednisone, can cause diabetes, osteoporosis, or even death.
Metformin is a drug used to treat type II diabetes. It functions via different mechanisms to restore youthful metabolic-glucose metabolism. Metformin’s ability to lower elevated blood insulin levels helps explain why it has been shown to significantly lower C-reactive protein levels in human studies, which reduces inflammation. |
Not recommended for:
Heel Pain| | Cortisone injections should be avoided in the initial treatment of plantar fasciitis; they should be suggested only as supplemental treatment in patients who have resistant chronic plantar fasciitis after achieving adequate biomechanical control. These injections may provide only temporary relief and can cause a loss of the plantar fat pad if used injudiciously. |
Tendonitis| | Cortisone shots may reduce the pain and assist in recovery, but will not regrow damaged tissue. Some doctors have made the claim, now supported by evidence, that cortisone shots can in fact weaken the structures being treated, and do not recommend them in spite of the temporary relief they may offer. (Care must be taken when injecting cortisone near any ligament or tendon: they must not be injected into.)
While the use of anti-inflammatories may reduce the swelling and pain, they also may hinder permanent recovery. Inflammation is part of the process for normal tendon regrowth. The chronic use of anti-inflammatories should be approached with caution. |
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Lab Values |
Low Platelet Count| | Attacking a platelet-depleting autoimmune disease in a whole new way, an experimental drug is helping patients with immune thrombocytopenic purpura (ITP) once again produce healthy amounts of platelets -- with no major side effects.
That's the conclusion of a new, multicenter study led by Dr. James B. Bussel, professor of pediatrics at Weill Cornell Medical College, attending pediatrician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, and director of the Hospital's Program for Platelet Disorders.
His team's findings appear in The New England Journal of Medicine, November 19, 2006.
The new drug, a novel protein called AMG 531, successfully boosted platelet production in patents with chronic ITP, a serious autoimmune disorder that affects more than 16,000 adult Americans, and perhaps as many children, each year. |
Not recommended for:
Low White Count| | DMSA (used for removing heavy metals) can cause bone marrow suppression and is potentially hepatotoxic. There have been no reports yet of permanent bone marrow suppression or liver damage, but the literature has many case reports of significant neutropenia and thrombocytopenia during therapy with DMSA. |
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Mental |
Bipolar Disorder, Manic-Depressive| | People with this condition generally require life-long treatment with lithium or other drugs to control manic episodes, sometimes with antidepressants to control the depression, although it improves both depression and mania. In fact, the occurrence of depression in a person who has been taking lithium is often an indication that a higher dose is needed. For lithium to reach its maximum effectiveness, 2 or even 3 weeks is often required.
Some of the brand names under which lithium is sold are Lithane, Eskalith, Lithobid and Cibalith. Lithium is effective only for about half the people with bipolar disorder.
Some doctors believe that a significant bipolar disorder will not respond sufficiently to alternative interventions alone.
There aren't many studies with Seroquel (quetiapine fumarate) as the only medication used to treat bipolar disorder. As far as the anecdotal evidence goes, people are reasonably satisfied with this medication when it does work for bipolar mania. It does do a good job at boosting an antidepressant's effect on the depression side of things and often can work as a stand-alone mood stabilizer, dealing with both mania and depression, despite being approved to treat only mania. |
Attention Deficit Disorder (ADD / ADHD)| | Results of a study found that an extended-release form of methylphenidate - sold as CONCERTA (methylphenidate HCl in the OROS delivery system) may be associated with a lower likelihood of abuse than immediate-release methylphenidate (sold as Ritalin). - Nov 3, 2006.
"The abuse of prescription stimulant medications is a growing concern among physicians who prescribe these medications to treat Attention Deficit Hyperactivity Disorder (ADHD) and parents of children and teens who rely on these treatments to restore normal function," said Edward Sellers, M.D., Ph.D., an investigator on this study and professor of Pharmacology, Medicine and Psychiatry at the University of Toronto. "Our study suggests that slowing the rate of drug delivery through the extended-release OROS technology may decrease the likelihood of abuse." |
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Metabolic |
Narcolepsy| | Xyrem has been approved by the FDA for narcolepsy drug treatment, but with tight restrictions on its use. In high doses, it can cause dependence in over time. In addition very serious side effects, including seizures, coma, respiratory arrest, and death have been reported in people who abused it.
Another narcolepsy drug treatment is Selegiline (Eldepryl, Movergan), also known as deprenyl. It is an antioxidant drug that blocks monoamine oxidase B, an enzyme that degrades dopamine and may play a role in narcolepsy drug treatment. It has adverse interactions with nearly every antidepressant, some very serious. Patients suffering from depression should discuss all narcolepsy treatment options with their physician.
People taking any monoamine oxidase inhibitor are at risk for high blood pressure if they consume tyramine-containing foods or beverages, including aged cheeses, most red wines, vermouth, dried meats and fish, canned figs, fava beans, and concentrated yeast products.
Antidepressants have been very useful in narcolepsy drug treatment. They can be effective controlling symptoms of narcolepsy, particularly cataplexy.
Tricyclic Antidepressants. The tricyclic antidepressants protriptyline (Vivactil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and viloxazine appear to suppress REM sleep and may be added to the stimulant regimen in severe cases. These antidepressants do not cause sedation and are useful in managing cataplexy, sleep paralysis, and hypnagogic hallucinations (the hallucinations that occur between sleep and wakefulness).
Selective serotonin reuptake inhibitors (SSRIs) may also be helpful in combination with stimulants for narcolepsy drug treatment. For example, fluoxetine (Prozac), the standard SSRI, and citalopram (Celexa), another SSRI, have been reported to be effective in treating cataplexy that does not respond to standard narcolepsy treatments. |
Hypersomnolence| | Ritalin or other stimulant drugs have been used successfully in controlling the need to sleep during the day. One such is Provigil, a wake-promoting drug which improves wakefulness in patients with excessive daytime sleepiness (EDS) associated with narcolepsy or hypersomnia, without affecting nighttime sleep. |
Bulimic Tendency| | Research has lead to the development of selective serotonin reuptake inhibitors (SSRIs) to regulate serotonin in the body while suppressing food craving and promoting weight loss. Fluoxetine (Prozac) and fluvoxamine (Luvox) are two such inhibitors. To date, fluoxetine is the only drug approved by the FDA.
One study has shown that there is little difference between groups that incorporate the use of fluoxetine and psychotherapy and groups with psychotherapy alone (who were given a placebo). Both groups showed tremendous improvement in eating behaviors. The only observable difference was significant weight loss with the group receiving the fluoxetine. However, other studies have shown that when no psychotherapy is used, groups receiving fluoxetine produce dramatically different results than do groups receiving a placebo. Those receiving fluoxetine displayed improved eating behaviors and mood, while those receiving a placebo did not. |
Edema (Water Retention)| | There is no single, accepted gold standard treatment for idiopathic cyclic edema. Several different treatments have been reported. An agent used for treating high blood pressure called Captopril has also been used with success. It works against the kidney hormone aldosterone which is elevated in this condition and causes excess salt and water retention.
Sometimes a mild diuretic will help reduce fluid retention but can worsen the edema of idiopathic cyclic edema. While one would think that taking a "water pill" or diuretic would improve this edematous condition, it turns out that in most cases this is the wrong long term treatment. In fact, chronic diuretic use will increase the secretion of aldosterone which in turn produces more edema. If the chronic use of diuretics is discontinued, the cyclical swelling disappears in most cases within about 3 weeks.
Patients experiencing a disturbance in their ability to normally excrete salt may need to either be placed on a diet limited in salt and/or given diuretic medications. In the past, patients with diseases associated with edema were placed on diets that were very restricted in salt intake. With the development of new and very potent diuretic agents (water pills), this marked restriction in dietary salt intake is generally no longer necessary. These diuretics work by blocking the reabsorption and retention of salt by the kidneys, thereby increasing the amount of salt and water that is eliminated in the urine. |
Nephrotic Syndrome (NS)| | People with NS may be at risk for developing a blood clot in the legs or in the renal veins that transport blood from the kidney. Some patients take blood thinners to prevent this complication.
Controlling hypertension is essential in reducing proteinuria in NS. This is accomplished with angiotensin converting enzyme (ACE-1) inhibitors. ACE-1 inhibitors are the preferred blood pressure lowering medication because they provided added protection to the kidneys.
ACE-1 inhibitors cause a dry cough in approximately 8% of patients who take them. ACE-1 inhibitors are given in the highest dose tolerable to ensure kidney protection. If a patient develops a cough, a new class of drugs may be used, known as angiotensin receptor blockers (ARB). ARBs work by blocking angiotensin receptors, which blocks the effects of angiotensin after it is produced. They offer the same kidney protection as ACE-1 inhibitors without causing cough. If tolerable, ARBs may be combined with an ACE-1 inhibitor for added benefit. |
Acute, Intermittent Porphoria| | Medications and drugs are often the worst triggers. The following drugs can percipitate an attack of AIP and should be AVOIDED:
- barbiturates
- sulphonamides
- enzyme inducing anticonvulsants, for example carbamazepine, phenytoin, phenobarbitone and primodone
- oral contraceptives
- diphenylhydantoin
- rifampicin
- chlordiazepoxide
- griseofulvin
- ergots
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Headaches, Cluster| | Subcutaneously injected sumatriptan (6mg in 0.5ml) (Imitrex in the US) is the most effective, reliable, and rapid abortive therapy for cluster headache attacks. An injection (easily given by the patient) eliminates or markedly diminishes cluster headaches within 15 minutes in essentially all patients at every attack. Some patients have had headaches eliminated in as little as 7 minutes. This effect does not lessen with continued use. Some patients have had satisfactorily rapid results with sumatriptan nasal spray. The oral triptans are less effective, but some especially good responders with relatively milder and slower-developing headaches may prefer this route of administration. |
Insomnia| | Use of benzodiazepine medications for sleep disorders has become more and more common, and is implicated in a long list of side effects and difficult withdrawal symptoms. Benzodiazepines are often found under the following names, Xanax (Alprazolam), Valium (Diazepam), Ativan, Alzapam (Lorazepam), Halcion (Triazolam), Klonopin (Clonazepam), and Restoril, among others. Patients often find it very difficult to withdraw from these medications, and at the same time long-term medication with these drugs is often discouraged due to the addictive nature of the drugs and the accompanying side effects.
HOWEVER, restorative sleep is so important, if natural methods do not provide the deep sleep needed, a prescription drug may be worth trying.
Americans spent $2.1 billion on prescription sleeping pills in 2004, and bought 600 million over-the-counter ones. But many of these medicines, including antihistamines and antidepressants, haven't been proven safe and effective for the problem. And almost none of them have been approved for long-term use by the Food and Drug Administration (FDA), yet they are often taken for months or years. [USA Today July 27, 2005]
Since 1998, my colleagues and I found gabapentin (Neurontin) to fit the above description of the ideal pharmacotherapy for insomnia among alcoholics and substance users (Karam-Hage and Brower, 2000). To date, we have yet to observe any abuse or subjective effects reported by patients. In 2000, we reported an open-label study of 15 successfully treated cases. Gabapentin was started at 300 mg hs, the dose was increased to response by 300 mg/day to reach a maximum of 1800 hs (average dose=900 mg) with follow-up at one month. [Psychiatric Times, February 2004, Vol. XXI, Issue 2] |
Not recommended for:
Headaches, Migraine/Tension| | The regular and frequent use of conventional drugs should be avoided when possible. While pain killers may provide relief, they don’t deal with the cause of the problem. Pain medications, though apparently effective, may even aggravate the problems they attempt to solve. The use of medication, even in quantities as low as ten aspirin tablets per week, can be the cause of a chronic daily headache syndrome. One medical study found that stopping all treatments and pain medication actually decreased headache frequency and intensity in the subjects by more than 50%. The best thing to do when tolerable and circumstances allow is to avoid taking medication and assist the body's detoxification process. |
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Musculo-Skeletal |
Gout / Hyperuricemia| | Medications such as NSAIDs, corticosteroids and allopurinol are commonly used against gout.
Since the 1800s, colchicine has been the standard treatment for acute gout. While colchicine is very effective, it often causes nausea, vomiting and diarrhea. These side-effects are uncommon when this drug is given intravenously, but because of their unpleasant nature, non-steroidal anti-inflammatory drugs (NSAIDs) have become the treatment of choice for most acute attacks of gout. The NSAID that is most widely used to treat acute gout is indomethacin. NSAIDs may also have significant toxicity, but if used for the short-term, are generally well tolerated. Aspirin and aspirin-containing products should be avoided during acute attacks because they will further elevate uric acid levels.
Therapy directed at normalizing uric acid levels in the blood should be considered for patients who have had multiple gout attacks or have developed tophi or kidney stones. Several drugs that help the kidneys eliminate uric acid are available, such as probenecid, and a drug that blocks production of uric acid by the body, such as allopurinol. The choice between these two types of drugs depends on the amount of uric acid in the urine. With correct treatment, gout should be well controlled in almost all cases. |
Rheumatoid Arthritis| | Sulfasalazine is a prodrug, that is, it is not active in its ingested form. It is broken down by bacteria in the colon into two products: 5-aminosalicylic acid (5ASA), and sulfapyridine. There is some controversy as to which of these two products are responsible for the activity of azulfidine. Whereas it is known that 5ASA has therapeutic benefit, it is not clear whether sulfapyridine adds any further benefit. In the colon, the products created by the breakdown of sulfasalazine work as anti-inflammatory agents for treating inflammation of the colon. The beneficial effect of sulfasalazine is believed to be due to a local effect on the bowel, although there may also be a beneficial systemic immune-suppressant effect as well. Following oral administration, 33% of the sulfasalazine is absorbed, all of the sulfapyridine is absorbed, and about 33% of the 5ASA is absorbed. Sulfasalazine was approved by the FDA in 1950.
Plaquenil may be used for short or long-term rheumatoid arthritis treatment. In treating rheumatoid arthritis, Plaquenil may slow down the substances which harm the joints.
Centocor, Inc., Schering-Plough Corporation, and Mitsubishi Tanabe Pharma Corporation have announced that an estimated one million patients have now been treated with REMICADE® (infliximab), the leading anti-tumor necrosis factor (TNF)-alpha therapy worldwide (2007). In fact, REMICADE has been used to treat more patients worldwide than all other anti-TNF-alpha agents combined. REMICADE was the first anti-TNF-alpha treatment approved by the U.S. Food and Drug Administration (FDA), when it was indicated for the treatment of acute moderate to severe Crohn's disease in 1998. The indication for Crohn's disease was quickly followed by additional indications, such as rheumatoid arthritis.
"Rheumatoid arthritis derailed my life," said Ellen Shmueli, RA patient. "Simple tasks like lifting my child or holding a pen were nearly impossible. It's hard to put into words what REMICADE has meant to me."
Through a long line of firsts in the biotechnology industry, the history of REMICADE includes 15 FDA indications spanning across inflammatory diseases that include Crohn's disease (adult and pediatric), ulcerative colitis, rheumatoid arthritis (RA), ankylosing spondylitis, psoriatic arthritis and psoriasis.
"This significant milestone was achieved as a result of nearly three decades of expanding and improving access for people living with life-altering inflammatory diseases," said Neal Fowler, President, Centocor, Inc. "In partnership with Centocor R&D, we will continue our pledge of bringing the promise of biomedicine to physicians and patients through continued research and development, REMICADE and our promising pipeline portfolio."
REMICADE has been studied in more than 37 clinical trials, evaluating its use in a wide variety of diseases of the immune system and is approved for use in 88 countries. |
Osteoarthritis| | First US approval for a prescription NSAID (non-steroidal anti-inflammatory drug) treatment that can be applied directly to site of osteoarthritis pain (October 2007). Voltaren Gel is the only prescription topical medication proven to significantly reduce osteoarthritis pain in both the knees and the joints of the hands.
Voltaren Gel offers highly effective pain relief with minimal drug absorption throughout the body - shown to be 94% less than comparable oral diclofenac treatment. Voltaren Gel (diclofenac sodium topical gel) 1% has received US regulatory approval as the first topical prescription treatment that patients can apply directly to sites of pain associated with osteoarthritis. |
Juvenile Rheumatoid Arthritis| | The U.S. Food and Drug Administration (FDA) approved Celebrex (celecoxib) for a new use - the relief of the signs and symptoms of Juvenile Rheumatoid Arthritis (JRA) in patients two years of age and older. This approval follows the November 29 meeting of FDA's Arthritis Advisory Committee, in which the committee voted 15 to 1 in favor of approval of this product. [29 Dec 2006] |
Peyronie's Disease| | The most favorable nonsurgical treatment for Peyronie's involves injecting medication directly into the plaque in the attempt to soften the hardened tissue and decrease the pain and curvature. Injection medications include steroids, collagenase, verapamil and interferon. It is not yet clear which of these substances works best, although collagenase and verapamil appear the most promising at this time. |
Osteoporosis / Risk| | Servier, a leading independent French research-based pharmaceutical company, discovered and developed Protelos. Protelos has been recently licensed across Europe in the treatment of postmenopausal osteoporosis to reduce the risk of vertebral and hip fractures. It is the first agent of its kind with a dual action on bone metabolism, simultaneously increasing bone formation and decreasing bone resorption. This action rebalances bone turnover in favour of the formation of new and strong bone.
The results of two large-scale phase III clinical trials have shown that Protelos is effective at reducing the risk of vertebral and hip fractures in postmenopausal osteoporotic women. Results published in the New England Journal of Medicine from the first major clinical trial show that in women with existing vertebral fractures the risk of new vertebral fractures is halved within a year and in the longer-term. This efficacy has also been confirmed in patients without fracture at baseline. Recent results from the second major clinical study show that Protelos also significantly reduces the risk of hip fracture in postmenopausal osteoporotic patients . These results show the efficacy of Protelos whatever the severity of the disease and the site of fracture. Throughout its development Protelos was shown to be safe and well tolerated. Protelos is easy for patients to take; one sachet daily diluted in water taken at bed time.
Although Evista is frequently recommended for osteoporosis, a study indicated that calcium and vitamin D alone may produce the same benefit.
Two years of treatment with calcium at 500mg per day and vitamin D3 at 400-600IU per day plus placebo increased iliac crest bone mineral density similarly to calcium and vitamin D3 plus raloxifene (Evista; 60 mg/d or 120 mg/d) in a randomized, three-arm study of 54 postmenopausal women with osteoporosis. Compared to baseline, all treatments shifted the mean degree of bone mineralization to closely resemble that of premenopausal bone. [ J Clin Endocrinol Metab 2003;88(9):4199-4205]
A long-term study of the most widely used osteoporosis drug has found that many women can discontinue the drug after five years without increasing their fracture risk for as long as five more years.
The study on alendronate (fosamax) was led by researchers at the University of California, San Francisco, and findings are published in the December 27, 2006 issue of the "Journal of the American Medical Association." The research also showed that women at very high risk of painful spine fractures might be better-off continuing treatment.
"This has important implications as it has not been known whether treatment of osteoporosis should be continued indefinitely," said lead author Dennis Black, PhD, professor in the UCSF Department of Epidemiology and Biostatistics. "Because women with osteoporosis, particularly older post-menopausal women, often need to take multiple drugs, this would be welcome news for this group."
Fosamax Once Weekly (alendronate sodium) increased bone mineral density (BMD) more than Actonel Once-a-Week (risedronate) with similar tolerability, according to results of the Fosamax Actonel Comparison Trial (FACT). This is the first U.S. head-to-head study comparing FDA approved once weekly osteoporosis treatments in postmenopausal women with osteoporosis. In this study, Fosamax provided greater increases in BMD at all sites measured as early as six months, and lowered levels of biochemical markers of bone turnover further within the normal pre-menopausal range than Actonel within three months. Reducing and stabilizing bone turnover, which leads to increased bone density, are important factors in improving bone strength in patients with osteoporosis.
However, Merck, maker of osteoporosis drug Fosamax, may have “seriously under reported” the risks of "jawbone death" related to the drug, according to the American Association of Oral and Maxillofacial Surgeons. A class-action lawsuit has been filed claiming that Merck knew about the risk of jawbone death but hid it from the public.
"Jawbone death" is associated with the use of a bisphosphonate class of drugs (to which Fosamax belongs). Also known as Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ), is a serious side effect that destroys the bone in the jaw, and is difficult to treat.
BRONJ was reported by oral surgeons, who noticed the condition among patients treated with intravenous forms of bisphosphonates in 2003. A broader warning of BRONJ was issued for the entire class of drugs in 2005.
Fosamax is prescribed to about 10 million men and women -- mostly postmenopausal women -- each year to help increase bone density, with annual sales of $3 billion. Over 190 million prescriptions for oral bisphosphonate drugs have been dispensed worldwide. [LawyersAndSettlements.com July 19, 2007] |
Restless Leg Syndrome (RLS) / Periodic Limb Moveme| | Apart from the use of drugs to treat RLS, components used in the manufacture of drugs or supplements may be causing or aggravating the problem. If you can remember having started taking a new medication or supplement shortly before the onset of symptoms, consider stopping it for a time to see if symptoms improve. You may also wish to consider stopping all 'unnecessary' supplements to see if any of those may be causing the problem.
Gabapentin was effective for restless leg syndrome (RLS), according to the results of a double-blind crossover study published in the Nov. 26, 2002 issue of Neurology. Longer studies will be needed to confirm long-term tolerability of this drug.
"Gabapentin may be a potent agent for treatment of even severe RLS, without the disadvantages of long-term complications of previously favored treatments," study author Diego Garcia-Borreguero, MD, from the Fundacion Jimenez Díaz in Madrid, Spain, says in a news release.
Generally, there are three classes of drugs that are used to treat PLMD and RLS. These are benzodiazepines, Parkinson drugs, and narcotics. Medical treatment of PLMD and RLS often significantly reduces or eliminates the symptoms of these disorders, though not always. There is no cure for PLMD or RLS, and medical treatment must be continued to provide potential relief.
Clonazepam is the most commonly employed benzodiazepine treatment. It is effective in many cases, but not all, and it usually causes drowsiness or sedation. Sometimes, clonazepam allows the patient a better, more restful night's sleep without affecting the occurrence of limb movement. Patients with PLMD may have other sleep disorders, such as obstructive sleep apnea, which the use of clonazepam could worsen.
The drugs used to treat Parkinson's disease are also very effective against PLMD and RLS. These include, L-dopa/carbidopa, bromocriptine (which suppresses the excretion of prolactin), pergolide, and selegiline. If either benzodiazepines or Parkinson's medications do not relieve symptoms, then narcotics, such as codeine, oxycodone, methadone, and propoxyphene are sometimes employed.
In May of 2005, ropinirole HCl (Requip®), which also is used to treat Parkinson's disease, was approved by the Food and Drug Administration (FDA) to treat moderate-to-severe (i.e., 15 or more episodes per month) restless legs syndrome. This medication may result in extreme drowsiness and may cause patients to fall asleep during daily activities (e.g., driving). Other side effects include dizziness, nausea and vomitting, sweating upon standing |
Costochronditis| | Cortisone shots are one way of reducing the inflammation of costochondritis but repeated injections are not recommended as they are said to weaken the cartilage after extended periods of use. |
Not recommended for:
Muscle Cramps / Twitching| | Medications such as diuretics or water pills can lead to cramping due to loss of sodium and potassium. |
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Nervous System |
Bell's Palsy| | If you do decide to use conventional medications that may help relieve the compression, such as prednisone and antivirals, they should be started as quickly as possible. The "window of opportunity" for starting these medications is thought to be 7 days from the onset of Bell's palsy. |
Seizure Disorder| | Many anti-epileptic drugs inhibit glutamine synthase, which may partly explain their toxic side effects. |
Not recommended for:
Tremors| | The following drugs, medications, substances or toxins are some of the possible causes of Tremors as a symptom.
This list is incomplete and various other drugs or substances may cause your symptoms.
* Alcohol
* Amphetamine intoxication - in high doses.
* Ancobon
* Blanex
* Caffeine
* Certain asthma medications
* Certain epileptic medications
* Chlorofon-F
* Chlorphenesin Carbamate
* Cocaine
* Compazine
* Dilantin
* Enoxacin
* Enoxin
* Flexaphen
* Flucytosine
* Illicit drugs
* Lobac
* Maolate
* Miflex
* Mus-Lac
* Paraflex
* Parafon Forte DSC
* Pargen Fortified
* Polyflex
* Skelex
* Theophylline
* Valproic acid (Depakote) |
Neuritis/Neuropathy| | Atenolol, a beta-blocker, is one of any number of drugs that can have side effects. Fatigue is a common side-effect and paraesthesia, peripheral neuropathy and myopathies have been reported. |
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Organ Health |
Diabetes Type II / Risk| | Many diabetics are able to control their blood sugar levels by natural means alone. When, for whatever reason, this is not possible, insulin use may be needed. The type of insulin and dose will need to be worked out carefully under your doctor's supervision.
Metformin (not a type of insulin) is the generic version of Glucophage. Even though it should be chemically identical, many who have tried both find they have less side-effects on the patented form.
If essential fatty acid metabolism is badly broken and the supplementation of GLA (gamma-linolenic acid) will not produce the necessary products in the quantities needed, then also the drug pentoxifylline can be used. Pentoxifylline has a more immediate effect, while EPO (evening primrose oil) is slower, but has a more complete spectrum of effects in managing the fatty acid deficiencies that diabetics suffer from. EPO and pentoxifylline used over a longer time (4 months to 1 year) cause the blood to become thinner - which is not a bad thing for diabetics - but is a bad thing if it is excessive which can lead to bruising and slower wound-healing. Getting the correct balance might require some attention. |
Uveitis| | Many uveitis specialists treat intermediate uveitis according to the method outlined by Kaplan. Patients whose visual acuity is better than 20/40 are generally not treated, unless they have CME, extensive neovascularization of the peripheral retina, extensive vasculitis, or if they complain of severe floaters. Patients whose visual acuity is 20/40 or worse usually are treated. As with most forms of uveitis, corticosteroids are the mainstay of therapy.
Topical therapy with prednisolone acetate 1% or prednisolone sodium phosphate 1% is only helpful in the treatment of the anterior segment inflammation. The intravitreal concentration of drugs administered topically is too low to be efficacious in the face of moderate-to-severe vitritis, especially in the phakic patient.
Periocular injections of corticosteroids are preferentially given in unilateral cases and occasionally in bilateral cases. Triamcinolone acetonide can be administered superotemporally into the sub-Tenon space or through the inferior eyelid into the retroseptal space. If the disease is not controlled after 2-3 injections given over an 8-week period, systemic prednisone should be considered. Some authorities advocate the use of a combination of betamethasone and depot methylprednisolone in an effort to achieve early onset and prolonged duration of action.
Oral prednisone may be the preferred treatment in patients with bilateral intermediate uveitis or in cases resistant to topical or periocular steroids. A purified protein derivative (PPD) test is imperative prior to starting any patient on systemic corticosteroids if there are any risk factors for TB. Once the inflammation stabilizes, the oral dose is tapered according to disease activity. An H2 blocker (Tagamet or Zantac) or a proton pump inhibitor (Prilosec or Prevacid) can be prescribed adjunctively to oral steroids.
Finally, intravitreal triamcinolone acetonide injections have been used to treat CME. In a small series by Androudi et al of 16 patients (20 eyes) with noninfectious uveitis and CME, of which 3 had intermediate uveitis, visual acuity improved in 11 eyes and improved but returned to baseline levels in another 5 eyes, respectively.
For recalcitrant cases with high corticosteroid requirements to control the inflammation, the surgical implantation of a device releasing fluocinolone acetonide in the vitreous can be considered (see Surgical Care).
In the event that corticosteroids cannot control the intermediate uveitis or in those whose disease invariably flares when steroids are discontinued, immunosuppressive therapy often is attempted. Immunosuppression or immune-modulation is also used as part of the concept of steroid-sparing therapy in an effort to reduce the patient's requirement for systemic corticosteroids and, therefore, to diminish the adverse effects of systemic corticosteroid therapy.
Cyclosporine, tacrolimus, azathioprine, and methotrexate are the most commonly used agents with documented efficacy in many uveitic conditions. Chlorambucil can be considered for intractable cases. They can be used concurrently with corticosteroids as steroid sparing agents or alone.
Murphy et al prospectively evaluated the efficacy and the safety of cyclosporine and tacrolimus in patients with posterior and intermediate uveitis. The 2 agents did show a similar response rate (approximately 67%), but cyclosporine was associated with a higher incidence of adverse effects.
The use of infliximab, an anti-tumor necrosis factor (anti-TNF) monoclonal antibody, has been shown to be effective in improving macular thickness and visual acuity in patients with uveitic refractory CME due to intermediate uveitis or other noninfectious uveitis. Initial successful reports by Markomichelakis et al were duplicated by Rajaraman et al in a pediatric population in which infliximab achieved reduction in intraocular inflammation with concurrent elimination or decrease in steroid requirements.
More recently, daclizumab, an interleukin-2 receptor blocking antibody, has been shown to be effective in noninfectious uveitis in a multicenter nonrandomized interventional case series. It allowed control of ocular inflammation with stability in visual acuity with reduction of concomitant immunosuppression by at least 50%.
Finally, interferon-beta (INF-beta), which has an established value in the treatment of MS, appears to have a positive effect in terms of visual acuity, CME, and aqueous and vitreous inflammation in intermediate uveitis associated with MS. This information was taken from emedicine.com. |
Gallbladder Disease| | Oral dissolution therapy with ursodiol (Actigall) and chenodiol (Chenix) works best for small, cholesterol gallstones. These medicines are made from the acid naturally found in bile. They most often are used in individuals who cannot tolerate surgery. Treatment may be required for months to years before gallstones are dissolved.
Mild diarrhea is a side effect of both drugs; chenodiol may also temporarily elevate the liver enzyme transaminase and mildly elevate blood cholesterol levels. |
Glaucoma| | Nearly all the medications for glaucoma are aimed at reducing eye pressure. Lowering IOP is even proving to be beneficial for about two-thirds of patients with normal pressure glaucoma.
Often, glaucoma is treated first with medication or laser therapy is tried. If these treatments fail or are thought likely to fail, filtration surgery is offered. However, in certain situations (especially when medication cannot be tolerated) filtration surgery may be used |
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