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15
Ampicillin (Acillin)
July 15, 2011 | Leave a Comment
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Aug
13
Entecavir - Guaifenesin - Epoetin - Sildenafil Citrate - Ergoloid Mesylates
August 13, 2009 | Leave a Comment
Generic Name
Entecavir (m-M-ah-veer)
Brand Name Baraclude
Information in this monograph also applies to:
Generic Ingredient: Telbivudine Tyzeka
Type of Drug Antiviral.
Prescribed For
Chronic hepatitis B infection in adults.
General Information
Entecavir is a prescription medicine for adults with chronic hepatitis B virus (HBV) infection in which the virus is multiplying and damaging the liver. Entecavir can reduce the amount of virus in the body, make it harder for new liver cells to be infected by the virus, and improve the general condition of the liver. They work by attacking HBV polymerase, an enzyme essential to the reproduction of the hepatitis B virus inside an infected cell. These drugs are eliminated from the bodj,4kalbe kidney. Telbivudine does not wGCK alg4msl HIV infection and can be taken together with HIV drug therapy. These medicines do not cure HBV or stop you from spreading HBV to others, generally through sexual contact or exposure to infected blood. The HBV virus can live outside the body for one week.
Cautions and Warnings
Do not take these medicines if you are allergic or sensitive to any
of their ingredients.
Entecavir should be used with caution in people who have both HIV and HBV because of possible HIV resistance developing after entecavir is taken.
Severe worsening of HBV has occurred in people who stopped taking this medication.
These drugs can lead to further liver damage. In rare cases, they have been associated with liver failure that resulted in death. The safety of this drug in people who have had a liver transplant is not known.
These drugs are eliminated through the kidneys. People with kidney disease may require lower doses.
Telbivudine has also been associated with lactic acidosis, a condition in which excess lactic acid in the body causes the blood to become acidic. Feeling very weak or tired, experiencing unusual Muscle pain, difficulty breathing, stomach pain with nausea and vomiting, feeling cold—especially in your arms and legs, feeling dizzy or lightheaded, and a fast or irregular heartbeat may be signs of lactic acidosis. It is a medical emergency and must be treated in the hospital. This has happened in some people taking these medications.
Possible Side Effects
Entecavir
♦ Most common: headache, fatigue, dizziness, and nausea.
✓ Less common: diarrhea, upset stomach, vomiting, tiredness, and sleeplessness.
✓ Rare: Rare side effects may affect almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Telbivudine
✓ Most common: upper respiratory infection, latigue, not feeling well, missO2 tenderness or weakness, abdominal pain, nasal irritation, and sore throat.
♦ Common: flu or flu-like symptoms, diarrhea or loose stools, and throat pain.
✓ Less common: fever, joint pain, rash, back pain, dizziness, muscle ache, sleeplessness, and upset stomach.
Drug Interactions low in-
• These drugs do not affect liver enzymes and have a
teraction potential.
• Drugs that affect kidney function may affect blood concentrations of entecavir and telbivudine.
• Other hepatitis B treatments (lamivudine, adefovir, cy-
closporine, and pegylated interferon-alpha 2a) do not affect
either entecavir or telbivudine and are not affected by them. Food Interactions
Take entecavir at least 2 hours after a meal and 2 hours before the next meal. Telbivudine may be taken without regard to food or meals. Usual Dose
Entecavir
Adult and Child (age 16 and over): 0.5-1 mg once daily. People with kidney failure may be treated with as little as 0.05-0.1 mg a day. Child (under age 16): not recommended.
Telbivudine
Adult and Child (age 16 and over): 600 mg once daily. People with moderate to severe kidney failure may be treated with a single 600 mg dose every 2, 3, or 4 days depending on the seriousness of kidney disease.
Child (under age 16): not recommended.
Overdosage
There are no reports of entecavir overdose. People taking single doses up to 40 mg or multiple doses up to 20 mg per day for up to 14 days had no unusual side effects. One person accidentally took an overdose with no consequences. People taking up to 1800 mg a day of telbivudine had no increase in side effects. Overdose victims should be taken to a hospital emergency room for treatment, where dialysis may be necessary to remove the drug from the blood. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor il you develop muscle aches, pains, or weakness; ‘it your skin or the white part of your eyes turns yellow; if your urine becomes dark; if your bowel movements turn light in color; if you don’t feeling like eating food for several days or longer; if you become nauseous; or if you have lower stomach pain. These can be signs of a serious liver problem called hepatotoxicity, which has occurred in some people taking these medications.
Your hepatitis B may get worse or become very serious if you stop taking these medications. Do not stop taking them or change your daily dose without talking to your doctor.
If you forget to take your daily entecavir dose, take it as soon as you remember but do not take a double dose. Call your doctor if you forget to take 2 or more doses in a row.
Entecavir oral solution is a ready-to-use product and should not be mixed with water or any other liquid product. Each bottle of the oral solution comes with a dosing spoon that is calibrated in 1 -mL increments, up to 10 mL. Hold the spoon upright and gradually fill it to the mark next to the prescribed dose. Drink the liquid directly from the dosing spoon. Your pharmacist can help you properly measure your medication dose. Rinse the dosing spoon with water after each daily dose and allow it to air dry.
Special Populations
Pregnancy/Breast-feeding: Animal studies of entecavir revealed slowed development of the skeleton. Animal studies of telbivudine did not reveal any effects on the developing fetus. However, it is not known if either medicine is safe to use during pregnancy or if it helps prevent the hepatitis B virus from passing on to a developing fetus. If your doctor considers entecavir or telbivudine crucial for you, potential benefits must be carefully weighed against their risks. A data bank has been established to collect information from doctors on pregnant women who do take these medicines.
These medicines may pass into breast milk. Nursing mothers who must take these drugs should use infant formula.
Seniors: Dosage reduction may be needed in seniors because of normal declines in kidney function.
Brand Name
Entex PSE
Generic Ingredients
Guaifenesin + Pseudoephedrine Hydrochloride M
Other Brand Names
Anatuss LA Coldmist Jr.
Aquatab D Dosepack Coldmist LA
Coldmist Congess Jr.
Congess SR Nasabid
Congestac Nasabid-SR
Deconsal LA Nasatab LA
D-Feda 11 PanMist
Durasal U PanMist-Jr.
Duratuss AM/PM PanMist LA
Dynex Profen 11
Endal-SR Pseudovent
Guaimax-D Sudal 60/500
Guaipax PSE SudaI120/600
Guaitab Sudal SR
Guaituss PE Syn-RX
Guai-Vent PSE Touro LA
losal El Tuss-LA
Maxifed V-Dec-M
Maxifed G Versacaps
Med-RX Zephrex
Miraphen PSE Zephrex LA
The information in this profile also applies to the following drugs:
Generic Ingredients: Guaifenesin + Ephedrine Hydrochloride 19 Broncholate Bronkaid
Generic Ingredients: Guaifenesin + Phenylephrine Hydrochloride 91
Deconsal Il PhenaVent
Deconsal Pediatric PhenaVent D
Endal PhenaVent LA
Entex LA PhenaVent PED
Liquibid D Rescon GG
Liquibid-D 1200 Sinupan
Liquibid-PD Sinuvent PE
Type of Drug
Decongestant and expectorant combination.
Prescribed For
Cold or allergy and for nasal congestion, runny nose and cough associated with other upper respiratory conditions.
General Information
The decongestant ingredient in Entex PSE, pseudoephedrine, dramatically reduces congestion and stuffiness. The decongestant ingredients ephedrine and phenylephrine act similarly. The expectorant, guaifenesin, is used to help loosen thick mucus that may contribute to chest congestion; the effectiveness of guaifenesin and other expectorants has not been established. There are other drugs on the market using this same general formula—an expectorant plus a decongestant—but they use different decongestant ingredients or a combination of decongestants plus guaifenesin. Nothing cures a cold or allergy, but Entex PSE may provide relief from symptoms.
Cautions and Warnings
Do not take Entex PSE if you are allergic or sensitive to any of its ingredients.
Entex PSE may cause anxiety or nervousness or interfere with sleep.
Do not use Entex PSE if you have ventricular tachycardia (quickened heartrate), or hypertension (high blood pressure).
Entex PSE should be used with extreme caution in those with heart disease, other heart rhythm disorders, thyroid disease, diabetes, glaucoma, stomach ulcer, urinary blockage, or a prostate condition.
Entex PSE should not be used over extended periods of time to treat persistent or chronic cough especially one that may be caused by cigarette smoking, asthma, or emphysema.
Possible Side Effects
Mritl common: anxiety, restlessness, sleeplessness, tension, excitation, dizziness, drowsiness, and headache.
♦ Less common: nausea, vomiting, upset stomach, low blood pressure, heart palpitations, chest pain, rapid or slow heartbeat, abnormal heart rhythms, irritability, euphoria (feeling Possible Side Effects (continued)
“high”), eye irritation and tearing, hysterical reaction, appetite loss, kidney stones, urinary difficulties in men with a prostate condition, weakness, loss of facial color, and breathing difficulties.
Drug Interactions
• Entex PSE should be avoided if you are taking a monoamine oxidase inhibitor (MAGI) antidepressant for depression or hypertension because the MAGI may cause a very rapid rise in blood pressure or increase side effects such as dry mouth or nose, blurred vision, and abnormal heart rhythms.
• The decongestant in Entex PSE may interfere with bloodpressure-lowering medication.
Food Interactions
Take Entex PSE with food if it upsets your stomach.
Usual Dose
Adult and Child (age 12 and over): 1 tablet or capsule twice a day or 2 tsp. of liquid 4 times a day.
Child (age 6-11):1/2-1 tablet or 1 capsule twice a day or 1 tsp. of liquid 4 times a day.
Overdosage
Most cases of overdose are not severe. Symptoms include sedation, sleepiness, increased sweating, and increased blood pressure. Hallucinations, convulsions, nervous system depression, and breathing difficulties are more prominent in older adults. Most cases of overdose are not severe. Induce vomiting with ipecac syrup—available at any pharmacy. Call your local poison control center or a hospital emergency room before doing this. If you lseey, treatment. ALWAYS bring the prescription bottle or container.
-SIDt’dial Information
Call your doctor if your side effects are severe or gradually become intolerable.
If you forget a dose, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Women who are or might be pregnant should avoid Entex PSE. When your doctor considers this drug crucial, its potential benefits must be carefully weighed
against its risks.
The decongestant in Entex PSE may pass into breast milk. Nursing mothers who must take Entex PSE should consider using in-
fant formula.
Seniors: Seniors are more sensitive to the effects of Entex PSE.
Generic Name
Epoetin (EE-poh-eh-tin)
Brand Names Epogen
Type of Drug
Red-blood-cell growth stimulator.
Prescribed For
Anemia; may also be used for reducing the need for blood or redblood-cell transfusions.
General Information
Epoetin is a natural hormone that stimulates the bone marrow to produce red blood cells. It is used for anemia that does not respond to iron supplements. In most cases of anemia, there are plenty of red blood cells circulating, but they lack iron. People who need epoetin do not have enough red blood cells. Epoetin stimulates the production of new red blood cells to carry needed oxygen.
Cautions and Warnings
Do not use epoetin if you are allergic or sensitive to albumin or products manufactured from animal cells.
People with urtvaRtmliked high blood pressure should not use epoetin.
Some people with chronic kidney failure and severe anemia should not take epoetin. Epoetin is not a replacement for emergency blood transfusion.
Epoetin is not intended for anemia caused by folate or iron deficiency, hemolysis, or gastrointestinal bleeding.
Procrit People using epoetin may require anticoagulant medicine to prevent blood clotting during treatment. Tell your doctor it you have any blood-clotting disorders.
In rare cases, people taking epoetin may have seizures. Avoid driving or any other activities where a sudden seizure could be dangerous. Do not take epoetin if you have a history of seizures or strokes.
Epoetin should be avoided in patients with blood cancers such as lymphoma, because it can act as a growth factor for the tumor.
If your hemoglobin levels become too high, your chance of heart attack, stroke, heart failure, blood clots, and death is increased. It is important to have your blood tested and adjust dosage of epoetin accordingly throughout treatment.
Possible Side Effects
Side effects reported in studies of epoetin were similar to those reported with an inactive placebo (sugar pill).
♦ Most common: high blood pressure, headache, constipation, diarrhea, nausea, joint pain, fever, fatigue, itching, rash, and difficulty breathing.
✓ Common: swelling, vomiting, chest pain, skin reactions at the site of injection, weakness, dizziness, urinary infections, diarrhea, upset stomach, blood clots, anxiety, tingling in the hands or feet, and trunk pain.
✓ Rare: stroke and heart attack. Contact your doctor if you experience any side effect not listed above.
Food and Drug Interactions None known.
Usual Dose
Adult: starting dose-23-69 units per 1b. of body weight 3 times a week by intravenous or subcutaneous injection. Final dose is based on response and need. Surgery patients take 138 units per lb. for 10 days before Surgery or 276 units once a week for 3 weeks before surgery and another dose on the day of surgery. Dialysis patients take epoetin once a week.
Child (under age 12): 23 units per lb. of body weight 3 times a week by intravenous or subcutaneous injection. Final dose is based on response and need.
Child (under 1 month): not recommended.
Overdosage
Little is known about the effects of epoetin overdose. Call your local poison control center or a hospital emergency room for information. If you seek treatment, ALWAYS bring the prescription container.
Special Information
People taking epoetin should have regular blood tests to assure the drug is working well. Your doctor may want to take blood samples twice a week for several weeks and then test your blood regularly.
Epoetin has been used by athletes to enhance physical performance. This is called blood doping and has resulted in several deaths because the percentage of red blood cells in a blood sample can reach hazardous levels.
Epoetin must be stored in a refrigerator.
Most patients will need to take iron supplements with this drug.
This drug can be given by injection under the skin. For more in-
formation on how to properly administer this drug, see page 1242.
Special Populations
Pregnancy/Breast-feeding: Animal studies suggest that epoetin may enter fetal circulation. When this drug is considered crucial by your doctor its potential benefits must be carefully weighed against its risks.
It is not known if epoetin passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors may use this product without special precaution.
Type of Drug
Erectile Dysfunction Drugs
Generic Ingredient: Sildenafil Citrate
Viagra Revatio
Generic Ingredient: Tadalafil Cialis
Generic Ingredient: Vardenafil Levitra
Prescribed For
Erectile dysfunction (ED). sildenafil is also prescribed for pulmonary
hypertension.
General Information
The chemical nitric oxide is released in the penis during sexual stimulation. Nitric oxide causes the release of an enzyme called cyclic guanosine monophosphate (cGMP), which increases blood flow into the penis, producing an erection. cGMP is broken down by the enzyme phosphodiesterase type 5 (PDE5). In men with low levels of cGMP, these medicines help achieve and maintain an erection by inhibiting PDE5, thus causing higher levels of cGMP. ED can be the result of nerve, blood vessel, or psychological problems. These drugs, which are effective in about 70% of men, only help when poor blood flow is the cause of the dysfunction. Women have reported some benefit from sildenafil, although it has been widely studied only in men. Vardenafil and tadalafil are intended only for men. These medicines start working in 30-60 minutes and their effects usually last from 2-4 hours, although some have noted an effect for 24 hours or more. Some drug interactions and kidney or liver diseases extend this time. Tadalafil begins working in 30-60 minutes and can remain in the body for more than 2 days, much longer than the other medicines in this group. Low-dose tadalafil may be taken every day for chronic ED.
Pulmonary hypertension, a rare disease in which high pressure in the blood vessels moves from the heart to the lungs, is sometimes treated with sildenafil.
Cautions and Warnings
Do not take ED drugs if you are allergic or sensitive to any of their ingredients.
These medicines lower blood pressure and should be avoided if you have high (greater than 170/100) or low (less than 90/50) blood pressure. Several people have died from a sudden blood-pressure drop after combining erectile dysfunction medications with other medications that can reduce blood pressure.
These Medicines should never be taken by those taking heart medications called nitrates, as fatal reactions have occurred.
People with heart disease may experience heart problems with sildenafil or vardenafil, including a heart attack. These reactions can occur during or shortly after sexual activity.
Avoid these medicines if you have had a heart attack, stroke, or life-threatening abnormal heart rhythms in the past 6 months, or if you have heart failure, unstable angina pectoris, damage to the penis, or a progressive eye disease called retinitis pigmentosa. Blindness is a rare side effect of sildenafil and may be a problem with all of these medications.
People taking sildenafil or vardenafil have experienced difficulties seeing blue or green colors and may see things with a blue tinge surrounding them. This happens because they affect an enzyme in the eye. The effect clears up after the drug passes out of the body.
People with kidney or liver damage retain these medicines in their bodies longer than people whose kidneys and liver function normally. People with kidney or liver problems should always begin with the lowest possible dosage.
People with priapism (painful erection lasting more than 6 hours) or a condition that predisposes them to priapism—such as leukemia, multiple myeloma, or sickle cell anemia—should be cautious about taking these medicines.
Vardenatil and sildenafil should be avoided by people with stomach or bleeding ulcers because its effect on these conditions is not known.
Possible Side Effects
Sildenafil
✓ Most common: headache and flushing.
♦ Less common: upset stomach, stuffy nose, urinary tract infection, diarrhea, rash, dizziness, seizure, anxiety, prolonged and possibly painful erection, double vision, visual changes, bloodshot eyes, burning eyes, swelling in the eye, and blood vessel diseases in the retina.
✓ Rare: Rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Tadalafil
I Most common: headache.
✓ Common: upset stomach. Back pain and muscle aches can develop 12-24 hours after taking tadalafil and go away on their own after 2 days.
Possible Side Effects (continued)
♦ Less common: flushing, nasal congestion, and arm or leg
pain.
♦ Rare-. prolonged or painful erections. Other rare side ef-
fects can occur in almost any part of the body. Contact
your doctor if you experience any side effect not listed
above.
Vardenafil
✓ Most common: headache and flushing.
✓ Less common: upset stomach, sinus infection, flu-like symptoms, dizziness, and nausea.
♦ Rare: prolonged or painful erection. Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Do not combine any of these drugs with nitrates (such as nitroglycerin) and other drugs that lower blood pressure. The combination can cause a sudden, rapid drop in blood pressure.
• Do not take vardenafil if you are taking an alpha blocker (such as alfuzosin, doxazosin, prazosin, tamsulosin, or terazosin). Tadalafil may be taken only with tamsulosin. You may take sildenafil at its lowest possible dose with an alpha blocker, but you must separate the doses by at least 4 hours.
• Combining cimetidine and sildenafil leads to a substantial (more than 50%) increase in the amount of sildenafil in the blood.
• Erythromycin, itraconazole, ketoconazole, and protease inhibitors (used to combat HIV) can cause sildenafil blood levels to almost double. Vardenafil levels can increase by 400-1000% when combined with these medicines. It you are taking one of these medicines, do not take more than the %west possible dose of your ED drug. Do not take tadalafil more than once every 3 days if you are also taking one of these medicines.
• Rifampin can be expected to reduce the effect of ED medicines by reducing the amount of drug in the blood. Other
drugs that may reduce the effects of these drugs are carbamazepine, phenobarbital, and phenytoin.
• Dihydrocodeine—a widely used prescription pain reliever—may increase the effects of sildenafil, yielding substantially prolonged erections, sometimes lasting for hours.
• Do not combine sildenafil, tadalafil, and vardenafil. The effects of combining these drugs are not known.
• Do not take vardenafil if you are taking any medicine to treat an abnormal heartbeat, including amiodarone, procainamide, quinidine, and sotalol.
• Combining sildenafil with selective serotonin reuptake inhibitors (SSRIs) or tacrolimus may increase the risk of sildenafil side effects.
• Alcohol adds to the blood-pressure-lowering effects of these medicines.
Food Interactions
Grapefruit juice may increase the amount of these drugs in the blood. Taking sildenafil with a high-fat meal reduces the amount of drug absorbed. Tadalafil and vardenafil may be taken without regard to food or meals.
Usual Dose
Sildenafil
Adult: 50 mg taken about 1 hour before sexual activity. Individual doses can range from 25-100 mg. The maximum dosing frequency is once a day.
Senior: Begin with 25 mg and gradually increase dosage as needed.
Tadalafil
Adult: 10 mg taken about 1 hour before sexual activity. Individual doses can range from 2.5-20 mg. Do not take more than 1 dose of tadalafil a day.
Senior: Begin with 5 mg and gradually increase dosage as needed.
Adult: 10 mg taken about 1 hour before sexual activity. Individual doses can range from 5-20 mg.
Senior: Begin with 5 mg and gradually increase dosage as needed.
Overdosage
sildenafil and tadalafil overdose are likely to produce exaggerated drug side effects. Vardenafil overdose may cause neck pain, muscle aches, or vision changes. Call your local poison control center or hospital emergency room for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor and do not engage in sexual activity if the erection produced by ED drugs is painful or lasts 4 or more hours, or if you experience dizziness, nausea, or chest pain after taking an ED drug. In rare cases, men taking ED drugs have reported a sudden decrease or loss of vision and/or hearing. Call your doctor right away if you experience this adverse side effect.
People who use organic nitrates for gardening or other purposes can experience a severe and dangerous blood pressure drop if they take sildenafil or vardenafil. It is not known how long you have to wait to resume nitrate use.
These drugs do not protect against sexually transmitted diseases.
Special Populations
Pregnancy/Breast-feeding: There is no evidence that sildenafil or vardenafil harm the fetus; however, they are not intended for pregnant women or nursing mothers.
Seniors: Men age 65 and over eliminate these drugs more slowly than younger men and should begin with the lowest possible dosage.
Generic Name
Ergoloid Mesylates (ER-goe-loid
MES-il-ates) (GI
Brand Names Caerimal
Hydergine
Type of Drug Psychotherapeutic agent.
Hydrogenated Ergot Alkaloids
Prescribed For
Age-related decline in mental capacity.
General Information
Ergoloid mesylates are used to treat decreased mental capacity of unknown cause in people over age 60. These drugs should not be used for any condition that is treatable with another drug or that may be reversible. People who respond to ergoloid mesylates are likely to have Alzheimer’s disease or some other cause of dementia. Nobody knows exactly how ergoloid mesylates produce their effect, but they improve the supply of blood to the brain in test animals, reduce their heart rate, and improve muscle tone in blood vessels. Some studies show the drugs to be very effective in relieving mild symptoms of mental impairment, while others find it to be only moderately effective. They are most beneficial in people whose symptoms are due to the effects of high blood pressure in the brain.
Cautions and Warnings
Do not take ergoloid mesylates if you are allergic or sensitive to any of their ingredients or you have psychotic symptoms or psychosis.
Ergoloid mesylates should be used with caution in people with liver disease, low blood pressure, or slow heartbeat.
Possible Side Effects
Ergoloid mesylates do not produce serious side effects.
♦ Common: When taken under the tongue, these drugs may
cause irritation, nausea, or upset stomach. Other side ef-
fects are drowsiness, slow heartbeat, and rash.
Drug Interactions None known.
Food Interactions
Do not eat, drink, or smoke while you have an ergoloid mesylates pill under your tongue.
Usual Dose
Starting dose is 1-2 mg 3 times a day. Increase as needed. Do not exceed 12 mg a day.
Overdosage
Symptoms include blurred vision, dizziness, fainting, flushing, headache, appetite loss, nausea, vomiting, stomach cramps, and stuffy nose. Take the victim to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
The effects of ergoloid mesylates are gradual and frequently not seen for up to 6 months. A 6-month period of treatment with ergoloid mesylates is recommended before your doctor can fully evaluate your response to the drug. Your doctor should periodically reevaluate your condition to determine if ergoloid mesylates treatment is still needed and that it is working for you.
Dissolve sublingual tablets under the tongue. Do not chew or crush them; they are not effective if swallowed whole.
If you forget a dose, skip it and go back to your regular schedule. Do not take a double dose. Call your doctor if you miss 2 or more consecutive doses.
Special Populations
Pregnancy/Breast-feeding: Ergoloid mesylates may interfere with fetal development. When these drugs are considered crucial by your doctor, their potential benefits must be carefully weighed against their risks.
Ergoloid mesylates pass into breast milk. Nursing mothers who must take these drugs should use infant formula.
Seniors: Seniors are more likely to develop side effects, especially hypothermia (low body temperature).
Generic Name
Erythromycin (eh-rith-roe-MYE-sin) 10
Brand Names
Akre-mycin Eryderm
Arr/S Erygel
E-Base Ery-Tab
E-Glades Erythra-derm
E-Mycin PCE Eryc
The information in this profile also applies to all forms of erythromycin:
Generic Ingredient: Erythromycin Estolate LN
Generic Ingredient: Erythromycin Ethylsuccinate E.E.S. Pediamycin EryPed
Generic Ingredients: Erythromycin Ethylsuccinate + Sulfisoxasole
Eryzole Pediazole
Generic Ingredient: Erythromycin Stearate Erythrocin Stearate
Type of Drug Macrolide antibiotic.
Prescribed For
Infections of virtually any part of the body: upper and lower respiratory tract infections; sexually transmitted diseases; urinary tract infections; infections of the mouth, gums, or teeth; and infections of the nose, ears, or sinuses. It is prescribed for acne and may be used for mild to moderate skin infections. Erythromycin is effective against diphtheria and dysentery. It is also prescribed for legionnaires’ disease, rheumatic fever, whooping cough, and bacterial endocarditis. It is prescribed to patients with pelvic inflammatory disease as an alternative to penicillin. The eye ointment is used to prevent newborn gonococcal or chlamydial eye infections.
General Information
Erythromycin and other macrolide antibiotics are either bactericidal (bacteria-killing) or bacteriostatic (inhibiting bacterial growth), depending on the organism in question and amount of antibiotic present. Erythromycin is deactivated by stomach acid, so the tablet form is made to bypass the stomach and dissolve in the intestine.
Since the action of this antibiotic depends on its concentration in the invading bacteria, kk is crucial that you follow your doctor’s ISNVKi10ns regarding the spacing of doses as well as the number of days you must take the medication—otherwise, this antibiotic may be much less effective.
Cautions and Warnings
Do not take erythromycin if you are allergic or sensitive to any of its ingredients or to any macrolide antibiotic.
Erythromycin is excreted primarily through the liver. People with liver disease or damage should consult their doctors. Those on long-term therapy with erythromycin should have periodic blood tests. If you restart erythromycin after having experienced liver damage, it is likely that symptoms will recur within 48 hours.
Erythromycin estolate has occasionally produced liver problems (symptoms include fatigue, nausea, vomiting, abdominal cramps, and fever). If you are susceptible to stomach problems, erythromycin may cause mild to moderate stomach upset; discontinuing the drug will reverse this condition.
Colitis (bowel inflammation) has been associated with all antibiotics and can range from mild to life-threatening (see “Possible Side Effects”),
Possible Side Effects
• Most common: nausea, vomiting, stomach cramps, and diarrhea. Colitis (symptoms include severe abdominal cramps and severe, persistent, and possibly bloody diarrhea) may develop. Side effects of the topical erythromycin include peeling, dryness, itching, and oiliness.
♦ Less common: hairy tongue, itching, irritation of the anal or vaginal region, eye irritation, and skin tenderness. If any of these symptoms appear, call your physician immediately.
♦ Rare: hearing loss—which reverses itself after the drug is stopped and occurs most often in people with liver and kidney problems—and abnormal heart rhythms. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Antacids may slightly affect the release of erythromycin from your body. This effect is not considered important.
• Do not combine erythromycin with astemizole or terfenadine.
• Erythromycin may slow the breakdown of carbamazepine (an anticonvulsant prescribed for seizures). Avoid this combination.
• Mixing erythromycin with rifabutin or rifampin can interfere with the antibiotic’s effect and increase the risk of intestinal side effects.
• Do not combine erythromycin and pimozide. Two people died after combining pimozide and a macrolide antibiotic.
• Erythromycin may neutralize penicillin. It may also neutralize the antibiotics lincomycin and clindamycin.
• Erythromycin interferes with the elimination of theophylline
from the body, possibly leading to theophylline overdose.
• Mixing erythromycin with a statin cholesterol-lowering drug increases the risk of developing a potentially fatal condition involving severe muscle pain and destruction.
• Do not mix erythromycin with sparfloxacin, ketoconazole, itraconazole, fluconazole, diltiazem, verapamil, troleandomycin, mibefradil, nefazodone, or clarithromycin. These mixtures can lead to severe, possibly fatal, abnormal heart rhythms. Grepafloxacin (another fluoroquinolone) should only be mixed with erythromycin in hospitalized patients whose hearts can be monitored during treatment.
• Combining erythromycin and alfentanil (an injectable pain reliever), bromocriptine, buspirone, digoxin, disopyramide, ergotamine, cyclosporine, methylprednisolone (a corticosteroid), tacrolimus, vinblastine, or benzodiazepines (such as alprazolam, diazepam, midazolam, and triazolam) increases the risk of drug side effects.
• Erythromycin estolate may increase the liver side effects of other drugs that affect the liver.
• Erythromycin may increase the anticoagulant (blood-thinning) effects of warfarin in people who take it regularly, especially older adults. People taking this combination should be tested regularly.
• Erythromycin may increase the effects of caffeine.
Food Interactions
Grapefruit juice slows the breakdown of erythromycin, increasing the amount of drug in the blood. For optimum effectiveness, take erythromycin base and erythromycin stearate on an empty stomach with a 6-8 oz. glass of water 1 hour before or 2 hours after meals. Other forms of erythromycin can be taken without regard to food or meals.
\huall Dose
Tablet and Suspension
Adult: 250-400 mg every 6 hours, taken 1 hour before meals, or 500 mg every 12 hours. Maximum dose is 4 g a day.
Child: 15-25 mg per lb. of body weight a day in divided doses depending on age, weight, and severity of infection.
Eye Ointment 1/2 inch 2-6 times a day.
Topical Solution: Apply morning and night.
Doses of erythromycin ethylsuccinate are 60% higher due to differences in chemical composition.
Overdosage
Overdose may cause severe side effects, especially nausea, vomiting, stomach cramps, and diarrhea. Mild hearing loss, ringing or buzzing in the ears, or fainting may also occur. Call your local poison control center or a hospital emergency room for more information. ALWAYS bring the prescription bottle or container.
Special Information
Erythromycin is used instead of penicillin for mild to moderate infections in people who are allergic to penicillin. Erythromycin is not the antibiotic of choice for severe infections.
Erythromycin products should be stored at room temperature, except for oral and topical liquids, which should be kept in the refrigerator.
Call your doctor if you develop nausea; vomiting; diarrhea; stomach cramps; severe abdominal pain; rash, itching, or redness; dark or amber-colored urine; yellowing of the skin or whites of the eyes; or any severe or persistent side effect.
If you forget a dose of oral erythromycin, take it as soon as you remember. If it is almost time for your next dose, space the next 2 doses over 4-6 hours, then continue with your regular schedule. Do not take a double dose.
Remember to complete the full course of therapy prescribed even if you feel well before you finish the medication.
Special Populations
Pregnancy/Breast-feeding: Erythromycin passes into the fetal circulation. Erythromycin estolate has caused mild liver inflammation in about 10% of pregnant women who took it and should not be used if you are or might be pregnant. Other forms of erythromycin have been used sale)y without difficulty.
Erythromycin passes into breast milk. Nursing mothers who must take erythromycin should use infant formula.
Seniors: Seniors with liver disease should use caution. Seniors taking high doses of erythromycin may be at an increased risk of hearing loss.
Jul
18
Prostatitis Terminology Glossary.
July 18, 2009 | Leave a Comment
Glossary
ACUTE - Often used to describe a disorder, or symptom, that comes on suddenly. An acute condition may or may not be severe, but it is usually of short duration.
ANDROGENS - Bodily hormones that help in the development of male sex characteristics. Testosterone is the most important of these.
ANUS - The exterior opening, through which waste products are excreted, located at the end of the digestive tract.
BACTERIA - A group of single-celled micro-organisms, many -though not all - of which cause diseases.
BENIGN - Not malignant. Characteristic of a mild illness. Recovery is likely.
BIOPSY - The removal of tissue from a patient so that it may be
studied under a microscope in order to make a precise diagnosis.
BLADDER - An elastic sac that stores urine before it is excreted from the body.
BOGGY - A term used to describe the prostate when it is swollen, spongy and soft.
CANCER - A group of diseases in which symptoms are due to the uncontrolled growth of abnormal cells creating a cellular tumour. These cells can spread throughout the body through the bloodstream or the lymphatic system.
CAPSULE - The structure in which an item, such as the prostate, is enclosed.
CATHETER - A hollow, flexible, surgical tube that is used to drain or inject fluid. It is used, in particular, to drain urine via the urethra from the bladder.
CAT SCAN (CT SCAN) - A diagnostic imaging technique using X-rays and computer technology to provide cross-sectional pictures of the body.
CHLAMYDIA - A group of non-bacterial infections in the urethra and genital tract, and one of the most common sexually-transmitted diseases.
CHRONIC - A chronic condition is one that persists fora long time (sometimes in spite of treatment).
CYSTOSCOPE - A lighted viewing instrument that is inserted up the urethra in order to examine the urethra and the bladder.
DYSURIA - Pain on passing urine.
EJACULATION - The act of emission of semen from the penis.
ENZYME - A protein that regulates the rate of a chemical reaction in the body. Every cell in the body produces various enzymes.
ERECTION - The stiffening, hardening and elevation that occur in the penis in response to sexual arousal.
FREQUENCY - The need to urinate at short intervals.
GENITALS - The reproductive organs - both male and female, both internal and external.
GENITO-URINARY - Referring to a man’s or woman’s reproductive and urinary tract.
GLAND - A group of specialised cells that manufacture and release certain chemicals, including hormones and enzymes, for use in the body.
HAEMATURIA - Blood in the urine.
HAEMOSPERMIA - Blood in the seminal fluid.
HESITANCY - Slowness to start the initial urinary flow.
HORMONE - A chemical that is released into the bloodstream by a particular gland or tissue and which has a specific effect on tissues elsewhere in the body.
HYPERPLASIA - Cell proliferation.
HYPERTROPHY - The excessive, abnormal growth of an organ.
IMPOTENCE - Inability to achieve a good enough erection for sexual intercourse.
INCONTINENCE, URINARY - Inability to control the passing of urine.
INTERMITTENCY - Stopping and starting the flow of urine, often resulting in an inability to empty the bladder completely.
INTRAVENOUS PYELOGRAM (IVP) - Also known as urography.
• diagnostic procedure for taking X-ray pictures of the urinary tract.
• dye - or, to give its proper name, a radio-opaque medium - is injected intravenously into the bloodstream, which then shows up on X-rays when it is excreted by the kidneys, ureter and bladder.
KIDNEYS - Two small organs located on either side of the spinal column. Impurities in the blood are removed in the kidneys and dissolved to form urine.
LASER - An acronym, which stands for Light Amplification by Stimulated Emission of Radiation. Laser beams, which are concentrations of light and heat, can be used to cut, and are now being employed increasingly in surgery.
LIBIDO - Sexual desire.
MALIGNANT - Not benign. Cancerous, with the ability to invade other tissues, and to spread, or metastasise, throughout the body.
METASTASIS - A resulting cancer that has spread from another part of the body. Metastases are spread by the bloodstream or the lymph system.
MID-STREAM URINE (MSU) - A urine sample is taken mid-way in the flow of urination - neither at the beginning nor at the end, which gives less opportunity for contamination from surrounding tissues. This gives the best sample for culture or analysis.
NOCTURIA - The urge to urinate during the night, which wakes you up and means you have to get up to go to the toilet. Normally, the kidneys will produce less urine during the night when you are asleep, and the bladder will not signal that it is full until the morning. If the bladder is irritable, however, or if there is residual urine left over in the bladder, a man will be woken by the sensation of a full bladder.
ORCHIDECTOMY - The surgical removal of one or both testicles.
ORGASM - The ultimate climax of the sexual act. In a man, ejaculation normally occurs at this point.
PEAK URINE FLOW - The maximum urine flow that a man can produce, measured in millilitres per second.
PERINEUM - The area between the scrotum and anus.
PROSCAR (Finasteride) - A popular prosratitis treatment prescription drug. You can buy it online without a prescription. Generic Proscar is available in 5mg pills. Purchase Finasteride (generic Proscar) at a very affordable price.
PROSTATECTOMY - The surgical removal of all or part of the prostate gland.
PROSTATE GLAND - Male gland, about the size of a chestnut, through which the urethra, or urinary pipe, passes.
RADIATION - Energy that is emitted in the form of waves or particles of light. Used in medicine for both diagnosis and treatment.
RADIOTHERAPY - The use of radiation in medicine for the treatment of disease, usually cancer.
RESECTOSCOPE - A surgical instrument that allows the surgeon to see inside the urethra and is used in a transurethral prostatectomy (TURP).
SCROTUM - The pouch at a man’s crotch containing the testicles.
SEMEN - The fluid that is produced by the male on ejaculation.
SEMINAL FLUID - The fluid that is emitted by the penis when a man ejaculates.
SECRETIONS - The manufacture and release by a gland, cell or organ of chemical substances.
SEXUALLY-TRANSMITTED DISEASE - One of the many diseases that can be transmitted through sexual relations. Used to be known as venereal disease.
SITZ BATH - A sit-down bath, which can be beneficial to people suffering from rectal and urinary problems.
SPERM - The male sex cell produced by the testes, also known as spermatozoon (singular) or spermatozoa (plural), which can fertilise the female egg, or ovum.
STERILITY - The inability of a man to father children.
TESTICLES - A man’s two reproductive glands located in his scrotum. The testicles produce sperm and androgens (primarily testosterone).
ULTRASOUND - Also known as sonography. A diagnostic technique in which very high frequency sound waves are passed into the body, and reflected echoes are analysed to build up a picture of the internal organs. The procedure is entirely safe, and quite painless.
URETHRA- Urinary pipe which passes through the penis, through which urine passes from the bladder to the outside. Seminal fluids also pass through the urethra during ejaculation.
URINARY FLOW RATE - How quickly urine is voided from the bladder at the peak of urination. If the urinary flow is weaker than normal, it may indicate that there is some urethral obstruction.
URINE - The pale yellow fluid produced by the kidneys, which is excreted four the body via the bladder and the urethra.
URINE CULTURE - The study of a sample of urine to allow the growth of micro-organisms. This allows a urinary tract infection to be identified.
UROLOGIST - Doctor specialising in disorders of the urinary tract and the male genital tract.
VASECTOMY - Male sterilisation, performed by cutting through the vas deferens on each side of the body, which carry sperm from the testicles to the urethra.
X-RAY - Probably the best known of all imaging techniques, first discovered by Wilhelm Konrad Rbntgen in 1895. It is a useful diagnostic procedure, using electromagnetic radiations of short wave length, which produce high-quality images of bones, organs and internal tissues.
Jul
16
Acebutolol
July 16, 2009 | Leave a Comment
Generic Name
Acebutolol (ah-seh-BUTE-uh-lol) 91
Brand Name Sectral
Type of Drug
Beta-adrenergic blocking agent. Prescribed For
High blood pressure and abnormal heart rhythms.
General Information
Acebutolol hydrochloride is one of many beta-adrenergic blocking drugs, or beta blockers. These drugs interfere with the action of adrenaline and other chemicals in the body that affect many body functions. Individual beta blockers have different characteristics that can make them more suitable for certain conditions or people.
Cautions and Warnings
Do not take acebutolol if you are allergic or sensitive to any of its ingredients or to beta blockers.
You should be cautious about taking acebutolol if you have asthma, severe heart failure, a very slow heart rate, or heart block (disruption of the electrical impulses that control heart rate) because the drug may worsen these conditions.
People with angina taking acebutolol for high blood pressure risk aggravating their angina if they suddenly stop taking the drug. These patients should have their acebutolol dosage reduced gradually over 1-2 weeks.
Acebutolol should be used with caution if you have liver or kidney disease because your ability to eliminate this drug from your body may be impaired.
Acebutolol reduces the amount of blood pumped by the heart with each beat. This reduction in blood flow may aggravate the condition of people with poor circulation or circulatory disease.
If you are undergoing major surgery, your doctor may want you to stop taking acebutolol at least 2 days before surgery.
People with a history of severe anaphylactic reaction to alergens may be unresponsive to usual doses of epinephrine while taking beta blockers.
Possible Side Effects
Side effects are relatively uncommon and usually mild; normally they develop early in the course of treatment and are rarely a reason to stop taking acebutolol.
✓ Most common: fatigue.
✓ Common: dizziness and headache.
✓ Less common: chest pain, swelling in the legs or arms, depression, sleeplessness, abnormal dreams, rashes, constipation, diarrhea, upset stomach, stomach gas, nausea, frequent urination, back pain, joint and muscle pain, difficulty breathing, stuffy nose, and vision changes.
♦ Rare: cough, low blood pressure, slow heart beat, anxiety, impotence, changes in response to touch stimulation, itching, vomiting, abdominal pain, painful urination, nighttime urination, liver changes, sore throat, wheezing, eye irritation, pain or dry eye, and lupus erythematosus (extremely rare). Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• Acebutolol may interact with surgical anesthetics to increase the risk of heart problems during surgery. Some anesthesiologists recommend gradually stopping the drug by 2 days before surgery.
• Acebutolol may interfere with the normal signs of low blood sugar and with the action of oral antidiabetes drugs.
• Acebutolol increases the blood-pressure-lowering effects of other blood-pressure-reducing agents, including clonidine, guanabenz, and reserpine, and calcium channel blockers such as nifedipine.
• Aspirin-containing drugs, nonsteroidal anti-inflammatory drugs (NSAIDS), and sulfinpyrazone may interfere with the blood-pressure-lowering effect of acebutolol.
• Cocaine may reduce the effectiveness of all beta blockers.
• Acebutolol may worsen the problem of cold hands and feet associated with ergot alkaloids, used to treat migraine. Gangrene is a possibility in people taking both an ergot and acebutolol.
• Acebutolol will counteract thyroid hormone replacements.
• Calcium channel blockers, flecainide, hydralazine, contraceptive drugs, cimetidine, propafenone, haloperidol, phenothiazine sedatives (molindone and others), quinolone antibacterials, and quinidine may increase the amount of acebutolol in the bloodstream and lead to increased acebutolol effects.
• Acebutolol should not be taken within 2 weeks of taking a monoamine oxidase inhibitor (MAGI) antidepressant.
• Acebutolol may interfere with the effects of some antiasthma drugs, including theophylline and aminophylline.
• Combining acebutolol with digitalis drugs may result in excessive slowing of the heart, possibly causing heart block.
• If you stop smoking while taking acebutolol, your dose may have to be reduced because your liver will break down the drug more slowly afterward.
• Aluminum salts, barbiturates, calcium salts, cholestyramine, colestipol, ampicillin, and rifampin may reduce the effectiveness of acebutolol.
• Beta blockers may block the effects of epinephrine.
Food Interactions
None known.
Usual Dose
High Blood Pressure
Adult: starting dose-100 mg a day, taken all at once or in 2 divided doses. The daily dose may be gradually increased. Maintenance dose-400-800 mg a day.
Senior: Older adults may respond to lower doses and should be treated more cautiously, beginning with 100 mg a day, increasing gradually to a maximum of 400 mg a day.
Child: not recommended.
Abnormal Heart Rhythms
Adult: starting dose-200 mg a day. Maintenance dose-200600 mg a day in 2 divided doses.
Senior: Older adults may respond to lower doses and should be treated more cautiously, beginning with 100 mg a day, increasing gradually to a maximum of 400 mg a day.
Child: not recommended.
Overdosage
Symptoms of overdose include extremely slow or irregular heartbeat, very low blood pressure, breathing difficulties, and seizures. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Acebutolol is meant to be taken continuously. When ending acebutolol treatment, dosage should be reduced gradually over a period of about 2 weeks. Do not stop taking this drug unless directed to do so by your doctor.
Do not take other medications, including over-the-counter medications, without consulting with your doctor. The use of some nasal decongestants with acebutolol may result in severely high blood pressure.
Acebutolol may cause drowsiness or dizziness. Be careful when driving or performing complex tasks.
It is best to take acebutolol at the same time each day. If you forget a dose, take it as soon as you remember. If you take acebutolol once a day and it is within 8 hours of your next dose, skip the dose you forgot and continue with your regular schedule. If you take acebutolol twice a day and it is within 4 hours of your next dose, skip the missed dose and continue with your regular schedule. Never take a double dose.
Special Populations
PregnancylBreast-feeding. Acebutolol crosses into the placenta. Infants born to women who took a beta blocker while pregnant had lower birth weights, low blood pressure, and slow heart rates. Acebutolol should be taken during pregnancy only if the potential benefit outweighs the risk.
Large amounts of acebutolol pass into breast milk. Nursing mothers taking acebutolol should use infant formula.
Seniors: Seniors taking acebutolol may need a reduced dosage.
Jul
15
Recovery from Prostate Surgery.
July 15, 2009 | Leave a Comment
Recovery from Prostate Surgery
Whatever anyone tells you, a prostatectomy is a major operation and you need to allow yourself sufficient time to recover from it bupropion. Men are notoriously impatient, especially if they have to go back to work, but you must accept that you will probably have to slow down for a while. Don’t expect miracles, and don’t be too hard on yourself. You may not have had a leg amputated, but you have nevertheless had a major operation and you must make allowances for this. You must not expect too much of yourself during your recovery period in order to give yourself the best chance to get better as quickly as possible. Any impatience may, in
the long run, only make matters worse and set you back on your road to recovery. Exactly how long it takes you to get yourself back to a state of good health depends to a large extent on how fit you were before you had the operation. It also depends on how large your prostate gland was, and on whether or not there were any complications as a result of surgery.
Remember that old cliche about time being the great healer? It may not be very original but, like a lot of cliches, it’s true. So grit your teeth and take things easy for a while. It may take as long as three months before you feel completely well again, but once you do, you’ll be utterly convinced that it was worth every minute!
Your bladder
In the first few weeks after your operation, don’t be surprised if your symptoms do not seem any better than before. They may even seem worse. This doesn’t mean that the operation hasn’t been a success - only that you haven’t healed yet. It can take anything up to about six weeks for the cut surface inside the prostate to heal over completely. Expecting everything to work perfectly before this happens is unrealistic. Until then, you will have to be prepared to make allowances. Even when your urinary system returns to a state of good health, do not be surprised if you have problems getting used to this. You’ve probably spent a long time - years maybe - getting used to having to empty your bladder all too frequently, and it may take a long time -several weeks, probably, or even months - before you succeed in unlearning those habits. Be patient and you will gradually build up confidence in your bladder again until you are able to forget about it completely.
Medication
You will probably still be taking a course of antibiotics when you leave hospital. You must be disciplined about taking these. Remember to finish the course, and don’t just stop taking the pills as soon as you feel better. This could set you back a long way and allow any leftover bacteria to multiply and mount another attack just when you’re least expecting it and you’re congratulating yourself on getting better .
AFTER AN OPEN PROSTATECTOMY
If you’ve had an open prostatectomy, you will have stitches in your abdomen and you will have been given strict instructions on what you can and can’t do. You will be tired after your general anaesthetic and you will need to look after your wound. A district nurse will probably come to your house every other day to change the dressing, and she will take the stitches out when necessary. You will have been told what movements you can make to avoid putting too great a strain on both the scar and the surrounding muscles. You should also:
• Avoid carrying anything at all heavy - even a full kettle may be too heavy, so fill it only half full.
• Get out of your chair cautiously and gently by wriggling your way to the edge of the chair before getting up.
• Build up slowly to normal activities.
• Use your common sense at all times and don’t attempt to do too much.
• STOP immediately if you suspect you are doing too much.
Even when you’ve had the stitches removed, you will still need to be careful. It takes a good six weeks for the wound to heal itself, and several months before the abdominal muscles get back to their full strength.
AFTER A TRANSURETHRAL PROSTATECTOMY (TURP)
If, on the other hand, you’ve had the more common transurethral prostatectomy (TURP), you won’t have any visible signs of your operation, like a scar, and it’s all too easy to forget that you’ve actually had an operation at all. But you have, and you mustn’t forget it. Any operation puts a great physical strain on the body and, as a result, takes a surprisingly long time for you to get over. In hospital, you will have spent most of your time sitting or lying in bed. You probably won’t have done anything more strenuous than reading or watching television. As soon as you get home, the temptation will be to resume all your favourite occupations - going for a walk in the park, perhaps, or doing a bit of gardening. But it is not a good idea to get back into the swing of things too soon. This should be a slow and gradual process, and you must be careful not to push yourself too far, or to do more than you can genuinely cope with. In the meantime, make sure that you get plenty of rest. Get up late, have a rest whenever you feel you need one, and go to bed early. Whenever you are sitting, remember that a firm seat is more comfortable than a soft one that can press upwards between the buttocks.
The problem is obviously greater for people who live alone and who are looking after themselves. But even where this is the case -perhaps even more so, in fact, because you can’t risk driving yourself so hard that you make yourself ill - you must restrict yourself at First to doing the essentials. You’ll obviously need to do the cooking and washing, but most other things can wait. There is absolutely no shame in spoiling yourself at a time like this. Your priority is to get well, and everything else comes second to that average.
BLADDER CONTROL
The great majority of prostatectomies are successful, and recovery is usually straightforward. Having said that, though, recovery can sometimes be slow, and efficient urination is something you may have to work at will.
Just after the operation, the urethra may be swollen, which may in turn be painful. This pain can make the urethral muscles contract from time to time, which can mean that the flow of urine is either slow or intermittent. Bruising of the tissues around the urethra can also prevent the muscles surrounding the urethra working properly, which can mean that the urethra neither opens nor closes completely. This can result in a low stream of urine, of continual leakage of urine. Such problems are, of course, unpleasant and debilitating, but they should disappear as soon as the swelling and bruising get better, which should take only a fortnight or so.
Another problem following the operation may be that you suffer from just as bad - if not worse - a degree of frequency and urgency of urination as you did before the operation. This is likely to be brought about by inflammation of the prostate and urethra, and may continue until the cut surface of the prostate is completely healed, which can take as long as six to eight weeks. It can last even longer 11′ you develop a urinary tract infection, which is a good reason to have your urine tested at your six-week check-up. It may surprise you to know that the opposite problem of an absence of urgency can, contrary to what you might expect, be
even more worrying than its presence. This is because if you suffered from chronic retention of urine before your operation, your bladder may have become so accustomed to holding a large amount of urine that it does not send the right signal when it is full. The danger, in this case, is that the bladder may become so full that it will be unable to contract properly and empty itself efficiently. You will have to empty it by the clock - say every hour or so - until you begin to feel the natural urge to urinate. This should happen spontaneously, if gradually. In short, you can expect your bladder to behaving abnormally for up to six weeks or so after the operation.
Bladder training
You will probably benefit from training - or retraining - your bladder to hold more urine and to last comfortably for longer periods of time. This should help reduce increased frequency and urgency of urination, as well as night-time urination.
Start by making a urination chart, or frequency/volume chart, detailing the time and amount of urine each time you go to the toilet. Equip yourself with a measuring jug, of the type you can buy in hardware or kitchen equipment shops, so as to measure the volume of urine. Continue keeping this chart while you are bladder training. You will probably be used to emptying your bladder each time you feel the slightest urge to do so, or even each time you pass a toilet ‘just in case’. Stop doing this and gradually increase the time between visits to the toilet. Start by holding on for another two minutes after you feel the need to go to the toilet, then increase this to five minutes, then another five minutes, and so on. All this is easier said than done, but there are a few ‘tricks’ that should make it easier for you to hold on between visits.
• Sit rather than stand when you feel the desire to urinate.
• Keep still rather than moving around.
• Pull up your pelvic floor muscles.
• Cross your legs.
• Hold your penis, if you can do this discreetly .
• Take regular, slow, deep breaths.
• Think about something else to keep your mind off your bladder.
• Try to do something else to take your mind off your bladder, such as making a telephone call, or reading the newspaper.
You will find that you can gradually manage to hold on for longer and longer intervals. Aim, ultimately, for an interval of three to four hours.
Bladder training can achieve a lot for most people in just four weeks. Try to keep it up for three months or, even better, six months. Don’t expect to have dealt with all your problems even after six months. Symptoms can continue to improve for as long as a year -or even longer.
RESUMING SEXUAL ACTIVITY
You can resume sexual activity as soon as you feel up to it. Some doctors are wary of advising patients to do this, in case of disturbing clots and scabs, others say that the passage of semen cannot do any more harm than the passage of urine. Be alert to how you feel, and follow your natural inclinations. You may, however, not feel like sex for some time after the operation. If this happens to you, you shouldn’t worry It does not mean that you have lost your sex drive or your potency as a result of the operation - it simply means that you have a natural degree of fatigue after what is, after all, a major operation side affects. This is even more likely if you have had a general anaesthetic.
Retrograde ejaculation
You are unlikely to ejaculate in quite the same way as you did before the operation and may experience retrograde ejaculation. This means that semen goes backwards up the urethra into the bladder, rather than forwards and down into the urethra. This often has the effect of making you sterile, and a lot of men find this a very difficult hurdle to deal with, even if they do not actually want to father any more children. In their eyes, the fact that they are now sterile seems to emasculate them in some way, to make them less of a man. It is important that a man is told that this is a likely side-effect of a prostatectomy before the operation, as this seems to help them deal with it better. Even if you do have retrograde ejaculation, this cannot guarantee that your partner won’t become pregnant and you should still use some form of contraception if this is an issue. You cannot rely on a prostatectomy to give you a reliable form of contraception medicare. It is estimated that between 5 and 10 per cent of men are still fertile afterwards. If you want a reliable and permanent method of contraception, you may want to discuss the possibility of having a vasectomy with your surgeon, as this can easily be done at the same time as a prostatectomy. Your urine will probably look a little cloudy after intercourse, as the semen that went into the bladder is washed out. You may also find that you bleed slightly after intercourse during the first six weeks or so after the operation - just as you notice a little blood in your urine - but as long as this is not a large amount of blood, you should not have anything to worry about.
YOUR SIX-WEEK CHECK-UP
By six weeks after the operation, most of your symptoms should have cleared up, though you may still be suffering from frequency and urgency of urination. You will probably have a check-up after six weeks, which is your opportunity to discuss anything that is worrying you. It is particularly important to have a test done on a urine sample, just to check that you are free of any urine infection. Some hospital clinics also like to repeat the urine flow test, which will indicate that the operation has been successful.
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15
Prostatitis. DIAGNOSIS OF PROSTATITIS. CHRONIC PROSTATITIS. ACUTE BACTERIAL INFECTION.
July 15, 2009 | Leave a Comment
Prostatitis. DIAGNOSIS OF PROSTATITIS. CHRONIC PROSTATITIS. ACUTE BACTERIAL INFECTION.
Prostatitis is a catch-all expression covering various types of inflammation of the prostate. It is not as serious as enlargement of the prostate, and especially not as serious as cancer of the prostate. It can, however, be a very difficult condition to treat and can sometimes drag on for several years. In prostatitis, the tiny glands in the prostate become infected, inflamed or clogged - either with thickened secretions or with small gravel-like stones. As we have seen in Chapter 1, the prostate is a complex system of glands, cells, tubules and ducts. Once infection gets a hold in this complicated network, it is hardly surprising that it can be very difficult to eradicate.
Even when it has been treated - and even when it seems as though it has been successfully treated - it can still come back. And in the absence of successful treatment, it can flare up for years, with depressing regularity.
THREE TYPES OF PROSTATITIS
There are three main types of prostatitis. These are:
• Acute bacterial infection.
• Chronic infection, which may be bacterial or non-bacterial.
• Prostatodynia, which may cause the symptoms of prostate pain without any obvious signs of inflammation or infection.
DIAGNOSIS OF PROSTATITIS
Prostatitis is sometimes difficult to diagnose. In general, the person best qualified to diagnose prostatitis is a doctor specialising in urology or genito-urinary medicine clinical trials. Your doctor may refer you to a special genito-urinary (GU) clinic. This does not mean that your doctor suspects that you are suffering from a sexually-transmitted disease. It simply means that genitourinary clinics have the best experience and equipment to investigate and treat your symptoms. The staff are used to dealing with this kind of problem, and will do so sympathetically and in confidence, so you have no need to feel embarrassed. You are likely to have a number of tests as part of the investigation of your symptoms. These may include some, or all, of the following:
• A digital rectal examination, which means that the doctor inserts a lubricated gloved finger into the rectum and gently palpates, or feels, the prostate through the front wall of the rectum, which lies against the back of the gland. If you have prostatitis, the prostate will feel boggy, soft and tender. A digital rectal examination should not hurt,
though it may be uncomfortable if the prostate is inflamed and therefore tender to the touch. A lot of men are embarrassed to have one, but they shouldn’t be: doctors are used to doing this and have a very matter-of-fact attitude to it.
• Swabs from the end of the penis, which are taken by gently inserting a sterile cotton bud into the end of the penis and taking any fresh discharge.
* Urine tests to check for cloudiness, signs of protein or blood, and threads of cellular niaterial, which are then examined under the microscope for pus cells or bacteria.
® Urine cultures to see if any bacteria grow, which should also distinguish between infection in different parts of the urinary tract.
• A blood test to check for a raised white cell count.
• Routine screening for sexually-transmitted diseases such as chlamyclia.
• The doctor will look for a discharge from the penis, and for signs of inflammation and soreness both on the penis and in the testicles. If prostatitis is untreated, or it’ drug treatment is unsuccessful, there is a risk that the prostate gland may become full of pus 5 online sildenafil citrate . Not surprisingly, this can have dreadful consequences. It may eventually burst, releasing pus into the urethra, which will discharge from the tip of the penis. And it may also result in severe infection elsewhere in the urinary tract.
ACUTE BACTERIAL INFECTION
This is an uncommon complaint. It is usually caused by bacteria from the intestines. These find their way into the urinary system, either through the urethra or through the bloodstream or lymphatic fluids.
Sometimes there is a link with organisms that cause a sexually-transmitted disease, such as gonorrhoea or chlarnydia. Sometimes, too, the fungus that causes thrush (Candida) is responsible.
Symptoms
These can happen suddenly and can include one or several of the following:
• Feeling generally under the weather.
• Chills or fever.
• An aching feeling around the thighs and genitals.
• A deep pain in the perineurn, which is the area between the pouch containing the testicles, known as the scrotum, and the anus.
• Low back pain.
• Pain in the lower abdomen.
• Pain on passing water.
• Blood in the urine.
• Difficulty in passing water.
• Increased frequency of passing water.
• Urine may be cloudy or smelly.
• Pain on ejaculation.
Diagnosis
The doctor will probably perform a digital rectal examination by inserting a lubricated gloved finger into the rectum. He will then feel the prostate through the wall of the rectum. If a man has prostatitis, the prostate will probably feel hot, swollen and tender. The doctor will then do a series of tests on a sample of urine and On urethral secretions obtained after massaging the prostate gland, in order to investigate the cause of the infection.
Treatment
Acute bacterial prostatitis, when symptoms come on suddenly, is the most dramatic form of the disease, but it is also the form that responds best to treatment. A prolonged course of antibiotic tablets is prescribed. This is usually for at least four weeks. Acute infection responds well to antibiotics, probably because the intense inflammation allows the drugs to penetrate into the interior of the gland. Symptoms should begin to show some improvement within the first few days. Sometimes, though, infection may persist in the prostate, in spite of treatment, and it is necessary to have careful follow-up treatment to make sure that the condition has cleared up. If this does not happen, the condition may tend to recur and chronic prostatitis will usually result. Occasionally, though rarely, infection may cause the gland to swell sufficiently for the urethra to be squeezed shut. This causes urinary outflow obstruction . It necessitates urgent admission to hospital, where urinary flow is eased by inserting a catheter directly into the bladder. With rest and the administration of antibiotics, the infection will usually clear up well in only a few days.
CHRONIC PROSTATITIS
Chronic prostatitis is more common than acute prostatitis, but is much more difficult to eradicate. There are two types of chronic prostatitis, which can be bacterial or non-bacterial. Chronic bacterial prostatitis Swelling occurs rapidly and this traps the bacteria in the gland, as the usual drainage channels become blocked. Prostatic secretions may coat the offending bacteria, which then harden to form tiny stones, or crystals. This protects them from being attacked by the body’s immune system or by antibiotics. This explains the repeated flare-ups that tend to occur in chronic bacterial prostatitis. This means, too, that the condition can be difficult to treat successfully. Some sufferers may even be unlucky enough to suffer from recurrent symptoms throughout their lives.
Symptoms
These vary from one person to another. They may include any, or several, of the following:
• Frequency in passing water.
• Pain on passing water.
• Pain in the prostate, genitals or rectum.
• Swelling of the testes.
• Lower back pain.
• Watery discharge from the penis.
• Pain on ejaculation.
• Blood in the semen.
• Premature ejaculation.
• If the doctor feels the prostate during a digital rectal examination, it may feel boggy, soft and squelchy.
Fertility
There is some evidence that chronic bacterial prostatitis may impair. This may probably be true in all cases of prostatitis, but seems to be especially true of chronic bacterial prostatitis. Analysis of the prostatic fluid of men with chronic bacterial prostatitis has shown significant changes in both the physical properties and the chemical constituents of the fluid. It is thought that these changes may well affect the quality of the semen, and thus the level of fertility. It is not unusual for doctors to hear the wives of men with chronic bacterial prostatitis complain that they are finding it difficult to become pregnant. A sperm count and sperm quality assessment can be done to find out how much a man’s fertility has been affected.
Chronic non-bacterial prostatitis
This is a complaint in which inflammation is present without any signs of infection. In other words, prostate secretions contain white pus cells, but no bacteria. It is not known exactly what causes chronic non-bacterial prostatitis, but several theories have been suggested. One is that it is caused by abnormal emptying of the bladder, which forces urine into the prostate channels and ducts, where it causes irritation and inflammation. This may be triggered, or aggravated, if a man jogs or plays any strenuous sport on a
full bladder. Another theory is that some men produce thicker prostate secretions, which are perhaps more acid then normal. These secretions are unable to drain away through the narrow ducts and therefore build up to cause irritation and swelling.
Symptoms
The most common symptoms of chronic non-bacterial prostatitis are:
• Frequency in passing water.
• Pain on passing water.
• Pain or ache in the prostate, genitals or rectum.
• Lower back pain, especially after sexual intercourse.
• Discharge from the urethra, especially after intercourse.
Treatment
Any chronic infection is difficult to treat, particularly when inflammation and swellings trap the infection inside the gland. In the case of chronic bacterial prostatitis, a course of the appropriate antibiotic, depending on which bacterium is responsible for the condition, will be prescribed for at least six weeks. Sometimes antibiotics may be required for as long as three months, or even longer. Chronic non-bacterial prostatitis can be treated with a natural food supplement derived from rye pollen extracts, which
has been shown to reduce inflammation, irritation and swelling, though improvement may not be apparent for at least three months and full recovery may take as long as six months or even more. Swelling, inflammation and pain may be helped by anti-inflammatory painkillers such as ibuprofen.
Self-help
Chronic non-bacterial prostatitis is sometimes relieved by an increased frequency of ejaculation. This can be brought about through intercourse, of course, but if this does not happen it may equally be brought about by masturbation. Ejaculation drains the prostate of any excess secretions and causes a temporary increase in blood. Both these things help to flush away any toxins. In some cases, however, an increased frequency of ejaculation only makes the problem worse.
PROSTATODYNIA
This is characterised by the usual symptoms of prostate problems, including pain, but with no evidence of inflammation or infection in the gland. Prostate secretions look perfectly normal and contain no pus cells. Prostatodynia is surprisingly common and accounts for around one third of all cases where men experience the symptoms of chronic prostatitis.
Symptoms
The symptoms of prostatodynia are therefore similar to those of chronic prostatitis. They may often also include psychosexual problems.
Symptoms include the following:
• Frequency in passing water, sometimes with associated pain.
• Pain in the prostate, genitals or rectum.
• Lower back pain.
• Watery discharge from the penis.
• Blood in the semen (haemospermia).
• Premature ejaculation.
• Pain on erection.
• Pain on ejaculation.
• Low sex drive.
• A diminished volume of semen.
• Impotence.
• If the doctor feels the prostate during a digital rectal examination, it may feel boggy, soft and squelchy.
Treatment
Prostatodynia can be difficult to treat. Painkillers are not usually helpful. It is, however, likely to have a physical cause, such as spasm of the pelvic muscles, which may be brought on by stress and anxiety. In this case, tranquillisers may be prescribed in order to reduce muscular spasm in the gland, though it is not a good idea to take these in the long-term as they can become addictive. Recent studies have suggested that prostate pain can be relieved by microwave hyperthermia. The technique was originally developed at the Beilinson Medical Centre, Petah Tiqva, in Israel in the early 1980s and is now attracting a lot of interest in other countries. An hour’s treatment is usually given weekly for six weeks.
Other treatments that have been tried for prostatodynia include:
• Acupuncture.
• Laser irradiation.
• Muscle-relaxant drugs, such as diazepam.
• Antispasmodic drugs.
Self-help
As in chronic non-bacterial prostatitis, symptoms may be worsened when ejaculation is infrequent, in which case the pain may be caused by prostatic gland engorgement. Symptoms may therefore be relieved by an increased frequency of ejaculation, as a result of either intercourse or masturbation. Ejaculation drains the prostate of any excess secretions
and causes a temporary increase in blood supply. In some cases, however, an increased frequency of ejaculation only makes the problem worse. Sitting in a hot bath for half an hour can help to warm up the prostate gland. Relaxation techniques may also be used to relax the muscles and as an alternative to muscle-relaxant drugs. The combination of regular exercise and a high-fibre diet will help keep the bowels regular, which is particularly important for men suffering from prostatodynia. This is of special benefit to those men who sit at a desk for most of the day, as both constant sitting and constipation tend to increase prostate congestion. Symptoms of prostatodynia may be triggered by the nicotine in cigarettes and by alcohol or caffeine, so it is best to reduce consumption of all three. It may also be advisable to consult an allergy specialist who may be able to identify foods that you should avoid.
Natural treatments
Rye pollen extracts have been shown in clinical trials in Europe to help ease the symptoms of prostatitis, particularly chronic non-bacterial prostatitis and prostatodynia. They reduce inflammation and ease irritation. They may take as long as three months before they show any improvement, which may then continue over the next three months. Rye pollen
extracts, such as Cernilton and ProstaBrit, are available from health food stores.
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Acne: Blue Light Photodynamic Therapy
July 2, 2009 | Leave a Comment
Blue Light Photodynamic Therapy
The latest thing in acne treatment is the Dusa Blue Light. The FDA initially approved this therapy for treating precancerous skin lesions called actinic keratoses. The approach utilizes a special photosensitizing chemical, aminolevulinic acid.
Dusa Blue Light
For people with precancerous skin lesions or severe acne, the Blue Light may be a valuable tool. The skin may took worse for a few days, but within a week or two the acne should clear up significantly. Results may last several months. This photodynamic therapy requires a two-step process: First a photosensitizing chemical.(Levulan Kerastick) is applied to the skin and then removed. Then the skin is exposed to the special light.
Side effects: Crusting, stinging, and redness.
Downside: Cannot be used if you have active cold sores (herpes simplex) or warts, if you’ve recently had chemotherapy, or if you are pregnant. People who have used isotretinoin within the last year may not be able to undergo Blue Light therapy. Stay out of the sun and avoid fluorescent light exposure for a couple of days after treatment.
Cost: Varies according to the practitioner. Some plastic surgeons charge $500 to $1,000 for a series of treatments. It is then rinsed off and the patient sits in front of the Dusa Blue Light for 8 to 12 minutes. This special fluorescent tube emits a narrow band of blue light (417-nanometer wavelength). It is not a laser. It looks like an ordinary fluorescent light.
This photodynamic therapy reverses precancerous damage to the skin and also seems to undo some of the effects of long-term sun exposure. In addition, this treatment appears to change the hair follicle and make the environment inhospitable for acne-causing bacteria. Dermatologists who adopted the Blue Light early on seem quite enthusiastic about its use for hard-to-treat acne. There is also a hint that it may help “rejuvenate” skin by reducing wrinkles and improving skin texture. It is a rather expensive treatment course, more expensive than taking Accutane Isotretion for acne treatment. Accutane remains one of the most popular remedies for fighting acne. Generic Accutane is available to buy online at a very affordable price without a prescription.