Jul
5
Corticosteroids in Arthritis Treatment
July 5, 2009 | Leave a Comment
Corticosteroids
When cortisone was first introduced in the 1950s it was heralded as a wonder drug. Doctors became overnight heroes because they helped patients who had been crippled by rheumatoid arthritis get out of bed and begin functioning again. Even people with milder conditions like osteoarthritis, allergies, asthma, and eczema were thrilled because corticosteroids relieved their symptoms amazingly well. But the very reason these medications were so successful was also their Achilles’ heel. As great as they are at easing inflammation, they profoundly affect cells throughout the body. Taking high doses for long periods of time is a little like dancing with the devil.
Once people woke up to the downside of steroids, the drugs lost their luster and fell into disfavor. Don’t get us wrong, though. These medications are incredibly valuable, especially for short-term use. People experiencing an arthritis flare-up, a bad ’sunburn, or a terrible case of poison ivy will benefit im- mensely from a pulsed dose of corticosteroids. When Joe went deaf in one ear, a course of prednisone restored his hearing. If used cautiously and with respect for their risks, these drugs can be extremely valuable. But using corticosteroids regularly to treat arthritis is a slippery slope.
COMMON CORTICOSTEROIDS
• Cortisone
• Dexamethasone
• Hydrocortisone
• Methylprednisolone
• Prednisolone
• Prednisone
• Triamcinolone
• Cataracts
• Osteoporosis
• Diabetes
• Spontaneous fractures
• Bone deterioration
• Insomnia
• Irritability
• Glaucoma
• Fluid retention
• Weight gain
• Moon face
CORTICOSTEROIDS
• Infections
• High blood pressure
• Blood clots
• Potassium loss
• Stomach ulcers
• Muscle weakness
• Menstrual disturbances
• Impaired wound healing
• Fatigue
• Steroid “psychosis”
Jul
3
Allergy: Your Home Environment
July 3, 2009 | Leave a Comment
Your Home Environment
People are now exposed to a chemical soup at home and in the workplace. Buildings are tightly sealed for energy efficiency and may trap chemical gases and dust from a variety of sources. Cleaning agents left on floors and other surfaces dry and can eventually circulate on dust particles throughout the house or workplace and be inhaled with each breath. Fire retardants and other chemicals used in fabrics and foams in furniture, mattresses, and electrical insulation can be irritating to the airway. Mold can flourish wherever there is humidity—in basements, crawl spaces, bathrooms, air conditioners, and automobile air ducts.
It is crazy to treat the symptoms of allergies if you don’t examine your environment and try to eliminate what’s causing the problem in the first place. If you lived in a house with faulty wiring that kept blowing fuses or tripping the circuit breakers every day, it would be foolish to ignore the underlying problem. Continually throwing the circuit breaker to the on position or replacing fuses might leave you vulnerable to a fire. In the old days, people sometimes stuck a penny in the fuse box to bypass the warning system completely. No doubt some homes burned down as a result.
We know of one family that moved into a charming old house. Within a few months, the dad starting sniffling and sneezing. Then he developed asthma for the first time in his life. Not long after, both children also became congested and had periodic bouts of asthma. They were all treated with various medications to relieve their symptoms. It wasn’t until they moved that their symptoms eventually went away and their need for allergy and asthma drugs disappeared.
No dermatologist in his right mind would keep prescribing prednisone to someone who showed up with a poison ivy outbreak every other week. At some point the dermatologist would tell this patient to stay away from poison ivy to avoid the itchy, red rash in the first place. We wish allergists and lung experts would do more than prescribe antihistamines, bronchodilators, and corticosteroids for their patients. If they actually visited their patients’ homes or workplaces they might discover the cause of the symptoms.
Of course, that is not going to happen. Instead, you will have to become your own Sherlock Holmes, sniffing out the culprits if you can. In some cases it might even be worthwhile to employ a certified environmental engineer to look for sources of allergens in a house or apartment. Watch out for charlatans, though. There are lots of quacks out there who would love nothing more than to sell you a pricey home inspection and cleanup. Make sure that whoever analyzes your living space isn’t selling a service or recommending an organization they have a financial relationship with.
Jul
1
Drugs for Bell’s Palsy Treatment
July 1, 2009 | Leave a Comment
Bell’s palsy
Bell’s palsy is a unilateral facial paralysis, characterizedby sudden onset and pain, usually behind the ear. The cause is unknown, but the symptoms are thought to be due to local swelling and a compression of the facial nerve. Patients should be reassured that the paralysis is unrelated to stroke and spontaneous recovery usually occurs after some weeks. Corticosteroids are effective if the condition is diagnosed early, and prednisolone is given initially in doses of 60-80 mg daily, decreasing by 10 mg every 2 days for about a week. As the palsy may prevent closure of the affected eye, local treatment with artificial tears or liquid paraffin may be required.
Approved names Brand names
hypromellose Tears Naturelle
(artificial tears) Isopto Alkaline & Plain
prednisolone Deltacortril, Deltastab, Precortisyl, Prednesol
liquid paraffin
Lacri-Lube
polyvinyl alcohol
Hypotears