Pharmacy
Vasopressin
· Trade Name
Pitressin
· Generic Name
VASOPRESSIN
· Drug Class
Endocrine medication
Advanced Cardiac Life Support medication
· How It Works
Medication mimics activity of anti-diuretic hormone.
· Serious Side Effects
allergic reactions
chest pain
heart arrhythmias
heart attack
high blood pressure
slow heart rate
water intoxication
· Common Side Effects
diarrhea
dizziness
fever
headache
gas
nausea
rash
stomachache
sweating
tremor
vomiting
Read more – April 10, 2009
Study Indicates HIV Medication Should Be Started Earlier.
· HIV infection destroys the immune system over time. As HIV infection worsens, the number of CD4 cells will 
progressively fall. HIV treatment with medications has routinely been delayed until the immune system cell CD4 count drops below 250 or a patient has an AIDS defining illness such as an opportunistic infection.
· A recent study in the journal The Lancet reports that patients with HIV would benefit from starting anti-viral HIV medication earlier.
· The study analyzed data from 18 studies of patients with HIV which included 45,000 individuals.
· The study reported that waiting to start medication until a CD4 cell count dropped to 251-350 cells was associated with higher rates of the development AIDS and death when compared with starting medications earlier, when CD4 cells counts were higher, between 351-450 cells.
· The study authors concluded that their data indicates that medications should be started earlier in the course of the disease, when patients have CD4 cells that have dropped to 350 cells.
· This study is a retrospective observational analysis of previous clinical trials. The authors present a convincing argument to start treatment earlier, possibly at CD4 cell count as high as 450.
Reference
The Lancet, Early Online Publication, 9 April 2009
April 9 2009
Read more – April 9, 2009
Aspirin May Lower Cancer Risk
· According to an article in the journal Lancet, Aspirin and other Nonsteroidal Anti-inflammatory Drugs 
(NSAIDs) may prevent certain forms of cancer.
· The authors of this review article report on multiple previous studies showing protection against certain forms of cancer and aspirin use. Due to ethical constraints, there are no long-term randomized placebo-controlled clinical trials on aspirin use and prevention of cancer.
· The current evidence of a reduction in cancer with aspirin use comes from studies of aspirin that were designed to test vascular protection, heart disease and stroke.
· The authors of this article summarized the evidence from previous published studies supporting the potential benefit of aspirin in cancer prevention.
These trials include:
· The Physicians’ Health Study, which showed a relative risk reduction for developing colorectal cancer in the aspirin group, compared with the placebo group.
· A British study of 5,000 male doctors showed that after six years, cancer deaths were 18% lower in the aspirin-treated group.
· The Nurses’ Health Study of almost 80,000 American women, showing a 12% reduction in cancer deaths with aspirin use.
· Cancer Prevention Study II showed a significant reduction in overall cancer for men only, a reduction in colon and prostate cancer, and a nonsignificant reduction in breast cancer.
· There are 20 other observational studies that have found that NSAIDs appear to offer a degree of protection against breast cancer and might be of benefit to women with cancer. Some benefit has also been observed for both gastric and esophageal cancers.
· The dose and duration of aspirin needed for a protective effect against cancer is not known.
· The information from these studies is observational and many variables cannot be analyzed, which complicates conclusions made by the authors.
· The authors also point out that there are differing viewpoints within the medical community as to whether or not patients at a high risk for cancer should be advised to use prophylactic aspirin.
Reference
The Lancet, Early Online Publication, 27 March 2009
Read more – April 1, 2009
Chronic Pain Linked to Low Vitamin D
· Low vitamin-D levels may be the source of nerve dysfunction seen in chronic pain syndromes, according to a study published in the journal Pain Medicine.
· Dr. Turner, lead investigator of the study comments “many patients who have been labeled with fibromyalgia are, in fact, suffering from symptomatic vitamin-D inadequacy.”
· The study found that patients who had inadequate vitamin-D levels and required narcotic pain medication were taking much higher doses; almost twice as much medication as those with adequate vitamin-D levels. Subjects with low vitamin-D levels also reported worse physical function and worse overall health perception.
· This was a retrospective study of 267 patients who were admitted to the Mayo Comprehensive Pain Rehabilitation Center.
· The study’s authors compared vitamin-D levels at the time of admission along with the duration of pain, the medication patients were taking, self-reported levels of pain, emotional distress, health perception, physical functioning, and demographic information such as sex, age and body-mass index.
· Patients with low vitamin-D levels, below 20 ng/mL, were considered to have inadequate amounts of vitamin-D. The prevalence of low vitamin-D was 26%.
· Researchers report that the patients with low vitamin-D levels required 48% more pain medication to control pain. The patients with low vitamin-D levels also needed narcotic pain medication for 38% longer than the patients with normal vitamin-D levels.
· The researchers also observed a link between increasing body-mass index and decreasing levels of vitamin-D.
· The authors conclude that low vitamin-D levels may create or sustain pain.
· One of the study authors suggested that patients with inadequate vitamin-D levels may benefit from vitamin-D supplementation. But he urged caution for patients with calcium or phosphate-processing disorders. Dr. Turner comments, “Increasing vitamin-D levels could be problematic in patients with kidney failure or stones, or primary hyperparathyroidism, or sarcoidosis. ” For patients with adequate vitamin-D looking to maintain levels, he recommends 10 to 15 minutes of sun exposure with no sunscreen on the trunk and arms and legs 3 times a week.
· The importance of adequate vitamin-D is just recently being recognized by the medical field. Vitamin-D may help reduce some forms of cancer and heart disease. Deficiencies may be important in the development of Multiple Sclerosis and now researchers are seeing an association with chronic pain.
Our society is likely at a higher risk of vitamin D deficiency today with the current avoidance of sun exposure, one of the sources of vitamin-D.
Vitamin D levels can be easily checked with a simple laboratory test and reviewed with your doctor.
References
Pain Med. 2008;9:979-984.
Read more – March 27, 2009
Gas
• Definition
Gastrointestinal gas is:
· Flatus: the gas passed from the colon
· Belching: the gas release from the stomach
• Overview
Flatus is derived from:
· swallowing air
· the fermentation of undigested carbohydrates which produces hydrogen gas, carbon dioxide gas and methane gas
• Common gas producing foods include:
· beans
· beer
· brussels sprouts
· cabbage
· coffee
· lentils
· onions
· peas
• Symptoms
Bloating
crampy abdominal pain
• Treatment
Dietary restriction of complex starches and fiber
References
Gas distribution within the human gut: effect of meals. Am J Gastroenterol. 2007 Apr;102(4):842-9. [PMID: 17397409]
Read more – September 24, 2008
Chicken Pox
• Definition
· Chickenpox is the disease of the initial infection of the Varicella zoster virus.
• Overview
· Chickenpox will occur about two to three weeks after an exposure to the virus in an individual who does not have immunity either by a previous infection or vaccine.
· Chickenpox is spread by direct hand to hand contact or by respiratory droplets (cough)
• Symptoms
· Vesicles (very small blisters) with red borders that begin in the mouth spreading to the face, scalp, trunk and arms and legs
· fever
· fatigue
• Complications
· pneumonia
· hepatitis
· inflammation of the brain
· Reye’s syndrome if given aspirin during the infection
• Treatment
· Antiviral medications
References
Varicella. Lancet. 2006 Oct 14;368(9544):1365–76. [PMID: 17046469]
Health Benefits: Flaxseed Oil Vs. Fish Oil
Flax seed oil, also known as linseed oil, is derived from the flax seed, which has become increasingly popular, because of its high concentrations of alpha-linolenic acid(ALA) also known as an omega-3. The name omega-3 describes the molecular structure of this unsaturated fatty acid. Alpha-linolenic acid is called an essential fat because it is essential for normal metabolism and cannot produced in your body and must be obtained through your diet. Flax seed oil has about six times the concentration of omega-3 fatty acids as most fish oils.
Fish oils from anchovies, herring, salmon and to a lesser extent tuna; contain two additional types of omega-3 fatty acids: eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).
Omega-6 fatty acid, is also essential for normal human metabolism and has to be obtained from dietary sources. There is growing concern that excessive amounts of dietary omega-6 in the American diet has led to the increases in heart disease. Omega-6 probably competes with the health benefits of the omega-3 fatty acid. Therefore we should limit dietary omega-6 fatty acids.
Both the omega-3 and omega-6 fatty acids are required for good skin health and maintenance of cell membranes.
Many physicians believe that supplemental omega-3 fatty acids are protective against heart disease and prescribe them to patients. However, we do not have good evidence-based studies to prove this is true. Some anima-based models have shown that omega-3 supplemental can reduce the production and secretion of some forms of bad cholesterol and triglycerides. Other studies show an anti-inflammatory effect which may be cardio-protective.
Supplemental omega-3 is probably good for you. But, flax seed oil verses fish oil: which form is better? There is no data supporting one over the other and although there are more clinical studies on the fish oils EPA and DHA, flax seed oil has a higher concentration of the omega-3 ALA.
Many patients have difficulty taking fish oils due to the foul taste. Because flax seed oil has a more favorable taste, it may be a better option since patients will be more eager to take it.
August 25, 2008
Read more – August 25, 2008
