March 14, 2008 at 9:19 pm
· Filed under DRUG SAFETY ·Tagged aminoglycosides, avoiding toxicity, best pharmacy guide, compliance, dosing, drug monitoring, drugs, frequent seizures, immunosuppressants, Online Pharmacy, online pharmacy guide, patient compliance, patients, pharma, pharma help, pharmacy, prophylactic drugs, TDM, Therapeutic drug monitoring, toxicity
Below are the indications where TDM is highly useful to interpretate the drug concentration.
toxicity
- diagnosing toxicity when the clinical syndrome is undifferentiated (unexplained nausea in a patient taking digoxin)
- avoiding toxicity (aminoglycosides, cyclosporin
dosing
- after dose adjustment (usually after reaching a steady state)
- assessment of adequate loading dose (after starting phenytoin treatment)
dose forecasting to help predict a patient’s dose requirements1 (aminoglycosides)
monitoring
- assessing compliance (anticonvulsant concentrations in patients having frequent seizures)
- diagnosing undertreatment (particularly important for prophylactic drugs such as immunosuppressants, anticonvulsants)
- diagnosing failed therapy (therapeutic drug monitoring can help distinguish between ineffective drug treatment, non-compliance and adverse effects that mimic the underlying disease).
The target concentration may depend on the indication.Another important aspect of TDM is when the sample is taken as we know different drugs have different half lives, therefore there timings are also differ.
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November 13, 2007 at 1:18 am
· Filed under CLINICAL PHARMACOLOGY AND PHARMACY ·Tagged anti-aging expert, best online pharmacy, Bioidentical Hormone Replacement, bioidentical hormones, chemicals, compounding pharmacy, diseases of aging, health and wellness services, Hormone Replacement, Hormone testing, nutritional supplements, online pharmacy help, organic products, pharmaceutical companies, pharmacy, pharmacy help, prescription, progesterone, saliva test, symptoms, Testosterone, wellness, Women's Health
Bioidentical hormones are defined as biologically identical to what the human body manufactures. Their molecular structure is exactly the same as the molecular structure of hormones made by the body. They are derived from plant sources: soy, wild yam and other plant extracts and processed in a lab to replicate the hormones in the body.
Bioidentical hormones have been used in Europe for over 50 years. They are not chemical synthetic drugs like Premarin which is made from a pregnant mare’s urine and then prescribed in a one dose fits all regimen. Premarin will leave you with symptoms of bloatedness, low libido, brittle bones and depression, not to mention the serious consequences of heart attack, stroke and breast cancer. The big and powerful pharmaceutical companies have no interest in bioidentical hormones because they are not able to patent them and churn out big profits. Instead, the big pharmaceutical companies have pushed their synthetic hormones onto women, chemicals which are dangerous to women’s health (Women’s Health Initiative, 2002).
It can be difficult to find a doctor who is able to prescribe bioidentical hormones and who will be able to monitor your hormone levels and your progress. An excellent source for locating these doctors is a compounding pharmacy. Your bioidentical hormones will be made up in the compounding pharmacy.
For your first visit, you doctor will either prescribe estrogen, progesterone and perhaps Testosterone or progesterone alone, depending on your symptoms and then see how your symptoms are in a couple of months. Or the doctor may test your hormone levels and then give you a prescription to solve your symptoms. You will take these cyclically to mimic your natural cycle before the onset of these symptoms. Hormone testing can be done either by a blood test or a saliva test. A saliva test is more accurate in measuring your hormones.
T.K. Robb became an anti-aging expert over the last few years from an interest which led to serious study on the subject, which in turn, led to the development of the PureAgeless.com website. Her research led to the writing of articles, reviewing organic products and services for companies which provide health and wellness services. Her website is based on the organic approach to fighting the diseases of aging, from bioidentical hormones to nutritional supplements.
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November 11, 2007 at 11:40 am
· Filed under CLINICAL PHARMACOLOGY AND PHARMACY ·Tagged pharmacy, pharmacy articles, Medical, medicine, articles, expert pharmacy help, Cancer, rheumatoid arthritis, Arthritis Pain, medi care, painkillers, arthritis treatment, immune system, expert guideline, expert guidelines, mind-body connection, Understanding Arthritis, depressed feel pain, disease, osteoarthritis, debilitating immune disorder
When you have arthritis pain, you need relief. But with so many warnings in the news about painkillers, it’s hard to know the best choice. Many medications that ease arthritis pain have the potential for health risks, including increased risk for heart attack, stomach problems, or infections.
You have difficult decisions to make, whether you’re fighting pain from osteoarthritis that comes with age — or pain from rheumatoid arthritis, a debilitating immune disorder. Do you somehow tough out the pain? Or do you accept the risk because your pain requires it, and take the drug for arthritis? Which drug is right for your body? And which medicine may work best for your type of arthritis?
Easing arthritis pain can help someone with osteoarthritis “get up and going, and get walking,” White tells WebMD. “If you have osteoarthritis, losing 15 pounds will stop the progression of your disease and reduce your pain. Then you can quit taking the pain medication!”
Although pain from rheumatoid arthritis cannot be reduced through weight loss, the risk of not treating this immune disease is even more dramatic. Without treatment, RA tends to progress and worsen. New drugs called biologics can stop the damaging effects of the disease. “These drugs carry a slight risk of cancer, because they suppress the immune system,” says White. “Yet if you don’t take them, you are going to be disabled. You have to put that risk-benefit ratio on the table.”
Hadler has researched the mind-body connection in arthritis pain, and has found that people who may be lonely or depressed feel pain more acutely.
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October 22, 2007 at 3:54 am
· Filed under Uncategorized ·Tagged American Medical Association (AMA) Code of Ethics, best pharmacy guide, Chinese medicine, Clinical pharmacy, consultant pharmacists, consultation, cost-effective medication, direct consultation with patients, dispensing doctors, DRUG SAFETY, drugs, future of pharmacy, medical clinic, pharmacy, physician, senior care, senior care pharmacy, side-effects, traditional Chinese medicine
Separation of prescribing from dispensing
In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. Specifically, the legislation stipulates that the practice of prescribing must be separate from the practice of dispensing. [citation needed] These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them “kickback” payments. However, the American Medical Association (AMA) Code of Ethics provides that physicians may dispense drugs within their office practices as long as there is no patient exploitation and patients have the right to a written prescription that can be filled elsewhere. 7 to 10 percent of American physician practices reportedly dispense drugs on their own.
In other jurisdictions (particularly in Asian countries such as China, Hong Kong, Malaysia, and Singapore), doctors are allowed to dispense drugs themselves and the practice of pharmacy is sometimes integrated with that of the physician, particularly in traditional Chinese medicine.
In Canada it is common for a medical clinic and a pharmacy to be located together and for the ownership in both enterprises to be common, but licensed separately.
The reason for the majority rule is the high risk of a conflict of interest. Otherwise, the physician has a financial self-interest in “diagnosing” as many conditions as possible, and in exaggerating their seriousness, because he or she can then sell more medications to the patient. Such self-interest directly conflicts with the patient’s interest in obtaining cost-effective medication and avoiding the unnecessary use of medication that may have side-effects. This system reflects much similarity to the checks and balances system of the U.S. and many other governments.
A campaign for separation has begun in many countries and has already been successful (like in Korea). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have pecuniary interests may prove a major stumbling block (e.g. in Malaysia).
The future of pharmacy
In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists will be paid for their patient care skills.
This paradigm shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for conducting comprehensive Home Medicines Reviews. In the United Kingdom, pharmacists (and nurses) who undertake additional training are obtaining prescribing rights. They are also being paid for by the government for medicine use reviews. In the United States, the Clinical pharmacy movement has had an evolving influence on the practice of pharmacy. Moreover, the Doctor of Pharmacy (Pharm.D.) degree is now required before entering practice and many pharmacists now complete one or two years of residency training following graduation. In addition, consultant pharmacists, who traditionally operated primarily in nursing homes are now expanding into direct consultation with patients, under the banner of “senior care pharmacy.”
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October 21, 2007 at 1:28 am
· Filed under CLINICAL PHARMACOLOGY AND PHARMACY ·Tagged ACE inhibitors, Alpha-blockers, angiotensis II receptor antagonists, best pharmacy articles, blood pressure, Blood Pressure Medication, Blood Pressure treatment, BP, calcium channel blockers, care, Edecrin, High Blood Pressure, Hypertension, hypertention care, Lasix, online pharmacy guide, PHARMACOLOGY, pharmacology articles, prescription, prescription drugs, RMP's, side-effects, Tektuma and Hyperexol, treatment
Hypertension is known to affect millions of people around the world. Fortunately though advances in medical science have meant that there are numerous prescription drugs too that are available to treat hypertension or high blood pressure. Edecrin, Lasix, Tektuma and Hyperexol are some of the drugs used for treating high blood pressure. These drugs are again categorized as
- beta-blockers
- ACE inhibitors
- Alpha-blockers
- calcium channel blockers
- angiotensis II receptor antagonists
based on various criteria. Among all the drugs that are available for treating hypertension, Hyperexol is perhaps the most popular. The reason for its popularity lies in the fact that there are virtually zero negative side effects associated with the drug.
Hyperexol has changed the lives of millions of people around the world. Although other conventional medicines help in controlling high blood pressure, they do so only by delaying the disastrous affects of high blood pressure. Most of the prescription drugs such as Edecrin, Tektuma and Lasix, contain chemical ingredients that may cause potentially dangerous negative side effects. This is where Hyperexol scores over other prescription drugs. This drug does not cause any negative side effect. Since it is totally made up of natural ingredients, there is virtually no question of any negative side effect. The formulation of the drug consists of essential nutrients that help in lowering high blood pressure.
The reason for the rising popularity of Hyperexol can be directly attributed to its all-natural formula. The drug does not contain any fillers, steroids or chemical compounds, unlike the case of several other prescription drugs used for treating high blood pressure. It is the reason which makes this drug totally safe and this fact can be seen from the fact that you do not need a prescription to buy this product in many countries. Although this is the case, you should always talk to your physician before you take Hyperexol.
Vitamin B6, Magnesium, Calcium, Garlic, Vitamin C, Potassium and Selenium are among the ingredients that are used in Hyperexol. All the ingredients are scientifically and synergistically combined in such a way so as to support the natural blood pressure levels in the body. The ingredients also help in other ways by providing protection against risk of heart disease and heart attacks. Hyperexol works by reducing blood ’stickiness’, which in turn helps in proper flow of blood through the veins and arteries. The drug helps in soothing nerves and helps people remain calm even in stressful situations. All these benefits have made it the most preferred solution to hypertension.
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September 1, 2007 at 7:13 pm
· Filed under CLINICAL PHARMACOLOGY AND PHARMACY ·Tagged Benfotiamine, best pharmacology articles, BMC Pharmacology, central nervous system, deficiency, dietary supplement, disulfides, health articles, health articles and post, health post, malnutrition, Online Pharmacy, PHARMACOLOGY, PHARMACOTHERAPY, pharmacy, pharmacy guide, sensory perception, Supplement, Vitamin, Vitamin Supplement, weakness
vitamin supplement is being advertised with claims that are demonstrably untrue, as revealed by research reported in the open access journal BMC Pharmacology. Benfotiamine is a synthetic derivative of thiamine (vitamin B1). It is marketed heavily as a dietary supplement using a selection of unsubstantiated, ‘not-quite-medical’ claims that tend to characterize this field. A large part of this campaign has been built around the belief that benfotiamine is lipid-soluble and, therefore, more physiologically active. Scientific research led by Dr Lucien Bettendorff of the Center for Cellular and Molecular Neurobiology at the University of Lige, Belgium, has entirely disproved these claims.
A severe deficiency of thiamine is known to cause weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart rate. Deficiencies can occur as a result of alcoholism or malnutrition. As thiamine itself is very poorly absorbed by the body, it must be taken in as various precursor forms. This research shows that benfotiamine may not be as effective in this regard as has been claimed, in particular concerning its ability to raise effective thiamine levels in the central nervous system.
As per Bettendorff, “We suspect that those companies selling benfotiamine have poisoned much of the recent literature in an attempt to bestow it with properties that it does not have”. Benfotiamine has been previously shown to prevent several diabetic complications in experimental animal models. The scientists carried out experiments in mice in which benfotiamine was administered using several different techniques and the resulting levels of thiamine were measured in various parts of the body. Contrary to other claims about its solubility, the results show that benfotiamine is only sparingly soluble in water under physiological conditions and cannot be dissolved in octanol or oils.
As Bettendorff explains, “Benfotiamine is very often considered a ‘lipid-soluble’ thiamine precursor from the disulfide derivative family though it is neither lipid-soluble, nor a disulfide. Sometimes, it is considered to have more biological activity than thiamine disulfides, but our study shows that it does not even penetrate cell membranes, except in those cells containing an ecto-alkaline phosphatase. There is no evidence that benfotiamine would be more effective than other precursors as a therapeutic agent for complications of diabetes”.
Due to the wide-reaching nature of the false claims about this supplement, it was important to the authors that their work be published in BMC Pharmacology as it is an open access journal that makes research freely available.
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July 12, 2007 at 3:05 pm
· Filed under CLINICAL PHARMACOLOGY AND PHARMACY ·Tagged Anti-Inflammatory Painkillers, arthritis, Arthritis Foundation, Arthritis medicine, Arthritis Pain, cholesterol, combination of drugs, elevated cholesterol, High Blood Pressure, ibuprofen, lowest effective dose, Motrin, naproxen, Nonsteroidal anti-inflammatory drugs, NSAID, or Advil, painkillers, PHARMACOLOGY, pharmacology journals, pharmacy guide, short-term solution
Nonsteroidal anti-inflammatory drugs called NSAIDs help relieve joint swelling, stiffness, and pain — and are among the most commonly used painkillers for people with any type of arthritis. You may know them by the names such as ibuprofen, naproxen, Motrin, or Advil.
While NSAIDs are reasonably safe, when taken for months or years, they can cause stomach ulcers and may increase your risk for heart attack. Cox-2 inhibitors like Celebrex are more stomach-friendly, but may have a slightly higher risk of heart problems than milder NSAIDs such as ibuprofen or naproxen.
Recent research also indicates that people who take daily aspirin for their heart should talk to their doctors before taking any NSAID regularly for pain. NSAIDs may alter the effect of aspirin.
But here’s the question that White at the Arthritis Foundation tells her patients to ask themselves: “How does a slight risk of heart disease compare to the risk of arthritis pain itself?”
To reduce the chance of side effects, turn to NSAIDs as a short-term solution if possible, says White. Ask your doctor to prescribe the lowest effective dose, or a combination of drugs.
To protect your heart, it also helps to control other risk factors of heart disease such as high blood pressure and elevated cholesterol.
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June 16, 2007 at 5:12 pm
· Filed under Uncategorized ·Tagged Alzheimer's disease, Asthma, Autism, best pharmacy, dementia, diet and health, expert pharma reviews, genetic mutations, health, health articles, Health News, medicine, Online Pharmacy, PHARMACOLOGY, pharmacology articles, pharmacy and health, pharmacy journal, pharmacy journals and reviews, Respiratory and Critical Care Medicine, Schizophrenia, Severity of Asthma, Thoracic Society
Those who take ibuprofen on a regular basis for five years may be less likely to develop Alzheimer’s disease as they get older, according to a new study. And people who take nonsteroidal anti-inflammatory medicines in general may have a decreased risk. But the findings are not concrete enough to warrant advising patients to take a daily dose of ibuprofen, or any other type of NSAID, to ward off Alzheimer’s, noted the researchers, led by Steven Vlad, a fellow in rheumatology at Boston University School of Medicine. Long-term use of NSAIDs carries a risk of gastrointestinal problems.
Still, “this trial is big enough and the results are good enough that it may reopen the debate–that we should do a prevention study with these medications,” William Thies, vice president of medical and scientific relations for the Alzheimer’s Association, told HealthDay.
Find out how to reduce your risk for dementia by shedding excess belly fat, and learn the difference between Alzheimer’s disease and other types of dementia.
Autism and Schizophrenia May Be Related
A new study supports the idea in autism research that people diagnosed with either schizophrenia or autism often share the same rare genetic mutations, Nancy Shute reports. Julie Daniels, an epidemiologist at the University of North Carolina-Chapel Hill, looked at the health records of the parents of 1,227 Swedish children with autism who were born between 1977 and 2003. Those parents were twice as likely to have been diagnosed with schizophrenia as parents of children who didn’t have autism. Other studies of early childhood brain development have shown that in both autism and schizophrenia, the brain development process is accelerated from birth to age 3.
In the On Parenting blog, Shute explains why the new study–while scary on its face–is actually good news. Earlier, she reported on evidence dismissing the link between vaccines and autism. And U.S. News’s Bernadine Healy recently looked into the autism-vaccine link, after the independent Office of Special Masters of the Court of Federal Claims–with a 20-year record of handling vaccine matters–conceded that the brain damage and autistic behavior of Hannah Poling stemmed from her exposure as a toddler to five vaccinations on one day in July 2000.
Wal-Mart and Target Expand Drug Discount Programs
Wal-Mart has expanded its drug discount program to include some over-the-counter medicines and additional women’s health medications priced at $4, and it adds a new option to purchase 90-day supplies of certain medications for $10. Target also announced that it is expanding its drug discount program to remain competitive with Wal-Mart.
Wal-Mart provides a list of drugs that are eligible for discounts. U.S. News’s Michelle Andrews reported on Wal-Mart’s discount program when it first launched in 2006.
Obesity May Affect Severity of Asthma
A study published in the May issue of the American Journal of Respiratory and Critical Care Medicine points to significant differences in lung function among asthmatic women with varying body mass index numbers, Matthew Shulman reports. Obese women appear to be more prone to “dynamic hyperinflation,” a condition in which air breathed into the lungs becomes trapped and cannot be exhaled. As such, these women may have more trouble breathing during an asthma attack than do nonobese women. “They may experience more shortness of breath and, compared with nonobese patients, are closer to severely exacerbating an asthma attack,” says John Heffner, the immediate past president of the American Thoracic Society and a specialist in pulmonary and critical care medicine in Oregon.
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May 5, 2007 at 9:31 am
· Filed under CLINICAL PHARMACOLOGY AND PHARMACY ·Tagged arthritis, arthritis drugs, arthritis treatment, best online pharmacy guide, Biological Response Modifiers, Cancer, Disease-Modifying Anti-Rheumatic Drugs, DMARDs, drugs, immune system, impressive drugs, inflammation, medication, medicine, Online Pharmacy, painkillers, patients, pharmacy, pharmacy guide, precautions, rheumatoid arthritis, rheumatology
In rheumatoid arthritis, DMARDs such as methotrexate can help prevent the serious joint damage that is caused by inflammation (they are not used to treat osteoarthritis). Because DMARDs take weeks to really start working, steroids or painkillers are sometimes used until they kick in.
“These drugs are revolutionizing the field of rheumatology,” White tells WebMD. “They really have something important to offer people, a chance to not be disabled and out of work. They also offer a chance to do basic lifestyle changes that relieve pain.”
There is a downside to many DMARDs: They work by suppressing the immune system, so there is greater susceptibility to infection while taking these drugs. Also, there is risk for liver problems, low blood count, and a slightly increased risk of cancer.
White says she advises her patients to weigh the benefits versus the risks. A person with painful progressive rheumatoid arthritis could face serious disability without treatment.
Biologics (Biological Response Modifiers)
If DMARDs like methotrexate don’t help stop rheumatoid arthritis, biologics are the next course of action, says Hadler.
Biologics are a more aggressive, targeted therapy that can actually significantly slow progression of rheumatoid arthritis within a few weeks — rather than just treating the symptoms. However, biologics can cause flare-ups of other chronic diseases that are in remission, particularly infections like tuberculosis. Biologics may also cause an increased risk of cancer.
“It’s something we have to consider,” says White. As always, White asks her patients to weigh the risks and benefits given the stage and severity of their rheumatoid arthritis.
Hadler calls biologics “impressive drugs,” but usually waits a few months before prescribing them, and is wary about prescribing them for patients in their 20s, 30s, 40s.
“We have had the drugs for a decade, so we know about toxicities for that time frame,” Hadler tells WebMD. “But we don’t know what these drugs will do if you’re taking them for longer than 10 years or for five years and stop for awhile.”
He notes that only a third of people with rheumatoid arthritis need aggressive treatment. He says he turns to biologics only for patients who have progressive rheumatoid arthritis. “If we treat them all aggressively, how will we know if they really need these serious drugs — and for how long?”
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April 18, 2007 at 4:24 am
· Filed under CLINICAL PHARMACOLOGY AND PHARMACY ·Tagged breast cancer, Estrogen, expert pharmacy articles and help, Female sex hormone, healthy sexual urge, heart attack or stroke, hormonal imbalances, irritation, long-term drug usage, menopause, online drug store, osteoporosis, ovaries, over-dosage, pharmacy articles, post-menopausal problems, Post-Menopause Issues, Premarin, prescription, price factor, serious side effects, symptoms, vaginal dryness
Come menopause and the trouble time for women starts. The post-menopausal problems like osteoporosis, vaginal dryness, hot flashes, burning, irritation and other hormonal imbalances announce their arrival as soon as the woman is past her menopausal phase. For long, women have been waiting for a single pill that could take care of all their problems arising out of post-menopause. And their prayers have been answered. Premarin is a mixture of estrogen hormones used to treat all the above-mentioned symptoms that are the result of hormonal imbalances post-menopause.
For the uninitiated, Estrogen is a Female sex hormone produced by the ovaries. Estrogen not only contributes to a healthy sexual urge, but also responsible for many other body functions. Premarin is a prescription pill and meant for your benefit. Any kind of drug abuse, like taking without prescription, over-dosage, under-dosage etc., will invite all kinds of trouble. Moreover, there is a warning associated with the long-term usage of the drug. It may be the cause of breast cancer, heart attack or stroke. So, stick religiously to what your doctor prescribed and never indulge in self-medication.
Any kinds of serious side effects must be immediately reported to the doctor. Normally, the body absorbs Premarin pretty well but still no chance should be taken if the condition of the patient deteriorates after taking Premarin. Always let your doctor know the drugs you are already taking. This is because there may be certain drugs that are not prescribed to be taken along with Premarin. Your doctor may change the drug or salt or dosage of the prescription to suit your body.
Premarin must be purchased from the authorized pharmacy. You can order Premarin from an authorized online drug store that will make sure that you get your drugs at your doorsteps without any delay. The price factor also goes in favor of online drug purchases.
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