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Drug addict

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  1. Benadryl = diphenhydramine in the US? (In the UK its acrivastine, a non sedating antihistamine). By itself shouldn't do much harm, but he'll need to be careful when he gets up in the morning, as diphenhydramine can cause a 'hangover' type effect. His doctor should really know about this, if for no other reason than he knows the whole picture. Personally I prefer zopiclone or zolpidem.
  2. Drug addict

    Animal Testing

    Why don't you have a look at where fetal calf serum (widely used in cell cultures) is obtained?
  3. No drug can ever be 100% 'safe', because drugs interact with systems in the body and so will have untoward effects. When a drug is licensed, it means that it is safe enough to use in the general population. The definition of safe depends on the drug and there can be a wide variation. For example statins are considered fairly safe (rhabdomyolysis occurs in about 1 in 100,000 patients), but clozapine is also licensed, and therefore considered safe enough to use, but causes agranulocytosis in 3% of patients. If you look at medicines.org.uk and look at any drug (uk trade names), you'll see that pretty much any drug can have serious adverse effects.
  4. Actually, the calcium is probably the best recomendation of the lot (prescribed calcium supplements contain 600mg of calcium and are taken twice a day [i.e Adcal and Calcichew preparations]). Bearing in mind that most teenagers, particularly females, do not consume enough calcium during their youth, thus increasing their risk of osteoporosis in late life, its not a bad idea to take supplements.
  5. I'll try and find some sources for that, but I was told it by another pharmacist I work with and is very good on clinical issues. The named patient basis was more of a side note. Licences are granted on the basis of safety and efficacy (ignoring the recent debacle with homeopathic preparations), so melatonin doesn't have a licence because either a) it's not effective or b) it's not safe.
  6. Your teacher is a fool. Melatonin is not harmless, it has been linked with liver damage, and in the UK it is only available on a 'named patient basis' - i.e. GP writes prescription and then pharmacy either has to have it imported or specially manufactured. Herbs can be useful for certain conditions, for example St Johns Wort (Hypericum perforatum is effective for mild depression, however it is essential that proper trials are carried out to assess the merits of the claims put forward for these herbs. Some of them can also be downright dangerous, for example black cohosh has been associated with liver problems. As for blood pH being between 6.8 and 7.4, look at http://scienceblogs.com/insolence/2006/09/your_friday_dose_of_woo_acid_base_or_woo_1.php#more Blood pH is very tightly regulated by the body, mainly by means of the bicarbonate/carbonic acid buffer system. If your blood pH is 6.8 you are in deep trouble.
  7. Emergency hormonal contraception has been available from pharmacies in the UK for at least 7 years I believe. It can be sold to women over 16 (as 16 is the age of consent in the UK), and costs approx £25. Many areas have set up special schemes, where clients under 20 can get EHC free of charge ( i.e. at NHS expense), as part of a government drive to reduce teenage pregnancies. Although there was some negative publicity to start with which led to some Tesco and Asda (Walmart) pharmacies refusing to sell it. It is now widely accepted and I haven't seen any stories about it for a long time. As for effectiveness, the figure I have from a training pack for community pharmacists in the UK is that treatment with EHC can be expected to prevent 7 out of 8 preganancies that would have occured without treatment. The most important thing with EHC is the need to use it as soon as possible after unprotected sex. if taken within 12 hours, the pregnancy rate is 0.5%. If left to 61-72 hours after sex the pregnancy rate is 4%. (again this is from the training pack for community pharmacists in the uk - I can dig the references out if needed.) This is why it is so important that EHC is available from pharmacies, to enable rapid access.
  8. My recollection of A level maths was that it was a significant step up from GCSE (my school only let people who got A or A* do it), but I did my A-levels 99-01 and I've heard that they have changed the syllabus since then. Chemistry only needs pretty basic maths, stats was useful for biology. Going on to uni, A-level maths was definitely helpful as we had a five lecture course on calculus- those of us who had done maths didn't bother going and the others were so confused.
  9. Drug addict


    The Merck Manual is very good, and is available free of charge at http://www.merck.com/mrkshared/mmanual/sections.jsp you can also get it in print if you so wish
  10. well obviously I'm not going to know about something like that...
  11. Rifampacin does this. And turns your tears orange as well. Not really recomended, but useful for checking that patients are actually taking their TB meds
  12. Prescribing antibiotics for viral infections also exposes the patient to the side effects and interactions of the antibiotic. While the side effects may just be some nausea or diarrhoea, death (due to anaphylaxis) and pregnancy (due to OC failure) could occur.
  13. Homeopathy can be dangerous when people use it to the exclusion of conventional medical treatment and when you have homeopaths doing realy crazy things like recommending homeopathic prepartions for malaria prophylaxis: http://news.bbc.co.uk/1/hi/uk/5178488.stm
  14. Rimonabant: the RIO-North America trial showed that "treatment for two years promoted modest but sustained reductions in weight and waist circumference..., however there was a high drop-out weight" http://jama.ama-assn.org/cgi/content/abstract/295/7/761?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=RIO-North+America&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT No head to head studies have been done yet comparing rimonabant to orlistat or sibutramine, so the current adivce is that rimonabant is fourth line treatment. http://www.prescriber.org.uk/?p=193
  15. Asthma is a fairly straightforward condition to treat, but asthnma patients can be a pain to treat because they don't take their medication properly. Asthmatics are amongst the worst compliers with treatment, because a short acting beta agonist (salbutamol or terbutaline) relieves symptoms quickly, but an inhaled corticosteroid has no immediately noticable effect. Anybody who uses a beta agonist regularly (i.e. more than a couple of times a day) should also be on inhaled corticosteroids, which must be used regularly. It is important to remember to wash your mouth out after using them to prevent oral thrush from occuring. It is also important to ensure that you can use your inhaler properly. Hyperthyroidism can be treated in several ways. Drug treatment with either carbimazole or propylthiouracil is used in the short term (normally upto about a year) before either surgery or treatment with radioactive iodine. Antithyroid drugs can however cause blood dyscrasias. Also, treatment for an overactive thyoid can go to far and cause hypothyroidism, neccesitating treatment with levothyroxine
  16. Emmolients can dilute steroid creams, so there needs to be a gap between their application, because you need the full effect of the steroid to reduce the inflammation. Topical steroids should not need to be used continuosly, they should only be used to treat flare ups. Emollient use is the cornerstone of eczema treatment, and it is important to realise that emollients can also be used as soap substitutes. Using a standard soap will just strip the lipid layer away from the skin, drying it out. There are many different emollients available, and the most effective ones are the most greasy ones, such as emulsifying ointment, however they are also the least cosmetically acceptable. Unfortuantely, for some people emollients and topical steroids aren't sufficient and some quite heavy duty drugs may be used by dermatololgists
  17. I don't particularly like combined antifungal/corticosteroid preparations. The problem with them is that the steroid should be stopped once the rash has gone, but the antifungal needs to continue for about a week after the rash hs gone to completely get rid of the fungus. With regards to eczema, it is essential that emollients are used as frequently as possible, and at least three times a day. If used in this way the need for steroid treatment is greatly reduced.
  18. 1) Stop politicians reorganizing the NHS whenever they feel like it, often they just bring things back that were scrapped a few years ago - one example: previously there were Strategic Health Authorities, but these were felt to be too large, so Primary Care Trusts were introduced (which brought in a lot of extra administration). And now PCTs are being merged and will be similar in size to the SHAs. 2) stop Patricia Hewitt making speeches that haven't been vetted by someone who knows what they're talking about. 3) Gag the BMA (GP committee) and we might get faster progress in primary care 4) Introduce full electronic patient records, available to all healthcare professionals, especially pharmacists.
  19. It might be worth having a look into benzodiazepine and barbiturate dependence as well as these both act on GABA receptors.
  20. Thiazides alone are normally first line treatment for hypertension, have few side effects (at appropriate doses) and are dirt cheap. Zestoretic (lisinopril and hydrochlorthiazide) is now availble as a generic so would be cheaper than capozide. The single most common side effect of ACE inhibitors is a dry cough since they also inhibit the breakdown of bradykinin. If you find you suffer from a dry cough then best to go and see your doctor.
  21. Ever heard of risk/benefit analysis? Yes drugs can cause serious side effects (which is why they are tightly controlled), but they also have great benefits. Take statins for example - they can cause seriuos renal damage leading to death as a result of rhabdomyolysis, but the risk of this is very small, but the 4S trial showed that simvastatin reduced risk of total mortallity by 30% (http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=13432) So would you take simvastatin off the market? At least give specific drugs you think should be withdrawn.
  22. Grapefruit juice inhibts cytochrome P450 enzymes in the liver, which is the route by which most drugs are metabolised. So, if you drink grapefruit juice, you'll get higher plasma concentrations of the drug. In a lot of cases this isn't a problem, but with some drugs it can be very serious, or even fatal, such as terfenadine. Here's a list of drugs that are affected by grapefruit juice: http://www.bnf.org/bnf/bnf/current/noframes/41001i829.htm
  23. Hypoglycaemia is a serious problem for diabetics and can lead to coma and death. This is why it is important that diabetics recognise the signs of developing hypoglycaemia so they can take prompt action to remedy it.
  24. It all depends on what course you do and which university you go to. I did pharmacy at Aston university and in my first three years I typically had around 25 hours of lectures (with around 120 people in lectures). Each lecture had around 1 hour of directed study, which can be done or not, and I had around 6 hours of labs, all of which had preparation and write ups which needed to be done, as well as having the odd essay to do. So quite a bit of work then. A lot of my final year was spent in the lab working on my project, or in the library reading papers for my project, or revising for finals. However, I would guess that most courses aren't quite as intense as pharmacy was, and don't have anywhere as many people on. Uni is quite different to anything else, you have to take responsibility for your own learning, no one will chase you up if you don't go to lectures, and you can specialise in whatever takes your fancy.
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