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long time beta-blockers use doesn’t enhance heart health.

long time beta-blockers use doesn’t enhance heart health.

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Following a heart attack, beta-blockers are frequently prescribed to patients to treat high blood pressure and heart conditions.

According to a recent study, taking drugs over the long term after a heart attack doesn’t seem to benefit cardiovascular health.

The observational study, according to experts, offers useful data, but they also point out that beta-blockers continue to be helpful for a large number of people.

Research in the journal Heart found no evidence that long-term beta-blocker use improved cardiovascular health or decreased the risk of further heart attacks.

Researchers looked at the medical records of persons who had a heart attack between 2005 and 2016 and required hospital treatment using the Swedish national registry for coronary heart disease.

Records from 43,618 persons, with an average age of 64, were included in the study. There were about 1 in 4 women. None of them had left ventricular systolic dysfunction or cardiac failure.

One year after being hospitalized for a heart attack, of the participants, 34,253 (78%) were using beta-blockers, whereas 9,365 (22%) were not.

For an average of 4.5 years following their hospitalisation, the researchers followed up with the participants.

Researchers evaluated the two groups in terms of:

  • Death rates from all causes
  • Additional heart attacks
  • Getting re-vascularized, a procedure to bring back blood flow to certain areas of the heart
  • Heart attack

2,028 (22%) and 6,475 (19%) of the beta-blocker users had one of these occurrences during the observation period.

There was no noticeable difference in the rates between the two groups, according to the researchers, who took demographic factors and pertinent co-morbid disorders into account.

According to real-time data, the use of long-term beta-blockers after a heart attack in persons without heart failure or left ventricular systolic dysfunction was not linked to better cardiovascular outcomes.

Physician response to beta-blocker research

The interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Centre in California, Dr. Hoang Nguyen, recommended beta blockers for patients with left ventricular dysfunction since they had a demonstrable mortality benefit.

According to him, beta blockers are a lifetime in this patient population. “Beta blockers are necessary for patients with a history of coronary artery disease who are not candidates for bypass surgery or stents to lower angina symptoms and hospitalizations for this symptom. I might try to wean them off of beta blockers, especially if they have serious adverse effects if they have undergone revascularization (either with stents or bypass surgery) or have normally left ventricle function.“

This study has prompted some doctors to reconsider their methods, but not all of them are presently prepared to do so.

According to Dr. Devin Kehl, a non-invasive cardiologist at Providence Saint John’s Health Centre in California, “this study suggests that a long-term continuation of beta-blockers following myocardial infarction may not be of significant benefit in patients without any of those factors and with normal cardiac function.” However, because it was an observational study, the results might have been impacted by unrecognized confounders.

To be more clear about whether beta-blockers should be continued or stopped after one year following myocardial infarction, randomized trials are required, according to Kehl, who spoke to us. “Caution is needed in interpreting the results of this type of analysis and applying this clinical practice,” Kehl said.

In conclusion, it is still necessary for a patient’s cardiologist to exercise careful clinical judgement when deciding how long beta-blocker therapy should be administered after myocardial infarction.

Beta-blockers

Beta-blockers are used to treat high blood pressure and heart conditions.

They accomplish this by preventing the negative effects that stress hormones have on the heart and can lower heart rate. They are also beneficial for migraines.

Beta-blockers are typically regarded as secure and efficient. However, there are some adverse effects, such as:

  • Fatigue
  • easily running out of breath
  • Unsteadiness or faintness
  • Depression

Nguyen notes that side effects of the drugs include memory loss and impaired sexual function.

“Perhaps we should try to wean patients off beta blockers if a beta blocker is not needed after one year, especially if the patient’s heart function is normal,” Nguyen suggested.

Some people might not be able to take them or might quit taking them because of the negative effects.

The use of beta-blockers

After the first year of treatment, Miller typically stops prescribing beta-blockers to heart attack survivors with intact cardiac function.

They are only kept on the drug if there is another condition, like hypertension, that calls for it.

Those with heart failure, irregular cardiac rhythm, hypertension, and recurring palpitations that happen without a known trigger (like caffeine), are candidates who can benefit from beta-blockers.

“The patient should always discuss with their physician whether or not a beta-blocker is a suitable treatment and/or should be discontinued,” he said.

Reduce the dosage gradually rather than stopping the drug all at once if a patient decides to stop taking it.

Considering the future

Medication observation studies examine participants’ responses to a drug or treatment without changing their circumstances.

Observational studies are not regarded by medical practitioners as being as reliable as randomised, controlled trials. However, when prescribing medications, they provide important information for doctors and other medical professionals.

“Beta-blockers have long been and will continue to remain a cornerstone medical therapy following a myocardial infarction as they have been clearly demonstrated to reduce the risk of recurrent events and death,” said Kehl. However, clinical trials have not examined the benefit of beta-blockers in patients with normal cardiac function beyond three years after a myocardial infarction, and their benefit is strongest in the early period post-myocardial infarction, according to the study.

Additionally, patients with and without cardiac dysfunction were included in a mixed cohort in clinical trials looking at the benefits of beta-blockers, the author continued. “It is unclear if long-term use of beta-blockers after myocardial infarction benefits people with normal cardiac function. Due to a lack of data from clinical research, the American College of Cardiology guidelines do not directly address the issue. Currently, a long-term continuation of beta-blockers depends on carefully examining the patient’s cardiac history and determining whether there are any other distinct indications for using beta-blockers, such as arrhythmias, angina, cardiac dysfunction, heart failure, or hypertension.”

REFERENCES:

For Heart disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=77_99

Is moderate exercise safe for the muscles of statin users?

Is moderate exercise safe for the muscles of statin users?

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According to a recent study, statin users are concerned about exercising. Because they think it can cause muscle damage and shouldn’t be. Both the statin-taking participants and the control participants in the research reported similar muscle soreness after moderate activity.

Nonetheless, statin users are not advised to engage in vigorous activity. Those on statins who are reluctant to exercise out of concern that it could harm their muscles should take heart from a recent study.

Some persons using the cholesterol-lowering medication claim to have muscle pain, and they may stop engaging in cardiovascular-healthy physical exercise.

The study reveals that statin users, regardless of whether they have muscle issues or not, have the same muscle-related consequences from moderate-intensity exercise.

Everybody who engages in such exercise is likely to experience brief muscle soreness and weariness. For those using statins, this is also accurate. Statin users, however, recovered slightly more slowly than trial participants who did not take any medication.

The effects of exercising at a moderate intensity were examined in this study. According to other studies, patients using statins are more likely to have skeletal muscle injuries when engaging in eccentric, or high-intensity, activity.

The most recent research results have been published in the Journal of the American College of Cardiology. The study’s results are crucial for the cardiovascular health of statin users, as is highlighted in an editorial that is included with the paper.

An analysis of the effects of walking

100 people took part in the study as a participant. This comprised 31 individuals not taking statins as a control group. 34 individuals on statins who did not display any muscle difficulties. And 35 individuals taking statins who had statin-associated muscular symptoms.

Before the research, those taking statins had been doing so for at least three months. The following health conditions were omitted from the study: diabetes, hypo or hyperthyroidism, and genetic skeletal muscle disease. Supplement users of CoQ10 were also not included.

Body mass index (BMI), waist circumference, levels of physical activity, and vitamin D3 levels were identical at the beginning of the trial. Those who had symptoms at the start of the trial scored higher on muscle soreness and fatigue.

The researchers looked at those who participated in the 4Days Marches, a four-day event in Nijmegen, the Netherlands. Participants walk anything between 18 and 30 miles each day.

“During four days, participants walk 30, 40, or 50 kilometers (18, 24, or 31 miles) each day. Accordingly, participants walk anywhere from 120 (74 miles) to 200 (124 miles) km over four days, according to the study’s lead author, Dr. Neeltje A.E. Allard of the Radboud Institute for Health Sciences and the Department of physiology at Radboud University Medical Center in the Netherlands.

The participants prepare beforehand because there is a lot of walking. In actuality, it was first held as a military exercise in 1909 and has since developed into the biggest walking competition in the world, in which both active duty personnel and casual walkers compete.

The effects of walking on muscular damage in people who experienced symptoms and those who did not were compared by the researchers.

What are statins?

Low-density lipoprotein (LDL) cholesterol, also known as “bad cholesterol,” can be reduced by using the statin drug class. The best treatment for hyperlipidemia is statins.

According to cardiologist Dr. David Lee from Oregon Health & Study University (OHSU), who was not engaged in the study, “high cholesterol” and a significant treatment after a heart attack.

He emphasised that they are crucial preventative measures against repeat heart attacks and strokes.

Further stating that statins “have been a primary reason that heart disease and strokes have declined dramatically since their debut in the early 1990s,” Emilee Taylor, a doctor of pharmacy who works at OHSU but is not involved in the present study, was quoted.

They have significant enough effects to lower all-cause mortality in persons with even modest cardiac disease, according to the researcher.

Workout volume matters.

The study included 31 non-statin users, 34 asymptomatic statin users, and 35 symptomatic statin users—those who experienced muscle issues as a result of taking statins.

Eighty percent of the participants with symptoms were men, and their average age was 64. The participants in the control group were all of the same age, and 62% of them were men. The asymptomatic participants were 82% male and slightly older, at 68 years old.

Each person took part in a moderate exercise regimen that involved walking 30, 40, or 50 kilometers (km) per day for 4 straight days at a pace of their choosing.

One or two days before the start of the walking experiment, researchers took the participants’ baseline measurements of height, weight, and waist circumference. Every 5 kilometers on the first walking day, their heart rates were recorded.

Participants’ weights were measured after the first, second, and third days to gauge their level of hydration. The researchers were able to gauge their walking pace and workout duration based on their start and finish times. An estimate of exercise intensity was provided using a heart rate-based calculation.

Finally, participants discussed how their muscles felt both before and after exercise. The effects of exercise were similar in both groups, the researchers discovered, except the fact that statin users required more time to recover from post-exercise muscle weakness than the control group.

Participants’ levels of CoQ10 were also monitored in the trial. CoQ10 has been suggested as a potential contributor to statin-related muscular issues.

The levels of CoQ10 were not different between the three groups, and they were also unrelated to muscular function, reported muscle problems, or injury signs.

Statin-associated muscle symptoms

SAMS, which stands for “statin-associated muscular symptoms,” is the aggregate term used to describe muscle issues that have been documented while taking statins. Myalgia, cramps, and a feeling of weak muscles are a few of these.

Due to worries about SAMS, some individuals who could benefit from statins choose not to take them or do not take the recommended amounts.

Regarding how common SAMS are, there is some disagreement. According to the American Academy of Cardiology, clinical observation studies show a substantially higher frequency of SAMS than randomized controlled trials do.

According to one survey of former statin users, 62% of them stopped using the medication due to negative effects.

The National Lipid Association (NLA) reports that research indicates the true incidence of SAMS is approximately 10%, with several studies indicating its prevalence among statin users to range from 5% to 25%. While the symptoms that patients experience are real, 80% of them, according to the NLA, are not brought on by statins.

For patients to be more aware of what to watch out for, Dr. Lee believes it is crucial that doctors adequately inform them of how SAMS often manifest.

Exercising on statins

The current advice for those taking statins was summarised by board-certified interventional cardiologist Dr. Michael S. Broukhim of Providence Saint John’s Health Center in Santa Monica, California. He was not involved in the study.

“Patients should establish a regular exercise regimen, with a preference for a moderate-intensity exercise programme,” he advised. “Patients should continue to take their statins at their maximally tolerated dose following discussion with their healthcare professionals.”

Dr. Broukhim noted that he advises 150 minutes of moderate activity each week, the same amount of exercise as is advised for those who do not take statins.

He advised against high-intensity exercise since it can increase the levels of muscle enzymes that can cause muscle damage in statin-using individuals.

Exercises with a moderate level of intensity include:

  • rapid walking
  • Cycling
  • Aquatic exercise
  • general exercises
  • Tennis pairs
  • tango dancing

According to Masi, doctors advise a mix of resistance training and cardiovascular exercise for people who wish to start working out. Everyone should begin at their own pace and abilities and progressively increase both duration and resistance, according to Masi.

REFERENCES:

For Muscle disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=28

New drug combination reduces Lung cancer tumors.

New drug combination reduces Lung cancer tumors.

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The second most frequent type of cancer in the world is lung cancer. Around 2 million people are given a lung cancer diagnosis each year, and 1.8 million people pass away from the condition.

Small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) are the two forms of lung cancer, with NSCLC accounting for the majority of instances. Surgery, radiation, and chemotherapy are all effective treatments for NSCLC, although it is rarely curable.

Today, studies have discovered that a combination of two medications reduces the size and quantity of tumours in mice with NSCLC, a finding that could result in human clinical trials.

Lung cancer is the second most prevalent cancer diagnosed in the United States, according to the American Cancer Society. Moreover, it is the main cause of cancer mortality, accounting for one in five cancer-related deaths, more than colon, breast, and prostate cancers put together.

The typical age of diagnosis for lung cancer is 70 years old, with most cases being found in older patients. The good news is that cases are declining as fewer individuals smoke tobacco, which is responsible for more than 80% of lung cancer cases. A diagnosis of lung cancer is still given to over 2 million people annually worldwide.

Lung tumours other than small cell comprise 85% of cases (NSCLCs). There is an urgent need for novel therapies because immunotherapy and chemotherapy are not very successful against this kind of lung cancer.

Now, researchers from the Salk Institute and Northwestern University have discovered that treating NSCLC-affected mice with a cocktail of two drugs—one of which is already approved by the Food and Drug Administration (FDA) and the other is undergoing clinical trials—reduced the size and frequency of the tumours.

Need for new treatments

According to Dr. Lillian Eichner, a principal author of the study and an assistant professor of biochemistry and molecular genetics at Northwestern University, “This medication might be helpful for patients with KRAS/LKB1 mutant lung adenocarcinoma.”

About 20,000 new cases of this disease’s molecular subtype are reported each year in the United States, she said. “Patients with this terrible disease currently have an average survival duration of 10 months after diagnosis, and improved therapeutic techniques are desperately needed.”

Histone deacetylase (HDAC) inhibitors have been suggested as a possible therapy for this particular form of lung cancer by the researchers. Animal tumour growth has been demonstrated to be slowed by HDAC inhibitors, which are epigenetic regulators.

After proving that HDAC3 was essential for the development of difficult-to-treat LKB1-mutant cancers, the study’s authors investigated if pharmacologically inhibiting HDAC3 may have an impact on tumour growth.

In this study, they treated KRAS/LKB1 mutant NSCLC in mice with two different medications: the FDA-approved MEK inhibitor trametinib and the HDAC1/HDAC3 inhibitor entinostat, which is currently in clinical development.

Lung tumor study

The LKB1 genetic mutation is present in NSCLCs, and Salk researchers were interested in investigating a novel targeted therapeutic option.

According to Dr. Andrew McKenzie, vice president of personalised medicine at Tennessee’s Sarah Cannon Research Institute and scientific director at Genospace, targeted therapies are medicines created for certain molecular subtypes of NSCLCs.

Since that these treatments are “tailored,” he explained, “it is preferable to administer a targeted therapy rather than immunotherapy or immunotherapy and chemotherapy if you test a patient and discover a mutation.

Initially, the Salk team demonstrated that the body’s histone deacetylase 3 (HDAC3) protein is essential for the development of NSCLCs with the LKB1 mutation.

This was unexpected, according to co-lead of the study Lillian Eichner, PhD, a professor at Northwestern University in Illinois who was a postdoctoral researcher at Salk during the research.

She said, “We believed the entire HDAC enzyme class was intimately related to the origin of LKB1 mutant lung cancer.

“We didn’t know the exact involvement of HDAC3 in lung tumour formation,” Eichner stated. She then moved to two drugs with the assistance of the team.

The potent drug combination

Entinostat was the first medication. Although the Food and Drug Administration (FDA) has not yet approved this medication, clinical tests have demonstrated that it targets HDACs.

Trametinib was the second medication and it works by preventing the growth of cancer cells. Trametinib is FDA-approved for the treatment of NSCLCs, but it must be used in conjunction with the medication dabrafenib, McKenzie added.

These two medications are only permitted for use in NSCLCs with the BRAF V600E mutation, the author continued.

According to McKenzie, “Trametinib on its own has not been very effective and requires to be paired with dabrafenib to see the clinical outcomes associated with FDA approval.” Because trametinib might cause tumours to become resistant, dabrafenib is often used in conjunction with it.

The goal of the study was to determine whether trametinib and the HDAC3-targeting drug entinostat would reduce resistance in the same way. Mice with LKB1-mutated NSCLC were treated with the medication cocktail for 42 days, and then the tumours were examined again.

Tumors in recipient mice have shrunk by 79% in size compared to mice not receiving the medication treatment. The researchers also noted a 63% decrease in lung cancers in the treated animals.

Human trials needed

Cancers are already being treated with these medications. For the first time, the FDA approved trametinib in 2013 to treat metastatic malignant melanoma. In 2017, it received approval for the treatment of NSCLC.

Entinostat has undergone phase 1 and phase 2 clinical trials but has not yet received FDA approval for clinical usage. Phase 3 trials in people with breast cancer are also still being conducted. People have typically tolerated the medication well during the studies.

The medications have not yet been combined in human subjects. The following stages in evaluating the combined therapy were described by Dr. Eichner.

She said that in order to determine the safety of this combined therapeutic method, a phase 1 clinical research would be conducted first.

“Based on the known safety profiles of both medications, we are hoping that this would also be the case in people,” said Dr. Eichner. “Our preclinical investigations were extremely encouraging with regard to the safety of this pharmacological combination.”

A phase 2 research would then determine whether this combination inhibits tumour growth and lengthens the patients’ lives, she continued.

New hope for cancer patients

On average $1.3 billion is spent to bring a new treatment to market, according to a recent study, making drug development a time-consuming and expensive process.

Also, it often takes 6 to 12 years for new cancer medications to be approved. So, it is quicker and more cost-effective to identify new ways to use existing medications.

According to our research, cancer treatments that were previously unsuccessful might be successful if they are modified. In some cases, understanding basic tumour biology can result in novel cancer therapy strategies without the need to first create new medications, which can be a lengthy process, according to Dr. Lillian Eichner.

Although it is still early, their discoveries might result in new lung cancer medicines for this difficult-to-treat disease. Dr. Eichner is upbeat, but more study is required to validate the results.

According to “our findings,” treating patients concurrently with both of these already-approved medications “may significantly limit the growth of lung tumours for this set of patients.”

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Medications that Seniors Should Use With Caution.

Medications that Seniors Should Use With Caution.

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There is a higher likelihood of developing unfavourable drug side effects in older persons since they frequently have chronic health conditions that call for treatment with several medications. Moreover, older persons may react more strongly to some drugs.

The American Geriatrics Society’s Health in Aging Foundation advises older people to use caution when using the following types of medications. This includes some that can be purchased without a prescription. In order to help you make better-informed decisions about your medications and to reduce your chances of overmedication and serious drug reactions (over-the-counter).

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Be wary of long-lasting NSAIDS such indomethacin and piroxicam (marketed under the brand name Feldene) (Indocin).

The issue: NSAIDs are prescribed to treat pain and inflammation. Older persons who take them run the risk of developing indigestion, stomach or colon bleeding, renal damage, high blood pressure, and worsening heart failure. They can also increase the risk of blood pressure and kidney damage. The quicker-acting ibuprofen (Motrin) and salsalate are preferable options if NSAIDs are required (Disalcid).

Use caution when combining NSAIDs with aspirin, clopidogrel (Plavix), dabigatran (Pradaxa), dipyridamole (Persantine), prasugrel (Effient), ticlopidine (Ticlid), or warfarin due to the increased risk of bleeding (Coumadin).

You might need to take a prescription medication like misoprostol (Cytotec) or a proton pump inhibitor like omeprazole to prevent stomach bleeding. Only if you regularly take NSAIDs, have a history of ulcers, or are 75 years of age or older. These drugs can help stop stomach bleeding (Prilosec).

Drugs that relax the muscles

Cyclobenzaprine (Flexeril), methocarbamol (Robaxin), carisoprodol (Soma), and other comparable drugs should be avoided.

The issue: These drugs may make you feel sleepy and dazed, raise your risk of falling, and result in constipation, dry mouth, and urine issues. However, there is little proof that they are effective.

Drugs that treat anxiety and sleeplessness

Avoid using benzodiazepines like diazepam (Valium), alprazolam (Xanax), or chlordiazepoxide (Librium, Limbitrol, Librax). Also, nonbenzodiazepine sleeping medications like zaleplon (Sonata) and zolpidem (Ambien).

The issue: Certain medications can make you more likely to fall and can also make you confused, especially in older folks. You may experience drowsiness and grogginess for a long time because it takes your body a long time to eliminate these medications from your body.

Medications for Anticholinergics

Be cautious of: medications including the antidepressants amitriptyline (Elavil) and imipramine (Tofranil). The anti-drug Parkinson’s trihexyphenidyl (Artane), the irritable bowel syndrome drug dicyclomine (Bentyl), the overactive bladder drug oxybutynin (Ditropan) and diphenhydramine, an antihistamine (Benadryl) often included in over-the-counter sleep medicines such as Tylenol PM.

Anticholinergic medications run the risk of causing low blood pressure, constipation, urinary issues, confusion, and other side effects.

Heart Medications

Digoxin (Lanoxin) in doses larger than 0.125 mg should be avoided.

Digoxin, a drug used to treat heart failure and irregular heartbeats, raises safety concerns because it can be harmful for older adults and those with impaired renal function.

Medications for diabetes

Glyburide (Diabeta, Micronase) and chlorpropamide should be used with caution (Diabinese).

These can result in extremely low blood sugar in elderly persons, which is a worry.

Opioids as painkillers

Meperidine (Demerol) and pentazocine should be avoided (Talwin).

The problem: These opioid analgesics, often called narcotic analgesics, can lead to confusion, falls, seizures, confusion, and even hallucinations, especially in elderly people.

Antipsychotic medication

Avoid anti-psychotic medications such haloperidol (Haldol), risperidone (Risperdal), and quetiapine unless you are being treated for schizophrenia, bipolar disorder, or some types of depression (Seroquel).

Antipsychotic medications raise the possibility of a stroke or possibly death; they also raise the possibility of tremors and falls.

Estrogen

Pay close attention to: Estrogen patches and pills, which are frequently prescribed to treat hot flashes and other menopause-related symptoms.

The issue: Estrogen can raise your chances of dementia, blood clots, and breast cancer. Female urine incontinence caused by oestrogens might also become worse.

Anticholinergics

These medications may be recommended by your doctor to help treat disorders like Parkinson’s disease, irritable bowel syndrome, and depression. Anticholinergics, however, can make people feel confused, have a dry mouth, and have hazy vision, especially in older people.

The likelihood of their causing urination issues is higher in older men. Antihistamines, tricyclic antidepressants, cimetidine, muscle relaxants, and several cold medicines are additional common pharmaceuticals with anticholinergic characteristics.

Ask your doctor the reason for any drug changes or new prescriptions that are made.

For instance, consider if it makes sense to continue taking the medicine that is causing the negative reaction if a new prescription is prescribed to lessen the adverse effects of one you are already taking.

When taking five or more medications already, it is extremely important to ask your doctor or pharmacist to verify any new prescriptions in a database of possible drug interactions.

Review your medication schedule.

Ask your doctor or other health care provider to examine the prescription drugs, dietary supplements, and vitamins you are taking once or twice a year. Check to see if you still need to take each one at the prescribed dosage.

Try to have the same pharmacy fill all of your medications if at all possible. Most pharmacies employ computer programmes that alert them to potential drug interactions.

Inform your medical professionals of any prior drug allergies you may have experienced.

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How to Deal With Side Effects of Medicine?

How to Deal With Side Effects of Medicine?

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Prescription medications treat our illnesses, lessen our suffering when we are hurt, and help us avoid or manage chronic disorders. However, even when they perform as intended, they may produce unwanted side effects.

If a medicine is crucial to controlling a medical condition, don’t let that cause you to instantly rule it out. But you also shouldn’t take unfavourable responses at face value.

Know What to anticipate

According to Jim Owen, a doctor of pharmacy and vice president of practise and science affairs at the American Pharmacists Association, side effects can occur with practically any medication. They frequently occur with everything from birth control pills to chemotherapy medications that treat cancer.

For instance, many prescription medicines travel through your digestive system and result in stomach issues including nausea, diarrhoea, or constipation.

Others, including blood pressure or diabetic medications, muscle relaxants, and antidepressants, may make you feel lightheaded. Some might give you a groggy, downcast, or agitated feeling. Some might result in weight gain. Also, some may interfere with your ability (or desire) to have sex or with sleeping.

Risk of Developing Side Effects

Each of us is special. However, some of us are more susceptible to experience adverse effects than others due to certain personal circumstances. Age is the most important of these variables. The extremely young and the extremely old are ALWAYS more prone to adverse effects.

Little adults are not children. Babies’ bodies process medications differently from adults’ bodies in terms of absorption, metabolism, and elimination. Younger children typically have a slower rate of stomach absorption of medication but a greater rate of intramuscular (IM) absorption. They have a greater liver to bodyweight ratio and a higher body water to lipid ratio in the early stages of life. Their kidney function is also immature, as are their liver enzymes.

Additionally, their blood-brain barrier, a layer of cells that prevents drugs from passing from the bloodstream to the brain, has a higher permeability. Studies have found that older persons often use more medications and are twice as likely to visit the ED. This is due to a drug-related adverse event and seven times more likely to be hospitalised. They are more likely to be on drugs like warfarin, insulin, digoxin, and anti-seizure medications that have a razor-thin line between being beneficial and harmful.

Their bodies typically contain more fat and less water, which may lengthen the duration of some medications’ effects. Liver metabolism and kidney excretion are often slowed down. Additionally, due to the fact that their brains are more susceptible to the sedative effects of medications. Also, pre-existing conditions like dizziness, eye, and ear issues may be made worse, they are at an increased risk of falling.

Individual factors that also increase risk

The likelihood of side effects is significantly influenced by a number of additional factors. Examples that stand out include:

Genetics: The study of how your genes affect how you react to medications is known as pharmacogenetics, and genetic factors account for 20–95% of patient variability. Testing for differences in liver enzymes is becoming more common in this area of pharmacology, which is developing quickly.

For instance, the conversion of codeine to one of its active metabolites, morphine, requires metabolism through CYP2D6. In the 5–10% of patients who have poor metabolizers, very little codeine is metabolised to morphine, which leads to insufficient pain alleviation. A increased risk of toxic effects, such as respiratory depression, results from 1-2% of people having ultra-rapid metabolizers.

Kidney operation. If your kidneys aren’t working properly, taking medications that are excreted through the kidneys increases your risk of experiencing negative effects. When kidney function is compromised, some other medications may become less effective.

Gender: Compared to men, women have less activity of some hepatic enzymes, a higher body fat to water ratio, and less kidney clearance of medicines. According to studies, women are more likely than men to experience drug-induced liver damage, gastrointestinal side effects, allergic skin reactions, and long QT syndrome.

Ask for assistance

Tell your doctor about typical side effects when they prescribe a new medication. Together, you, your doctor, and your pharmacist should share information so that everyone is informed, advises Owen. You should be aware of the side effects that can be avoided, those that will go away on their own, and those that are significant.

Any unusual symptoms you experience after starting a medication should be discussed as soon as possible with your doctor or pharmacist. According to Liu, this includes changes in your sexual life, which many patients are ashamed of or frightened to discuss.

Your doctor may advise you to continue with your existing plan for a little while longer because some side effects fade with time as your body becomes adjusted to a new medication. In some circumstances, you might be able to reduce your dosage, try a different medication, or incorporate another into your regimen, such as an anti-nausea treatment.

Factors Related to Drugs

influences brought on by drugs include:

  • Medication’s dosage: The danger of side effects increases with dosage.
  • The phrase used is: For instance, compared to oral steroids, which have a more systemic effect, inhaled steroids target the lungs specifically and cause less side effects.
  • How the medication is transported, metabolised, and removed
  • Concurrent use of additional pharmaceuticals.

REFERENES:

  • https://www.webmd.com/a-to-z-guides/features/manage-drug-side-efects
  • https://www.healthlinkbc.ca/health-topics/dealing-medicine-side-effects-and-interactions
  • https://www.drugs.com/article/drug-side-effects.html

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How to make smart medicines choices for ourself?

How to make smart medicines choices for ourself?

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IIn primary, secondary, and tertiary care settings, medications are a crucial component of patient management. Medication safety is still an issue both within and outside of hospitals, since roughly 9% of prescriptions contain errors1 and patients frequently take their prescribed medications inappropriately or not at all.

By 2036, when one in four people will be 65 or older, as the baby boomer generation reaches their senior years, the population that requires the majority of drugs is anticipated to have doubled. This tendency is prevalent in many industrialised nations, where efforts are being made in social and health policy to reduce unnecessary morbidity that results in the need for healthcare and loss of independence.

Apps and other digital tools have been included into healthcare systems recently to help with drug management. However, these new smart technologies could provide new difficulties for patients, nurses, pharmacists, and prescribers. Patients must take their drugs as directed, report any side effects, and the healthcare system and employees must make sure that the right prescriptions are written. Human factors are just as crucial as the role of technology in achieving better patient outcomes.

As a follow-up event to the International Forum on Quality and Safety in Health Care Europe 2021, a roundtable discussion was conducted in July 2021 to talk about the difficulties and potential directions in smart drug management.

What should you ask to the doctor?

A treatment that is good for you depends on a variety of things. Ask your doctor the following queries:

Why do I require this medication?

Eva Waite, MD, assistant professor of internal medicine at Mount Sinai Hospital in New York City, asserts that understanding the purpose of taking a drug increases the likelihood that you will really take it.

Your health may suffer if you skip a dose of a medication. For instance, not taking your blood pressure medication can result in heart disease or a stroke.

What negative impacts are there?

Learn what to anticipate. You can use it to determine which meds suit your lifestyle the best. Together, you can try to choose the medications that have the fewest adverse effects or that you find most tolerable, advises Waite.

For instance, some medications may cause you to feel as though you need to use the restroom more frequently. This might not be a huge concern for some individuals. You may need to locate a medication that manages your disease without this adverse effect if, however, your profession requires you to spend a lot of time in a car.

How frequently should I take it?

Talk to your doctor if it’s a struggle for you to remember to take your medication multiple times per day.

According to Waite, many drugs are available in combinations. This means that you might be able to take only one pill that contains all three blood pressure medications rather than three separate ones.

What is the price?

Even with health insurance, prescription medicines can be expensive. That shouldn’t deter you from taking them.

If you let your doctor know that the expense is a concern, he or she will frequently be able to recommend a less expensive option, according to Filer. “Your doctor may occasionally change the dosage of a drug so that you only need to take it once day rather than twice. The price may also change as a result of this.”

Discuss the medications you are taking.

Write down all of the medications you currently take before your appointment. The list should be with you. Include any supplements you take as well, advises Waite. This comprises supplements made of vitamins, minerals, and herbs. You can prevent negative interactions by using the knowledge.

She cites ginkgo biloba as an illustration. “Your doctor would want to know that you are taking it before adding a blood thinner that can increase your risk of bleeding, too,” she says.

How well your treatment plan is implemented can be greatly influenced by your connection with your doctor. Never stop taking a medicine without first talking to them about it.

Every problem you could have while taking a drug has a solution, according to Waite. Simply inform your doctor of them so you may work on a solution together.

REFERENCES:

  • https://www.webmd.com/a-to-z-guides/features/how-choose-medication
  • https://informatics.bmj.com/content/29/1/e100540
  • https://www.sciencedirect.com/science/article/pii/S2314728818300230

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