Prescriptions for safety

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Let’s talk about medicine safety, shall we? Safe medicine use depends largely on you, and your understanding of the drug, its benefits and its risks.

What you need is clear communication with your doctor and your pharmacist.

This is what you should know:

The medicine’s name

Modern meds have three names. The chemical name is the full official name of the drug. Chemical names can be tongue twisters so the drug is commonly known by a short generic name. A drug manufacturer gives the drug a unique brand name.

Thus, N-acetyl-para-aminophenol is the heavy chemical name for a drug commonly known as paracetamol (or acetaminophen) and sold under popular brand names like Crocin, Metacin and Tylenol.

Doctors usually prescribe brand names. There’s no problem in taking an alternative brand if the prescribed brand is not available. Your retail pharmacist will guide you on brand alternatives.

Brand names can be confusing, so please read the label very carefully.

Phenoxyl is a brand of the antibiotic amoxycillin. Phensedyl, however, is a brand of cough syrup. Phensedyl has been banned by the Indian government, by the way.

Tell your doctor to write legibly and to mention the drug’s generic name along with his preferred brand. A mature, responsible doctor will understand and oblige. The doctors I know do oblige. If the doctor still insists on scribbling … dump him.

Your safety is more important than his ego. Dump him.

Why the medicine is prescribed

I’m astounded at the number of patients who take medication simply on faith. If you’re not clear why you’re taking any drug, for heaven’s sake, please ask.

How it is to be taken

This is important. Some medications are best taken on an empty stomach for maximum absorption. Some are taken on a full stomach to prevent gastric irritation. Many drugs have to be taken on a schedule. Keep a written record, particularly when several medications are being taken. Or get yourself a pill box.

Side effects

The words that make nutra-peddlers and alt-meds drool. Anything you ingest, including dietary supplements and “natural” herbal stuff, has side-effects. Be thankful that in the case of ‘allopathic’ drugs, detailed information on all drugs is readily available. So be sure to clarify matters with your doctor.

Precautions of use

Drugs can interact with food, nicotine, alcohol and other drugs. Please avoid alcohol with any drug. It is absolutely foolish to drink alcohol while on sedatives. You might die, you see.

Also, inform your doctor if you’re taking any so-called alternative medicine or dietary supplement. Several herbals and nutraceuticals (the ones which allegedly have ‘no side-effects’) adversely react with prescription drugs.

The bill

Insist on a bill from the pharmacist. The bill must clearly mention the batch number of the drug and the name of the prescribing doctor. The pharmacist may insist on a prescription if you insist on a bill. I know this is India … but the law is the law. If a particular drug requires a prescription, you get one. Period.

Besides, this is India, and there are naughty people who make spurious drugs. Get a prescription. Get a bill. And don’t lose them.

Expiry

Always check the expiry date on the label – especially for sterile products like eye drops or injections. If the date is illegible simply refuse to buy the drug.

Beware of OTC’s!

Over-the-counter drugs, by law, do not need a prescription. Cold remedies, certain painkillers, syrups and the like are legally advertised in the media and sold over the counter.

That doesn’t make them safe. Many of them do have adverse effects.

Phenylpropanolamine (PPA), used in many OTC cold remedies has been recently banned in the US since it can cause a stroke in some people. Chlorpheniramine maleate (CPM), also found in cold remedies, can cause palpitations. Many OTC anti-allergy remedies can cause intense drowsiness.

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There’s plenty of reliable information available, so ask your pharmacist before buying any OTC drug. Most pharmacists have reference books in their shops.

Medication tools

Various types of aids are available for forgetful people. These include medication calendars, instruction sheets, color-coded bottles and blue-pill-box-7576187.jpg calendar trays. Many of these knick-knacks are given away to doctors by medical reps, so shamelessly ask your doctor

MORE PRECAUTIONS

Do not ever change dosage without informing your doctor. Don’t stop a medicine because you think it isn’t working. Some drugs have to be taken for several days before they work. Conversely, don’t stop just because you feel better. Some drugs, like antibiotics, have to be continued to prevent a relapse.

If you miss a dose, do tell your doctor. Call the doctor promptly if an unusual reaction occurs.

Keep your drugs in their original containers to prevent confusion.

Just destroy any expired medicines in your cabinet. Only an irresponsible moron will donate expired drugs to charity. Drugs are not recyclable.

And please don’t get carried away by any ‘side-effects’ hype.

Modern drugs are effective and safe, when used responsibly. They save lives, including those of people who swear by ‘alternative’ medicine.

Listen to your doctor and to your pharmacist. And get a good dose of your own medicine.

Stay healthy. Stay safe. As Nature intended.

Cheers … Srini.

Some juicy facts.

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Public domain image

So you thought fruit juices are good for your kids, eh?  So you thought all those “fortified” juices in fancy tetrapaks would make your child bounce and glow, eh?  So you thought a hefty swig of fruit juice four times a day would make you healthy, wealthy and wise, eh?

You’re wrong.

Way back in 2001, The American Association of Pediatrics (AAP) had issued a policy statement on the use of fruit juices [The use and misuse of fruit juice in pediatrics. Pediatrics, Volume 107, pages 1210-1213, 2001.] Here’s an extract:

Fruit juice offers no nutritional benefit for infants younger than 6 months and therefore should not be introduced into their diet.  For older infants and children, fruit juice offers no nutritional benefits over whole fruit.  Fruit drinks are not nutritionally equivalent to fruit juice. Juice is not appropriate for treating dehydration or managing diarrhea. 

Surprised?  You ought to be.  Here are some more juicy facts for you:

Excessive juice consumption may be associated with malnutrition and can cause diarrhea, flatulence, abdominal distention and tooth decay.

Unpasteurized juice may contain pathogens that can cause serious illnesses.  In place of ‘unpasteurized’ read ‘squeezed in a fruit juicer at home’.

Infants should not be given juice from bottles or hi-tech transportable covered cups that allow them to consume juice easily throughout the day. Infants should not be given juice at bedtime. Intake of fruit juice should be limited to one small glass per day for children 1 to 6 years old.  For children 7 to 18 years old, juice intake should be limited to two servings per day.

Children should be encouraged to eat whole fruits to meet their recommended daily fruit intake. Infants, children, and adolescents should not consume unpasteurized juice.

You can download the entire report here.

I could quote several other reports and articles about the perils of juicing, but I’m sure you can do your own research, instead of taking me at my word.

No point in squeezing the life out of all those fruits and raw vegetables. You may actually be doing yourself and your child some harm.

In case you didn’t get it, the message is …

JUICING IS UNSAFE!

Diet gurus would have us believe that juicing is the answer to mankind’s ills.  There are all kinds of ‘organic’ juice concoctions that promise to reverse disease, stop aging and generally bring happiness to one and all.  “Live”, uncooked juices, we are told, flush the body of “toxins”, leaving us in state of eternal bliss.

Bullshit.

When you juice the crap out of a fruit or vegetable, you lose all the other benefits you can get from it, like fiber for instance.

Fruit or vegetable juice is not a substitute for food. Fruits and vegetables are meant to be eaten.  What do you think your teeth are for?

Yes, fruits and vegetables are good for you. That’s the primary message of my blog.

But…eat your fruits and vegetables. Don’t drink them!

Stay healthy. Stay safe. As Nature intended.

Cheers … Srini.

The mark of a man!

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CC attribution: Etan J Tai

It’s the one part of a man that grows and grows.

Sorry chaps, it isn’t what you think it is. It happens to be your Prostate gland. Almost every man will have a problem with his prostate one fine day.  The most common prostate ailment is Benign Prostatic Hyperplasia (BPH).

ABOUT BPH:  The prostate is a walnut-sized gland wrapped around the urethra (the tube that drains the urinary bladder).  Its primary function is to produce seminal fluid that is mixed with sperm from the testes and released during an orgasm.

It’s a man’s answer to the female uterus.  In fact, they both start out the same.  The male hormone, testosterone, makes the prostate what it is.  Unfortunately, the same hormone also makes the prostate grow and eventually causes BPH.  Before the age of 40 or so, the prostate doesn’t grow much, but after that there’s no stopping it.  At least 90% of men past the age of 70 may have BPH.

SYMPTOMS:  As the term implies, BPH is essentially benign, i.e. it’s usually not cancerous. But it can still cause trouble when it pinches on the urethra.

The main symptom of BPH is a decrease in urine flow.  Other symptoms of BPH include difficulty in starting flow, uncontrolled dribbling, a constant desire to urinate and frequent urination during the night. Sometimes, the prostate may impinge upon the rectum and cause constipation.

Very rarely, men with BPH may suddenly be unable to urinate at all. This condition is known as acute urinary retention (AUR) and is serious.  AUR may stretch the bladder or cause kidney failure.  Treatment must be prompt and is usually done by carefully inserting a thin tube, called a catheter, through the penis or through the belly using a large needle.  There it will remain until the urethra can be opened up, usually by surgery.

TREATMENT:  The preferred drugs for BPH are the alpha-blockers and alpha reductase inhibitors.

Alpha-blockers like prazosin and tamsulosin relax the bladder muscles and improve urine flow.

5-alpha reductase inhibitors like finasteride and dutasteride block the effects of testosterone, and have been shown to shrink enlarged prostates. As an added bonus, 5-alpha reductase inhibitors can, in some cases, regrow some hair on your bald head. But not without side effects mind you.

As always, you talk to your doctor first.

For advanced cases of BPH, there are surgical treatment options. Modern prostate surgery has come to the stage where the procedure can be done under local anesthesia and you can get back home in a day or two.

The most common surgical procedure goes by the complicated name of Transurethral resection of the prostate or TURP. Which is a polite way of saying that the surgeon will insert a long implement known as a cytoscope right through your urethra and gently enlarge the passage, like coring an apple. After the procedure, a catheter is kept in place until healing occurs.

Of course there are possible complications, but the procedure is generally safe and effective in severe cases of BPH.

Don’t fool around with your prostate. If you’re above 40, and have never had a prostate exam, please overcome your fears and get it done. It’s usually a simple ultrasound test, so don’t worry too much.

BPH RISK FACTORS:  The only risk factor is … being a man.  Women have no risk of BPH at all.  That’s because women have no prostate you see.

PREVENTION: Sorry, guys. There’s nothing you can do to prevent prostate enlargement.

No matter how much the nutra-peddlers and alt-meds shout and scream, there are no dietary supplements or herbal remedies that have been conclusively proven to work against or prevent BPH.

However, there is a general theory going around that regular sex (or rather, regular ejaculation) can help delay the onset of BPH. There’s no real evidence to support this theory.

Don’t let that stop you from taking things into your own hands and testing the theory – as often as you can. As Nature intended.

Cheers … Srini.

Aloe, aloe? Wrong number.

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So. You want to drink Aloe juice. Why? Out of your mind?

It is a complete myth that herbs are safe for you. There’s a long list of herbs that are hyped out of proportion but are directly harmful to you. At the head of this list, stands Aloe. And not just for alphabetical reasons.

Aloe vera or Aloe barbadensis, has been used in folk medicine since a few thousand years across various countries, including ours. Traditionally, aloe gel was a topical application for small wounds, cuts and burns and for skin conditions like eczema and dermatitis. The term ‘topical’ means ‘applied on the skin’.

Aloe juice is used in Ayurveda as a cathartic. The term ‘cathartic’ means ‘crap your guts out’.

That you see, is Aloe’s primary effect when ingested. It will make you crap your guts out.

That is why Ayurveda uses aloe juice as a medicine, not as a “health drink”. And like any other medicine, Ayurveda uses it sparingly. And under strict medical supervision.

There are innumerable claims being made about the juice of Aloe vera. You know, the usual tall tales – antidiabetic, antibacterial, anti-cholesterol, anti-hypertensive, anti-arthritic – and to top it all, the claim that aloe gel can cure burns caused by an atom bomb. Yeah. Atom bomb

Finally, as with all herbal remedies, it boils down to … evidence.

And in the case of Aloe, as with many other over-hyped herbal remedies, the evidence about its claimed health benefits is exactly equal to zero.

On the other hand, the evidence about Aloe’s nasty effects on your body is very real indeed.

  • A two-year study has shown that Aloe extract can cause intestinal cancer in rats and mice. And this study was done by a division of the US government’s department of health, no less. You can download the entire report here.
  • Abdominal cramps and diarrhea have been reported with oral use of aloe vera.
  • Diarrhoea caused by aloe can in turn decrease the absorption of many drugs.
  • Aloe can interact with your diabetes medication, and can bring down your blood sugar drastically.
  • Some studies have shown that aloe can adversely affect your liver.

Please don’t believe me. Download a detailed technical report from the US Dept of Health and Human Services, here.

If you want even more information, please visit  The National Center for Complementary and Integrative Health, this being the US Government’s “lead agency for scientific research on the diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine“.

On the other hand, no major toxicity has been reported from the use of Aloe gel as a topical application for sunburn, rashes or minor abrasions on the skin. Mind you, aloe gel will not treat any skin condition, especially sunburn. But it can soothe irritated skin and have a cooling effect, while your body heals itself. Use a reputable commercial brand, not some home-made junk that you made yourself.

Bottom line:

Use the gel on your bottom, if it’s been exposed to the sun.

Instead of using aloe gel after you burn your skin in the sun, don’t you think it’s better to stay out of the sun in the first place? Or, use sunscreen. Or, use an umbrella. I’m not joking. Dermatologists will tell you that the best way to protect yourself from the sun is to use an umbrella.

And here’s what you do not do. You do not guzzle aloe juice, as if it’s nimbu paani. Aloe juice, no matter where you get it from, is not entirely safe for you. Why do you want to drink aloe juice anyway? What incurable disease can it cure? What miracles can it perform in your body? Make you young again? Grow your hair back?

Do you know how awful that stuff tastes?

Herbs can cure. Herbs can kill. Look at the evidence first. Get your facts right. Talk to a real doctor.

And even then, think twice about taking any herbal remedy instead of properly prescribed medicine, a sensible diet and regular exercise.

Stay healthy. Stay safe. As Nature intended.

Srini.

Key References:

  1. http://www.niehs.nih.gov/news/assets/docs_f_o/ntp_draft_technical_report_577_a_nondecolorized_whole_leaf_extract_of_aloe_barbadensis_miller_aloe_vera_508.pdf
  2. https://nccih.nih.gov/health/aloevera#science