side effects

pantoprazole Protonix
pantoprazole Protonix
pantoprazole Protonix
Nexium GenericEsomeprazole is in a class of drugs called proton pump inhibitors PPIs which block the production of acid by the stomach. Other drugs in the same class include omeprazole Prilosec lansoprazole Prevacid rabeprazole Aciphex and pantoprazole Protonix. Chemically esomeprazole is very similar to omeprazole. Proton pump inhibitors are used for the treatment of conditions such as stomach and duodenal ulcers gastroesophageal reflux disease GERD and the Zollinger-Ellison syndrome which all are caused by stomach acid. Esomeprazole like other proton-pump inhibitors blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme the production of acid is decreased and this allows the stomach and esophagus to heal. Esomeprazole was approved by the FDA in February 2001.

how to use
For GERD 20 or 40 mg of esomeprazole is given once daily for 4-8 weeks.

For the treatment of H. pylori 40 mg is administered once daily in combination with amoxicillin and clarithromycin for 10 days.

Esomeprazole capsules should be administered one hour before meals swallowed whole and should not be crushed or chewed. Patients with difficulty swallowing can open the capsule and mix the pellets with applesauce. The applesauce should not be hot and the pellets should not be chewed or crushed.

side effects
Esomeprazole like other PPIs is well-tolerated. The most common side effects are diarrhea nausea vomiting headaches rash and dizziness. Nervousness abnormal heartbeat muscle pain weakness leg cramps and water retention occur infrequently.

interaction
Esomeprazole potentially can increase the concentration in blood of diazepam Valium by decreasing the elimination of diazepam in the liver. Esomeprazole may have fewer drug interactions than omeprazole.

Kidney stone

Kidney stones, one of the most painful of all urologic disorders, are not just a problem of modern life. Scientists found evidence of kidney stones in a 7,000-year-old Egyptian mummy. In 2000, patients made 2.7 million visits to health care providers and more than 600,000 patients went to emergency rooms with kidney stone problems.

Most kidney stones pass out of the body without any help. A kidney stone is a hard mass developed from crystals that separate from the urine and can build up on the inner surfaces of the kidney. Normally, urine contains chemicals that prevent or inhibit the crystals from forming. These inhibitors do not seem to work for everyone, however, so some people form stones.

Doctors do not always know what causes kidney stones. While certain foods may cause stones to form, that is only in people who are susceptible. A person with a family history of kidney stones, urinary tract infections, kidney disorders such as cystic kidney diseases, and certain metabolic disorders such as hyperparathyroidism are also linked to stone formation.

Other causes of kidney stones are hyperuricosuria (a disorder of uric acid metabolism), gout, excess intake of vitamin D, urinary tract infections, and blockage of the urinary tract. Certain diuretics or calcium-based antacids may increase the risk of forming kidney stones by increasing the amount of calcium in the urine.

Kidney stones often do not cause symptoms. Usually, the first symptom of a kidney stone is extreme pain, which occurs when a stone blocks the flow of urine. The pain often begins suddenly when a stone moves in the urinary tract. A person typically feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen, sometimes accompanied by nausea and vomiting, and occasionally, pain that spreads to the groin.

Surgery is not usually necessary. A simple and most important lifestyle change to prevent stones is to drink more liquids, preferably water. If you tend to form stones, you should try to drink enough liquids throughout the day to produce at least 2 quarts of urine every day.

People who form calcium stones used to be told to avoid dairy products and other foods with calcium, but recent studies have shown that foods high in calcium, including dairy products, may actually help prevent calcium stones. Taking calcium in pill form, however, may have the opposite effect, and increase the risk of developing stones.

You may be told to avoid food with added vitamin D and certain types of antacids that have added calcium. If you have very acidic urine, you may need to eat less meat, fish, and poultry, as these foods increase the amount of acid in the urine.

Mental Health and Depression

Not everyone who is depressed or manic experiences the same symptoms. Some people experience a few symptoms, some many, and the severity of the symptoms varies with the individual.

Some symptoms of Depression include persistent sad, anxious, or "empty" mood; feelings of hopelessness, pessimism; feelings of guilt, worthlessness, helplessness; loss of interest or pleasure in hobbies and activities, including sex; decreased energy, fatigue; difficulty concentrating, remembering, making decisions; insomnia, early-morning awakening, or oversleeping; appetite and/or weight loss or overeating and weight gain; thoughts of death or suicide; suicide attempts; restlessness, irritability; and persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

Some symptoms of Mania are abnormal or excessive elation; unusual irritability; decreased need for sleep; grandiose notions; increased talking; racing thoughts; increased sexual desire; markedly increased energy; poor judgment; and inappropriate social behavior.

Some types of depression run in families, particularly bipolar disorder. Apparently, though, additional factors, possibly stresses at home, work, or school, are involved in its onset, as well. Whether inherited or not, major depressive disorder is often associated with changes in brain structures function. People who have low self-esteem are also prone to depression.

Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and a doctor should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done.

A good diagnostic testing will include a complete history of symptoms, whether the patient had them before and, if so, whether the symptoms were treated, and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. The doctor will also ask questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective.

Depending on the patient's diagnosis, and how severe the symptoms are, the therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.

Rosuvastatin review

Rosuvastatin is an HMG CoA reductase inhibitor which is also known as “statins” group. A class of drug that works by blocking the production of cholesterol (a type of fat) in the body.

Indications: for primary hypercholesterolemia (excessive choletesterol in the blood), mixed dyslipidemia , isolated hypertriglyceridemia (including fredrickson type lla, llb & IV & heterozygous familial hypercholesterolemia) and homozygous familial hypercholesterolemia. Rosuvastatin is also used to reduce the amounts of low density lipoprotein (LDL) or the bad cholesterol, total cholesterol, triglycerides (another type of fat), and apolipoprotein B (a protein needed to make cholesterol) in the blood. Rosuvastatin also increases the level of high density lipoprotein (HDL) or the good cholesterol in the blood. These actions are important in reducing the risk of atherosclerosis (fatty deposits in the arteries), which can lead to heart attack, stroke, and peripheral vascular disease.

Contraindication: Active liver disease. Pregnancy & lactation. Rosuvastatin is in the FDA pregnancy category X. This means that rosuvastatin is known to cause birth defects in an unborn baby when taken during pregnancy. Do not take rosuvastatin if you are pregnant or could become pregnant during treatment. It is not known whether rosuvastatin passes into breast milk and if it will be harmful to a nursing baby. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. .

Special precautions: Use is limited to a small number of children 8 years old or older with homozygous familial hypercholesterolemia. Patients who consume excessive quantities of alcohol. History of liver disease. Skeletal muscle effects: Monitor creatine kinase (CK) levels. Patients with predisposing factors for myopathy e.g. renal or kidney impairment, advanced age and hyperthyroidism. Women of child- bearing potential should use contraceptives. Your doctor may want to monitor your liver function with blood tests before starting treatment with rosuvastatin, at twelve weeks after start of treatment and after any increase in dose, and periodically (every 6 months) thereafter.

Talk to your doctor before taking rosuvastatin if you have: kidney problems, hypothyroidism (low thyroid function), have a chronic muscular disease, a blood disorder and if you require a major surgery. You take rosuvastatin exactly as instructed, it can be taken with or without food and with a full glass of water. It is usually prescribed once a day and must be taken regularly to get the most benefit which may be seen after several weeks and months. Avoid fatty, high-cholesterol foods while taking rosuvastatin to maximize its therapeutic effect. Do not take a double dose once you miss a scheduled dose of this drug. Although symptoms of rosuvastatin overdose is not known, seek emergency consult once an overdose is suspected.

Adverse reactions: rare cases of muscle problems and liver problems may have been associated with this medicine. Contact your doctor immediately if you experience the following symptoms : unexplained myalgia (muscle pain), tenderness or weakness accompanied by a fever or flulike symptoms or yellowing of the skin or eyes, abdominal pain, unexplained fatigue, dark colored urine or pale colored stools. Rarely, angioedema (difficulty of breathing; closing of the throat; swelling of the lips, tongue, or face; hives) & rhabdomyolysis.

Less serious side effects: headache, diarrhea, constipation, nausea or upset stomach.

Drug interactions: increased systematic exposure in concomitant treatment with cyclosporin (Sandimmune, Neoral); gemfibrozil (Lopid); clofibrate (Atromid-S); fenofibrate (Tricor); niacin (Nicolar, Nicobid, Nicotinex, others); warfarin (Coumadin) and decreased plasma concentration with antacids that contain aluminum and magnesium such as Maalox, Mylanta, Gelusil and others. If an antacid containing aluminum and magnesium is needed, it should be taken at least 2 hours following a dose of rosuvastatin. You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Reduce cholesterol

No matter why you are having a problem with high cholesterol – heredity, diet, or both – you doctor will invariably start your treatment with a good, low cholesterol diet. If this does not lower your level in 6 months or so, your doctor may consider using medication along with diet to help control your cholesterol levels.

If he does prescribe medication for your cholesterol, don’t think that means you can eat anything you like. Diet will still be a very important part of your treatment. Medication will not work all on its own.

Here are some guidelines to make choosing the right foods a little easier.

There are two major types of dietary fat - saturated and unsaturated, and all foods contain some mixture of both of these fats. Saturated fat raises your blood cholesterol level more than anything else in your diet does. There are several types of saturated fats.

Animal Fats Butter, cheese, whole milk, ice cream, cream, and other animal products all contain high amounts of saturated fat. Poultry, fish, and shellfish also contain saturated fat, although generally less than meat products do.

Vegetable Fats A few vegetable fats, namely coconut oil, cocoa butter, palm kernel oil, and palm oil, are high in saturated fat. These fats are found in many commercially baked goods - cookies and crackers - and in nondairy substitutes, such as whipped toppings, coffee creamers, cake mixes, and even frozen dinners. They are also in some snack foods like chips, candy bars, and buttered popcorn.

Unsaturated Fats Unsaturated fat actually helps to lower cholesterol levels when it is substituted for saturated fat. So, when you do eat fat, try to eat as much unsaturated fat as possible.

Polyunsaturated fats are found primarily in safflower, corn, soybean, cottonseed, sesame, and sunflower oils, which are common cooking oils. Polyunsaturated fats are also contained in most salad dressings, though many commercially available salad dressings also contain large amounts of saturated fats. The word “hydrogenated” is one clue that this is true.

Olive and canola oil are examples of oils that are high in monounsaturated fats. Like other vegetable oils, these oils can be used in cooking as well as in salads.

Another very important point in cholesterol control is your weight. If you are overweight, it is very important that you reach and maintain a healthy weight. Excess weight can make your cholesterol level very high, and can strain your heart and other functions as well.

While cholesterol is needed for normal body function, a healthy liver makes enough for your body's needs so that you don’t really need extra cholesterol from food at all. Restricting your intake of high cholesterol foods will help to greatly reduce your cholesterol levels.

What are generic drugs?

1. What are generic drugs?
A generic drug is a copy that is the same as a brandname drug in dosage, safety, strength, how it is taken, quality, performance and intended use.

2. Are generic drugs as safe as brandname drugs?

Yes. FDA requires that all drugs be safe and effective. Since generics use the same active ingredients and are shown to work the same way in the body, they have the same risks and benefits as their brandname counterparts.

3. Are generic drugs as strong as brandname drugs?

Yes. FDA requires generic drugs to have the same quality, strength, purity and stability as brandname drugs.

4. Do generic drugs take longer to work in the body?

No. Generic drugs work in the same way and in the same amount of time as brandname drugs.

5. Why are generic drugs less expensive?

Generic drugs are less expensive because generic manufacturers don’t have the investment costs of the developer of a new drug. New drugs are developed under patent protection. The patent protects the investment—including research, development, marketing, and promotion—by giving the company the sole right to sell the drug while it is in effect. As patents near expiration, manufacturers can apply to the FDA to sell generic versions. Because those manufacturers don’t have the same development costs, they can sell their product at substantial discounts. Also, once generic drugs are approved, there is greater competition, which keeps the price down. Today, almost half of all prescriptions are filled with generic drugs.

6. Are brandname drugs made in more modern facilities than generic drugs?

No. Both brandname and generic drug facilities must meet the same standards of good manufacturing practices. FDA won’t permit drugs to be made in substandard facilities. FDA conducts about 3,500 inspections a year to ensure standards are met. Generic firms have facilities comparable to those of brandname firms. In fact, brandname firms are linked to an estimated 50 percent of generic drug production. They frequently make copies of their own or other brandname drugs but sell them without the brand name.

7. If brandname drugs and generic drugs have the same active ingredients, why do they look different?

In the United States, trademark laws do not allow a generic drug to look exactly like the brandname drug. However, a generic drug must duplicate the active ingredient. Colors, flavors, and certain other inactive ingredients may be different.