HEALTH DISCUSSION FORUM » DRUGS AND TREATMENTS.

Some years back I was on fairly high doses of Beta-blockers.I started having severe problems with cramp and tightening up of muscles in my legs particularly the left,it got so I could walk only a short distance wihout having to rest.I was also having to get out of bed 3-4 times a night to ease it.I didn't do anything about it but it was picked by up doctors at an exercise test.A Prof McCullum at Withington Hosp gave me a scan and found two narrowings in the Arteries. He tried changing the Beta Blockers but eventually had to reduce them down to just 25ml of Atenolol.The problems in my legs eased.

I was wondering if anyone else has had a similar problem and how it was treated?

This is an article from the BBC website about the use of Calciun pill supplements. As always if anything in the report applies to you don't make any changes until you have seen your GP or relevant medical professional.

CALCIUM PILLS "INCREASE" RISK OF HEART ATTACK.

Calcium supplements taken by many older people could be increasing their risk of a heart attack, research shows.

The study, in the British Medical Journal, said people who took supplements were 30% more likely to have a heart attack.

Data from 11 trials also suggested the medicines were not very effective at preventing bone fractures.

Almost 3m people in the UK are thought to have osteoporosis and many take calcium pills to prevent fractures.

The study recommends doctors review their use of calcium supplements for managing osteoporosis.

The National Osteoporosis Society said most people should be able to get enough calcium through their diets, rather than reaching for the medicine cabinet.

The researchers said those who had a diet naturally high in calcium were at no increased danger.

THIS IS WHAT THE BRITISH HEART FOUNDATION SAYS ON THE SUBJECT.

30/07/2010

Caution needed over calcium supplement research results New analysis of previous research shows there could be a link between taking calcium supplements and risk of heart attack.

We say that if your doctor has advised you to take the supplements you should not stop taking them based on the results of this analysis alone.

Our Senior Cardiac Nurse, Judy O'Sullivan, said:

“We need to be cautious about the results of this analysis because none of the studies involved were designed to look specifically at the relationship between calcium supplements and the risk of heart attack.

“However, the research should not be completely ignored. Any new guidelines on the prevention of fractures in those most vulnerable to them should take this type of analysis into account.

“Anyone who has been advised by their doctor to take calcium supplements shouldn’t stop because of this research alone.”

The analysis of 15 separate studies, published in the British Medical Journal, found that calcium supplements were associated with about a 30 per cent increased risk of heart attack.

If you’re taking these sorts of supplements and are concerned, discuss the treatment with your doctor.

KEEPING TRACK OF YOUR MEDICINES.

Heart disease usually requires a variety of heart medications. If you are caring for a loved one with heart disease, you may need to remind him or her when it's time to take different drugs, or you may actually need to give out the medication when it's time to be taken.

Daily Heart Medication Tips:

• Know the names, dosages, and side effects of your heart medications and what they are used for. Always keep a list of the medications with you.


• Heart medications need to be taken as scheduled, at the same time every day. Medications should not be stopped or changed without first consulting with your doctor. Continue taking a heart drug even if you feel better; stopping medications suddenly can make your condition worse.


• Develop a routine for taking your heart drugs. Get a pillbox that is marked with the days of the week, and fill the pillbox at the beginning of each week. This is an easy way to tell when each day's medications have been taken.


• If a dose is missed, take it as soon as it's remembered. However, if it is almost time for the next dose, ask your doctor about skipping versus making up the missed dose. Two doses should never be taken to make up for the dose missed.


• Make sure prescriptions are filled regularly, and ask the pharmacist any questions you have. Don't wait until you're completely out of medication before filling prescriptions.

Safety Tips for Heart Medication

• Don't take less heart medication than your doctor prescribes in order to save money. You have to take the full amount in order to get the full benefits. If medication costs are too high, talk with your doctor about ways to reduce the costs.


• Don't take any over-the-counter medications or herbal therapies until you've consulted with your doctor or pharmacist. These drugs can make heart disease symptoms worse and/or change the effect of prescribed medications. Even common drugs such as antacids, salt substitutes, cough/cold/allergy medications (including Benadryl and Dimetapp), and non-steroidal anti-inflammatory agents (NSAIDs, such as Advil, Motrin, and Aleve) can worsen heart disease symptoms or cause harmful effects when taken with some heart medicines.


• If you're going to have surgery -- including dental surgery -- be sure to tell your doctor or dentist what heart medications you're taking.

IT COULD BE WORSE!

Couldn't resist Surferboy. I know a couple of people that have had similar and know it can be very uncomfortable and sore. I hope it settles down soon and that the hot weather doesn't make things more difficult. Fez.

I knocked my leg in a fall  and the wound's not healed after a few weeks so now it's been classed as an venous ulcer. I've had my leg bound from ankle to knee to help circulation and help with healing. Anybody had similar? It's really horrible trust up like Tutankamuhn and very depressing.

This is from the British Heart Foundation.

12/03/2010

Research could lead to next step in blood pressure management

Research published in the Lancet today suggests our ability to regulate blood pressure – measured as blood pressure variability – might be an important health measure. The study supports current guidelines which recommend that beta blockers should not be first choice medicines for hypertension in asymptomatic patients.

To read the full article in our A-Z click HERE

The British Heart Foundation highlights a new technique which may offer an additional way of helping a patient immediately after a heart attack. It sounds promising but as the BHF says it does need further research.

26/02/2010

Cheap and effective technique could be used to protect the heart Cutting off blood flow temporarily to an arm or a leg helps save heart muscles from further damage.

In response to a study which looks at how remote ischaemic conditioning (RIC) can prevent damage to the heart muscle following a heart attack, published today in the Lancet1, Fotini Rozakeas, Cardiac Nurse at the British Heart Foundation said:

“RIC is a technique where blood flow is temporarily deprived to one arm or leg using a blood pressure cuff. This phenomenon has previously been shown to protect the heart muscle from further damage when applied shortly before planned heart surgery.

“This interesting, yet small study suggests that RIC is also effective in reducing damage to heart muscle in patients who have had a suspected heart attack and are about to be treated with angioplasty.

“More research is now needed to find out if this treatment results in better recovery and ongoing clinical benefit. If so, it will pave the way for this simple, cheap and effective technique to be adopted more widely, in ambulances or in hospital.”

RANEXA.

During my recent visit to hope I was once again told that I was on the maximum levels of medication for my heart disease but have been prescribed a new drug called Ranexa in addition to my current medication. I was told by the consultant that it works by dilating the larger blood vessels as do the traditional drugs but also dilates the smaller blood vessels. It was interesting that the pharmacy at Hope had to order the drug in and none of the nurses or doctors seemed familiar with it so I'm guessing that it is pretty new or expensive. Here's some stuff about it:-

Ranexa has anti-anginal and anti-ischemic effects which are not dependent upon decreases in the heart rate or blood pressure levels. The technique of its function is also yet unknown. The drug does not enhance the rate-pressure product, the measure of myocardial work at optimum exercise. 

Ranexa is prepared for the treatment of chronic angina as it continues the QT interval; it should be reserved for the patients who have not received the sufficient reaction with some other anti-anginal drug preparations. It is suggested that the drug should be used in permutation with amlodipine, beta-blocker or nitrates. However, the effect of angina rate as well as exercise forbearance exhibited to be lesser in women as compared to men. Ranexa should be taken with or without meals, but the tablets should never be chewed, crushed or broken instead it should be swallowed intact.  

Also while I was in there they tried unsuccessfully to put a stent in a graft that was already extensively stented but did manage to do a ballon angioplsty with a drug eluting balloon which once again is something I hadn't heard of. Here's somthing about them:-

This article appeared in Diagnostic and Invasive Cardiology, July/August 2009 Issue

The focus on balloon angioplasty largely slipped from the interventional limelight a decade ago after the introduction of stents, but today there is some renewed interest with the advent of new balloon technology.

Willow, I have found some information on tinnitus and it is possible for some drugs to cause tinnitus but this is uncommon and the most common cause is I'm afraid old age. You can click HERE to go to the page in question.

This is a list of some of the drugs which could cause the problem and the link to the page above gives a list of other possible causes.

Rarer causes. Less commonly, tinnitus may also develop as a result of:

• a head injury,


• exposure to a sudden or very loud noise, such as gunfire or an explosion,


• acoustic neuroma. A rare, benign growth that affects the hearing nerve in the inner ear,


• impacted wisdom teeth, when wisdom teeth have not completely moved into their normal position,


• adverse reactions to certain medications, such as antibiotics, diuretics, aminoglycosides, quinine, and aspirin (this is more likely to occur when the dosage is exceeded),


• solvent abuse, alcohol abuse and other forms of drug abuse,


• high blood pressure and narrowing of the arteries (atherosclerosis), or


• an overactive thyroid gland.

Stress is not a direct cause of tinnitus but it can sometimes make the symptom worse. For example, some people have reported that their tinnitus was worse during stressful events in their life, such as bereavement.

HOPE THIS HELPS?

Anyone any idea which of the drugs may cause Tinnitus? It is driving me crazy.

For an overview about Aortic aneurisms please click AORTA to go to our A-Z of Heart health terms and conditions.

This is from the British Heart Foundation website.

11/12/2009

Research published in the Lancet today1 links the use of antithrombotic drugs on heart attack patients with an increased risk of bleeding.

June Davison, Cardiac Nurse at the British Heart Foundation, said:

“This Danish study found an increased risk of hospital admission for bleeding in heart attack patients who had been prescribed aspirin, clopidogrel and vitamin K antagonists and that these risks increased with the number of drugs used.

“The risks of bleeding from blood-thinning drugs are well known. However, this is only one side of the story; it is well established that these drugs help to prevent death and recurrent cardiac events in those people who have had a heart attack.

“Therefore before these medications are prescribed, the potential risks and benefits to people will have been weighed up carefully.”

Please note - Aspirin and clopidogrel, are routinely prescribed to treat heart attack patients in the UK but vitamin K antagonists are not.

AORTIC ANEURISM

I can endorse everything in Fez's piece. It is symptomless and is only discovered, usually by accident, when looking for something else. I my case it was a scan of the kidneys. The aorta runs between the kidneys before dividing in the lower abdomen. The aneurism swells and, once discovered, is monitored at 6 monthly intervals. The normal width of the aorta at this point is approx. 3 cm. Mine is about 4.5 cm and once it reaches 5 cm the risk of it bursting is considered to be a greater threat than the risk of the operation. Long may it remain stable.

Bacause it is symptomless the idea of scanning people above a certain age is a terrific idea.

AORTIC ANEURYSM.

About 1,500 men in the East Midlands are among the UK's first to be included in a programme screening for a potentially fatal condition.

So far 22 have been found to have an abdominal aortic aneurysm (AAA), which often has no symptoms. Seven of these have been referred for urgent surgery.

At the moment, the test is available in Leicester, Leicestershire and Rutland.

The NHS is aiming to invite all men aged 65 and over for testing in England and Wales by 2013.

'Promising results'

The aorta is the body's main blood vessel, but with age the wall of its abdominal section can become weak and expand.

If the aneurysm gets too big and bursts, the patient usually dies.

Akhtar Nasim, of Leicester Royal Infirmary, said: "The end results are promising but we have already in the last four, five months already screened about fifteen hundred men.

"We have picked up 22 aneurysms, out of which seven have been referred for urgent surgery."

Arthur Spence, from Market Harborough, was one of the patients screened found to have an aneurysm, for which he is due to undergo keyhole surgery later this month.

He said: "I've been perfectly healthy, and [with] no sign of any pains or anything like that.

"I went along for the test and found out then that I had this aneurysm which needed further attention."

Meldrew, I did a couple of trials some time back at Wythenshawe hospital. The first was for GTN patches and the second for Clopidogrel. If I was asked to do any more trials I would say yes unless there was a compelling reason why I shouldn't. In your case with this I can fully understand your reluctance after your experience with Simvastatin and that you would need to start taking it again as a condition of the trial.

Back from a few days away today and lying behind the door is a letter from Salford Royal.

Apparently I have been selected to take part in a new drug trial. Apparently they are to test a new drug on a total of 25,000 men and women in The UK, Scandinavia and China. The purpose of the new drug is to raise the levels of HDL (good) cholesterol in people at risk of further heart attacks or strokes.

The drug comprises Niacin, which has been in use for more than 50 years, combined with Laropiprant. The reason for the combination is that Niacin has side-effects (flushing of the skin) and Laropiprant is supposed to control those side-effects. They say that Laropiprant is a new drug "which is not known to have any particular side-effects, but it is possible there may be some, as yet unknown side-effects". In addition you have to take 40mg of Simvastatin, which in my case produces a serious weakness in the muscles.

I have decided that I will opt out of the trial and gamble that I am at less risk from a heart attack or stroke than from the medication. Would anybody opt in and why and if everybody is of similar mind to me, how will they find volunteers? 

Meldrew, any news yet on what is the cause of your allergic reaction?

I am taking  antihistimine medication at the moment for a severe allergic reaction to something and the advice I an getting is stay away from aspirin even though it is recommended for my heart problems. 

MORE ON THE USE OF DAILY LOW DOSE ASPIRIN WHICH HAS BEEN DISCUSSED PREVIOUSLY IN HERE.

This from the BBC website:- 

Healthy people who take aspirin to prevent heart attacks could be doing more harm than good, experts said.

Many people are thought to take a daily dose of the drug in the hope it will help prevent heart trouble.

But the Aspirin for Asymptomatic Atherosclerosis (AAA) trial found its routine use to prevent vascular problems "cannot be supported".

A recent Lancet study said low-dose aspirin should not routinely be used to prevent heart attacks and strokes.

Professor Peter Weissberg, of the British Heart Foundation which part-funded the latest research, said: "We know that patients with symptoms of artery disease, such as angina, heart attack or stroke, can reduce their risk of further problems by taking a small dose of aspirin each day.

"The findings of this study agree with our current advice that people who do not have symptomatic or diagnosed artery or heart disease should not take aspirin, because the risks of bleeding may outweigh the benefits."

THIS IS A RESPONSE FROM THE BRITISH HEART FOUNDATION TO THE REPORT

 Professor Peter Weissberg, said:

“We know that patients with symptoms of artery disease, such as angina, heart attack or stroke, can reduce their risk of further problems by taking a small dose of aspirin each day.

“The findings of this study agree with our current advice that people who do not have symptomatic or diagnosed artery or heart disease should not take aspirin, because the risks of bleeding may outweigh the benefits.”

A new kind of "patch" that can mend a broken heart has been successfully tested by scientists.

The tissue-engineering technique, which uses the body as a "bioreactor", may in future be used to repair damage caused by heart attacks.

Cells lost from the heart do not grow back naturally, leaving the organ in a weakened and vulnerable state.

Researchers in Israel demonstrated the new patch in rats with injured hearts.

First, a biodegradable "scaffold" was seeded with immature cells taken from the hearts of newborn rats.

For 48 hours, this was exposed to a cocktail of growth-promoting chemicals in the laboratory. Then it was transplanted into a rat's abdomen where it developed a network of blood vessels and muscle fibres.

After seven days the patch was removed and grafted onto the animal's heart. A month later the patch had completely integrated itself into the heart, synchronising its "beat" with that of the surrounding tissue.

Experimental heart patches have been tested before in animals but with limited success. In human patients, they would probably be seeded with cells derived from stem cells.

The Israeli researchers wrote: "Using the body as a bioreactor to engineer cardiac tissue with stable and functional blood vessel networks represents a significant improvement in cardiac patch performance over ex vivo (outside the body) methods currently used for patch production.

This is the British Heart Foundations response to the post I made in here on 31st may regarding Aspirin.

"A new study published in The Lancet has shown that although taking aspirin is beneficial in preventing heart attacks and strokes among people with established cardiovascular disease, its benefits don’t outweigh the risks of bleeding in healthy people.

Responding to the study, Ellen Mason, Senior Cardiac Nurse at the British Heart Foundation said: "This study on the use of aspirin in primary prevention, partly funded by the BHF, provides further confirmation that in those without existing heart disease there is limited benefit from taking aspirin due to the risk of bleeding.

"For this reason it is better for doctors to weigh up the benefit and risk of prescribing aspirin on an individual basis, rather than develop a blanket guideline suggesting everyone at risk of heart disease is routinely given aspirin. This ensures patient safety"

More up to date information on the values and problems of daily aspirin. Again remember the following article is not definitive and you should not stop or start taking aspirin withot consulting your GP.

May 28, 2009 -- Daily aspirin therapy is often recommended for otherwise healthy people who are at risk for heart attack or stroke, but a new analysis suggests that aspirin's risks may outweigh it benefits in this population.

It is clear that aspirin therapy is indicated in patients who have had a heart attack or stroke, as well as patients with established heart disease.

There has been much debate, however, about whether aspirin should be routinely recommended for the primary prevention of cardiovascular events in people who do not have heart disease or a history of cardiovascular events, but who have risk factors for such events.

On the benefit side, aspirin therapy has been proven to lower the risk for both primary and secondary heart attacks and non-bleeding-related strokes. On the risk side, its use is also associated with rare but potentially life-threatening gastrointestinal bleeding and strokes caused by bleeding.

In people without established heart disease, aspirin is usually recommended for those most at risk for having a heart attack or stroke.

But the new analysis reveals that these patients also have high risk for bleeding events.

To read the full article click HERE

Not only must you read and follow the instructions very carefully but also keep a note of changes in medication and any changes in the way you feel during the few weeks or months which follow. Some effects will be positive but those which aren't should be reported to the GP.

The last two occasions I have been hospitalised were as a result of incorrect doses and incorrect instructions on how to take the medication. In addition my medical records show an intolerance to three different drugs.

I am sure that I have mentioned it before in these forums that a doctor at Hope, who I was walking with in the local park, said that 75% of patients at Hope were there because of problems associated with medication. That is probably why a doctor will always ask what medication you are taking before moving on to other questions to help his diagnosis.

Be careful.

DRUG SIDE EFFECTS TOLL.

There is some discussion in this topic about the side effects of drugs. Now figures published in the Sun, use your own judgement on accuracy, show a record 1313 deaths were attributed to patients'adverse reactions to drugs last year- a rise of 28% in 12mths.

Another 4390 were hospitalsed but survived. In 1997 the death toll wwas 447.

It does show that we have to be careful about how we take our drugs.There are some TIPS FOR SAFELY TAKING YOUR MEDICINE in this topic on 9th Jan 2009.

And this advice in a piece on 4th May 2008 in here:-

Now Chemists/pharmasists are being urged to make more use of what is called "The Yellow card Scheme".You can report side effects to your chemist as well as your doctor. It does make sense because if you are on a repeat prescription as I expect many of us are then we probably see the Chemist much more often than we do the doctor.

Heart Patients seem to be increasingly prescribed Omega3 supplements but do they really help? This article seems to suggest that the answer is YES.

Have you been prescribed Omacor by your GP or hospital consultant?

Omega-3s in Fish Oil and Supplements: What’s Your Best Strategy?

If you’re thinking about adding an omega-3 fatty acid supplement to your daily regimen, there are things to consider first. Do you really need one? What type of supplement should you choose? What are the risks? WebMD’s got the answers.

The evidence suggests that just about all of us could stand to get more omega-3s in our diet. Many experts believe that the level of healthy omega-3s in the average U.S. diet has plummeted in the last century.

Increased intakes of omega-3s may be especially important to people with certain diseases or risk factors. Studies have found very strong evidence that omega-3 fatty acids may help:

• Boost heart health
  
• Control triglycerides
  
• Lower blood pressure

There’s good evidence that omega-3 fatty acids may help with lots of other conditions too – including depression, rheumatoid arthritis, asthma, ADHD, osteoporosis, and more.

In general, experts say that it’s always best to get nutrients from food. So if you’re looking to get more omega-3s in your diet, eating fatty fish – like salmon, trout, or sardines – two or three times a week is the best way to do it. Fish contain DHA and EPA omega-3 fatty acids, the type most beneficial. Plants contain ALA omega-3 fatty acids, less potent but still good for you. You find ALA in foods such as walnuts, flax, and canola oil.

What about supplements? Experts stress that popping an omega-3 supplement can’t excuse an unhealthy diet. That said, many people are resistant to changing the way they eat. Eating more fish may not be an option for vegetarians -- or for people who just don’t like it. For them, omega-3 supplements, algae oil capsules, or products fortified with algal oil DHA may be a good choice.

Even for people who are healthy and eating well, experts say that adding a daily omega-3 supplement might not be a bad idea. After all, the benefits of omega-3 supplements are numerous and the risks are very low.

It’s always best to ask your doctor about what dose of omega-3 supplements you should take

For the rest of the article click HERE

Tips for safely taking your medication.

I'm sure we all know how easy it can be to make a mistake when taking our medication, I once took double the dose of one tablet by mistake, and a surprising number of hospital admissions are due to problems caused by peole making mistakes with their pills and potions so have a read of these tips.

Some people do apparently have some pain but whether theirs is much larger I don't know. When the scans are offered to over 65s snap their hands off. Because there are usually no symptoms it will probably never be discovered until it is too late.

The scan is an ultrasound scan and is exactly the same as pregnant mothers are subjected to and therefore painless and harmless. 

Like Mr Chapman In the Glossary item my aneurism was discovered during an unrelated CT kidney scan. At that time the widthof the aorta was 4.8cm as opposed to the normal width of approx. 3cm.

The width is relevant insofar as the more stretched the wall of the aorta becomes, the greater the risk of it bursting. It is considered that the risk of a "burst" is less if the width is under 5cm than the risk associated with the operation. For this reason I have an ultrasound scan at MRI every 6 months. I was told on the last occasion (1st October) that the aneurism showed no change from the previous occasion.

If an operation becomes necessary it will probably be done using a stent, as at Guys, but the procedure is fairly new at MRI and no mortality statistics are yet available.

I am hoping that mine will remain stable until the success rate is 100%.

ANOTHER ADVANCE IN THE TREATMENT OF AORTIC ANEURISM. But be aware that it won't be available across the country for some time.

Instead of the traditional open surgery, which can be too demanding for the sickest patients, surgeons carried out keyhole surgery - effectively operating on the aneurysm from inside the blood vessels through small holes made in the groin.

An expandable tube called a stent is passed through the femoral artery and into the aorta. The stent is then expanded open and blood flows through it

Around its circumference are kinked wires made of stainless steel or nitinol, a metal alloy that stiffens when heated to body temperature.

It allows surgeons to stop haemorrhaging and protect the artery wall from further damage.

They use a local anaesthetic because a general anaesthetic would relax the muscles and cause even more blood to leak away.

FOR MORE DETAIL CLICK THE TITLE TO READ THE WHOLE ARTICLE OR CLICK  AORTIC ANEURISM to read it in the glossary

They've been reading my posts again!

By Joanna Corrigan (Telegraph)
Last Updated: 9:16PM BST 24 Aug 2008

Experts believe everyone over an age threshold - possibly as young as 50 - should be told to take the simple painkillers to ward off serious cardiac problems.

Aspirin lowers the chance of suffering a heart attack or stroke because it helps stop blood clots forming in the arteries of the heart or brain.

Under current guidelines, GPs only prescribe it to a patient who has already had a heart attack or stroke, or who is considered at high risk of another attack in the near future.

Previous studies have already suggested taking aspirin could cut the chance of having a heart attack or stroke by a third and the risk of a fatal attack by 15 per cent.

New joint research by Nottingham and Sheffield universities bolsters the view that blanket prescriptions could help millions of people later in life.

Analysis of 12,000 patients indicated men as young as 48 and women from the age of 57 could benefit from taking the drug every day.

Researchers, writing in the journal Heart, also claimed many of those who should be receiving aspirin under the current system were falling through the net.

The study suggests it would be easier to have a specific age threshold as a catch-all to ensure everyone is treated.

It found that by the time men are 47 and women 58, the risk of coronary heart disease was 10 per cent, which it deemed a proportion worth tackling.

Only if the patient could suffer dangerous side effects, for example if they had a stomach ulcer, diabetes or were at high risk of bleeding, should they be exempt, it concluded.

Lead author Dr Iskander Idris said routine prescriptions for people in these age groups were feasible, but added: "The final decision about use of aspirin must eventually be made after discussion with a healthcare provider."

Dr Mike Knapton, director of prevention and care at the British Heart Foundation, warned further "robust research" was needed before blanket prescription could be recommended.

"We would encourage everyone to examine their own individual risk and take steps to reduce it by adjusting their lifestyle," he said.

Previous research has already indicated patients resistant to aspirin are four times more likely to have a heart attack, stroke or blood clot, and six times more likely to die.

Another study suggested the drug could also help prevent osteoporosis, the painful condition also known as brittle bone disease.

GRAPEFRUIT AND DRUGS.

We've had it pointed uot in the past that grapefruit and grapefruit juice can have an adverse effect on some statins and some blood pressure treatments. Now a study has shown that oranges and possibly apples can have a similar effect.

Study author Dr David Bailey said that orange and apple juices appeared to contain naringin-like substances which might have a similar effect.

"Recently, we discovered that grapefruit and these other fruit juices substantially decrease the oral absorption of certain drugs undergoing intestinal uptake transport.

"The concern is loss of benefit of medications essential for the treatment of serious medical conditions."

Please note that the study was into an anti-histamine drug, fexofenadine and should be read with that in mind....A proffessional word of caution:-

Professor James Ritter, a clinical pharmacologist at King's College London, said: "The observation is very interesting. It will need more work to establish how important such interactions are in clinical practice and for what drugs and juices."

To read the whole article click....HERE

News released on the 17th. I'm beginning to think some people in power are reading my posts on here or am I in the forefront of opinion with my views? See my entries of the 8th and 9th.

Drug chief angry at medicine cost







NICE advises on which drugs should be bought by the NHS

The head of a government health advisory body has accused pharmaceutical companies of driving up the price of medicine. (BBC NEWS)

Professor Sir Michael Rawlins says drugs are expensive because of "perverse incentives" in the pharmaceutical industry.

The chairman of the National Institute for Clinical Excellence (NICE) made his comments to the Observer newspaper.

NICE has recently been criticised for failing to approve kidney cancer drugs.

Double-digit growth

It advises the NHS in England and Wales on which drugs to buy.

Sir Michael said: "We are told we are being mean all the time but what nobody mentions is why the drugs are so expensive.

"Pharmaceutical companies have enjoyed double-digit growth year on year and they are out to sustain that, not least because their senior management's earnings are related to the share price.

CAN IT EVER BE RIGHT FOR THE NHS TO REJECT DRUGS THAT COULD SAVE LIFES?

There is a really good article about this in the independent. Click the title for the full article.

It's a debate which will go on and on and as always there are two sides to it. It all hangs round a formula that NICe the National Institute For Clinical Excellence calls a QUALY a Quality Adjusted Life Year. For a definition of this click  QUALY.

The questions have risen lately in the news of people being denied treatments based on cost, it's happened before and it will happen again. So have a read and find out what criteria are used in making those decisions.

Costs of drug research. What would happen if commercial drug companies were unable to make enough profits to cover their costs and yes pay divis to their shareholders would governments be able to take up the costs? Or would charities be able to fund the total research as they do to a very limited extent in this country?

News from the BBC,

Patients with advanced kidney cancer will be denied four treatments on the NHS under proposals from the government's drugs advisory body.

The drugs - bevacizumab, sorafenib, sunitinib and temsirolimus - do not offer value for money, according to draft guidelines for England and Wales.

Some experts reacted angrily to the decision, saying it left them with little option for treating patients.

More than 7,000 people are diagnosed with kidney cancer annually in the UK.

Of these, around 1,700 patients will be diagnosed with advanced kidney cancer.

He said they would consider proposals from manufacturers to reduce the cost of the drugs once it had been approved by the Department of Health.

It may seem a bit of a stupid question and maybe I'm naieve but why do these drugs cost so much in the first place? They are only chemical compounds and not full of gold, platinum or anything else we the average person would relate to as valuable to others.

I know all about research costs but what is the point of these companies spending so much time producing these drugs and then pricing themselves out of the market and literally making the drugs worthless to the patients or themselves. Also if the market sales to the rich and privileged in America and Europe cover initial research costs is it not offensive to keep on charging inflated prices purely for the benefit of their shareholders.

 Do these companies want to find cures for the benefit of all mankind which ethically should be the reason for their existance? Of course not, sadly it's plain they're just in it for the money. It's a sad state of affairs.

See this video from the BBC.

http://news.bbc.co.uk/1/hi/health/7546572.stm

DRUG ERRORS COMMUNICATION LINK.

1 in 15 hospital admissions due to drug errors.

Poor communication is most often to blame for people ending up in hospital due to "medication errors", UK researchers say.

Limited access to the patient's medical notes was also found to contribute to mistakes over medicines.

The study, published in Quality and Safety in Healthcare, found some patients may also not be told enough information about their prescription.

It is estimated one in 15 hospital admissions are due to drug errors.

A team of researchers at the University of Reading looked in detail at 18 cases of patients in Nottingham who ended up in hospital due to a drug prescribed by a GP.

Interviews with 62 GPs, pharmacists, practice nurses and patients showed failure of clinicians to communicate between themselves and with to patients were the main reason for the medication errors.

Better liaison could have prevented many cases regardless of whether the problem was related to prescribing, monitoring or patient adherence to the medication

"Simple communication is very important - even basic things like checking understanding."

ONE IN FIVE TAKE DRUGS WRONGLY.

It seems that sometimes we are our own worst enemy. We go to our physicians when we have something wrong with us then fail to take proper care when we use the medication prescribed.

Almost one in five people say they have taken prescription medicines wrongly, a survey has suggested.

The poll of almost 2,000 people for Lloydspharmacy found many misread labels - and take the wrong dose or take drugs at the wrong time.

One man whose asthma was triggered by his cat sprayed the animal with the inhaler, as a "cure" for his symptoms.

The poll comes as NHS data showed the number of prescriptions written in 2007 in England was double the 1997 figure.

The NHS Information Centre data showed around 796 million prescriptions were written last year, up 59% from 1997.

And two thirds of prescriptions are now provided to people over 60.

On average, people in that group received 42.4 items per head last year, compared to 22.3 items in 1997.

One patient set out a range of medicines and described the frequency and dosage for each.

"It turns out that for several months she had been taking a sleeping pill first thing in the morning."

He added: "Another patient reported difficulty using his asthma inhaler.

"When the pharmacist asked him to demonstrate, the problem became clear; he wasn't removing the cap."

Professor Steve Field, chairman of the Royal College of GPs, said: "We are concerned at the staggeringly high numbers quoted in the survey.

"It is vital that patients are given the information they need to get the best results from their medication.

In some instances it seems that patients are not given proper information by the prescribing doctor or chemist on the when and how of taking the medication and this is something I feel is probably very common. I tend to be given a prescription with little or no advice and always read the leaflet that comes with the drugs and this in itself can be confusing.

BLOOD PRESSURE DRUG DEMENTIA HOPE.

From the BBC.

A drug used to lower blood pressure could prevent or delay thousands of Alzheimer's cases, US research has suggested.

People taking angiotensin receptor blockers were up to 40% less likely to develop dementia than those taking other blood pressure drugs.

And patients already suffering from dementia were less likely to get worse. The number of people in the UK with dementia is expected to soar to 1.7 million over the next two decades

This could mean an enormous extra burden for families and the taxpayer, but the Boston University School of Medicine research, presented at a conference in Chicago, suggests there could be ways to prevent it.

High blood pressure over long periods can lead to damaged blood vessels, and is known to increase the risk of not only strokes and heart disease, but dementia as well.

Some types of dementia are directly related to the condition of the arteries supplying the brain, but blood pressure is also thought to play a role in Alzheimer's disease, which is linked to the appearance of protein deposits in brain tissue.

However, the reasons for this are not clear.

Meldrew, it sometimes seems to me that we are a bit like old cars, once one bit fails and has to be repaired or replaced it seems to open the door for other things to follow.

I too have read about the "Yellow Card Scheme". However, having discussed my intolerance of certain drugs with several hospital consutants, my GP, the heart failure nurse and my pharmacist none have suggested using the scheme. Virtually all of them shrug ther shoulders and say that all drugs have side effects.

Unfortunately having arrived at a combination of drugs that seem to suit me, I have now been told that I have an underactive thyroid and that the treatment for that has implications on the treatment of the heart and kidney problems.

Here we go again!!!!!!!!!!!

COULD ALLIGATOR BLOOD BE THE ANSWER TO HOSPITAL SUPERBUGS

This might not be as far fetched as it sounds. Remember most of our medicines, vaccines, antibiotics etc originate from things occurring in nature. Here's a bit from an article, what do you think?

From inthenews.co.uk

 Alligators could become the unlikely saviours in the battle to clamp down on antibiotic-resistant infections such as MRSA.

Biochemists in Louisiana say proteins in alligator blood may provide a source of powerful new antibiotics to help fight infections.

Previous research has shown that alligators have an unusually strong immune system that is different from that of humans.

Unlike humans, alligators can fight microorganisms such as fungi, viruses and bacteria without having prior exposure to them.

Scientists believe they have evolved this ability as they need to heal wounds quickly as they are often injured during territorial battles.

For the latest study, researchers at Louisiana State University and McNeese State University collected blood samples from American alligators.

They then isolated disease-fighting white blood cells and extracted the active proteins from those cells.

In laboratory tests small amounts of the protein killed a wide range of bacteria including MRSA and six out of eight different strains of Candida albicans.

The researchers are now working to find the exact chemical structures of the antimicrobial proteins and determine which proteins are most effective at killing different microbes.

They estimate that the alligator blood extract may contain at least four promising substances.

Check the bathroom carefully if you have to be in hospital you never know what they may be keeping in the bath! 

It's interesting but there have been more and more suggestions just lately that we should ask our pharmacists about problems we find relating to the medication we take.

This is from a post in the "Side Effects of Drugs"topic in this forum on 16th March. 

Now Chemists/pharmasists are being urged to make more use of what is called "The Yellow card Scheme".You can report side effects to your chemist as well as your doctor. It does make sense because if you are on a repeat prescription as I expect many of us are then we probably see the Chemist much more often than we do the doctor.

Meldrew your GP may even be grateful for you letting him know about the problem and your solution it could prevent someone else being prescribed the same combination as yourself. The doctors must have so much to keep up-to-date with. Mind you he/she might not let on that they are grateful.

Thanks Fez.

The reason I asked is the symptoms I experienced were not amongst those listed on the various sites.

I started on 2mg per day. After kidney function tests a week later the dose was doubled and I immediately started to experience pain in the area of the liver i.e. just below and beneath right ribcage. After further blood tests to check kidney function the dose was doubled to 8mg per day. Because of the pain my GP also prescibed paracetomol despite which the pain increased. After discussing with the pharmacist (who questioned whether I should be taking Candesartan AND Ramipril) I stopped taking Candesartan. After 2 days the pain has gone.

The trouble is now that I have to tell my GP who will feel I am questioning his ability

Hi Meldrew. I've never heard of Candesartan but here are two links about it

This is about the drug itself  http://www.patient.co.uk/showdoc/30002374/

This is to a patient forum about it. http://experience.patient.co.uk/discussion_list.php?d=565

I think its worth remembering on this item and others that forums often include the few who have problems with a drug or treatment but not the ones who have positive experiences.

I've put it in the glossary as well just click  CANDESARTAN AND BLOOD PRESSURE.

GTN.  GLYCERYL TRINITRATE.

I'm sure many of us use, or have available in case of need, a Glyceril Trinate spray or less commomly now tablets for the relief of angina symptons. But how much do we actually know about it. For instance there are several different forms available not jus the two mentioned. Well here's the gen on it not just my waffle.

About Glyceryl Trinitrate

This belongs to the group of medicines known as Nitrates.

Nitrates are used to treat and prevent the symptoms of angina (chest pain) and other heart conditions including heart failure.

Angina is pain or tightness of the chest caused by a lack of oxygen reaching the heart muscle. Nitrates work in two different ways. They widen the arteries that carry blood to the heart muscle and they relax the veins that return blood from the body to the heart. Together these actions allow more oxygen to reach the heart muscle and reduce the work of the heart. This lowers the overall strain on the heart reducing the risk of angina and relieving the pain associated with an acute angina attack.

Glyceryl Trinitrate can be used to treat an angina attack or can be taken before exercise or exertion to help prevent an attack.

Glyceryl Trinitrate is available in sublingual (under the tongue) tablets, aerosol spray, buccal tablets (dissolve next to the cheek), patches, ointment and injection form. It is also available as a modified release tablet which means it is released slowly to give a more even effect..

Glyceryl Trinitrate is also sometimes known as: GTN; Coro-Nitro; Glytrin; Nitrolingual; Nitromin; Suscard; Sustac; Nitrocine; Nitronal; Deponit; Minitran; Nitrodur; Transiderm Nitro; Trintek; Percutol.. You may notice the use of any of these names on the packaging of your medicine

I currently have a spray but more frequently use the under the tongue tablet. I have in the past also used the Buccal tablets which you pop between your cheek and your gum. I found them great if I needed to do something like a bit of decorating because the effects of the nitrate could last 2-3 hours.

Has anybody else used anything other than the spray or under the tongue tablets?

For more info click...GLYCERYL TRINITRATE

AORTIC ANEURISM. There is an entry in the glossary about this subject and the introduction of a screening programme for this condition which is much more common in men than women.

Abdominal aortic aneurysms, which can cause one of the body's main blood vessels to burst, is the third most common cause of death among older men, responsible for 3,000 deaths a year.

This screening is a good example of increasing preventive healthcare in the NHS


Department of Health spokeswoman

The government announced the screening programme earlier this year - the first male-only programme as men are six times more likely to have an aneurysm than women.

Aneurysms are like balloons, the larger they grow the more likely they are to burst. But if detected early enough, the condition can be corrected by surgery.

Now doubts are being cast about a screening programme in England for this potentially fatal blood vessel condition.

FOR MORE ON THIS CLICK  AORTIC ANEURYSM.

Here's some more about vitamins from natural foods on the Virgin Media site,

 http://www.virginmedia.com/homefamily/health/vitamins.php?vmsrc=vmhpld

 and so called,

 Super foods

Heard the hype but still not quite sure what superfoods are or what they can do for you? If you indulge in the likes of green tea, alfalfa, oatmeal, kale or spinach, chances are you've had your fair share of superfoods.

This select group of foods provide enhanced nutrition to our bodies. By adding superfoods to your diet, you can provide your body with extra vitamins, minerals, protein, essential fatty acids, fibre, and powerful antioxidants. Superfoods have been proven to help improve the immune system, aid in weight management, stabilise blood glucose levels, improve cardiovascular and bowel health, help detoxify the body, fight aging, and prevent other diseases such as cancer.

And with winter looming, you can beat those colds by eating your way to good health and supplementing your diet with some of the following superfoods.

Beans are an excellent source of hearty, low-fat plant protein. Soluble fibre from foods such as beans, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. Use in soups or add to salads.

Blueberries have been heralded a chemical warrior against heart disease and cancer. They are not only a powerful antioxidant but have also been proven to preserve vision. Try adding blueberries to smoothies, fruit salad or yoghurt.

Some people steer clear of avocado for fear of it having a high-fat content, however this potassium-rich superfood is great for fatigue, depression and poor digestion. Rich in vitamins A, C and E it stimulates production of collagen, and is beneficial for circulation, skin and fertility.

A bit of a wonder bean, soy is known for its culinary versatility and health properties. Around 25 grams of soy protein each day, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. To savour soy in its many forms, try tofu, tempeh, miso, edamame and soymilk.

With high levels of healthful flavonoids shown to have many health benefits and only two calories per cup, a cuppa is a great way to support your health.

Dulse, hijiki, kombu, nori and wakame are but a few ingredients used in Japanese culinary delights. Commonly sold dried, in sheets or strips, it's easy to add essential minerals including potassium, calcium, magnesium, iron and iodine to soups, stews and sushi.

Pomegranate juice has recently been hailed as the new cranberry juice. But did you know, pomegranates are rich in vitamins and have two to three times the antioxidant power of equal quantities of green tea or red wine.

Oatmeal provides a prime source of complex carbohydrates. Full of soluble fibre, eating oats as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease. Best enjoyed in a cereal, try adding fruit or nuts to a bowl for added flavour.

Spinach, kale, romaine lettuce and Swiss chard all contain beta-carotene which support healthy eyes. Try adding crispy Romaine to salad or steaming rainbow chard to accompany meat.

A handful of nuts a day are a great alternative to sweets and cakes. Walnuts, hazelnuts, almonds, macadamia and pistachio nuts contain Omega 3 fats, which are great for your heart. Raw, unsalted nuts and seeds are best.

Listening to a Radio 5 discussion this morning re this latest research.

Vitamins 'could shorten lifespan'






 Taking certain vitamin supplements may adversely affect people's lifespan, researchers have suggested.

Millions worldwide use antioxidant supplements such as vitamins A and E, and beta-carotene.

Looking at dozens of previous studies, Copenhagen University researchers suggested these appeared to raise, not lower, the risk of early death.

A supplements industry expert said the Journal of the American Medical Association study was fatally flawed.

But nutritionists said it reinforced the need to eat a balanced diet, rather than relying on supplements.

While vitamin supplements have been popular for decades, the precise benefits they offer - if any - remain uncertain, despite hundreds of research projects.

Considering that 10% to 20% of the adult population in Europe and North America may consume the supplements, the public health consequences may be substantial


University of Copenhagen research team

More recent theories suggest that certain vitamins consumed as part of a healthy diet - and perhaps taken in supplement form - may be able to prevent damage to the body's tissues called 'oxidative stress' by eliminating the molecules called 'free radicals' which are said to cause it.

This damage has been implicated in several major diseases including cancer and heart disease, yet the implication that vitamin supplements might protect people from these illnesses is controversial.

Vitamin overview

The Copenhagen team reviewed more than 815 clinical trials into the benefits of vitamins A, E, and C, alongside beta-carotene and selenium - all commonly-used supplements.

How sensible scientists can suggest a single antioxidant supplement can have a major effect where patients already have advanced cardiovascular disease is ridiculous


Dr Ann Walker
Health Supplements Information Service

They selected 68 whose methods were more likely to produce an accurate picture of vitamin benefits, then added their results together to form one, large-scale study.

This overview suggested that taking antioxidant supplements neither increased, nor reduced, the risk of early death.

However, when the researchers eliminated a further 21 trials which had a slightly higher possibility of producing a skewed result, the picture changed considerably.

While the risk of death was unchanged among selenium and vitamin C users, a statistically significant increase in risk emerged for the other three supplements.

Beta-carotene produced an approximate 7% increased risk, vitamin E a 4% increase and vitamin A, a 16% increase.

We already know that taking supplements isn't in any way a replacement for a good balanced diet


Dr Frankie Phillips
British Dietetic Association

The researchers wrote: "Our findings contradict the findings of observational studies claiming that antioxidants improve health.

"Considering that 10% to 20% of the adult population in Europe and North America may consume the supplements, the public health consequences may be substantial."

They said there were several different explanations for this increase in risk - and suggested that knocking out 'free radicals' might actually interfere with a natural defence mechanism within the body.

The team called for more research into the effects of vitamin supplements on health.

'Balanced diet

Dr Frankie Phillips, a nutritionist at the British Dietetic Association, said food contained a complex matrix of different components which could not be replicated by supplements.

"Our advice is to eat a wide range of foods in a balanced diet which can provide all of the nutrients the body needs to protect itself and combat diseases."

Ellen Mason, of the British Heart Foundation, said: "We would recommend that you only take substances to protect against heart disease, whether dietary supplements or drugs, that have been proven in well conducted clinical trials."

However, Dr Ann Walker, of the Health Supplements Information Service, said the findings of the study were "worthless".

She said some of the studies which had been examined by the Copenhagen team involved patients who were already seriously ill.

"How sensible scientists can suggest that a modest intervention of a single antioxidant supplement, can have a major effect in reversing life-threatening pathology, where patients already have advanced cardiovascular disease, is ridiculous.

"Vitamin, mineral and dietary supplements not only have proven health benefits, they are essential to the maintenance of good health and can help bridge the nutritional gap for many people in the UK whose diets are often lacking in essential nutrients."

HAND HELD ECG GIVES INSTANT RESULT IN GP SURGERIES.there was news last year about handheld ECG devices being trialed in GP surgeries. the results of the trials are in and one of the trials in Manchester and Cheshire has cut the need for hospital referrals by 60%. Apparantlt they take your ECG then hold the device to a phone and cardiac nurses at the other end interpret the readings and advise whethe the patint needs hospital treatment. There is no mention of whether they are to be rolled out across the country.

It sounds good, I mean it can instantlt ease the mind if you are concerned instead of having to attend a hospital appointment[when?] then wait 7-10 days if you are lucky for the results to get back to the GP

To read the full story here on Hearts click HAND HELD ECG.

I've probably said it before but I eat very little fruit but I do have at least one banana a day,do you think that will keep the doctor away? Mind you i do eat a lot of fresh veggies.As you mention the kidneys wnen I was at hope cardio 2 weeks ago the consultant did send me for a blood test and when I saw my copy of the GP letter it was for haemoglobin and renal[kidney] function. Back soon,must look up haemoglobin. Thak goodness I know what a kidney is

Haemoglbin is the coloured pigment inside red blood cells that carry oxygen round the body. click HAEMOGLOBIN for a full explanation

Interestingly low levels of Haem whatnot can cause angina symptoms.

ASPIRIN CUTS RISK OF FIRST HEART ATTACK IN MEN BUT LESS SO IN WOMEN.

A Report of Oct 87 suggests that aspirin is not as effective at preventing a first heart attack in women as it is in men. The study was by the University of Brirish Colombia. it shows that aspirin helps everyone who has had a heart attack but did not help some avoid a first one.

Why? Studies that looked predominantly at men found that aspirin helped. Trials that looked predominantly at women found no effect.

THESE ENTRIES HAVE BEEN COPIED AT RANDOM FROM A PREVIOUS FORUM.

GTN SPRAY and TABLETS:- A while back my G.P. noticed that my use of GTN spray was increasing.He suggested that I tried the GTN tablets,theory being that when I only needed the gtn for a short period I could get rid of what was left of the tablet without having to always absorb the whole dose which you must do with the spray.It's working out OK.

One snag is the tablets come in bottles of 100 and once opened they must be used within 8 weeks so you really need to be a fairly frequent user.He left me with a spray as well.Of course one reason he might have suggested the Tablets could be because they are cheaper.

Here's the link to the BBC story on garlic and cholesterol, as it's now disappeared from the front page

I was told by Doctor Barnes Houseman[Heart specialist] to include garlic in my medication to help lower Cholesterol but in the Daily Mail this week it says a study taken in America proves it is of no use at all. Who do you believe. Anyone know?

Garlic doesn't lower bad Cholesterol? Have a look at the News section on the right of the first page where you sign in.It does have some health advantages

I was changed from Atenolol to Bisoprolol fairly recently to try to help with Extra Heartbeats I was getting.It has helped but was causing similar problms to the Atenolol so he has put me back to 5mg but it still does help with the heartbeat thing.I am on 40mg of Lipitor statins they don't seem to cause me any problems.So all's pretty fair in the garden or in my case the balcony!

Had similar problem for years ,taking quinine and gabapentin helped a little,recently my cardiologist took me off atenolol and replaced it with bisoprolol 90% improvememt,by the way he also changed my statins as these can give you cramps

THESE ENTRIES HAVE BEEN COPIED AT RANDOM FROM A PREVIOUS FORUM.

For the first time the National Institute for Health and Clinical Excellence [NICE] has recommended lifestyle changes alongside drugs in treating heart attack patients to stop further attacks.

Doctors are being advised to prescribe Oily Fish or Omega3 fatty acid supplements to patients.

This is good news for us with heart disease,specially those entitled to free prescroption or those of us who don't like fish.It also re-inforces much that has been written about the benefits of fish oils.For More on the BBC article and the NICE guidance click Fish Oils,Omega3 to go to the scrapbook.

Will you ask your GP about it?

I had similar problems for a long time, recently my doctor put me on a drug called gabapentin that has improved the situation by 75%,just as an after thought do you suffer from diabetes or been checked for same.

I'm no doctor but it sounds as though it could be a narrwed blood vessel,Peripheral Arterial Disease.In my case high doses of Betablockers made the problem much worse. Edwin had similar problems,see his entry 22nd Feb.in this topic. Might be worth mentioning it to your Doc next time you have to go,could be something else or nothing.

I have noticed that I sometimes get cramp in the middle two toes of my left foot.I occasionally get cramp in my calf but it is my toes that now give me regular bouts of cramp.

Anybody anything similar and any ideas for dealing with it.

I have cramp in bed sometimes but not regularly and usually in my calf or achilles tendon. ne of them as been tight and stiff for a couple of weeks now but I put it down to my new trainers which are really springy. I think we all don't drink enough water and get dehydrated. Of course being on water tablets and not eating a lot of salt it's a double edged sword.

Try eating lots of bananas Bernard as I think the potassium helps prevent attacks e.g tennis players scoff them during long matches