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Monday 31 October 2011

What is Vitamin K?Helping to Maintain the Health of Bones

Vitamin K is a fat-soluble vitamin, so it is stored in the body's fat tissue and liver.
Vitamin K is important to help support proper coagulation (blood clotting). The liver uses vitamin K to synthesize blood-clotting proteins. Without vitamin K, the level of the blood-clotting proteins drops, and clotting time is prolonged. Vitamin K has also been recognized for its role in helping to maintain the health of bones. There are three types of vitamin K:

Phylloquinone, which was discovered in Denmark and termed vitamin K for the Danish word koagulation, is the natural vitamin K found in alfalfa and other foods. It is known as K1.

Menaquinone, produced by intestinal bacteria, is K2. Menadione, a synthetic compound with the basic structure of the quinones, is K3.

Sources of Vitamin K
Vitamin K is found in dark leafy greens, most green plants, alfalfa and kelp. Blackstrap molasses and the polyunsaturated oils, such as safflower, also contain some vitamin K. Animal sources of vitamin K include liver, milk, yoghurt, egg yolks and fish liver oils.

Absorption of vitamin K takes place primarily in the upper part of the small intestine with the help of bile or bile salts and pancreatic juices. It is then carried to the liver for the synthesis of prothrombin, a key blood-clotting factor.

Since natural vitamin K (K1) is fat soluble, it requires bile and pancreatic juice in the intestine for optimal absorption. In contrast, some of the synthetic vitamin K compounds (K3) are water soluble and more easily absorbed. So people who do not tolerate natural vitamin K, such as those with decreased bile acid secretion, may find K3 helpful.

Menaquinone (K2), which is produced by intestinal bacteria, may be the most beneficial source of vitamin K. This is why vitamin K supplementation may be particularly important for those whose normal balance of intestinal bacteria has been disrupted.

Vitamin K Deficiency
Vitamin K deficiency results from extremely inadequate intake, fat malabsorption, or use of coumarin anticoagulants. Deficiency is particularly common among breastfed infants. It impairs clotting. Diagnosis is suspected based on routine coagulation study findings and confirmed by response to vitamin K. Treatment consists of vitamin K given orally or, when fat malabsorption is the cause or risk of bleeding is high, parenterally.

Symptoms of Vitamin K Deficiency
Vitamin K deficiency decreases levels of prothrombin and other vitamin K–dependent coagulation factors, causing defective coagulation and, potentially, bleeding.

Persons deficient in vitamin K are first and foremost likely to have symptoms related to problematic blood clotting or bleeding. These symptoms can include heavy menstrual bleeding, gum bleeding, bleeding within the digestive tract, nose bleeding, easy bruising, blood in the urine, prolonged clotting times, hemorrhaging, and anemia. A second set of vitamin K deficiency-related symptoms involves bone problems. These symptoms can include loss of bone (osteopenia), decrease in bone mineral density (osteoporosis), and fractures-including common age-related fractures like that of the hips. Yet another set of vitamin K deficiency-related symptoms involves excess deposition of calcium in soft tissues. These calcification-based problems include hardening of the arteries or calcium-related problems with heart valve function.

Recommendations
The Recommended Dietary Allowance (RDA) for vitamins reflects how much of each vitamin most people should get each day.

    The RDA for vitamins may be used as goals for each person.
    How much of each vitamin you need depends on your age and gender.
    Other factors, such as pregnancy, breast-feeding, and illness may increase the amount you need.

The Food and Nutrition Board at the Institute of Medicine Recommended Intakes for Individuals - Adequate Intakes (AIs) for vitamin K:

Infants
    0 - 6 months: 2.0 micrograms per day (mcg/day)
    7 - 12 months: 2.5 mcg/day

Children
    1 - 3 years: 30 mcg/day
    4 - 8 years: 55 mcg/day
    9 - 13 years: 60 mcg/day

Adolescents and Adults
    Males and females age 14 - 18: 75 mcg/day
    Males and females age 19 and older: 90 mcg/day

Sources
http://health.nytimes.com/health/guides/nutrition/vitamin-k/overview.html
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=112
http://www.merckmanuals.com/professional/sec01/ch004/ch004m.html

Unknown Vitamin K deficiency, Vitamin K functions, Vitamin K recomondation, Vitamin K Sources, Vitamin K symptoms

Saturday 29 October 2011

About Normal Abdominal Pain During Pregnancy

Abdominal pain and cramping: Normal abdominal pain during pregnancy is due to the following changes:

1. Implantation Bleeding:
During implantation you experience a little spotting termed as the bleeding. Implantation is nothing but the fertilized egg penetrating the uterine lining.

2. Stretching of the ligaments:
The muscles and the ligaments supporting the uterus stretch during the second trimester which can cause a dull ache across the belly or sometimes a sharp pain on one side. Many women feel it while getting up from the bed or from the bath tub or while coughing.

False Labor:
False labor pains are also called as the Braxton Hicks contractions which are generally irregular and painless but some women feel the pain.

Cramping: In the last week of pregnancy cramping may be a sign that the labor is almost ready to begin. Sometimes cramps are due to the gas pains and bloating due to the hormonal changes resulting in the slow digestion, constipation and the pressure of the growing uterus.

With the normal abdominal pains you can always try these techniques like -sit down, put your feet up and relax, rest comfortably and relieve the symptoms. Avoid sudden changes in the position, when you feel the pain bend towards the pain, Gas pains can be relieved by doing the regular or the light house work, try taking a warm bath, ensure that you are getting enough fluids.

It is most likely the round ligament pain and is a consequence of the enlarging uterus.

The round ligaments are the supporting ligaments and muscles when you are pregnant. As the uterus grows in the first pregnancies especially the ligaments are stretched beyond their capacity and comfort level. During sneezing, coughing, laughing or even during the sudden movements the pain can be quite a stabbing lower right or more commonly lower left, abdominal pain during pregnancy. The round ligament would start stretching somewhere around the first or second week of pregnancy and can go till the 12th week of pregnancy or sometimes continue throughout the term of pregnancy. There are no long term effects from the round ligament pain and this pain is no more in the subsequent pregnancies. Prevention is better than cure. Ligaments are stretched when they are pulled. However sudden movements can trigger and aggravate the pain. Thus whenever you sneeze, cough or laugh hold the bottom half of your abdomen and press on the area where you usually feel the pain. Securing the ligament in this manner can prevent the sudden stabbing pain.

There is immediate medical attention needed in the following cases: Pain that is not localized or is accompanied by difficulty in breathing, headaches, a skin rash or even the vaginal discharge may not be the round ligament pain. Along with these the following also require some medical attention:

    Severe pain: The pains which are in the form of cramps, bleeding or vaginal discharge, accompanied by fever, chills, and lightheaded or faintness.
    Ectopic Pregnancy: In the initial 3 months of pregnancy abdominal pain can be an indication of ectopic pregnancy. An ectopic pregnancy causes slight irregular bleeding, pain in the lower abdomen, especially on one side, and is sometimes accompanied by shoulder pain, faintness, dizziness, and nausea or vomiting.
    Pre term labor if you have any of the following:

Contractions every 10 minutes and Pelvic pressure
Change in the vaginal discharge or bleeding from the vagina
Low dull backache and Cramps that are similar to the one you have during your periods
Abdominal cramps with or without diarrhea

Labor also needs immediate medical attention: The contractions indicating labor are more severe than the pre term labor. The contractions are regular between 5-10 minutes, you cannot speak or walk during the contractions, you have vaginal bleeding, and the bleeding is of dark greenish or brown in color.

Unknown Normal Pregnancy, Pregnancy Pain

Calcium Channel Blockers(Nifedipine) Taking During Pregnancy

Calcium channel blockers (CCBs) are a highly prescribed class of drugs used for the treatment of angina pectoris, hypertension, and cardiac arrhythmias. These vasodilating agents relax smooth muscle by inhibiting the entry of calcium into muscles or by inhibiting its release from intracellular storages. This relaxation in blood vessel walls results in dilation of arteries and, subsequently, in reduction of blood pressure (Ducsay et al., 1987).

Nifedipine is a calcium channel blocker medicine that slows smooth muscle function. Muscles need calcium to function properly, and a calcium channel blocker interferes with the supply of calcium to the muscle. This allows the smooth muscle wall of the blood vessels to relax and widen, reducing blood pressure.

Nifedipine was given a pregnancy Category C rating because of potential problems in animal studies. When given to pregnant rabbits, mice, and rats, nifedipine caused increased miscarriages and birth defects. These birth defects included problems with fingers or toes, rib deformities, and cleft palate.

However, it is important to note that animals do not always respond to medicines the same way that humans do. Therefore, a pregnancy Category C medicine may be given to a pregnant woman if her healthcare provider believes that the benefits to the woman outweigh any risks to the unborn child.

Nifedipine is sometimes used to stop preterm labor, especially when other medications have failed. It helps to relax the smooth muscle of the uterus, stopping premature labor. Since nifedipine is not approved for preterm labor, however, this is considered an "off-label" use.

If you are pregnant or are thinking of becoming pregnant while taking nifedipine, let your healthcare provider know. He or she will consider both the benefits and risks of using nifedipine during pregnancy before making a recommendation in your particular situation.

Sourceshttp://health.msn.com/pregnancy/nifedipine-for-high-blood-pressure-during-pregnancy
http://www.fetal-exposure.org/resources/index.php/1996/09/01/calcium-channel-blockers-and-pregnancy/
http://blood-pressure.emedtv.com/nifedipine/nifedipine-and-pregnancy-p2.html

Unknown Clinical Pharmacology

Few Pregnancy Exercises To Control Pregnancy Pain

The hormones level in your body change, your uterus grows larger, you have to sleep in restricted postures and you experience fatigue due to increasing weight of baby. All these factors contribute towards hip and pelvic pain during pregnancy. But don’t worry now. We have few pregnancy exercises for you that will help your muscles get relaxed and reduce the pain.But before following these pregnancy exercises, you should be very careful because they can directly affect our body and baby. It is better to have some fitness trainer to guide and do not do these exercises until you get to learn the exact posture.

Leg Raises
The most simple exercise to relax your pelvic area is leg raising. Just lay down on your back with your leg muscles stretched. Lift both your legs by supporting your hips with hands, keep them like this for 10 seconds and then bring back. Repeat this procedure for 5 times. This will release tension from your hips and make your leg muscles flexible.

Hip Flexor Stretches
Now for hip flexor stretches, again you have to lay down on your back with legs stretched. Now raise your right leg in air and bend it down from knees towards your chest and then rest it back on floor. Now you have to stand up slowly. After standing straight, move your left leg forward and right leg backward and then bend the left leg from knee and stretch your body lightly. Do the same with your right leg forward and left leg backward.

Pelvic Tilts
This exercise is good to eliminate pain from abdomen and pelvic muscles. After laying down straight, fold your legs on knees and keep your hands at your sides. Now you have to inhale and exhale while keeping the movement of hips and back in rhythm to it. Inhale slowly while keeping your back and hip slightly rose. Then exhale slowly while your hips and back will come to the rest position again.

Butterfly Stretches
Butterfly stretches are useful for your body to make it relax but it affects the thighs most. You don’t need to lie down here. Just sit on the exercise mat and bend your knees while your feet’s soles should be touching each other. Now you have to press your knees up and down, not exerting much pressure. It you find it strenuous the leave it immediately.
These exercises can be dangerous rather being useful if you do them on your own. The best solution is to join some parental yoga centre. They also give physiotherapy exercises that will reduce your pain.

Source
http://www.indiancookerychannel.com/pregnancy-exercises-for-hip-pain

Unknown Pregnancy, Pregnancy Excercise

Improve Mental and Emotional Health by Taking Care of Yourself

A healthy mind is as important as a healthy heart but little attention is paid to mental wellbeing. People who are emotionally strong are in control of their emotions and behaviour.
In order to maintain and strengthen your mental and emotional health, it’s important to pay attention to your own needs and feelings. Don’t let stress and negative emotions build up. Try to maintain a balance between your daily responsibilities and the things you enjoy. If you take care of yourself, you’ll be better prepared to deal with challenges if and when they arise.

Taking care of yourself includes pursuing activities that naturally release endorphins and contribute to feeling good. In addition to physical exercise, endorphins are also naturally released when we:

    Do things that positively impact others. Being useful to others and being valued for what you do can help build self-esteem.
    Practice self-discipline. Self-control naturally leads to a sense of hopefulness and can help you overcome despair, helplessness, and other negative thoughts.
    Learn or discover new things. Think of it as “intellectual candy”. Try taking an adult education class, join a book club, visit a museum, learn a new language, or simply travel somewhere new.
    Enjoy the beauty of nature or art. Studies show that simply walking through a garden can lower blood pressure and reduce stress. The same goes for strolling through a park or an art gallery, hiking, admiring architecture, or sitting on a beach.

More tips and strategies for taking care of yourself:
    Appeal to your senses. Stay calm and energized by appealing to the five senses: sight, sound, touch, smell, and taste. Listen to music that lifts your mood, place flowers where you will see and smell them, massage your hands and feet, or sip a warm drink.
    Engage in meaningful, creative work. Do things that challenge your creativity and make you feel productive, whether or not you get paid for it – things like gardening, drawing, writing, playing an instrument, or building something in your workshop.
    Get a pet. Yes, pets are a responsibility, but caring for one makes you feel needed and loved. There is no love quite as unconditional as the love a pet can give. Animals can also get you out of the house for exercise and expose you to new people and places.
    Make leisure time a priority. Do things for no other reason than that it feels good to do them. Go to a funny movie, take a walk on the beach, listen to music, read a good book, or talk to a friend. Doing things just because they are fun is no indulgence. Play is an emotional and mental health necessity.
    Make time for contemplation and appreciation. Think about the things you’re grateful for. Mediate, pray, enjoy the sunset, or simply take a moment to pay attention to what is good, positive, and beautiful as you go about your day.

Everyone is different; not all things will be equally beneficial to all people. Some people feel better relaxing and slowing down while others need more activity and more excitement or stimulation to feel better. The important thing is to find activities that you enjoy and that give you a boost.

Source
http://helpguide.org/mental/mental_emotional_health.htm

Unknown Mental and Emotional Health

How Do Use Aminophylline Drugs Adverse Effects and Precautions

Indications:Treatment and prophylaxis of bronchial asthma, bronchial spasm associated with emphysema, chronic bronchitis & treatment of neonatal apnea.

Doses & Administrations:
Oral:
Adult:100-300 mg 3-4 times daily after food.
Pediatric:6mg/kg every 12 hours increased to 12 mg/kg.
For better dose range in children see theophylline.

Parenteral :Adult : Slow I/V (over 20 min ) 250 - 500 mg i.e (5 mg/kg) when necessary.
Maintenance if required, in patients notpreviously treated with xanthines
500 mcg/kg/hour slow I/V.

Pediatric :
Neonates : 0.2mg/kg/hr
6 weeks-6 months: 0.5mg/kg/hr
6 months - 1 yr : 0.6-0.7mg/kg/hr
1 to 9 years : 1-1.2 mg/kg/hour
9-12years and young adult smokers: 0.9mg/kg/hr
12 years healthy non smokers : 0.7mg/kg/hr

Adverse Effects:Nausea, vomiting, anorexia, diarrhea, rectal irritation, dizziness, headache, insomnia, convulsion,severe depression, tachycardia, circulatory failure and life threatning ventricular arrythmia.

Warnings / Precautions:Aminophylline should be used with caution in patients with severe heart, kidney, liver diseases, hyperthyroidism, congestive heart failure (CHF) or peptic ulcer. It should be used with caution in neonates and in elderly persons.

Mechanism of Action:Theophylline has two distinct actions in the airways of patients with reversible obstruction: smooth muscle relaxation (i.e., bronchodilation) and suppression of the response of the airways to stimuli (i.e., non-bronchodilator prophylactic effects). While the mechanisms of action of theophylline are not known with certainty, studies in animals suggest that bronchodilatation is mediated by the inhibition of two isozymes of phosphodiesterase (PDE III and, to a lesser extent, PDE IV) while non-bronchodilator prophylactic actions are probably mediated through one or more different molecular mechanisms, that do not involve inhibition of PDE III or antagonism of adenosine receptors. Some of the adverse effects associated with theophylline appear to be mediated by inhibition of PDE III (e.g., hypotension, tachycardia, headache, and emesis) and adenosine receptor antagonism (e.g., alterations in cerebral blood flow).

Theophylline increases the force of contraction of diaphragmatic muscles. This action appears to be due to enhancement of calcium uptake through an adenosine-mediated channel.

Sources
http://www.globalrph.com/pulmonary_theophylline.htm

Unknown aminophylline Drugs, Clinical Pharmacology

Health Benefits of Onion and Garlic

Onion and garlic have been revered since ancient times for both their culinary properties as well as their medical benefits. These pungent members of the lily family, with their distinctive flavour and pungent aroma, are used to enhance meat and vegetable dishes in cuisines of Asia, the Middle East and the Mediterranean, whereas their fried, baked or pickled variants are a versatile delicacy in their own right. In addition to their use in cooking, both vegetables have been employed for their medicinal purposes by more cultures over more millennia than any other plant product or substance.

Garlic as well as onion is characterised by the rich content of thiosulfinates, sulfides, sulfoxides and other odoriferous sulfur compounds. The cysteine sulfoxides are responsible for giving the bulbs their distinctive flavour and production of the eye-irritating compounds that induce lacrimation. The thiosulfinates exhibit antimicrobial properties that help fight off bacteria, viruses and fungi. Though the sulfur compounds in onion are only about onequarter the level found in garlic, the former is rich in quercetin, a phytochemical which contributes to a healthy cardio vascular system; the more pungent the onion is, the higher is the level of quercetin. Quercetin has also been shown to reverse some age-related memory loss.

Onion is also loaded with chromium, a trace mineral that helps cells respond to insulin. As for garlic, clinical experiments have shown that its regular consumption helps improve blood circulation and decrease calcium deposits as well as deposits of arterial plaque in coronary arteries. Thanks to their potent antioxidant properties, onion and garlic–rich diets appear to reduce the risk of colon and esophagus cancers, and may aid in prevention of cancers of breast, skin and lungs. It is important to note here that garlic and onion are best eaten raw as cooking, especially for too long or at high temperatures, can affect their curative properties.

Packed with vitamins A, B and C, along with minerals such as potassium, selenium, iron, calcium and zinc, these strongly scented bulbs contain small amounts of prostaglandins A1 and E which help lower high blood pressure and control cholesterol level. Studies prove that ingesting four grams of garlic a day can help maintain normal blood pressure, whereas daily intake of one clove of fresh garlic for 16 weeks lowers cholesterol by up to 21 per cent.

Garlic also reduces the ability of blood platelets to form clots, thereby reducing the risk of heart attacks or stroke.Another of its most potent health benefits includes the ability to enhance the body’s immune cell activity. Moreover, those who eat a clove of garlic every day have a lower risk of stomach and bowel cancer. Two cloves, or more, a day will provide you a shield against flu or help you recover faster if you get the flu or the common cold.

In herbal medicine, garlic is traditionally considered to be not only a reliable remedy for hoarseness and coughs, but also an effective inflammatory to treat small injuries. Just wash the wound with a mixture of one part garlic juice and three parts of water and watch it heal. Use raw garlic juice on rashes and bug bites, it stops the itching immediately. For scratchy throat, suck a small slice of garlic for 10-15 minutes, the juice sliding down the throat will ease the pain. Cut raw garlic and rub the cut edge on tooth and gums two to three times a day to stop toothache.

Besides being an excellent worm expeller, garlic also has a soothing effect on the various forms of diarrhoea. Problems such as colitis, dysentery and many other intestinal problems can be successfully treated with fresh garlic and without affecting the beneficial organisms which aid digestion. To relieve the symptoms, infuse crush ed cloves of garlic in water or milk and sip slowly.

Onion, sometimes called ‘gar lic’s little brother’, also has a long list of medical virtues. It is a powerful antiseptic and a potent source of folic acid, calci um, phosphorus, magnesium, iron and dietary fibre. Its antiallergenic properties make it useful for treating allergy related diseases. Consumed in raw state, onion not only helps to in crease the HDL cholesterol in the blood, but also clears it of unhealthy fats. Its powerful anti-inflammatory and anti-bacterial properties can deliver relief for upset stomach and related gastro syndromes. Its increased consumption is believed to lessen the risk inherent in developing diabetes and ward off infectious bacteria.

Onions are a traditional remedy for tooth decay and oral infections: for a germ-free mouth, chew a piece of raw onion for two to three minutes. Mixture prepared from equal amounts of onion juice and honey taken several times during the day facilitates the melting of phlegm in a patient suffering from severe cough. It helps break down mucus and prevents its further formation. It is also one of the best preventive potions against the common cold.

Many types of onions are high in iron, with red ones having the highest concentrations. Iron helps to maintain the proper consistency and thickness of blood. Onion is also great for skin disorders: to improve the blood circulation in the skin and to banish warts, just rub fresh onion slices on the affected place. Roasted or raw onion tied to boils dries them up quickly while fresh onion juice is a proven instant remedy for nausea.

Unknown Health, Onion and garlic

Difference Between Sedative and Hypnotic Drugs

A sedative is a drug that produces a relaxing, calming effect. Sedatives are usually given during daytime hours,and although they may make the patient drowsy, they usually do not produce sleep. A hypnotic is a drug that induces sleep, that is, it allows the patient to fall a sleep and stay a sleep. Hypnotics also may be called soporifics. Hypnotics are given at night or hour of sleep (HS).
Sedatives and hypnotics may be divided into two classes:
barbiturates and miscellaneous sedatives and hypnotics. The barbiturates are divided into several
groups, depending on their duration of action:
• Ultrashort-acting (eg, thiamylal [Surital], thiopental [Pentothal]). The ultrashort-acting barbiturates
are used as anesthetics. Single doses have a duration of 20 minutes or less.
• Short-acting (eg, secobarbital [Seconal], pentobarbital [Nembutal]). The average duration of action
of the short-acting barbiturates is 3 to 4 hours.
• Intermediate-acting (eg, amobarbital [Amytal],aprobarbital [Alurate], butabarbital [Butisol]). The
average duration of action of the intermediate-acting barbiturates is 6 to 8 hours.
• Long-acting (eg, phenobarbital, mephobarbital[Mebaral]). The average duration of action of the
long-acting barbiturates is 10 to 16 hours

The miscellaneous sedatives and hypnotics consist of a group of nonrelated drugs and a second group called the benzodiazepines. Examples of the nonrelated group of drugs include ethchlorvynol (Placidyl), zaleplon (Sonata),and zolpidem (Ambien). The benzodiazepines are also called antianxiety drugs. Examples of the benzodiazepines include estazolam (ProSom), flurazepam (Dalmane), and quazepam (Doral).

Unknown Anti Sedative Drug, Clinical Pharmacology

About Skin Disease Psoriasis Causes and Treatment

Psoriasis is certainly a very chronic skin disease which time and again causes a lot of aching,
pain,throbbing, and inflammation to the patients. Generally there are more than enough
psoriasis causes out there
but the most common causes typically involve: stress, smoking, drugs, infection, sunburn,
hereditary factor,hormonal disturbances, environmental factors, vitamin’s deficiency, lack of minerals, deficiency of water, andchemicals. When it comes to psoriasis symptoms, they are more than enough
such as raised red spots overdifferent skin areas, aching, itching, soreness, irritation, and
mental exhaustion.
Psoriasis can be occurredin a plenty of forms and shapes such as Plaque Psoriasis, Nail Psoriasis,
Guttate Psoriasis,FlexuralPsoriasis, Pustular Psoriasis, and Psoriatic Arthritis.

Avoid drugs and chemicals as much as you can for the reason that they are the biggest causes of psoriasis.
Organic Aloe Vera is one of the best treatments for psoriasis. Another worthwhile treatment for psoriasis is
that of topical treatment. As a matter of fact, there are many topical treatments out there such as
Topical corticosteroids, Vitamin D Analogues, Anthralin, Topical Retinoids, Calcineurin Inhibitors,
Coal Tar, and Moisturizers. Another affordable psoriasis treatment is that of light therapy (Phototherapy).
It divides into many categories such as Sunlight, UVB Phototherapy, Narrowband UVB Therapy,
Excimer Laser, etc. Then there are some other psoriasis cures on hand out there cost effectively i.e.
Retinoids, Methotrexate, Hydroxyurea,Cyclosporine, and so on.

Unknown Skin care, Skin Disease

How To Get Ride Lower Back Pain Take Essential Tips and Tricks

Lower back pain occurs due to severe muscle strain or a back injury. Those who suffer from lower back pain often resort to shortcuts like popping pain killers or applying pain-relieving ointments. This, however, as said earlier, is a shortcut, which merely provides temporary relief and eventually turns into a habit. Take a break from those pain killers and ointments and practice these simple exercises to help relieve lower back pain.

Knee chest exercise
On a mat, lie flat on your back with your legs straight. Place your hands over your right knee and gradually pull it towards your chest. Maintain this posture for about 10 seconds. Then take off your hands from your knee and lower your leg back on the mat. Do the same with your right knee and repeat five times. You can gradually increase the number of repetitions and later practice this exercise using both your knees simultaneously.

Mid back stretch
Stand with your feet apart and hand on your hips. Gently twist to your left at the waist, without changing the position of your feet. Try to look over your shoulder and hold for five to 10 seconds. Now untwist. Repeat by twisting to your left. Do this about five times.

Hip Rolls
Stand with your feet apart with hands on your hips. Slowly move your hips in a clock-wise circular motion. Next, go in an anti-clock wise circular motion. Repeat it about five times.

Lunges
Stand with your right leg in from of your left leg. Bend your knees gradually, sinking into a lunge. Keep your back straight and your left knee directly above your left foot. Hold for five to 10 seconds. Vary with your left knee. Make five repetitions.

You don`t need to visit a gym or need a trainer to perform these simple exercises. You can do the same in the comfort of your own home in just about 15 minutes. Not only will they provide you lower back pain relief but also strengthen your back muscles.

Unknown Health, Lower Back Pain

What is Parkinson's disease?and What You Know?

Parkinson's disease is the most common form of Parkinsonism. It is a disorder of the brain. All types of Parkinsonism occur when nerve cells in a particular part of the brain die or lose the ability to function. These cells normally produce a chemical called Dopamine, a chemical messenger that helps relay signals to different parts of the brain. This process is important in producing smooth, coordinated movement throughout the body. When Dopamine-producing cells are lost, normal movement becomes impossible. In people with late-stage Parkinson's disease, 80% or more of these important cells are dead or impaired.

Causes of Parkinson's disease
Experts agree that low dopamine levels in the brain cause the symptoms of Parkinson's disease, but no one really knows why the nerve cells that produce dopamine get damaged and die. Some experts think that a change in a specific gene could explain why a person develops Parkinson's disease. Others think it could be something in the environment that causes the damage, such as pesticides or other chemicals.

Symptoms of Parkinson's disease

Mask-like facial expressions
Slow, shuffling gait
Pill-rolling movements of hands
Anxiety, depression, isolation
Stooping posture
Tremor at rest
Slow response to questions
Change in handwriting—gets progressively smaller over time
Bradykinesia (slow movement)
Excessive salivation
Excessive sweating
Rigidity
Trouble chewing or swallowing
Drooling

Treatment of Parkinson's disease
Medications. Some medications may help you manage your condition and symptoms. Your doctor may prescribe the drug levodopa, a natural chemical that your body converts into dopamine. Often, you'll take levodopa with a medication (carbidopa) that protects levodopa from premature conversion to dopamine in your bloodstream, before it reaches your brain.
Other medications may include drugs that imitate the effects of dopamine in your brain (dopamine agonists), drugs that inhibit an enzyme (monoamine oxidase B) that metabolizes dopamine in your brain (MAO B inhibitors), drugs that inhibit another enzyme (catechol-O-methyltransferase) that breaks down dopamine (COMT inhibitors), or a medication that affects another brain chemical system (amantadine). Medications may have side effects. Your doctor will work with you to determine which medications are most appropriate for you.
Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific area of your brain. The electrodes are connected to a generator that sends electrical pulses to your brain and may help control your Parkinson's disease symptoms. Surgery may involve risks, and your surgeon will work with you to determine if surgery is the most appropriate treatment for you.
Physical therapy. You may benefit from physical therapy and exercise. Physical activity may help improve your physical and mental well-being, balance, flexibility and strength.

sources
http://www.mayoclinic.org/parkinsons-disease/treatment.html
http://kidshealth.org/kid/grownup/conditions/parkinson.html#

Unknown Health, Parkinson's disease

Vitamin D Essential Of Our Life Overdose of Vitamin D

Vitamin D belongs to a group of fat-soluble vitamins. This means you need to transport the fats.
Vitamin D is essential for us to soak up calcium and keep bones and teeth healthy. It allows the intestinal
absorption of calcium and reduces the removal of it through urine. It regulates calcium and phosphorus
metabolism. Vitamin D foods appear to assist in the treatment of psoriasis and increase our resistance to
tuberculosis. Additionally , it protects against breast and color cancer.
vitamin D is a great supplement to take as proper supplementation prevents you from getting sick as often,
especially if you are prone to a lot of allergies. If you have adequate amounts of vitamin D in your diet, you
are less prone to cancer and other illnesses than you usually are.
Sources of Vitamin D
There are two sources of Vitamin D in humans. It is either obtained through ingestion of appropriate foods in the diet or photolysis of 7-dehydrocholesterol in the skin. Once vitamin D is absorbed, it gets bound to a specific globulin and reaches the blood to the liver.

Symptoms of overdose of vitamin D
Some symptoms of overdose of vitamin D are experiencing weakness in the muscles, nausea, vomiting, poor appetite, constipation, weakness, and weight loss Excessive Thirst, The overdose can also raise blood levels of calcium. It can give rise to mental confusion. High blood levels of calcium can cause abnormalities in heart rhythms. Cases have been reported of Calcinosis also. Calcinosis is the deposition of calcium and phosphate in the body’s soft tissues such as the kidney. They can be caused by vitamin D toxicity.

References:
Metabolic Typing® Advisors privately circulated document, “Nutrients As Per Systems,” 1987, 2000 Healthexcel, Inc.

Unknown Health, Vitamin D

Vitamin b6 Important Deficiency Several Benefits and Source of Food

Vitamin b6 is very important for our bodies. It helps our bodies to create anti bodies against any external diseases. Thus our natural immunity increases in the presence of vitamin b6. Vitamin b6 helps in the formation of red blood cells in our bodies. The functions of the brain are also supported by this vitamin. The proteinsin our body are broken down with the assistance of this vitamin.
There are several benefits of vitamin b6. Pyridoxine is also referred to as “mood vitamin”.This vitamin helps our brain in performing its functions. It also helps the body to produce energy by the process of metabolism. The nerve cells are also controlled by vitamin b6. The nerve cells can communicate between themselves because this form of vitamin is present. Protein synthesis in the body takes place with the help of vitamin b6.
The signs that indicate vitamin b6 deficiency

dermatitis (skin inflammation)
glossitis (a sore tongue)
depression
confusion
convulsions

Vitamin b6 deficit in the body also results in anemia in some patients

Some food items which are rich in vitamin b6

Cereals,Baked potato,Banana,Garbanzo beans,Chicken breast meat,Oatmeal,Pork loin,
Roastedbeef,Trout,Sunflower seeds,Spinach,Tomato juice Tuna,Wheat bran,Peanut butter,Walnut,Soybeans,Lima beans,garlic,cauliflower,mustard greens
Vitamin b6 is necessary for treating the following diseases
tunnel syndrome,asthma,endometriosis,premenstrual syndrome,edema,atherosclerosis, acne,
Attention deficit disorder,schizophrenia,depression.
lack of vitamin b6
The following conditions might develop if there is a lack in the consumption of vitamin b6:

Discomfort of the skin
Breathing problems
Fatigue
Fluctuations in appetite
Complications related to nerves.

sources
http://vitaminb6benefits.com/

Unknown Health, Vitamin b6

Friday 28 October 2011

How To Get Back Healthy Heart Take Some Essential Steps

A healthy heart is key to having a healthy life. Sedentary and stressful lifestyle is leading to more and more people having cardiovascular problems at an early age. Here are a few tips to keep your heart beating for long:

1) Check your blood pressure timely: It is important to keep your blood pressure low by eating a diet low in sodium, exercising and keeping your arteries functioning.

2) Eating less cholesterol, Trans and saturated fats.

3) Eating less meat: A diet low in saturated fat is one crucial factor in preventing heart disease, obesity, cancer and diabetes among others.

4) Exercising regularly: Exercising has so many benefits. It relieves stress, lowers your blood pressure, burns fat, strengthens your immune system and just leaves you feeling good for the rest of the day.

5) Staying at your healthy weight, or lose weight if you need to in order to be healthy.

6) Avoiding unnecessary stress as it raises your blood pressure.

7) Avoid smoking and cut down on your alcohol intake. A smoker is twice more likely to have a heart attack than a non-smoker and regular consumption of alcohol leads to increase in blood pressure, weight gain and can even damage heart muscles.

Unknown Healthy heart, Heart disease

Wednesday 26 October 2011

Take Some Steps To Looking Slim and Smart

Some women are lucky enough to reach 30 and look like they should still be at high school. For the rest of us, there’s the daily grind of applying endless lotions, dieting and hitting the gym to make sure our bodies stay younger than the number of candles on our next birthday cake.

Eat the rainbow
Eat your greens... and your reds, oranges, yellows and purples. Nutritionists know that the natural nutrients and chemicals which are responsible for giving fruit and vegetables their gorgeous bright colours protect us from numerous health disorders, including cancer, heart disease, arthritis and premature aging. The hundreds of different antioxidants help to mop up harmful free radicals before they damage cells and make us look old before our time, so always try to eat a wide variety of fruit and veg to reap the benefits.

Keep calm and carry on
If you're an excessive worrier, or if there is just too much stress in your life, then you could be at risk of making yourself ill and looking haggard before your time. Scientists say there is a direct link between emotional strain and premature aging; chronic stress appears to shrivel the tips of genes inside cells, shortening their life span and hastening the body's deterioration. Try to tackle the source of your anxiety head on, while meditation, exercise and yoga can also help you to relax.

Eat oily fish
Eating oily fish - such as fresh tuna, salmon and mackerel - can keep you disease-free and your skin from aging prematurely. Fish like these contain long-chain omega-3 fatty acids, which experts know can prevent heart disease, cancer and arthritis. Your two portions a week may also protect your eyesight in old age. Boffins from the University of California, San Francisco, found that these fatty acids stop DNA from unravelling, causing cell damage.

Sun factor
Unless you want to arrive at middle-age looking like a prune's handbag, then it's not enough just to religiously apply moisturiser every day. Your skin is at constant risk of sun damage, even in the mild British climate where the sun doesn't often feel hot. Ultra-violet rays penetrate deep into the skin and damage cells, causing the skin to peel away and replenish - though the permanent damage has already been done. Make sure you apply lotion that comes with added SPF (at least 15), especially to your face and neck.

Find love
Easier said than done, perhaps, but studies show that having sex regularly while in a happy, loving relationship, helps to keep us looking young. One piece of research, by neuro-psychologists at the Royal Edinburgh Hospital found that couples who have sex at least three times a week look more than 10 years younger than the average adult who makes love twice a week. They claim that this intense form of pleasure triggers the release of a growth hormone in women which slows the aging process.

Eat for your skin
When you get older, the collagen in your skin is produced more slowly, which means skin cells aren't replenished as quickly as they used to be. Research suggests that a diet that is rich in lycopene and beta-carotene may help to keep skin looking young and glowing. These nutrients mop up free radicals before they can damage - and age - cells. Sweet potatoes, carrots and green leafy vegetables are full of beta-carotene, while tomatoes and watermelons provide the body with a rich bounty of lycopene.

Do yoga
Ever seen a yoga instructor with a body you wouldn't die for? There's a reason for that; yoga is one of the best forms of exercise to keep you looking and feeling sprightly. For one thing, it's low impact, so your joints will thank you for hitting the mat rather than pounding the pavement. Yoga also provides elasticity to the spine and corrects bad posture, firms up the skin and strengthens and tones muscles, meaning you'll keep burning calories even when you're not working out. Finally, of course, it's extremely relaxing, so you'll reduce stress levels just by going to a class 2-3 times a week.

Switch to whole grains
Despite studies showing that eating whole grains can reduce the risk of heart disease and cancer by up to 30%, many Brits have no idea what they are and how they give their health such a significant boost. 'Whole grain' means all three parts of the grain have been used, including the outer-layer, which is full of fibre, and the nutrient-rich germ. Whole grains help stop the heart and artery walls from thickening and stiffening, meaning you're less likely to suffer from high blood pressure or heart disease. They also provide a steady supply of energy to cells, including the skin, keeping it looking good and controlling oil production. You should aim to eat around 2-3 servings of whole grain cereal, bread, pasta and other products every day to make the most of these benefits.

Get a good night's sleep
Think the term 'beauty sleep' is a myth? Think again. According to one study carried out in Sweden, people deprived of sleep for long periods appear less attractive and unhealthier than those who are well rested. Over time, this has a huge impact on how youthful you look. Sleep is one of the most rejuvenating treatments around. When you're in the land of nod your cells have a chance to repair and rebuild, whereas sleep deprivation limits this function. Lack of sleep also means you are more susceptible to stress, which can cause the capillaries in your skin to tighten, stopping nutrients from reaching the skin and leaving you looking worn-down and dull.

Get off your butt
We live increasingly sedentary lifestyles these days, but this is all the more reason to unchain yourself from your desk and start exercising regularly. As well as helping you to lose weight, tone up, boost your mood and strengthen bones, there is also a clear link between working out and the aging process. According to the National Institute on Aging, even walking for just 10 minutes a day can lower your risk of Alzheimer's disease by an incredible 40% - so your brain benefits too.

Unknown Slim and smart, weight lossing

Narcotic Analgesics Control Short Acting Long Acting Pain

Pain is a complex occurrence that is uniquely experienced by each individual. It has been defined as the emotional and sensory perceptions associated with real or Acute pain is a warning that something is not right in the body. Chronic pain is pain that persists beyond the expected time for healing. Analgesics are drugs that relieve pain. The narcotic analgesics are con-trolled substances used to treat moderate to severe pain. Nurses must be knowledgeable concerning pain assessment and management if the patient’s pain is to be adequately managed. Despite advances in technology and pharmacologic measures, evidence exists indicating that for many, pain is not managed adequately.Drugs that counteract the effects of the narcotic analgesics are the narcotic antagonists. These drugs compete with the narcotics at the receptor sites and are used to reverse the depressant effects of the narcotic analgesics.

NARCOTIC ANALGESICS

Opioid analgesics are the narcotic analgesics obtained from the opium plant. More than 20 different alkaloids are obtained from the unripe seed of the opium poppy plant. The analgesic properties of opium have been known for hundreds of years. The narcotics obtained from raw opium (also called the opiates, opioids, or opiate narcotics) include morphine, codeine, hydrochlorides of opium alkaloids, and camphorated tincture of opium. Morphine, when extracted from raw opium and treated chemically, yields the semisynthetic narcotics hydromorphone, oxymorphone, oxycodone, and heroin.Heroin is an illegal narcotic in the United States and is not used in medicine. Synthetic narcotics are those man-made analgesics with properties and actions simi-lar to the natural opioids. Examples of synthetic narcotic analgesics are methadone, levorphanol, remifen-tanil, and meperidine. Additional narcotics are listed in the Summary Drug Table: Narcotic Analgesics.

ACTIONS

Narcotic analgesics are classified as agonists, partial agonists, and mixed agonists-antagonists. The agonist binds to a receptor and causes a response. A partial agonist binds to a receptor, but the response is limited (ie, is not as great as with the agonist). Antagonists bind to a recep-tor and cause no response. An antagonist can reverse the effects of the agonist. This reversal is possible because the antagonist competes with the agonist for a receptor site.

An agonist-antagonist has properties of both the agonist and antagonist. These drugs have some agonist activity at the receptor sites and some antagonist activity at the receptor sites.
Classification of the narcotic analgesics is based on their activity at the opioid receptor sites. Although five
categories of opioid receptors have been identified, only three of these receptors affect the action of the narcotic analgesics:
• mu
• kappa
• delta
The narcotic agonists have activity at the mu and kappa receptors (and possi-bly the delta sites). Remifentanil is a very short-acting agonist with potent analgesic activity. It is a mu opioid agonist with rapid onset, peak effect, and short duration of action. The mixed agonist-antagonist drugs act on the mu receptors by competing with other substances at the mu receptor (antagonist activity) and are agonists at other receptors. Partial agonists have limited agonist activity at the mu receptor. The actions of the narcotic analgesics on the various organs and structures of the body (also called secondary pharmacological effects) are

USES

The major use of the narcotic analgesic is to relieve or manage moderate to severe acute and chronic pain. The ability of a narcotic analgesic to relieve pain depends on several factors, such as the drug, the dose, the route of administration, the type of pain, the patient, and the length of time the drug has been administered. Morphine is the most widely used opioid and an effective drug for moderately severe to severe pain. Morphine is considered the prototype or “model” narcotic. Morphine’s actions, uses, and ability to relieve pain are the standards to which other narcotic analgesics are often compared.Other narcotics, such as meperidine and levorphanol, are effective for the treatment of moderate to severe pain. For mild to moderate pain, the primary health care provider may order a narcotic such as codeine or pentazocine.
In addition to the relief or management of moderate to severe acute and chronic pain, the narcotic analgesics may be used for the following reasons:
• To lessen anxiety and sedate the patient before surgery. Patients who are relaxed and sedated when
anesthesia is given are easier to anesthetize (requiring a smaller dose of an induction anesthetic), as
well as easier to maintain under anesthesia
• Support of anesthesia (ie, as an adjunct during
anesthesia)
• Obstetrical analgesia
• Relief of anxiety in patients with dyspnea associated
with pulmonary edema
• Intrathecally or epidurally for pain relief for
extended periods without apparent loss of motor,
sensory, or sympathetic function
• Relief of pain associated with a myocardial infarc-
tion (morphine)
• Management of opiate dependence (levomethadyl)
• Detoxification of and temporary maintenance of
narcotic addiction (methadone)
• To induce conscious sedation before a diagnostic
or therapeutic procedure in the hospital setting
• Treatment of severe diarrhea and intestinal
cramping (camphorated tincture of opium)
• Relief of severe, persistent cough (codeine, although
the drug’s use has declined)

Use in Management of Opioid Dependence

Two opioids are used in the treatment and management of opiate dependence: levomethadyl and methadone.Levomethadyl is given in an opiate dependency clinic to maintain control over the delivery of the drug. Because of its potential for serious and life-threatening proarrhythmic effects, levomethadyl is reserved for use in the treatment of addicted patients who have no response to other treatments. Levomethadyl is not taken daily; the drug is administered three times a week (Monday/Wednesday/Thursday or uesday/Thursday/
Saturday). Daily use of the usual dose will cause serious overdose.
Methadone, a synthetic narcotic, may be used for the relief of pain, but it also is used in the detoxifi-cation and maintenance treatment of those addicted to narcotics. Detoxification involves withdrawing the patient from the narcotic while preventing withdrawal symptoms.Maintenance therapy is designed to reduce the
patient’s desire to return to the drug that caused addic-tion, as well as to prevent withdrawal symptoms. The dosages used vary with the patient, the length of time the individual has been addicted, and the average amount of drug used each day. Patients enrolled in an outpatient methadone program for detoxification or
maintenance therapy on methadone must continue to receive methadone when hospitalized.

ADVERSE REACTIONS

The adverse reactions differ according to whether the narcotic analgesic acts as an agonist or as an agonistantagonist.
Agonists
One of the major hazards of narcotic administration is respiratory depression, with a decrease in the respira-
tory rate and depth. The most common adverse reactions include light-headedness, dizziness, sedation, constipation, anorexia, nausea, vomiting, and sweating.
When these effects occur, the primary health care provider may lower the dose in an effort to eliminate or
decrease the intensity of the adverse reaction. Other adverse reactions that may be seen with the administration of an agonist narcotic analgesic include:
• Central nervous system—euphoria, weakness,headache, pinpoint pupils, insomnia, agitation,tremor, and impairment of mental and physical tasks
• Gastrointestinal—dry mouth and biliary tractspasms
• Cardiovascular—flushing of the face, peripheral circulatory collapse, tachycardia, bradycardia, and palpitations
• Genitourinary—spasms of the ureters and bladder sphincter, urinary retention or hesitancy
• Allergic—pruritus, rash, and urticaria
• Other—physical dependence, pain at injection site, and local tissue irritation

Agonist-Antagonists
Administration of a narcotic agonist-antagonist may result in symptoms of narcotic withdrawal in those addicted to narcotics. Other adverse reactions associated with the administration of a narcotic agonist antagonist include sedation, nausea, vomiting, sweating, headache,vertigo, dry mouth, euphoria, and dizziness.

CONTRAINDICATIONS

All narcotic analgesics are contraindicated in patients with known hypersensitivity to the drugs. These drugs are contraindicated in patients with acute bronchial asthma, emphysema, or upper airway obstruction and
in patients with head injury or increased intracranial pressure. The drugs are also contraindicated in patients with convulsive disorders, severe renal or hepatic dysfunction, acute ulcerative colitis, and increased intracranial pressure. The narcotic anal-gesics are Pregnancy Category C drugs (oxycodone,Category B) and are not recommended for use during pregnancy or labor (may prolong labor or cause respi-ration depression of the neonate). The use of narcotic analgesics is recommended during pregnancy only if the benefit to the mother outweighs the potential harm to the fetus.

PRECAUTIONS

These drugs are used cautiously in the elderly and in patients with undiagnosed abdominal pain, liver dis-ease, history of addiction to the opioids, hypoxia,supraventricular tachycardia, prostatic hypertrophy, and renal or hepatic impairment. The obese must be monitored closely for respiratory depression while tak-ing the narcotic analgesics. The drug is used cautiously during lactation (wait at least 4 to 6 hours after taking the drug to breastfeed the infant). The narcotics are used cautiously in patients undergoing biliary surgery because the drug may cause spasm of the sphincter of Oddi.

INTERACTIONS
The narcotic analgesics potentiate the central nervous system (CNS) depressant properties of other CNS
depressants, such as alcohol, antihistamines, antide-pressants, sedatives, phenothiazines, and monoamine oxidase inhibitors. Use of the narcotic analgesics within 14 days of the MAO inhibitors may potentiate the effect of either drug. Patients taking the agonist-antagonist narcotic analgesics may experience withdrawal symptoms if the patient has been abusing or using narcotics. The agonist-antagonists drugs can cause opioid with drawal symptoms in those who are physically dependent on the opioids. There is an increased risk of respiratory depression, hypotension, and sedation when narcotic analgesics are administered too soon after barbiturate general anesthesia.

Unknown Narcotic Analgesics

Monday 24 October 2011

What is Narcotic Analgesics Mechanisms of Action Side Effects

Unknown Clinical Pharmacology, Narcotic Analgesics

An Antiarrhythmic drugs To Treat Cardiac Arrhythmias

The antiarrhythmic drugs are primarily used to treat cardiac arrhythmias. A cardiac arrhythmia is a distur-bance or irregularity in the heart rate, rhythm, or both,which requires administration of one of the antiarrhythmic drugs.
An arrhythmia may occur as a result of heart disease or from a disorder that affects cardiovascular function.Conditions such as emotional stress, hypoxia, and electrolyte imbalance also may trigger an arrhythmia. An electrocardiogram (ECG) provides a record of the elec-trical activity of the heart.Careful interpretation of the ECG along with a thorough physical assessment is nec-essary to determine the cause and type of arrhythmia.The goal of antiarrhythmic drug therapy is to restore normal cardiac function and to prevent life-threatening arrhythmias.

ACTIONS
The cardiac muscle (myocardium) has attributes of both nerve and muscle and therefore has the properties of both. Some cardiac arrhythmias are caused by the gen-eration of an abnormal number of electrical impulses (stimuli). These abnormal impulses may come from the sinoatrial node or may be generated in other areas of the myocardium. The antiarrhythmic drugs are classified according to their effects on the action potential of car-diac cells and their
presumed mechanism of action. As understanding of the pathophysiology of cardiac arrhyth-mias and the drugs used to treat these arrhythmias has increased, a method of classification has been developed that includes four basic classifications and several sub-classes. Drugs in each class have certain similarities, yet each drug has subtle differences that make it unique.

Class I Antiarrhythmic Drugs
Class I antiarrhythmic drugs, such as moricizine, have a membrane-stabilizing or anesthetic effect on the cells of the myocardium, making them valuable in treating car- diac arrhythmias. Class I antiarrhythmic drugs contain the largest number of drugs of the four classifications.Because the actions differ slightly, they are subdivided into classes I-A, I-B, and I-C.

Class I-A
The drugs disopyramide, procainamide, and quinidine are examples of class I-A drugs. Quinidine depresses myocardial excitability or the ability of the myocardium to respond to an electrical stimulus. By depressing the myocardium and its ability to respond to some, but not all, electrical stimuli, the pulse rate decreases and the arrhythmia is corrected. Quinidine also prolongs or lengthens the refractory (resting) period and decreases the height and rate of the action potential of the impulses traveling through the myocardium.All cells are electrically polarized, with the inside of the cell more negatively charged than the outside. The difference in electrical charge is called the resting mem-brane potential. Nerve and muscle cells are excitable and can change the resting membrane potential in response to electrochemical stimuli. The action poten-tial is an electrical impulse that passes from cell to cell in the myocardium, stimulating the fibers to shorten, causing muscular contraction (systole). After the action potential passes, the fibers relax and return to their resting length (diastole). An action potential generated in one part of the myocardium passes almost simultaneously through all of the fibers, causing rapid contraction. Only one impulse can pass along a nerve fiber at any given time. After the passage of an impulse, there is a brief pause, or interval, before the next impulse can pass along the nerve fiber. This pause is called the refractory period, which is the period between the transmission of nerve impulses along a nerve fiber. By lengthening the refractory period, the number of impulses traveling along a nerve fiber within a given time is decreased. For example, a patient has a pulse rate of 120 bpm. By lengthening the refractory period between each impulse and decreasing the height and rate of the rise of action potential, fewer impulses would be generated each minute, and the pulse rate would decrease. Procainamide is thought to act by decreasing the rate of diastolic depolarization in the ventricles, decreasing the rate and height of the action potential and increasing the fibrillation threshold.
Disopyramide (Norpace) decreases the rate of depolar-ization of myocardial fibers during the diastolic phase of the cardiac cycle, prolongs the refractory period, and decreases the rate of rise of the action potential.
Nerve cells have positive ions on the outside and neg-ative ions on the inside of the cell membrane when they are at rest. This is called polarization.
When a stimulus passes along the nerve, the positive ions move from outside the cell into the cell, and the negative ions move from inside the cell to outside the cell. This movement of ions is called depolarization.Unless positive ions move into and negative ions move out of a nerve cell, a stimulus (or impulse) cannot pass along the nerve fiber. Once the stimulus has passed along the nerve fiber, the positive and negative ions move back to their original place, that is, the positive ions on the outside and the negative ions on the inside of the nerve cell. This movement back to the original place is called repolarization. By decreasing the rate (or speed) of depolarization, the stimulus must literally wait for this process before it can pass along the nerve fiber. Thus, decreasing the rate of depolarization decreases the number of impulses that can pass along a nerve fiber during a specific time period.

Class I-B Drugs
Lidocaine (Xylocaine), the representative class I-B drug, raises the threshold of the ventricular myocardium. Threshold is a term applied to any stimulus of the lowest intensity that will give rise to a response in a nerve fiber. A stimulus must be of a spe-cific intensity (strength, amplitude) to pass along a given nerve fiber To further illustrate the threshold phenomenon using plain figures instead of precise electrical values,a certain nerve fiber has a threshold of 10. If a stimu-lus rated as 9 reaches the fiber, it will not pass along the fiber because its intensity is lower than the fiber’s threshold of 10. If another stimulus reaches the fiber and is rated 14, it will pass along the fiber because its intensity is greater than the fiber’s threshold of 10. If the threshold of a fiber is raised from 10 to 15, only the stimuli greater than 15 can pass along the nerve fiber.
Some cardiac arrhythmias result from many stimuli present in the myocardium. Some of these are weak or of low intensity but are still able to excite myocardial tissue. Lidocaine, by raising the threshold of myocardial fibers, reduces the number of stimuli that will pass along these fibers and therefore decreases the pulse rate and corrects the arrhythmia. Mexiletine (Mexitil) and tocainide (Tonocard) are also antiarrhythmic drugs with actions similar to those of lidocaine.

Class I-C Drugs
Flecainide (Tambocor) and propafenone (Rythmol) are examples of class I-C drugs. These drugs have a direct stabilizing action on the myocardium, decreasing the height and rate of rise of cardiac action potentials, thus slowing conduction in all parts of the heart.

Class II Antiarrhythmic Drugs
Class II antiarrhythmic drugs include beta ()-adrener-gic blocking drugs, such as acebutolol (Sectral), esmolol (Brevibloc), and propranolol (Inderal). These drugs also decrease myocardial response to epinephrine and nor-epinephrine (adrenergic neurohormones) because of their ability to block stimulation of receptors of the
heart. Adrenergic neurohormones stimu- late the receptors of the myocardium and therefore increase the heart rate. Blocking the effect of these neurohormones decreases the heart rate. This is called a blockade effect.

Class III Antiarrhythmic Drugs
Bretylium (Bretylol) prolongs repolarization, prolongs refractory period, and increases the ventricular fibrilla-tion threshold. Amiodarone (Cordarone) appears to act directly on the cardiac cell membrane, prolonging the refractory period and repolarization and increasing the ventricular fibrillation threshold. Newer class III antiar-rhythmic drugs include ibutilide (Corvert) and dofetilide (Tikosyn). These two drugs are used to con-vert atrial fibrillation or flutter to a normal sinus rhythm. Ibutilide acts by prolonging the action potential, producing a mild slowing of the sinus rate and atri-oventricular conduction. Dofetilide selectively blocks potassium channels, widens the QRS complex, and prolongs the action potential. The drug has no effect on cal-cium channels or cardiac contraction.

Class IV Antiarrhythmic Drugs
Class IV antiarrhythmic drugs include verapamil (Calan) and the other calcium channel blockers.Calcium channel blockers produce their antiarrhythmic action by inhibiting the movement of calcium through channels across the myocardial cell membranes and vas-cular smooth muscle. Contraction of cardiac and vascular smooth muscle depends on the movement of calcium ions into these cells through specific ion channels. By reducing the calcium flow, conduction through the sinoatrial (SA) and atrioventricular (AV) nodes is slowed and the refractory period is prolonged, resulting in suppression of the arrhythmia. The calcium channel blockers are also called slow channel blockers or cal-cium antagonists. Two calcium channel blockers that have been approved as antiarrhythmics are verapamil and diltiazem.

USES
The uses of the antiarrhythmic drugs are given in Antiarrhythmic Drugs. In general these drugs are used to prevent and treat cardiac arrhythmias, such as premature ventricular contrac-tions (PVCs), ventricular tachycardia (VT), premature atrial contractions (PACs), paroxysmal atrial tachy-cardia (PAT), atrial fibrillation, and atrial flutter.Some of the antiarrhythmic drugs are used for other conditions. For example, propranolol, in addition to its use as an antiarrhythmic, may also be used for patients with myocardial infarction. This drug has reduced the risk of death and repeated myocardial infarctions in those surviving the acute phase of a myocardial infarction. Additional uses include control of tachycardia in those with pheochromocytoma (a tumor of the adrenal gland that secretes excessive amounts of norepinephrine), migraine headaches,angina pectoris caused by atherosclerosis, and hyper-trophic subaortic stenosis.

ADVERSE REACTIONS
General adverse reactions common to most antiarrhyth-mic drugs include light-headedness, weakness, hypoten-sion, bradycardia, and drowsiness. Adverse reactions associated with the administration of specific antiar-rhythmic drugs are given inAntiarrhythmic Drugs. All antiarrhythmic drugs may cause new arrhythmias or worsen existing arrhythmias,even though they are administered to resolve an existing arrhythmia. This phenomenon is called the proar-rhythmic effect. This effect ranges from an increase in frequency of premature ventricular contractions (PVCs), to the development of more severe ventricular tachycardia, to ventricular fibrillation, and may lead to death. Proarrhythmic effects may occur at any time but occur more often when excessive dosages are given,when the preexisting arrhythmia is life-threatening, or if the drug is given IV.

CONTRAINDICATIONS
The antiarrhythmic drugs are reserved for emergency situations and are contraindicated in patients with known hypersensitivity to the antiarrhythmic drugs and during pregnancy and lactation. Most antiar-rhythmic drugs are Pregnancy Category B or C drugs,indicating that safe use of these drugs during pregnancy, lactation, or in children has not been estab-lished. The antiarrhythmic drug amiodarone is a Pregnancy Category D drug, indicating that fetal harm can occur when the agent is administered to a preg-nant woman. It is used only if the potential benefits outweigh the potential hazards to the fetus.
Antiarrhythmic drugs are contraindicated in patients with second- or third-degree AV block (if the patient has no artificial pacemaker), severe congestive heart failure (CHF), aortic stenosis, hypotension, and car- diogenic shock. Quinidine and procainamide are con-traindicated in patients with myasthenia gravis

PRECAUTIONS
All antiarrhythmic drugs are used cautiously in patients with renal or hepatic disease. When renal or hepatic dysfunction is present, a dosage reduction may be necessary. All patients should be observed for renal and hepatic dysfunction. Quinidine and procainamide are used cautiously in patients with CHF. Disopyramide is used cautiously in patients with CHF, myasthenia gravis, or glaucoma, and in men with prostate enlarge-ment. Bretylium is used cautiously in patients with digitalis toxicity because the initial release of norepi-nephrine with digitalis toxicity may exacerbate arrhyth-mias and symptoms of toxicity. Verapamil is used cautiously in patients with a history of serious ventric-ular arrhythmias or CHF. Electrolyte disturbances such as hypokalemia, hyperkalemia, or hypomagnesemia may alter the effects of the antiarrhythmic drugs. Electrolytes are monitored frequently and imbalances corrected as soon as possible.

INTERACTIONS
When two antiarrhythmic drugs are administered con-currently the patient may experience additive effects and is at increased risk for drug toxicity. When quinidine and procainamide are administered with digitalis,the risk of digitalis toxicity is increased. Pharmacologic effects of procainamide may be increased when pro-cainamide is administered with quinidine. When quini-dine is administered with the barbiturates or cimetidine,quinidine serum levels may be increased. When quinidine is administered with verapamil, there is an increased risk of hypotensive effects. When quinidine is administered with disopyramide, there is an increased risk of increased disopyramide blood levels and/or decreased serum quinidine levels. Propranolol may increase procainamide plasma levels. Additive cholinergic effects may occur when procainamide is administered with other drugs with anticholinergic effects. There is the potential of additive cardiodepressant effects when procainamide is adminis-tered with lidocaine. When a beta blocker, such as Inderal, is administered with lidocaine, there is an increased risk of lidocaine toxicity.Propranolol may alter the effectiveness of insulin or oral hypoglycemic drugs. Dosage adjustments may be necessary.
Dofetilide is not administered with cimetidine because dofetilide plasma levels may be increased by as much as 50%. When treatment for gastric disor-ders is necessary, patients receiving dofetilide should take omeprazole, ranitidine, or antacids as an alterna-tive to cimetidine.Verapamil may cause an additive hypotensive effect when administered with other antihypertensives, alco-hol, or the nitrates. Verapamil increases plasma digoxin levels and may cause bradycardia or CHF.

Unknown An Antiarrhythmic drugs

How Do Work Anti Tuberculosis Medication Uses and Contraindication

Tuberculosis is a major health problem throughout the world, infecting more than 8 million individuals each year. It is the world’s leading cause of death from infectious disease. Individuals living in crowded conditions, those with compromised immune systems, and individuals with debilitative conditions are especially susceptible to tuberculosis. Tuberculosis is an infectious disease caused by The Mycobacterium tuberculosis bacillus. The pathogen is also referred to as the tubercle bacillus. The disease is transmitted from one person to another by droplets dis-persed in the air when an infected person coughs or sneezes. These droplet nuclei are released into the air and inhaled by noninfected persons. Although tubercu-losis primarily affects the lungs, other organs may also be affected. For example, if the immune system is poor,the infection can spread from the lungs to other organs of the body. Extrapulmonary (outside of the lungs) tuberculosis is the term used to distinguish tuberculosis affecting the lungs from infection with the M. tuberculo-sis bacillus in other organs of the body. Organs that can be affected include the liver,kidneys, spleen, and uterus. People with acquired immunodeficiency syn-drome (AIDS) are at risk for tuberculosis because of their compromised immune systems.
Tuberculosis responds well to long-term treatment with a combina-tion of three or more antitubercular drugs.Antitubercular drugs are used to treat active cases of tuberculosis and as a prophylactic to prevent the spread of tuberculosis. The drugs used to treat tuberculosis do not “cure” the disease, but they render the patient nonin- fectious to others.
Antitubercular drugs are classified as primary and second-line drugs. Primary (first-line) drugs provide the foundation for treatment. Second-line or secondary drugs are less effective and more toxic than primary drugs.
These drugs are used in various combinations to treat tuberculosis. Sensitivity testing may be done to determine the most effective combination treatment,especially in areas of the country showing resistance.Second-line drugs are used to treat extrapulmonary tuberculosis or drug-resistant organisms. The primary antitubercular drugs are discussed in this chapter. Both primary and second-line antitubercular drugs fluoroquinolones such as ciprofloxacin, ofloxacin, levofloxacin, and sparfloxacin have proven effective against tuberculosis and are considered second line drugs.

ACTIONS
Most antitubercular drugs are bacteriostatic (slow or retard the growth of bacteria) against the M. tuberculosis bacillus. These drugs usually act to inhibit bacterial cell wall synthesis, which slows the multiplication rate of the bacteria. Only isoniazid is bactericidal, with rifampin and streptomycin having some bactericidal activity.
USES
Antitubercular drugs are used in combination with other antitubercular drugs to treat active tuberculosis.Isoniazid (INH) is the only antitubercular drug used alone. While isoniazid is used in combination with other drugs for the treatment of primary tuberculosis, a primary use is in preventive therapy (prophylaxis)
against tuberculosis. For example, when a diagnosis of tuberculosis is present, family members of the infected individual must be given prophylactic treatment with isoniazid for 6 months to 1 year.

RESISTANCE TO THE
ANTITUBERCULAR DRUGS
Of increasing concern is the development of mutant strains of tuberculosis that are resistant to many of the antitubercular drugs currently in use. Bacterial resistance develops, sometimes rapidly, with the use of anti-tubercular drugs. Treatment is individualized and based on laboratory studies identifying the drugs to
which the organism is susceptible. To slow the devel-opment of bacterial resistance, the Centers for Disease Control (CDC) recommends the use of three or more drugs with initial therapy, as well as in retreatment.Using a combination of drugs slows the development of bacterial resistance.Tuberculosis caused by drug-resistant organisms should be considered in patients who have no response to therapy and in patients who have been treated in the past.

STANDARD TREATMENT
Standard treatment for tuberculosis is divided into two phases: the initial phase followed by a continuing phase.During the initial phase, drugs are used to kill the rapidly multiplying M. tuberculosis and to prevent drug resist-ance. The initial phase lasts approximately 2 months and the continuing phase approximately 4 months, with the total treatment regimen lasting for 6 to 9 months,
depending on the patient’s response to therapy.The initial phase must contain three or more of the following drugs: isoniazid, rifampin, and pyrazin-amide, along with either ethambutol or streptomycin.The CDC recommends treatment to begin as soon as possible after the diagnosis of tuberculosis. The treatment recommendation regimen is for the administra-tion of rifampin, isoniazid, and pyrazinamide for a minimum of 2 months (8 weeks), followed by rifampin and isoniazid for 4 months (16 weeks) in areas with a low incidence of tuberculosis. In areas of high incidence of tuberculosis, the CDC recommends the addi-tion of streptomycin or ethambutol for the first 2 months.

RETREATMENT
At times treatment fails due to noncompliance with the drug regimen or to inadequate initial drug treatment.When treatment fails, retreatment is necessary.
Retreatment generally includes the use of four or more antitubercular drugs. Retreatment drug regimens most often consist of the secondary drugs ethionamide,aminosalicylic acid, cycloserine, and capreomycin.Ofloxacin and ciprofloxacin may also be used in retreat-ment. At times during retreatment, as many as seven or more drugs may be used, with the ineffective drugs dis-continued when susceptibility test results are available.

ETHAMBUTOL

ADVERSE REACTIONS
Optic neuritis (a decrease in visual acuity and changes in color perception), which appears to be related to the dose given and the duration of treatment, has occurred in some patients receiving ethambutol. Usually, this adverse reaction disappears when the drug is discontinued. Other adverse reactions are dermatitis, pruritus, anaphylac-toid reactions (unusual or exaggerated allergic reactions), joint pain, anorexia, nausea, and vomiting.

CONTRAINDICATIONS, PRECAUTIONS
AND INTERACTIONS
Ethambutol is contraindicated in patients with a history of hypersensitivity to the drug. Ethambutol is not rec-ommended for children younger than 13 years. The drug is used with caution during lactation, in patients with hepatic and renal impairment, and during preg-nancy (Category B). Because of the danger of optic neuritis, the drug is used cautiously in patients with dia-betic retinopathy or cataracts.

ISONIAZID
ADVERSE REACTIONS
The incidence of adverse reactions appears to be higher when larger doses of isoniazid are prescribed. Adverse reactions include hypersensitivity reactions, hemato-logic changes, jaundice, fever, skin eruptions, nausea,vomiting, and epigastric distress. Severe, and some-times fatal, hepatitis has been associated with isoniazid therapy and may appear after many months of treat-ment. Peripheral neuropathy (numbness and tin-gling of the extremities) is the most common symptom of toxicity.

CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
Isoniazid is contraindicated in patients with a history of hypersensitivity to the drug. The drug is used with caution during lactation, in patients with hepatic and renal impairment, and during pregnancy (Category C). Daily consumption of alcohol when taking isoni-azid may result in a higher incidence of drug-related
hepatitis. Aluminum salts may reduce the oral absorption of isoniazid. The action of the anticoagu-lants may be enhanced when taken with isoniazid.There is a possibility of increased serum levels of phenytoin with concurrent use of isoniazid. When isoniazid is taken with foods containing tyramine,such as aged cheese and meats, bananas, yeast prod-ucts, and alcohol, an exaggerated sympathetic-type response can occur (eg, hypertension, increased heart rate, palpitations).

PYRAZINAMIDE
ADVERSE REACTIONS
Hepatotoxicity is the principal adverse reaction seen with pyrazinamide use. Symptoms of hepatotoxicity may range from none (except for slightly abnormal hepatic function tests) to a more severe reaction such as jaundice. Nausea, vomiting, diarrhea, myalgia, and rashes also may be seen.

CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
Pyrazinamide is contraindicated in patients with a his-tory of hypersensitivity to the drug. The drug is also contraindicated in patients with acute gout (a metabolic disorder resulting in increased levels of uric acid)and in patients with severe hepatic damage. The drug is used with caution during lactation, in patients with hepatic and renal impairment, and during pregnancy (Category C). Pyrazinamide is used cautiously in patients infected with human immunodeficiency virus,who may require longer treatment, and in patients with diabetes mellitus, in whom management is more diffi-cult. Pyrazinamide decreases the effects of allopurinol,colchicines, and probenecid.

RIFAMPIN
ADVERSE REACTIONS
Nausea, vomiting, epigastric distress, heartburn,fatigue, dizziness, rash, hematologic changes, and renal insufficiency may be seen with administration of rifampin. Rifampin may also cause a reddish-orange dis-coloration of body fluids, including urine, tears, saliva,sweat, and sputum.

CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
Rifampin is contraindicated in patients with a history of hypersensitivity to the drug. The drug is used with cau-tion during lactation, in patients with hepatic and renal impairment, and during pregnancy. Serum concentra-tions of digoxin may be decreased by rifampin. Isoniazid and rifampin administered concurrently may result in a higher risk of hepatotoxicity than when either drug is used alone. The use of rifampin with the oral anticoagu-lants or oral hypoglycemics may decrease the effects of the anticoagulant or hypoglycemic drug. There is a decrease in the effect of the oral contraceptives, chloram-phenicol, phenytoin, and verapamil when these agents are administered concurrently with rifampin.

STREPTOMYCIN
ADVERSE REACTIONS
Nephrotoxicity (damage to the kidneys), ototoxicity (damage to the organs of hearing by a toxic substance),numbness, tingling, tinnitus (ringing in the ears), nau-sea, vomiting, vertigo (dizziness), and circumoral (around the mouth) paresthesia may be noted with the administration of streptomycin. Soreness at the injection site may also be noted, especially when the drug is given for a long time.

CONTRAINDICATIONS, PRECAUTIONS,
AND INTERACTIONS
Streptomycin is contraindicated in patients with a his- tory of hypersensitivity to the drug or any other aminoglycoside. Streptomycin is a Pregnancy Category D drug and can cause fetal harm when administered to a preg-nant woman. This drug is used cautiously in patients with preexisting hearing difficulty or tinnitus and in patients with renal insufficiency. The ototoxic effects of streptomycin are potentiated when administered with ethacrynic acid, furosemide, and mannitol.

Unknown Anti Tuberculosis Medication

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