Medical Prescriptions Ebook
Commencement of such skills training starts early, as doctors involve children more in the consultation. In an interesting study of 302 consecutive outpatient pediatric encounters, children's contributions were limited to 4 , and pediatricians directed only one in every four statements to the child (40). Although pediatricians asked children a lot of medical questions (26 ), only a small amount of the medical information (13 ) was directed at the children (40). Other key skills young people need include self-medication and other forms of self-management, to know how to contact health care providers directly, get prescriptions and so on these are integral components of transitional care (41). They are further discussed in Chapter 16. It remains important to acknowledge the differences between self-management for adolescents with chronic illness from that of adults (42) and to involve young people directly in service development in this area.
In general, because of multiple and chronic diseases, older patients often take multiple prescription and over-the-counter drugs. Persons over sixty-five may take seven or more prescription drugs in addition to some over-the-counter drugs (Stewart & Cooper, 1994). However, such multiple-drug therapy predisposes the elderly to an increased risk of unintended, adverse drug reactions (ADRs). The overall incidence of ADRs in this age group is two to three times that found in young adults. Although the results of studies vary, about 20 percent of all adverse drug reactions occur in the elderly (Korrapati, Loi, & Vestal, 1992) they may result from drug overuse, from drug misuse, from slowed drug metabolism, or from slow elimination of the drug in the urine. These bad side-effects may be caused or increased by age-related chronic diseases, by intake of alcohol, and or by incompatibilities between the foods and the medicines which the elderly person takes. Furthermore, ADRs are more severe...
Stafford et al. (29) reported data that reflected prescribing patterns of office-based U.S. physicians. This information was obtained from the National Disease and Therapeutic Index, which tracked trends from 1978 to 2002 in the frequency of asthma visits and patterns of asthma prescriptions. Although annual visits for asthma in the United States increased gradually from 1978 to 1990, the number of physician encounters for asthma had stabilized since 1990. At the same time, use of controller medication increased eight-fold between 1978 and 2002. Utilization of ICSs represented the largest increase in controller medications. An increase was also noted in the ratio of controller-to-reliever medication prescribed. Thus, these data indicate that patterns of asthma pharmacotherapy had changed over 25 years and are perhaps responsible for stabilization in numbers of patient visits since 1990. These prescribing patterns were likely influenced by dissemination of evidence-based guidelines to...
Boulet et al. examined a large population of asthma patients who were suboptimally controlled according to Canadian asthma consensus guidelines (38). In separate surveys of patients with uncontrolled asthma and their physicians, 66 of patients and 43 of physicians rated control of asthma symptoms as adequate to very good. These findings indicate that physicians are still not utilizing diagnostic guidelines to assess asthma severity and highlight the need to more effectively disseminate this information to both physicians and their patients. A survey of 445 asthmatic patients in New Zealand used the GINA guidelines as a gold standard for defining asthma control and, on this basis, revealed that 93 of adults and 90 of children were suboptimally controlled (39). Another large survey of parents of children with asthma reported that despite suboptimal control defined by guidelines in 49 of children and under treatment for the level of asthma severity, 89 of parents were satisfied with...
Small numbers (approx. 400-500) of mainly ''therapeutic addicts'' and addicted physicians receive opiate prescriptions as treatment for addiction. Guidelines for Good Clinical Practice in the Treatment of Drug Misuse are published. This is the first central guidance to physicians since the inception of the system, which indicates the flexibility of practice that physicians had been accorded. The ACMD publishes two reports on AIDS and Drug Misuse. This major policy review is prompted by the epidemic in HIV infection in injecting drug takers. The reports recommend greater emphasis on attracting and retaining in treatment drug takers unable or unwilling to change their behavior. This results in less restrictive opiate prescribing practices, the introduction of low threshold and user friendly services, and the further expansion of injecting-equipment exchange schemes through the late 1980s and early 1990s. The ACMD's third report on AIDS and drug misuse is published. The constituency of...
Adherence in the context of orthopedic aids and adaptations is also under-researched. Studies of adherence with prescriptions for ergonomic measures deal only with the use of wrist splints. Parent-reported nonadherence with splint wearing was 58 in a study of Feldman et al. (28). Similarly, Kyngas (1) found that less than one-fifth (18 ) showed good adherence with wearing splints, and over half (53 ) had poor adherence. A study of Rapoff et al. (32) found that 43 of 41 children and adolescents that were prescribed splints had negative reactions to wearing them and cited perceived lack of efficacy and embarrassment among peers as the main
Psychiatrists, who hold medical degrees such as MD, are treatment providers who can prescribe medications, much like your primary care physician. However, they also have specialized training in diagnosing and treating mental illness. Since most people with bipolar disorder decide to take medication to help treat their symptoms and extend periods of wellness, it's likely that you'll have a psychiatrist on your treatment team. Typically, you'll see your psychiatrist about once a month or less for medication checkups, or sooner if you have a medication emergency. Alternatively, you may choose to receive medication advice and prescriptions from your primary care physician. Although this is often a more convenient and affordable way to get medications, these doctors don't have the specialized training in mental illness that psychiatrists receive as part of their medical training.
The therapeutic potential of gene silencing agents is being intensively explored in cancer and other human diseases, due its ability to silence any gene whose deregulation is causing disease. We are probably facing the emergence of a new class of pharmaceutical drugs that could be part of the solution for diseases with limited treatment options 292 .
Several other classes of drugs act as depressants on the central nervous system. The profile of impairment with barbiturate intoxication largely resembles the acute effects of alcohol. Because of the relatively high abuse potential and severe withdrawal associated with these drugs, the Benzodiazepines have largely displaced Barbiturates in prescriptions for SEDATIVE-HYPNOTIC drugs. Currently the most prescribed class of PSYCHOACTIVE drugs in Western industrialized countries, they are typically used for muscle relaxation, sedation, and reduction of ANXIETY. It has become clear that benzodiazepines (e.g., Valium)
To begin with, the RDAs take no account of individual circumstances. The fact is, nutritional needs vary enormously. Requirements for nutrients can vary according to genetic make-up, sex, age, levels of stress, activity levels, alcohol consumption, pollution, smoking, the use of prescription medications, pregnancy and menopause. The RDAs make no provision for the special requirements individuals may have for nutrients.
Is there any evidence that people live longer or are any healthier taking handfuls of supplements every day
Numerous scientific studies demonstrate that nutrients can be effective in treating a wide range of conditions. It is important to remember that while we know people do not get sick because of lack of a prescription medication, nutrient deficiencies are quite often an important factor in disease.
IMPAIRED PHYSICIANS AND MEDICAL WORKERS Concern about impairment from alcohol and drugs in health-care professionals in the United States and in other countries has waxed and waned during the twentieth century. Until the 1960s, ALCOHOL, the OPIATES, and other PRESCRIPTION Drugs were the primary concerns. More recently, the concern was extended to MARIJUANA and Cocaine.
In hospitals, drug use by health-care professionals is often uncovered during inventory audits of medications, and the concealment efforts of impaired health-care professionals are often reflected in their treatment of or attitude toward patients. Some physicians who abuse prescription medications routinely overprescribe opiates or other drugs to patients in an effort to hide their self-prescription others may prescribe unusually conservatively to avoid drawing attention to themselves.
Addiction is a common and harmful effect of stimulant abuse. Addiction is a step beyond dependence. When a person is addicted to a drug, his or her dependence leads to reckless behaviors. These behaviors help the addict support his or her drug habit and get more drugs. Many addicts spend all of their money and lose their jobs. Some become homeless. Addicts may resort to stealing money or drugs. Some addicts may begin selling or manufacturing drugs. Addicts forge prescriptions, steal identities, write bad checks, and lie to their friends and families. Many addicts wind up in jail, or dead.
The surveys have all been conducted using similar methods. Civilian researchers first randomly selected a sample of about sixty military installations to represent the armed forces throughout the world. At these designated installations, they randomly selected men and women of all ranks to represent all active-duty personnel. Civilian research teams administered printed questionnaires anonymously to selected personnel in classroom settings on military bases. The few personnel (about 10 ) who were unable to attend the group sessions (e.g., were on leave, sick, or temporarily away from the base) were mailed questionnaires and asked to complete and return them. Participants answered questions about their use of illegal drugs (e.g., marijuana, cocaine, heroin), the misuse of prescription drugs (e.g., stimulants, tranquilizers), about the frequency and amount of alcohol use, and problems resulting from drug or alcohol use. These data collection procedures yielded from over 15,000 to nearly...
Physicians themselves may be involved at various levels in multidoctoring and the diversion of drugs to the street. These are the physicians termed ''script doctors,'' who willfully prescribe controlled substances to people seeking them, or who prescribe them as a result of being misled or simply uniformed about the prevalence of multidoctoring and the substances involved. Educating the public regarding the risks of prescription-medication abuse and increasing the skills of physicians in recognizing patients engaged in multidoctoring will help to decrease the diversion and misuse of prescription drugs. American Medical Association Council on Scientific AFFAIRS. (1992). Drug abuse related to prescribing practices. Journal of the American Medical Association, 247(6), 864-866. GOLDMAN, B. (1987). Confronting the prescription drug addict Doctors must learn to say no. Canadian Medical Association Journal, 136, 871-876.
This is a description of some of the behaviours of happy couples in successful long-term relationships. Turning the coin over, these ways of behaving in a relationship could be seen as prescriptions for happiness, actions to aim at if one wishes to develop a satisfactory and enduring relationship. Although they might come easily to some couples, for others they take work.
Ancient texts from India, mainly the Ayurveda, contain prescriptions for applications of brown mustard (Sarson, in Hindi Raajikaa, in Sanskrit) seeds for internal and external diseases. The recipes, written 5000 years ago, recommended Raajikaa internally as an appetizer, or for enlargement of the liver and spleen. The seeds were applied externally mainly for inflammations, skin diseases, catarrh, or rheumatic problems (Khare, 2004). Other famous authors, including Pythagoras (6 BC) and Plinius Secundus (1 AD), also emphasized the medicinal values of mustards, including Indian mustard (Peter, 2004).
Therapy for depression includes prescription medication combined with talk therapy. Cognitive behavioral strategies largely have replaced psychoanalysis in the treatment of mood disorders. The main key to success in treatment appears to be early and adequate intervention. Drug classes for depression include tri-cyclic antidepressants, SSRIs, SNRIs, and occasionally monoamine oxidase inhibitors (MAOIs). However, MAOIs have multiple drug and food interactions. Occasionally, stimulants or anti-anxiety medications are used in conjunction with antidepressants. Exercise, electrical therapies, and light therapy are all helpful in some types of depression.
Pharmacological approaches to treat cigarette smoking have been studied for the past 30 years. The pharmacological therapies available are categorized as either nicotine replacement agents (e.g., gum, patch) or non-nicotine medication (i.e., bupropion, clonidine, fluoxetine). Medications are reported to reduce cravings for nicotine, though they do not replace it (Benowitz & Wilson Peng, 2000). The products that fall into the category of non-nicotine medication require prescriptions and physician monitoring to obtain and use these drugs and therefore will not be reviewed in this chapter as they cannot be conceptualized under the rubric of self-help.
The analysis of PVA members with MS estimated that the average annual cost was 51,318 in healthcare items and services and lost earnings. Forty-seven percent of that total, or approximately 24,352, was direct costs for hospitalization, medical practitioner services, personal assistance and custodial care, durable medical equipment, and prescription medications. The aggregate cost for all 1,904 PVA members with MS in 1992 was 97.7 million. For anyone living with a chronic condition, it is important to understand that these studies show unequivocally that economic aspects can be quantified and that, over a lifetime, we are talking about serious amounts of money. You need to count your costs in order to understand your personal financial needs.
PRESCRIPTION DRUG ABUSE Unfavorable responses to medical treatments addiction to prescribed drugs or to those used in treatments is termed iatrogenic. A wide array of medicines can be associated with addiction or abuse in some people. Such drugs include the OPIOIDS, antihistamines, anticholinergies, and steroids, among others but the most common are those prescribed for psychological problems. Some prescription drugs, such as barbiturates and amphetamines, have a high potential for abuse and dependence when taken in non-prescribed doses or combinations. (Drug Enforcement Administration)
This followed 1 year of treatment by the same therapist with a more psychodynamic supervisor. Her presenting problems included dysthymia and substance abuse. She was referred for DBT after an overdose on a mixture of unprescribed pharmaceutical drugs (sedative-hypnotic abuse) and street drugs (cocaine) that required hospitalization. C. N. denied actively wanting to die, endorsing instead the desire to sleep and escape life. She also had problems with her primary support group given that her domestic partner was an alcoholic and a drug dealer. All of her friends and acquaintances were drug users.
The active metabolite of vitamin A, all-trans retinoic acid, or ATRA, has received a fair amount of research as an anticancer compound. In fact, ATRA is now a prescription drug approved by the Food and Drug Administration for the treatment of some types of cancers. Because this book concentrates on compounds not yet approved as drugs (see Chapter 1), our discussions focus on vitamin A (retinol), covering ATRA only in its role as a metabolite. More specifically, we focus on the form of retinol commonly found in foods and supplements, the retinyl ester form (i.e., retinyl palmitate). ATRA remains a viable treatment compound, however, and it may be preferable in some situations. For information on the use of ATRA, the reader is referred to drug reference books and manufacturer's literature.
Nature versus nurture issues will also continue to be debated with regard to nutrient requirements, especially in later life. Of course, with the recent assembling of the genetic code, the issues of 'nutri-genomics' and 'nutrigenetics' theoretically could soon be brought to bear on understanding individual variation in needs for and tolerances of essential and nonessential nutrients and dietary bioactive substances. The significance of this potential for the already aged person is likely to be limited for two reasons. First, the accumulative effects of nutrient imbalance will already have been established. Second, the economic and intellectual wherewithal to access and execute such individualized prescriptions for nutrient intakes and dietary patterns will likely escape the majority of older persons with limited financial means. Hence, further refinements in recommended intakes for older persons are likely to remain at the level of this segment of the population as a group and will...
The prescription medications are much stronger. They include barbiturates, benzodiazepines, and a number of other compounds. However, due to the risk for fatal overdose, especially in combination with alcohol or other CNS depressants, the barbiturates are no longer widely prescribed for this indication. In general, the shorter-acting sleeping pills are used to help one relax enough to get to sleep, while the longer-acting ones are used to help prevent frequent awakenings during the night. Long-term or inappropriate use can cause Tolerance
Do Race Differences In Iq Imply That Immigration To The United States Will Lead To More Social Problems
Psychologists do need to be careful when offering prescriptions for public policy. If the immigration policy in the United States were changed, then it would have large implications for very many people, not just migrants, but also for people currently living there. For example, if, in fact, the future economic, social, and intellectual prosperity of America stands to be enriched by migration, then excessive restriction could damage the country. Psychology as a science is ill equipped to forecast the effects of policies like these. The hypotheses are not amenable to experimental test. Herrnstein and Murray's study does not have a sufficiently rigorous methodology to allow even relatively weak conclusions to be drawn. Psychologists should clearly distinguish between science and opinion, between what can be shown to be the case and what they speculate might be so. Indeed, one of the authors, Murray, was not actually a professional psychologist. The conclusions about immigration policy...
Estimated hundreds of millions prescribed medication doses are diverted to the street each year. Triplicate-prescription programs were developed as an effort to decrease the diversion of prescription medications to illicit markets at a reduced cost of government investigation. States with such laws require physicians to write prescriptions on special triplicate forms for all Schedule II drugs, including narcotic analgesics, Barbiturates, and stimulants. In 1989 New York State passed legislation requiring triplicate prescribing for the Benzodiazepines (Schedule IV substances). triplicate prescribing of benzodiazepines is often considered an example of this. Although benzodiazepine prescriptions were reduced by up to 60 percent, the number of prescriptions for the older and potentially more hazardous sedatives (such as Meprobamate, methyprylon, Ethchlorvynol, butalbital, and Chloral Hydrate) increased markedly in contrast to continued decreases in prescribing them in the rest of the...
If cancer has been diagnosed, you should always seek approval from your doctor for a nutritional strategy. Nutrients simply enhance health and only your doctor will know if an allopathic treatment is necessary as an urgent life-saving measure, and some drug prescriptions conflict with normally required nutrients.
The purpose of nicotine replacement is to substitute a safer and controllable form of nicotine to the smoker to aid in cessation. Although nicotine replacement delivery systems vary, all attempt to reduce the amount of nicotine available during cessation so that an individual is weaned from nicotine addiction. Two nicotine replacement therapies are available over-the-counter nicotine polacrilex gum and the transdermal nicotine patch. Two other delivery systems are available through prescriptions an oral nicotine inhalation system and a nasal nicotine spray. The effectiveness of each of the systems has been well-established in randomized, controlled trials.
Similarly, the NWCR data discussed earlier show that successful weight loss maintainers are very active, reporting more than 2500kcals week of activity. This suggests that an exercise prescription of at least 200 minutes per week may be needed to improve long-term weight loss. One study compared the effect of a standard activity recommendation (1000 kcals week) versus a higher physical activity prescription (2500 kcals week, equivalent to walking 75 minutes 5 days per week) in a standard behavioral weight loss intervention. The group with the higher physical activity prescription had greater long-term weight loss at 12 months (-8.5 vs. -6.1kg) and 18 months (-6.7 vs. -4.1kg). However, even with the higher exercise prescriptions, participants still regained weight during the maintenance phase. Strategies for improving maintenance of physical activity One of the most challenging problems with physical activity in weight control programs is adherence to activity...
Whether you have severe pain, fatigue, and or sleep problems from your fibromyalgia or just minor discomfort, at some point, you'll need prescription drugs to treat your FMS symptoms. You may need meds on a regular basis, or you may need to take them only when symptoms flare up. Whatever your needs, I provide information about different types of prescription medications prescribed for fibromyalgia.
In addition to the vaccine, two oral prescription drugs (amantadine and rimantadine) may prevent or reduce the severity of influenza A but are not effective against type B (which accounts for 30 percent of flu cases). Rimantadine (Flumadine) or amantadine (Symmetrel) are designed to shorten illness by preventing the flu virus from reproducing. They work best if taken as soon as the flu strikes. Rimantadine is a closely related product that produces fewer side effects and can be used safely by adults it is being tested for safety in children.
Orally administered enzymes are very safe. In Germany in 1992, over 1.4 million prescriptions were made for enzyme preparations with no reports of any grave adverse effects.217 No lethal dose for orally administered polyenzyme preparations could be determined in animal models, even at a daily dose of 15 g kg. This was also true for individual enzymes (trypsin, chymotrypsin, papain, and bromelain). At high doses mild effects may be seen, such as stool modifications, sedation, appetite reduction, and weight loss.185
The introduction of lithium in the United States has been credited with a dramatic reduction in both direct and indirect costs associated with bipolar illness. From 1970 to 1980, a 2.88 billion decrease was estimated due to lithium use in direct treatment costs (including prescription medications, laboratory monitoring, outpatient psychosocial treatments, and hospitaliza-tion) 47 . Relatedly, marked decreases in length of hospital stay within the United Kingdom have been observed in the pre- to post-lithium era, associated with an approximate 34 million saving in costs related solely to hospitalization 48, 49 .
Promoting fertility and memory, also as a sialogogue, to treat cancer and frequently included in polyherbal prescriptions for diabetes mellitus. The Indochinese uses the rhizomes to treat fever and inflammation, as a febrifuge, galactagogue, and also for intestinal, kidney and liver ailments. 3
Sajan, Amin , Corneil, Trevor, et al. The Street Value of Prescription Drugs. Canadian Medical Association Journal 159 (1998) 139-142. National Drug Threat Assessment 2007 Pharmaceutical Drugs. National Drug Intelligence Center. October 2006. URL htm. Prescription Drug Abuse Chart. National Institute on Drug Abuse. February 2007. URL
The Chinese herb Jue-ming-zi has been used in many traditional Chinese medical prescriptions. C. tora was first recorded in Shen-Nung-Pen-Tsao-Ching as upper category, and in the successive Pen-Tsao of descending dynasties. It is used to remove ''heat'' from the liver and improve visual acuity, to moisten the supposedly dry digestive apparatus, and to facilitate bowel movement as a laxative. Previous studies on C. tora show its therapeutic effects on hypertension (7,8), on hypercholesterolemia (9,10), as an antihepatotoxin (11), an antimicrobial (12-14), on blood platelet coagulation (15), on the eyes, and in constipation (16). This herb has been reported to contain many active substances, including chrysophenol, emodin, rhein, etc. (17). Recently many researchers have studied the antioxidant activity and antigenotoxicity of C. tora. Choi et al. (18) reported that anthraquinone aglycons and naphthopyrone glycosides from C. tora had inhibitory activity against aflatoxin B1 in the Ames...
Prescription Drugs Non-prescription drugs alcohol, tobacco, herbs If the claim is accepted, people receiving SSI are usually entitled to receive Medicaid benefits. However, Medicaid is administered by the state, and the payments are so low that many physicians will not accept them. If SSDI is awarded, there is a two-year wait to apply for Medicare. Medicare has two parts one part covers hospitalization, including all in-patient care, and the second part covers medical doctors and outpatient expenses. The hospitalization part is covered by Social Security and costs the individual nothing. The second part, however, requires a monthly premium. Neither the hospitalization nor the medical expense policies cover the cost of prescription drugs. While SSDI may be helpful, it obviously has some drawbacks. The long wait for approval before receiving benefits may be devastating the two-year wait for hos-pitalization insurance could be a death sentence for someone with no other means of obtaining...
The first drug-paraphernalia laws, prohibitions against possessing opium pipes, were enacted by western states in the late nineteenth century as part of broad statutory efforts to suppress opium smoking by CHINESE immigrants. During the first third of the twentieth century, some states, in conjunction with a legislative attempt to criminalize the nonmedical use of OPIATES and COCAINE, also prohibited the possession of hypodermic syringes without a medical prescription. By 1972, when the NATIONAL Commission on Marijuana and Drug ABUSE conducted a survey of state drug laws, about twenty states had adopted some type of drug-paraphernalia prohibition.
The more you relax (which I know is often not easy ), the more likely you are to achieve a deep, restorative sleep state. Research has shown that, for some people, tricyclic antidepressants, such as Elavil, may help to prolong sleep stages 3 and 4. If tricyclic antidepressants don't work, Prozac (generic name fluoxetine), another type of antidepressant, helps some people. (For more on these medications, check out Taking prescriptions for sleepyland, later in this chapter.)
If antacids do not work or are not appropriate for my GERD what is the next step or tier ofmedications to try
The prices in the table are approximate and are included only to show you that the generics are dramatically cheaper than the proprietary drugs. The dosing given is average or usual dosing the actual dosing for GERD could be less or more depending on the severity of your GERD, so read the dosing recommendations on the package label. As mentioned, these are all available without a prescription, but many nonprescription drugs are not covered under most prescription drug insurance plans. Higher dosing may be available with a doctor's prescription and could be medications covered by insurance. In most states, there is usually a mandatory substitution to a generic drug if you use a doctor's prescription.
Abuse means using a substance in a way that deviates from approved medical use or social patterns within society. Abuse is subject to cultural disapproval and is often associated with the recreational use of substances. Approximately one-third of the U.S. population have used illicit drugs. It is estimated that 6-15 percent of the population has some form of substance-use disorder. People are most familiar with abuse in the context of illegal street drugs however, estimates indicate that up to 28 percent of controlled substances are abused. Moreover, according to estimates, more than 4 million Americans use prescription drugs for nonmedical purposes. Prescription medications are often diverted from legitimate channels to illicit ones via falsified prescriptions.
The drug cocaine comes from the leaves of the coca plant. People in South America have chewed coca leaves for thousands of years. Among other effects, chewing coca leaves helped people living in Andes Mountain regions to breathe at high altitudes, where less oxygen was available. It was not until the 1800s that the coca plant made its way to other parts of the world. In 1850, the first coca tinctures (medical mixtures) were used during throat surgeries to relieve pain. A few years later, the pharmaceutical drug maker Merck & Company began to produce cocaine. In the 1870s, doctors began using cocaine to treat morphine addiction. During that same period, wines that contained cocaine were made and sold legally. Cocaine also was used as a local anesthetic. Many influential people, including the world-famous psychoanalyst Sigmund Freud, praised the drug and encouraged its use.
Fatigue assessment and prescriptions for managing fatigue should be a vital aspect of care for cancer patients and survivors during treatment and follow-up care. Exercise and physical activity should be considered as an important fatigue management strategy. Prescription of exercise or physical activities should consider individual health status, exercise type, intensity, duration, frequency, and progression. Table 14.4 lists suggested considerations when prescribing exercise and physical activities (Winningham 1999). Table 14.4 Prescriptions of physical exercise and activity Table 14.4 Prescriptions of physical exercise and activity
Ingredients of some herbal prescriptions and Chinese proprietary medicines often contain cinnabar (mercuric sulfide), realgar (arsenic sulfide), or litharge (lead oxide) as part of the traditional formula. Furthermore, during growth and storage, crude plant material can become contaminated by pesticide residues, microorganisms, aflatoxins, radioactive substances, and heavy metals lead, cadmium, mercury, arsenic, and thallium have been reported as contaminants of some herbal preparations (50). In a case series of five patients in England with lead poisoning from Asian traditional remedies, the preparations implicated contained 6-60 by weight of lead (51).
Factors may affect energy balance by promoting increased intake and or reduced energy expenditure, causing weight regain to occur. The strong impact that environmental cues have on energy intake and expenditure have recently been acknowledged, as Americans are now described to be living in an obe-sogenic environment.'' This environment provides greater exposure to a variety of highly palatable, energy-dense foods and expanding portion sizes that potentially increase intake. Additionally, the environment is filled with products of convenience and efficiency that promote decreased energy expenditure. The psychological self-control needed to override these environmental cues may be difficult for most people to sustain over long periods. Finally, during obesity treatment, weight loss can provide reinforcement for adherence to eating and activity prescriptions that promote weight loss. During weight loss maintenance, weight loss no longer occurs therefore, there is less reinforcement of...
The term herbalism has changed over the years, once being almost synonymous with botany, though it is now generally used to refer to the use of plant remedies to treat medical conditions. It is often associated with medical systems having a tradition of using herbs for healing, whether in North America, Europe, or China. Western herbalism, as practiced in the United States and Europe, and distinct from allopathic medicine, is characterized by an emphasis on building and maintaining health rather than fighting disease. More significant, traditional herbalists practicing outside mainstream medicine often view healing very differently from allopathic physicians. The latter tend to regard herbal preparations as being essentially no different from conventional pharmaceutical drugs. Many herbalists take a more holistic approach, believing that herbal medicine is a healing technique that is inherently in tune with nature. 1 This emphasizes the self-healing capacity of the body and its...
Formulas can only inhibit freedom, said Lee, They are externally dictated prescriptions that only squelch creativity and assure mediocrity. Learning is definitely not mere imitation, nor is it the ability to accumulate and regurgitate fixed knowledge. Learning is a constant process of discovery - a process without end.
Symptoms to the typical demands of caring for a new baby. Now both of her children are in elementary school, and none of her friends have the same amount of pain and disrupted sleep that Florinda still endures. She saw a rheumatologist because she thought she might have lupus and was diagnosed by the rheumatolo-gist with FM due to her widespread pain and tender points on physical exam. Lupus was ruled out based on a negative history of sun-exposure rash, nonelevated liver or kidney enzymes, no history of fluid around her heart or lungs, or other signs common in lupus. She also had a negative ANA and normal sedimentation rate. She tried Amitriptyline first but found she gained weight, had difficulty thinking clearly and multitasking, and experienced dry mouth and constipation. She now orders Apo-zopliclone from Candadrugs.com. Her doctor gives her a prescription for three months, which she faxes to the Canadian Web site. A pharmacist at the Web site contacted her for a medical...
Licorice (Gancao) is one of the most frequently used ingredients in many traditional Chinese prescriptions. It is used primarily as a demulcent, expectorant, and mild laxative. Licorice is known to exhibit many pharmacological actions, including anti-inflammatory, antiallergic, antibacterial, antiviral, antihepatotoxic, anticonvulsive, and anticancer. Licorice has been shown to possess antimutagenic activity in the Ames test using Salmonella ty-phimurium (65). Glycyrrhizic acid, an active component of licorice, was found to protect DNA damage induced by benzo a pyrene and ear edema induced by croton oil in mice (66,67). The extract of G. uralensis was also found to induce apoptosis by a p53-independent pathway in human gastric cancer cell
Developing the diabetes nutrition plan With the emphasis on individualization, the meal plan is driven by the diagnosis, pharmacologic treatment, lifestyle, and treatment goals. Important consideration is given to dietary preferences, socioeconomic factors, and the patient's ability to understand and implement instructions. Some patients will need instruction on fine points such as carbohydrate counting others will benefit from the crudest of prescriptions, such as advice to stop buying concentrated sweets or frequenting fast-food restaurants.
The woman with the issue of blood had a hormone imbalance that precipitated heavy flow. Proper liver function is critical in keeping estrogen balanced with progesterone. Elevated estrogen is challenging to deal with today due to the addition of man-made, synthetic compounds called xenohormones which mimic estrogen. Our toxic environment with excess xenohormones increases estrogen in a female disabling the liver from clearing the estrogen. B vitamins are necessary for this process. Sugar and stress deplete B vitamins while snack foods, processed convenience meals, partially hydro-genated or trans fats, and prescription medication can stress an already overworked liver.
Guide for Separating Food Folklore Facts from Fiction in Clinical Situations and A Practical Example
In the late 1980s, in a study examining the interaction between alcohol and felodopine (a calcium antagonist used to lower blood pressure), it was accidentally discovered that grapefruit juice, which was being used as a placebo, dramatically altered the drug's metabolism. The drug was a common one, the juice dose - about 6 ounces (180 ml) - was within the range many people drink, and the effects were large (similar to a doubling of the drug dose). Therefore, it was of potential clinical importance. Since then, more than 200 scientific papers have been published in peer-reviewed journals on the issue of drug interactions with grapefruit, confirming the original observations. By the mid-1990s, the finding had received a great deal of media coverage and the notion that grapefruit juice was dangerous for those on prescription drugs had become a subject of food folklore. This particular bit of folklore is an example of a strongly held belief for which there is some scientific evidence....
People have taken drugs that effect mental activity since prehistoric times, most often alcohol and opiates. One third of all prescription drugs in the United States are chemicals given to affect mental activity which can be made more effective by individualization of treatment by molecular imaging, or the use of dedicated simple, single detectors.
59 Lutze had published his daily routine in 1866 and evoked vehement critcism. Printed in Eppenich (1995), p. 130. For reasons of rationalisation Lutze had also introduced the Fliegende Journal (flying journal), which consisted of loose printed sheets on which he wrote the most important comments and which were then used to wrap up the powders. After six weeks he would receive the envelope back with a report on the remedy, and he continued to note down on it the current condition. This had made it possible for Lutze to manage 80,000 prescriptions by letter in 1853, and 20,000 to 30,000 in his clinic. Lutze (1860), p. LXIV and Eppenich (1995), p. 127.
Hydrochloric acid is secreted in gastric juice by parietal cells in the stomach lining. This plays an important role in protecting the body from pathogens in food or water. In vivo and in vitro data documenting the bactericidal effects of gastric juice have been reviewed extensively (Smith, 2003 Martinsen et al., 2005). Decreased gastric acidity can occur through a variety of mechanisms. These include acquired disease states (atrophic gastritis) and surgery (vagotomy, gastric resection). However, the most common mechanism for gastric acid reduction is through medications. These include antacids (such as calcium carbonate), histamine H2 antagonists (such as cimetidine), and proton pump inhibitors (such as omeprazole). These are used for a variety of disorders, including peptic ulcer disease and gastroesophageal reflux disease (GERD) (Del Valle, 2005). These medications are very frequently used. A survey of prescription drug use data in the United States from 2000 to 2001 found that...
Over the counter and by prescription. Generally speaking, the prescription drugs are stronger and work better for more severe symptoms. Also, some medications are effective only when taken appropriately. For example, the class of GERD drugs called proton pump inhibitors (PPIs) such as omeprazole need to be taken 30 to 45 minutes prior to eating to get maximum effect. So, if you have rare or infrequent heartburn and you take a PPI while having symptoms, it generally does not work because you have taken it the wrong way. A more effective medication to take during symptoms might be an OTC antacid. This is an example of why a doctor's visit can be helpful.
Investigate all patients by early endoscopy It has been argued that, as most dyspeptic patients end up having some investigation anyway, earlier investigation may prove more cost effective. However, cost effectiveness modelling has shown that if the incidence of peptic ulcer disease in dyspeptic patients is less than 10 , it would take more than five years for the costs of investigation to be recouped in savings from fewer prescriptions. Results of several large trials based in primary care of the cost effectiveness of this approach are expected soon. Figure 1.3 Cost of prescriptions for ulcer healing drugs in England and Wales Figure 1.3 Cost of prescriptions for ulcer healing drugs in England and Wales
Reflux is affected by weight, diet, medications, and lifestyle habits such as smoking and alcohol consumption. A patient with GERD can change or modify many of these factors to improve symptoms. If conservative measures fail, then many medications are available for treatment of GERD. The spectrum of medications spans from over-the-counter antacids used to treat infrequent and episodic reflux, to powerful prescription drugs that you take several times a day to treat severe GERD and its complications.
The next phase of DTC advertising led to ads in magazines and newspapers that mentioned the name of the product and its indication for use. The advertising of prescription drugs on television or radio remained greatly restricted at this time since it was not possible to include the necessary brief summary of prescribing information on the air. Because of this limitation, the ads on television or radio had to focus on either the name of the product or the indication for the product.
In the early to mid-1990's, two prescription diet drugs, fenfluramine (often taken with phentermine and popularly known as fen-phen) and dexfenfluramine (Redux), grew in popularity. These drugs stimulated production of the brain chemical serotonin, creating a feeling of satiety. Stories in the news media hailed fen-phen and Redux as a miracle cure for obesity. By 1996, millions of prescriptions had been written for the diet pills.
As noted earlier, the women's self-help movement was born in response to distrust of and dissatisfaction with patriarchal health care institutions. By taking health matters into their own hands, individuals are meant to feel efficacious and empowered. Over the last 40 years, however, this ideal of self-help has changed so that individuals, mostly women, once again find themselves submitting to the authority of an (usually male) expert. Polivy and Herman (2002) state There is fine irony in the notion that following prescriptions of others constitutes self-help (p. 678). Greenberg (1994) agrees that the work has already been done by the authority, thus the individual simply consumes the material presented. As with Dorothy in the Wizard of Oz, Simonds (1992) says that self-hood is discovered only by means of experts' insights.
If validated, that version of the SAT is considered efficacious and preferable to other SH programs, even those designed from the same basic set of treatment prescriptions proven effective in Step 1. The basic difference is that the validated treatments have been shown to work, whereas the unvalidated ones have not.
A disclaimer has traditionally been appended to the official pronouncements of recommended nutrient intakes whether they are from national or international expert panels, the prescriptions are meant to apply to 'healthy' individuals. Nutrient needs in disease conditions are considered to be a clinical matter, and are related to the pathologies in question.
Most states have supplemental insurance programs for families with children who are living with chronic conditions. These programs often help cover services, prescriptions, and co-payments that your primary insurance will not. You can get more information on the specific programs in your state from your medical team or hospital social worker or by calling the state department that regulates insurance. In Michigan, besides my husband's insurance, we also have what is called Children's Special Health Care Services (CSHCS). It is a secondary insurance that pays for what our primary insurance doesn't Jake's co-pays and prescriptions, trips back and forth to the hospital, doctor appointment and prescription co-pays for my husband and me, our stay at the Ronald McDonald House. Any expenses related to treatment that our primary insurance won't cover, this will. The amount you pay for this coverage is based on family income. It has been a lifesaver for us.
Other weight-loss methods, such as weight-loss diet pills, anorexic and bulimic behavior, and various surgical options pose an even greater risk to health than general diet. Prescription diet pills with the combination of fenfluramine and phentermine were proven to have dangerous side effects the most worrisome problem was the development of leaky heart valves. A study reported by the FDA in 1997 found that one-third of all patients on the fenfluramine, phentermine combination developed a leaky heart and another 25-30 percent displayed an abnormal echocardiogram (Berg 1999 279). More commonly used diet pills are sold over the counter (OTC). These can be dangerous because they are not regulated in the same fashion as prescription drugs by the FDA. OTC diet pills are usually classified as dietary supplements and not drugs, though drug manufacturers may claim that their product will diagnose, cure, mitigate, treat, or prevent a disease. Such claims may not legally be made for dietary...
Although prescription medications undergo much study before they come to the market, medical doctors sometimes try other treatments and procedures that have not been rigorously tested. A well-known example occurred during the 2004 American League Championship Series. When pitcher Curt Schilling injured his right ankle, the Boston Red Sox's general manager vowed to explore every medical technique under the sun to try to get his tendon stabilized. According to the Boston Globe, here's what happened next
Pharmacokinetics, safety, and efficacy of bioactive compounds can be examined scientifically in animal models. Finally, these herbal products can be tested in human studies where the outcome parameter can be refined according to the mechanisms of action defined in vitro and in animal models. The complete process will take many years and will be expensive. Here an enlightened and practical attitude on the part of legislators and regulators will help the industry move forward. Funds for research will have to be set aside from industry. Exclusive marketing rights for products that have been certified will help manufacturers recoup the costs of research and product standardization. Such a system has already been suggested by the U.S. FDA's guidance document for industry on botanical drug products (45). As in the German system, the first emphasis should be on manufacturing quality and standardization of bioactive components. Safety has to be assured in the recommended doses. Efficacy can...
More broadly, a basic question in addressing safety in herbal medicines is''Safe with respect to what '' Research has found that in the United States, 51 of FDA-approved drugs have serious adverse effects not detected prior to their approval. One and one-half million people are sufficiently injured by prescription drugs annually that they require hospitalization (Moore et al., 1998). Once in hospital, the problem may be compounded. The incidence of serious and fatal adverse drug reactions (ADRs) in U.S. hospitals is now ranked as between the fourth and the sixth leading cause of death in the United States, following after heart disease, cancer, pulmonary disease, and accidents (Lazarou et al., 1998). Randomized controlled clinical trials of selected ISM prescriptions have been initiated to document their safety and efficacy and to provide the basis
The manufacturers of herbal products are currently not required to submit proof of safety and efficacy to the FDA before bringing a product to market. For this reason, the adverse effects and drug interactions associated with herbal remedies are largely unknown. Physicians and pharmacists are increasingly likely to encounter patients who are using herbal remedies. They need to be aware of the adverse effects of herbal remedies and the possibility of interactions with prescription drugs.
After the Flexner Report, and with the rise in the belief that pharmaceutical drugs could eliminate all disease, the use of herbal remedies experienced a dramatic decline. Plant extracts did not disappear completely from the American materia medica, however, for around one-quarter of all conventional drugs on pharmacy shelves are still derived one way or another from plants aspirin, for example, was originally extracted from the bark of willow trees (Salix spp.) a heart drug called atropine, from deadly nightshade (Atropa belladonna) and the anticancer drug paclitaxel, from the Pacific yew tree (Taxus brevifolia).5 Up until the mid-1990s, herbal preparations such as valerian and echinacea continued to be available to consumers, but they were largely confined to health food stores. It seemed that with the advent of computers and molecular biology, scientific medicine in Western
Your doctor will likely want to review the medications that you are taking. There are many prescription drugs that can contribute to emotional problems. Keep in mind that even if you are on a medication that may have some unintended psychological side effects, your doctor might want you to stay on this drug because it treats other health concerns. Or there may be alternative treatments to try. I always recommend having this discussion with your physician rather than abruptly going off prescription medications. Avoid self-medicating with alcohol or other substances. Alcohol is a depressant, and although sometimes individuals use it to help relieve feelings of anxiety and frustration, it almost always has the opposite effect, particularly when used regularly. St. John's wort is another product that people often use to help their moods. Because of the many interactions of this compound with prescription medications, if you are taking St. John's wort, I recommend that you discuss it with...
When my patients obtain driver's licenses and begin to come alone to their appointments, they rapidly recognize their responsibility. Just as they can drive themselves to the appointments, they realize they are responsible for being sure that their blood tests are done in a timely fashion, the prescriptions are obtained or renewed, and their medications purchased. It's amazing how much more responsible they suddenly become when they can take themselves places.
All too often I see children who were supposed to be back in two weeks who come back in six months and still have the problem. Often the parents will say that the child took a few of the pills and then had a stomachache, so they stopped. Instead of calling the doctor to discuss the problem, they did nothing until everything got worse again. The more damage you let accumulate, the harder it is to fix. If you do not like the advice, call and discuss it with your doctor, or find another doctor. Prescriptions left in pockets or purses and pills sitting in bottles
Insomnia is a common sleep problem throughout the world. Many available prescription medications for insomnia are associated with significant side effects including daytime somnolence and dependence. The search for a more natural and safer hypnotic has stimulated many patients to turn to herbal products such as valerian root. Although it has been used for centuries, its mechanism of action, as well as the constituents of the plant responsible for its activity, is not well defined.
Medical practitioners have to follow specific rules for each schedule when prescribing or dispensing controlled drugs. Drugs in Schedule I can only be obtained, prescribed, and dispensed to an individual after special approval is obtained from the Food and Drug Administration (FDA). Drugs in Schedule II cannot be refilled or dispensed without a written prescription from a practitioner, except in an emergency. When they are dispensed in an emergency, a written prescription must be obtained within 72 hours. Drugs in Schedule III and in Schedule IV may not be dispensed without a written or an oral prescription. Prescriptions for these drugs may not be filled or refilled more than six months after their issue date or refilled more than five times unless authorized by a licensed practitioner. Drugs in Schedule V can be refilled, with a practitioner's authorization, without the limitation on number of refills or time. Certain Schedule V drugs may be purchased directly from a pharmacist, in...
Many barbiturate users become dependent to some degree during the course of treatment for insomnia. This type of problem is called iatrogenic, because it is initiated by a physician. In some instances the problem will be limited to continued use at gradually increasing doses at night, to prevent insomnia that is in turn due to withdrawal. However, some individuals who are susceptible to the euphoric effects of barbiturates may develop a pattern of taking increasingly larger doses to become intoxicated, rather than for the intended therapeutic effects (for example, to promote sleepiness). To achieve these aims, the person may obtain prescriptions from a number of physicians and take them to a number of pharmacists or secure their needs from illicit distributors (dealers). If the supply is sufficient, the barbiturate abuser can rapidly increase the dose within a matter of weeks. The upper daily limit is about 1,500 to 3,000 milligrams however, many can titrate their daily dose to the...
An international survey at the beginning of the 1980s showed that tranquilizers and sedatives of any type had been used at some time during the previous year by 12.9 percent of U.S. adults, 11.2 percent in the United Kingdom (U.K.), 7.4 percent in the Netherlands, and 15.9 percent in France. Persistent long-term users comprised 1.8 percent of all U.S. adults, 3.1 percent in the U.K., 1.7 percent in the Netherlands and 5.0 percent in France. The proportion of repeat prescriptions for tranquilizers has increased steadily since about 1970 in many countries, the U.K. in particular. This suggests that fewer people are being newly started on tranquil-
The NHSDA has tracked the changing nature of drug abuse since 1971. At the time of the first survey, about 10 percent of the population age twelve and older had ever used illicit drugs. This was estimated to be more than double the rate of lifetime use as of the early 1960s. In 1998, an estimated 13.6 million persons or 6.2 percent of the American population of 12 years of age or older were current illicit drug users, meaning they had used an illicit drug in the month prior to interview. The report for current use showed that more than one drug had been used by some of the total 13.6 million, with a breakdown of this figure as follows Some 11 million reported using marijuana or HASHISH an estimated 1.8 million cocaine and 130,000 heroin. The rate of current use of inhalants by Americans has remained steady since 1991 (between 0.3-0.4 percent of the population). The rate of current use of HALLUCINOGENS and Prescription Drugs was estimated at 0.7 percent and 1.1 percent respectively in...
It is estimated that families of children with cancer spend 25 percent or more of their income on items not covered by insurance. Examples of these expenses are gas, car repairs, motels, food away from home, health insurance deductibles, prescriptions, and dental work. Many of these items can be deducted on federal income tax. Often parents are too fatigued to go through stacks of bills at the end of the year to calculate their deductions. If a monthly total is kept in a notebook, then all that needs to be done at tax time is adding up the monthly totals.
Another fruitful source of natural medicines is plants. Many have already proved their value and there is a huge untapped potential for further discoveries, since more than 90 percent of the world's half million plant species have never been tested for their pharmaceutical value. Only 120 prescription drugs worldwide are based on extracted plant products.
Model can produce intuitively incorrect prescriptions for action. This is a result of its ignoring the role of plans in practical reasoning. With its focus on plans, the planning-theory model is onto something important. It is, however, incomplete because it does not address the question of how plans are to be compared for purposes of choosing among them. What is needed is a theory of practical reasoning that takes plans seriously and generalizes the concepts of the decision-theoretic model to apply them to plans rather than acts.
Creation groans, anxiously awaiting the return of Jesus. We live in a global community. Pollution from around the world settles in distant landing spots. Your liver is the critical organ to process the various pollutants. You need to be conscious of this and be disciplined to minimize the direct toxins you put into your body. Soda, prescription medication, processed food, or any man-made composition may stress your filter system. Water filtration plants are not designed to clear modern petrochemical based prescription medication. Mutated fish are a part of the ecosystem in areas where the water is sourced from ground water. Focus on drinking your daily water intake from a pure source. I do not promote distilled water. I have seen from practice experience that patients who drink distilled water appear to have challenges when testing muscle strength.
My vision problems range from a bit of blurriness to a complete lack of sight. I inherited extreme myopia I wear contact lenses and glasses even in the shower. Before MS, changes in my vision required new prescriptions and picking out the least offensiveframes. MS vision symptoms and
ADVERTISING AND THE PHARMACEUTICAL INDUSTRY The pharmaceutical industry, which researches, develops, produces, and markets prescription drugs in the United States, is the most heavily regulated of all industries when it comes to the advertising and promotion of its products. Through its Drug Marketing, Advertising, and Communications Divisions, the Food and Drug Administration (FDA) regulates all advertising and promotional activities for prescription drugs, including statements made to physicians and pharmacists by pharmaceutical sales representatives. Advertising of over-the-counter (OTC) drugs, which is not regulated by the FDA, is under the jurisdiction of the Federal Trade Commission (FTC). Before a new prescription drug is approved for marketing, the FDA and the pharmaceutical company must agree on the ''full prescribing information'' that will accompany the product and that must be included in all ads, brochures, promotional pieces, and samples. This full prescribing...
When a sharp line needs to be drawn between legalization and prohibition, it is useful to say that a drug is legal if it is legal for that substance to be produced and distributed for unsupervised consumption by a significant portion of the population (e.g., all adults). By this definition making marijuana available for medical use is not legalization if prescriptions are restricted to those experiencing specific, medically-diagnosed conditions (glaucoma), but it would be if any adult could write his or her own prescription. Likewise by this definition the Netherlands has legalized retail production, distribution, and use of marijuana, although wholesale (large-volume) marijuana production and distribution is still prohibited. Most other drugs in most countries are either clearly legal or clearly prohibited by this definition.
Drug and alcohol abuse are strongly opposed within the U.S. armed forces because of their negative effects on the health and well-being of military personnel and because of their detrimental effects on military readiness and the maintenance of high standards of performance and military discipline (Department of Defense, 1997). In the U.S. military, drug abuse is defined as the wrongful use, possession, distribution, or introduction onto a military installation of a controlled substance (e.g., marijuana, heroin, cocaine), prescription medication, over-the-counter medication, or intoxicating substance (other than alcohol). Alcohol abuse is defined as alcohol use that has adverse effects on the user's health or behavior, family, community, or the Department of Defense (DoD) or that leads to unacceptable behavior.
Alcohol, itself a drug, mixes unfavorably with many other drugs, including those purchased over the counter. In addition, use of certain prescription drugs may intensify the older person's reaction to alcohol, leading to more rapid intoxication. Alcohol, when combined substantially and quickly with certain groups of drugs, can dangerously slow down performance skills such as driving, running machinery, and even walking. It lessens judgment, and reduces alertness when taken with drugs such as those prescribed against psychosis, those meant to lessen anxiety, sedative-hypnotics, pain-killers derived from opium, antihistamines, and certain blood-pressure medicines (Table 1). Large amounts drunk quickly reduce the clearance of It is very difficult to determine the actual incidence of combined drug and alcohol use by the elderly, but it is likely to be reasonably high for the following reasons the average adult over sixty-five takes two to seven prescription medicines daily in addition to...
Anxiety is everywhere All around us And, if you have PD, you may be even more anxious. Anxiety, recognized or unrecognized, is an aggravating factor in many diseases, including PD. It's estimated that 95 million Americans, about one-third of us, are sufficiently anxious to seek help from our anxiety through counseling, meditation, alcohol, tobacco, and prescription drugs such as Ativan, Klonopin, Valium, Xanax, Paxil, and Zoloft. It's further estimated that 35 million people, about one-third of all anxious people, have panic attacks.
A number of pharmaceutical drugs, such as folic acid antagonists (e.g. methotrexate), can affect folic acid status by interfering with absorption, use and conversion to its active forms. In such cases, oral folic acid supplements are sometimes given to reduce side-effects, although it may marginally reduce drug efficacy (Kumar & Clarke 2002, Strober & Menon 2005).
There are four parts to the Medicare program Part A is the Hospital Insurance program, covering primarily hospital inpatient services, skilled nursing facility services, home health agency, and hospice services Part B is the Supplementary Medical Insurance program, covering outpatient and physician services, as well as laboratory services and products provided for home use Part C is the Medicare Advantage program,5 which is a managed care program and Part D is the new Prescription Drug Benefit program.4 In addressing coverage and payment, we focus on Parts A and B as they relate to the longstanding Medicare fee-for-service program.
In the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Medicare Modernization Act), Congress directed CMS for the first time to publish the factors considered in making national coverage determinations on whether an item or service is reasonable and necessary. The factors will be published using guidance documents similar to those developed by the FDA.23
Two complications emerged after the BCBSA TEC made its assessment. First, approximately 67 of the BCBS plans did not establish medical policy. Second, the coverage they developed was narrow, as only patients with nonunions demonstrated by two sets of X-rays obtained at least 90 days after initial surgery were eligible for this product. With such limited medical policy, approximately 50 of physician-ordered prescriptions for SAFHS were pre-authorized by individual BCBS plans across the United States.
Think carefully, though, about using ingestible therapies like naturopathy, homeopathy and Chinese herbal treatments, which involve taking substances for specific conditions. The effects of most herbal therapies haven't been tested in the way that society expects prescription medication to be tested and little is known about their safety, benefits and potential side
Although the combination of exercise and dieting might be expected to improve weight loss, most data show only a modest increase (2 or 3 kg). When the total daily deficit is kept constant, diet, exercise, and diet plus exercise result in similar weight loss, but the inclusion of exercise generally results in greater fat loss and an increased lean tissue mass. There is evidence that the long-term maintenance of weight loss may require more regular activity (approximately double the current guidelines of 30min day) than that required to prevent weight gain in the first place. The ideal dietary and exercise prescriptions to control body weight in the long-term remain elusive.
The Food and Drug Administration (FDA) is the U.S. government agency responsible for ensuring the health and safety of the American public by enforcing laws and regulations related to pharmaceutical drugs. Before they reach the marketplace, potential drugs must go through several phases of testing before they are approved. The U.S. system is perhaps the most rigorous in the world. On average, it costs a pharmaceutical company close to 400 million to get one new drug from the laboratory to the pharmacy shelf, and the whole process takes an average twelve years to complete.1 This involves a complicated system of clinical trials designed to assess the drug's safety and efficacy. Unfortunately, little information is available to accurately assess the safety and effectiveness of many herbal therapies. A pharmaceutical manufacturer has little or no economic incentive to invest in expensive basic research programs and clinical trials when many naturally occurring plant extracts cannot be...
Are other metabolic pathways involved What are the metabolites present within feces and do they have any biological properties These could all have a significant effect on human health and disease incidence. Furthermore, the ability of ITCs to induce phase II enzymes is deemed a benficial property. However, what effect does this induction have on the metabolism of pharmaceutical drugs in humans Or, more importantly, what effect does this have on chemicals that are made more toxic by metabolism by NQO1 or GSTs Hopefully in the future many of these questions will be answered.
Viproblem 5 The Products May Produce Harm By Interacting With Each Other Or With Pharmaceuticals Taken Concurrently
TCM prescriptions may contain multiple different products whose ingredients can interact with each other in unexpected ways, or can influence the effects of Western drugs taken concurrently. TCM is often used by subjects with chronic diseases, who are likely to take Western drugs at the same time. For example, PC-SPES is allegedly a combination of eight herbs sometimes used by patients with prostate cancer. It was found to have potent oestrogenic activity (34). Coadministration of PC-SPES with estrogens might thus cause overdose problems, and PC-SPES in high doses may itself produce side effects such as breast tenderness and loss of libido (34). PC-SPES was banned in 2002 in the United States after chemical analysis showed it to be adulterated with diethylstilbestrol (a known carcinogen) indomethacin and warfarin (35). The action of St. John's wort in inhibiting monoamine oxidase can potentiate the effects of serotonin-reuptake inhibitors (3,36). It also induces hepatic enzymes,...
Ancient TCM theory states that the physical condition of the human body is controlled by the interaction of five elemental organs, heart, liver, kidney, lung, and spleen, although the nature of these organs is not the same as understood in Western medicine. The brain was not classified in the five elemental organs but its function is considered strictly related to liver, kidney, and heart functions. Therefore, it is worth examining protective effects on cerebral oxidative damage by TCM prescriptions that have been used for treating complex diseases, especially related to heart, lung, or kidney failure. In this sense, it is interesting to study the effect of SMS on cerebral oxidative injury. We first examined the antioxidant property of SMS by five different antioxidant assays in vitro and the antioxidant activity was compared using Trolox as the reference antioxidant in each antioxidant assays. (Table 1). Interestingly, SMS was found to have extremely strong...