Monday, June 30, 2008

Is This High Blood Pressure Medicine Right For You?


What is Aldactone?

Aldactone (generic name: Spirionolactone) is a water pill (diuretic) and antiandrogen. The medicine is also marketed under other names such as Novo-Spiroton, Spirotone, Spiractin and Berlactone.

Aldactone is known as a potassium-sparing diuretic, as the term suggests, this medication keeps your potassium levels from getting too low while preventing your body from absorbing too much salt .

While regularly prescribed for high-blood-pressure patients, the drug can also be prescribed along with other drugs. However, the drug is useful only for controlling, rather than curing, high blood pressure. Aldactone has to be taken regularly for its effect to become apparent. Blood pressure cannot be brought under control quickly. It is also advisable to keep using Aldactone even after you have started feeling better.

Aldactone also treats fluid retention (edema) in people with congestive heart failure, cirrhosis of the liver, or a kidney disorder called nephrotic syndrome. This medication is also used to treat or prevent hypokalemia (low potassium levels in the blood).

What is Aldactone prescribed for?

Aldactone is also used for the diagnosis as well as the treatment of Hyperaldosteronism. This is a condition in which you have too much aldosterone in your body. Aldosterone is a hormone produced by your adrenal glands to help regulate the salt and water balance in your body. Excessive amounts of Aldosterone can increase the fluid retention in the body and is a contributing factor of high blood pressure or hypertension.

Precautions

The safety and effectiveness of Aldactone is dependant upon a strict adherence to a medication schedule and should never be used without a prescription and consultation of your doctor. To avoid any complications and possible worsening of the condition it is essential to follow a specific schedule for dosage and avoid any sudden discontinuation of the drug. If a dose is missed, Aldactone should be taken as soon as possible, however, doubling-up on the dosage can be dangerous and is not recommended.

Certain foods should be avoided while taking the medicine. In case of surgery or other medical emergencies, the doctor should be informed beforehand about the usage of the drug.

What are the Side effects?

Because aldactone is designed to alter the levels of potassium in your system, some side effects may occur as your body adjusts to these changes. These may include symptoms such as excessive thirst and dry mouth, arrythmia, cramps or muscle pain all conditions related to the change in the levels of potassium in the body.

Other potential side effects may include breast development in among male users, deepening of voice, excessive hairiness, irregular menstruation, fever, headache, diarrhea, drowsiness, bleeding or inflammation of the stomach and liver, and skin problems.

Last word

Patients who have problems related to the heart, kidney or liver, and a high level of potassium in the blood should not be prescribed the drug.

Do not start using a new medication without telling your doctor. If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms but can be treated effectively without adversely affecting your active lifestyle.

You can buy Aldactone here

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SirCruizer's weblog

Clomid for Infertility: What You Must Know


Clomid as an infertility drug is considered to be the cornerstone of all other medications that have followed the trend. While many years have passed since Clomid was first introduced into the market, it is still the same drug as it was before that most infertile couples come in contact with initially before everything assumed their places in the industry.

Clomid, an infertility drug that appears in other names like CC, Clomiphene citrate, Serophene or simply Clomid is considerably inexpensive as compared with the brands that have invaded the market recently. Its main uses are focused on ovulation problems by means of oral consumption rather than via injection.

While it was produced several years earlier than its predecessor, the workings of the drug still facilitate in a very complicated fashion but with desirable potency. It does not have effects on women whose ovaries have already reached the termination of their use. Nonetheless, Clomid is still a very potent drug when it comes to inducing satisfactory effects on all estrogen receptors. Thus, it has the capacity of creating reactions on all body tissues, which contain estrogen receptors.

Tissues lying in organs like cervix, endometrium, pituitary, vagina and hypothalamus are some for which its known effects are working.

Clomid is also useful in assessing the possibility of using the potential ovary reserve in a female. And it is also utilized for patients with defects on their luteal phase.

Clomid, aside from its efficiency in working with estrogen, also has the property of influencing the functions of other four major and vital hormones in infertility namely GnRH, LH, FSH and estradiol.

Although we still have no complete understanding of the exact manners by which Clomid conducts its processes, it still seem pretty obvious that its major effects in the brain is to fool it into believing that the estrogen level of the system is low. Thus bringing a domino effect of releasing more hormones to compensate for the lack of hormones for which infertility is said to have rooted.

The effect of this normal reaction is to make the system a feasible environment for ovulation.

The known side effects though of using Clomid in aid of fertility are the following:
  • Multiple pregnancy

  • Ovarian enlargement

  • Pelvic and abdominal discomfort

  • Bloating or distention

  • Breast discomfort

  • Nausea and vomiting

  • Abnormal uterine bleeding

  • Visual symptoms like appearances of waves, floaters, lights and etc.

  • While there may be side effects like these, Clomid is still clear of having any association with increase of congenital abnormalities, complications in pregnancy, birth defects appearing in children and premature labor.

    You can buy Serophene here

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    Old Grumpy Dwarf's weblog

    Creams For Stretch Marks


    Stretch marks are a normal part of puberty for most girls and guys. They are generally associated with pregnancy, obesity, and can develop during rapid muscle growth from body building. It is a common condition that does not cause any significant medical problems but can be of cosmetic concern for some people. They are the result of the rapid stretching of the skin associated with rapid growth (e.g. puberty) or weight gain (e.g. pregnancy), and anabolic steroid use. Men and women can get them on several areas of their bodies, including the abdominal area, thighs, hips, breasts, upper arms or lower back.

    They can also occur from prolonged use of oral or topical corticosteroids. Stretching of the skin may cause a tingling or itchy sensation. They occur in about 50-90 of pregnant women.

    They can appear anywhere on the body. Most common places are the abdomen (especially near the belly-button), breasts, upper arms, underarms, thighs (both inner and outer), hips, and buttocks. They are usually several centimetres long and 1-10 mm wide. Those caused by corticosteroid use or Cushing's syndrome are often larger and wider. The glucocorticoid hormones responsible for the development of stretch marks affect the epidermis by preventing the fibroblasts from forming collagen and elastin fibers, necessary to keep rapidly growing skin taut. There are plenty over-the-counter treatments for stretch marks. StretchNil is a unique herbal preparation that has been specifically created for the prevention or minimization.

    Collagen creams claim (maintain property or right) that they will improve. Some cream manufacturers claim the best results are reach a goal

    on recent stretch marks; however, few studies exist to support these claims. Cocoa butter cream, which is available from pharmacies, is often recommended to soften scars, so might be worth a try. Some cream manufacturers claim the best results are achieved on recent stretch marks; however, few studies exist to support these claims. These creams should not be used during pregnancy or breastfeeding. Biological Oils (Rose Hip Oil or Emu Oil), Plant Oils, Cocoa Butter and Shea Butter do become better the lipid content of the skin, embellish water retention, and soften the skin texture for a while.

    You can buy here

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    Samina's weblog

    News About the Type 2 Diabetes Drug Avandia


    Studies continue to try to dive into the cause and cure for type 2 diabetes and the drug once thought to be a major breakthrough for type 2 diabetes, Avandia, is coming under a lot of significant study and skepticism.

    Health Canada is currently claiming that the deaths of six Canadians are "very likely" linked to the Type 2 Diabetes drug Avandia, which of course raises concerns about whether the potential detrimental effects of the drug are worth the risks. Other studies on the drug Avandia indicate that it may be linked to a much higher risk of heart attack in certain patients, according to reports in the respected New England Journal of Medicine. To support this study, Health Canada says that 28 Canadians who had been taking Avandia for type 2 diabetes had suffered heart attacks since being introduced to the drug Avandia in 2000. In the US, there have been 19 confirmed reports of heart attacks from US citizens who have been taking Avandia.

    While this is not a lot of people based on the number of total people taking Avandia, the number is statistically significant, and people taking a drug for one ailment should not be "e encouraging" another, potentially life-threatening disorder. More clinical study is needed, but the evidence exists that there is probably a connection between the heart attacks and Avandia. While the studies do not conclusively prove that Avandia is the culprit and Avandia has definitely been ruled out in some of the heart attack cases, there are strong signs that it is a factor in the majority of the cases.

    A review published in the New England Journal of Medicine indicates multiple studies on the drug Avandia which indicate a higher risk of heart attack in approximately 43% of patients who take the drug.

    The pharmaceutical firm GlaxoSmithKline PLC manufactures Avandia. To add to their problems, the Food and Drug Administration has declined to grant a priority review to their newest experimental cancer vaccine Cervarix, which serves to add pressure to the company with the current controversy surrounding their manufacture of Avandia. The Avandia family of drugs manufactured by Glaxo includes Avandamet and Avandaryl, which showed sales last year of well over a billion dollars. This makes the Avandia family of drugs the second best selling drug after the company's Advair product which is for asthma treatment.

    While Glaxo claims that the reported incidents of heart attack are "statistically the same" for Avandia patients as those patients who are on other anti-diabetes drugs, it remains clear that further research and study is required before these drugs can be claimed safe and effective for treating what they were designed to treat.

    You can buy Avandamet here

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    Redwizard's weblog

    Sunday, June 29, 2008

    The Perfect Cure for Acid Reflux?


    Protonix - Acid Reflux is History With Protonix!

    Acid reflux is one of the most common health conditions that can bother someone day or night. Actually it is known that hyper-acidity can be significantly worse when you lie down, so for many people, eating and sleeping could be a total nightmare.

    Protonix Information

    Protonix is part of a group of drugs known as proton pump inhibitors that actually lower the amount of gastric juice secreted by the stomach. Many doctors prescribe it for various conditions that are related to hyper-acidity.

    Administered in cases of esophagitis and the Zollinger-Ellison syndrome, Protonix has proved extremely successful even for the most deteriorated of conditions. However, in order to increase the efficiency of this medication you will definitely need to stick to a healthy antacid diet.

    Some ailments require long-term administration of Protonix, but you'll have to learn on the pros and cons in the impact this drug can have on the overall health given the fact that it is not free of side effects.

    In case you have already used Protonix for quite some time, you should take some blood tests and see where your mineral and vitamin levels stand. For instance, it is well known that you may develop a deficiency in the absorption of B-12 vitamin and slowly show the signs specific to it: pale skin, tiredness, fast heartbeat or shortness of breath.

    Warnings and Precaution Measures

    Some drugs are likely to interfere with Protonix so either these or the Protonix ought to be avoided. If taken together, one or both of the drugs might not work properly.

    Blood thinners are likely to interfere with Protonix

    Several types of antibiotics might be less efficient if taken with Protonix - one example is ampicillin which is often used to treat minor infections

    Protonix can also affect certain anemia treatments which work by iron supplementation, making them less efficient

    Your doctor might alter dosages if you need to take Protonix in combination with any of the drugs mentioned above. This will reduce your risk of side effects.

    Adverse reactions to Protonix can include allergic responses, such as swelling, hives or a skin rash. Other side effects might be vomiting, nausea or digestive symptoms like gas, bloating or diarrhea.0

    You can buy Protonix here

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    Boogs's weblog

    Treximet - A New Migraine Medication


    On May 16, Glaxo-Smith-Kline Pharmaceuticals, the makers of Imitrex, announced that they were releasing a new drug for the treatment of migraines. The new drug was to be called Treximet and according to the makers, was to be a vast improvement over Imitrex. Like Imitrex, it is made to be taken at the onset of a migraine, but is supposed to work faster and better to reduce migraine pain. GSK has spent several years and millions of dollars researching and "pre-marketing" Treximet in anticipation of FDA approval and product launch.

    So what's the deal? Is this really better than Imitrex alone? From a strict treatment point of view, yes, the medication probably is better than Imitrex alone for a migraine. The reason for this is twofold. First of all, several years ago, Dr. Silberstein of the Jefferson Headache Center was able to demonstrate through research, that Imitrex combined with naprosyn taken at the onset of a migraine was better in treating that migraine than either drug alone. Such a combination is deemed synergistic, meaning basically that two plus two equals ten. Naprosyn is the prescription form of Aleve which is sold over the counter and is an anti-inflammatory. Once this research was confirmed, GSK began to develop a combination drug.

    The second reason this drug might be better is something called RT technology. GSK has developed this and uses it currently for its Imitrex tablets. Think of it as "burst" technology as the tablet does burst apart when it begins to dissolve. This may speed absorption, and speed is of the essence when treating a bad migraine.

    All treatment benefits aside, is Treximet really a great deal? Well for some, maybe not. One of the reasons a combination drug is usually developed is because the patent on the original drug is about to expire. And sure enough, that is what is happening to Imitrex this year. Unfortunately, samples of Imitrex are rapidly disappearing from doctor's offices. For those who have prescription coverage, the best answer is to ask for a prescription for naprosyn and take both pills at the onset of a migraine. Failing that you could just take two Aleve tablets with your Imitrex.

    For those with no prescription coverage, hang in there! Two pharmaceutical companies who make generic drugs have announced that they will be manufacturing sumatriptan (generic Imitrex) by the end of 2008. Once that is available, it will open up the availability of the drug for millions of migraineurs who previously could not afford the drug. Even with no prescription coverage, the generic may be cheap enough to afford by paying cash. The downside to generics is, different fillers which are cheaper are used in manufacture. GSK still holds the patent on RT technology so it most probably will not be available in the generic sumatriptan.

    As will all medications in the class of triptans, you cannot take these medications if you are pregnant, have uncontrolled hypertension or heart problems such as coronary artery disease. Check with your provider to be sure before taking any new medication and remember, treat early and treat fast to get rid of migraines.

    You can buy Naprosyn here

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    Khaoz's weblog

    Friday, June 27, 2008

    An Inside Look at Prostate Cancer Cures In The Various Forms Of ...


    Prostate cancer cures lay in the various forms of treatments available as therapy for the disease.

    Common Treatments for Prostate Cancer

    Radiation, hormone therapy, radical prostatecomy, chemotherapy, and cryotherapy, which seeks to destroy cancer cells by freezing them, are amongst the most common treatments for prostate cancer, and the closet modern medicine has come to finding prostate cancer cures.

    Radiation for prostate cancer treatment involves the use of external-beam radiation therapy, and radioactive seed implants.

    Prostate cancer hormone therapy implements the use of drugs to stop the biological production of male sex hormones. Androgens are male sex hormones that have been clinical linked to the development of prostate cancer when produced in excess.

    Radical prostatecomy is the surgical removal of the prostate gland. There are two radical prostatecomy surgical procedures available, retropubic surgery, and perineal surgery. The retropubic surgery removes the prostate gland through an incision placed below the navel. The perineal surgery features an incision for removal placed between the anus and scrotum.

    Conventional Prostate Cancer Medications

    Luteinizing hormone-releasing analogs (LHRH) are designed to lower testosterone levels. Such prostate cancer medications are administered via injections and can be given monthly or every three, six, or nine months. Many metastases (with the cancer spreading outside of the prostate gland) prostate cancer patients opt for this round of prostate cancer treatments as opposed to a surgical removal of their testicles.

    Plenaxis is the newest LHRH antagonists. The drug works to lower testosterone but does not cause a sharp rise in testosterone levels before taking affect, as LHRH analogs do. LHRH antagonists can only be used in men who are not able to use other forms of hormonal treatment. Abarelix, Lupron, Zoladex, Eulexin, and Casodex are other common types of LHRH antagonists.

    Finding Prostate Cancer Cures Through Clinical Trials

    Clinical trials serves as one way of finding prostate cancer cures. All prostate cancer medications must take pass the three phases required to gain approval from the Food and Drug Administration.

    Phase I of the clinical trials test the safety of a new drug. The second clinical phase is designed to determine how the proposed new prostate cancer treatment works. Patients are given the drug in high doses during this phase. The patients are watched to see what effect the test drug has on their prostate cancer. The final phase of clinical trial testing pits test medications against standard treatments. A control group is given dosages of the test drug while a second group uses standard methods of medicine-with the effects documented.

    You can buy Casodex here

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    Khaoz's weblog

    Serevent Side Effects Put Serevent in Top 5 Most Dangerous Drugs


    Serevent is an asthma inhalation medication, a bronchodilator, that relaxes the muscles in airways. It is preventative and not effective when taken during an asthma attack.

    Possible side effects of Serevent include allergic reactions noted by breathing problems or swelling of the throat, lips, tongue or face, hives, headaches, dizziness, insomnia, tremors, sweating, nausea, and dry mouth. In many cases, Serevent users have an increased risk of dying from asthma related problems especially if they are taking anti-inflammatory medications even though the FDA first approved Serevent to supplement and not replace anti-inflammatory drugs. Furthermore, the FDA did not approve Serevent to treat acute symptoms of asthma, just basic asthma symptoms and COPD (chromic obstructive pulmonary disorder). Then in 2004 the FDA named Serevent among the top five most dangerous prescription drugs on the U.S. market.

    If you or a loved one has suffered from the adverse effects of Serevent, then you may be able to file a lawsuit against GlaxoSmithKline, the manufacturer of Serevent. GlaxoSmithKline was instructed by the FDA to put a black box warning on the drug about the potential side effects, but it did not comply and has yet to add the black box warning. This is willful negligence and if it has injured you, then you should be compensated financially to repay your medical expenses, lost wages and physical and emotional suffering.

    You can buy Serevent here

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    SirCruizer's weblog

    Thursday, June 26, 2008

    HRT, Breast Cancer, And Bioidentical Hormones


    The symptoms of menopause are akin to labor pains in that they feel like they will go on forever, yet they herald the birth of new life. In fact, whilst perimenopause lasts a lot longer - from 5 to 10, or up to 13 years, it is not an indicator of how 'life will be'. Menopause is a time of growth and adaptation, and our bodies are an intimate part of the journey. The symptoms associated with menopause intimately reflect the flux of the body's hormonal systems.

    Menopause can be extremely disruptive, however. Whether it's sleeplessness, menopause related depression, hot flushes, vaginal dryness, or emotional swings, the good news is that these symptoms can be alleviated. A good menopause treatment will help many seemingly diverse symptoms, as they are all related to the root hormonal flux in the body.

    HRT is one choice, popular with doctors, and one that many women have found extremely useful. But what is often not understood, is that there are different types of hormone replacement therapy, even amongst those prescribed by doctors.

    Premarin is one of the best well know, and oldest, types of hormone treatment. Premarin is made from the urine of pregnant horses, and is an estrogen only hormonal pill. It was advocated as being beneficial for, amongst other things:

    * thickening vaginal tissue


    * helping depression


    * stopping hot flushes


    * preventing heart disease, osteoporosis, and alzheimers

    However, research has also found a link between estrogen-only supplementation and breast cancer. The cells in the breasts and the uterus are responsive to estrogen. So to add estrogen in, without the checks and balances intrinsic to our normal hormonal system, can stimulate the growth of this tissue.

    What many believed was a mitigating factor in premarin's favor was the belief that it helped prevent heart disease. This presumption was based on the fact that premarin lowered LDL cholesterol. High levels of LDL cholesterol had earlier been identified as a risk in developing heart disease. However, this belief has been found to be unsupported in several large clinical trials. In one involving women who had heart disease, those taking premarin (in combination with a synthetic form of progesterone which was given with premarin to prevent endometrial cancer), these women actually significantly increased their risk of having another heart attack in the first year of use. This risk leveled off after that, but it didn't provide any heart protective effects. In a study with healthy women, hormone replacement with premarin, with or without a synthetic progesterone supplement, did not decrease the risk of heart attacks or heart disease.

    Another drawback to premarin and other hormone replacement therapies is the way they are often prescribed, in a kind of 'one size fits all' way, irrespective of a woman's size or medical history.

    But the news is not all bad with HRT therapies. When premarin was developed, there was not the ability amongst scientists to produce other types of estrogen. Because the estrogen in horses is not natural in women, side effects like bloating, headaches, and sore breasts are common. And because the breakdown products of estrogen from horses are so strong, actually more active in the body than the original horse estrogen, they have a pronounced effect on estrogen sensitive tissues, such as the breast. And given that numerous studies have shown that these metabolic by-products can produce changes in the DNA of cells that are carcinogenic to living tissue, it is no surprise that the incidence of breast cancer increases when women take premarin.

    But there are alternatives. Bioidentical hormones are developed from soy beans or yams, and their chemical structure is designed to reflect that which is found in women's bodies. Further, bioidentical hormones are not usually given in a standardized, 'one size fits all' dose, but tailored to a woman's presenting history. They are generally given at low doses, and because chemically they behave more like regular estrogen, they are not associated with the side effects of premarin, although they have not been used in the large scale studies that premarin has.

    References: Dr Christiane Northrup, The Wisdom Of Menopause

    You can buy Premarin here

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    Ayven's weblog

    Clomid, Metformin and PCOS


    Polycystic Ovary Syndrome (PCOS) is a serious health condition for women that can lead to an unbalanced hormone output, irregular menstrual cycles, fertility issues, changes in one’s physical appearance, as well as problems with her heart and blood vessels. The cause of PCOS is unknown and many physicians believe that a combination of causes likely contribute to the overall condition. Some of these likely causes are heredity, genes, insulin, body chemistry and even weight. Additionally, it is not known if the disease is caused by one factor or a combination of issues.

    Women who suffer from PCOS often exhibit the same symptoms:

    • High levels of androgens, which are sometimes called male hormones. Please note that it is not uncommon for females to produce these male hormones but not in high levels as they occur in women with PCOS.

    • Infertility

    • Irregular or missed periods

    • Many small ovarian cysts

    • Acne, dandruff or oily skin

    • Weight gain

    • Diabetes

    • High blood pressure and cholesterol

    • Thinning or balding hair

    • Thickened or blackened skin on the necks, arms, breasts and/or thighs

    • Pelvic pain

    • Anxiety or depression

    • Sleep Apnea

    It is estimated that as many as one in ten women suffer from PCOS and it can occur in girls as young as ten. PCOS is also the most common reason females cannot get pregnant. Early diagnosis allows a female to treat the disease as fully as possible.

    PCOS is a common cause of infertility because affects a woman’s ability to ovulate. Typically, the easiest way to treat women who are not ovulating (because of PCOS or something else) is to give them medication that helps them ovulate.

    This is where Clomid and Metformin comes in.

    The two most common forms of medication prescribed for women with PCOS are Clomid (clomiphene citrate) and Metformin (a diabetes drug). The goal of these drugs is to aid women in ovulation and thus make them able to conceive. The two drugs can be used separately or in combination.

    Recent studies have been conducted to determine using Clomid separately, Metformin separately, or both in combination, were better for women with PCOS. These were conducted by the makers of the drugs but one independent study by the New England Journal of Medicine looked at the same issues and came to several interesting conclusions. Most studies indicated that the best first line defense for women who have problems ovulating due to PCOS, is Clomid.

    The pregnancy rate for women taking Clomid was 22.5%. The pregnancy rate for women taking Metformin was 7.2%. Groups taking both together had more ovulations, but pregnancy rates were not significant enough to make taking them in combination a better option than just taking Clomid. The rates of pregnancy success were the same in all groups tested.

    No drug, no matter how good, is complete without side effects. Individuals who take Clomid sometimes suffer from mood issues, headaches, hot flashes, ovarian enlargement and hostile cervical mucous. Your doctor can prescribe other drugs to combat the side effects, including over the counter drugs. Discussing your options with your doctor is the surest way to discover if Clomid can help you with your PCOS and infertility issues.

    You can buy Clomid here

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    enderhelpme's weblog

    Alternatives Provided For the Surgery of Breast Enlargement


    Why do a breast enlargement surgery to enlarge your breasts, when natural breast enlargement is a much cheaper and safer way? The surgery can cause up to over $10,000. Luckily, breast enhancement provides many alternatives to this found in the market today that allow you to choose from.

    Fennel Seed is rich in that it has lots of flavonoids that can boost up estrogenic effects, which is vital to forming new breast cells and tissues. Also, the boosting of excretion is important in the cleansing of the estrogen receptor sites that usually get clouded with environmental toxins that acts like an estrogen.

    Dong Quai Root helps the body in the use of hormones. However, this herb is primarily for women, and not for men. Scientists' studies have shown that one mechanism of the action of this herb is utilized to promote natural progesterone synthesis. The plant nutrients can then be used to wash these out of the system, thus increasing the health of the breast tissue.

    Blessed Thistle Herb is another herb that's used to treat a variety of female concerns. Due to its containing powerful estrogenic properties, Blessed Thistle Herb is primarily used for nursing mothers. Today, doctors consider it to be one of the best medicines for a woman.

    The enduring herb, Dandelion root, is commonly found anywhere. Dandelion root affects all forms of secretion and excretion from the body. This boosting of secretion is very important to the formation of breast cells and tissue, and the boosting of excretion is key to the cleansing of the estrogen receptor sites that tends to get clouded with environmental toxins that mimic estrogen.

    Many people prefer surgery over natural breast enlargement. However, with the herbs provided as alternatives above, there are safer and cheaper ways to enhance the size of the breast.

    You can buy Breast Augmentation here

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    Arkaig_Roe's weblog

    Neurontin Lawsuit: Neurontin Off-Label Abuse Lawyer


    Pfizer is currently marketing Neurontin as an oral medication for managing postherptic neuralgia, the pain that lingers after shingles has healed. This is an FDA-approved use, and studies have shown that Neurontin works to reduce patients’ pain. It is a good drug, with many useful applications and few negative side effects, but it has a surprisingly long and sordid past.

    Neurontin was originally approved in 1993 for the treatment of partial seizures in adults and children, especially epileptic seizures. However, this limited market for a drug with so few side effects was not enough for the company, Warner-Lambert. The company set up a massive campaign to improve sales of Neurontin, and it worked. By 2002 Neurontin was a $2 billion dollar drug, outselling even Viagra. How did a little epilepsy drug come to claim such a huge number of patients? It did so illicitly.

    There are not enough patients suffering from epilepsy that one drug could earn profits of $2 billion a year. In order to claim these kinds of profits, Warner-Lambert began promoting the drug for off-label uses. The company sent representatives directly to doctors, urging them to prescribe Neurontin for to treat not only epilepsy but also bipolar disorder, alcohol withdrawal, cocaine abuse, HIV/AIDS neuropathy, phantom limb pain, anxiety, and a host of other diverse and unrelated conditions.

    Though it has since been shown to work for some of these conditions, it was not clear at the time exactly what Neurontin did. The Warner-Lambert salesmen were lying to doctors about what Neurontin could do, and the doctors were listening. While it is illegal for a drug company to promote off-label uses directly and immoral to bribe doctors into prescribing a certain drug, it was also absolutely dangerous to claim Neurontin could cure disorders that it simply couldn’t.

    For example, Neurontin has no effect on bipolar disorder. Warner-Lambert sold thousands of doctors on the idea that Neurontin should be prescribed for bipolar disorder. If it did not work, they suggested increasing the dosage. One of the drug company managers told a salesman: “I don’t want to see a single patient coming off Neurontin before they’ve been up to at least 4,800 milligrams a day. I don’t want to hear that safety crap either.... It’s a great drug.” An untold number of bipolar patients were taken off their FDA-approved medication and prescribed Neurontin alone. Although Neurontin has few side effects, it also did nothing for their disorder, leaving these patients effectively unmedicated. Nobody knows how many lives were shattered as a result, but unmedicated bipolar disorder has a mortality rate of 55-60%.

    Luckily for the public and patients taking Neurontin, a Warner-Lambert sales representative came forward and revealed the entire scandal. Pfizer has now purchased the Warner-Lambert Company, making Pfizer responsible for the injuries caused by the drug it now profits from. Lawsuits are being filed to claim damages for the dangerous corporate marketing strategies that have caused so much pain. If you or someone you love was wrongly administered Neurontin, please contact a lawyer and discuss your options.

    You can buy Neurontin here

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    Kestra's weblog

    Wednesday, June 25, 2008

    Medication Treatment of Hypertension - Which Drugs are Best?


    Drugs used in the treatment of hypertension include thiazide diuretics, beta blockers, angiotensin converting enzyme (ACE) inhibitors, and calcium channel blockers. The newer ACE inhibitors and calcium channel blockers were promoted as being better for the treatment of hypertension than the older thiazide diuretics and beta blockers, however this was mostly marketing hype since the newer drugs were on patent and made more money for the drug companies. However the studies showed that, at least compared to thiazide diuretics, the newer drugs weren't as good, even they cost much more.

    Thiazide diuretic drugs work for hypertension by increasing urine output and decreasing the volume of fluid in your circulation, which they achieve by increasing sodium excretion from the kidney, which drags water along with it. Examples include hydrochlorothiazide (Esidrix, Hydrodiuril, Microzide) and chlorthalidone (Hygroton). Thiazides promote calcium retention and prevent bone loss and fractures. However, they can negatively interact with an extensive list of medications, which are listed in the Physicians Desk Reference.

    Their main problem is that they cause is frequent urination, which is inconvenient to say the least. They can also be associated with a loss of potassium Low serum potassium, or hypokalemia, is a potentially fatal condition, that can be associated with symptoms of muscle weakness, confusion, dizziness that can lead to falls, and heart arrhythmias. For people with a healthy diet, this is not a problem. You can also possible to take potassium supplements by mouth every day, to avoid the problem of potassium depletion with diuretics. A sub-category of these drugs, the so-called thiazide-like diuretic indapamide (Lozol) can cause life-threatening drops of sodium in the blood. In 1992 the Australian authorities reported 164 cases of this potentially life threatening condition, which is associated with confusion, lethargy, nausea, vomiting, dizziness, loss of appetite, fatigue, fainting, sleepiness, and possible convulsions. Since it doesn't work better than hydrochlorothiazide, and is potentially dangerous, it should not be used.

    ACE inhibitors are one of the newest types of hypertension drugs. They act on the renin-angiotensin system that regulates blood pressure and kidney function. Normally, the molecule angiotensin I is converted to angiotensin II by the angiotensin-converting enzyme. Angiotensin II is a potent vasoconstrictor that makes your blood vessels close down. By blocking the angiotensin-converting enzyme, you make the blood vessels relax, decreasing blood pressure. Examples of this type of drug include lisinopril (Prinivil), enalapril (Vasotec), ramipril (Altace), benazepril (Lotensin), fosinopril (Monopril), and captopril (Capoten). Side effects of ACE inhibitors include headache, flushing, diarrhea, rash, and more rarely dizziness, heart failure or stroke. One of the most annoying side effects is a dry persistent cough. Angiotensin receptor blockers (ARBs), like valsartan (Diovan), irbesartan (Avapro), olmesartan (Benicar), candesartan (Atacand), and losartan (Cozaar; Hyzaar when combined with hydrochlorothiazide) act on the angiotensin receptor to block its effects, thereby reducing blood pressure. Side effects include dizziness, diarrhea, rash, and more rarely anxiety, muscle pains, upper respiratory track infection, low blood pressure or elevations in potassium.

    Calcium channel blockers act on the lining of the blood vessels. When these channels let calcium in, the blood vessels constrict. By blocking the calcium channels, these drugs cause the vessels to relax, as a result blood pressure goes down. Examples of this type of drug include amlodipine (Norvasc), verapamil (Calan), nifedipine (Procardia, Adalat), and diltiazem (Tiazac). Side effects include constipation, dizziness, headache, nausea, and more rarely low blood pressure, heart failure or arrhythmias.

    Calcium channel blockers have not been found to prevent heart attacks better than diuretics (ALLHAT 2002; Black et al 2003; Brown et al 2000; Hansson et al 2000). In fact, one study showed that calcium channel blockers (nifedipine) did not prevent heart attacks or chest pain (angina) any better than a placebo, or sugar pill (Poole-Wilson et al 2004). A meta analysis of all studies combined showed that treatment with calcium channel blockers did not improve mortality more than a placebo, although ACE inhibitors did (BPLTTC. 2000). Another meta analysis found that treatment with calcium channel blockers when compared to other medication treatments for high blood pressure was associated with a relative 26% increase in heart attacks, 25% increase in heart failure, and 10% increase in major cardiovascular events (Pahor et al 2000). Furthermore, for women calcium channel blockers increased the risk of heart attack or stroke by 18% (Poole-Wilson et al 2004). Calcium channel blockers have been found to increase the risk of heart failure relative to other antihypertension drugs in several studies,(Black et al 2003; BPLTTC. 2000; Pahor et al 2000; Pepine et al 2003) overall by about 20% (BPLTTC 2003). In spite of this, one of the calcium channel blockers, amlodipine, continues to be a blockbuster drug, with 2 billion dollars a year in sales reported in 2003, a year after the troubling reports of heart failure with calcium channel blockers was published.

    In the NIH-sponsored Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). In ALLHAT, the largest study of antihypertensive medications ever performed, different types of antihypertensive treatments were compared in 33,357 patients with high blood pressure and one other risk factor for heart disease were randomly assigned to the "old" drug chlorthalidone (diuretic), or the "new" drugs amlodipine (calcium channel blocker), or lisinopril (ACE inhibitor). Rates of fatal and nonfatal heart attacks were essentially the same between the three treatments (ALLHAT 2002). There was a 38% increase in heart failure with amlodipine compared to chlorthalidone. For lisinopril there were increased rates of total cardiovascular disease outcomes (10%), stroke (15%) and heart failure (19%) compared to chlorthalidone.

    Since the time of ALLHAT other studies have not shown that ACE inhibitors and calcium channel blockers work better than diuretics, even though they cost more. And like ALLHAT, some of these studies show cause for concern.

    As I mentioned above, many of the studies involved a comparison of "old" and "new" drugs, showing no difference in heart attacks and strokes for the two types of drugs. For the old drugs the studies often lumped together atenolol and a diuretic. However as I will explain later in more detail atenolol is probably not a very good drug, so these studies may have hid the fact that diuretics are better! In any case they show that there is no reason to spend more money on the new drugs. Follow along now while I spell out some of those studies.

    For instance, in the NORdic DILtiazem (NORDIL) study, (Hansson et al 2000) which compared diltiazem (calcium channel blocker) to diuretics and/or beta blockers in 10,881 patients from Norway and Sweden, there were no differences in rates of fatal or non-fatal heart. Other studies which showed essentially identical rates of heart attack or stroke included The Controlled ONset Verapamil INvestigation of Cardiovascular End points (CONVINCE) Trial, a study of 16,602 patients who received verapamil (calcium channel blocker), or atenolol (beta blocker)/hydrochlorothiazide (diuretic) (Black et al 2003). The INternational VErapamil trandolapril STudy (INVEST), which compared the calcium channel blocker verapamil to the beta blocker atenolol in 22,576 patients (Pepine et al 2003). The Swedish Trial in Old Patients with Hypertension 2 (STOP-2) (Hansson et al 1999a) study, which randomised 6614 patients age 70-84 to either "new" drugs like calcium channel blockers or ACE inhibitors, or "old" drugs diuretics and beta blockers, and the CAptopril Prevention Project (CAPPP) as study of captopril (ACE inhibitor) versus diuretics and/or beta blocker in 10,985 patients (Hansson et al 1999b).

    Not only was it difficult to show that the new drugs were better than the old (the marketing goal that drove the design of the studies), it wasn't easy to show that taking the drugs was better than doing nothing. For instance, in the ACTION Study (A Coronary disease Trial Investigating Outcome with Nifedipine), 7665 patients with stable angina received the calcium channel blocker nifedipine or placebo in a randomized trial (Poole-Wilson et al 2004). There was no difference in a combined measure of fatal and non-fatal heart attack or stroke, revascularization, or heart failure. Death from heart disease was equal in the groups, and there was a 16% increase in non-cardiac deaths with nifedipine that was not statistically significant. Women on nifedipine had an 18% increase in this measure of cardiac events, although the difference was not statistically significant. In the Heart Outcomes Prevention Evaluation (HOPE) Study, 9297 patients at high risk for heart disease were randomized to the ACE inhibitor ramipril or placebo in addition to their usual treatment (HOPE 2000). A fatal or non-fatal heart attack or stroke was seen in 14.0% of the ramipril patients compared to 17.8% on placebo, a difference that was statistically significant. In the Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) Trial, a study of 8290 patients with heart disease, the addition of the ACE inhibitor Trandolapril had no effect on reducing heart attacks and coronary revascularization procedures compared to a placebo (PEACE 2004). These results led to an editorial called "ACE inhibitors in Patients with Stable Heart Disease-may they rest in Peace?"

    The Valsartan Antihypertensive Long term Use Evaluation (VALUE) study compared the ARB valsartan to the calcium channel blocker amlodipine in 15,245 patients over age 50 with high blood pressure and a high risk of heart disease (Julius et al 2004). The study found no difference between the two drugs in fatal and non-fatal heart attacks and other cardiac events. More non-fatal heart attacks were seen with valsartan, but there was also less development of diabetes. This study led to an editorial called "Is there Value in Value?"

    When new drugs were compared to diuretics alone, their performance was worse. For instance, the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS) compared the calcium channel blocker isradipine to the diuretic chlorthalidone in 883 patients with high blood pressure. Twenty five patients on isradipine had a major cardiovascular event (heart attack, stroke, heart failure, death or angina) compared to 14 on diuretic, a difference which was statistically significant (Borhani et al 1996). In the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study (Brown et al 2000) 6321 patients aged 55-80 with hypertension and one risk factor for heart disease were randomly assigned to nifedipine or co-amilozide (hydrochlorothiazide+amiloride, both diuretics). In the nifedipine group, 200 had cardiovascular death, heart attack, heart failure or stroke (combined) versus 182 in the diuretic group, which was not statistically significant. The nifedipine group did have significantly more fatal heart attacks (16 versus 5) and non-fatal heart failure (24 versus 11).

    Dr. Bruce Psaty and colleagues from the University of Washington in Seattle looked at all of the data from trials that had been published up to 2003. Overall they found that diuretics were superior to all other treatments (Psaty et al 2003). Compared to placebo diuretics reduced the risk of heart disease by 21%, heart failure by 49%, stroke by 29% and total mortality by 10% (all significant). Diuretics compared to calcium channel blockers had 6% fewer cardiovascular disease events and 26% less heart failure; compared to ACE inhibitors there was 12% less heart failure, 6% less cardiovascular disease events and 14% less stroke. Diuretics compared to beta blockers had 11% less cardiovascular disease events. All treatments were similar in their ability to lower blood pressure. The authors concluded that diuretics (but not beta blockers, as was the recommendation at the time) should be the first line of treatment for high blood pressure.

    Most of the studies of antihypertensive medications have been done in men. In the only study focused on women, 30,219 women with hypertension without heart disease were assessed for the relationship between anti-hypertensive therapy and outcome. Use of calcium channel blockers compared to diuretic was associated with a 55% increased risk of cardiovascular death, diuretic plus calcium channel blocker was associated with an 85% increased risk of cardiovascular death compared to diuretic plus beta-blocker. The risk increased to 2.16 when women with diabetes were excluded (Bhatt et al 2006; Wassertheil-Smoller et al 2004).

    The alpha-blockers block the alpha noradrenergic receptor in the heart and blood vessels, and include doxazosin (Cardura), prazosin (Minipress) and terazosin (Hytrin). A related drug called Labetalol (Normodyne) blocks both alpha and beta-receptors. The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) Study showed that the alpha blocker Cardura doubled the risk of heart failure and increased the risk of stroke and all cardiovascular disease when compared to diuretic. This led to the study being stopped early; the authors of ALLHAT concluded that alpha-blockers should not be used in the treatment of hypertension (Davis 2000). Based on this I believe that there is no role for alpha-blockers in the treatment of patients with hypertension.

    What is the bottom line for the treatment of hypertension? First things first. Cut sodium from your diet. That means making your own dinner whenever possible, since processed, canned and frozen foods are full of sodium, as food meals. Exercise by moderate walking for 30 minutes three times a week. Try stress reduction or meditation. Stop smoking. Do not drink alcohol in excessive amounts.

    If these changes fail to lower your blood pressure, you may need medication. Work with your doctor to find out what works best for you. You may need to be started on the standard and least expensive treatment, diuretics. They work better than the newer drugs, based on the research I outlined earlier, and they have fewer side effects overall than the newer medications. This is especially true if you are African-American. You should definitely not take an ACE inhibitor or calcium channel blocker if you are not taking a diuretic.

    Alpha-blockers should not be taken under any circumstances. These drugs seem to cause more heart problems than conventional diuretic treatments. Potassium sparing diuretics are dangerous and should be avoided.

    If your blood pressure is not controlled with a diuretic, you may need to add another medication. This means going to a beta blocker, ACE inhibitor or calcium channel blocker. I do not recommend atenolol; you can use another beta blocker like metoprolol. Women should not take a calcium channel blocker. ACE inhibitors or ARB drugs can help whites with left ventricular (heart pump) failure.

    ALLHAT (2002): Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). Journal of the American Medical Association 288:2981-2997.

    Bhatt D, Fox KAa, Hacke W, et al (2006): Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. New England Journal of Medicine 354:1706-1717.

    Black HR, Elliott WJ, Grandits G, et al (2003): Principal results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) Trial. Journal of the American Medical Association 289:2073-2082.

    Borhani N, Mercuir M, Borhani PA, et al (1996): Final outcome results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS): A randomized controlled trial. Journal of the American Medical Association 276:785-791.

    BPLTTC (2003): Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet 362:1527-1535.

    BPLTTC. (2000): Blood Pressure Lowering Treatment Trialists Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Lancet 355:1955-1964.

    Brown MJ, Palmer CR, Castaigne A, et al (2000): Morbidity and mortality in patients randomised to double-blind treatment with long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet 356:366-372.

    Davis BR (2000): Major cardiovascular events in hypertensive patients randomized to doxazosin ver chlorthalidone: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Journal of the American Medical Association 283:1967-1975.

    Hansson L, Hedner T, Lund-Johansen P, et al (2000): Randomised trial of effects of calcium antagonists compared with diuretics and beta blockers on cardiovascular morbidity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 356:359-365.

    Hansson L, Lindholm LH, Ekborn T, et al (1999a): Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study. Lancet 354:1751-1756.

    Hansson L, Lindholm LH, Niskanen L, et al (1999b): Effect of angiotensin-converting-enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captropril Prevention Project (CAPPP) randomised trial. Lancet 353:611-616.

    HOPE (2000): Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. New England Journal of Medicine 342:145-153.

    Julius S, Kjeldsen SE, Weber B, et al (2004): Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 363:2022-2031.

    Pahor M, Psaty BM, Alderman MH, et al (2000): Health outcomes associated with calcium antagonists compared with other first-line antihypertensive therapies: a meta-analysis of randomised controlled trials. Lancet 356:1949-1954.

    PEACE (2004): The PEACE Trial Investigators. Angiotensin-Converting Enzyme inhibition in stable coronary artery disease. New England Journal of Medicine 351:2058-2068.

    Pepine CJ, Handberg EM, Cooper-DeHoff RM, et al (2003): A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease: The International Verapamil-Trandolapril Study (INVEST): A randomized controlled trial. Journal of the American Medical Association 21:2805-2816.

    Poole-Wilson PA, Lubsen J, Kirwan B-A, et al (2004): Effect of long-acting nifedipine on mortality and cardiovascular morbidity in patients with stable angina requiring treatment (ACTION): randomised controlled trial. Lancet 364:849-857.

    Psaty BM, Lumley T, Furberg CD, et al (2003): Health outcomes associated with various antihypertensive therapies used as first-line agents: A network meta-analysis. Journal of the American Medical Association 289:2534-2544.

    Wassertheil-Smoller S, Psaty B, Greenland P, et al (2004): Association between cardiovascular outcomes and antihypertension drug treatment in older women. Journal of the American Medical Association 292:2849-2859.

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