Showing posts with label side effects. Show all posts
Showing posts with label side effects. Show all posts

Tuesday, 22 September 2015

Is The Medication You Are Taking For Knee Pain Safe?

Invariably people suffer from knee pain. The reasons for knee pain can be various, but most often people are prescribed pain relievers. Most pain relievers belong to the class of drugs called Non-Steroidal Anti-inflammatory Drugs (NSAID). Few do take only paracetamol which is not an NSAID.

                                                Image Courtesy: Flickr -James Buck


Recently we had a second opinion consultation for high blood pressure (BP). She is a 55 year old lady who suffers from severe knee pain on account of osteoarthritis since few years. As the first Orthopedician was not able to relieve her pain, they consulted a second orthopedician, who had put her on Oxaceprol for more than a month. She was also on Piroxicam. She was having giddiness since one month. Six days earlier they had visited their general physician who prescribed her Olemasartan for her high BP. The next day her giddiness symptoms aggravated. At this point, we were consulted.

When we went through the detailed history, we diagnosed that her BP was high because of the two NSAID drugs, that is, Oxaceprol and Piroxicam, for her knee pain. This was preventing the Olemasartan to reduce her BP. We immediately asked her to stop her pain medications (NSAIDS).
She improved significantly within 24 hours. We suspected that her kidneys might have been damaged because of NSAIDS. Blood report indicated elevated creatinine and urea. Luckily, they were just above the upper limit of normal.

Why are reporting this story here?

We have come across many patients who take pain relievers for prolonged duration only to end up having more severe side effects like elevated blood pressure, kidney damage, gastric ulceration.

So if you are suffering from knee pain or if you any one known to you suffers from knee pain and is on chronic NSIADS, get them checked for side effects. People with diabetes need to be 100 times more careful when they take pain relievers.

Be informed, stay healthy!

Saturday, 4 April 2015

Know Your Drug-Azithromycin



Prana Doctors come across many people who take Azithral or any brand of Azithromycin over the counter antibiotic, when they have sore throat, cold cough. While it might have helped you on numerous occasions, the risks and benefits vary according the age and other co-morbidities the person has.

We highlight below the risk and benefits  associated with taking Azithromycin.

Azithromycin is an important antibiotic used by Pulmonologists, ENT specialists, General Practitioners and other doctors.

It is used in 


1. Community acquired pneumonia

2. Acute bacterial exacerbations of chronic obstructive pulmonary disease.

3. Uncomplicated skin and skin structure infections.

4. Genitourinary tract infections

In Pediatric :

Acute otitis media, Pharyngitis and Tonsiliitis.

Dosage:



Side-effects:

1. Diarrhoea/loose stools (4-5%)

2. Abdominal pain (2-3%)

3.Nausea (3-4%)

4. Vomiting (1%)
Azithromycin has had a recent label change which warrants this writing.

The revised label advises against the use of azithromycin in patients with known risk for QT interval prolongation, hypokalemia, hypomagnesemia, bradycardia. 

This label revision is because of post marketing surveillance findings, an observational study involving Tennessee Medicaid Patients and also Danish national healthcare data.

Excerpts"


For every 21,000 outpatient prescriptions written for azithromycin, one cardiovascular death occurred in excess of those observed with the same number of amoxicillin prescriptions. The excess risk over amoxicillin varied considerably according to cardiovascular risk factors; the researchers estimated that there was one excess cardiovascular death per 4100 prescriptions among patients at high cardiovascular risk but less than one per 100,000 among patients with lower cardiovascular risk.”


The risks and benefits of antibacterial therapy should be considered in prescribing decisions. Pharmacologic and epidemiologic data point to lethal arrhythmias as a potential consequence of QT-interval prolongation with use of azithromycin, other macrolides, and fluoroquinolones. This possibility should give clinicians pause when they're considering prescribing antibacterial drugs, especially for patients with preexisting cardiovascular risk factors or clinical conditions in which antibacterial drug therapy has limited benefits.”


Cardiovascular Risks with Azithromycin and Other Antibacterial Drugs

Andrew D. Mosholder, M.D., M.P.H., Justin Mathew, Pharm.D., John J. Alexander, M.D., M.P.H., Harry Smith, Ph.D., and Sumathi Nambiar, M.D., M.P.H.
N Engl J Med 2013; 368:1665-1668May 2, 2013DOI: 10.1056/NEJMp1302726

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