Author: Jennifer Bowles

Anorexia Nervosa and Bulimia Nervosa

Anorexia nervosa and bulimia nervosa are eating disorders that are distinct but related syndromes that have in common an intense preoccupation with food. Patients with anorexia nervosa are characterized by a fear of becoming obese, disturbance in body image, anorexia, extreme weight loss, and amenorrhea. On the other hand, bulimia is characterized by periods of binge eating, alternating with fasting; self-induced vomiting; and the use of diuretics and cathartics.

Current Management

The management of patients with a chronic multisystem infection is more complex. Once a diagnosis of intestinal Whipples disease is reached, it is important to evaluate other commonly involved organ systems. After staging is completed, the choice and adequate duration of antibiotic treatment is critical for the patient’s long term outcome.

Antiarrhythmic drugs

A 62-year-old man is being managed in the intensive care unit following a large anterior wall MI. He has been appropriately managed with oxygen, aspirin, nitrates, and P-adrenergic receptor blockers but has developed recurrent episodes of ventricular tachycardia. During these episodes he remains conscious but feels dizzy, and he becomes diaphoretic and hypotensive.

Irritable bowel syndrome (IBS). Epidemiology

Irritable bowel syndrome (IBS) is a chronic disorder characterized by recurrent symptoms of lower abdominal pain with disturbed defecation and bloating. The disorder affects up to 20% of the population and is the most common gastrointestinal (GI) ailment diagnosed by general practitioners. Although it is estimated that only one in five patients with IBS seeks medical attention, direct medical costs account for an estimated $8 billion each year within the United States.

Baclofen

Slightly soluble in water; very slightly soluble in alcohol; practically insoluble in acetone; dissolves in dilute mineral acids and in dilute solutions of alkali hydroxides. A white to off-white, odourless or practically odourless, crystalline powder.

Ellence – Medication for Adjuvant Therapy of Breast Cancer

Ellence (pronounced el-LENCE) (epirubicin hydrochloride injection), marketed by Pharamacia &Upjohn, is an anthracycline antineoplastic antibiotic marketed as Farmorubicin(r) outside the U. S. and is currently used in more than 80 countries to treat a variety of cancers, including metastatic breast cancer.

Antisense Oligonucleotides

No antisense oligonucleotides are on the market yet for cancer. Despite the compounds’ high specificity and low toxicity, this drug class has been plagued with disappointing results, such as those reported for ISIS-3521 (Isis Pharmaceuticals/Eli Lilly’s Affinitak) in non-small-cell lung cancer. Their appeal is further limited by the fact that they require long periods of intravenous administration.

OTC Famotidine (Pepcid) for Acid Control

Johnson & Johnson-Merck has won the race to bring an H(2)-receptor antagonist to the over-the-counter (OTC) market. The joint pharmaceutical venture has received marketing approval for its 10-mg preparation of famotidine (Pepcid AC Acid Controller) from the Food and Drug Administration (FDA).

Heartburn in practice

I’ve been having trouble with heartburn. In fact, it is one of the reasons I wanted to lose weight. I used to get it every once in a while, but then it started to get more frequent.

Pipecuronium Bromide

Pipecuronium bromide is an aminosteroidal competitive neuromuscular blocker (see Atracurium). Pipecuronium is reported to have no significant cardiovascular adverse effects or histamine-related effects. On intravenous injection muscle relaxation occurs within 2.5 to 3 minutes with a duration of action of about 30 minutes to 2 hours, depending on the dose.

Hepatitis C

Hepatitis C virus, identified in 1988, is an RNA virus that appears to be responsible for most instances of parenterally transmitted non-A, non-B hepatitis. The virus seems to mutate frequently and appear in many subtypes.

Rabeprazole

Rabeprazole sodium is a proton-pump inhibitor that suppresses gastric acid secretion by blocking acid (proton) pump within gastric parietal cells. It is indicated in short-term treatment in healing and symptomatic relief of duodenal ulcers and erosive or ulcerative gastroesophageal reflux disease (GERD); maintaining healing and reducing relapse rates of heartburn symptoms in patients with GERD; and treatment of daytime and nighttime heartburn and other symptoms associated with GERD; long-term treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome and in combination with amoxicillin and clarithromycin to eradicate Helicobacter pylori. The most potent suppressors of gastric acid secretion are inhibitors of the gastric H+K+-ATPase (proton pump).

ReFacto for Hemophilia A

To date patients with hemophilia A, the most common type, have had to rely on factor VIII products purified from human serum albumin. In March the FDA approved ReFacto (recombinant antihemophilic factor VIII), the first recombinant factor VIII product formulated without human serum albumin, for the control and prevention of bleeding episodes and surgical prophylaxis in patients with hemophilia A.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

How many of your patients chronically take non-steroidal anti-inflammatory drugs (NSAIDs)? In a recent Saskatchewan survey, approximately 13% of the general population had filled a prescription for an NSAID during the preceding year. In British Columbia these drugs accounted for 6.4% of total claims and 9.8% of drug cost to the Pharmacare Program.

Amsacrine

Amsacrine is incompatible with sodium chloride 0.9% injection and with other chloride-containing solutions, apparently because of the poor solubility of the hydrochloride salt in aqueous solution. Amsacrine reacts with certain plastics.

Pathogenesis Of Joint Damage

Although the cause of rheumatoid arthritis remains elusive, the destructive features of the disease have been extensively documented and described. The following sections review each key element of disease pathogenesis. They include the infiltration of lymphocytes and macrophages into synovial tissue, hyperplasia of synovial cells, and the enhanced expression of multiple inflammatory mediators, such as cytokines and degradative enzymes.

Could the Blues Increase Your Risk for Stroke?

Many factors that put individuals at risk for stroke have been identified, including physical inactivity, high cholesterol, obesity, use of alcohol or cigarettes, diabetes and high blood pressure. For the first time, researchers have identified a psychological factor that also affects stroke risk — depression. A study published in the July/August issue of Psychosomatic Medicine reports that increasingly, levels of depression are associated with increasing levels of risk for later stroke.

Busulfan

Very slightly soluble in water and in alcohol; freely soluble in acetone and in acetonitrile. Very slightly soluble in water; slightly soluble in alcohol; soluble 1 in 45 of acetone. The major adverse effect of busulfan with standard doses is bone-marrow depression, manifest as leucopenia, thrombocytopenia, and sometimes, anaemia.

Treatment/Clostridium difficile Infection and Pseudomembranous Colitis

A 68-year-old woman complained of a 2-week history of loose stool and abdominal cramps. One month ago she was treated by her primary care physician for a sinus infection with amoxicillin.

Treatment of Inflammatory Bowel Disease

Patients with mild symptomatic Inflammatory bowel disease usually are able to take food orally. The diet should be nutritious. Traditionally, fiber has been restricted during periods of active symptoms.