When you (or loved ones) are taking prescription or over the counter medications…there is a lot you should be worried about, and a lot that your pharmacist may not be telling you.

Most people are aware, for example, that several medications taken together can sometimes cause harmful interactions. Most also know that drug allergies can pose significant hazards. (These are topics of other articles in this series). And, many people know that young children, elderly adults, pregnant women, nursing women, and severely debilitated people may all be at higher risk for adverse drug events.

But what most people don’t know is that a simple blood test can be one of the most important pieces of information in determining the correct dose of many medications…and the results of that test are almost never available to your pharmacist, especially if your pharmacist fills your prescription in a retail drugstore. (And, that’s a bummer.)

The test I’m talking about, of course, is the ’serum creatinine test’ (’SEAR-’em cree-AT-tuh-neen tehst’. It’s a difficult name to pronounce and a difficult test to understand…but one that you NEED to know about if you or loved ones are taking over-the-counter or prescription medications.)

A serum creatinine test gives a physician or pharmacist an estimate of kidney function.

Serum creatinine is the ‘bean counter’ of modern medicine… letting folks know if the beans (the kidneys) are working as well as they should.

Why is that important?

Well, kidney function is extremely important in determining the correct doses of many medications since the kidneys (along with the liver) assist in the removal of medications from the body.

Almost all medications (and/or their chemical by-products) are either removed by the liver, by the kidneys, or, in many cases, by both the kidneys and liver working together.

So, simply put, when the beans are not working well, many medications will accumulate in the body and increase the risk of drug side effects. And that’s an even bigger bummer. (The same is true for liver problems, and we will talk about that in another article in this series.)

As a result, patients with reduced kidney function often need LOWER doses of many medications.

So how does this all work?

Well, creatinine is a chemical that occurs and circulates naturally in the human body. It is the result of normal protein break-down. And, like many medications, creatinine is normally removed from the blood by the beans. So, when the kidneys are not working well, the level of creatinine circulating in the bloodstream will start to go up…just like the blood level of many medications.

Physicians and pharmacists are routinely and easily able to determine how much creatinine is in the blood with the results of a serum creatinine test. (This test is part of a very common panel of blood tests. And, if the serum creatinine is high, many drugs need to have a lower dose.) The normal value for serum creatinine is about 0.4 to 1.5 mg/dl…but that can vary a bit from lab to lab.

So remember: ‘kidneys no work…serum creatinine go UP’.

Now, serum creatinine is not the best measure of kidney function (there are other tests that are much more accurate), but results of the serum creatinine test are usually the most readily available…and cheapest…and are generally accurate enough for most purposes…so serum creatinine is the de facto standard for estimating kidney function…most of the time.

The gold standard test that doctors use for measuring kidney function is called ‘creatinine clearance’ (cree-AT-tuh-neeeen CLEAR-uhhh-nce) However, not many patients get this particular test because it is pretty darn inconvenient…and smelly. You have to collect all of your urine for 24 hours and keep it in the fridge. Not a lot of volunteers for this test…

Creatinine clearance is the volume of blood that the kidneys clear of creatinine in a given amount of time (and it is usually reported as milliliters per minute).

So, when kidney function decreases, creatinine clearance (the amount of blood that the kidneys are successfully ‘cleaning’) also decreases.

So remember: ‘kidneys no work…creatinine clearance go DOWN’. (Note: this is easy to remember because it is the exact opposite of what you were initially thinking, and the opposite of what happens with serum creatinine. Most of medicine is like this.)

Now for the super tricky part just for those gunning for an A. There is a way to ‘guestimate’ creatinine clearance using serum creatinine…isn’t that neat. And, that’s probably the best way to determine renal function if a measured creatinine clearance is not available.

What you do is run the serum creatinine value through a fancy equation that will give you an estimated creatinine clearance, which is itself an estimate of kidney function. (Estimates of estimates of estimates…that’s the kind of exacting science I live for.)

For adults, that equation is the famous ‘Cockcroft-Gault equation corrected for ideal body weight and gender’…the equation everyone loves to hate. The Cockcroft-Gault equation (presumably named after Drs. Cockcroft and Gault…or maybe just Dr. Cockroft-Gault, or maybe Lara Croft), is generally considered very reliable since it has never been well validated in young patients, old patients, thin patients, fat patients…basically all the patients it gets used on. So go figure. Double bonus points if you can remember this:

For men, creatinine clearance =

((140- Age) ‘ IBW) / (72 ‘ SCr)

For women, creatinine clearance =

((140- Age) ‘ IBW ‘ 0.85) / (72 ‘ SCr)

Where Age is in years, IBW is ideal body weight in kilograms, and SCr is serum creatinine in mg/dl.

Now once you run this a few times, you’ll find that creatinine clearance for young healthy people is about 100 ml/min (we’ll just leave off the ‘ml/min’ part from now on).

And, dead people have a creatinine clearance of about 0, depending on how healthy they are.

Everyone else falls somewhere in between.

(Now someone in the back of the room is saying, ‘I just ran this on myself and I have a creatinine clearance of 150′. Well aren’t you special? In fact, young good-looking people can have creatinine clearances of 130, 140, or more…but it doesn’t do a whole lot of good since 100 is perfectly acceptable. In fact, it’s just another case of overachiever overkill.)

Now, if someone has a creatinine clearance of 80, that means that they have about…80% kidney function.

And, if someone has a creatinine clearance of 50, that means that they have about…50% kidney function. (Are you following all of this?)

Many drugs that are eliminated by the kidney will require moderate dosage reductions once a patient’s renal function is in the 40-60 range.

Patients in the 20-40 range will typically require very large reductions in dose.

And, patients who are in the ‘less than 20′ range will often need HUGE dosage reductions for medications eliminated by the kidney (or better yet, they’ll need to take medications that are removed by some other organ altogether…if such an alternative is available).

One last tidbit to consider. Renal function declines as people age. No getting around that. But, the rate of decline is different for different people. By the time you’re 50 years old, there is a reasonable chance you’ll have moderate renal function (or worse)…by the time you’re 80, you’ll almost certainly have some important degree of renal impairment… and you probably won’t even know it or feel it.

Now that you know more renal physiology than you ever, EVER wanted to know…let’s get back to the main thread of this article…medication safety.

If you (or a loved one) are at risk for having decreased kidney function (and I’ll tell you who such folks are in just a second), you need to step up to the plate and get a handle on this issue (because there is a very good chance that your physician and pharmacist either didn’t have renal function data or didn’t consider it when coming up with a dosage for you).

Here are the steps I recommend for everyone taking prescription or over-the-counter medications:

1) For everyone: If you have access to the results of a recent serum creatinine test (it is probably part of your annual physical and you may have gotten a copy), memorize it or write it down and then say to your physician or pharmacist when you get a medication, ‘Say, I think my serum creatinine is about X. So, does this medication need any dosage adjustment in order to be safe for me?

2) If you are in one of the following categories, you should expect your physician and pharmacist to have considered your renal function before dosing a medication:

• known kidney disease;
• age greater than 50;
• history or heart attack, angina, stroke, or other artery blockages;
• history of diabetes (any type);
• history of high blood pressure;
• prior exposure to chemotherapy drugs;
• prior prolonged exposure to IV antibiotics;
• frequent use of pain medications (especially non-steroidal anti-inflammatory drugs, but others as well).

So you might say to your physician or pharmacist, ‘Is this drug removed by the kidney, because I have condition X that could decrease kidney function and I just want to be safe.’ If the drug is removed by the kidney, you might also ask the physician or pharmacist to tell you what your serum creatinine is…and if he or she does not have this information, a big red flag should be going up in your head.

3) If you are not in one of the categories in question 2 and you don’t have a serum creatinine available, don’t worry. You’re probably safe. But you may want to ask your physician if there is a serum creatinine in your chart and if so, what it is.

4) If you are on dialysis of any sort, serum creatinine is not all that useful for dosing medications. Just make sure your physician and pharmacist are aware that you are on dialysis and perhaps ask, ‘Now is this the usual dose for someone on dialysis?’

These are some of the steps I hope you will consider the next time you get a prescription or over-the-counter medication so you can be sure that that you (or your loved one) are getting the right dose.

Are you currently on one or more pharmaceutical drugs? Perhaps you are not aware, but every pharmaceutical drug depletes the body of various nutrients, depriving your cells of the essential raw materials which drive normal, natural cell function. The data on our industrialized food supply already suggestes that each of us is not getting enough nutrition from diet alone. If you’re taking one or more pharmaceutical drugs, your situtation is likely to be even worse.

In the Drug-Induced Nutrient Depletion Handbook the following information is listed.

“HMG CoA Reductase Inhibitors delete the body of Coenzyme Q10, an important nutrient, and that result of this depletion could lead to mitochondrial dysfunction, decreased body function, and decreased cardiac output.”

How could that be affecting your life if you are currently on one of those drugs? Perhaps you should consider a high-quality supplement that contains Qoenzyme Q10 (CoQ10) so make up for your depletion.

If you found our your were iron deficient (anemic), you’d probably take an iron supplement, right?

Other items listed in the Drug-Induced Nutrient Depletion Handbook.

“Many anticonvulsants cause a depletion of Vitamin D, folic acid, and calcium. Depleting these nutrients has the potential to cause problems such as osteoporosis, muscle weakness, blood pressure irregularities, and heart disease.”

In this case, perhaps you should consider a high-quality multivitamin supplement to simply replace the nutrients your body needs.

“Almost every antibiotic causes a disruption of normal bowel flora and a reduction in the production of important vitamins, leading to diarrhea and other gastrointestinal side effects.”

I have a personal experience where my life was saved through antibiotics, but I certainly experienced these side effects. Fortunately there are quality bowel flora supplements which help provide the body with normal levels of intestinal bacteria. This is critical in the metabolization of many vitamins, such as the Vitamin B family.

Here’s what the Drug-Induced Nutrient Depletion Handbook has to say about Estrogen Replacement Therapy.

“Taking Estrogen Replacement Therapy can cause a depletion of important B vitamins, leadingto anxiety, depression, cardiovascular disease, and depression.”

Again perhaps you should choose a high-quality multivitamin supplement and also provide the nutrients that support normal endocrine function.

The Drug-Induced Nutrient Depletion Handbook provides a drug index, which alphabetically lists drugs by both brand and generic name, with cross-references and the scientific basis, studies and abstracts for the research which determined which nutrients are depleted by the particular drug. It also lists nutrient information with concise descriptions of the effects of depletion. What medications are you taking that are depriving your body of essential nutrients?

The recent removal of several high profile and popular prescription pain medications of the same pharmaceutical family, nonsteroidal anti-inflammatories, from the buyer’s market has left many people searching for a safer alternative for powerful, fast and effective pain relief. The most recent removal was Pfizer’s pulling of Bextra, citing serious skin reactions, sometimes fatal, and two others, Vioxx and Celebrex have been linked to heart related risks. The dangerous side effects of this particular family of medications is definitely cause for alarm, and has many seeking alternatives that will manage their pain effectively, without the serious risks of several pharmaceutical pain killers.

While there have always been natural and homeopathic pain relief remedies, there has never really been a powerful and viable alternative for people with chronic pain related to ailments ranging from back pain, osteoarthritis, and fibromyalgia, to rheumatism and hundreds of other joint, mucle, and nerve related ailments. These individuals are in need of serious pain reduction therapy on an ongoing basis, and the typical natural remedy simply cannot compare to the speed and effectiveness of prescription pain medications and narcotic drugs, which suppresses pain by targeting the central nervous system. That is, until now.

Before we get into that, let’s look at some of the more widely known natural and herbal remedies for pain relief. These include varying dosages and combinations of “Devil’s Claw”, Willow Bark, the ayurvedic compound Boswellia, Camomile, Bromelain, St. John’s Wort, Horsetail, and numerous others too abundant to mention.

As previously mentioned, these herbs and natural compounds can soothe minor pains and aches, but do not work as effectively as their man-made prescription couterparts. There is now a natural pain remedy on the market that is actually highly effective, and has worked very well for many as a natural pain relief alternative by utilizing a specific blend of several high-grade botanicals designed to aggressively manage pain throughout the day.

These people not only are enjoying the benefits of it’s natural pain relief, but also, and perhaps even more importantly, they are enjoying the peace of mind knowing that they are not seriously endangering their health in other ways simply so they can manage their pain.

No one want to be incapacitated and limited by pain, but who wants to endanger their health just to manage it and live a fulfilling life, and why should you have to? Well, now these people have a natural pain relief solution that has literally been harvested from the land, unaltered, and in it’s purest state. Now, doesn’t that sound healthy?

A thick, yellowish nail with splotchy white areas is a classic presentation for a fungal toenail. In the early stages the toenail is only slightly discolored, or slightly thickened. In the late stages the nail can become very thick and has a tendency to “grow up” more than in grows out. The nail will be very discolored, typically dark yellow-brown and will start to change shape and crumble. In some cases the nail becomes very loose and many will lose the nail, only for it to regrow with the fungus.

The medical term for toenail fungus is “onychomycosis,” pronounced on * EE * ko * my * ko * sis. The prevalence in America is about 2-3%, but some have reported it as high as 13%. Toenail fungus affects men twice as often as it affects women and the prevalence among elderly individuals and diabetics is 25%. In the 1800s, fungal toenails were very rare. The increased prevalence is linked to the increased exposure to fungus through the use of showering facilities in gyms, the use of hot tubs, saunas and public pool areas. There has also been an increase in the number of individuals participating in sporting activities and wearing occlusive footwear. More individuals have diabetes and there has been an overall increase in age of the general population, both of which are associated with a less than optimal immune system. It is no surprise that the risk factors for developing toenail fungus are increasing age, male gender, nail trauma, sweaty feet, poor circulation, poor hygiene, foot fungus and a compromised immune system. Athletes will also have a higher risk.

There are a number of treatments for toenail fungus. The most aggressive and effective way to treat the fungus is with oral anti-fungal medications.

What’s Insomnia?

Identifying insomnia is a little like the old joke about art: you know it when you’re having it. For people with insomnia, though, it’s no laughing matter. Having reduced or interrupted sleep is as bad for your physical and mental health as getting the wrong, or not enough, food.

People suffering insomnia may experience difficulties falling asleep, waking too early, or sleeping in small bursts throughout the night. Worse yet, someone with sleep difficulties wakes up and doesn’t feel rested, may have trouble focusing, and worry about their sleep problem to the point where they can’t sleep for worrying.

What Can I Do?

Like any other health problem, a combination of medication and new behavior can make a big difference. Behavior changes sleep specialists recommend including exercising regularly early in the day, reducing caffeine consumption, and making sure there’s no TV in the bedroom.

A medication can help reinforce these changes by allowing you to get unbroken, healthy sleep. One medication many physicians recommend is Ambien.

I Don’t Want To Take Sleeping Pills!

Over the years, “sleeping pills” have gotten some pretty bad publicity. Many 50’s movie thrillers involved villains sneaking sleeping pills into the unsuspecting hero’s drink. Famous people (like the poet Sylvia Plath) attempted suicide with sleeping pills. It’s no wonder that you might feel reluctant to take a pill to help you sleep!

But modern drugs that help with sleep are much safer and gentler than the drugs of the past. Ambien works with a chemical in your brain called GABA. GABA helps calm the activity of certain brain cells, allowing you to sleep. Because the drug has a gentle effect on GABA, you won’t wake up in the morning feeling like a zombie - you’ll be refreshed and ready for a new day.

The Doctor’s Office

You don’t need to visit a sleep specialist to get a prescription for Ambien, though you will need to speak with a physician. Talk with your doctor about your current sleep pattern (keeping a sleep diary before your appointment can be useful) as well as the medications you are currently taking.

If Ambien seems like a good match for you, your doctor will probably prescribe it for 7 to 10 days. In rare cases, she may extend the time you use it.

A week of Ambien can help break the cycle of sleeplessness, letting you recover your natural, healthy sleep pattern. Very, very few people (1-2% of people taking Ambien) experience very mild side effects (diarrhea, drowsiness, or dizziness). You should work with your doctor to prescribe you the lowest effective dose for you, since you don’t need the nighttime drowsiness to linger when you’ve got a big meeting with your boss the next day!

Why Can’t I Just Stay On Ambien Since It’s The Best Sleep I’ve Gotten In Years?

One of the few problems with Ambien is that it can become habit-forming (addictive) if used for several weeks. In fact, if your doctor prescribes it for two weeks or more, do not go “cold turkey” and stop the medication all at once; instead talk with her about creating a plan to taper off your dosage gently until you’re ready to stop.

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Remember the last time you stubbed your toe? OUCH! It’s painful. But a stubbed toe usually doesn’t send us running to the medicine cabinet, since we know that the pain will pass within a few minutes.

But for more serious “acute” pain (pain that’s severe and constant for a couple of days), waiting it out may not be an option. For some acute pain, we might even make things worse: for example, if you hold a painful joint at an awkward angle to relieve the pain, you might end up with a muscle strain.

So what are our options? Sometimes simple over the counter medications may do the trick. But for when they don’t, a prescription medication may be the best bet.

UltraCET: Two Tough Drugs in one Small Pill

For acute pain from sprains, muscle strains, surgery, or dental work, or for arthritis flare-ups, UltraCET is a terrific option.

UltraCET is like any heroic dynamic duo (think Batman and Robin, or Xena and Gabrielle): One drug has the high-profile effect, but the other has an equally important, though less noticeable set of activities.

The “ultra” part of UltraCET is tramadol, the generic name for Ultram. Tramadol’s effect on your body is similar to the effect of narcotics (drugs like opium and heroin which are illegal, and codeine and morphine, which aren’t). Tramadol is just as good as narcotics in relieving pain but because unlike narcotics, it doesn’t affect your breathing or have other side-effects which stop us from regularly using medical narcotics.

The “CET” part of UltraCET is probably familiar to you in its day-to-day formulation; you might even have it in your medicine cabinet! It’s acetaminophen, the same drug that’s in Tylenol.

The two drugs work together (in “synergy”) to control pain. Acetaminophen helps “increase your threshold to pain.” That’s a fancy way of saying that mild pain signals from your body don’t even make it up to your brain so they don’t register. The bigger pain signals do make it to your brain, but that’s where tramadol kicks in - stopping the pain signals while they’re working their way through your brain. It’s just like Robin capturing the villain’s henchmen while Batman tackles the mastermind villain!

This Sounds Like The Perfect Rescue!

If you’ve just been seen by a doctor (a surgeon, or a dentist), she may well have already prescribed UltraCET for you. If you haven’t, but you’ve got a sprain or regular arthritis flares, you should talk with your doctor about a prescription for this drug.

Like anything powerful, though, you need to use it at the right time for the right reasons (letting Xena show off her acrobatic skills in a china shop is not a terrific idea!). The most important thing about taking UltraCET is to remember that it’s for short term use only!

Most doctors will suggest using it for up to five days only because you can otherwise become dependent on (addicted to) it. Stopping the drug after taking it a long time can cause severe withdrawal symptoms, so never take more than the doctor prescribes.

Your doctor will also ask you about other drugs that you’re taking. Tylenol, some antidepressants, and some seizure medications don’t mix with UltraCET. Neither does drinking, so you might wait to celebrate until after your sprain has healed!

Once these issues are resolved, your doctor can send you home with a prescription for UltraCET. It’ll help you get through the worst of the pain, and then best of all, it can ride off into the sunset when its job is done, leaving you to your pain-free life!

Prescription drugs can save your life. But interactions between prescription drugs and other drugs or with illnesses or conditions you have can lead to significant consequences. Drug interactions may make your drug less effective, cause unexpected side effects, or increase the action of a particular drug.

Keep in mind that this table does not show you:

-all the interactions with the drug in the left column

-other things that might interact with drugs in the middle column

-all the effects of the interaction between the two drugs (as shown in the right column)

How Can I prevent these interactions?

Here are several suggestions for limiting the possibility of experiencing these effects:

* Make sure that all of your doctors know all of the medications you’re taking, including over-the-counter drugs. Elderly persons in particular may see several different specialists. All your doctors should know about anything you’re taking

* Make sure you know all the medications you’re taking. If you’re on several, you should keep their names and doses jotted down on an index card in your wallet or purse. That way, you can reference them if you happen to end up in the emergency room or if you begin working with a new healthcare provider.

* Read the labels. Before using any product, including an over-the-counter medication, read the label for interactions. If you don’t know whether one of the medications you’re taking fits a category of drugs you shouldn’t use, ask the pharmacist for assistance.

* Make friends with your pharmacist. If you always go to the same pharmacy, your pharmacist will have all your drugs on record and can alert you to potential interactions. If possible, finding a pharmacy where there are only one or two pharmacists who are always on duty will improve the chances of them catching problems.

* Even topical medications can interact. You may be receiving an antibiotic ointment for a skin condition - ask your healthcare provider about whether you need to wear sunscreen (to prevent the sun interacting with the medication and giving you a burn!) while using it.

* Other things to think about:

1. Herbal supplements, even if purchased in the store, may not have a complete list of interactions available. Speak with your physician about whether these herbal supplements might harm you - if you’re not sure, it’s not worth the risk.

2. If you enjoy alcoholic beverages, ask your pharmacist about possible interactions with your medications; you may need to give them a miss until you are through with your medication

3. Even things that don’t seem like “real” medicine (antacids, vitamins, diet pills, fiber supplements) may make it difficult for you to absorb your medications or interfere with their function; your pharmacist can be a good resource in determining what to take.

With the recent front-page news about the possible hazards of pain medications, you may be taking a look at your over-the-counter (or OTC) pain medications with a wary eye. While all drugs, including those you don’t need a prescription for, can be dangerous, some basic knowledge can help you avoid the pitfalls for the pain relief you need.

Types of OTC pain medication:

The pain-relief aisle of any drug store can make it seem like there’s an infinite number of pain-relief medications. But there are really only three types. Each type works in a different way and can cause different types of problems.

Aspirin: Aspirin blocks the activity of pain hormones called prostaglandins, which would otherwise send pain information to the brain. In addition, by blocking prostaglandins you reduce the pain and discomfort of inflammation (swelling and heat indicating immune function).

Acetaminophen: Acetaminophen is found in drugs like Tylenol, as well as some generic OTC medications and in prescription pain-relief products. Acetaminophen travels through your bloodstream to the brain, reducing pain-related brain activity and fever. Because it doesn’t work through the hormonal system, it doesn’t do as good a job of reducing swelling and inflammation as the other two types of pain medication.

Non-steroidal anti-inflammatories: These are sometimes called NSAIDs (pronounced N-Saidz). This isn’t a single chemical, like acetaminophen, but a group of chemicals including ibuprofen, naproxen and ketoprofen, all of which block the production of prostaglandins, and thus pain and swelling. A number of NSAIDs are available over-the-counter, including brands like Aleve, Ibuprofen (generic) and Motrin; some newer NSAIDs, like Celebrex and Vioxx , need a prescription.

How To Take Aspirin Safely

In addition to blocking pain signals, aspirin blocks the production of blood clots. Strokes can be caused by blood clots blocking the brain’s blood vessels and aspirin reduces the chance that such clots will form, so physicians will sometimes recommend a low dose of daily aspirin to prevent strokes in high-risk patients.

However, this also means that it’s harder to stop bleeding if you’re taking aspirin. People who are already on blood thinners (like Coumadin) should not take. Similarly, pregnant women have an increased risk of bleeding if they take aspirin, so if you need pain relief while pregnant, speak with your healthcare worker for a better options.

Aspirin can quickly lead to ulcer formation and potentially-dangerous gastric (stomach) bleeding. Enteric coating reduces the likelihood of harm, but even so, aspirin should not be taken for long periods of time without consulting a physician.

Some people are allergic to aspirin, and may experience a variety of symptoms (potentially serious) on taking it. If you’re allergic to aspirin, you shouldn’t take aspirin or NSAIDs without consulting a physician.

Lastly, children and teens with chicken pox, flu, or other viral illness should not be given aspirin (even children’s aspirin) without first consulting a physician, as the combination of certain illnesses and aspirin can lead to a potentially fatal complication called Reye’s syndrome.

How To Take Acetaminophen Safely:

Acetaminophen, taken in high doses or over long periods of time, can cause liver damage and, eventually, liver failure. If you think you may have taken too much, call a healthcare provider or poison control center right away.

Alcohol consumption can magnify the effect of acetaminophen on the liver. If you regularly have three or more alcoholic drinks per day, you should check with your healthcare provider before taking acetaminophen (or any other pain reliever).

Because of the potential for overdose, children should never be given “extra strength” acetaminophen products. Regular strength ones should be given at the stated doses for children or after speaking with a healthcare professional or pharmacist.

How To Take Over The Counter NSAIDs Safely:

NSAIDs slightly increase the risk of bleeding. People on blood thinners, pregnant or nursing women, and people at risk for internal bleeding should not take these products. They can also affect your liver’s function and health and lead to gastrointestinal bleeding.

In order to avoid these effects, you shouldn’t take more than one NSAID at a time or an NSAID with aspirin without first consulting a physician. If you’re taking a multi-drug medication (for example, pills for relief of menstrual symptoms may include several different medications), make sure it doesn’t already contain an NSAID if you’re taking an NSAID separately. Lastly, pregnant and nursing women should speak with their healthcare provider before using an OTC NSAID.

Do you suffer from ulcers?

If yes, what kind is it and how do you cope?

In American society where most people depend on junk food, ulcers can become a familiar and persistent health problem.

Some of these foods contain additives and chemicals that can become toxic in our bodies and so cause various health ailments including ulcers.

It is not surprising that most people depend on junk food.

Most people must have two or more jobs in order to survive.

So, they hardly have time to cook. They have no choice but to eat fast and junk foods most of the time.

One type of ulcer that some people suffer from is peptic ulcer.

Peptic ulcers, which are in the stomach and the duodenum (the first part of the intestine leading from the stomach) can occur at any age and affect both men and women.

Untreated, sufferers can look forward to a long siege with them. But today’s peptic ulcer sufferers have a brighter prospect for relief than did those of even a single generation ago.

There is now less than 1 chance in 18 that surgery will every be necessary and new medications act faster and better and offer more relief than ever before.

The warning sign of active ulcers you will most likely experience (if you get any warning at all) is a gnawing discomfort in the middle or upper abdomen that typically comes between meals or in the middle of the night.

Food or liquids, including antacids and milk, can provide some temporary relief, but milk might not be all that good a remedy since it stimulates production of hydrochloric acid and other digestive juices which further aggravates the pain.

Antacids blended from aluminum, calcium or magnesium salts, have long been the non prescription drugs most people quickly reach for to get relief from their stomach pains.

But, because antacids interfere with absorption of some medications, be sure to go over this with your doctor and get his approval.

You should never ignore any warning signs of ulcers. Ulcer complications are serious and in some cases can be life-threatening.

If paid from ulcers persists after more than 10 to 14 days of self-treatment or comes back when treatment ends, you should see your doctor.

The passing of blood through the bowels may be caused by some other problem, but it can also be an urgent warning of a bleeding ulcer.

Bleeding ulcers can cause anemia or, if the ulcer gets larger it may expand into a major blood vessel, a leak can turn into a hemorrhage, with only minutes available for life saving emergency treatment.

Ulcers can also perforate and may erode completely through the wall of the stomach or duodenum.

If this happens and the stomach’s contents flow into the abdominal cavity, severe infection can result. A perforated ulcer is an emergency that requires immediate surgery.

It has been determined that smoking doubles a person’s risk for ulcer disease.

Physicians and researches have found that ulcers heal a lot slower for smokers, and smokers also have a higher relapse rate.

And you’re definitely at risk for ulcers if you take aspirin and any of the other products containing aspirin.

High-dose Aspirin, Ibuprofen, Maproxen and Piroxicam are in wide use today for many conditions, especially to relive pain and swelling among the millions of people who have arthritis.

These medications can irritate the stomach’s lining and cause gastrointestinal bleeding.

Ulcers have frequently been the target for humor in describing the stereotypical aggressive, pressured, goal-or-career-oriented person.

But for those who have them, ulcers are certainly no laughing matter. Peptic ulcers strike 1 out of ever 50 Americans each year.

As research continues, there is now mounting evidence that something other than smoking, drinking, spicy meals, or a possible battle with the boss may be associated with ulcers.

It is now believed that ulcers are the result of a combination of conditions, the dynamics of which researchers don’t yet fully understand.

Hopefully, these health information and insights about ulcers will help you to cope with them and enable you suffer less.

What Medication Can Cure Me?

1. Am I expecting a cure? Some medications relieve symptoms ? that is, they stop the itching, pain, redness, etc ? but do not actually get to the source of the illness. Some illnesses, like the common cold, can’t be treated/cured, so looking for an OTC drug may be a waste of time; getting rest and drinking fluids may be a better way to spend your afternoon! Other things, like yeast infections, can be treated by over the counter medications; if the infection is making you uncomfortable as well as needing treatment, make sure that you pick a product that gives you both symptomatic relief and treatment.

Is It Safe For Your Child?

2. Is it for your child? If so make sure that you’re getting a drug that can be given to children. Some drugs that help adults can be dangerous for children; others need to be given at a special dosage. Read the fine print on the box before buying for your child.

What About Interactions With Other Drugs?

3. What else am I taking? If you’re on any other medications, whether over-the-counter or prescription, stop by the pharmacist’s desk before heading to the check-out counter. She can check to make sure that the drugs you are taking don’t change the effect of the drugs you are taking.

Wait… Shouldn’t My Illness Be Over Already?

4. Should my illness have ended by now? If you think you have something that has a natural lifecycle - that is, something like a cold that should end on its own - but you don’t feel better after that time is up, you may have misdiagnosed your illness. If you’re having to take pain-reliever nonstop to keep functioning, your body is trying to tell you something and you should listen. What feels like a cold might be bronchitis; that achy foot may require orthotics, not aspirin.

Long Term Medication Use

5. Is it a chronic problem? If you’re having to take over-the-counter medications over a long period of time to prevent symptoms, it is time for your health care practitioner to find out what the underlying cause is. Even something as simple as scaly skin may be a warning sign that you’re developing diabetes. And some relatively harmless medications can have serious long-term consequences; for example, some over the counter pain medications can cause stomach bleeding if you take them for a long time. If you’re taking an OTC medication constantly to reduce long-term discomfort, talk to your health care provider to make sure that a) you’re not missing something important and b) that if it’s a chronic problem, you’re taking medication that your body can handle chronically.

Compare Ingredients

6. What’s the active ingredient? If the same active ingredient is found in both the name brand and the generic, chances are they will have the same effect.

Pregnant Or Breast Feeding?

7. If you’re pregnant or nursing, check with your physician before taking ANY medication, including OTC drugs and alternative products (such as herbal remedies). Some drugs can cross the placenta or through the milk glands, giving your fetus or baby a whopping dose of medication. While the medication might be fine for you, it may not be fine for your baby.

Watch Out For Alcohol

8. Does the medication contain alcohol? If it does, it’s probably going to make you sleepy, it will probably make you feel dehydrated, and adding more alcohol on top of it can be dangerous.

Double-Doses: Be Careful!

9. Am I doubling up? If you’re taking more than one over-the-counter medication, make sure that they don’t have the same ingredients; if they do, you might be doubling the recommended dose of that medication and setting yourself up for unpleasant side effects. This is a particular problem when you take something that combats multiple symptoms of an illness (like “flu” medications that relieve pain, fever, stuffy nose, and sore throat) - often they contain multiple active ingredients, one of which may overlap with another medication (like a pain killer) that you’re taking

Side Effects And Allergies

10. Check the label for side effects and symptoms of allergic reaction. If side effects include drowsiness and you drive a truck or care for several active toddlers, this medication might not be right for you. Similarly, if you start running a fever or develop a rash, having read the label ahead of time will help you know if you need to stop the medication and call a doctor to avert a full-blown allergic attack.