MEDICATION EXPIRATION DATES

Is the expiration date a marketing ploy by drug manufacturers, to keep you restocking your medicine cabinet and their pockets regularly? You can look at it that way. Or you can also look at it this way: The expiration dates are very conservative to ensure you get everything you paid for. And, really, if a drug manufacturer had to do expiration-date testing for longer periods it would slow their ability to bring you new and improved formulations.

One of the largest studies ever conducted that supports the above points about "expired drug" labeling was done by the US military 15 years ago, according to a feature story in the Wall Street Journal (March 29, 2000), reported by Laurie P. Cohen. The military was sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every 2 to 3 years, so it began a testing program to see if it could extend the life of its inventory. The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.

In light of these results, a former director of the testing program, Francis Flaherty, said he concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer. Mr. Flaherty noted that a drug maker is required to prove only that a drug is still good on whatever expiration date the company chooses to set. The expiration date doesn't mean, or even suggest, that the drug will stop being effective after that, nor that it will become harmful. "Manufacturers put expiration dates on for marketing, rather than scientific, reasons," said Mr. Flaherty, a pharmacist at the FDA until his retirement in 1999. "It's not profitable for them to have products on a shelf for 10 years. They want turnover."

If the expiration date passed a few years ago and it's important that your drug is absolutely 100% effective, you might want to consider buying a new bottle. And if you have any questions about the safety or effectiveness of any drug, ask your pharmacist. He or she is a great resource when it comes to getting more information about your medications.

First, the expiration date, required by law in the United States, beginning in 1979, specifies only the date the manufacturer guarantees the full potency and safety of the drug -- it does not mean how long the drug is actually "good" or safe to use. Second, medical authorities uniformly say it is safe to take drugs past their expiration date -- no matter how "expired" the drugs purportedly are. Except for possibly the rarest of exceptions, you won't get hurt and you certainly won't get killed.

Even 10 years after the "expiration date," most drugs have a good deal of their original potency. So wisdom dictates that if your life does depend on an expired drug, and you must have 100% or so of its original strength, you should probably toss it and get a refill, in accordance with the cliché, "better safe than sorry." If your life does not depend on an expired drug -- such as that for headache, hay fever, or menstrual cramps -- take it and see what happens.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

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For more health info and links visit the author's web site www.hookman.com

Are Statin Medicines Good For Everyone?

Statins like Lipitor have gotten great publicity-with some advocating putting it in the drinking water. New research,however, shows that statin drugs may negatively impact some patients with cardiac disorders. A new study presented at the 75th annual international scientific assembly of the American College of Chest Physicians found that statins benefit patients with systolic heart failure (SHF), but not those with diastolic heart failure (DHF). These patients experienced increased dyspnea, fatigue, and decreased exercise tolerance. “It is possible that statins would help patients with systolic heart failure more than patients with diastolic heart failure due to the cholesterol-lowering and anti-inflammatory effects of statins. US Pharm. 2009;34(12):10.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

HEATSTROKE

Everyone is at risk for Heatstroke in times of extreme heat, those who are exerting themselves, but also those sitting quietly in the sun. Heat stroke is defined as a core body temperature in excess of 40.5ºC (105ºF) with associated central nervous system dysfunction in the setting of a large environmental heat load that cannot be dissipated

The truth is, you can develop heat stroke while sitting perfectly still, if you have certain risk factors like chronic medical conditions or use certain medications.
Hyperthermia is defined as elevation of core body temperature above the normal range of body temperature. Body temperature is maintained within a narrow range by balancing heat load with heat dissipation. The body's heat load results from both metabolic processes and absorption of heat from the environment. As core temperature rises, the the autonomic nervous system is stimulated to produce sweating and cutaneous vasodilation.

Evaporation is the principal mechanism of heat loss in a hot environment, but this becomes ineffective above a relative humidity of 75 percent. The other major methods of heat dissipation — radiation (emission of infrared electromagnetic energy), conduction (direct transfer of heat to an adjacent, cooler object), and convection (direct transfer of heat to convective air currents) — cannot efficiently transfer heat when environmental temperature exceeds skin temperature.

In other words when it gets hot and needs to pump faster, hearts weakened by heart disease may be unable to get the body cooled fast enough. People with high blood pressure or hypertension also experience greater stress on the heart, and hypertension sufferers often follow low-salt diets. Not having enough salt in your system can lower the threshold for heat stroke. People with diabetes can also easily become dehydrated, which keeps the body from sweating normally, and obesity not only puts extra pressure on the heart, but it also must work even harder to cool down a larger person.

Medications like diuretics (water pills) reduce the amount of fluid in the body and lead to easier dehydration. Beta blockers, often used to treat heart problems, can also prevent the heart from beating faster, thus inhibiting the body's cooling system. Older people are especially at risk for these factors affecting how your body reacts to the heat. Untreated heat exhaustion can lead to heat stroke, which is signified by a rapid heartbeat, confusion or even delirium, a fever of greater than 104 degrees, severe headaches and seizures or muscle twitching. The skin of a heat stroke victim will be warm and dry, because the body is no longer able to perspire.

The reason is --Your body must maintain its normal temperature to work well. When it gets hot, your body begins to cool itself by sweating. Your body cools as the perspiration evaporates. In order to get more blood to the skin's surface and aid sweating, the heart will beat faster. This occurs even if you're sitting still in the sun.If your body is unable to rid itself of excess heat, your organs can begin to overheat and stop working. This is called heat stroke, and can result in confusion, seizures, permanent disabilities, multiorgan system failure, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation, renal, hepatic failure, hypoglycemia, rhabdomyolysis, seizures and death.

Physical findings in heat stroke may include cutaneous vasodilation, tachypnea, rales due to noncardiogenic pulmonary edema, excessive bleeding due to disseminated intravascular coagulation, and evidence of neurologic dysfunction such as altered mentation or seizures. The skin may be moist or dry, depending upon underlying medical conditions, the speed with which the heat stroke developed, and hydration status. Not all victims of heat stroke should be assumed to be volume-depleted. Laboratory studies may reveal coagulopathy, acute renal failure, acute hepatic necrosis, respiratory alkalosis, and a leukocytosis as high as 30,000 to 40,000/mm3.

Warning signs for heat stroke or exhaustion are dizziness or fainting, excessive sweating, muscle cramps, cold or clammy skin, headaches, rapid heartbeat or nausea. If you experience any of these, get out of the heat right away, drink water, juice or sports drinks and seek medical attention.

PRECAUTIONS
The risk of serious consequences can be reduced with a few simple precautions. If you have A chronic medical conditions discussed, try to get out of the sun sooner than others, and avoid outdoor activities during the hottest times of day. Wear loose fitting clothes and unless otherwise directed, get plenty of extra fluids (like water, but avoid alcoholic or caffeinated beverages).

TREATMENT
Cooling measures — Augmentation of evaporative cooling is considered the treatment modality of choice because it is effective, noninvasive, and easily performed. The naked patient is sprayed with a mist of lukewarm water while air is circulated with large fans. Shivering may be suppressed with intravenous benzodiazepines such as diazepam (5 mg IV) or lorazepam (1-2 mg IV) or, if NMS is not suspected, with chlorpromazine (25 to 50 mg IV).

Other effective cooling methods are less commonly utilized. Immersing the patient in ice water is the most effective method of rapid cooling. Immersing the patient in ice water results in rapid cooling but complicates monitoring and access. Applying ice packs to the axillae, neck, and groin is effective, but is poorly tolerated in the awake patient.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

* Tune in tomorrow for Swimming pool diseases

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

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“SUN ALLERGY”---DRUG-INDUCED PHOTOSENSITIVITY IS PRIMARILY DUE TO UVA RAYS.

Advise patients taking photosensitizing drugs to use a broad-spectrum sunscreen.

A list of the usual culprits (isotretinoin, thiazides, etc)...include also ones that are often forgotten such as benzodiazepines and NSAIDs. This table summarizes drugs which have been associated with photosensitivity. It is important to note that many of the drugs listed were included based on case reports. However, patients taking these drugs should be counseled to minimize sun exposure and to use broad-spectrum (UVA and UVB) sunscreens when sun exposure cannot be avoided.

Drug-induced photosensitivity may present in a variety of ways. Most reactions are either phototoxic or photoallergic. Photoallergy is a rare, immunological response, which is not dose-related and occurs after continuous exposure. Photoallergy occurs when light causes a drug to act as a hapten, triggering a hypersensitivity response which often manifests as pruritic and eczematous rash.Phototoxic reactions are chemically-induced reactions which occur when the drug absorbs UVA light and causes cellular damage. This reaction can be seen with initial exposure to a drug, may be dose-related, and doesn't demonstrate cross-sensitivity. It usually has rapid onset and manifests as an exaggerated sunburn. This reaction will be seen only on skin areas exposed to the sun.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

* Tune in tomorrow for information on Heatstroke

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

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