March 3, 2010
Low Blood Pressure (Hypotension)
8:12 AM | 
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المشرف
causes of hypotenision:-
codisions that reduce volume of blood --- reduce the cardiac out put
- Dehydration is common among patients with prolonged nausea, vomiting, and diarrhea. Large amounts of water are lost when vomiting and with diarrhea, especially if the patient does not drink adequate amounts of fluid to replace the depleted water.
Other causes of dehydration include exercise, sweating, fever, and heat exhaustion, or heat stroke. Individuals with mild dehydration may experience only thirst and dry mouth. Moderate to severe dehydration may cause orthostatic hypotension (manifested by lightheadedness, dizziness, or fainting upon standing). Protracted and severe dehydration can lead to shock, kidney failure, confusion, acidosis (too much acid in the blood), coma, and even death.
- Moderate or severe bleeding can quickly deplete an individual's body of blood, leading to low blood pressure or orthostatic hypotension. Bleeding can result from trauma, surgical complications, or from gastrointestinal abnormalities such as ulcers, tumors, or diverticulosis. Occasionally, the bleeding may be so severe and rapid (for example, bleeding from a ruptured aortic aneurysm) that it causes shock and death rapidly.
- Severe inflammation of organs inside the body such as acute pancreatitis can cause low blood pressure. In acute pancreatitis, fluid leaves the blood vessels to enter the inflamed tissues around the pancreas as well as the abdominal cavity, depleting the volume of blood.
Causes of low blood pressure due to heart disease
- Weakened heart muscle can cause the heart to fail and reduce the amount of blood it pumps. One common cause of weakened heart muscle is the death of a large portion of the heart's muscle due to a single, large heart attack or repeated smaller heart attacks. Other examples of conditions that can weaken the heart include medications that are toxic to the heart, infections of the muscle of the heart by viruses (myocarditis), and diseases of the heart's valves such as aortic stenosis
- Pericarditis is an inflammation of the pericardium (the sac surrounding the heart). Pericarditis can cause fluid to accumulate within the pericardium and compress the heart, restricting the ability of the heart to fill and pump blood.
- Pulmonary embolism is a condition in which a blood clot in a vein (deep vein thrombosis) breaks off and travels to the heart and eventually the lung. A large blood clot can block the flow of blood into the left ventricle from the lungs and severely diminish the blood returning to the heart for pumping. Pulmonary embolism is a life-threatening emergency.
- A slow heart rate (bradycardia) can decrease the amount of blood pumped by the heart. The resting heart rate for a healthy adult is between 60 and 100 beats/minute. Bradycardia (resting heart rates slower than 60 beats/minute) does not always cause low blood pressure. In fact, some highly trained athletes can have resting heart rates in the 40s and 50s (beats per minute) without any symptoms. (The slow heart rates are offset by more forceful contractions of the heart that pump more blood than in non-athletes.) But in many patients bradycardia can lead to low blood pressure, lightheadedness, dizziness, and even fainting.
Several common reasons for bradycardia include: 1) sick sinus syndrome, 2) heart block, and 3) drug toxicity. Many of these conditions occur in the elderly.
- Sick sinus syndrome: Sick sinus syndrome occurs when the diseased electrical system of the heart cannot generate signals fast enough to maintain a normal heart rate.
- Heart block: Heart block occurs when the specialized tissues that transmit electrical current in the heart are damaged by heart attacks, degeneration from atherosclerosis, and medications. Heart block prevents some or all of the electrical signals from reaching the rest of the heart, and this prevents the heart from contracting as rapidly as it otherwise would.
- Drug toxicity: Drugs such as digoxin (Lanoxin) or beta blockers for high blood pressure, can slow the transmission of electricity in the heart chemically and can cause bradycardia and hypotension (see section below "Medications that cause low blood pressure").
- An abnormally fast heart rate (tachycardia) also can cause low blood pressure. The most common example of tachycardia causing low blood pressure is atrial fibrillation. Atrial fibrillation is a disorder of the heart characterized by rapid and irregular electrical discharges from the muscle of the heart causing the ventricles to contract irregularly and (usually) rapidly. The rapidly contracting ventricles do not have enough time to fill maximally with blood before the each contraction, and the amount of blood that is pumped decreases in spite of the faster heart rate. Other abnormally rapid heart rhythms such as ventricular tachycardia also can produce low blood pressure, sometimes even life-threatening shock.
Medications that cause low blood pressure
- Medications such as calcium channel blockers, beta blockers, and digoxin (Lanoxin) can slow the rate at which the heart contracts. Some elderly people are extremely sensitive to these medications since they are more likely to have diseased hearts and electrical conduction tissues. In some individuals, the heart rate can become dangerously slow even with small doses of these medications.
- Medications used in treating high blood pressure (such as ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and alpha-blockers) can excessively lower blood pressure and result in symptomatic low blood pressure especially among the elderly.
- Water pills (diuretics) such as furosemide (Lasix) can decrease blood volume by causing excessive urination.
Medications used for treating depression, such as amitriptyline (Elavil), Parkinson's disease, such as levodopa-carbidopa (Sinemet), erectile dysfunction (impotence), such as sildenafilvardenafil (Levitra), and tadalafil (Cialis) when used in combination with nitroglycerine, can cause low blood pressure (Viagra),
Other conditions that cause low blood pressure
- Vasovagal reaction is a common condition in which a healthy person temporarily develops low blood pressure, slow heart rate, and sometimes fainting. A vasovagal reaction typically is brought on by emotions of fear or pain such as having blood drawn, starting an intravenous infusion, or by gastrointestinal upset. Vasovagal reactions are caused by activity of involuntary (autonomic) nervous system, especially the vagus nerve, which releases hormones that slow the heart and widen the blood vessels. The vagus nerve controls the heart rate (slows it down). The vagus nerve also controls digestive tract function and senses activity in the digestive system. Thus, some people can have a vasovagal reaction from straining at a bowel movement or vomiting.
- Postural (orthostatic) hypotension is a sudden drop in blood pressure when an individual stands up from a sitting, squatting, or supine (lying) position. When a person stands up, gravity causes blood to settle in the veins in the legs, so less blood reaches the heart for pumping, and as a result the blood pressure drops. The body normally responds automatically to the drop in blood pressure by increasing the rate at which the heart beats and by narrowing the veins to return more blood to the heart. In patients with postural hypotension, this compensating reflex fails to occur, resulting in symptomatic low blood pressure. Postural hypotension can occur in persons of all ages but is much more common among the elderly, especially in those on medications for high blood pressure and/or diuretics. Other causes of postural hypotension include dehydration, adrenal insufficiency (discussed later), prolonged bed rest, diabetes that has caused damage to the autonomic nerves, alcoholism with damage to the autonomic nerves, and certain rare neurological syndromes (for example, Shy-Drager syndrome) that damage the autonomic nerves.
- Another form of postural hypotension occurs typically in young healthy individuals. After prolonged standing, the individual's heart rate and blood pressure drops, causing dizziness, nausea, and often fainting. In these individuals, the autonomic nervous system wrongly responds to prolonged standing by directing the heart to slow down and the veins to dilate.
- Micturition syncope is a temporary drop in blood pressure and loss of consciousness brought about by urinating. This condition typically occurs in elderly patients and may be due to the release by the autonomic nerves of hormones that lower blood pressure.
- Adrenal insufficiency, for example, due to Addison's disease, can cause low blood pressure. Addison's disease is a disorder in which the adrenal glands (small glands next to the kidneys) are destroyed. The destroyed adrenal glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary to maintain normal bodily functions. Cortisol has many functions, one of which is to maintain blood pressure and the function of the heart. Addison's disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and, sometimes, darkening of the skin.
- Septicemia is a severe infection in which bacteria (or other infectious organisms such as fungi) enter the blood. The infection typically originates in the lungs (as pneumonia), bladder, or in the abdomen due to diverticulitis or gallstones. The bacteria then enter the blood where they release toxins and cause life-threatening and profound low blood pressure (septic shock), often with damage to several organs.
- Anaphylaxis (anaphylactic shock) is a potentially fatal allergic reaction to medications such as penicillin, intravenous iodine used in some x-ray studies, foods such as peanuts, or bee stings (insect stings). In addition to a severe drop in blood pressure, individuals may also experience hives, wheezing, and a swollen throat with difficulty breathing. The shock is caused by enlargement of blood-containing blood vessels and escape of water from the blood into the tissues.
January 28, 2010
DISEASES CAUSED BY SMOKING
As per the World Health Organization statistics, it has been established that 7 people die due to tobacco use. Tobacco consists more than 400 toxic substances and a further 4,000 chemical compounds.
The most hazardous substances are tar, a carcinogen substance and nicotine which is addictive and increases cholesterol and carbon monoxide levels in the body. Carbon monoxide decreases the amount of oxygen in the body and this gives rise to different health problems. Smoking decreases the levels of oxygen reaching tissues because it constricts and damages blood vessels, giving rise to different health problems.
Smokers are more likely to suffer from respiratory infections and other minor complaints such as colds and coughs. Smokers suffer from severe diseases such as heart diseases, cancer, cardiovascular diseases, lung disease, respiratory problems and other problems related to pancreas, kidneys, and liver. Hereunder is a breakdown of smoking related diseases:
Chronic Obstructive Pulmonary Disease (COPD): This is a group of health conditions that blocks airflow and thus one will have difficulty in breathing. The COPD causes health dysfunctions like chronic bronchitis and emphysema. Emphysema is when one has breathlessness because alveoli or air sacs have been damaged. Chronic bronchitis leads to frequent coughing with a lot of mucus. Smoking is 80% responsible for about 80% of COPD cases. The lungs decline at a faster rate, 3 times in fact in smokers than normal rate. Breathlessness starts due to the lungs dysfunction.
Cancer: Smokers are more likely to get cancer; cancer of the lungs, throat, gullet and mouth is caused by Carcinogen that is present in tobacco smoke. It is approximated that 90% of lung cancer cases are associated with smoking.
Other cancer diseases associated with smoking is cancer of the bladder, pancreatic, kidneys and esophagus, cervical cancer is more prevalent in female smokers.
Cardiovascular Diseases: These are diseases of the heart, the blood vessels, including veins and arteries. Major causes of smoke related deaths fall in this category. As it had earlier been established that nicotine increases the cholesterol levels in the blood, these cholesterol and other fats are deposited in the arteries. The arteries therefore become rigid, narrow or blocked. Due to the narrowing of these arteries, there will be blood clots and thus the risk of cardiovascular diseases. Common cardiovascular diseases are peripheral vascular disease, coronary thrombosis, coronary heart diseases, cerebral thrombosis and cerebrovascular diseases like stroke.
The lining of blood vessels are damaged, this affects the level of fats in the bloodstreams, the risks of atheroma are increased; this is the major source of stroke, aneurysms and heart diseases. Additionally, smoking causes mouth ulcerations.
Smoking has been associated with sexual problems, from performance in sex to infertility. Further smoking increases the risk of high blood pressure. Pale skin and more wrinkles are caused due to decrease in vitamin A levels, smokers have a lower supply of blood to the skin.
During pregnancy, it is advisable not to smoke since it heightens the risk of miscarriage, complications such as bleeding, ectopic pregnancy, premature birth and detachment of placenta. Also still births, low birth weight or congenital defects such as cleft palate.
Basically the health of the smoker and those around them are affected; smokers don’t get old, they die young
January 9, 2010
Tamiflu Dosage
Tamiflu Dosage
doctor will consider a number of factors, including:
*Your age
*Other medical conditions you may have.
As is the case with all medicines, do not adjust your dosage unless specifically instructed by your healthcare provider to do so.
Tamiflu Dosage for the Treatment of Flu in Adults and Adolescents
The recommended starting dosage for most adults and adolescents over the age of 13 is 75 mg, twice a day, for five days. Tamiflu should be started within two days of first noticing flu symptoms.
Tamiflu Dosage for Prevention of the Flu in Adults and Adolescents:
Tamiflu should be started as soon as one has been in close contact with someone who has the flu, preferable within two days. The recommended dose for flu prevention in people age 13 or older is 75 mg once a day for at least 10 days. If there is a flu outbreak in your area, you can take 75 mg once a day for up to six weeks.
Tamiflu Dosage for Treatment or Prevention of the Flu in Children:
For the prevention or treatment of the flu in children ages 1 to 12, the recommended dosage of Tamiflu will be based on the weight of the child. Talk to your healthcare provider or pharmacist about the specific dosage for your child.
The Food and Drug Administration has authorized emergency use of Tamiflu for infants under one year of age for the 2009-2010 H1N1 flu season. However, Tamiflu is not recommended for very young infants (under three months of age) unless the situation is critical, since there is very little information about how to properly dose this medication in young infants.
Because there is a shortage of Tamiflu oral suspension, your pharmacist may need to make a suspension using the capsules. It is very important to understand that this pharmacist-made suspension will be a different concentration (15 mg per mL) from the commercially available Tamiflu suspension (12 mg per mL).
Tamiflu
INDICATIONS:
Treatment of Influenza
TAMIFLU is indicated for the treatment of uncomplicated acute illness due to influenza infection in patients 1 year and older who have been symptomatic for no more than 2 days.
Prophylaxis of Influenza
TAMIFLU is indicated for the prophylaxis of influenza in patients 1 year and older.
The following points should be considered before initiating treatment or prophylaxis with
TAMIFLU:
TAMIFLU is not a substitute for early vaccination on an annual basis as recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices.
Influenza viruses change over time. Emergence of resistance mutations could decrease drug effectiveness. Other factors (for example, changes in viral virulence) might also diminish clinical benefit of antiviral drugs. Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use TAMIFLU.
January 4, 2010
Swine Flu Vaccine Side Effects
Many people are wondering if they should get the swine flu vaccine and worry about side effects. Here is the latest information to help with these important questions.
The swine flu is a new virus and many government bodies around the world are recommending getting the H1N1 influenza vaccine to protect against getting sick. But many people have questions when it comes to getting the swine flu vaccine, and some of the big ones include whether to get a vaccine or not and what are the side effects from getting a swine flu vaccine.
people who want to get an H1N1 flu vaccine can choose between getting an injection or a nasal spray. Read on to find about the side effects for both forms of vaccination.
Swine Flu Vaccine Side Effects for Shot
It’s expected that side effects for the H1N1 flu vaccine shot will be much like the ones experienced when getting a seasonal influenza vaccine shot. For the shot form of the vaccine, the side effects can include the following mild symptoms:
Headache
Headache
Fatigue for several days after
Fever
Muscle aches
Nausea
Redness, soreness, swelling or tenderness near injection site
Fainting (mainly with teens)
The 2009 H1N1 vaccine that is given by injection has a form of the virus that has been killed, so it’s not possible to get influenza from the shot.
What are the Side Effects of the H1N1 Flu Nasal Vaccine?
The expected side effects for the nasal spray form of the swine flu vaccine vary from children to adults. Kids and teens ages two to 17 have reported some of the following mild symptoms
Cough
Headache
Fever
Muscle aches
Nasal congestion
Runny nose
Stomach pain
Vomiting/Diarrhea
Wheezing
Adults aged 18 to 49 years have reported some of the following symptoms:
Cough
Cough
Chills
Headache
Tiredness/Weakness
The nasal vaccine is not being recommended for everyone and has not been approved for pregnant women. People who are healthy and between the ages of two to 49 years old are generally considered good candidates for this nasal spray swine flu vaccine.
Possibility of Severe Side Effects to Swine Flu Vaccine
Severe side effects after getting a vaccine are considered very rare. If they do happen, it’s usually within minutes to hours after receiving the shot. It should also be noted that back in 1976, there was a version of the swine flu vaccine that was linked with people getting Guillain-Barré Syndrome (GBS). Studies have been done since that date and a clear association between flu vaccines and GBS has not been found.
There is a risk for a severe allergic reaction with just about every product people use. The Centers for Disease Control and Prevention says that the risk of dying or becoming extremely ill is very minute from getting a flu vaccination.
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