Pantoprazole Protonix

Pantoprazole Protonix
Pantoprazole Protonix
Nexium GenericEsomeprazole is in a class of drugs called proton pump inhibitors PPIs which block the production of acid by the stomach. Other drugs in the same class include omeprazole Prilosec lansoprazole Prevacid rabeprazole Aciphex and pantoprazole Protonix. Chemically esomeprazole is very similar to omeprazole. Proton pump inhibitors are used for the treatment of conditions such as stomach and duodenal ulcers gastroesophageal reflux disease GERD and the Zollinger-Ellison syndrome which all are caused by stomach acid. Esomeprazole like other proton-pump inhibitors blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme the production of acid is decreased and this allows the stomach and esophagus to heal. Esomeprazole was approved by the FDA in February 2001.

how to use
For GERD 20 or 40 mg of esomeprazole is given once daily for 4-8 weeks.

For the treatment of H. pylori 40 mg is administered once daily in combination with amoxicillin and clarithromycin for 10 daysEsomeprazole capsules should be administered one hour before meals swallowed whole and should not be crushed or chewed. Patients with difficulty swallowing can open the capsule and mix the pellets with applesauce. The applesauce should not be hot and the pellets should not be chewed or crushed.

side effects
Esomeprazole like other PPIs is well-tolerated. The most common side effects are diarrhea nausea vomiting headaches rash and dizziness. Nervousness abnormal heartbeat muscle pain weakness leg cramps and water retention occur infrequently.

interaction
Esomeprazole potentially can increase the concentration in blood of diazepam Valium by decreasing the elimination of diazepam in the liver. Esomeprazole may have fewer drug interactions than omeprazole.

Sildenafil review

Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. It relaxes muscles and increases blood flow to particular areas of the body.

Discontinue sildenafil if you are using nitrate drug for chest pain or heart problems. Taking sildenafil with nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack. If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away.

Do not take sildenafil more than once a day. Allow 24 hours to pass between doses. If your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

A small number of patients have had a sudden loss of eyesight after taking sildenafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether sildenafil is the actual cause of such vision loss. Sudden vision loss with sildenafil use has occurred most often in people with heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.

You must tell to your doctor if you have the following conditions such as: heart disease or heart rhythm problems; a recent history (in the past 6 months) of a heart attack, stroke, or heart rhythm disorder; a recent history (in the past 6 months) of a heart attack, stroke, or heart rhythm disorder; high or low blood pressure; liver and kidney disease; a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia; bleeding disorder such as hemophilia; a stomach ulcer; retinitis pigmentosa (an inherited condition of the eye); a physical deformity of the penis (such as Peyronie's disease); or if you have been told you should not have sexual intercourse for health reasons.

The revation is usually taken three times each day, about 4 to 6 hours apart. It is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day. It can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.

Erectile dysfunction

In older men, ED usually has a physical cause, such as disease, injury, or the side effects of drugs. Chances of suffering from ED increase with age.

Damage to nerves, arteries, smooth muscles, and fibrous tissues, such as the result of disease, is the most common cause of ED. Diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurological diseases account for about 70 percent of ED cases.

Certain lifestyle choices like smoking, being overweight, and not exercising, contribute to heart disease and vascular problems and also raise the risk of erectile dysfunction.

Surgery, especially prostate and bladder surgery for cancer, can injure nerves and arteries near the penis, and cause ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can harming nerves, smooth muscles, arteries, and fibrous tissues, and also lead to ED.

Many common medicines, like blood pressure drugs, antihistamines, antidepressants, tranquilizers, and appetite suppressants, can produce ED as a side effect, as well.

About 10 to 20 percent of ED cases may be caused by psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure. Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not having enough testosterone in the body.

It is a good idea that treatment start with the least invasive treatment possible. For some men, making a few healthy lifestyle changes may solve the problem. Quitting smoking, losing weight, and increasing physical activity may help some men regain sexual function. If not, considering medication changes should be considered next. If you think a particular drug you are taking is causing your ED, ask your doctor if there is a replacement drug you can try.

If there seems to be a need, psychotherapy and behavior modifications is considered next, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered to help treat erectile dysfunction.

Drugs and Pregnancy

Drugs are assigned a pregnancy risk factor category ranging from A through E, and sometimes X by the Food and Drug Administration, depending on what has been learned about the drug through prior animal and human studies. If you are pregnant, or are planning to becoming pregnant, check with your doctor or pharmacist before taking any medications or supplements.


FDA Pregnancy Risk Factor Categories

    * Category A: Controlled studies in women failed to demonstrate a risk to the fetus in the first or subsequent trimesters. Possibility of fetal harm seems remote.
    * Category B: Animal reproduction studies have not demonstrated fetal risk, and there are no adequate human studies OR animal studies have demonstrated adverse effects, but human studies have not demonstrated fetal risk.
    * Category C: Animal studies have demonstrated adverse fetal effects, but there are no adequate human studies. Benefits to the mother may outweigh potential risks to the fetus.
    * Category D: Positive evidence of human fetal risk is demonstrated in human studies or post-approval data, but benefits to the mother may outweigh potential risks to the fetus, and safer drugs cannot be used or are ineffective.
    * Category E: Animal or human studies demonstrated fetal abnormalities, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
    * Category X: Strong evidence that the drug causes birth defects, either in humans or in animals, and fetal risks outweigh any possible benefit.

Secondary Glaucoma

The pathophysiology of glaucoma lies on the overproduction of the aqueous humor, the clear fluid that fills the anterior chamber (the space between the cornea and iris) or a drainage problem. Any imbalance between the production and drainage of the aqueous will lead to an increase in intraocular pressure. Normal IOPs of most people falls between 8 and 21 mmHg. Some eyes can tolerate higher pressures than others.

The following are the common types of glaucoma:

1. Open angle - also known as the chronic open angle or primary open angle glaucoma (POAG)
2. Acute angle-closure
3. Secondary glaucoma
4. Congenital

The most common type of glaucoma is the primary open angle. With this type even though the complex drainage system and the space between the iris and the cornea appear normal, the aqueous fluid continue to accumulate within the anterior chamber causing the IOP to become elevated. Patients with the open angle type often don’t have symptoms at all. The visual loss is subtle and first affects the peripheral vision and may be left unnoticed by the patient. Eventually, the patient experiences “tunnel vision” and finally progressing to blindness because of optic nerve and retinal damage. On the other hand, although the acute angle closure type affects only about 10% of cases with glaucoma, these patients need emergency treatment by an ophthalmologist. The problem here is the aqueous outflow because of the narrow than normal angle between the iris and the cornea. If the outflow of the aqueous humor becomes completely blocked then the IOP rises abruptly causing sudden angle closure attack. Therefore, patients with this angle closure type typically experience symptoms like extreme eye pain accompanied by nausea, vomiting, headache, sudden blurring of vision, and rainbows around lights and eye redness which prompted them to seek emergency consult. Secondary glaucoma usually has an underlying disease or problem within the eye such as the following: inflammation, trauma, previous surgery, diabetes, tumor and certain medications. Hence, treatment approach should be both the glaucoma and the underlying problem. Congenital glaucoma is generally seen in infants; most of these cases require surgical treatment.

In general, glaucoma does not cause symptoms in most cases because it is an insidious disease. Risk factors include: family history, diabetics, black, Asians and hypertension. Ideally, at the age of thirty-five and above, screening for glaucoma should be performed by ophthalmologists. The following are components of a complete glaucoma evaluation: tonometry (measure the IOP); opththalmoscopy (evaluate the optic nerve); visual field test or perimetry (test the peripheral vision) and gonioscopy (examine the structures in front of the eye.

Lung cancer

Treatment and prognosis depend upon the type of cancer and the stage, or how far it’s spread.

Symptoms that suggest lung cancer include dyspnea (shortness of breath); hemoptysis (coughing up blood); chronic cough; wheezing; chest pain; cachexia (weight loss), fatigue and loss of appetite; dysphonia (hoarse voice); and clubbing of the fingernails (uncommon). If the cancer grows a certain way, it may obstruct the airway, causing breathing difficulties.

Depending on the type of tumor, it may not be the tumor itself that draws attention to the problem. In lung cancer, Lambert-Eaton myasthenic syndrome (muscle weakness due to autoantibodies), hypercalcemia, and SIADH may be what draw attention to the disease. Tumors in the top of the lung may invade the local part of the sympathetic nervous system, leading to changed sweating patterns and eye muscle problems, as well as muscle weakness in the hands.

In many patients, the cancer has already spread by the time they have symptoms and seek medical attention. Common sites of metastasis include the bone, and the brain.

Performing a chest X-ray is the first step. If there are no X-ray findings but the suspicion is high (for example a very heavy smoker with bloodstained sputum), bronchoscopy, and/or a CT scan may provide the diagnosis.

If investigations have confirmed lung cancer, scan results and often positron emission tomography (PET) are used to determine whether the disease is localized or whether it has spread too far to be cured surgically.

There are two main types of lung cancer categorized by the size and appearance of the malignant cells: small-cell and non-small cell lung cancer.

There are four major causes of lung cancer (and other cancers in general, as well): carcinogens such as those in cigarette smoke; radiation exposure; genetic susceptibility; and viral infection.

Treatment for lung cancer depends on the cancer's specific type, how far it has spread, and the patient's status. Common treatments include surgery, chemotherapy, and radiation therapy.

Eliminating tobacco smoking is a primary goal in the fight to prevent lung cancer, and quitting smoking is probably the most important tool to help prevent this and other cancers.