Date: Sun, 23 Jun 1996 21:53:57 -0700
From:SG
Subject: DURICEF
Our twenty month old daughter was recently bitten by some unknown bug.
To relieve the swelling and discomfort of the area around the bite her
doctor prescribed DURICEF to fight the infection. We are unable to find
out any additional information about DURICEF. What can you tell me
about it. From the information on the net I have been able to determine
that it is a cephalosporin. That is the only info we have been able to
find so far.
Thanks,
Sean
Dear Sean:
Duricef is a cephalosporin antibiotic used to treat infections in the throat, including pharingitis, tonsillitis and "strep". It is also used for skin and urinary tract infections.
The chemical name for Duricef is CEFADROXIL.
This drug is usually taken once or twice a day. Duration of therapy is usually 7 to 10 days.
Side effects from Duricef are not common but can occur. These include nausea, and vomiting which can be avoided by taking the medication with crackers or a light snack.
Antibiotics taken orally can change the normal microbial flora found in the stomach resulting in diarrhea. If this happens and is severe or continues for longer than 2 days, contact your physician.
As with most antibiotics one should complete the full course as prescribed.
I hope this will answer some of the questions you had about Duricef.
Sincerely,
Eric Brandt, BSc. Pharm
Pharmacist
Date: Mon, 24 Jun 1996 22:09:23 -0400
From: TVG
Subject: Prozac Pulvule, Isoptin SR Tabs
Would like some info on these two drugs that my husband is taking. Some of
the side affects ect. Is Prozac habit forming at a dose of 20MG
To the best of my knowledge Prozac is not habit forming.
As for side effects from Prozac, although they are not common, they can occur. Nausea, nervousness, anxiety, insomnia and dizziness are the most frequently reported. If they are severe or persist you should contact your doctor. Sometimes a dose adjustment can overcome these. Other side effects affecting virtually every body system have been reported, but they are considered infrequent or rare. You should report anything unusual to your doctor.
As for Isoptin SR, the side effects reported with it are generally mild and are rarely a cause for stopping the medication. The most common ones are low blood pressure, constipation, nausea, abdominal discomfort, headache and fatigue. Isoptin should be taken with food to lessen the gastro-intestinal side effects. Increasing the amount of fibre will help with the constipation. If they persist or are severe, report them to your doctor, as you should any other unusual symptoms.
Sincerely,
Eric Brandt, BSc. Pharm
Rinfocan
Rinfocan@islandnet.com
Dear Mr. Brandt,
I heard a lot about Prozac (flouxetine) but I still have questions that I
couldn't find answer for.
I wonder if Prozac is suitable for people who are NOT depressed but let's
say, a little bit shy and not self-assured enough.
Can it make person be more open in discussions and generally in public?
Can it be used occasionally? For instance, before a person starts looking
for a girlfriend or before important occasions.
I would really appreciate your answer and any other remarks that you may
have on Prozac.
Best regards,
Nikola T
Prozac is an antidepressant which is not suitable to be taken on an as needed basis. It has a long half life and requires several weeks for the drug to reach steady state blood levels to exert its effec, and the drug must be taken regularly to maintain the effect. It is indicated in the treatment of major depressive illness and not as a sedative before important occasions nor as a disinhibiting agent to make a person more open in discussions.
Sincerely,
Eric Brandt, BSc. Pharm
Rinfocan
Dear Mr Eric Brandt,
I am a pharmacist working in Hong Kong. I wish to know some more
information regarding a health food called Ginkgo Biloba. Can you help
me? Is it really helps elderly people in dementia? Any precaution in
taking particularly for those who has chronic diseases such as
hypertension?
Thank you so much for your help.
With Best Regards,
FW.
Dear FW:
Here is the information I have on Ginkgo.
The Ginkgo is the world's oldest living tree species that has been traced back more than 200 million years.
Few medicinal plants have been investigated as extensively as Ginkgo.
The physiological actions of Ginkgo biloba extract (GBE) appears to be dependent on the flavonoid and terpenoid components, bioavailability is decreased when given in their isolated forms. GBE exerts a protective action on cell membranes, maintaining thei integrity by several means. The flavonoids possess profound antioxidant properties, decreaseing lipid peroxidation by free radicals. In addition, by activating the cell membrane sodium pump, stable stable intracellular polarity is ensured.
The ginkgolides, notably ginkgolide B, competitively inhibit the action of platelet activating factor. Consequently, this decreases platelet aggregation and degranulation as well as conversion of membrane phospholipid into arachidonic acid. Due to this, and the fact that flavonoids inhibit cyclooxygenase and lipoxygenase, production of leukotrienes and prostaglandins decreases. This may, in part, explain GBE anti-inflammatory action as well as its use in the treatment of bronchoconstriction seen in asthma.
The effect of GBE on the vascular system is quite unique. By stimulating the action of the endothelium derived relaxing factor and synthesis of prostacyclin by platelets, it exerts a vasodilatory effect. In addition, it affects the tone of the smooth muscles around the vessels in a way dependent on their original state. In cases of paralysis, GBE increases tone and in cases of spasm it exerts a relaxant effect. This action seems more pronounced in cases of ischemia.
GBE appears to have an affinity for neuronal tissue and cerebral function. It exerts a protective action especially in cases of low oxygen levels. In addition to inhibiting the lipid peroxidation of the high proportion of unsaturated fatty acids present, it maintains aerobic glycolysis in cases of hypoxia. It also appears to increase certain neuro transmitter production, notably dopamine and noradrenalin, as well as increase acetylcholine and serotonin receptor numbers in animal models. It has been suggested that bilobalides may aid the regrowth of damaged neurons in the central nervous system. The results of GBE in reversing the consequences of decreased cerebral function due to vascular insufficiency have been well documented in numerous clinical trials.
Ginkgo is indicated for:
Asthma
Cerebrovascular disease, memory loss, depression, dementia symptoms of early stage Alzheimer's disease
Peripheral vascular disease, intermittent claudication and Raynaud's syndrome
Diabetic retinopathy, macular degeneration
Edema and vascular fragility
Impotence
Premenstrual syndrome
Ischemic heart disease
Inner ear dysfunction
Adverse effects are rare, incidents of mild gastrointestinal upset, headache and allergic skin reactions have been observed.
A toxic syndrome has been recognized in the Orient in children who have ingested Ginkgo seeds. Approximately 50 seeds produce tonic/clonic seizures and loss of consciousness. Ginkgo pollen can be strongly allergenic
There are no reports of drug interactions but an additive effect with other drugs affecting clotting is theoretical.
References available on request.
Sincerely,
Eric Brandt BSc. Pharm
Answer:Hi Dr. M Here are the treatments I am familiar with: 1)Bismuth subcitrate, metronidazole 250 mg, and tetracycline 500 mg all given 4 times a day x 10-14 days. 2) Bismuth subcitrate(pepto-Bismol 2 tabs), metronidazole 250 mg, amoxicillin 500 mg all given 4 times a day (not as effective as 1 above.) 3)omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1 g all given twice a day x 7 days. 4)omeprazole 20 mg, clarithromycin 250 mg, metronidazole 500 mg all given twice a day x 7 days. 5) you can substitute lansoprazole for omeprazole in 4), and 5) above. The effectiveness is decreased with lower doses of antibiotics. Sincerely, Eric Brandt, B,Sc. Pharm Rinfocan
Got your name off PharmInfoNet and would like to ask a question about Zoloft.
Supposedly it is not physically addictive, however I have been having some
decidedly physical symptoms trying to ween myself off it. I've been on Z for 1
yr, 8 mnths at 100mg. Prescribed for depression (although probably more
accurately some sort of panic or anxiety disorder). BTW, I'm 37 with no history
of recurrent depression or other mood/mental disorders. I have had no symptoms
of either the panic or depression for almost a year now, but whenever I try to
drop the Z I get a tingly feeling in my face and dizziness. Trouble is, I
experienced both these symptoms for several months before I experienced the real
severe emotional problem that left me disfunctional and led me to Z in the first
place.
I read a thread in sci.med.pharmacy related to this and it seems that a number
of people develop these and even more serious side-effects when going off Z.
The question is this (or actually these):
Have you any knowledge of more specific information on discontinuation
side-effects?
What are the odds that these side effects are a recurrence of an underlying, and
probably physiological, problem that is chronic and will plague me again to the
point of anxiety, panic, depression, etc. if I am drug-free (which is my
preference)?
What might be the long term effect on my symptom of remaining "permanently" on
Z?
Any advice would also be appreciated.
Thanks for your willingness to participate in this public service.
Ross
Hi Ross.
There are several reports in the literature describing withdrawal symptoms following the discontinuation of drugs in the selective serotonin reuptake inhibitor class. Zoloft is one of those drugs.
I was able to get an abstract for you describing withdrawal symptoms following discontinuation of paroxetine- a drug similar in many ways to Zoloft. Here is the abstract:
Dominguez RA Goodnick PJ
Adverse events after the abrupt discontinuation of paroxetine.
In: Pharmacotherapy (1995 Nov-Dec) 15(6):778-80
Paroxetine is an antidepressant of the selective serotonin reuptake
inhibitor (SSRI) class. In contrast to other SSRIs, it has a
relatively short half-life and lacks active metabolites. In three
patients the abrupt discontinuation of paroxetine seemed associated
with sudden and impairing effects. All three reported marked sleep
disturbances and dizziness. They were prescribed the drug for a
minimum of 10 weeks, and the maximum dosage was 40 mg/day. All
patients experienced rapid remission of symptoms after paroxetine was
reintroduced. We failed to observe similar reactions from the abrupt
discontinuation at lower dosages. Gradual tapering of the agent for
patients receiving more than 20 mg/day is recommended.
Institutional address:
Department of Psychiatry
University of Miami
School of Medicine
Florida
USA.
As you see gradual discontinuation is the recommended procedure for getting off the drug.
Here is another abstract (Sertraline is the generic name for Zoloft)
Rosenstock HA
Sertraline withdrawal in two brothers: a case report.
In: Int Clin Psychopharmacol (1996 Mar) 11(1):58-9
Two case histories are reported describing sertraline withdrawal in
two brothers. The case histories document withdrawal symptoms of (1)
dysequilibrium (2) dysesthesias (3) dizziness and (4) a flushing
sensation. The literature of selected serotonin reuptake inhibitors
(SSRI) withdrawal is reviewed. Advocated is the monitoring of
patients' withdrawal symptoms from SSRI's even when prescribed at
modest doses.
Here is a list of additional references you may be able to obtain from the library. If you can't and would like me to get them you can e-mail me.
Article reprints if I can get them are $15 each if I get them for you plus postage.
Here is the list:
1)Debattista C Schatzberg AF
Physical symptoms associated with paroxetine withdrawal [letter]
In: Am J Psychiatry (1995 Aug) 152(8):1235-4
2)Frost L Lal S
Shock-like sensations after discontinuation of selective serotonin
reuptake inhibitors [letter]
In: Am J Psychiatry (1995 May) 152(5):810
3)Louie AK Lannon RA Ajari LJ
Withdrawal reaction after sertraline discontinuation [letter]
In: Am J Psychiatry (1994 Mar) 151(3):450-1
(Sertraline is Zoloft)
4)Lazowick AL Levin GM
Potential withdrawal syndrome associated with SSRI discontinuation.
In: Ann Pharmacother (1995 Dec) 29(12):1284-85
5)Fava GA Grandi S
Withdrawal syndromes after paroxetine and sertraline discontinuation
[letter]
In: J Clin Psychopharmacol (1995 Oct) 15(5):374-5
Sincerely,
Eric Brandt, BSc. Pharm
Rinfocan
Date: Mon, 08 Jul 1996 15:29:21 +0000
From:Rhonda
Subject: Coumadin
My father 83 yo takes coumadin 5mg qd. What can you tell us about the
effects of certain foods with this drug? Specifically green leafy
vegetables. Also, whats the latest on this drug in any aspect? We
would like to know all we can.
Thanks,
Rhonda
Hi Rhonda
Coumadin (generic name warfarin) is an anti-coagulant which acts by blocking the action of vitamin k. Vitamin K promotes the production of prothrombin which is a factor in the blood clotting mechanism.
Foods rich in Vitamin K may reduce the effectiveness of warfarin, therefore one should avoid LARGE amounts of these foods. They include asparagus, bacon, beef liver, cabbage, cauliflower, fish, green leafy vegetables. Moderate amounts however are ok.
Sincerely,
Eric Brandt, BSc. Pharm. Rinfocan@islandnet.com
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