What causes allergic reactions to drugs?

Following ingestion of a particular medication, the body sometimes responds by signaling the immune system to produce an allergic reaction, which can be mild, or life threatening.

 

Occasionally, when a drug enters the body (by swallowing, contact with the skin, inhaled or injected) the immune system recognizes that substance as foreign and triggers a heightened response causing a multitude of allergic symptoms.  The immune system uses protective antibodies that are already present to fight the offending agent.  Someone who is allergic to a drug has an overabundance of these antibodies against a particular drug.  This is why it is possible to have an allergic reaction even after already taking the drug before without a noticeable reaction; the body can build up these antibodies over time.  The antibody immunoglobulin E, or IgE, begins the process of an allergic reaction and then triggers cells to release chemicals such as histamine.  Histamine is actually the chemical response for the side effects that take place during an allergic reaction.

 

Symptoms of an allergic reaction include rashes, hives, swelling of the face, eyes or tongue, difficulty swallowing or breathing, and dizziness or fainting.  It is important not to panic if you are experiencing an allergic reaction as anxiety can worsen the symptoms.  For a mild reaction such as rash or hives, your doctor or pharmacist might recommend an anti-histamine like Benadryl^® (diphenhydramine) to lessen the effects of circulating histamine.  For more serious reactions, swelling of the throat or tongue with difficulty breathing, immediate medical help should be first priority.  If you are unsure if symptoms are an allergic reaction versus normal side effects, please call your local pharmacist.

 

Whenever you have a prescription filled,  always present a list of known drug allergies.

 

Dr. Melissa Vice, PharmD.

Memory Reseach

FRIDAY, April 25 (HealthDay News) — A new report finds that where protein-destroying machines reside in the brain’s nerve cells may help determine how memories are formed, a finding that may play a role in future treatments for Alzheimer’s and other brain diseases.

Wake Forest University School of Medicine researchers studying mice discovered that cylinder-shaped proteasomes, which help control protein levels, play different roles in controlling synapse strength depending on where they are in the nerve cells of the hippocampus, an area of the brain linked to memory.

 When humans or animals learn and store information in their memory, these connections between cells become stronger or weaker, Ashok Hegde, associate professor of neurolobiology and anatomy at Wake Forest, said in a prepared statement. For example, if people learn to do something better, such as playing softball, the synapses that control hand-eye coordination will become stronger. If they learn to ignore something, such as the barking of a neighbor’s dog, then the synapses that control paying attention will become weaker.

The findings were published in the current issue of Learning & Memory.

 It is known that the degradation of proteins, which are made by cells to control cell functions, plays an important role in memory function. The team found that proteasomes in the dendrites — the branched parts of a neuron that conduct electrical stimulation — limit the connection strength between cells. Proteasomes in the nucleus, which contains the cell’s genetic material, help maintain synapse strength for long periods of time.

The researchers are now trying to learn how to block proteasome activity specifically in the dendrites of mice to increase the strength of synapses and of memory. In their ongoing studies, the mice will be analyzed on how well they can learn to navigate a maze.

 ”If we see a memory enhancement when we block the proteasome in dendrites, we can use this strategy to treat memory loss,” Hegde said.

 More information

 The Alzheimer’s Association has more about current treatments for Alzheimer’s disease.

Medication, Water, Kidneys

When taking medications does drinking lots of water help prevent possible kidney problems?

 

Certain medications need to be taken with plenty of water.  Depending on the medication, there are different reasons for this:

-         The medication could damage the kidneys or lead to kidney stones if too much of it reached the kidney at the same time (e.g. Cotrimoxazole, indinavir);

-         The medication could cause you to become dehydrated (e.g.. Lithium);

-         The medication could irritate the throat or esophagus (e.g. fosamax).

 

In general, all medications should be taken with a full glass of water, unless your doctor or pharmacist recommends otherwise.  If your medication needs to be taken with “plenty of water,” you may need to drink more than a full glass of water with your medication.

 

Kelley Stout, Pharm. D.
University of Kentucky College of Law

Babies’ Sleep and Obesity

CHICAGO (AP) - When the wind blows, the cradle will rock. And when babies sleep less, they may gain too much weight. A new Harvard study finds that babies and toddlers who sleep fewer than 12 hours daily are at greater risk for being overweight in preschool, startling evidence that the link between sleep and obesity may affect even very young children.

For full story: Babies’ Sleep Tied to Childhood Obesity

Blood Pressure and Age

Does normal blood pressure reading differ because of age?

 

Although blood pressure can change as we age, the normal range of blood pressure in adults is part of a standard guideline that does not change with age. 

 

The following table explains the various categories for blood pressure in adults.  It is important to note that these recommendations address high blood pressure as a single health condition.  If you also have heart disease, diabetes, chronic kidney disease, or certain other conditions your blood pressure goals and treatment may vary.

 

 

 

Top Number		Bottom number	Your category	What to do
(systolic)		(diastolic)
Below 120	and	Below 80	Normal Blood Pressure	Maintain or adopt a healthy lifestyle.
120-139	or	80-89	Pre-hypertension	Maintain or adopt a healthy lifestyle.
140-159	or	90-99	Stage 1 hypertension	Maintain or adopt a healthy lifestyle.  If blood pressure goal isn’t reached in about 6 months, take on or more medications
160 or more	or	100 or more	Stage 2 hypertension	Maintain or adopt a healthy lifestyle.  Take on or more medications

 

 

Kelley Stout, PharmD. Candidate
University of Kentucky College of Pharmacy

 The National Institute of Health’s Your Guide to Lowering Blood Pressure is available at:
http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_low/hbp_low.pdf

Arthritis, Treating with Gold

Ask the Pharmacist
Question:  How does gold help arthritis? 

Answer: 
While it is not known exactly how gold works in patients with arthritis, we do know it is not a cure, but simply one treatment to help control the disease. 

Not many decades ago, gold was the standard in the treatment of rheumatoid arthritis.  It was replaced with drugs like methotrexate in the 1990’s.  Gold was used due to its abilities to relieve joint pain and stiffness, reduce swelling and bone damage, and reduce the chance of joint deformity and disability.  When used early in the disease, gold has shown it helps the symptoms in about 50% of patients receiving the treatment. 

Gold comes in both capsule and muscular injection form, though the injection form is far superior in producing positive results.  Neither form is used as first line treatment today due to numerous side effects and necessary monitoring requirements.  Those patients who should not try gold treatment for arthritis include people with severe anemia, kidney disease, or certain skin conditions. 

Choosing gold as a treatment method is not a decision to be made lightly. Discuss the pros/cons with your doctor and inform your pharmacist if you are taking gold injections to check for drug interactions. 

Dr. Melissa Vice, PharmD.

   Grant County Drugs “Ask the Pharmacist” appears in the Grant County News print edition each Thursday (www.grantky.com).  If you have a question, you can email it to gcdrug@fuse.net, just place Ask the Pharmacist in the subject line. 

Vytorin and Zetia Use Questioned

The blockbuster anti-cholesterol drugs Vytorin and Zetia should be used only after all other cholesterol-lowering drugs fail until research proves that the medications work according to a panel of heart specialists convened by the American College of Cardiology.  The panel based its assessment on detailed evidence from a controversial study, released Sunday, showing that Vytorin worked no better than a statin drug now sold as a cheap generic.“There is absolutely no difference … between the two treatment groups,” said lead investigator John Kastelein of the Academic Medical Center in Amsterdam at the group’s annual scientific session.

The panel’s spokesman, Harlan Krumholz of Yale University, said: “Our strongest recommendation is that people need to go back to statins. … If you were put on this drug before you were fully treated on a statin, you should go back.”

The study’s results also were released online in the New England Journal of Medicine. The journal’s editor, Jeffrey Drazen, and three colleagues offered similar guidance in an editorial.

The New England Journal of Medicine editorial:
http://content.nejm.org/cgi/content/full/NEJMe0801842 

For AP news coverage at CNN.com: http://www.cnn.com/2008/HEALTH/03/30/cholesterol.drug.ap/index.html

It should be emphasized, do not stop taking Vytorin or Zetia without consulting your doctor.  If you are taking one of these drugs, you may need to be changed to another drug.  Your doctor, reviewing your medical history, is the one who can make an informed decision on your anti cholesterol medications.

Singulair

What you need to know about Singulair and Suicide. 

The Food and Drug Administration (FDA) is investigating anecdotal reports that people using Singulair (montelukast) are at greater risk for suicidal thoughts and actions.  Singulair is a popular asthma and allergy drug.  It has been prescribed in the US since 1998. 

The FDA Report states, “Singulair is an effective medicine that is indicated for the treatment of asthma and symptoms of allergic rhinitis.  Patients should not stop taking Singulair before talking to their doctor if they have questions about this new information. Until further information is available, healthcare professionals and caregivers should monitor patients taking Singulair for suicidality (suicidal thinking and behavior) and changes in behavior and mood.” 

If you are taking Singulair and you have experienced mood swings, behavioral changes and thoughts of suicide since you began taking the drug, you should consult with your doctor immediately.  Otherwise, continue taking it until you have discussed it with your doctor.  The FDA has not found any link between the drug and suicide.  The FDA is investigating a possible link based on reports that have raised concern. 

You can read the report (http://www.fda.gov/cder/drug/early_comm/montelukast.htm) and link to the FDA’s reporting form at the FDA’s website, www.fda.gov.

For help with suicidal thoughts, The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. If you need help, please dial 1-800-273-TALK (8255). You will be routed to the closest possible crisis center in your area. With over 120 crisis centers across the country, their mission is to provide immediate assistance to anyone seeking mental health services. Call for yourself, or someone you care about. Your call is free and confidential.

For more information on preventing suicide, go to http://www.suicidepreventionlifeline.org/.

Tetanus, Is It Everywhere?

Tetanus, commonly called lockjaw, is caused by a bacterial toxin, or poison, that affects the nervous system.  It is contracted through a cut or wound that becomes contaminated with tetanus bacteria.  The bacteria can get in through even a tiny pinprick or scratch, but deep puncture wounds or cuts like those made by nails or knives are especially susceptible to infection with tetanus.  Tetanus bacteria are present worldwide and are commonly found in soil, dust and manure.  Tetanus causes severe muscle spasms, including “locking” of the jaw so the patient cannot open his/her mouth or swallow, and may lead to death by suffocation.  Symptoms usually begin 7 days after the bacteria enter the body through the wound, but the incubation period may range from 3 days to 3 weeks.  Tetanus is not transmitted from person to person. 

Treatment for tetanus is available, but the process is lengthy and not uniformly effective.  Tetanus may be fatal despite treatment.  The disease is rare in the United States, with less that 100 cases of tetanus reported annually.  The best defense against tetanus is prevention.  The tetanus vaccine can prevent tetanus but its protection does not last forever.  Adults should get a tetanus shot or booster every 10 years.  If you get a bad cut or burn, see you doctor.  You may need a booster. 

Submitted by
Kelly Stout
PharmD Candidate
University of Kentucky College of Pharmacy

For additional information on tetanus and tetanus vaccinations:
www.cdc.gov/vaccines/vpd-vac/tetanus/default.htm
For printable CDC fact sheet on Tetanus:
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/tetanus.pdf

Biggest Winner Challenge

A winning combination of nutrition information and exercise classes helped Grant County residents to lose 370 pounds last year in the first Biggest Winner Challenge.  Grant County residents are being challenged again this year, with a four-week program starting on March 31.  Anyone who lives in Grant County is eligible to participate in the Biggest Winner Challenge, which encourages participants to eat better and be more physically active while monitoring their weight. 

span>The challenge starts on Monday March 31 and runs through Saturday April 26.  Cost to participate is $10 per person or $20 per family.  The fee includes access to a variety of nutrition and physical activity classes being offered during the month, as well as memberships for the length of the challenge to Body Works Gym in Dry Ridge and Curves in Dry Ridge and Crittenden.  The challenge culminates with prizes awarded at the annual Derby Dash 5k Walk/Run in Williamstown on May 3. 

Participants must register for the Biggest Winner Challenge during one of the following dates/times at the Grant County Library, 201 Barnes Road, Williamstown:       

9 am to 7 pm Thursday March 27
9 am to 5 pm Saturday March 29

Participants will be given a calendar of the physical activity and nutrition classes when they register.  Prizes will be determined by a point system, with awards to the participants with the most points accumulated. 

The Biggest Winner Challenge is sponsored by Fitness For Life Around Grant County (FFLAG), the Northern Kentucky Health Department, and Grant County Parks and Recreation.  For more information, visit www.nkyhealth.org, or call Marsha Ball at the Health Department at (859) 363-2095, or Tabitha Fryman of Parks and Recreation at 428-4500.