Friday, June 20, 2008

Morphine and Other Opioid Drugs

An opioid is a chemical substance that has a morphine-like action in the body. The main use is for pain relief. These agents work by binding to opioid receptors, which are found principally in the central nervous system and the gastrointestinal tract. The receptors in these two organ systems mediate both the beneficial effects, and the undesirable side effects.
Amongst analgesics are a small number of agents which act on the central nervous system but not on the opioid receptor system and therefore have none of the other (narcotic) qualities of opioids although they may produce euphoria by relieving pain - a euphoria that, because of the way it is produced, does not form the basis of morbid seek orientation, habituation, physical dependence, or addiction.


Clinical use

Opioids have long been used to treat acute pain (such as post-operative pain). They have also been found to be invaluable in palliative care to alleviate the severe, chronic, disabling pain of terminal conditions such as cancer. Contrary to popular belief, high doses are not required to control the pain of advanced or end-stage disease, with the median dose in such patients being only 15mg oral morphine every four hours (90mg/24 hours), i.e. 50% of patients manage on lower doses, and requirements can level off for many months at a time despite the fact that opioids have some of the greatest potential for tolerance of any category of drugs.

In recent years there has been an increased use of opioids in the management of non-malignant chronic pain. This practice has grown from over 30 years experience in palliative care of long-term use of strong opioids which has shown that addiction is rare when the drug is being used for pain relief. The basis for the occurrence of iatrogenic addiction to opioids in this setting being several orders of magnitude lower than the general population is the result of a combination of factors. Open and voluminous communication and meticulous documentation amongst patient, any caretakers, physicians, and chemists (pharmacists) is one part of this; the aggressive and consistent use of opioid rotation, adjuvant analgesics, potentiators, and drugs which deal with other elements of the pain (NSAIDS) and opioid side effects (stimulants in some cases, antihistamines) both improve the prognosis for the patient and appear to contribute to the rarity of addiction in these cases.

Common adverse reactions in patients taking opioids for pain relief:

These include: nausea and vomiting, drowsiness, dry mouth, miosis, and constipation. Fortunately, most of these are not a problem.

Infrequent adverse reactions in patient taking opioids for pain relief:
These include: dose-related respiratory depression (see below), confusion, hallucinations, delirium, urticaria, hypothermia, bradycardia/tachycardia, orthostatic hypotension, dizziness, headache, urinary retention, ureteric or biliary spasm, muscle rigidity, myoclonus (with high doses), and flushing (due to histamine release, except fentanyl and remifentanil).

Find out more about Opioid in Wikipedia

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Thursday, June 12, 2008

Acne Skin Care Tips That Work

How should people go about acne skin care? This article enumerates some basic guidelines to go by. For example, you should clean your skin gently, avoid frequent handling of the skin, avoid sun tanning, and lastly, women should choose their cosmetics carefully and men must shave carefully for good acne skin care.


People with acne may try to stop outbreaks and oil production by scrubbing their skin and using strong detergent soaps. However, scrubbing will not help acne skin care; in fact, it can make the problem worse.
Most doctors recommend that people with acne gently wash their skin with a mild cleanser for acne skin care, once in the morning and once in the evening.

Patients should ask their doctor or another health professional for advice on the best type of cleanser to use for acne skin care. Acne skin care also means washing your skin after heavy exercise. Patients should wash their face from under the jaw to the hairline; rough scrubs or pads should not be used. It is important that patients thoroughly rinse their skin after washing it.
Astringents are not recommended for acne skin care unless the skin is very oily, and then they should be used only on oily spots.
Doctors also recommend that patients regularly shampoo their hair as part of acne skin care. Those with oily hair may want to shampoo it every day for proper acne skin care.



People who squeeze, pinch, or pick their blemishes risk developing scars.
Acne lesions can form in areas where pressure is frequently applied to the skin. Frequent rubbing and touching of skin lesions should be avoided if you take your acne skin care seriously.

Men who shave and who have acne can try electric and safety razors to see which is more comfortable for acne skin care. Men who use a safety razor should use a sharp blade and soften their beard thoroughly with soap and water before applying shaving cream. Nicking blemishes can be avoided by shaving lightly and only when necessary.

A suntan or sunburn that reddens the skin can make blemishes less visible and make the skin feel drier for a little while. But the benefits are only temporary and cannot take the place of proper acne skin care. The sun can seriously damage skin, promote aging of skin, and cause skin cancer. Furthermore, many of the medications used to treat acne make a person more prone to sunburn.

People being treated for acne often need to change some of the cosmetics they use. Acne skin care demands that all cosmetics, such as foundation, blush, eye shadow, and moisturizers, should be oil free. Patients may find it difficult to apply foundation evenly during the first few weeks of treatment because skin may be red or scaly, particularly with the use of topical tretinoin or benzoyl peroxide.

Lip products that contain moisturizers may cause small, open and closed comedones to form. Hairstyling products that come in contact with the skin along the hairline can cause burning or stinging in people with acne. Acne skin care products that are labeled as noncomedogenic (do not promote the formation of blemishes) should be used for acne skin care; in some people, however, even these products may cause acne.

For more information visit the Best Acne Treatment Solutions web site here:
http://www.best-acne-treatment-solutions.com/

By: Mike Spencer

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Sunday, May 11, 2008

Tropical Disease in Indonesia: Malaria ?

Few weeks ago a guy from Skype chat was asking me about what kind of disease in Indonesia. He's from USA and never been to Indonesia before, and he probably imagined Indonesia is a country full of diseases (?) Maybe in some rural or isolated area it's true. In my experience, when I was living in Sumbawa Island for few months, Malaria was a common disease among the population. In the health center,


where I was in duty, new case of Malaria probably 1-3 each day (or even more in certain season). Some people in Java gave me advice to took Quinine as a prophylactic for Malaria -but it was only lasted for 4 weeks- because then I found out that only people lived in particular area who were vulnerable to the mosquito.

The mosquito - Anopheles sp- apparently likes to make their nest in a water where river flow met the salt water from the sea.
So in several area, for example, people lived near the sea, they are much more vulnerable to Malaria.
And planting Mangrove tress could prevent the Anopheles sp to built the nest, unfortunately most of the people there did not know this.
So they often cut down the trees (they sold it for money cause most of them very poor) and for the result Malaria increasing in months.

But if there are people who wants to go vacation to Indonesia, this should not make you getting paranoid because it's not easily transmitted however.
You don't have to take prophylactic either, except if you have to go to high epidemic areas of Malaria.

More source about Malaria and Anopheles :
cdc.gov
wikipedia.org

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Tuesday, April 15, 2008

diet : you are what you eat


A friend of mine was asking me about what kind of diet she should have had. For information, she only weight about 45 kgs ( = 100 pounds ) with 1,60 height. In my calculation her BMI or Body Mass Index is around 17. Which you could say she's thin. But she said that she want to lose another 3 kgs if she can.
The normal Body Mass Index should be around 18-25, you could get your BMI in this way :



BW / ( HxH )
BW : Body Weight (in kgs) , H : height (in meter).

Contrary to the story I have mentioned, I have another friend who get overweight by her eating habit. She have gone through many diets for losing her weight, and it only lasted for a while, until she backed to her old eating habit.


I really think that instead of being victim of many kinds of diet style ( for example, I named few of them : South beach diet, Blood type diet, Food combining diet )
it is more important to know what kind of diet who suits with one's eating habit.
To get it clear, if you get used to with taking breakfast in a medium portion, do not try to eliminate your daily habit at once. But, instead of taking high calories intake as a breakfast, you could switch to a healthier meal or even replace it with fruits like banana or apple.


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Thursday, January 11, 2007

who wants to be a doctor ?

If you ask me, " what makes me wanna be a doctor ? "
I would say, " my parents did. "
But apparently it wasn't a secret that many parents who are doctors, also want their
children to be a doctor,too.
FYI, both are my parents aren't doctor, I guess they're just proud to have one of their children become a doctor [ one of honourable professions ? ]


In the end, I wasn't regret my decision [ or we say, my parents decision ] for entering medical school. I have learned a lot about diseases and medicines, more about human being, a whole lot more about how to deal with them.
And now I am able to help people and get satisfaction from seeing them in a better condition. [ in terms of physiology or psychology ]


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