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	<title>Savings or convenience? Why not both! Buy Indocin with us!</title>
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	<pubdate>Mon, 12 Jan 2009 23:26:03 +0000</pubdate>
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		<title>Medication for Excessive Sweating - You Must Know This Before It Is Too Late!</title>
		<link>http://www.buyindocin.com/medication-for-excessive-sweating-you-must-know-this-before-it-is-too-late.html</link>
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		<pubdate>Mon, 12 Jan 2009 23:26:03 +0000</pubdate>
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		<description><![CDATA[If you are looking for a medication for excessive sweating, they are most definately out there.  In today&#8217;s society, when we have a  problem, often times we look to pills as the solution.  It may not be the best mindset to have though as there are very often side effects involved with [...]]]></description>
			<content:encoded><![CDATA[<p>If you are looking for a medication for excessive sweating, they are most definately out there.  In today&#8217;s society, when we have a  problem, often times we look to pills as the solution.  It may not be the best mindset to have though as there are very often side effects involved with taking medication<span id="more-45"></span>.  There is also the potential for abuse, as of late we all know how the talented actor Heath Ledger died from an overdose of pills.  </p>
<p>If despite all that though you are still looking for a medication for excessive sweating, your options include anticholinergics, beta  blockers and clonidine hydrochloride.  More specifically, these include drugs such as Benztropine, Diltiazem, Indomethacin, Oxybutynin, Robinul and Propantheline to name a few.  All of these medications are meant to treat excessive sweating and although they may be  effective, they are not reccommended as a long term solution.  The reason for this is there are several serious side effects which can  come about from long term use.  These include blurred vision, dry mouth, impaired speech and heart palpatations.  </p>
<p>If you do intend on going ahead with medication for excessive sweating, be sure to listen to your body.  If you find yourself having any of the above mentioned symptoms, discontinue use, it&#8217;s not worth putting your health at risk just to sweat less.  It is strongly  reccommended that you have a look at more natural methods to stop excessive sweating first, there are plenty of natural or herbal methods which have cured many people of their excess sweating.</p>
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		<title>Chain Drug Review -  Able approval</title>
		<link>http://www.buyindocin.com/chain-drug-review-able-approval.html</link>
		<comments>http://www.buyindocin.com/chain-drug-review-able-approval.html#comments</comments>
		<pubdate>Tue, 06 Jan 2009 14:41:03 +0000</pubdate>
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		<guid ispermalink="false">http://www.buyindocin.com/chain-drug-review-able-approval.html</guid>
		<description><![CDATA[  Able Laboratories Inc. has received FDA approval of its abbreviated new drug application for Indomethacin Extended Relief capsules, a generic version of Eon Labs&#8217; Indocin SR capsules, which are used to treat rheumatoid arthritis and other conditions.
		Related Results
		Trust, E-innovation and Leadership in ChangeForeign Banks in United States Since World War II: A Useful [...]]]></description>
			<content:encoded><![CDATA[<p>  Able Laboratories Inc. has received FDA approval of its abbreviated new drug application for Indomethacin Extended Relief capsules, a generic version of Eon Labs&#8217; Indocin SR capsules, which are used to treat rheumatoid arthritis and other conditions.</p>
<p>		Related Results</p>
<p>		Trust, E-innovation and Leadership in ChangeForeign Banks in United States Since World War II: A Useful FringeBuilding Your Brand With Brand Line ExtensionsT<span id="more-44"></span>he Impact of the Structure of Debt on Target GainsProject Management Standard Program	</p>
<p>COPYRIGHT 2002 Racher Press, Inc.<br />
COPYRIGHT 2008 Gale, Cengage Learning</p>
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		<title>Journal of Family Practice -  Acute gout: oral steroids work as well as NSAIDs: prednisone is a safe and effective alternative when NSAIDs are contraindicated</title>
		<link>http://www.buyindocin.com/journal-of-family-practice-acute-gout-oral-steroids-work-as-well-as-nsaids-prednisone-is-a-safe-and-effective-alternative-when-nsaids-are-contraindicated.html</link>
		<comments>http://www.buyindocin.com/journal-of-family-practice-acute-gout-oral-steroids-work-as-well-as-nsaids-prednisone-is-a-safe-and-effective-alternative-when-nsaids-are-contraindicated.html#comments</comments>
		<pubdate>Tue, 30 Dec 2008 17:26:02 +0000</pubdate>
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		<guid ispermalink="false">http://www.buyindocin.com/journal-of-family-practice-acute-gout-oral-steroids-work-as-well-as-nsaids-prednisone-is-a-safe-and-effective-alternative-when-nsaids-are-contraindicated.html</guid>
		<description><![CDATA[  Practice changer
  Use a short course of oral steroids (prednisone 30-40 mg/d for 5 days) for treatment of acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated. Steroids are also a reasonable choice as first-line treatment. (1,2)
  Strength of recommendation B: 2 good-quality, randomized controlled trials (ROTs)
  Janssens H J, [...]]]></description>
			<content:encoded><![CDATA[<p>  Practice changer<br />
  Use a short course of oral steroids (prednisone 30-40 mg/d for 5 days) for treatment of acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated. Steroids are also a reasonable choice as first-line treatment. (1,2)<br />
  Strength of recommendation B: 2 good-quality, randomized controlled trials (ROTs)<br />
  Janssens H J, Janssen M, van de Lisdonk EH, van Riel PL, van Weel C. Use of oral predni<span id="more-43"></span>solone or naproxen for the treatment of gout arthritis: a double-blind, randomized equivalence trial. Lancet. 2008;371:1854-1860.</p>
<p>		Related Results</p>
<p>		ACR white paper to address use of naproxen, aspirinVioxx label now says it&#39;s riskier than naproxenNaproxen debutNaproxen Versus RofecoxibFDA statement on Naproxen.	</p>
<p>  Man CY, Cheung IT, Cameron PA, Rainer TH. Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute goutlike arthritis: a double-blind, randomized, controlled trial. Ann Emerg Med. 2007;49:670-677.<br />
  ILLUSTRATIVE CASE<br />
  A 68-year-old man with a history of ulcer disease and mild renal insufficiency comes to your office complaining of severe pain in his right foot. You note swelling and redness around the base of the big toe and diagnose acute gout. Wishing to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine because of the patient&#8217;s medical history, you wonder what you can safely prescribe for pain relief.<br />
  NSAIDs have become the mainstay of treatment for acute gout, (3,4) replacing colchicine&#8211;widely used for gout pain relief since the early 19th century. (5) Colchicine fell out of favor because it routinely causes diarrhea and requires caution in patients with renal insufficiency. (6) Now, however, there is growing concern about the adverse effects of NSAIDs.<br />
  * Comorbidities, age, mean fewer options<br />
  NSAIDs increase the risk of gastrointestinal (GI) bleeding, especially in the first week of use. (7) Cyclooxygenase-2 (C OX-2) inhibitors, considered as effective as NSAIDs in treating acute gout pain, (8) are also associated with GI bleeds. (9) In addition, NSAIDs and COX-2 inhibitors increase cardiovascular risks, prompting the American Heart Association to recommend restricted use of both. (10) NSAIDs&#8217; effect on renal function, fluid retention, and interactions with anticoagulants are additional concerns, because gout patients are generally older and often have comorbid renal and cardiovascular diseases. (3, 11-13)<br />
  In the United States, nearly 70% of patients who develop acute gout seek treatment from primary care physicians. (12) Family physicians need a safe alternative to NSAIDs to relieve the severe pain associated with this condition. Will oral corticosteroids fit the bill?<br />
  STUDY SUMMARIES<br />
  * Oral steroids: A safe and effective alternative<br />
  Janssens et al (1) conducted a double-blind, randomized equivalence trial of 118 patients to compare the efficacy of prednisolone and naproxen for the treatment of monoarticular gout, confirmed by crystal analysis of synovial fluid. The study was conducted in the eastern Netherlands at a trial center patients were referred to by their family physicians. Those with major comorbidities, including a history of GI bleed or peptic ulcer, were excluded.<br />
  Participants were randomized to receive either prednisolone 35 mg * or naproxen 500 mg twice a day, with look-alike placebo tablets of the alternate drug, for 5 days. Pain, the primary outcome, was scored on a validated visual analog scale from 0 mm (no pain) to 100 mm (worst pain experienced). (15) The reduction in the pain score at 90 hours was similar in both groups. Only a few minor side effects were reported in both groups, and all completely resolved in 3 weeks.<br />
  The study by Man et al (2) was a randomized trial that compared indomethacin with oral prednisolone in 90 patients presenting to an emergency department in Hong Kong. Diagnosis of gout was made by clinical impression. Participants in the indomethacin group also received an intramuscular (IM) injection of diclofenac 75 mg, and those in both groups were monitored for acetaminophen use as a secondary endpoint.<br />
  Pain reduction, the primary endpoint, was assessed with a 10-point visual analog score, and was slightly better statistically in the oral steroid group. The study was not designed to evaluate for safety, but the authors noted that patients in the indomethacin group experienced more adverse effects (number needed to harm [NNH] for any adverse event: 3; NNH for serious events: 6).<br />
  Short-term steroids have few side effects<br />
  In both studies, patients receiving oral steroids experienced no significant side effects. This finding is consistent with other studies that have investigated short-term oral steroid use in the treatment of both rheumatoid arthritis and asthma. (16,17)<br />
  WHAT&#8217;S NEW?<br />
  * Evidence supports use of steroids for acute gout<br />
  In the United States, prednisone is prescribed as treatment for acute gout only about 9% of the time. (12) These 2 studies&#8211;the first randomized trials comparing oral steroids with NSAIDs, the usual gout treatment&#8211;may lead to greater use of steroids for this painful condition.<br />
  Both studies were well designed and conducted in an outpatient (or emergency) setting. Both showed that a short course of oral steroids is as effective as NSAIDs, and without significant side effects.</p>
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		<title>Life Extension -  Zinc L-carnosine guards against NSAID damage</title>
		<link>http://www.buyindocin.com/life-extension-zinc-l-carnosine-guards-against-nsaid-damage.html</link>
		<comments>http://www.buyindocin.com/life-extension-zinc-l-carnosine-guards-against-nsaid-damage.html#comments</comments>
		<pubdate>Mon, 29 Dec 2008 15:36:04 +0000</pubdate>
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		<description><![CDATA[  [ILLUSTRATION OMITTED]
  The nutritional supplement zinc L-carnosine protects the upper-gastrointestinal tract against damage often caused by the nonsteroidal anti-inflammatory drug (NSAID) indomethacin (Indocin[R]), according to a recent report. *
  [ILLUSTRATION OMITTED]
  The use of NSAIDs such as ibuprofen (Advil[R]), naproxen (Aleve[R], Naprosyn[R]), and piroxicam (Feldene[R]) is often limited by their [...]]]></description>
			<content:encoded><![CDATA[<p>  [ILLUSTRATION OMITTED]<br />
  The nutritional supplement zinc L-carnosine protects the upper-gastrointestinal tract against damage often caused by the nonsteroidal anti-inflammatory drug (NSAID) indomethacin (Indocin[R]), according to a recent report. *<br />
 <span id="more-42"></span> [ILLUSTRATION OMITTED]<br />
  The use of NSAIDs such as ibuprofen (Advil[R]), naproxen (Aleve[R], Naprosyn[R]), and piroxicam (Feldene[R]) is often limited by their adverse gastrointestinal effects, including stomach ulcers and upper-gastrointestinal bleeding. Sold as a prescription ulcer medication in Japan, zinc L-carnosine supports gastrointestinal healing.</p>
<p>		Related Results</p>
<p>		P&#038;G&#8217;s naprosyn concerns rivalsAvailability of Naprelan, a once-daily version of Naprosyn, announced by&#8230;Drug firm agrees to correct Naprosyn false advertising - Syntex Laboratories;&#8230;Trust, E-innovation and Leadership in ChangeForeign Banks in United States Since World War II: A Useful Fringe	</p>
<p>  In an animal model of indomethacin- and stress-induced upper-gastrointestinal damage, oral zinc L-carnosine decreased stomach injury by 75% and small intestinal injury by 50%. While adult volunteers who took indomethacin (50 mg, three times daily) for five days had increased gut permeability&#8211;a pathological change that may contribute to inflammation&#8211;no significant increase in intestinal permeability was seen when zinc L-carnosine (37.5 mg, twice daily) was co-administered. People who take NSAIDs may thus be able to guard their gastrointestinal health using supplemental zinc L-carnosine.<br />
  Reference<br />
  * Mahmood A, FitzGerald AJ, Marchbank T, et al. Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut. 2007 Feb;56(2):168-75.<br />
  &#8211;Elizabeth Wagner, ND<br />
COPYRIGHT 2007 LE Publications, Inc.<br />
COPYRIGHT 2008 Gale, Cengage Learning</p>
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		<title>Medications for the Treatment of Gout</title>
		<link>http://www.buyindocin.com/medications-for-the-treatment-of-gout.html</link>
		<comments>http://www.buyindocin.com/medications-for-the-treatment-of-gout.html#comments</comments>
		<pubdate>Fri, 26 Dec 2008 00:11:02 +0000</pubdate>
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		<guid ispermalink="false">http://www.buyindocin.com/medications-for-the-treatment-of-gout.html</guid>
		<description><![CDATA[Understanding the medications for the treatment of gout can be somewhat overwhelming at first. However, with a little guidance you should be able to understand some of the medications and the side effects those medications can cause.
For many individuals, they prefer to use natural approaches to controlling their gout symptoms because they are not willing [...]]]></description>
			<content:encoded><![CDATA[<p>Understanding the medications for the treatment of gout can be somewhat overwhelming at first. However, with a little guidance you should be able to understand some of the medications and the side effects those medications can cause.<br />
For many individuals, they prefer to use natural approaches to controlling their gout<span id="more-41"></span> symptoms because they are not willing to deal with potential side effects from medications.<br />
For the most part, a gout sufferer will not be required to take medication between gout attacks. Generally, the only time they need a prescription is when they are suffering with an attack. Many people are able to minimize their risks f gout attacks through diet modifications and maintaining a healthy weight.<br />
The most popular medications for treating gout are NSAID&#8217;s, Colchicine and Corticosteroids. These are generally for acute gout attacks. They are generally started very early so the swelling, inflammation and pain can be reduced before it is severe and crippling.<br />
There are also non-steroid medication that can be suggested by a medical doctor. These are generally also anti-inflammatory medications as well. Generally, a doctor will suggest using NSAID&#8217;s for patients that do not have any other serious medical conditions. Here are some of the most popular NSAID&#8217;s that are available without a prescription:<br />
* Motrin<br />
* Nuprin<br />
* Aleve<br />
* Advil<br />
* Aspirin<br />
* Actron<br />
Here are some of the most frequently prescribed NSAID&#8217;s:<br />
* Motrin (larger dose than can be bought over the counter)<br />
* Tolmetin<br />
* Naproxen<br />
* Indomethacin<br />
* Dexibuprofen<br />
* Flurbiprofen<br />
The vast majority of doctors will begin with medication treatment by prescribing Indomethacin. However, if there are other underlying medical conditions the doctor will likely prescribe something that will not interfere with the other condition. Your doctor will also take into consideration the other prescriptions you take when determining the best medication to prescribe you.<br />
In regards to this medication a doctor usually prescribes it in large doses for a few days in order to control the discomfort from the gout. Most people that have taken this medication reported feeling better in 24 hours of taking the initial dose.<br />
The remaining medications are usually considered alternatives. They are generally considered when prescribing Indomethacin is not a safe option. It is most common for elderly individuals and patients with serious medical conditions. Medications for the treatment of gout might not be necessary, however they can prove to be an alternative you want to try.</p>
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		<title>Arthritis victims prone to stomach illness</title>
		<link>http://www.buyindocin.com/arthritis-victims-prone-to-stomach-illness.html</link>
		<comments>http://www.buyindocin.com/arthritis-victims-prone-to-stomach-illness.html#comments</comments>
		<pubdate>Fri, 19 Dec 2008 04:56:03 +0000</pubdate>
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		<guid ispermalink="false">http://www.buyindocin.com/arthritis-victims-prone-to-stomach-illness.html</guid>
		<description><![CDATA[Persons suffering from arthritis are more likely to develop upset stomachs.
      Medical researches say most persons with arthritis have taken traditional pain killers like aspirin. Although these drugs ease the pain and inflammation, there is always a downside. 
      These drugs often lead to more [...]]]></description>
			<content:encoded><![CDATA[<p>Persons suffering from arthritis are more likely to develop upset stomachs.</p>
<p>      Medical researches say most persons with arthritis have taken traditional pain killers like aspirin. Although these drugs ease the pain and inflammation, there is always a downside. </p>
<p>      These drugs often lead to more trouble including upset stomach and bleeding ulcers.</p>
<p>      There are some 20 traditional nonsteroidal anti-infl<span id="more-40"></span>ammatory drugs or NSAIDs, including aspirin, ibuprofen, naproxen, indomethacin and piroxicam.</p>
<p>      These drugs can bother the gastrointestinal tract in a number of different ways, says Robert Hoffman, MD, chief of rheumatology at the University Of Miami Miller School Of Medicine. He added that gastritis, esophageal reflux disease [heartburn or GERD], and bleeding ulcers are all problems that can develop from NSAIDs.</p>
<p>      Though there are a few things you can do to reduce stomach upsets, there are no guarantees that serious problems won&#8217;t develop - serious enough to mean hospitalization and even death, he adds. </p>
<p>      Older people with other medical problems are at especially increased risk.</p>
<p>      These findings have prompted medical advisors to shift from pain relievers without or with less concentration of these components. Some recommend other types of pain relievers like Tromadol which is NSAID-free.<br />
      Tramadol belongs to a class of drugs known as opioid analgesics. It is available online through drugstoretm.com. It relieves pain but does not hurt the stomach.</p>
<p>      Dr. Hoffman added that sour stomach, abdominal pain, dark stools, bright blood in stools, and passing out &#8212; are all symptoms of problems like stomach ulcers.</p>
<p>      However, many people don&#8217;t have any symptoms even though they have serious or life-threatening bleeding, he added. </p>
<p>      Another symptom is vomiting blood or material that looks like coffee grounds.</p>
<p>      It is then highly recommended that patients with arthritis consult their doctors for proper medication than self-medicate. Self-medication may give them more harm than good.</p>
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		<title>Colon Cancer Prevention</title>
		<link>http://www.buyindocin.com/colon-cancer-prevention.html</link>
		<comments>http://www.buyindocin.com/colon-cancer-prevention.html#comments</comments>
		<pubdate>Tue, 16 Dec 2008 02:56:05 +0000</pubdate>
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		<guid ispermalink="false">http://www.buyindocin.com/colon-cancer-prevention.html</guid>
		<description><![CDATA[Gout is a painful and sudden illness that can affect joints. It is caused by the accumulation of excess uric acid, which is normally removed through the urine. The crystals of uric acid can then accumulate in joints and cause inflammation and pain. Often patients are not able to get to their healthcare provider right [...]]]></description>
			<content:encoded><![CDATA[<p>Gout is a painful and sudden illness that can affect joints. It is caused by the accumulation of excess uric acid, which is normally removed through the urine. The crystals of uric acid can then accumulate in joints and cause inflammation and pain. Often patients are not able to get to their healthcare provider right away. If it is a first attack the symptoms can be alarming. Fortunately, it is rarely life threatening and often resolv<span id="more-39"></span>es in a few days even without treatment. However everyone who gets an attack should see their healthcare provider since there are many excellent treatments available. But what can one do while at home? The home remedy can include NSAIDs but you may want to get a diagnosis first since other conditions can cause joint swelling including other forms of arthritis such as osteoarthritis and rheumatoid arthritis. Sometimes a joint infection can also look like gout especially if it is hot and red and swollen. If it is quite clear that it is gout, especially if it has affected a joint before, local ice and heat may be applied if comfortable. Taking an NSAID will help as long as the side effects are kept in mind which include stomach ulcer formation and at times high blood pressure. Some examples of NSAIDs are ibuprofen, naproxen and indomethacin. Recent research has shown that vitamin C lowers uric acid level but whether this means something in patients with gout is not clear. Avoiding medication that cause gout such as diuretics or water pills or adjusting doses after discussing with the healthcare provider can also help. Decreasing the intake of alcohol is also helpful since alcohol affects the elimination of uric acid. Although the effect of foods that cause gout is only small it must not be forgotten. Meat and seafood are common causes of gout if taken in excess.</p>
<p>Gout is a painful and sudden illness that can affect joints. It is caused by the accumulation of excess uric acid, which is normally removed through the urine. The crystals of uric acid can then accumulate in joints and cause inflammation and pain. Often patients are not able to get to their healthcare provider right away. If it is a first attack the symptoms can be alarming. Fortunately, it is rarely life threatening and often resolves in a few days even without treatment. However everyone who gets an attack should see their healthcare provider since there are many excellent treatments available. But what can one do while at home? The home remedy can include NSAIDs but you may want to get a diagnosis first since other conditions can cause joint swelling including other forms of arthritis such as osteoarthritis and rheumatoid arthritis. Sometimes a joint infection can also look like gout especially if it is hot and red and swollen. If it is quite clear that it is gout, especially if it has affected a joint before, local ice and heat may be applied if comfortable. Taking an NSAID will help as long as the side effects are kept in mind which include stomach ulcer formation and at times high blood pressure. Some examples of NSAIDs are ibuprofen, naproxen and indomethacin. Recent research has shown that vitamin C lowers uric acid level but whether this means something in patients with gout is not clear. Avoiding medication that cause gout such as diuretics or water pills or adjusting doses after discussing with the healthcare provider can also help. Decreasing the intake of alcohol is also helpful since alcohol affects the elimination of uric acid. Although the effect of foods that cause gout is only small it must not be forgotten. Meat and seafood are common causes of gout if taken in excess.</p>
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		<title>Chain Drug Review -  Able approval. (RXs).(Able Laboratories Inc.)(Brief Article)</title>
		<link>http://www.buyindocin.com/chain-drug-review-able-approval-rxsable-laboratories-incbrief-article.html</link>
		<comments>http://www.buyindocin.com/chain-drug-review-able-approval-rxsable-laboratories-incbrief-article.html#comments</comments>
		<pubdate>Thu, 11 Dec 2008 12:46:02 +0000</pubdate>
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		<description><![CDATA[    Able Laboratories Inc. has received FDA approval of its abbreviated  new drug application for Indomethacin Extended Relief &#8230;
   Related Results
                             [...]]]></description>
			<content:encoded><![CDATA[<p>    Able Laboratories Inc. has received FDA approval of its abbreviated  new drug application for Indomethacin Extended Relief &#8230;</p>
<p>   Related Results</p>
<p>     <span id="more-38"></span>                                                       Reputation for dependability is key element to G&#038;W success. (G and W Labo&#8230;</p>
<p>                                                The New NSAIDs: Cox-2 Inhibitors</p>
<p>                                                DDMAC slams Abbott, Forest, Merck</p>
<p>                                                            Iroko Pharmaceuticals Acquires Rights to Two Pharmaceutical Products from Mer&#8230;</p>
<p>                                                Able approval. (RXs).(Able Laboratories Inc.)(Brief Article)</p>
<p>					Read the rest of this article with a Free Trial at HighBeam Research.</p>
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		<title>Townsend Letter for Doctors and Patients -  The Pharmacist and Homeopathy</title>
		<link>http://www.buyindocin.com/townsend-letter-for-doctors-and-patients-the-pharmacist-and-homeopathy.html</link>
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		<pubdate>Sun, 07 Dec 2008 04:26:03 +0000</pubdate>
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		<description><![CDATA[  Herb Rothouse, RPh considers himself a conventional pharmacist with an interest in complementary approaches to health care. I had the opportunity to talk with him about homeopathy in his pharmacy practice.
  Allen Kratz, PharmD (AK): I understand your background as a pharmacist is unusual.
  Herb Rothouse, RPh (HR): This is true, [...]]]></description>
			<content:encoded><![CDATA[<p>  Herb Rothouse, RPh considers himself a conventional pharmacist with an interest in complementary approaches to health care. I had the opportunity to talk with him about homeopathy in his pharmacy practice.<br />
  Allen Kratz, PharmD (AK): I understand your background as a pharmacist is unusual.<br />
  Herb Rothouse, RPh (HR): This is true, because my varied education pulls me in different directions. First of all, I am a conventional, by-the-b<span id="more-37"></span>ook pharmacist you are used to seeing fill your prescriptions. But I also have a Master&#8217;s Degree in Nutrition and I am a Licensed Nutritionist as well. I have been told there are fewer than twenty persons in the country with this dual licensure. This has given me a unique opportunity to offer guidance on diet and nutritional supplements along with drug information. This is a combination that very few pharmacists have.</p>
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<p>  But what has really made my career different has been learning and practicing homeopathy Many years ago when my European customers were asking for products I had never heard of and spoke of them in such glowing terms, I knew I had to learn as much as I could about them. So I did.<br />
  For the past 15 years, I have used, recommended, sold, written and lectured about homeopathic medicines with considerable and unexpected success. I cannot speak too highly of their safety and efficacy.<br />
  AK: In your published articles, you are very critical of the very prescriptions you dispense every day.<br />
  HR: Yes, and with good cause. For example, if we just look at the class of drugs called NSAIDs (Non-Steroid Anti-Inflammatory Drugs), we can see the problem. These drugs; Motrin [TM], Advil [TM], Aleve [TM], Indocin [TM], Clinoril [TM], Anaprox [TM], etc., kill between 15,000 and 17,000 persons each year. And if we combine the results of studies in JAMA, NEJM, The National Academy of Science Institute of Medicine, we find almost 250,000 Americans die each year from some physician-prescribed medication. Think about that. Almost 1 out of every 10 deaths in this country is physician-induced. This is more than serious&#8230; this is alarming.<br />
  AK: Since you see the dangers in these medications, how is it you still work as a pharmacist. Is this not hypocritical?<br />
  HR: No, because many medicines are essential to maintain good health. We must be more selective and choose the safer ones. The patient has to learn as much as possible about their condition and see what he/she can do on his/her own. Because of my education, Tam in a better position to advise and inform. Sometimes the answer is simply behavioral: no smoking, no alcohol, reduce caloric intake or exercise. Sometimes a nutritionist is needed for more intensive dietary alterations, and sometimes an acupuncturist or chiropractor or homeopath is necessary.<br />
  The first thing a patient has to consider is: how safe is this therapy? Then, what are the associated dangers and what are my alternatives?<br />
  AK: What are the safest healing modalities you have found?<br />
  HR: First of all, one modality will not solve all our health concerns. But clearly, there are advantages in each one. For example, acupuncture and acupressure are very safe. In fact, whenever I get a headache I put pressure on the Large intestine 4 spot. And for a sore throat, my first choice is Lung 11. For more serious conditions I turn to homeopathy. But homeopathy is not a one-size-fits-all therapy. You must be well trained to pick the correct medicine, and this can take considerable time to learn, even years. It is an art. This should not discourage anyone from starting to learn. There are many excellent books for a beginner where you can learn homeopathic first aid very quickly. I suggest you call Homeopathic Educational Services for a catalog, 510-649-0294.<br />
  AK: If homeopathic medicines are so effective, why don&#8217;t more pharmacists suggest them?<br />
  HR: Two reasons. one&#8230;homeopathy is not a subject taught in pharmacy school, and two&#8230;most chain pharmacies do not promote or display them. To find homeopathic medicines, you have to go to a reputable health food store or locate a natural pharmacy, which is usually an independent pharmacy. If you need to locate a homeopathic practitioner, I suggest you contact the National Center for Homeopathy in Alexandria, Virginia, 703-548-7790.<br />
  AK: Aside from your pharmacy customers, how do you get your message out?<br />
  HR: As I have said, whenever opportunity and time allows and need warrants, I advise my customers not only on their prescription medication but the concerns and dangers attached to them and of the safer alternatives to investigate.<br />
  But to reach a larger audience, I write and lecture. I give a Continuing Education program called &#8220;Health, Healing and Homeopathy&#8221; to groups and organizations of health professionals, which has been very successful. It brings a great deal of new information to pharmacists and others about options they never knew existed. And that is the most important thing I can teach: there are safe alternatives to unsafe drugs.</p>
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		<title>Review of Non-Steroidal Anti-Inflammatory Drugs</title>
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		<pubdate>Fri, 05 Dec 2008 18:21:02 +0000</pubdate>
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		<description><![CDATA[Non-Steroidal Anti-Inflammatory Drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed categories of drugs worldwide in the treatment of pain and inflammation in many conditions.
NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever. Specific uses include the treatment of headaches, arthritis, sports injuries, and menstrual cramps. Aspirin is used to [...]]]></description>
			<content:encoded><![CDATA[<p>Non-Steroidal Anti-Inflammatory Drugs<br />
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed categories of drugs worldwide in the treatment of pain and inflammation in many conditions.<br />
NSAIDs are used<span id="more-36"></span> primarily to treat inflammation, mild to moderate pain, and fever. Specific uses include the treatment of headaches, arthritis, sports injuries, and menstrual cramps. Aspirin is used to inhibit the clotting of blood and prevent strokes and heart attacks in individuals at high risk. NSAIDs also are included in many cold and allergy preparations. Two drugs in this category, ibuprofen and naproxen, also reduce fever.<br />
Uses<br />
NSAIDs are usually indicated for the treatment of acute or chronic conditions where pain and inflammation are present. These drugs also are effective in some neuropathic pain syndromes when used with other analgesics. NSAIDs are generally indicated for the symptomatic relief of the following conditions:</p>
<p> Rheumatoid arthritis<br />
 Osteoarthritis<br />
 Acute gout<br />
 Inflammatory arthropathies (e.g. ankylosing spondylitis, psoriatic arthritis, Reiter&#8217;s syndrome)<br />
 Dysmenorrhoea (painful menstruation)<br />
 Headache and migraine<br />
 Postoperative pain<br />
 Mild-to-moderate pain due to inflammation and tissue injury<br />
 Back pain and sciatica<br />
 Sprains, strains, and rheumatism<br />
 Dental pain<br />
 Pain from kidney stones (renal colic)<br />
 To reduce fever<br />
 Other painful conditions, especially where there is inflammation</p>
<p>Drugs in the class<br />
There are several different types of NSAIDs:</p>
<p> Salicylates: aspirin (Ascriptin, Bayer, Ecotrin), diflunisal (Dolobid, Diflunisal Tablets), salsalate (Argesic SA, Disalcid, Salflex, Salsitab, Mono Gesic)<br />
 Arylalkanoic acids: diclofenac (Voltaren, Cataflam), indomethacin (Indocin)<br />
 2-Arylpropionic acids (profens): ibuprofen (Motrin, Advil), ketoprofen (Orudis, Oruvail), naproxen (Naprosyn, Alleve), carprofen<br />
 Pyrroles: ketorolac (Toradol)<br />
 Enolic acids (oxicams): piroxicam (Feldene), meloxicam (Mobic)<br />
 Sulphonanilides: nimesulide<br />
 Napthylalkanones: nabumetone (Relafen)</p>
<p>Mechanism of action<br />
NSAIDs work by suppressing the production of fatty acids called prostaglandins that cause inflammation and pain. They do this by blocking the action of an enzyme, cyclooxygenase (COX). This enzyme is responsible for converting precursor acids into prostaglandins.<br />
In the periphery NSAIDs work by decreasing the sensitivity of the nociceptor to painful stimuli induced by heat, trauma, or inflammation. In the central nervous system, they are thought to function as antihyperalgesics and block the increased transmission of repetitive incoming signals to higher centers. In effect, they modulate perception of pain caused by repetitive stimulation from the periphery.<br />
Differences between NSAIDs<br />
NSAIDs vary in their potency, duration of action, and the way in which they are eliminated from the body. Another important difference is their ability to cause ulcers and promote bleeding. The more an NSAID blocks Cox-1, the greater is its tendency to cause ulcers and promote bleeding.<br />
Choice of NSAID for chronic and disabling inflammatory joint diseases like rheumatoid arthritis and osteoarthritis is governed by age, diagnosis, degree of severity, relative gastrointestinal safety, tolerability, and relative efficacy in the given clinical situation. It is a common misconception that all NSAIDs are therapeutically equally efficacious and any one of them could be used for the given indication. Use of multiple NSAIDs should be discouraged. An agent with comparatively less gastrointestinal (GI) side effects like ibuprofen and diclofenac should be preferred in place of indomethacin, piroxicam, or naproxen, which are more gastrotoxic. In conditions where diagnosis is uncertain, the medicine should be empirically chosen and given for a week or so and if the response is adequate it should be continued until side effects mandate its withdrawal. Ankylosing spondylitis responds better to a particular NSAID like indomethacin. It is probably related to its stronger inhibition of prostaglandin synthesis.<br />
Aspirin is a unique NSAID, not only because of its many uses, but because it is the only NSAID that is able to inhibit the clotting of blood for a prolonged period (4 to 7 days). This prolonged effect of aspirin makes it an ideal drug for preventing the blood clots that cause heart attacks and strokes. Most other NSAIDs inhibit the clotting of blood for only a few hours.<br />
The major NSAIDs of potency comparable to opioids are diclofenac and ketorolac. Moderate postoperative pain, for example, may be managed using these agents. The overall analgesic effect of 30 mg of ketorolac is equivalent to that of 6 to 12 mg of morphine. Efficacy has been demonstrated for postsurgical pain including oral, orthopedic, gynecologic, and abdominal procedures. Efficacy for acute musculoskeletal pain has also been shown. Ketorolac causes ulcers more frequently than any other NSAID and is, therefore, not used for more than five days.<br />
Naproxen provides effective relief in acute traumatic injury and for acute pain associated with migraine, tension headache, postoperative pain, postpartum pain, pain consequent to various gynecologic procedures, and the pain of dysmenorrhea.<br />
Possible Side Effects<br />
NSAIDs are associated with a number of side effects. The two main adverse drug reactions, associated with NSAIDs relate to gastrointestinal effects and renal effects of the agents. These effects are dose-dependent, and in many cases severe enough to pose the risk of ulcer perforation, upper gastrointestinal bleeding, and death, limiting the use of NSAID therapy.</p>
<p> Gastrointestinal adverse reactions. The most common risk of NSAIDs is that they can cause ulcers and other problems in your esophagus, stomach, or small intestine. Common gastrointestinal side effects include: nausea, dyspepsia, vomiting, diarrhea, gastric ulceration/bleeding. Risk of ulceration increases with duration of therapy, and with higher doses. To help protect the stomach, NSAIDs should always be taken with food or directly after a meal.<br />
 High Blood Pressure and Kidney Damage. NSAIDs reduce the blood flow to the kidneys, which makes them work more slowly. When your kidneys are not working well, fluid builds up in your body. The more fluid in your bloodstream, the higher your blood pressure. If you take NSAIDs in high doses, the reduced blood flow can permanently damage your kidneys.<br />
 Allergic Reactions. NSAIDs can also cause extreme allergic reactions. People with asthma are at a higher risk for experiencing serious allergic reaction to NSAIDs. Many specialists recommend that people who have asthma stay away from any NSAID, especially if they have sinus problems or nasal polyps.</p>
<p>Use of aspirin in children and teenagers with chicken pox or influenza has been associated with the development of Reyes&#8217;s syndrome. Therefore, aspirin and nonaspirin salicylates (e.g. salsalate) should not be used in children and teenagers with suspected or confirmed chicken pox or influenza.<br />
Indomethacin, ketoprofen and piroxicam appear to have the highest prevalence of gastrointestinal adverse drug reactions, while ibuprofen (lower doses) and diclofenac appear to have lower rates.<br />
Serious side effects are especially likely with one nonsteroidal anti-inflammatory drug, phenylbutazone. Patients of age 40 and over are especially at risk of side effects from this drug, and the likelihood of serious side effects increases with age.<br />
Precautions and Contraindications<br />
NSAIDs cannot be used in the following cases:</p>
<p> Allergy to aspirin or any NSAID<br />
 Aspirin should not be used under the age of 16 years<br />
 During pregnancy<br />
 During breast feeding<br />
 On blood thinning agents (anticoagulants)<br />
 Suffering from a defect of the blood clotting system (coagulation)<br />
 Active peptic ulcer</p>
<p>Cost<br />
Numerous NSAIDs are available as generics: diclofenac, etodolac, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, meclofenamate, naproxen, piroxicam, sulindac, and tolmetin. Only meloxicam (brand name: Mobic), nabumetone (Relafen), and oxaprozin (Daypro) are available by brand name only. Generic medications may be an equally effective and less expensive treatment option.<br />
Conclusions<br />
All NSAIDs are similarly effective. The choice of which NSAID to try first is usually empiric. If one doesn&#8217;t provide adequate pain control, try switching to another. All NSAIDS when used chronically can be associated with the development of ulcers. Differences in adverse effects seem to exist between different NSAIDs. Follow with your doctor closely and watch for signs or symptoms of gastrointestinal bleeding such as stomach pain and blood in the stools. Some NSAIDs are available in extended-release formulations that require less frequent dosing.</p>
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