Podcasts about anticholinergics

Part four of the PD Medications, Purposes, and Mechanisms #miniseries is here! If you have never heard of anticholinergics before then you will know them quite well after this episode. Resting #tremors are among the most debilitating symptoms of PD and these medications can possibly help with that, though you may discover some of the side effects may cause you to wonder if it is worth it. Keep scrolling down to access the link to the Parkinson's Foundation page about Anticholinergics. Join this channel to get access to member's only content and perks:  https://www.youtube.com/channel/UC0g3abv8hkaqZbGD8y1dfYQ/join  https://www.patreon.com/pdeducation  Anticholinergics Information: https://www.parkinson.org/living-with-parkinsons/treatment/prescription-medications/anticholinergic-drugs Medical Disclaimer All information, content, and material of this video is for informational purposes only and not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. Affiliate disclaimer: Keep in mind that links used for recommended products may earn me a commission when you make purchases. However, this does not impact what products I recommend. If I recommend a specific product it is because it has been vetted by myself or based on personal use #parkinson #parkinsonsawareness #parkinsonsdisease #parkinsons #medication #parkinsons #podcast #lecture

Welcome to the Happy Nurse Educator podcast by nursing.com. Since 2018, nursing.com has been at the forefront of nursing education, guiding over 400,000 nursing students to academic success while helping the average student raise their lowest grade by 11.6% with an impressive 99.25% NCLEX pass rate. Download free Lesson Plans at HappyNurseEducator.com Must Know NCLEX Meds Lesson Plan Objective By the end of the lesson, the nursing student will be able to identify and understand key medications commonly encountered on the NCLEX, focusing on Analgesics, Anticonvulsants, Anti-inflammatory/Steroids, Anticoagulants, Anti-Parkinsonian drugs, Beta Blockers, Potassium supplements, Respiratory drugs, Cardiac Glycosides, Antihypertensives, Psychotropic drugs, Maternity drugs, Antifungals, Anticholinergics, Oncology medications, Anti-Gout medications, and Ophthalmic medications (miotics and mydriatics). Through this lesson, nursing students will acquire knowledge about medication classes, indications, contraindications, and essential nursing considerations. The emphasis will be on recognizing potential side effects, monitoring for complications, and understanding the rationale behind medication administration. This foundational knowledge will empower students to approach NCLEX questions with confidence and ensure safe medication practices in clinical  settings. Download free Lesson Plans at HappyNurseEducator.com  

Have you been more forgetful lately? Confused? Hallucinating?? Have you had dry mouth associated with your PD medications? It's not just YOU! This week we are discussing Anticholinergic medications. You can find more details here Please be sure to check out the Aware in Care Kit from Parkinson's Foundation. It could be a true gamechanger in the event of a hospitalization, even an elective one. We discussed in this episode of the PWP: Episode 5: Hospital Stays and PWP - Aware in Care Please support this podcast and our endeavors by becoming a co-producer of the show! Sign up as a Patreon supporter here at https://www.patreon.com/pdwarriors Also, you can leave a one time tip in our virtual tip jar at: https://paypal.me/hylandptw Don't forget about our YouTube channel!!

Dr. Rena Malik Interviews Dr. Jacqueline Zilloux, the first author of the 2022. SUFU white paper on overactive bladder anticholinergic medications and dementia risk. Available online at: https://onlinelibrary.wiley.com/doi/10.1002/nau.25037

To get a hold of my books, you can find Memorizing Pharmacology Second Edition HERE or Memorizing Pharmacology Mnemonics HERE In this episode, I go over how you can use BUD, the wide-eyed tachycardia CAT (BUDCAT), to remember the anticholinergics and what that means for pharmacology indications and adverse effects in that drug group.

In this episode, Christoph U. Correll, MD, and John M. Kane, MD, discuss the various etiologies of tardive dyskinesia (TD). Although most healthcare professionals are aware of the risk for TD that comes with first- and second-generation antipsychotic use, there is less awareness around other modifiable and unmodifiable factors that increase risk for TD development. Some modifiable risks include metoclopramide use, anticholinergic use, and substance use disorder; unmodifiable risks include older age and female sex. The doctors agree that, regardless of the level of risk, careful documentation and evaluation should be conducted with patients to detect TD early—should it develop. Their conversation rounds out with considerations for treatment approaches and clinical pearls garnered from years in practice.Presenters:Christoph U. Correll, MDProfessor of Psychiatry and Molecular MedicineThe Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellNew York, New YorkProfessor of Child and Adolescent PsychiatryCharité – Universitätsmedizin BerlinBerlin, GermanyJohn M. Kane, MDVice President for Behavioral Health ServicesNorthwell HealthChairman of PsychiatryZucker Hillside HospitalQueens, New YorkChairman of PsychiatryProfessor of Psychiatry and Molecular MedicineZucker School of Medicine at Hofstra/NorthwellHempstead, New YorkFor more programs in this series, visit:https://bit.ly/3AhRXau

Get answers to the questions that you and your colleagues have asked! In this episode, Jonathan M. Meyer, MD; Leslie Citrome, MD, MPH; and Stuart Isaacson, MD, provide answers to audience questions that were submitted at recent CCO Psychiatry meetings. Their thoughtful responses cover your questions on screening, communicating with patients, medication management, and more. Moderators Rajesh Pahwa, MD; Charles DeBattista, DMH, MD; and Greg W. Mattingly, MD, provide complementary commentary throughout the question and answer session, adding interprofessional perspective to the activity.Presenters:Leslie Citrome, MD, MPHClinical ProfessorDepartment of Psychiatry and Behavioral SciencesNew York Medical CollegeValhalla, New YorkCharles DeBattista, DMH, MDChiefDepression Research ClinicDirectorMedical Student Education in PsychiatryProfessor of Psychiatry and Behavioral SciencesStanford University School of MedicineStanford, CaliforniaStuart Isaacson, MDDirectorParkinson's Disease and Movement Disorders Center of Boca RatonBoca Raton, FloridaClinical Associate Professor of NeurologyFIU Herbert Wertheim College of MedicineMiami, FloridaGreg W. Mattingly, MDAssociate Clinical ProfessorPsychiatryWashington University School of MedicineSt Louis, MissouriPresidentSt Charles Psychiatry AssociatesSt Charles, MissouriJonathan M. Meyer MDVoluntary Clinical Professor, Department of PsychiatryUniversity of California, San DiegoPsychopharmacology ConsultantBalboa Naval Medical Center First Episode Psychosis ProgramState of Nevada Project ECHO First Episode Psychosis ProgramRajesh Pahwa, MDChief, Parkinson and Movement Disorder DivisionDirector, Parkinson Foundation Center of ExcellenceUniversity of Kansas Medical CenterKansas City, KansasFor more programs in this series, visit: https://bit.ly/3Bg0oTv

In this podcast episode, Robert O. Cotes, MD, and Jonathan M. Meyer, MD, discuss tardive dyskinesia from identification to follow-up and ongoing management. They provide valuable insights on pharmacologic options to both consider and avoid to optimize outcomes in patients with tardive dyskinesia, including a focus on clinical strategies for use of VMAT2 inhibitors.Presenters:Robert O. Cotes, MDAssociate ProfessorDepartment of Psychiatry and Behavioral SciencesEmory University School of MedicineAtlanta, GeorgiaJonathan M. Meyer, MDVoluntary Clinical Professor, Department of PsychiatryUniversity of California, San DiegoPsychopharmacology ConsultantBalboa Naval Medical Center First Episode Psychosis ProgramState of Nevada Project ECHO First Episode Psychosis Program

Tasha McNerney CVT CVPP discusses best practices for anesthesia and pain control in a 0.8lb kitten. These cases are tricky and Tasha lays out why as well as what we can do to reduce the risk and decrease pain and discomfort of our patient. Tasha and Andy talk through the importance of maintaining cardiac outflow, O2 therapy, blood glucose monitoring, and thermoregulation. Anticholinergics and fasting protocols are also discussed. This is a FANTASTIC and short episode that is packed with clinical pearls. You won't want to miss it! LINKS: Veterinary Anesthesia Nerds: http://www.veterinaryanesthesianerds.com/ Dr. Andy Roark Exam Room Communication Tool Box Course: https://drandyroark.com/store/ What's on my Scrubs?! Card Game: https://drandyroark.com/training-tools/ Dr. Andy Roark Swag: drandyroark.com/shop All Links: linktr.ee/DrAndyRoark ABOUT OUR GUEST: Tasha McNerney obtained her CVT in 2005 and has worked clinically in the areas of anesthesia and surgery ever since. Tasha obtained her CVPP (certified veterinary pain practitioner) designation in 2013 and became a veterinary technician specialist in anesthesia in 2015. Tasha has been a featured speaker on various anesthesia and pain management topics at several international veterinary conferences. Tasha is the author of many articles and blogs on anesthesia and pain management related topics. In 2013 Tasha created the Facebook group Veterinary Anesthesia Nerds, which has over 65,000 members taking part in education and exchange of ideas from all over the world! Tasha is crazy and bought a 1920's fixer upper and is now obsessed with home improvement tutorials on YouTube. She lives in Philadelphia with her husband, son, one perfect cat, and one jerk cat. Trust me that cat is a jerk.

Episode 105: Antidotes to toxidromes. Some poisonings share common signs and symptoms and may be treated with antidotes without laboratory confirmation of the offending agent. Dr. Francis discussed with Dr. Arreaza some of those toxidromes and how to treat them. Written by Aida Francis, MD. Participation by Hector Arreaza, MD. Definitions: • Antidotes are substances given as a remedy that inhibit the effects of another drug of abuse or poison. Most are not 100% effective and fatality is still possible after administration. • Toxidrome is a constellation of signs and symptoms caused by an overdose or exposure to chemicals or drugs that interact with neuroreceptors. Toxidrome is the combination of the word “toxin” and “syndrome”. Management strategies of toxidromes are determined by the signs and symptoms even when the causative agent has not been identified. A little bit of Background: The World Health Organization reported that 13% of deaths caused by poisonings are children and young adults. Intentional poisoning attempts are more frequent among adolescent women than men. It is difficult to evaluate poisoned patients because they are too altered to provide history and there is often not enough time to perform a physical exam or obtain serum studies prior to life-saving interventions. To diagnose a toxidrome clinically, you need three elements: pupil size, temperature, and bowel sounds. For example: Pinpoint pupils with hyperactive bowel sounds point to cholinergic toxidrome, and dilated pupils with high temperature, and hypoactive bowel sounds point to anticholinergic (see details below). Pinpoint pupils -> Bowel sounds -> Hyperactive: CHOLINERGIC -> Hypoactive: OPIOIDS Normal or dilated pupils -> Temperature -> High -> Bowel sounds -> Hyperactive: SYMPATHOMIMETIC -> Hypoactive: ANTICHOLINERGIC -> Normal or Low -> Bowel sounds -> Hyperactive: HALLOCUNOGENIC -> Hypoactive: SEDATIVE-HYPNOTICS Anticholinergic Toxidrome and the Physostigmine antidote: • Anticholinergics inhibit the binding of acetylcholine to the muscarinic receptors in the central nervous system and the parasympathetic nervous system. Examples of anticholinergics include atropine and tiotropium. Other substances that may cause anticholinergic toxidrome include antihistamines (especially first-generation: diphenhydramine), antipsychotics (quetiapine), antidepressants (TCAs, paroxetine), and antiparkinsonian drugs (benztropine). Symptoms of toxicity include tachycardia, non-reactive mydriasis, anhidrosis, dry mucous membranes, skin flushing, decreased bowel sounds, and urinary retention. Neurological symptoms include delirium, confusion, anxiety, agitation, mumbling, visual hallucination, and strange behavior. Neurological symptoms last longer because of the anticholinergic lipophilic properties which cause them to distribute into fatty organs and tissues like the brain. “Mad as a hatter, red as a beet, blind as a bat, hot as a hare, dry as a bone” [Spanish: loco como una cabra, rojo como un tomate, ciego como un topo, seco como una piedra, caliente como el infierno] • The antidote for anticholinergic toxidrome is physostigmine. It is an acetylcholinesterase inhibitor and prevents the metabolism of acetylcholine. This increases the level of acetylcholine in both the central nervous system and peripheral nervous system. Physostigmine can cause seizures and arrhythmia, so close monitoring in the hospital is required during treatment. Cholinergic toxidrome and its antidotes atropine and pralidoxime: Acetylcholine is part of the parasympathetic nervous system and cholinergic substances can induce a parasympathetic response. Some of these substances include pesticides, organophosphates, carbamate, and nerve gas. Chlorpyrifos had been used to control insects in homes and fields since 1965. It has been used in our crops in Bakersfield, and the most recent mass exposure was in May 2017. it was banned on food crops in the US in August 2021. It has been banned for residential use for a longer period. Repeated exposure to chlorpyrifos causes autoimmune disorders and developmental delays in children and fetuses. The symptoms of cholinergic toxidrome can be summarized with the SLUDGE/ “triple” BBB acronym. This includes salivation, lacrimation, urination, defecation, gastrointestinal cramping, emesis, bradycardia, bronchorrhea, and bronchospasm. There can also be muscle fasciculations and paralysis. • The antidote is Atropine. Pralidoxime is used for organophosphates only because it cleaves the organophosphate-acetylcholinesterase complex to release the enzyme to degrade acetylcholine. Pralidoxime should be used in combination with atropine, not as monotherapy. It requires hospital admission, and a note for organophosphate, remember that the patient needs external decontamination (shower). Let's go to part 2 of our discussion, environmental exposure. Carbon Monoxide Toxidrome and the antidote oxygen: Carbon monoxide intoxication is usually due to smoke inhalation injury. Carbon monoxide is a silent gas produced by carbon-containing fuel or charcoal. Carboxyhemoglobin (COHb) forms in red blood cells when hemoglobin combines with carbon monoxide, reducing the binding and availability of oxygen at the tissue level. It's like CO falls in love with hemoglobin and hemoglobin cheats on Oxygen by binding to CO instead, and neglects oxygen delivery to tissues. Carbon monoxide also causes direct cellular toxicity. The symptoms and signs of poisoning include headache, altered mental status, nausea, vomiting, visual disturbance, Cherry-red lips, coma, and seizure. You can also see lactic acidosis and pulmonary edema. Neurological symptoms can be chronic, so it's important to follow up. The blood COHb level must be used to confirm the diagnosis because standard pulse oximetry (SpO2) and arterial partial oxygen pressure (PaO2) cannot differentiate COHb from normal oxygenated hemoglobin. You must obtain a serum COHb level. • The antidote is 100% oxygen or hyperbaric oxygen therapy and close follow-up. Consider intubating if there is edema of the airways due to inhalation injury. Cyanide Toxidrome which include sodium nitrite, sodium thiosulfate, and hydroxocobalamin In combination with Carbon Monoxide poisoning Cyanide poisoning can simultaneously be caused by inhalation of smoke or colorless hydrogen cyanide or ingestion of cyanide salts or prolonged use of sodium nitroprusside (ICU for hypertensive emergency). Symptoms are very similar to carbon monoxide poisoning. There may be long-term neurologic deficits and Parkinsonism. Diagnosis is clinical and waiting for serum cyanide levels can cause treatment delay. However, serum lactate levels over 10 mmol/L suggest cyanide poisoning. • Since cyanide poisoning resembles carbon monoxide poisoning and both toxidromes typically present simultaneously in the pathognomonic fire victim, treat simultaneously with sodium nitrite, sodium thiosulfate, and hydroxocobalamin as well as oxygen as mentioned with carbon monoxide poisoning. Hypnotic and sedative substances (antidote: flumazenil) Examples of hypnotic or sedative substances are alcohol, benzodiazepines, or zolpidem. Signs and symptoms of toxicity include slurred speech, ataxia, incoordination, disorientation, stupor, and coma with mild and rare hypoventilation and bradycardia. • The antidote is flumazenil which is a competitive antagonist at the benzodiazepine receptor. After treatment monitor patients for seizures in case of TCA poisoning, arrhythmia, or epilepsy. Opioid toxidrome (antidote: naloxone) Examples of opioid intoxication in children would be heroine in adolescents or accidental ingestion of pain medication in young children. Signs and symptoms are similar to the sedative toxidrome except for the pathognomonic finding of miosis or “pinpoint pupils” on physical exam. There will also be respiratory depression, hyporeflexia, bradycardia, muscle rigidity, and absent bowel sounds or constipation. Hypoventilation is severe and can cause death. • The antidote is naloxone which is a synthetic opioid receptor antagonist that can diagnose and treat opioid poisoning. It is indicated if the respiratory rate is less than 12. It has a short half-life and is repeatedly administered every 3-5 minutes until the respiratory drive is restored in order to avoid rebound respiratory depression and intubation. It has a rapid onset so the patient must be observed for 24 hours for opioid withdrawal symptoms. Summary: It is important to be able to recognize a toxidrome and antidote early. Once the antidote is administered, you should observe the patient 24 hours for symptoms of rebound toxicity or withdrawal. Consider repeat administration of the antidote if rebound symptoms occur and treat withdrawal symptoms as needed. Don't forget to consider multidrug poisoning if symptoms are non-specific. Thank you for having me on your podcast to review this topic. ____________________________ Conclusion: Now we conclude our episode number 108, “Antidotes to Toxidromes.” Remember you can start treatment of a patient with typical signs and symptoms of specific toxidromes, especially in patients who are unstable. We hope you enjoyed this episode. We thank Hector Arreaza, Aida Francis, and Arianna Lundquist. Audio Edition by Adrianne Silva. Even without trying you go to bed being a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________ References: 1) Jaelkoury, CC BY-SA 3.0 , via Wikimedia Commons. 2) Hon KL, Hui WF, Leung AK. Antidotes for childhood toxidromes. Drugs Context. 2021;10:2020 11-4. Published 2021 Jun 2. doi:10.7573/dic.2020-11-4, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8177957/. 3) Royalty-free music used for this episode: Space Orbit by Scott Holmes, downloaded on July 20, 2022 from https://freemusicarchive.org/music/Scott_Holmes/.

Moderator:       Jennifer T. Anger, MD, MPH, FPMRS Speaker:          Adrian Wagg, MB, BS, FRCP(Lond) FRCP (Edin) FHEA 

Overactive bladder (OAB) is a very common condition involving urinary urgency, with or without incontinence, plus frequency and nocturia. In this episode, urogynaecologist Dr. Kerac Falk joins me to discuss general information on overactive bladder (OAB) with a focus on the medical treatment options - particularly involving recent research he has worked on as part of a team regarding very common anticholinergic medication for OAB and evidence of potential dementia risk. Dr. Kerac Falk is a urogynecologist (Female Pelvic Medicine and Reconstructive Surgeon), and recently accepted an Assistant Professor of Urogynecology position at the University of Nevada, Reno School of Medicine. He has been involved in researching recurrent UTIs, biofilm, fluid dynamics and our focus for today's episode was based on his research as part of a founding member of the "Fellows OAB Taskforce for Treatment accessibility” advocacy group. Dr. Falk will be starting to see patients at his new practice in August 2021. You can find him through his new website (keracfalkmd.com) and a professional Instagram (@keracfalkMD) and Twitter (@KeracFalkMD).   Recent OAB publications include: Menhaji K, Cardenas-Trowers OO, Chang OH, Hall EF, Ringel NE, Falk K. Anticholinergic Prescribing Pattern Changes of Urogynecology Providers in Response to Evidence of Potential Dementia Risk. Int. Urogynecol.J. Accepted for publication 1/2021, available online 3/2021, pending print. Escobar C, Falk K, Mehta S, et al. Rethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment. Obstet. Gynecol. 2021 Mar;137:1-8. Johnson TM, Goode PS, Hammontree L, Markland AD, Vaughan CP, Ouslander JG, Falk K, McGwin G, Burgio KL. An Exploratory Analysis of Tamsulosin for Overactive Bladder (OAB) in Men With Varying Voiding Symptom Burden. Urology. 2021 Jan 20:S0090-4295(21)00085-6.  Bennett AT, Ringel NE, Menhaji K, Brown OE, Hall EF, Cardenas-Trowers OO, Falk K, Jeney SES, Barnes H, Escobar C, Tellechea LM, Sappenfield EC, Mehta S, Chang OH. "First, Do No Harm"-Trainees' Observation of Risk Reduction in the Treatment of Overactive Bladder. Female Pelvic Med Reconstr Surg. 2021 Jan 1;27(1):2-4.   Enjoy and thanks again to Always Discreet for sponsoring this episode!

Many patients over age 65 take daily medications that have anticholinergic properties. We know the addition of these drugs can affect quality of life and cognition.  In this episode, we talk with Dr. Kristin Meyer, an expert in geriatrics to  explore the latest data and discuss what Pharmacists can do to promote the appropriate use of anticholinergics. Additional Resources/References Beers Criteria: By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi:10.1111/jgs.15767 Anticholinergic Risk Scale: Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The Anticholinergic Risk Scale and Anticholinergic Adverse Effects in Older Persons. Arch Intern Med. 2008;168(5):508–513. doi:10.1001/archinternmed.2007.106 Recent arge study associating anticholinergics with dementia: Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study. JAMA Intern Med. 2019;179(8):1084–1093. doi:10.1001/jamainternmed.2019.0677 This episode is accredited for CPE.  For CE details and to claim credit click here: https://bit.ly/2UT97Ww  See omnystudio.com/listener for privacy information.

Many patients over age 65 take daily medications that have anticholinergic properties. We know the addition of these drugs can affect quality of life and cognition.  In this episode, we talk with Dr. Kristin Meyer, an expert in geriatrics to  explore the latest data and discuss what Pharmacists can do to promote the appropriate use of anticholinergics.Additional Resources/ReferencesBeers Criteria:By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi:10.1111/jgs.15767Anticholinergic Risk Scale:Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The Anticholinergic Risk Scale and Anticholinergic Adverse Effects in Older Persons. Arch Intern Med. 2008;168(5):508–513. doi:10.1001/archinternmed.2007.106Recent arge study associating anticholinergics with dementia:Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study. JAMA Intern Med. 2019;179(8):1084–1093. doi:10.1001/jamainternmed.2019.0677This episode is accredited for CPE.  For CE details and to claim credit click here: https://bit.ly/2UT97Ww See omnystudio.com/listener for privacy information.

Many patients over age 65 take daily medications that have anticholinergic properties. We know the addition of these drugs can affect quality of life and cognition.  In this episode, we talk with Dr. Kristin Meyer, an expert in geriatrics to  explore the latest data and discuss what Pharmacists can do to promote the appropriate use of anticholinergics. Additional Resources/References Beers Criteria: By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi:10.1111/jgs.15767 Anticholinergic Risk Scale: Rudolph JL, Salow MJ, Angelini MC, McGlinchey RE. The Anticholinergic Risk Scale and Anticholinergic Adverse Effects in Older Persons. Arch Intern Med. 2008;168(5):508–513. doi:10.1001/archinternmed.2007.106 Recent arge study associating anticholinergics with dementia: Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study. JAMA Intern Med. 2019;179(8):1084–1093. doi:10.1001/jamainternmed.2019.0677 This episode is accredited for CPE.  For CE details and to claim credit click here: https://bit.ly/2UT97Ww 

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Learn about anticholinergics, a type of medications that can be risky for brain health. Featuring Noll Campbell, PharmD, MS.

Eric Rieger  All right, you have now joined the gut check project. This is episode number 27. I'm here with your host, Dr. Kenneth Brown. I'm Eric Rieger. It's 2020.Ken Brown  We're in a new decade. This is unbelievable.Eric Rieger  So that's interesting. Some people will say that the decade does not begin on years that end in zero, because when the calendar started, there was no Year Zero. It was let's have a year this is year one. So lots of people end up saying technically a decade doesn't start to the ones but nobody talks that way. When you say the roaring 20s it started 1920. So I'm on board with you. I think this is the beginning of a new decade.Ken Brown  How did you...I mean, how could you say when you were born when it was BC, were you like I'm minus 20?Eric Rieger  Yep, that's pretty much what they did. Ken Brown  Is that what they did? Yeah, they'd just walk up...Eric Rieger  In 745 years they will begin to count. I think that's how it went down.Ken Brown  Is that how the whole the whole calendar went down? Like All right, everybody, we're starting over. Eric Rieger  Yeah, y'all are gonna love this. There's gonna be a Messiah. We're gonna start counting it's gonna be great. Ken Brown  I love it. Eric Rieger  Well, today's episode of course is brought to you by Atrantil developed by the guy right across the table from me Atrantil is a daily source of polyphenols to address issues of symptoms related to IBS, as well as definitely bloating. Ken Brown  You know what I'm really getting into also is all the new information coming out with polyphenols in sports performance. Talking about how polyphenols actually can improve blood flow by increasing nitric oxide. I can't wait till we can start working with some endurance athletes and start testing them to see if we can get some new prs and some of these people.Eric Rieger  Hundred percent! Ken Brown  If you're running some marathons. If you think about it, if you're an endurance athlete, like a triathlete or something, you know, I got my good friend Ron Tribendis who has his own podcast also tremendous chiropractor and he's like high level performance and all that he actually sells Atrantil. But we were talking about that, that, you know, he gets so many of his clients that he trains and that are his patients that when they start training for these triathlons and marathons and they're taking in all that goo and the high fructose stuff to try and or not even just the fructose based sugars to try and gain fuel from it. That's when they start having gi distress. I feel like we can help all those people.Eric Rieger  Definitely it's interesting that you bring that up right off the bat because at CPSDA and the reason why this is important is Atrantil is chock full of polyphenols. That's where the magic is. So that's why discussing Atrantil leads us to talking about athletes and when I was at CPSDA about a year and a half ago. Joe VotelKen Brown  The PhDEric Rieger  The PhD from Exeter University over in Europe. She came over and they've done extensive research on multiple different research opportunities where they've shown that daily polyphenol intake and athletes will decrease recovery time, increase blood flow, just as you pointed out, increase nitric oxide production. These are things that serious athletes love to know. And it's, it's natural. Even more importantly, though, you can always say, get rest, or eat polyphenols or have some fruits. But ultimately, when someone wants to do it, it's how much? And she was able to show that pre no, I'm sorry, proanthocyanidins, at 1000 milligrams per day was an optimal dose for active athletes. So anyhow...Ken Brown  If you want it to get that, I mean, what would I have to eat? If it was like cherries or something. Eric Rieger  If you wanted to have that. This was her example. It's awesome. She showed that you would probably have to have four to five bowls of cherries or blueberries. Good fruits. Unfortunately, there's a lot of high fructose or not high fructose. There's a lot of fructose that's in there. And serious athletes oftentimes don't want to over load their daily sugar even if it happens to occur naturally now-separate debate. But she she quickly pointed out that if you could consume proanthocyanidins that did not have high fructose content, you'd have something magical and just so happens that Atrantil four capsules roughly equals 1000 milligrams of proanthocyanidins...Ken Brown  I've actually had a lot of patients tell me that they do better. Oh, one thing we're going to start doing in 2020, and we're going to go back. Let's just do a little disclaimer here. Although I am a real doctor. Eric Rieger  Yeah. Ken Brown  Do not take this as medical advice for that weird rash or that unusual, extra toe growing out or something. Go see a doctor, don't listen to us. We're here to have fun, possibly educate a little bit but more importantly, help everyone to discover some new things because that's what we want to do. We want to find new things in the literature, new things that are coming out and make sure that everyone can biohack in the way that we have tested on ourselves. SoEric Rieger  Definitely. So find Atrantil at antrantil.com or lovemytummy.com is much easier to remember, forward slash kbmd Atrantil lovemytummy.com/kbmd. Not just for bloating, it's also for athletes. It's really for everyone.Ken Brown  It really is. And so that's how I mean it's...this is fun. In fact, this brings me up to something so I just shot a video for this. We have a new website that has launchedEric Rieger  finally,Ken Brown  Finally! So go to kbmdhealth.com. Check it out, give us your feedback. There's going to be a video there where I kind of get into the things that I like the things that I like our biohacking CBD, I'll try and deal with polyphenols and making sure that you can have access to some of the best vetted supplements meaning a lot of the stuff that people are buying may not actually benefit you or may have something dangerous in it. In fact, there was um, I need to find out what she had. But there was a news article here in the DFW Metroplex, a very unfortunate 23 year old, who was taking some woman's multi weight management. They didn't say the name of the product or what was in it. Eric Rieger  Sure. Ken Brown  But unfortunately, they believe that that actually caused daily drug induced liver injury. So that's one of the things when I've had patients come in, and you find out that they're on a supplement, but that supplement is not third party tested or that supplement is coming in from someplace else. Anything can happen to anybody. I understand that you can have a bad reaction, you can have an allergic reaction to something but make sure that you're at least if you're going out trying some different things to make sure it's third party tested, which is why we have the kbmd health subscription box. Eric Rieger  Yeah, we, definitely you can find that health subscription box prominently located on the right side of the new kbmchealth.com. Ken Brown  I think it looks so nice. You did an excellent job. Eric Rieger  I did not do that. That was was the help of Stephen and people that understand how to build websites. So our bad website that we had before was me. And we moved over to a real one. Ken Brown  Which is an awesome website for CRNA.Eric Rieger  Yeah, that's exactly right. So if you want me to build a home, and you want to say I got a home built by a CRNA, and it may or may not have a door that closes, you should totally ask me to do it. But otherwise, no, Stephen and Drew and Mark did a great job I think putting together a pretty cool, easy to understand website. And just so that everyone knows there are new pieces going to be added as time goes along. We have a large repository of CBD information that's going to be added to the website. We've got ways for people to access videos where they can get educated on on things that may not have anything to do specifically with polyphenols or CBD we there's a lot of things they're going to add to the site. They'll be easy to find. Ken Brown  This is so exciting because we've done so much background work of trying to set the store up trying to do different things now we can start to really interact with everybody. We want this to be a community. One of the things that can lead to disease is the feeling of loneliness. So if you're feeling lonely might as well join this community, hit us up, say, Hey, I read this article on this, can you look into it? And that's kind of what I want this podcast to grow into where we can sort of play. We can vet stuff, we can get new stuff out there, we can get people communicating. Look at all our patients that show up and they're like hey I watch your show. I would like to come on and talk about this like, yeah,Eric Rieger  Yeah, happens happens more often than I would have expected, especially as early as we've been doing this.Ken Brown  Oh, you wanna know. Another way we're going to get a lot more people here...our friend Dan Clark. brain.fm. Yes. So we we have this we have been fortunate enough to meet this incredibly intelligent CEO named Dan Clark, who was named I think 30 under 30 in Forbes. Yeah, well, they have a app that when you put headphones on, does something called neural phase locking neural phase locking, which some people confuse it with binaural beats like I did, but what it does It stimulates various areas of your brain so you can calm down or wake up. I actually when I actually use it to go to sleep, and I use it to wake up, and that's when you and I were talking, and we're going to start out seeing if this can help calm down my patients before colonoscopy, and help them wake up quicker. So if you're listening to this, and you need a colonoscopy, you can be part of something really cool. No, it's it's just headphones and music. So it's not dangerous, it's going to be really cool. And we're going to get some really neat data out of this. When we tried it on our first eight patients they all loved it. Eric Rieger  They all loved it. There was it wasn't just an absence of complaints. It was really just robust compliments and thanks so much for letting me be a part of it. Ken Brown  Can you imagine if you're sitting in the waiting room of a of a dentist's office or something that you really don't like or your gynecologist or whatever it is, I'm using doctors but this could be the IRS or whatever, putting some headphones on and taking yourself down and calming from the brain which will then tell the cortisol to decrease and everything will calm down. It will be all good. That's it. That's a whole new level of science, which I'm super excited about. Because there's really no side effects. It's music. Eric Rieger  It's just music. And it's actually really, really cool. Ken Brown  Based on science. Music based on science with functional MRIs and everything. They've got some studies where they showed a the relaxation scores of people that have listened to the most "relaxing" music are having the most relaxing and then the control was Coldplay, which I thought was really funny in their study, and then they had them listen to brain.fm and unequivocably all the people that had brain FM felt much more relaxed. So there is some really cool science to this. Now we're just going to add some objective data. And maybe we'll be able to get some patients that absolutely love it. This is this could be the future of what we're going to do. You use less medicines. My patients are happier and it's a win win win for everybody.Eric Rieger  Anything that we can do to make the experience of going in for an elective procedure or any really any stressful situation, but if we know that we can help people feel better, why not try it and it's just sound so we know we're not causing pain or harm.Ken Brown  So I'm going to like I'm trying to get my kids with this where if they are getting ready to like so my kids play tennis, which is where the family is right now they're in Florida winter nationals. In fact, Lucas i think is in the throes of a match right now he's still in it. They've been there since last Thursday. Eric Rieger  Right on. Ken Brown  Yeah, they've been there for four weeks. So the you know, you go home when you lose and he did he's out of the main draw. He'd lost in a really tough third set battle but mentally came back and has won three more matches which is which I think is the coolest thing when you lose to not just let your give up right there but and so he uses he actually uses my account at brainfm. Don't tell Dan that we're sharing an account. He uses my account for whenever he studies and so he likes it so yeah, I think that that's it I think it's super exciting. So what's going on? Oh, how were your holidays? Eric Rieger  Holidays were great. We had we had family in town for for Christmas to come visit we cooked steaks we chilled out we I mean we saw everyone we saw everyone on my side of the family, on Marie's side of the family it was it was a lot of fun. The boys the last obviously just like Lucas and Carla, they had basketball tournaments. Mac had a great tournament for the junior varsity. They really played up for the JV. They played bigger schools, they ended up closing out their last game they won by 30. Ken Brown  Won by 30?Eric Rieger  Yea. So they were really happy with being able to close up the tournament with that. Mac and his whole team. I mean, they're really preparing to next year they'll all be on varsity. So he he and his brother get along great. He just wants to be able to contribute just like his older brother did, who actually competed in one of the nation's longest I think the top four or top five longest running high school basketball tournaments and that's the Whataburger tournament and Gage's Decatur Eagles, second year in a row, won the whole tournament. And Gage was named all tournament. Ken Brown  Woo, woo. Go Gage!Eric Rieger  Yea. He played. He played really well. Super proud of both of the boys. It's I mean, it's just It's fortunate to have to have these opportunities with your kids. I wasn't an athlete like that. So it's just so much fun to watch them work so hard and achieve and they do it as a team for them.Ken Brown  You're not concerned that gage is going to try to be like Al Bundy sitting on a couch talking about his 2019 glory year of basketball when he's like 45. Eric Rieger  We talked about it every night. To make sure he doesn't do it. Ken Brown  Don't be Al Bundy. Eric Rieger  Yeah, we use the brain FM anti Bundy music track.Ken Brown  Yea, we have to make sure that he continues to succeed in other areas. He committed to Texas Tech so that's a good start. Eric Rieger  Yeah, he's gonna play there...intramural, but he'll play there. Ken Brown  There we go. Eric Rieger  There we go. Well, let's let's get into it. SoKen Brown  Yeah, well, I got one other thing that's super cool over the holidays. Oh, by the way, I'm one and a half days into my five day fast. I'm starting the year with a fast. Eric Rieger  Nice. Good for you. Ken Brown  Yeah, so we're that's where I'm at to get my get my water tea broth kind of thing. Just going to try and do that to liquid fast. So we'll see how that goes. Speaking of fasting, got a really cool contact. Do you remember Melanie Avalon podcasts intermittent fasting podcastEric Rieger  I definitely remember MelanieKen Brown  Super cool person very smart you know crushes it on the on the whole podcast scene. Well, she contacted me and she has a new app out. Oh no. Yeah, really cool an app called the food sense guide. I need a favor from you. Eric Rieger  Okay. Ken Brown  It's a searchable comprehensive guide to over 300 plus foods for general levels of different things like the amines, fodmaps glutamates, gluten, histamine, lectins, oxalates, salicylates, sulfites, and so on. If you don't know what any of those are, it's because you're very fortunate, and you don't have to worry about what you eat. But that world is my patients. They come in and we talk about diet. So now this is gonna be really cool. I'll be able to help Melanie out, put my patients on it. Unfortunately, it's not on Android yet. And I got a Google Pixel. So I'm going to have you download it and then we're going to play with it and then we're going to post a review for her. And if anybody else wants to download that, it's the what did I say it was it's the food sense guide on the iTunes it's for iPhones only now. So take a look at it if you've got food sensitivity or anything like that, or your doctor said, try fodmap or you just want to try some different things. It's a great start.Eric Rieger  Food sense guide. Sense?Ken Brown  Yeah, food sense guide.Eric Rieger  Food sense guide. Yeah, download that from Melanie. She runs a great podcast, actually two different podcasts. And she does an awesome job of keeping her audience up to date with the latest information. So I'd feel completely comfortable in going ahead and recommending it as we try it.Ken Brown  Absolutely. And we'll get to we'll eventually get a code for everybody that maybe we can get a code so that they can get a little discount or something. Who knows. Let's start the new year out. I want to ask you a question. Eric Rieger  I'm ready. Ken Brown  I want you to be honest. Eric Rieger  Okay. Ken Brown  Do you use your phone when you're in the bathroom? Much like our mascot here? Gutsy. Do you use your phone like him when you're in the bathroom? Eric Rieger  As much as I want to say no, that's not true.Ken Brown  Well, as it turns out, you are not alone. Eric Rieger  I didn't think it was. Ken Brown  Different studies have shown that up to 75% of Americans do this. So, next time you're scrolling through on your Instagram, and you see that sexy Instagram model picture, there's a good chance she's sitting on the toilet while doing that, while she's posting. Think about that for a moment. Eric Rieger  That's where the work that's where the work is done. Ken Brown  That's where that's what they're saying is that many a lot of the Instagram posts and everything are probably done when people have a little alone time when they've they've taken their photo shoots and then it's time to upload it. Eric Rieger  It's funny, they say probably with a with the GPS stuff that you give up just by using those apps, they probably know that that's where you Ken Brown  Well, they certainly know for sure. On 20% of the people to do it because 20% of Americans have admitted to dropping their phone in the toilet. Eric Rieger  Oh, and I've not done that. Ken Brown  20%Eric Rieger  Yeah, I'm in the other four out of five. I have not done that. And I don't know that I would reach in to grab it. That just may be it.Ken Brown  I think that's why I think that's why the new iPhone is bragging so much about being waterproof. That's what that's what the commercial should be. It should be an Instagram model that drops it in the toilet. She's like, eh, grabs it and pulls it up, keeps going.Eric Rieger  Now I don't think it should be that they may make one like that.Ken Brown  Now, wait a minute. As a gastroenterologist, I encourage everyone, to when you sit on the toilet, I want you to snap, tweet, Facebook, Insta, play Words with Friends or whatever it is that people do buy Atrantil online through, you know, through the website, and you can do any of that. Because when you sit on that toilet for a long time, you're going to create hemorrhoids. I love hemorrhoids. I love treating hemorrhoids. So I encourage everyone to go ahead and do that. But almost everyone, almost, I'm not gonna encourage my employees to do it.Eric Rieger  No No you probably wouldn't, because that would run up a bill on the opposite end trying to care for it.Unknown Speaker  Well, it would also run up the It would also decrease the productivity.Eric Rieger  Yeah, probably soKen Brown  And leave it up to the Brits to figure this part out. Eric Rieger  What's that?Ken Brown  Well, this is all leading up to a study, I was actually going somewhere with all this. I know you're looking at me like why are you focusing on the phone in the toilet so much? Eric Rieger  Well, I mean, I was but I was I was genuinely interested.Ken Brown  So let me ask you, in the UK, it's estimated that the lack of productivity due to extended toilet breaks, is costing the United Kingdom $7.5 billion dollars a year. Eric Rieger  7.5 billion? Ken Brown  Yeah. So you're the chancellor, Emperor of England. Is that Emperor now? or What is it? It's a...Eric Rieger  Guardian? Ken Brown  Guardian?Eric Rieger  Yeah.Ken Brown   Okay. Eric Rieger  Something like that.Ken Brown  That's beacuase I'm wearing my guardians of the galaxy shirt. Eric Rieger  That's exactly where I got that from.Ken Brown  All right. I want to know, Eric Rieger. What would you do if you were president of united states and you say, we can We can improve our our overall bottom line by getting people to get off their phones while they're in the bathroom. Eric Rieger  What would I do about it? Oh my goodness I if I honestly I just don't even have a smart alec answer. Scramblers? Not really sure.Ken Brown  Well, I was thinking about that also cuz I'm like, where's where's this article going? Where they're talking about people $7.5 billion being lost like every time you know, you go to the bathroom, you just go to Cha-Ching. Ken Brown  Seems like a lot seems like overkill and it seems like thers... So as it turns out, there was a who is now CEO of a company, a British designer was waiting to use the restroom at a truck stop while waiting for stalls to open up. And what he noticed is that all these guys were coming out holding their phones, and he was getting super annoyed because he had to use the bathroom and everything was taking a long time. Yeah. So it occurred to him that this is probably going on at work. So he designed a toilet that slants eight to 13 degrees down. Eric Rieger  It seems like a lot though.Eric Rieger  You know what I saw this. Ken Brown  You did? Eric Rieger  I saw the design, it looks like it was very uncomfortable to sit there for a very long time. is that right? Ken Brown  They purposely built a toilet so it's uncomfortable to sit in. Actually, what it does is and you can choose so if you're like, if you're a nice boss, you just do eight degrees, you do 13 degrees and what it does, it makes you kind of stand up so your quads burn. So you have all these now you can start seeing all kinds of Instagram models with giant quads and just big legs. It's gonna move from the Kardashian bottom to the to the Insta thighs that look like a good leg press. 1000 pounds, but so it's making them uncomfortable. What's your thoughts on that?Eric Rieger  Man, I don't know. It It's interesting, I don't think that you can. I think what we, where we are right now is we've just identified a in terms of the employer. A time waste is what they feel like. But I feel like that people have been finding ways to waste time since the dawn of time. I don't know that you're really gonna curve anything. In fact, I would say that there are probably some who's still trying to remain productive by answering email. I mean, I don't know what they're calculating. There's 7.5 billion on that of those who just can answer text or email. I'm just throwing that out there. Ken Brown  Oh, yeah. That wasn't taking into account maybe it's more productive for some people. Eric Rieger  Yeah. I mean, it probably really could be better. Ken Brown  But you're saying like since the dawn of time, what were those people that would send Telegraph's Do you think the guy would like take it into the bathroom and go?Eric Rieger  Yeah, you got an extension here. Little extension cord is one in there. Ken Brown  And it's been going on since the dawn of time. Eric Rieger  Beedle E Beat where ever he was to do that. Is that the correct word for it? From Western Union? Ken Brown  Yeah, exactly. It's the Western Union person I'm thinking. That's exactlyEric Rieger  I don't know. I mean, a slanted toilet though I mean, for those who don't waste time in the in the bathroom, it seems like a disservice to them to have to be on an uncomfortable toilet.Ken Brown  So it got me thinking a little bit. So I just found the article kind of funny. And I thought it'd be interesting to talk about here. But now let's science it up a little bit. So the reality is, what they're doing is they're actually, so there is something called the optimal angle of defication Eric Rieger  Wouldn't that be undoing that?  Ken Brown  It's undoing it. So it's going to be counterproductive. Yes, they might be off their phones, but they're not going to have an effective bowel movement. Eric Rieger  Sounds to me like they won't evacuate as well. Ken Brown  And it'll take them longer to evacuate leading... Ken Brown  Multiple trips, leading to more Hemorrhoids and things like that. So the whole concept of Oh, I'm just going to make this uncomfortable, is going to completely backfire. In fact, in 2011, I did a whole blog on this. If you go to Kenneth Brown, MD. com, I did a blog on the angle of defication. And what they did is some Japanese scientists, they took people and they well, it's unfortunate, but they took medical students, and they actually put radio paste in their bottoms, so they can watch them deficate. And then they had them do this multiple times with various angles. So they did it was like an engineering type thing. You can see the perfect angle. And the reason why we need a certain angle is that we have muscles down there, one of them called the puborectalis muscle. And when it doesn't completely relax, well, you can end up having a very ineffective bowel movement. So when I talk to my patients, I say, do you get the urge to go to the restroom? They say yes. When you go to the restroom, do you feel that you are fully evacuated? They're like, No, I have to strain a lot. Are they constipated? And by constipation meaning are you just not getting the urge but when you have the urge, you can't get it out. In my mind. That's not constipation. That is an evacuation issue that is pelvic floor. Dis synergy is what the actual medical term is. Wow. So there's little tricks to fix that. And it's the exact opposite of what this toilet is. The first trick is you actually get your knees above your hips. That's how squatty pottys making a living they're getting people to do that. Eric Rieger  Multiple trips. Eric Rieger  That'swhat they do. Ken Brown  And then if you lean slightly forward, what they figured out is you get that muscle to kind of come out of the way. One of the things is, I started really thinking about this the reason why I wrote the blogs because one of my patients said, Hey, whenever I go camping, I don't ever feel constipated. Why is that? I'm like, do you dig a hole in the ground? She goes, Yeah, yeah, cuz like, Okay, she goes camping a lot, she's like, and you dig a hole in the ground, you're squatting so we're one of the few countries well now England for sure. But we're one of the few countries Well, I just take it back. Western countries use toilets, but most of the countries that don't use aboveground toilets do not have hemorrhoid or constipation issues. Eric Rieger  No they're in optimal defication pose. Ken Brown  They're, an optimal defication pose so I just thought it was kind of interesting that somebody would go around and and purposely build a toilet. And I started thinking of all my patients that have like serious issues, Chrone's, colitis, irritable bowel, bacterial. It's it was described by a couple people on Twitter as a dystonia, dystonia era in the bathroom. Eric Rieger  Yeah. I mean, somebody's always gonna go a little too far. Yeah. I mean, so what were alternatives be, I've noticed that there are certain bathrooms that maybe only have like one or two stalls, and oftentimes because they aren't frequented, they'll have the motion detector. And I've heard stories that people saying that they they knew they were in there too long because the motion detector timed out and they were in there in the light went off. You know, so, I mean, I think there are other there are other ways that won't actually hamper your natural ability to use the bathroom, but maybe we'll get your attention that you've been there too long, whether it be lights off, you know, clicking off or maybe a bell with a lock on the stall doors been engaged for too long or who knows? Ken Brown  You know what? Something that might work. Also, did you see that YouTube video of Mark Rober with the exploding glitter bomb for the porch porch pirates?Eric Rieger  Oh yeah I did it the the parcel box it just basically shredded and sprayedKen Brown  And sprays glitter.Eric Rieger  Yeah. Ken Brown  For people that that actually steal it. It's I mean, he's gotten tons of notoriety. Yes, he's been on Jimmy Kimmel a bunch of other things, just little mini little things and have a timer that some people walked out they were glitter on their face. Ahh a little too long huh? It's the Mark Rober bathroom bathroom optimizer?Eric Rieger  Yeah. I mean, it seems. Again, it seems aggressive for somebody who may actually have a legitimate issue but I mean, you probably could be a little bit more inventive than creating a disadvantage for everyone that needs to use your your toilet. Ken Brown  Yeah, I thought that was kind of an interesting way to start a year. You show up to your job. And you're like has anyone seen those toilets yet?Eric Rieger  Well, when I saw that, I mean, I almost think it was a YouTube TV news story or something like that. Because when regardless, it doesn't matter. I saw over the holiday, but I thought it was a joke. So I didn't think it was real. I saw better I saw them showing the plane and then the the angle down of the toilet drawn there but I had no idea that was a serious solution proposed by somebody I thought it was other than being silly. Yeah, so it is pretty silly anywayKen Brown  Lead line them so you can't get Wi Fi or phone signal.Eric Rieger  Yeah I mean that that would probably be the quickest expediter and would filter the right people out right?Ken Brown  Oh, they'll die from lead poisoning eventually. That will filter them.Eric Rieger  Yeah, but I mean you would definitely filter the right people out because you wouldn't have you or at least have a scrambler because you could the people who are legitimately need to be in it for a long time are going to be there no matter what. And the people that were wanting to play on the phone couldn't access their phone.Ken Brown  Yeah, but in in all seriousness, it is. It is a really big deal in my field hemorrhoids rectal bleeding if you do this, go to YouTube and take a look at our rectal bleeding video so that you're not too concerned. And then we can if you're local, make an appointment to fix those hemorrhoidsEric Rieger  We got a cool e book coming out here pretty soon they'll be able to make public yeah That'll be not only will it have a couple of suggestions for solutions that you can participate in, but pretty soon it will have more than one option and I can't really talk about it today, but I'm excited about that.Ken Brown  Awesome. What else you got on your mind?Eric Rieger  I really don't. I mean, we're starting off a new year, new year for everyone and it's 2020 I think it's got a lot of cool plays on on words. It was pointed out to me earlier this morning that just as a quick PSA, if you're writing a check, or something that requires the date for you to have written in normally in the past, you may have written October 3 2019 is /19. You probably want to go ahead and write out the 2020. Okay, somebody else could miss date for whatever advantage that they may have. If you happen to run a 20 somebody else could follow in and put a one eight or 190 Yes, a trailer on there and possibly do something to a document just a little anectdotal has nothing to do it today. But then again, it does. So maybe just to protect yourself right out 2020 I don't know. I have no idea there's any legitimacy to that or not, but it's interesting.Ken Brown  So we that is Eric's public service announcement of the day. I wish I had one of those little shooting star things that you know Ken Brown  Yeah. The more you know.Eric Rieger  The more you know, Ken Brown  Eric's The more you know, segmentEric Rieger  Maybe Paul will give us a little wind chime or something right there.Ken Brown  You want to get nerdy for a moment? Eric Rieger  Let's do it. Ken Brown  Alright, so there's a there's been a lot going on in the news. A lot of stuff has been published. We haven't a chance to talk about. Something I came across that is a passion of mine, you know that one of my big things. I there are epidemics going on right now. And we know that autism is an epidemic,we know that autoimmune is increasing. Well, the other one that I'm you know, really want to fix because I feel like you spent a whole life loving, hurting, living seeing things collecting memories, and then dementia and Alzheimer's sets it. To me, that's one of the most horrific diseases that are going on. And it's exponentially increasing. And there's a lot of confusion as to or there's a lot of reasons as to why. But a recent study just came out of the University of Berkeley, it was in December 2019. It came on out of the Journal of science and translational medicine. What they did is they looked at essentially senile mice, and they're trying to figure out what made some of these mice and they were given them different markers to see if they could create neuro inflammation or brain inflammation. Well, as it turns out, even if they looked as the mice aged, almost all of them started having decreased cognition, especially fed on the typical human or Western diet. Yeah, the American diet. Eric Rieger  I think I know where we're going. Ken Brown  So very Interesting what they did is they talked about this in a very unique way. I've never heard of scientists going down this path. And this is University of Berkeley. This is you know, these are these are legit people that are finding something they had their aha moment that you and I've talked about a bunch. What they found is we used to think or the trend right now not we used to because the current trend is is that the aged brain ages in the same way that everything else does. You have neuro degeneration, you have less nerve cells, you've got decreased capacity to learn more and all these other things. There are some people that believe it's micro infarction, there are some people that believe that it's amyloid plaques, but either way, your nerve function is decreasing. So age involves loss of function and dead cells, generally speaking, which is how we age. But there's new data to tell a totally different story about why the aged brain is not functioning well. It is because of the fog of inflammatory load. Eric Rieger  Make sense. Ken Brown  And my we always talk about this patients that come in with irritable bowel bacterial overgrowth. They're like, Man, I'm not right, I'm in a brain fog. Now we realize that that brain fog could potentially be an inflammatory load in this mouse model, they're showing that. So when you remove that inflammatory fog, they call it the inflammatory fog. When you remove that inflammatory process within days, the brain starts acting like a young brain.Eric Rieger  That's impressive that they've been able to kind of morally morally more establish this connection because it wasn't that long ago that we were before we even started the podcast having a discussion that if you have a leaky gut, more or less, it's probably correlating with a leaky brain, right? So if you have permeability issues in your gut, chances are it's a systemic issue, and it's occurring, what they call the blood brain barrier, which protects your brainKen Brown  100% I think it is interesting you brought up morally because unlike the gavage study that we talked about a few weeks ago about the CBD, just gavaging tube down the mouse and just pouring buckets of it. These guys are actually waking or like helping these mice out there like, hey, look, you got a young brain now. So, more and more research is showing that with age, the filtration system, that's that blood brain barrier prevents molecules or infectious organisms from the blood leaking into the brain. This is the blood brain barrier, like I was saying, over time. In fact, they were showing that after the age of 70, it becomes more and more leaky, letting in chemicals that cause inflammation and a cascade, which ultimately creates this brain fog, which ultimately does lead to cell death. So after age 70, nearly 60% of adults have leaky brain barriers. I'll say that again. After age 70. Nearly 60% of adults have a leaky blood brain barrier and this is according to some really cool things. This is a MRI studies where they're looking at this, this is functional MRI studies. So it isn't just, you know, we can't really get in there and biopsy the brain and do these different things. So the inflammatory fog induced by leaky blood brain barrier alters the mouse's normal rhythms. And in these mice, this is fascinating. And I'll say it again, because my patients come in and they're like, I'm not right. I just feel like I'm just not firing on all cylinders. They showed in these mice, the very first signs of this are micro seizure like events, little tiny little seizures. It's not a total, it's not a total seizure, where your body does just in these little areas, like momentary lapses in the normal rhythm within the hippocampus. Eric Rieger  Interesting. Ken Brown  Alright, so now think about this. We talked early on about the neural phase programming, or neural phase locking. So the brain is an electrical impulse, everything comes down to this. This study shows that when you have leaky brain caused most likely by leaky gut, that you're going to have an electrical impedance problem, which they're detecting through eeg, or different processes as micro seizures. So everything comes down to electricity in the brain. So it's it's really interesting that I wonder if the science and neural phase locking could get to the point where you could counteract some of the seizures that are going on. That's a whole separate discussion, but it just gets you thinking. It's like hmm.Eric Rieger  It does get you thinking, but it also makes me wonder, a couple of different questions. One would, how would a lay person be able to identify they had a micro seizure? Two would be how do I control inflammation because it sounds to me like concentrated inflammation is putting me a risk of developing these issues are being a part of the 70% over 70 having these problems, right. And then three, the people that don't or the mice that didn't show that they had these breakdowns in their blood brain barrier were they without significant inflammation universally. So were they comparing these two and showing that we had people or mice that didn't have inflammation and they didn't exhibit these problems, see what I'm saying? Ken Brown  Oh, yeah. Eric Rieger  So or and then I guess the fourth would be would that number be as high in a country that didn't consume a traditional Western diet every day? And maybe had more polyphenols or Mediterranean style diet?Ken Brown  Very interesting fact. I will just look at this not to get off topic. I'm going to finish this. Yeah. And then we're going to talk about that because I watched a Netflix thing and I want to just briefly hit on because i'm really confused. Eric Rieger  Was it the office? No? Okay.Ken Brown  When you have this these little micro seizures, what they found in this mice is it produced some of the same symptoms seen in diseases like Alzheimer's and they were able to show with EEG's, really sensitive EEG's. That's what neurologists will put the, all those little wires attached to a head. And they can see if somebody's seizing, they could see this and really tiny little levels, they revealed very similar wave disruption, or they were showing a paroxysmal slow wave event. Literally, the inflammation was slowing your brainwaves down. Yeah, all my patients that go, I'm just not on, something's off. Their brain is being slowed. It's like trying to go through molasses as it's trying to conduct a current. So in a normal human with epilepsy with cognitive dysfunction, they can actually show that there's mild cognitive impairment. So even if you're not having the seizures, they can actually show that you could probably function at a higher level if you can get that fixed. So what's really cool about this paper is you were saying how do I know that this is happening? Right? This is the first time ever these The reason why I think this is a seminal article is because the papers give Doctors, two biomarkers. These two biomarkers are leaky barriers detectable by MRI and abnormal brain rhythm detectable by eeg, what they've been able to show is even in humans, young brain, old brain, they can show the leakiness of it or the permeability. And then they can show where that's happening, that there's increased micro seizure activity going on. really fascinating because what this allows it to do is it is a tool to say, Oh, I mean, that would be awesome. If I could, my patients were to come in, and I'm like, Look, we're trying to figure out if you've got leaky gut due to bacterial overgrowth, or whatever. And remember, nobody's been saying leaky. I mean, I've been saying leaky for five years, and people were laughing at me and now you've got people like at the Mayo saying leaky gut, now you've gotten these guys saying leaky brain. I mean, clearly, we're just defining something that inflammation is bad if you can keep inflammation out of your brain in any way possible. And that includes trauma and that includes drugs, alcohol, all that stuff, you're just going to be better offEric Rieger  Hundred percent I can remember we we tried to find five years ago if if leaky gut was anything that anybody was searching for. And at that time, the answer was no. And nowit's everywhere. Yeah, so it's applicable. Ken Brown  Yeah. And so what's what's really cool is, you know, you can imagine if I could take these, I could take a patient and say, Oh, you're you're having leaky brain, much like checking a low density lipoprotein or, and all the other cholesterol markers that we do to try and predict if you're gonna have a heart attack, if I can get in there and go, okay, you're having some leaky brain and some inflammatory process going on in your in in your brain. You're 40 years old. We need to stop this. And we now have a marker where we can do this through change in diet, protecting your gut, taking the polyphenols, things like that. Then we can show that that's going to decrease and then you do in a preventative thing for dimentia. Yeah, super cool. Now these guys are going to take it one step further. And they're not, I don't blame them. But they're, they've come together and raise some money and they're going to try and develop a drug to seal the blood brain barrier. Eric Rieger  Okay? Ken Brown  Make sense? I mean, you figured that out, they want to slow and reverse this, they have started this company to develop a drug to heal the blood brain barrier for clinical treatment. Now, that being said, I'm a little bit biased, because I believe that the inflammation doesn't start in the brain it can't. It's not like the something has to be out of the brain. Think about this for a moment. And they didn't get into this at all. They didn't talk gut at all. To cross the blood brain barrier, you must be coming from outside of the brain. So the blood something in the blood is inflammatory goes into your brain, and your brain reacts to it and then you have the fog or the heaviness of inflammation.Eric Rieger  This is not an just just for the listeners. The blood brain barrier itself is not a new concept we have drugs that we know that do and do not cross the blood brain barrier that apply to all kinds of different diseases or anesthesia that we use with patients.Ken Brown  Yeah, as an anesthesia provider. This is this is your world. Because your job is to get those drugs past that so that you can calm the brain down.Eric Rieger  Yeah, I mean, there there are some Anticholinergics that we know that do and technically do not cross the blood brain barrier. But every now and then, and then aged patients, some of those that we felt like shouldn't cross the blood, the blood brain barrier I can, I can still remember looking back and it's going well, we didn't think we would get that response with this. But we also weren't talking about leaky brain a decade ago. We weren't talking in those terms. And it's kind of exciting because I think that we're rounding a corner really understanding the systemic effect of bad gut health and how it actually affects the entire body. Ken Brown  What'sso one of the one of the problems I run into in traditional medicine is when I talk to my colleagues, I'll be like, Oh, I haven't seen a study on that. You want some water? Yeah. They'll say, Well, I haven't seen, I haven't seen a clinical trial on this. And the, the only way that clinical trials can get done in these kind of things, is to go through either a huge NIH grant to have a big pharmaceutical company pay for something like this. But what you need to do is look at the objective data, like this mouse study here. We're not talking whether a drug can do stuff, what we're showing is that there is a comparative analysis between a young mouse and a young human, and you do this functional MRI study, and an old mouse and an old human and you show the intestinal permeability, or I'm sure you show the blood brain permeability, and you can show that there's a cognitive decline. So we can agree if we can agree that and if I'm talking to even a skeptic, they'll be like I don't believe in that the blood right, but we know you just said the blood brain barrier is a selective brain barrier. Yep. The gut blood barrier. So the gut barrier, the tight junctions is a select permeable barrier permeable, its job is to let certain things in, keep certain things out. When you disrupt this, it can allow too many things in. So let's start with the gut. And let's just assume that you have something happened infection, drugs, bacterial overgrowth, and it causes an inflammatory response. Different things like zonulin show up which lead to some intestinal permeability, then that turns on your inflammatory cascade, and now you've got these little inflammatory markers floating around the blood. These guys believe that they can develop a drug that will actually block TNF beta. I think? Because that's what they're going to go after, so they're gonna, they're gonna try and chase the inflammation in the brain. I'm opposite. Eric Rieger  Let's just stop inflammation. Ken Brown  Let's just stop the inflammation. So there was that one study, I think you're making small reference to where they actually looked. And they took human intestinal tissue and then they took a blood brain barrier tissue, so cadaver tissue, and they did an impedance study where they soak the tissue in some inflammatory they started. And what they did is they took the normal tissue, and then they did these different size molecules. So one way to determine if somebody is having some leaky gut is that let's assume that our dung beetle here is a is a certain, whatever kill adult I don't even know what size there but it's like the really tiny. And so they use these molecules where they can sit there and show and what they'll do is they'll soak the tissue and then the dung beetle can't get through and so just moves on. Then they soaked the tissue in inflammatory typical inflammatory cytokines, meaning the stuff that you're going to produce with all disease, TNF alpha, interleukin beta, like all these different CRP, CRP, you know, stuff like that, so they did it specifically. And then what they showed is the dung beetle went straight through, so then they found the dung beetle on the other side. He was going around, they're like, Uh Oh, so then they did the exact same thing with the with the blood brain barrier. And the first time they went through the blood brain barrier, blocked it, they put it in the exact same inflammatory cytokines. And it just opened right up. And then he's had a little party.Eric Rieger  Well the cells, maybe in two different locations, but they are very similar both in structure and function in the way that they protect what they're there to protect. So it's not really that surprising. And you don't have to think that hard to understand that the blood is simply just a vehicle to spread markers all over the body in different parts of your body going to respond in different ways. There is no, to my knowledge, there is no set assignment for a marker to only go in one direction down one vessel to reach one destination. It just goes everywhere until it lands where it's gonna land. And so that's kind of how the brain gets affected. It's your gut is sick. Yeah, I mean, if you're gut is sick, chances are other parts of your body is going to be sick as well.Ken Brown  It's so then this kind of gets into this part. So now we're having these discussions. Finally we're finally seeing in the literature discussion about leaky gut leaky brain. But we're what we're talking about is these things cause chronic condition. And it seems to be getting worse. So I made either the mistake or a brilliant move. I think a lot of people have talked about game changers. Yeah, Game Changers the end. So I took it a step further because I was on I was on hospital this whole week. My family's out of town. So when I had a moment, I was watching some Netflix, sitting on the toilet, you know,Eric Rieger  texting? Ken Brown  Texting. No. I watched what the health and I think you had told me about this years ago. Eric Rieger  That one's a real kick in the gut man Ken Brown  That one. Oh, my goodness, that one's...Eric Rieger  That if you don't like game changers don't watch that one.Ken Brown  Yeah, that's worse. That one's next level. And the problem is, is that it's, there's just an I get that all of a sudden you guys I youtubed afterwards and rebuttal after rebuttal and all this other stuff, but you know some of the stuff you're like, Oh, no. What if I love meat!Eric Rieger  Well, I will at least say this. I think that the game changers for the most part, the producers, and the writers probably believe a lot of what they say. I felt like what the health was just engineered to mask. I mean, I felt like they were they were bad da withholding evidence through a lot of it. It just did not. It did not pass the smell test. Ken Brown  I could see how it could it could go around. So I had my annual doctor appointment this morning. And so it's with its with Kevin Wilson at smart wellness now, and he's a he's a functional medicine practitioner. And so we were I was asking him about this. We're going over my labs and everything and he is a strong, I guess, a paleo style. You know, autoimmune paleo style lifestyle here kind of thing. He looks great and he's got no fat on him his and so we talked about his blood work. You know his typical diet is six eggs with ham and cheese in the morning and then some leafy greens with some grass fed meat and then have a little bit of carbs like that sweet potato with a smaller meal and we're talking about his labs and his cholesterol is perfect and his you know, insulin levels are perfect his hemoglobin A1-C. And then so we started talking about different things. I tried the whole plant based diet but I think I did it wrong. And I went get all the the fake packaged sausage and chicken and everything and I got really inflamed. I don't think my body went with that. Then we started talking about differences in his patients and what he's seen and so he had two patients that went on the carnivore diet and one labs completely improved and the other one didn't change at all. And so you just start looking at these different these different movies and stuff and you go Okay, what is let's take a big step back, getting away from the whole thing of plant based slash veganism or carnivores slash paleo, you know, those are I guess, those are the The the diets that people will really be kind of passionate about because they're kind of on the extremes over here and go, okay, is it possible that we're all genetically meant to have a slightly different diet? Is it possible that you know, there's a lot of different so like in my blood work, I'm very surprised I my LDL has crept up a little bit. Fortunately, my HDL is still real high. Yeah, my inflammatory markers are nothing. And so we're trying to figure out well, why did your cholesterol go up a little bit? Well, I do play around with my diet a lot. I'll go into extreme. And I think it kind of throws my body for a little bit of a loop but then it got me thinking, I started looking at different countries with the highest incidence of coronary vascular disease and, and you look and it's, it's Russia, Germany, it's the US and then you come down and then there's Spain, Italy, Japan are that are the healthiest right now is that crops is that lifestyle is that the polyphenol content, you know, I always think that it's diets really based on the polyphenol content and then I watched Patriot Act patriot act with oh we're gonna have to look that up Hassan the comedian. Eric Rieger  Oh yeah the show? Ken Brown  The show. Yeah so I think the his last show of the of the year was looking at how America is making other countries fat and it really targeted one particular company, really Coca Cola. High fructose corn syrup when they have shown that high fructose corn syrup is brought in and some of these countries like China, Mexico I'm trying to think of all these other countries but just India, country after country that starts getting exposed to this then that's like the window to come in. And then it ends up being that you have these fast food places and stuff like that. And without a doubt everyone is definitely becoming more obese. So is it this all started. Oh, that's all I did not know this. It's gonna be blamed on Richard Nixon. As it turns out, yeah. When the economy dropped and he goes into explain it, obviously he's a super smart guy. Yeah. And he's funny, but he's really make sense. Yeah, he was describing that Richard Nixon did that for a bunch of different reasons. And Hassan actually says that he goes, there's a bunch of reasons here for like, economics. I won't get into them if you want to pause it right now and write these down. But it basically goes into why richard nixon did some sort of farming subsidy to allow the increased growth of corn.Eric Rieger  Okay, yeah.Ken Brown  And so it was some sort of subsidies to keep the economy up and all this other stuff. And so then they had this excess of corn that then became high fructose corn syrup. It's then as in everything, Eric Rieger  Yeah, it is. Ken Brown  That's where you start. That's I apologize earlier, when I said that the track athletes take high fructose corn syrup. They take straight fructose, which is the sugar in fruits. But once you convert corn to high fructose corn syrup, that may be the culprit. That's what's in all the sodas. That's what's in everything. You just got me thinking that if we're over here saying our plant based it's carnivore diet. I don't know. But I do know that if you're opening a package, probably like what happened to me, when I tried to do my whole vegan diet for a week where I was trying to subset I was trying to substitute every meat that I would normally have with some sort of meat substitute. I got super inflamed. Yeah, I don't think it was toxins leaving my body,Eric Rieger  Probably not in every instance. But it seems like if things are compounded to withstand or extend shelf life, more than likely, it's probably not the best way to consume whatever it is you're eating.Ken Brown  So I'll give everybody an update. What I'm gonna do is I'm gonna change my diet a little bit. I'm going to be actually I've, I just, you know, just dabble in different diets and have, you know, fun with it and go on the extreme and whatever. And so, Kevin and I talked, it's like, okay, we're gonna, we're gonna put you on an actual regimen. You're actually going to be a patient now and you're going to like, actually do what I say. And so I had to laugh. I'm like, okay, no, I don't really do that. We're gonna see what happens. I mean, it's the good news. You know, he's got he's got a lot of his patients where he wants to get their hemoglobin a one see below four.He doesn't play around with that 55-56-57 range that a lot of people are happy to be in. He wants him below four. And not really even looking at body fat, stuff like that, because then what he's looking at is inflammatory markers, sed rate CRP, different things like that. And what is really kind of interesting is that my cholesterol went up and we were trying to figure it out. And what I had been doing, which is a little bit of a curveball is you know, I do intermittent fasting. What could be and then we looked at my genetic profile, I'm a cholesterol hyper absorber genetically. So, it I may be the small subset of people that should probably have just strict three meals so that my body isn't absorbing. Because, you know, because that first meal I'll just rawr, yeah, sure. You know, and just ravenous don't know, it's just it's another little caveat. It just gets, it gets back to the whole thing that maybe there isn't one thing for everybody and everybody has to take a step back and maybe go see a really smart guy like that. That looks at your blood work, looked at your genetics and says, Okay, this may be better for you.Eric Rieger  Yeah, no, maybe it does make sense. We are all very much the same, and also very, very different in all of that's, okay. There's another, I would throw a monkey wrench in this train of thought. But there's even a subset of folks that talk about the natural eating should really mimic what is naturally available during the season, where you're at, for you to optimally be absorbing the right kind of nutrients. Like if you're eating a fruit that shouldn't really be available that time of year that probably isn't best for your body. I've not seen science behind it, but maybe there's something to it. I've no idea that's a whole nother topic, but it's interesting because that's how a lot of people try to figure out how to get healthier.Ken Brown  That's Why anytime any celebrity comes out with a cookbook, somebody's gonna buy it or anytime some new diet is because we have not figured out exactly what the ideal diet is. And I will give what the health credit that they did show that there is lots of lobbying lots of money. To try and make sure that our US government, the FDA, the USDA, things like that, that are looking out for our best interest. Really, there's, I was a little bit shocked to see the people that are funding some of these charities like the American diabetic Association, the American Heart Association, and Susan G. Komen. A little surprised. There's a lot of money accepted from fast food companies and things like that. Eric Rieger  Probably not really interested in the results. This more or less the continuation of lots of customers,Ken Brown  Although I will say that for the right price. I could just see you and I year from now and be like, Eric, this is the new Big Mac sponsored by McDonald's.Eric Rieger  I don't think so patna. I'm not going down that route.Ken Brown  Oh, I almost died number of the time you're telling the whole story of you were trapped when you almost died? Yeah.  Your near death experience.Eric Rieger  Oh on the run the rock.Ken Brown  Yeah, where you almost got waved to death.Eric Rieger  Yeah, yeah yeah that was almost the end of Marie and I for sure yeah.Ken Brown  And I gave you my near death story of wrong turned into a McDonald's drive through.Eric Rieger  Yours was scarier. Yeah no i don't i don't see us being sponsored by McDonald's,Ken Brown  I want to try this if everybody gets a chance to do this number one, if you look up fasting, specifically a prolonged fast, it's remarkably healthy for you on a cellular level. It's not there to lose weight. It's not there to do anything but it's the turn yourselves on. When I'm fasting. And I'm like walking by a TV. I want to say 80% of the time it's a food commercial. It's Pizza hamburgers or fried chicken or something here is I'm paying attention. I'm hungry. Wow, just all the commercials visually are just coming at us with food.Eric Rieger  What's weird is it's more appealing to me to learn what restaurant or eatery features are really good tasting salad with good lettuce. And I know that's not how I thought when I was a teenager as a teenager, I wanted the fried chicken or in every stomach is fried chicken tastes great, right? I mean, it's, it's good. But as I've gotten older, and I my body doesn't just accept anything that I put into it anymore, where I'm just happy and I'm sure a lot of our listeners feel the same. I've been conditioned that I want to know where I can get a great tasting meal that's going to be healthy for me. So how long would it be until that becomes more of the norm in what the advertising gets the market is for people to gain attention because I always say that I feel like it's going to change 15 years ago, 20 years ago, especially if you didn't have the restaurants like modern market, unrefined bakery, taco deli, which talks nothing about except for we have all organic ingredients. For all of our tacos, but that stuff is becoming far more popular,Ken Brown  Far more popular here, Bella green things like that. Eric Rieger  Yeah, Bella green. Ken Brown  Let's go to Galveston. Let's go to Corpus Christi. That makes it so it's super unfortunate that there is and I think in different socio economic climates you're the options to eat where was I that's just south of Oklahoma took Lucas to a tournament. Eric Rieger  Wichita? Is that right? Ken Brown  Bob Burnett? Is that right? Eric Rieger  Oh Burt Burnett. Ken Brown  Burt Burnett. Yeah.  I drove around trying to find something to eat that wasn't what a burger. It was nuts. Eric Rieger  Brahms and What-a-burger. Ken Brown  Brahms and water burger. Yeah. So in these, you know, smaller communities that's just not happening.Eric Rieger  And it's not like that there's anything wrong with an occasional what a burger and an occasional Brahms. drive through. That's not the point. But that can't be your core diet. That can't be your only core offering. And I would like to be optimistic and think okay, well, everybody else is eating great food at home when they're not eating out, but we know the stats that's not really at today's people live You don't have options like that though.Ken Brown  Yeah. And that's when when you see these extreme shows like that, whether it's the plant based when you have the exact anecdotal differences where people are strict paleo and they're in great shape and they're, you know, they've their cardiac calcium scores nothing and stuff, you're like, Okay, well wait a minute, you know, and so who knows, but it was just it got me thinking that I'm going to really try and focus a little bit harder on working on a few things be a little more disciplined and not being so reactive. Watch whatever show I'm watching and then it's a watch Joe Rogan. We're going carnivore, Eric.Eric Rieger  Yeah, I love meat, but I couldn't do that either. That would that would be really really hard. Who's it Shaun Baker.Ken Brown  Shaun Baker was the carnivoreEric Rieger  And he's all in and Jordan Peterson and his daughter to escape autoimmune issues went I think they're almost all carnivore isn't that right? Am i remebering that right?Ken Brown  Yeah. I think they are. I would just be curious. You know, one of my Friends, a cardiologist, Mordecai Klein, he completely went plant based he feels like a change his diet as a as a cardiologist, one of the few cardiologist discussing that we should have him on the show to talk about it.Eric Rieger  Yeah, I'd be interested in that. You know, I, there's probably nothing wrong with taking a break from meat. But I just don't think that a long term diet for success or somebody exists without meat. But that's my opinion. I just don't think so. Sounds really hard. If you're taking a bunch of supplements just to make up for the nutrients that you're not getting, or the fact that they can measure it. What is he saying you can measure a food by its certain protein content, but the difference is, plant based protein is not nearly as bioavailable as heme protein from an animal in certain instances. I mean, th

In this episode of The Brain Warrior’s Way Podcast, Dr. Daniel Amen and Tana Amen weigh in on brain-related current events. This week’s “Brain in the News” items feature a link between the supplement ashwagandha and improved sleep and stress, two types of medication that are linked to dementia, a 9 year-old arsonist charged with first degree murder, a startling childhood obesity prediction, and a correlation of ADD/ADHD in teen moms.

On this episode I discuss the pharmacology of donepezil. Donepezil is an acetylcholinesterase inhibitor. In dementia, that is a deficiency in acetylcholine and donepezil helps preserve this neurotransmitter. Donepezil can cause weight loss, GI upset, and diarrhea. This is an important monitoring parameter in our dementia patients. There is the possibility for donepezil to cause bradycardia and insomnia. Keep an eye out for these adverse effects as they can and do happen in real practice. Anticholinergics are notorious for blunting the effects of donepezil. We must look out for drug interactions from older anticholinergics like diphenhydramine, amitriptyline, and hydroxyzine.

In this episode I discuss urinary anticholinergics and their effects.  I cover mechanism of action, side effects, clinical practice pearls, and of course some drug interactions to look out for.  Enjoy the episode and be sure to check out our free 31 page pharmacology study guide!

This episode of CRACKCast Covers Rosen's Chapter 145, Anticholinergics. You will learn everything you need to know for the next hot and bothered patient that rolls in to the ED!

This episode of CRACKCast Covers Rosen's Chapter 145, Anticholinergics. You will learn everything you need to know for the next hot and bothered patient that rolls in to the ED!

  Anticholinergics- side effects Can’t see – burred vision Can’t pee – urinary retention Can’t spit – dry mouth Can’t s*** – constipation     Cholinergic Crisis – Signs and symptoms   SLUDGE Salivation Lacrimation Urination Defecation Gastric upset Emesis… The post Ep12 Cholinergic, Anticholinergic (SLUDGE) appeared first on NURSING.com.

As cars were banned from central Paris this weekend and the health risks of pollution hit the headlines, Mark Porter examines the statistic that pollution kills 29,000 people a year in the UK. And he visits a pioneering clinic at Southampton General Hospital where falls in the elderly are seen as a risk factor for underlying health problems; 'Having a hip fracture is like having a heart attack or stroke' explains Dr Mark Baxter. 50% of people who have a hip fracture will have previously presented with a fall, but once they go on to break a hip, 1 in 10 elderly people may not be alive at the end of the month and up to 25% by the end of the year. Many elderly people are found to be on multiple treatments - blood pressure pills or bladder pills for example - that make people fall over. In recent years there has been much more attention paid to the cumulative burden of the side effects of medicines in the elderly - particularly the group of commonly used drugs known as Anticholinergics. And according to new research by a team at the University of East Anglia, taking Anticholinergics increases the risk of falls too - particularly in men. Following news of the Meningitis B vaccine in children, an Inside Health listener got in touch to ask why it wasn't being given to teenagers in light of data showing that there is a second peak in incidence in the disease among 15 - 19 year olds? Mark talks to Professor Andrew Pollard, Chair of the Joint Committee on Vaccination and Immunisation. And Inside Language: Dr Margaret McCartney and Professor Carl Heneghan demystify the terminology of medicine and research. This week, false positives and false negatives; when is something not what it seems, and when does it seem what it's not?