Podcasts about nsaid

Sponsored by Elanco Elise Kelly, DVM, graduated from Eastern Illinois University with a Bachelor of Sciences degree in zoology and a minor in chemistry. She earned her DVM degree from Ross University School of Veterinary Medicine, then practiced in Blue Springs, MO for 9 years before joining Elanco in 2015 as a Regional Consulting Veterinarian.  In her nine years of practice, her special interests included dermatology, small exotics, and reproductive medicine, attaining a certification in canine AI in 2012. Since joining Elanco, Kelly has had the opportunity to train intensively and speak on topics including parasitology, pain management, dermatology and immunology. She has given over 500 presentations and spoken at continuing education events including Kansas City's Frostbite and the annual Missouri Veterinary Medical Association Conference. Kelly is Fear Free Elite, compassion fatigue and Human Animal Bond certified. She supports and works with Elanco sales representatives throughout the Midwest. She is a member of the Missouri Veterinary Medical Association and is Vice Chair for the board of directors at the Kansas City Pet Project. She currently resides in Independence, Missouri with her husband, two children, Sheepadoodle puppy, cat, and four goats.  In her spare time, you might find her cheering for the Kansas City Chiefs, boating, hiking or traveling with her family. Indication Galliprant controls pain and inflammation associated with osteoarthritis in dogs. Important Safety Information For use in dogs only. Keep this and all medications out of reach of children and pets to prevent accidental ingestion or overdose. Galliprant is a non-COX inhibiting NSAID. As a class, NSAIDs may be associated with gastrointestinal, kidney and liver side effects. Evaluation for pre-existing conditions and regular monitoring are recommended.  Do not use in dogs that have a hypersensitivity to grapiprant. Concomitant use of Galliprant with other NSAIDs or corticosteroids should be avoided. Concurrent use with other anti-inflammatory drugs or protein-bound drugs has not been studied. The safe use of Galliprant has not been evaluated in dogs younger than 9 months of age and less than 8 lbs (3.6 kg), dogs used for breeding, pregnant or lactating dogs, or dogs with cardiac disease. Owners should be advised to observe for signs of potential drug toxicity. Adverse reactions may include vomiting, diarrhea, decreased appetite, watery or bloody stools, and decreases in serum albumin and total protein. Click here for full prescribing information Galliprant, Elanco, and the diagonal bar logo are trademarks of Elanco or its affiliates. ©2025 Elanco or its affiliates. PM-US-25-1504

This week, we conclude a two-week series on the 4 areas of pain:  Analgesia, Activities of Daily Living, Adverse Effects, and Aberrant  Behavior.  In this episode, you'll discover:—Why Dr. Prather says "the only way to fix pain" is through Structure-Function Health Care, while the Disease Care approach focuses on the symptoms of pain.—The best effectiveness for the Disease Care approach of pharmaceuticals on a short-term basis or end-of-life care, but not for long-term or chronic pain issues. —How the long-term effect of opioids is actually…more pain.  And the physiology behind how opioids actually destroy the body's natural opioid receptors.—The shocking story behind how the pharmaceutical industry lied about the addictive nature of opioids.  And why Dr. Prather describes them as "SOB's"!—Dr. Prather's solution to the opioid crisis through natural, non-drug therapies that actually heal the body.  And how Homeopathy, Acupuncture, and Auriculotherapy help patients overcome their opioid addiction without suffering from the terrible withdrawal symptoms that have even driven people to suicide. —How the long-term effect of non-steroidal anti-inflammatory drugs (NSAID's) is that they actually CAUSE Osteoarthritis.  And how NSAID's not only destroy your joints, but your Liver and Kidneys as well.   —The natural alternatives that are more effective than NSAID's for Osteoarthritis, which is the #1 reason people take NSAID's.  And how these "really great" alternatives actually HEAL the Osteoarthritis, in addition to taking down the pain.—The Decompression Therapy at Holistic Integration that helps REVERSE the arthritis in the joints, which can be confirmed in follow-up X-Rays. —How the long-term effect of steroids is the destruction of the joint, plus negative effects on the Endocrine System.  And how studies have shown that 85% of Orthopedic surgeries are unnecessary and should have been dealt with through natural care first.—Why the first steroid shot is where a patient will have their best results.  And why Dr. Prather believes you should be hesitant to get a third shot and says "forget it" to any shots after that because it will only make things worse.http://www.TheVoiceOfHealthRadio.com

Five weeks ago, I could barely sit without pain. Bending over to brush my teeth required a strategic plan involving core activation and glute squeezing. Sneezing meant grabbing onto furniture for dear life. Today? I'm sitting comfortably having this conversation with my neurosurgeon about why disc replacement surgery changed everything.  In this episode, join me and Dr. Jared Ament as we dive deep into the world of motion-preserving spine surgery. You'll discover why spinal fusion became the "standard of care" (hint: it wasn't because it was the best option), how disc replacement technology has evolved to achieve 96% success rates, and why insurance companies still call a procedure with 20+ years of data "experimental." Dr. Ament reveals the shocking truth about why most surgeons don't offer disc replacement, the real recovery differences between fusion and motion preservation, and what actually happens when you go "through the stomach" for spine surgery. We also tackle the controversial emotional vs. mechanical pain debate, discuss when stem cells actually help (and when they don't), and explore why chronic NSAID use might be sabotaging your healing. Whether you or a loved one suffer from degenerative disc disease, bulging or ruptured discs, this episode is packed with valuable insights from both a patient's and a surgeon's perspective. Also, discover the benefits of nootropics in surgical recovery and daily cognitive function.    Catch the full episode on YOUTUBE HERE: https://bit.ly/MidlifeConversationsYouTube    Learn More About Dr. Jared Ament:   Instagram ➜ https://www.instagram.com/drjaredament Website ➜ https://www.nsg-la.com/  Episode Links: Consult ➜ Reach out to:  office@nsg-la.com   Axon Mastermind ➜ www.AxonMd.com  For the episode Natalie referenced on a Genius Life go to: https://podcasts.apple.com/us/podcast/the-genius-life/id1379050662?i=1000698582182   Thank you to our show sponsors! QUALIA SENOLYTIC: Experience the science of feeling younger—go to http://qualialife.com/nataliejill for up to 50% off your purchase of Qualia Senolytic and use code NATALIEJILL for an additional 15%.  FRESH PRESSED OLIVE OIL: Try a bottle of the world's most delicious artisanal olive oils direct from gold-medal-winning small farms for just $1 and taste the difference yourself  https://GetFreshNatalieJill.com  Free Gifts for being a listener of Midlife Conversations! Mastering the Midlife Midsection Guide: https://theflatbellyguide.com/ Age Optimizing and Supplement Guide: https://ageoptimizer.com   Connect with me on social media! Instagram: www.Instagram.com/Nataliejllfit Facebook: www.Facebook.com/Nataliejillfit   For advertising inquiries: https://www.category3.ca/  Disclaimer: Information provided in the Midlife Conversations podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before making any changes to your current regimen.  Information provided in this podcast and the use of any products or services related to this podcast does not create a client-patient relationship between you and the host of Midlife Conversations or you and any doctor or provider interviewed and featured on this show. Information and statements may have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease. Advertising Disclosure: Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links. Opinions expressed about products or services are those of the host and/or guests and do not necessarily reflect the views of any sponsor. Sponsorship does not imply endorsement of any product or service by healthcare professionals featured on this podcast.  

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPSES conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.    

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPS  conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.  

Podcast Summary This episode of the Pain Exam Podcast, hosted by Dr. David Rosenblum, discusses an interesting article about Ketorolac injections for musculoskeletal conditions. The podcast covers: Ketorolac is an NSAID that provides analgesic and anti-inflammatory effects through inhibition of prostaglandin synthesis Multiple studies comparing Ketorolac injections to corticosteroids and hyaluronic acid for various conditions Research shows Ketorolac injections are equally effective as corticosteroids for subacromial conditions, adhesive capsulitis, carpal-metacarpal joint issues, and hip/knee osteoarthritis Ketorolac may be a safer alternative to steroids for certain patients, though it has its own contraindications for those with renal, gastrointestinal, or cardiovascular disease Dr. Rosenblum considers the potential of using Ketorolac injections directly at pain sites rather than intramuscularly Upcoming Courses and Conferences Ultrasound courses in New York and Costa Rica (check unwrappedpain.org) Private ultrasound sessions available Dr. Rosenblum will be speaking at Pain Week about ultrasound in pain practice and PRP Presenting at a primary care conference in London Teaching ultrasound at ISPN LAPSES conference in Chile (Dr. Rosenblum won't attend this year) Ketorolac Injections: An Effective Alternative for Musculoskeletal Pain Management Musculoskeletal conditions such as bursitis, adhesive capsulitis, and osteoarthritis affect millions and often require injectable therapies to reduce pain and inflammation. Traditionally, corticosteroid injections have been the mainstay treatment. However, concerns over side effects like tendon rupture, cartilage damage, and systemic hyperglycemia have prompted exploration of alternatives. A recent narrative review by Kiel et al. (2024) highlights ketorolac—a parenteral nonsteroidal anti-inflammatory drug (NSAID)—as a promising substitute for corticosteroids in musculoskeletal injections. Warning: OFF Label use of Ketorolac discussed. Please consult your physician. See full article  for details. Subacromial Ketorolac Injections for Shoulder Pain Subacromial bursitis and impingement syndrome are common causes of shoulder pain and disability. Several randomized controlled trials have shown that subacromial ketorolac injections provide pain relief and functional improvement comparable to corticosteroids: Goyal et al. demonstrated significant reductions in pain scores after subacromial injection of 60 mg ketorolac versus 40 mg methylprednisolone, with no difference in outcomes between groups. Taheri et al. found similar short-term pain relief at 1 and 3 months with either ketorolac or corticosteroid subacromial injections. Kim et al. reported equivalent clinical improvement in rotator cuff syndrome patients receiving ketorolac or triamcinolone injections. Min et al. noted ketorolac led to better forward flexion and patient satisfaction at 4 weeks compared to corticosteroids. These studies support ketorolac as an effective agent for subacromial injection, offering an alternative for patients where corticosteroid use is limited. Intra-articular Ketorolac Injections for Adhesive Capsulitis and Osteoarthritis Adhesive capsulitis (frozen shoulder) and osteoarthritis of the hip, knee, and carpometacarpal joint are often treated with intra-articular corticosteroids. Ketorolac injections have shown comparable efficacy in these conditions: Akhtar et al. found intra-articular ketorolac significantly reduced shoulder pain at 4 weeks in adhesive capsulitis compared to hyaluronic acid. Ahn et al. reported similar pain relief between intra-articular ketorolac and corticosteroid injections in adhesive capsulitis, with ketorolac providing superior shoulder mobility at 3 and 6 months. Koh et al. showed that adding ketorolac to hyaluronic acid injections in carpometacarpal osteoarthritis resulted in faster onset of pain relief compared to hyaluronic acid alone. Park et al. observed equivalent functional improvements with intra-articular ketorolac or corticosteroids in hip osteoarthritis. Jurgensmeier et al. demonstrated similar symptom improvement at 1 and 3 months post-injection for ketorolac and triamcinolone in hip and knee osteoarthritis. Xu et al. and Bellamy et al. confirmed ketorolac's comparable pain relief and functional benefits to corticosteroids for knee osteoarthritis, with ketorolac being more cost-effective. Lee et al. noted quicker pain reduction with intra-articular ketorolac combined with hyaluronic acid versus hyaluronic acid alone in knee osteoarthritis. aSafety and Pharmacologic Considerations Ketorolac's anti-inflammatory action stems from cyclooxygenase inhibition, reducing prostaglandin synthesis. Its half-life is approximately 5.2–5.6 hours, and it is metabolized in the liver. Unlike corticosteroids, ketorolac avoids systemic hyperglycemia and cartilage damage risks. Animal and in vitro studies suggest ketorolac may protect cartilage by inhibiting inflammatory cytokines. While gastrointestinal, renal, and cardiovascular risks associated with NSAIDs remain considerations, localized intra-articular and subacromial ketorolac injections may limit systemic exposure and adverse effects. Mild, transient post-injection pain has been reported but resolves without intervention. Conclusion Ketorolac injections, administered intra-articularly or subacromially, are a safe, effective, and economical alternative to corticosteroids for managing common musculoskeletal conditions. Their comparable efficacy in reducing pain and improving function, combined with a more favorable side effect profile, makes ketorolac an appealing option for clinicians and patients alike. Further research is warranted to fully elucidate long-term safety and optimal dosing strategies. FAQS Ketorolac Injections for Musculoskeletal Conditions: Frequently Asked Questions Musculoskeletal pain from conditions like bursitis, adhesive capsulitis, and osteoarthritis often requires injectable treatments. Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is emerging as a promising alternative to corticosteroids. Below are common questions and answers based on a recent narrative review by Kiel et al. (2024). 1. What is ketorolac and how does it work? Ketorolac is a parenteral NSAID that reduces pain and inflammation by inhibiting cyclooxygenase enzymes, which decreases prostaglandin synthesis. It can be administered orally, intramuscularly, intravenously, or by injection directly into joints or around bursae. 2. How effective is ketorolac for musculoskeletal conditions? Studies show ketorolac injections provide significant pain relief and functional improvement comparable to corticosteroids in conditions like: Subacromial bursitis and shoulder impingement (subacromial injections) Adhesive capsulitis (frozen shoulder) (intra-articular injections) Osteoarthritis of the hip, knee, and thumb carpometacarpal joint (intra-articular injections) 3. What evidence supports subacromial ketorolac injections? Randomized controlled trials found: Goyal et al. and Taheri et al. reported similar pain reduction and functional outcomes between ketorolac and corticosteroids for subacromial injections. Kim et al. and Min et al. observed comparable or better patient satisfaction and shoulder mobility with ketorolac versus corticosteroids. 4. How does intra-articular ketorolac compare to corticosteroids for adhesive capsulitis? Akhtar et al. showed ketorolac reduced shoulder pain more than hyaluronic acid. Ahn et al. found ketorolac and corticosteroids equally effective for pain relief, with ketorolac providing better shoulder mobility at 3 and 6 months. 5. What about ketorolac for osteoarthritis? Ketorolac combined with hyaluronic acid provided faster pain relief than hyaluronic acid alone in thumb carpometacarpal joint osteoarthritis (Koh et al.). Intra-articular ketorolac had similar efficacy to corticosteroids in hip (Park et al., Jurgensmeier et al.) and knee osteoarthritis (Bellamy et al., Xu et al.). Ketorolac injections were more cost-effective compared to corticosteroids (Bellamy et al.). 6. Are ketorolac injections safe? Ketorolac's side effects are similar to other NSAIDs, mainly involving gastrointestinal, renal, and cardiovascular risks. However, localized intra-articular and subacromial injections may reduce systemic exposure. Animal studies suggest ketorolac does not harm cartilage and may protect against inflammatory damage. Mild, transient local pain post-injection is possible but usually resolves without treatment. 7. What are the limitations of ketorolac use? Ketorolac is not suitable for patients with: Renal impairment Gastrointestinal ulcers or bleeding risk Cardiovascular disease or hypertension NSAID hypersensitivity, especially in asthma or chronic urticaria patients Clinicians should assess individual risks before choosing ketorolac injections. 8. How does ketorolac's pharmacokinetics affect its use? Ketorolac has a plasma half-life of about 5.2 to 5.6 hours and is metabolized in the liver. Pharmacokinetics for subcutaneous or intra-articular administration are less defined but systemic absorption occurs. Its relatively short half-life supports repeated dosing if needed. 9. Why consider ketorolac over corticosteroids? Ketorolac avoids corticosteroid-associated risks such as tendon rupture, cartilage damage, and steroid-induced hyperglycemia. It is also more cost-effective, making it a favorable option for patients and healthcare systems. 10. What further research is needed? More large-scale, long-term studies are needed to fully understand ketorolac's intra-articular effects, optimal dosing, and safety profile compared to corticosteroids and other treatments. Summary: Ketorolac injections, whether intra-articular or subacromial, offer a safe, effective, and economical alternative to corticosteroids for managing various musculoskeletal conditions. This makes ketorolac an important option in pain management and inflammation control.     Reference: Kiel J, Applewhite AI, Bertasi TGO, Bertasi RAO, Seemann LL, Costa LMC, Helmi H, Pujalte GGA. Ketorolac Injections for Musculoskeletal Conditions: A Narrative Review. Clinical Medicine & Research. 2024;22(1):19-27. DOI: https://doi.org/10.3121/cmr.2024.1847 Disclaimer: This Podcast, website and any content from NRAP Academy (PMRexam.com) otherwise known as Qbazaar.com, LLC is  for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. Professionals should conduct their own fact finding, research, and due diligence to come to their own conclusions for treating patients. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.    

In this episode, YARAL Pharma CEO, Stephen Beckman joins clinical sports pharmacist Jessica Beal, PharmD. to discuss an important topic for athletes and active individuals – the role topical NSAID patches can play in acute pain management. Listeners can visit www.YARALPharma.com to learn more about the company and its products or connect on LinkedIn.    Diclofenac Epolamine Topical System 1.3%    Diclofenac Epolamine Topical System 1.3% is a nonsteroidal anti-inflammatory drug (NSAID) used for treating acute pain from minor strains, sprains, and bruises in adults and children aged 6 and older.     Serious side effects may include increased risk of cardiovascular and gastrointestinal (GI) events. NSAIDs can raise the risk of heart attack, stroke, gastrointestinal bleeding, ulceration, and perforation of the stomach and intestines, which can be fatal. The risk for serious cardiovascular events may occur early in treatment and may increase with duration of use. Elderly patients and those with a history of peptic ulcer disease or GI bleeding are at higher risk for serious GI events.    Do not use in patients who are allergic to diclofenac or any of its ingredients, or have a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Do not use in the setting of coronary artery bypass graft surgery. Avoid use on broken skin. Discontinue immediately if signs of hypersensitivity occur.      Patients should be informed about the warning signs and symptoms of liver problems. Discontinue use if abnormal liver tests persist or worsen or if signs of liver disease develop. Avoid using Diclofenac Epolamine Topical System 1.3% in patients with severe heart failure unless the benefits are expected to outweigh the risks.    The most common side effects include itching, nausea, and headache. Patients should stop use and consult their doctor at the first sign of skin rash or other signs of sensitivity.    Patients should ask their doctor if Diclofenac Epolamine Topical System 1.3% is right for them. For more information and Full Prescribing Information including Boxed Warning and Important Safety Information, visit www.yaralpharma.com   Dr. Beal is not affiliated with YARAL Pharma. All views and opinions regarding pain management are solely her own and are not attributable to YARAL or the Pharmacy Podcast Network. 

NSAIDs can reduce the effectiveness of antihypertensive medications such as ACE inhibitors, ARBs, beta-blockers, and diuretics by promoting sodium and water retention and decreasing renal blood flow. Combining NSAIDs with anticoagulants or antiplatelet agents like warfarin or aspirin significantly increases the risk of gastrointestinal bleeding, due to additive effects on platelet inhibition and mucosal irritation. NSAIDs can elevate lithium levels and increase the risk of toxicity, as they reduce renal clearance of lithium by decreasing renal perfusion. Co-administration of NSAIDs with methotrexate can impair methotrexate elimination, leading to elevated levels and potential toxicity, especially at high methotrexate doses. When NSAIDs are used with corticosteroids, the risk of gastrointestinal ulcers and bleeding is greatly amplified due to synergistic impairment of gastric mucosal protection.

Dr. Judy Morgan hosts Elizabeth Anne Johnson on the Naturally Healthy Pets podcast to discuss the Five Element Personalities of Dogs and Humans. Elizabeth, a veterinary technician and author, explains how each element—Wood (spring), Fire (summer), Earth (late summer), Metal (autumn), and Water (winter)—corresponds to specific traits and stress responses. She describes how these elements influence behavior, such as Wood dogs being overprotective and Water dogs experiencing visceral fear. She also stresses the importance of understanding these elements to support your pet's well-being and provides practical tips for recognizing and managing stress responses. Great info for any pet owner. Listen in! OFFER: Link to giveaway eBook: Excerpts from Know Your Dog's True Nature Website URL: ElizabethAnneJohnson.com Instagram and X: @5elementdogs FB: https://www.facebook.com/ElizabethJohnson4Leggeds FB: https://www.facebook.com/profile.php?id=61558138863715 LinkedIn: https://www.linkedin.com/in/4leggedwellness/ PRODUCT SPOTLIGHT #1Have you heard of PEA? Dr Judy is a huge fan, because PEA is a naturally occurring fatty acid compound found in plants and animals that has been shown to have anti inflammatory, neuroprotective and pain relieving properties. With no known drug interactions. It is often used as a safer alternative to an NSAID, opioid or steroid, but it can also be used alongside traditional medications, if needed. Dr Judy's PEA is a high quality human Grade Option for pets. Podcast listeners can take advantage of 15% off of any size with the code PODCAST59. Get your Dr. Judy's PEA today at NaturallyHealthyPets.com PRODUCT SPOTLIGHT #2 Are you interested in determining your pet's TCVM personality so that you can learn how to optimize their lifestyle and nutrition? Traditional Chinese Veterinary Medicine, TCVM theory revolves around the five elements. They're known as fire, earth, metal, wood and water. Each element is associated with specific organ systems and a specific personality or constitution, and each Constitution can be predisposed to medical issues based on the organs associated with the personality. Take the FREE pet personality quiz on NaturallyHealthyPets.com Just search for pet personality quiz and determine your pet's personality today.

Injuries are multi-factorial, and injury prevention is complex. In this episode, we chat with Dr. Victoria Sekely on injury risk, strength training, running form, and more. She will guide you through myths, facts, and nuance around running related injuries.You will learn:✅ Are some runners more injury-prone?✅ Is pronation a big deal - or normal?✅ How to manipulate training load✅ The mind-body connection of pain tolerance✅ Does Pilates reduce your injury risk?✅ Ice vs heat vs NSAID use for injury✅ Can your (under)fueling habits increase your injury risk?✅ Can you race through an injury?✅ The number 1 thing a PT wants you to do to reduce injury riskVictoria Sekely is a Physical Therapist with a passion for all things running. Victoria graduated with a Bachelor of Science degree from Georgetown University and went on to complete her Doctorate in Physical Therapy from New York University. Victoria is also a USATF Level 1 and RRCA certified run coach. She is dedicated to helping runners of all levels by using her skills and knowledge to assist runners who are rehabbing from an injury, interested in injury prevention, and/or looking to improve their training with custom running programs.Thank you to our sponsors:➡️ BodyBio: Research-backed, practitioner-trusted supplements. Use code AMANDA25 for 25% off at https://runtothefinish.com/bodybio/➡️ Previnex: Previnex creates clinically effective, third-party tested supplements made with high-quality ingredients. Use the code treadlightly for 15% off your first order at previnex.comLet's stay connected:➡️ Join our community at patreon.com/treadlightlyrunning➡️ Tread Lightly Running Podcast on Instagram: https://www.instagram.com/treadlightlyrunning/➡️ Laura Norris Running on Instagram: https://www.instagram.com/lauranorrisrunning/➡️ Hundreds of evidence-based training tips on Laura's website: https://lauranorrisrunning.com/➡️ Run to the Finish on Instagram: https://www.instagram.com/runtothefinish/?hl=en➡️ Thousands of running gear reviews and training guides:https://runtothefinish.com/

Today's Case A 44-year-old female presents to the emergency department with acute onset epigastric pain for the past 2 days, constant, with radiation to the back. Her eyes and skin “turned yellow” 1 day ago. She denies any fevers. The patient drinks one or two beers per week, does not smoke, denies nonsteroidal antiinflammatory drug (NSAID), use and is not on glucocorticoids. She denies any heartburn or acid reflux symptoms. She had right upper quadrant (RUQ ) abdominal pain that was colicky and worsened with food intake 1 week before, which resolved spontaneously after 1 day and she therefore did not seek medical attention. Her blood pressure is 118/55 mmHg, pulse rate is 105/min, respiration rate is 20/min, oxygen saturation is 97% on room air, and body mass index is 38. Her skin is noted to be jaundiced and scleral icterus is present. Murphy's sign is negative. Today's Reader Jared Fehlman is an Internal Medicine Resident at Huntington Health Hospital in Pasadena, California. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions MedPrepTGo Step 2 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

What if you didn't need surgery to fix your spine or joint pain—even if you've been told it's “bone on bone”? In this episode of Healthy Choices, neurosurgeon Dr. Jeff Gross shares how cutting-edge regenerative therapies are helping patients avoid surgery and heal naturally. From stem cell-derived exosomes to breakthrough bone injections, you'll learn the science—and real-world success—behind these non-invasive treatments. Whether you've been told surgery is your only option or you're looking for alternatives to long-term NSAID use, this episode is a must-listen. ---- In this episode of Healthy Choices, I sit down with neurosurgeon Dr. Jeff Gross to explore how regenerative medicine is giving new hope to patients with spine and joint pain. Dr. Gross walks us through the science behind exosome therapy—especially those derived from ethically sourced amniotic fluid—and how they help regenerate tissue, reduce inflammation, and provide a non-surgical path to recovery. He also shares how a bone injection technique encourages cartilage regrowth, debunks the myth of “bone on bone,” and explains the hidden damage long-term NSAID use can cause. If you've been considering surgery or are searching for better ways to manage chronic pain, don't miss this episode. ---- Dr. Jeff Gross is a board-certified neurosurgeon specializing in regenerative medicine and founder of Recelebrate, a clinic based in Las Vegas. With a focus on spine and joint care, Dr. Gross uses leading-edge regenerative techniques like exosome therapy to help patients heal naturally. He believes surgery should be a last resort and advocates for evidence-based, ethically sourced treatment options that align with the body's healing potential. Dr. Gross is currently leading a project exploring natural killer cell exosomes in potential cancer therapies. ---- Website: https://ifixspines.com Linkedin: https://www.linkedin.com/in/jeff-gross-md-5605605/ Instagram: https://www.instagram.com/ifixspines/ ---- www.linkedin.com/in/ray-solano-76960463 www.instagram.com/pdlabs/ open.spotify.com/show/78tLVSbC28VnDbpw2SqiEg podcasts.apple.com/us/podcast/heal…es/id1203354304 www.iheart.com/podcast/256-healt…choices-31040306/ ---- PODCAST Thank you for listening. Please subscribe and share. This podcast is produced by DrTalks.com drtalks.com/podcast-service/

In this episode of Quah (Q & A), Sal, Adam & Justin answer four Pump Head questions drawn from last Sunday's Quah post on the @mindpumpmedia Instagram page.  Mind Pump Fit Tip: The 5 best diets for ANY goal. (1:38) The MOST common mistake people make with fitness & diet. (19:53) The BEST recovery tool to manage stress. (31:03) Terrible/harming tactics by mainstream media. (35:27) Creatine and depression. (41:27) The history of ginseng. (44:12) The conspiracy theory behind art. (48:36) Kids say the darndest things. (53:12) Mind Pump Recommends You Can't Ask That on Netflix. (56:21) Train the Trainer 3-Part Bonus Series dropping May 19th! (1:00:47) #Quah question #1 – What do you guys do to keep up strength when resting an injury? (1:01:37) #Quah question #2 – What should you do if you are reverse dieting but see weight gain? (1:04:17) #Quah question #3 – Will taking NSAID's to treat an acute injury completely negate gains from strength training? (1:06:04) #Quah question #4 – How do you see AI affecting the fitness industry? What are the pros and cons that can come of its involvement for trainers, nutrition coaches and their clients? (1:09:26) Related Links/Products Mentioned Visit Eight Sleep for an exclusive offer for Mind Pump Listeners! ** Use the code MINDPUMP to get $350 off your very own Pod 5 Ultra. The best part is that you still get 30 days to try it at home and return it if you don't like it - - Shipping to many countries worldwide. ** Visit Joy Mode for an exclusive offer for Mind Pump listeners! ** Enter MINDPUMP at checkout for 20% off your first order. ** May Special: MAPS 15 Performance or RGB Bundle 50% off! ** Code MAY50 at checkout ** Labs - Stephen Cabral Why Are Americans So Obsessed With Protein? Blame MAGA Creatine Supplementation in Depression: A Review of Mechanisms, Efficacy, Clinical Outcomes, and Future Directions Mind Pump #2530: Why All Women Should Take Creatine The history of ginseng in the management of erectile dysfunction in ancient China (3500-2600 BCE) Watch You Can't Ask That - Netflix Train the Trainer Webinar Series – 3 Part Bonus Series  Visit Hiya for an exclusive offer for Mind Pump listeners! ** Receive 50% off your first order ** Mechanisms and applications of the anti-inflammatory effects of photobiomodulation Mind Pump Podcast – YouTube Mind Pump Free Resources People Mentioned Mikhaila Peterson (@mikhailapeterson) Instagram Dr. Stephen Cabral (@stephencabral) Instagram Benjamin Bikman (@benbikmanphd) Instagram  

Pannone (2023) What is known about the health effects of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultraendurance running: a scoping reviewIf you're an injured runner we can help you get back to running pain-free.Click the link to book a free call with ushttps://matthewboydphysio.com/booking/Running Fundamentals Coursehttps://matthewboydphysio.com/running-fundamentals-course/Instagramhttps://www.instagram.com/matthewboydphysio/SummaryThis episode explores the controversy surrounding the use of ibuprofen by runners, particularly in light of recent promotional campaigns. Matthew Boyd discusses the potential risks and benefits of taking ibuprofen before running, referencing a 2023 study that reviews the medical risks associated with its use. He emphasizes the importance of understanding the inflammatory response in training and cautions against using ibuprofen as a regular training aid, suggesting that it may not provide the expected benefits and could pose health risks.TakeawaysTaking ibuprofen before running has become a controversial topic.Recent promotions have sparked discussions about its safety and efficacy.Ibuprofen may blunt the body's natural inflammatory response to training.There are potential risks associated with ibuprofen use, including kidney injury and gastrointestinal issues.Evidence suggests limited benefits of ibuprofen for recovery and performance.Using ibuprofen regularly as a prophylactic is not advisable.The inflammatory response is crucial for training adaptations.Temporary use for specific conditions may be reasonable, but not long-term.Evaluate the necessity of ibuprofen on a case-by-case basis.Consult with health professionals before using ibuprofen for training.

In this episode, Dr. Kaur and Dr. Abhishek join us to discuss their recent study on acetaminophen, exploring how it compares to NSAIDs in safety and effectiveness. They break down their use of the Clinical Practice Research Datalink (CPRD), key findings—especially in arthritis patients—and what this means for clinical practice. It's an insightful look at how big data can challenge assumptions about one of the most used pain medications. 

In this episode, Dr Brad Leech shares the exclusive results of his PhD research, which produced the first comprehensive clinical practice guidelines for intestinal permeability. Dispelling common myths about "leaky gut syndrome," Dr Leech explains why intestinal hyperpermeability is a legitimate physiological reaction—not a syndrome—and how his meticulously developed, evidence-based guidelines can transform clinical practice.This episode provides invaluable insights into the following:The rigorous methodology behind developing clinical practice guidelines, including stakeholder engagement, comprehensive literature review, and systematic evaluation of over 10,000 research articlesThe critical importance of risk-of-bias assessment when evaluating research—a cornerstone of methodology that helps practitioners look beyond cherry-picked studies and misleading claimsHow to systematically evaluate research quality by examining randomization procedures, analysis methods, conflict of interests and  clinical relevance rather than accepting published findings at face valueSurprising findings about commonly used interventions in intestinal permeability, including evidence that certain probiotics may not be effective for NSAID-induced permeability despite their widespread recommendationEvidence-based assessment of treatments for intestinal permeability using the NHMRC grading matrix to evaluate research qualityPractical recommendations and evidence-supported interventions that meet the threshold for clinical relevanceDr Leech's work represents a significant advancement in the field, bringing scientific rigour to an area often clouded by opinion and marketing claims. Learn how these new guidelines can help you make more informed clinical decisions and improve patient outcomes through evidence-based approaches to intestinal permeability.Connect with Dr Leech: Dr Brad LeechRead: The IP GuidelineGet in touch! Shownotes and references are available on the Designs for Health websiteRegister as a Designs for Health Practitioner and discover quality practitioner- only supplements at www.designsforhealth.com.au Follow us on Socials Instagram: Designsforhealthaus Facebook: Designsforhealthaus DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health

Welcome to HCPLive's 5 Stories in Under 5—your quick, must-know recap of the top 5 healthcare stories from the past week, all in under 5 minutes. Stay informed, stay ahead, and let's dive into the latest updates impacting clinicians and healthcare providers like you! Interested in a more traditional, text rundown? Check out the HCPFive! New ACP Guidelines Recommend Adding Triptan to NSAID or Acetaminophen for Migraines The American College of Physicians now recommends adding a triptan to NSAIDs or acetaminophen for moderate to severe acute migraines and urges clinicians to initiate combination therapy early. Automated Insulin Delivery Effectively Lowers HbA1c in Type 2 Diabetes  Tandem Diabetes Care's Control-IQ+ automated insulin delivery system led to greater HbA1c reduction than continuous glucose monitoring alone in adults with insulin-requiring type 2 diabetes. FDA Approves Guselkumab (Tremfya) For Crohn's Disease  The FDA approved guselkumab for moderately to severely active Crohn's disease based on phase 3 trial data demonstrating superior efficacy over ustekinumab on endoscopic endpoints. FDA Approves Oral Iptacopan (Fabhalta) as First C3 Glomerulopathy Therapy  The FDA approved iptacopan as the first therapy for C3 glomerulopathy, with phase 3 data showing significant proteinuria reduction and sustained efficacy at 12 months. FDA Approves Vutrisiran (AMVUTTRA) for ATTR-CM  The FDA expanded vutrisiran's approval for cardiomyopathy in transthyretin-mediated amyloidosis, making it the first RNAi therapeutic to reduce cardiovascular mortality and hospitalizations in ATTR-CM.

In this episode, we dive deep into one of nature's most powerful superfoods—colostrum—and explore its incredible benefits for immune function, gut health, and overall well-being. But we're taking it a step further by introducing Immunel, a highly concentrated and bioactive colostrum extract developed by Sterling Technology. Immunel represents the 5th generation of colostrum, setting a new standard for immune and gut support. Topics Covered:  What is Colostrum? The first milk produced after birth, rich in antibodies (IgG), growth factors, and bioactive peptides. The science behind 9,000+ PubMed studies on colostrum's health benefits.  The Health Benefits of Bovine Colostrum Immune Boosting: Clinical research shows colostrum is 3x more effective than the flu vaccine in reducing flu incidence. Gut Healing Properties: Protects the GI lining, reduces diarrhea by 86.6%, and helps in ulcerative colitis management. Anti-Inflammatory Effects: Supports those with NSAID-induced GI issues. Stem Cell & Regenerative Potential.  Immunel: The Next Evolution in Colostrum A concentrated colostrum extract packed with key bioactive compounds: Growth Factors (IGF-1, TGF-ß2) Proline-Rich Polypeptides (PRPs) for immune modulation Enzymes (lysozyme, lactoperoxidase, lactoferrin) for pathogen defense Sialic Acid & Nucleotides essential for immune function & DNA synthesis  Immunel vs. Standard Colostrum Unlike standard colostrum, which focuses on IgG content, Immunel is clinically validated for immune activation and pathogen defense. Outperforms β-glucans and vitamin C in immune response.  Scientific Evidence on Immunel Enhances phagocytosis & innate immunity Activates Natural Killer (NK) cells (↑ CD69 expression) Reduces bacterial lung infections by 70.2% Lowers viral load by 64% in influenza  Why This Matters for Public Health The economic burden of flu & colds: 75M lost workdays annually, costing $37.5B. Growing consumer interest: 47% of people prioritize immune health, driving demand for functional foods. Immunel is a next-generation, scientifically backed immune and gut health solution—more bioavailable and effective than traditional colostrum. Perfect for daily supplementation to support overall health and resilience.

After 20 years of Rheumatoid Arthritis, Erika now knows how to reverse joint symptoms and has gotten off drugs she has been using for many years including daily steroids and NSAID's. Book Your RA Reversal Strategy Session Here https://www.rheumatoidsolutions.com/book-a-call/ 1. Learn how you can reverse your RA symptoms here: https://www.rheumatoidsolutions.com/training-2024/ 2. Follow me on Instagram to get daily pain-reduction insights: www.instagram.com/paddisonprogram

According to published estimates, the prevalence of an NSAID allergy (hypersensitivity) in the general population is estimated to be between 0.5% and 2%, with some studies reporting a range of 1-3% of people experiencing a reaction to NSAIDs; however, this rate can be significantly higher in individuals with conditions like asthma, nasal polyps, or chronic urticaria, where it may reach up to 20-30%. Genetic and epigenetic backgrounds are implicated in various processes of NSAID-induced hypersensitivity reactions. Aspirin is a type of NSAID and may result in some cross sensitivity in NSAID allergic people. Well, as low dose aspirin is currently the only pharmacological recommended prophylactic agent for HDP, what can we do for these patients? In a new publication (ahead of print, 2/17/2025), clinicians from Singapore provide helpful insights- and an easy to adopt protocol- for aspirin desensitization in pregnancy. Listen in for details.

Dante Picazo from Houston, Texas has experienced the life-changing benefits of a cannabis-based ointment for cartilage pain. However, strict state laws have made it difficult for him to access the full range of cannabis-based treatments that could help with his other medical conditions—including knee osteoarthritis, neuropathic tremors, and severe gastrointestinal damage caused by prolonged NSAID use. Visit our website: CannabisHealthRadio.comFollow us on Facebook.Follow us on Instagram.Find us on Rumble.Keep your privacy! Buy NixT420 Odor Remover

Tune in as Dr. Judy Morgan interviews Dr. Michele Broadhurst, a chiropractic sports physician and acupuncturist specializing in animal rehabilitation. Dr. Broadhurst discusses her transition from human to animal chiropractic, emphasizing the importance of addressing myofascial pain in animals, which is often overlooked in veterinary medicine. She highlights the benefits of integrative rehabilitation, including creating a team of specialists and using various tools like shockwave therapy and custom bracing. She also stresses the importance of conditioning and prevention for sporting dogs and couch potatoes alike, advocating for a holistic approach to animal health. www.integrativeanimalsolutions.com; rehab4pets.com Instagram: @rehab4pets; @drmichelebroadhurst Facebook:@rehab4pets; @drmichelebroadhurst LinkedIn:Dr Michele Broadhurst OFFER: Until the end of Feb 2025 we are offering a 15 % discount on all courses using the coupon code DRJUDY on www.integrativeanimalsolutions.com. PRODUCT SPOTLIGHT #1 Could your pet benefit from PEA? Dr Judy is a huge fan because Palmitoylethanolamide, also known as PDA, is a naturally occurring fatty acid compound found in plants and animals that has anti inflammatory, neuroprotective and pain killing properties. Better than an NSAID, opioid or steroid. Podcast listeners can take advantage of 15% off with the code PODCAST50. Get Dr Judy's PEA today at naturallyhealthypets.com PRODUCT SPOTLIGHT #2Are you looking for the ultimate one stop resource for canine hospice and palliative care? Then you need to check out our recent course, An Integrative Approach to Hospice and Palliative Care for Dogs. There are three versions to this course that include live meetings and a certification. These informative courses are led by Dr Judy Morgan and Michele Allen, two experts in dog hospice. Dr Judy covers integrative veterinary medicine aspect of hospice and Michele tackles the real life experiences and care expertise. The combination of these two skill sets has created the best online courses for knowledge on dog hospice. As a thank you to our podcast listeners use code PODCAST50 for 20% off any of these hospice related courses found on DrJudyU.com

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if you have any feedback, please send us a text! Thank you!Host: Rita Agarwal, MD, FAAP, FASAGuests: Rakhi Dayal, MD, and Amber Borucki, MDWelcome to another episode of Vital Times, the California Society of Anesthesiologists' Podcast with your host Dr. Rita Agarwal.Pain is the most common reason that people seek medical care and since the beginning of time, we have searched for better ways to treat pain. For many years opium and its derivatives were the mainstay of pain management, with local anesthetics making an appearance in this country in the past century or so. While scientists, physicians, researchers, and industry have sought to find better medications and approaches, the onset of the opioid crises in early 2000s really sped up that mandate. The FDA has committed resources and funding to help these new treatments and as a result there are now several new drugs on the market.Joining me today to explore these new modalities are Dr. Rahki Dayal who is a Professor at the University of California, Irvine, double board-certified in anesthesiology and pain medicine. She chairs the Pain Committee for the California Society of Anesthesiologists and is the Program Director of Pain Medicine at UCI. Dr. Amber Borucki is an Associate Professor of Anesthesiology at Stanford University and a pediatric anesthesiologist and pain specialist from Stanford School of Medicine. She is also the newly elected Sectrtary/Treasurer of the Society for Pediatric Pain Medicine.On January 30 the FDA approved a new non-opioid pan medication for moderate to severe pain. In the past few years several new classes and types of medications have also been approved for use. These include Zynrelef-a combination of bupivacaine ( a long acting local anesthesthetic ) and meloxicam ( a long lasting NSAID), and Vocacapsacian a prodrug to capasacian that in at ;east one study has been shown to provide up to 96 hours of pain relief , when injected locally after bunionectomy surgery.Join us as we explore these medications and the newly released suzetrigine (Journavx) with our 2 experts. ReferencesNewly Approved Painkiller Provides Relief Without Addictionhttps://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain A new long-acting analgesic formulation for postoperative pain management.Zhang W, Wu M, Shen C, Wang Z, Zhou X, Guo R, Yang Y, Zhang Z, Sun X, Gong T.Int J Pharm. 2024 Oct 25;664:124599. doi: 10.1016/j.ijpharm.2024.124599. Epub 2024 Aug 16.PMID: 39154917 Bupivacaine + meloxicam-~3 days duration-also for bunionectomySafety and Efficacy of Vocacapsaicin for Management of Postsurgical Pain: A Randomized Clinical Trial.Shafer SL, Teichman SL, Gottlieb IJ, Singla N, Minkowitz HS, Leiman D, Vaughn B, Donovan JF.Anesthesiology. 2024 Aug 1;141(2):250-261. doi: 10.1097/ALN.0000000000005027.PMID: 38662910

Prednisolone is a corticosteroid that is often used in pediatrics. Hyperglycemia, insomnia, and GI upset are relatively common adverse effects. Ibuprofen is a commonly used OTC pain reliever. It is classified as an NSAID and can increase GI bleed risk and exacerbate heart failure. Aceon is the brand name for perindopril. ACE inhibitors are well known to cause drug induced cough and will cause hyperkalemia. Trazodone is classified as an antidepressant but is frequently used to treat insomnia because of its sedative properties. Pioglitazone is an oral anti-diabetes medication that should be avoided in patients with heart failure.

**Dr. Lisa Faast here, kicking off a new video series highlighting winning pharmacy products that deliver value for both your patients and your pharmacy.** **Show Notes:** 1. **Cox Santo (Oxyprozin 300mg)—a once-a-day NSAID** [0:0] Websites Mentioned: https://www.drlisafaast.com/ Product Info: Learn more about Cox Santo (Oxyprozin) here: Solubiomix - https://solubiomix.net/products/ NDC: 69499-403-60 Where to Source: ▪️Axia Medical Solutions - https://axiamedicalsolutions.com/customer-app/ ▪️Real Value Products - https://realvalueproducts.com ▪️Wellgistics - https://wellgistics.com ▪️KeySource - https://keysourceusa.com ▪️GRx Pharma - https://grx-pharma.com   ----- #### **Becoming a Badass Pharmacy Owner Podcast is a Proud to be Apart of the Pharmacy Podcast Network**

In Episode 90 of Trail Society, we sit down with Leela Srinivasan, the CEO of Parity Now, a pioneering platform that aims to close the gender income and opportunity gap in professional sports. Parity, founded in 2020, works with over 1,000 women athletes across 80+ sports, from archery to weightlifting, empowering athletes through impactful brand partnerships. Leela, a runner, mother, and passionate advocate for women's sports, brings her unique perspective to the conversation, exploring how her platform is reshaping the future of women's athletics. Her leadership at Parity is focused on tackling the financial inequities faced by female athletes, with an emphasis on securing meaningful sponsorships and creating long-term opportunities for women in sports. A key highlight of this episode is the release of Parity's groundbreaking research, "Beyond the Game: Exposing The Economic Realities of Professional Women Athletes". The study sheds light on the harsh financial realities faced by many female athletes, with findings such as 50% reporting a negative or zero net income, and 74% working another job to make ends meet. Leela discusses the contrast between the booming investment in women's sports leagues, like the NWSL and WNBA, and the ongoing struggles for athletes themselves. Despite these challenges, the research also highlights the potential for growth in women's sports, with consumers increasingly backing brands that support female athletes. Leela's insights into the disparity between league success and individual athlete earnings offer a sobering look at the financial landscape, while also providing a call to action for brands and fans to invest in women's sports to create lasting change.   Follow Leela on LinkedIn: https://www.linkedin.com/in/leelasrinivasan/ Learn more or partner with Parity Now: https://paritynow.co/ Parity Report: https://20518965.fs1.hubspotusercontent-na1.net/hubfs/20518965/Parity%20Athlete%20Survey%20Report_Dec2024.pdf Sponsors: This episode is brought to you by Freetrail @runfreetrail www.freetrail.com - subscribe and JOIN US IN SLACK & Our Title Sponsor is The Feed!!! Follow the link to get $20 to spend every quarter ($80 every year!): https://thefeed.com/trailsociety + a cool Trail Society water bottle!   Keep sliding into our DMs with your messages, they mean so much to us! @trail.society   Study participants needed for NSAID use in ultra endurance https://app.onlinesurveys.jisc.ac.uk/s/ljmu/nsaid-use-in-ultra-running?fbclid=PAY2xjawGrFxRleHRuA2FlbQIxMQABpvuapRmCwZbGr1EUWHfwFKESpScIckcrKajtfiwy76m7LfUWDQh9r-lFBA_aem_Vvg3cX6CUqqjF0uPWb2JbQ Citations: Díaz‐Lara, Javier, et al. “Delaying Post‐Exercise Carbohydrate Intake Impairs Next‐Day Exercise Capacity but Not Muscle Glycogen or Molecular Responses.” Acta Physiologica, 12 Sept. 2024, https://doi.org/10.1111/apha.14215.  

On this top 200 drugs podcast, we are covering medications 141-145. Raltegravir, ustekinumab, meloxicam, infliximab, and Nighttime Cold and Flu are the medications that are covered on this episode. Raltegravir is an integrase inhibitor that is used to manage HIV infection and may also be used for post-exposure prophylaxis. Ustekinumab is a monoclonal antibody that can help reduce inflammation by binding interleukins. Meloxicam is an NSAID used for pain and anti-inflammatory purposes. GI bleeding risk is a top adverse effect to monitor for. Infliximab is a monoclonal antibody that can be used for autoimmune disorders such as psoriatic arthritis, rheumatoid arthritis, ulcerative colitis, and Crohn's disease. Nighttime Cold and Flu medication is a combination product that often includes acetaminophen, dextromethorphan, and doxylamine.

Jobs That Bite Jeremy Brandt has a strange and scary job. One minute, he'll be doing dental work on a lion. Next, he'll be tattooing a bear. It's all part of a day's work as a Nat Geo WILD television host. Listen Now Does Your Cat Have A Smart Phone? Yes, there's an "app" for that.  Just released, the Human-to-Cat Translator. This intriguing app says it can translate human words into cat language. Speak a word or phrase into your phone, and the app plays back a collection of meows, supposedly translating your English into Catlish. When we tried a translation for "come here," our cat tester showed a little curiosity but not enough to actually get off the couch. Of course, even if the app does work accurately, there's a good chance your cat will ignore you, anyway. Listen Now St. Francis of Bloomberg Ex-Mayor Bloomberg's daughter makes a pretty decent living riding horses. Georgina Bloomberg continually wins big stakes in riding competitions. But now she's taking time off to have a baby with her boyfriend. She has more info on the big Tinsel & Tails event. Listen Now Medicines Safe For Humans May Not Be Safe For Pets When people feel pain, they often reach for common medicines such as aspirin or Motrin. However, NSAID use in pets carries risks as well as benefits. Pet owners must be informed about possible side effects, including those that could signal danger. Listen Now Ahhh, The Holidaze Are Here. It's time to endure another year with drunk old Uncle Ned. This year, Vinnie Penn defends the right of the family dog to have a sock hanging from the fireplace mantle. This doesn't end well. Listen Now Read more about this week's show.

You can smell the excitement on this amazing episode! The main training topic was on David's favorite study of 2024, which caused major changes in his training approach. The study found some potential mechanisms for improved fatigue resistance, but we take it a step further into theories about solving for a puzzle that has flummoxed coaches and researchers forever. Could this study be the missing link connecting fatigue resistance and training interventions? Maybe. We dive into the cutting edge of endurance training to find out. We also talked about how Megan is planning to rebuild for big goals in 2025 and beyond. It's the perfect opportunity to discuss the interplay of power, speed, cross training, and strength work in an athletic journey. It's also the perfect opportunity to talk about critical internet comments. Scared money don't make money! And this one was full of awesome topics! Other topics: the perils of heat suit training and weak laundry practices, building strength and power, why people are weird on the internet, a shoe that really let us down, some reviews of "supertrainers" and why we think these shoes are so important in training, a triathlon case study on carb oxidation in long events, the controversy around NSAID use in endurance races, and Listener Corner. This one was SO MUCH FUN. Like the listener at the end of the episode, you (and we mean everything that goes into what makes you... plus what comes out of you) = awesome. We love you all! Huzzah! Follow Huzzah for science insights: https://www.instagram.com/thehuzzahhub/ Click "Claim Reward" for $80 at The Feed here: thefeed.com/swap Buy Janji's amazing gear: https://janji.com/ (code "SWAP") For weekly bonus podcasts, articles, and videos (plus hat purchases): patreon.com/swap

Dr. Lauren Barrow answers a listener question from Gloria in Florida. Gloria's dog was recently diagnosed with transitional cell carcinoma (TCC), and she is seeking advice on how to support her dog beyond the prescribed medication, piroxicam. Dr. Barrow shares her insights and offers general information on how to detect bladder cancer early on. Key Topics Covered: Piroxicam for TCC: Dr. Barrow explains the benefits of piroxicam, a nonsteroidal anti-inflammatory drug (NSAID) with anti-tumor properties, which is commonly prescribed for dogs with TCC. Diet and Supplements: While there is no specific diet or supplement proven beyond a doubt to kill cancer cells, maintaining a healthy diet and weight with a focus on reducing inflammation is crucial. Also important is ensuring your dog has enough nutrients to maintain muscle mass and appetite. Additional Medications: Other potential treatment options, such as Palladia (a targeted therapy drug), are discussed, though piroxicam remains the most studied and commonly used for TCC. Early Warning Signs: Dr. Barrow outlines symptoms that may indicate urinary problems associated with TCC, including accidents, blood in urine, straining to urinate, and frequent small urinations. General Management Tips: Dr. Barrow advises maintaining a healthy diet, regular exercise, and a stable weight to help manage a dog's overall health while fighting cancer. Your Voice Matters! If you have a question for our team, or if you want to share your own hopeful dog cancer story, we want to hear from you! Go to https://www.dogcancer.com/ask to submit your question or story, or call our Listener Line at +1 808-868-3200 to leave a question. Related Videos:            A wonderful everything-Palladia episode: https://youtu.be/GafVltlNWvY A veterinary oncologist discusses the little-known use of radiation in bladder cancer: https://youtu.be/ZGoyn-1TBsA What happens when a new veterinarian recommends surgery on an “inoperable” tumor? https://youtu.be/MCGJc_UvEXE Related Links: Our article on Bladder Cancer: https://www.dogcancer.com/articles/types-of-dog-cancer/bladder-cancer-in-dogs-including-transitional-cell-carcinoma/ Piroxicam: https://www.dogcancer.com/articles/drugs/piroxicam-for-dogs/ Palladia: https://www.dogcancer.com/articles/drugs/palladia-for-dogs/ Chapters: [00:00] - Introduction [00:30] Gloria's Question: Dog Diagnosed with TCC [01:15] Piroxicam for Transitional Cell Carcinoma [02:00] Why Seeing an Oncologist Is So Important [02:30] The Role of Piroxicam in Cancer Treatment [03:00] General Diet and Supplements for Dogs with Cancer [03:45] Resources for Dog Cancer Diet and Supplements [04:15] Other Medications for TCC [05:00] Palladia: A Potential Option for TCC [05:30] Managing TCC in Younger Dogs [06:00] Breeds Prone to Transitional Cell Carcinoma [07:00] Watch for Early Signs of Bladder Cancer [08:00] Final Tips for Keeping Your Dog Healthy [08:30] Outro and Resources Get to know Dr. Lauren Barrow: https://www.dogcancer.com/people/lauren-harper-barrow-dvm-cna/ For more details, articles, podcast episodes, and quality education go to the episode page: https://www.dogcancer.com/podcast/ Learn more about your ad choices. Visit megaphone.fm/adchoices

On this episode of the Real Life Pharmacology Podcast, I cover 5 more medications of the top 200. Fenofibrate is a medication used primarily to reduce triglycerides. This medication differs from statins which tend to focus on LDL management. Doxazosin is an alpha-blocker. The primary indications of doxazosin are hypertension and BPH. Naproxen is an NSAID. Of all the NSAIDs, naproxen is one of the lower-risk agents with regard to cardiovascular risk. Spironolactone is an aldosterone antagonist and also classified as a potassium sparing diuretic. Memantine is an NMDA antagonist that is indicated for the management of Alzheimer's dementia. If you are looking for study materials and our list of popular Amazon books, check out meded101.com/store!

Is your gut health compromising your overall wellness? Discover how to heal leaky gut syndrome naturally in this eye-opening episode of the Dr. Josh Axe Show. Did you know that 50-70% of long-term NSAID users experience increased intestinal permeability? Dr. Axe dives deep into the science behind leaky gut and reveals powerful, natural solutions to restore your gut health. In this episode, you'll learn: The hidden symptoms of leaky gut you might be overlooking Top 5 causes of intestinal damage and how to avoid them Nature's most potent herbs and nutrients for gut repair The surprising link between stress and gut permeability How to harness the power of probiotics for optimal gut health Tune in to arm yourself with cutting-edge knowledge on gut health restoration. You'll walk away with actionable steps to improve your digestion, boost your immune system, and enhance your overall well-being. Don't miss this game-changing episode on conquering leaky gut naturally! #leakygut #guthealth #draxe Want more of The Dr. Josh Axe Show? Subscribe to the YouTube channel. Follow Dr. Josh Axe Instagram Twitter Facebook TikTok Website ------  Staying healthy in today's world is an upstream battle. Subscribe to Wellness Weekly, your 5-minute dose of sound health advice to help you grow physically, mentally, and spiritually. Every Wednesday, you'll get: Holistic health news & life-hacks from a biblical world view Powerful free resources including classes, Q&As, and guides from Dr. Axe The latest episodes of The Dr. Josh Axe Show Submit your questions via voice memo to be featured on the show → speakpipe.com/drjoshaxe  ------  Links:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862683/ https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.1035912/full  https://my.clevelandclinic.org/health/diseases/22724-leaky-gut-syndrome https://www.preventivemedicinedaily.com/diseases-conditions/digestive-system/leaky-gut-syndrome-causes-and-treatments/ https://www.objectivenutrients.com/insights/leaky-gut-syndrome-causes-symptoms-and-solutions-for-gut-healing/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426480/  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563708/  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625701/  https://drjockers.com/heal-leaky-gut-lining/ https://blog.biotrust.com/leaky-gut-restore-intestinal-permeability/ https://karger.com/ddi/article/41/3/489/835349/Effect-of-a-Multistrain-Probiotic-on-Leaky-Gut-in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906476/  https://pubmed.ncbi.nlm.nih.gov/11383597/  https://www.amymyersmd.com/article/restore-gut-health-herbs-nutrients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065514/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407830/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940200/  Ads Get $200 OFF a Coldture cold immersion tub! Go to coldture.com and use code AXE. Follow @coldture on Instagram! Even if your bloodwork looks "normal," your symptoms could point to Cell Danger Response (CDR). Discover how to break free from CDR and unlock your full potential at beyondbloodwork.com.

Welcome to The Veterans Disability Nexus, where we provide unique insights and expertise on medical evidence related to VA-rated disabilities.Leah Bucholz, a US Army Veteran, Physician Assistant, & former Compensation & Pension Examiner shares her knowledge related to Independent Medical Opinions often referred to as “Nexus Letters” in support of your pursuit of VA Disability every Wednesday at 7 AM.In this video, Leah B from Prestige Veteran Medical Consulting discusses the top five conditions related to knee pain in VA disability claims, drawing from her extensive experience as a former compensation and pension examiner and current medical consultant for veterans. She explains how compensatory mechanisms and gait abnormalities can lead to issues in the other knee and hips, highlights the gastrointestinal problems caused by NSAID usage, and addresses the impact of weight gain due to reduced mobility. Additionally, Leah emphasizes the mental health challenges, such as depression and anxiety, that often accompany chronic orthopedic pain.

Please Subscribe and Review: Apple Podcasts | RSS Submit your questions for the podcast here News Topic: Decouple Podcast: The Bottomless Well Show Notes: The Bottomless Well  - Book by Peter Huber and Mark Mills Rescue The Republic Covid Critical Care Alliance Questions:    Pain Relief for Rotator Cuff Injury Kat writes:  Hello from Canada. Love your podcast. I've just found out Iikely have an injury/tear as mentioned above and am pending diagnostic tests. In the meantime, I've been prescribed Baclofen (Muscle relaxant) and an NSAID. Both are making me very ill to the point where I've pretty much stopped taking the meds as Baclofen is causing me to be very unstable on my legs, horribly nauseated, physically ill and feeling very groggy/sedated/intoxicated. The NSAID...I noticed lastnight I had some blood drip during an Ileostomy appliance change. I'm aware of the bowel bleed risks to myself with Crohn's and an ostomy, but after a bleed, more. As a result of choosing not to take these meds anymore, I am in excruciating agony and nothing is providing relief...hot baths, cold packs, hot packs. I cannot sleep for the agony. Every single movement/action excruciating to the point of wanting to scream. Is there a safer, easy remedy for the pain that I can try without requiring much use of my arm? Any suggestions are appreciated.   Air Hunger and Keto Joe writes: Hello Robb and Nikki. I have a couple of questions: I have been chronically experiencing "air hunger" (feeling of inability to get a deep enough breath, rather than a shortness of breath) when following a ketogenic diet. Being insulin resistant, it is critical that I find a solution. My doctor pointed me to ph balance but offered no real solutions. I've since begun drinking alkaline water almost exclusively and it seems to have helped some, though not completely. I don't think this is just in my head, though my research yields a correlation with anxiety, which I do not have. Is this real thing or am I imagining things just because of my carb addiction? If it is real, any ideas how to combat it? Next question is about LMNT. Though I've been a user for quite a while, I tend have a rather explosive intestinal response soon after ingesting it. I've tried cutting back, which is fine when not following a ketogenic diet, but when on diet I really need it. Thoughts? Thanks!   Previous Myocarditis and MRNA shot Marc writes: Hi Robb and Nikki, Long time listener, and reader from the beginning here. Really appreciate all that you do as I have made vast improvements in my life which all started with the paleo solution over a decade ago. I am a healthy, active 37 year old male, living in Brooklyn NY. I cycle 4-5 days a week, lift weights 3-5 days, play ice hockey and get plenty of sun! I eat a carnivorish, paleo type diet, with a strict aversion to gluten. Sleep is pretty dialed in, though I do enjoy alcohol one or two nights a week, but am also very aware of how it effects me etc.  When I was 20 years old I ended up hospitalized for over a week with myocarditis. I had strep throat, which was all the norm for me, as I used to get it once or twice a season until my mid 20's. The infection had actually gone down into my heart and which had caused the issue. It was a terrifying experience as they thought at first I was having a heart attack. After things went back to normal and I was discharged, the cardiologist told me to take a baby asprin every day, prescribed me nitroglycerin incase I had chest pain, and told me to "maybe try meatless Mondays, as heart disease runs in the family." I was far from thrilled with the "solutions" I was given. Long story short, it was after this that I started my health journey which eventually led me to you and the Paleo Diet. Within a month I was down 20 lbs, feeling great, and fast forward over 15 years later I never had another strep infection! Cutting to the chase, when covid struck, I went and got the first 2 jabs of pfizer, back in early 2021 living here in NYC I wouldn't have been able to participate in life, and they dangled the carrot in front our noses, promising freedom once the shot was taken. I had not heard anything about the dangers of myocarditis being a side effect at that point, and Needless to say I was infuriated once the side effects were made known. Its been about 3.5 years since getting my second shot, but seeing all of these healthy young people drop dead has been pretty frightening. There is also no way to "google" this stuff and get answers, we all depend on brave people like RFK Jr, and Brett Weinstein to stand up and inform us. I was wondering if you had any advice on anything I can continue to do, and/or if you think I should even be concerned at this point. I know there's probably alot to unpack here, but any advice, or information that you have would be greatly appreciated. Thanks again for everything, and wish you all the best! -Marc     Sponsor: The Healthy Rebellion Radio is sponsored by our electrolyte company, LMNT. Proper hydration is more than just drinking water. You need electrolytes too! Check out The Healthy Rebellion Radio sponsor LMNT for grab-and-go electrolyte drink mix packets and the new LMNT Sparkling electrolyte performance beverage! Click here to get your LMNT electrolytes   Transcript: Coming soon! .

On this episode of the Real Life Pharmacology podcast, I cover medications 81 through 85 on the top 200 drug list. Famotidine is an H2 blocker. H2 blockers are less potent than PPIs but can be used to manage heartburn symptoms. Aspirin is technically an NSAID but is primarily used for cardioprophylaxis purposes. Senna is a stimulant laxative. I often see this medication used with opioids to help manage opioid-induced constipation. Novolog is a rapid acting insulin used to bring down post prandial blood sugars. I discuss sliding scale insulin and other concepts with this medication. Baclofen is a skeletal muscle relaxant. It has central nervous system depressant effects which can be especially problematic in elderly patients. Support the sponsor Meded101.com by going to meded101.com/store - Study materials, books, review courses for pharmacists, pharmacy students, pharmacy technicians, nurses, physicians, prescribers, dietitians, and all others who want to learn pharmacology!

The plantar plate ligament that gets injured in runners is typically located on the bottom of the foot, at the base of the second toe.  It gets inflamed, it gets irritated, it may feel weird at first. The plantar plate may not even feel sprained, or sore, or injured. It might just feel like this weird sort of fullness sensation. I got a question from a runner who had those same strange symptoms. He was trying to figure out what treatment would best address the "fullness" sensation in and around the plantar plate. Which is better for an inflamed plantar plate in a runner who wants to run? Icing, cryotherapy, NSAIDs, which one is going to help the most?  Well, great question and that is what we're talking about today on the Doc On The Run Podcast.   

In this episode, Emma Fox and David Contorno dive into the whirlwind of 2024, a year that began with optimism but quickly spiraled into a series of unexpected health challenges. David opens up about his harrowing experience with chronic pain, a spiritual trip to Costa Rica that led to a cascade of health issues, and the discovery of acute kidney failure. The duo discusses the importance of understanding the risks of long-term NSAID use, the critical role nurses play in patient care, and the reality of navigating a flawed healthcare system. Tune in to hear about resilience, medical advocacy, and the next steps in David's health journey.TIMESTAMPS[00.49] David Contorno experienced a severe health crisis[02.25] Emma's point of view[05.52] Rushed to Mission Hospital ER in Asheville, NC[10.42] Diagnosed with acute kidney failure[13.42] Experienced frustration with hospital holding area[17.07] Learned about dangers of long-term NSAID use [18.09] Discussed potential need for back surgery[18.50] Mentioned the hospital's attempts to qualify David for Medicaid[19.47] Emma managed hospital paperwork and consent forms[23.39] Friends in the medical industry offered guidance[27.41] The community showed strong support during recoverySOCIAL MEDIA LINKSDavid ContornoLinkedIn: https://www.linkedin.com/in/dcontorno/Emma FoxLinkedIn: https://www.linkedin.com/in/emmamariefox/WEBSITEE-Powered Benefits: https://www.epoweredbenefits.com/Emma Fox: https://emmamariefox.com/Mixed & Edited by Next Day Podcastinfo@nextdaypodcast.com

How do our thoughts, emotions, behaviors, and health conditions impact our pet's well-being? Learn more as Dr. Judy chats with guest Lisa Tully, a professional animal healer from Ireland, who gets to the root cause of our animals' emotional or physical problems. You'll get real-life examples and practical tips on how to improve our happiness, therefore our pets' happiness. A win-win for all! OFFER: I offer a free meditation that they can do with their fluffs, to connect with them on a deeper level and heal together. It is part of the opt in for my mailing list, but here is the direct link to share https://animalhealing.ie/guided-meditation/ https://animalhealing.ie Social Media URLs or Tags Instagram https://www.instagram.com/animalhealinglisatully/ Facebook https://www.facebook.com/animalhealinglisatully LinkedIn https://www.linkedin.com/in/animalhealinglisatully/ PRODUCT SPOTLIGHT #1 DR. JUDY'S PEA Does your pet need PEA? Dr. Judy is a huge fan because PEA is a naturally occurring fatty acid compound found in plants and animals that has natural anti inflammatory, neuroprotective and painkilling properties. Much better than an NSAID, steroid or opioid. Podcast listeners can take advantage of 15% off with the code PODCAST39. Get your Dr. Judy Morgan's PEA today at NaturallyHealthyPets.com PRODUCT SPOTLIGHT #2 HOMEMADE FOOD FOR DOGS 101Are you ready to prepare complete and balanced meals at home for your dog with confidence? Let Dr. Judy take the guesswork out of home prepared food in our Homemade Food for Dogs 101. Once you purchase this fun and easy to understand course you will have permanent access and can rewatch it any time. Take advantage of a 20% discount on this fabulous course where Dr. Judy helps you feel comfortable making safe and balanced meals for your dog using fresh whole foods. Use code PODCAST39 When purchasing on DrJudyU.com Your dog will thank you.

In today's VETgirl online veterinary CE podcast, we interview Dr. Sheilah Robertson on the use of long-term use of NSAIDs in cats. She is one of several contributors to the recent open-access publication 2024 ISFM and AAFP Consensus Guidelines on the Long-Term Use of NSAIDs in Cats. Tune in to learn which NSAIDs are most commonly used in cats, what types of pain are responsive to NSAID therapy, and how we can better assess and treat pain in cats! Plus, find out what communication tips we must educate our pet owners on.

In the third episode of the NSAIDs saga, we focus on COX-2 inhibition! Did the hopes and dreams of selective COX-2 inhibition pan out? What can the rise and fall of VIOXX teach us about physiology? Intro 0:11 Recap of part 1 & 2 0:28 In this episode 1:44 Cyclooxygenase 2 (COX-2) and the rat experiment 3:12 What do we know about the prostaglandins? And what about COX-2 7:54 What does prostacyclin do? 10:33 The first COX-2 inhibitor: VIOXX 10:56 What is COX-2 doing?: Pfizer and Merck 12:15 Two more NSAID studies: colon cancer, Alzheimer's disease and COX-2 inhibitors 18:41 VIOXX: Why is myocardial infarction risk occurring? 22:34 Animal models and the Goldilocks theory of thromboxane and prostacyclin 23:49 PRECISION trial 30:25 Rheum + Boards 37:14  Thanks for listening 37:32 We'd love to hear from you! Send your comments/questions to Dr. Brown at rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum. References: Anderson GD, et al. J Clin Invest. 1996;doi:10.1172/JCI118717. Funk CD, et al. J Cardiovasc Pharmacol. 2007;doi:10.1097/FJC.0b013e318157f72d. Hennan JK, et al. Circulation. 2001;doi:10.1161/hc3301.092790. Krumholz HM, et al. BMJ. 2007;doi:10.1136/bmj.39024.487720.68. Nissen SE, et al. N Engl J Med. 2016;doi:10.1056/NEJMoa1611593. Disclosures: Brown reports no relevant financial disclosures.

Are you having a BRAT summer, because we sure are here on the NAVAS podcast! By BRAT, we mean Best Remedies for Analgesic Therapy! We're excited to continue our discussion on post-operative pain control for dogs and cats. If you haven't listened to part one of this conversation, please go back and listen before diving into this episode. We're going to finish up our conversation on surgical pain management by discussing the nuances of NSAID use in cats, confronting some controversial opinions on Gabapentin, rave about local anesthetic agents, and introduce some pharmacologic and non-pharmacological therapies to help tackle acute pain for our patients. Joining us again is Dr. Melina Zimmerman, veterinary anesthesiologist and owner of The Doggy Gym, where she provides pain management therapies for all kinds of species. Pain management is so much more than “set and forget”, and we hope to convince you of that right here on the NAVAS podcast.References are made to the following resources in the episode:Our previous short episode on Nocita with Dr. Tammy Grubb.2022 ISFM consensus guidelines on managing acute pain in cats that has been endorsed by the American Association of Feline Practitioners (AAFP): 2024 ISFM & AAPF consensus guidelines on long-term NSAID use in catsBuprenorphine as an additive agent with bupivacaine for certain dental blocks in dogsIf you like what you hear, we have a couple of favors to ask of you:Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content. Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! Sign up today!Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at education@mynavas.org.All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

In 2023, the opioid crisis claimed over 81,000 lives -- a staggering number, yet many of these deaths could have been prevented. While prescription opioids can be essential for managing pain, they come with significant risks that are often overlooked. In this episode, we dive deep into the hidden dangers of opioid prescriptions and explore the crucial questions you should ask before accepting these medications. Ellen Eaton, MD, a leading expert in opioid treatment from the University of Alabama Birmingham, joins us to discuss the real risks of misuse, the warning signs to watch for, and the steps you can take to protect yourself and your loved ones. From understanding the potential side effects, to navigating the road to recovery, this conversation sheds light on the opioid epidemic and the urgent need for prevention and education. UAB Medicine Addiction Recovery Services Transcript Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered Podcast. I'm Dr Neha Pathak, WebMD's, Chief Physician Editor for Health and Lifestyle Medicine. Many of us have talked to our children and loved ones about how to respond if they're offered an opioid or some other unknown substance, even if it's candy at a party, fearing the dangers of opioids and overdose. But how many of us think about the risks in these situations? Our child is injured playing sports and we're given a 14-day prescription for an opioid containing medication. We're at the dentist's office and we're given a prescription for an opioid for a short course after a procedure. New data shows that there were over 81,000 opioid deaths in 2023. So, what can we do to keep our loved ones safe? Today we'll talk about the best strategies to prevent opioid misuse and abuse in the first place. Even if it starts with a prescription from our doctor's office. The journey to addiction and to recovery and what we need to know about preventing opioid deaths.   But first, let me introduce my guest, Dr Ellen Eaton. Dr Eaton is an associate professor at the Department of Medicine at the University of Alabama at Birmingham. She's the director of the office based opioid treatment clinic at the UAB 1917 clinic, and a member of the leadership team of the UAB Center for Addiction and Pain Prevention and Intervention. Welcome to the WebMD Health Discovered podcast, Dr Eaton. Ellen Eaton, MD: Thank you so much for having me. Pathak: I'd love to just start by asking you about your own personal health discovery. So, what was your aha moment that led you to the work that you're doing with opioid treatment, management, and addiction and pain prevention interventions? Eaton: Yeah, I have an interesting story as an infectious diseases physician who is primarily working on substance use treatment and prevention. I had the honor of being a fellow with the National Academy of Medicine, really a health policy fellowship. And as an infectious disease physician, I was invited to a working group around infectious consequences of the opioid epidemic. And that was in 2017. It was a tremendous opportunity to go to D.C. and work with thought leaders in the field, other physician scientists, infectious diseases doctors, and those experiences and treatment models that I was hearing about in D.C. were not happening in my home institution at UAB. There were addiction medicine physicians, but we hadn't integrated care. We were not doing syndemic care where you're treating the infection, preventing Hep C, and you're treating their substance use disorder. So that opportunity in 2017 inspired me to come home to UAB, create a clinic here that is for our patients living with HIV who have opioid use disorder, and from there, we've really expanded services broadly for substance use and infectious diseases. So really grateful for the National Academy and that opportunity. That really was a launch pad for my career. Pathak: I would love to talk about what you've seen as the entry point for a lot of people when it comes to opioids and that progression to addiction, potentially overdose. What does that look like for many of the people that you see? Eaton: Because of the care I provide, I am seeing patients who are living with substance use disorder, but I always start when I meet them with really open-ended questions like tell me about your first exposure to opioids. Tell me when you began using them for medical reasons or recreationally. And what I hear over and over again is that many of our patients are starting to experiment or use from a prescriber for a medical condition in their teens or early twenties. And that is often a trusted medical provider. It may be an urgent care physician for a musculoskeletal injury, for a teenager on the athletic field who was injured. It may be a woman who just delivered a baby, a very healthy, common touch point, where there may have been a tear or maybe some residual pain.   Another common touch point is a dentist treating you for a dental infection. And so, I hear these types of anecdotes over and over from my patients, and often it is a trusted physician, so they don't feel like this is a scary medication. They may be given a 14-day supply of opioids, not realizing that can lead to physical dependency and opioid misuse in the future. And often don't ask questions about what to look for, warning signs, and certainly as young people, I haven't ever heard that their caregiver expressed concerns. I think more often the patient has a prolonged course seeking opioids for various conditions, becomes dependent, is seeking them more and more, and often caregivers or family members don't get involved until they are pretty far down the continuum of opioid use disorder. So, those are the stories I hear when I meet patients and ask about their journey. Pathak: What are some of the questions we should ask before we even accept that prescription? Eaton: This is a really important question at that prevention touch point, that we often miss. I think asking your provider do you really need oxycodone. Could you start with something like an NSAID or a Tylenol. Asking your provider to be very explicit. When my pain hits a seven out of 10, when my pain hits an eight or nine out of 10, when do I need to take this opioid as opposed to some other opioids sparing pain modulators? And then number of days. So not just at what point today, but also tomorrow, the next day, what pain should I expect, and I think setting the expectation you will have some pain. This is a challenge that many of us that see patients in a primary care setting have to remind patients, you will have some pain. That is normal. That is healthy. That means your nerves are telling you they're giving you feedback on what's going on after your leg fracture. And I think unfortunately opioids have been normalized as safe, in many cases they can be, but in many cases they are not.   I also see amongst families where an individual will tell me, “Oh, well, I got a Tramadol from grandma, or I had some opioids leftover from that time that I had a surgery and so I took that for some other condition,” comparing them to medications like chemotherapy, which also have risks. You would never hear a patient self-medicating, sharing with friends and loved ones. But I think because opioids became so ubiquitous, in past decades, entire families, kind of normalize them. They feel comfortable sharing them, taking others. And that type of culture leads to a culture where young people feel comfortable experimenting. They take pills at parties, they take pills from friends and, they purchase them off social media, like TikTok for example, because they do not appreciate the adverse outcomes that can be associated with these types of medications. Pathak: So, tell us about this slippery slope. What is it that happens to us when we take these medications unnecessarily? Eaton: Often one of the biggest teaching points that I make with trainees in my clinic, when is someone experimenting and when does it become a use disorder? And in my clinic, it's usually pretty clear and that includes negative consequences. So, taking opioids and falling asleep, nodding out, overdosing, right? Those patients have gone from opioid misuse to use disorder. So having negative consequences, becoming physically dependent. We do see that needing to take more and more to prevent withdrawals, which with opioids, unlike some other substances, you can pretty quickly become physically dependent. And then you need to continue to opioids just to not feel sick, to not have the flu-like symptoms. So, becoming physically dependent, having to take more and more, increasing your dose to get the same desired effect. Those are the things that I see most commonly in clinic. With opioids and certainly the very potent non-medical opioids we're seeing now, heroin, fentanyl, we don't see people who just dabble here and there at a party, at a wedding.   Now the other substances that I see pretty routinely used in my clinic with or without opioid use disorder, stimulant use disorder, marijuana use disorder. Alcohol use. I do have to ask more questions and certainly there are validated screening tools out there that physicians and clinicians can use to determine very objectively. Did they just drink too much at that wedding two months ago and it was a problem because they got in a fight or had a DUI? Or is this a pattern of use that meets criteria for alcohol use disorder?   So, it is important to ask those questions and know, but I would say really the negative consequences, the physical dependency, escalating use, those are things to look for in your patients. As a caregiver or a parent, those are things to look for as well because we are really in a position to identify these before our loved ones have escalated their use. Pathak: And then what do you do? So, you notice some of these types of red flags. What is the intervention that you should make as a parent or a loved one or a caregiver? Eaton: I think starting with a primary care provider is always the best step. And most of us do use these objective screening tools. There are several you can find. My clinic uses an assist. These are validated tools that have been tested on many patients, not physicians, not PhD scientists, that have been tested on patients to make sure that they are asking the right questions to get to the true use behaviors and patterns. And I would go from there with your primary care provider.   I think if you as a parent or loved one are even asking yourself, is it time to go? It's time to go. I think too many of us wait until there are very obvious motor vehicle accidents, overdoses. And I think most parents that I encounter in a clinical setting knew there were issues much longer before they sought help.   And this gets to your question around stigma, shame that a lot of families do not want associated with their loved one or their family. And so, they wait until there are really negative consequences. Ideally, we'd be intervening much sooner. Pathak: I'd love to talk a little bit and dig into what you just said about stigma and shame and some of the words we use when we talk about having a problem, quote unquote, with opioids, or becoming addicted or physically dependent. In that recovery phase, oftentimes we'll talk about someone becoming sober or sobriety from some of these medications. Can you talk a little bit about the terms that you use and what best helps uplift your patients? Eaton: This is a really nuanced area, and it does take some retraining of us as clinicians who have been in practice for a while. When I went through medical school, you were either 100 percent abstinent or not. We weren't taught that there was this whole middle ground of harm reduction, and I think as physicians, once we get some additional education on this, we realize that our words really matter. We can be much more supportive of our patients because this is a journey and much like diabetes or hypertension, your patient may have chapters where they aren't in care. Their chronic disease, substance use to chronic disease, is unmanaged.   But unlike diabetes or hypertension, where we just counsel them and support them and bring them in maybe more frequently to check in, have them bring their spouse to help with the pill bottles and set their phone alarms so they don't forget. Unlike those medical conditions, this chronic brain disease of substance use, we treat patients unintentionally as if they have failed. They have failed our clinics. They have failed the treatment. We treat them with judgment and shame. And there are a lot of complex routes for that that I am not an expert in. But what I tell my colleagues and my trainees is that we need to know and our patients need to know that they have not failed us. They are not a failure. They are living with a chronic disease, just like diabetes or hypertension. And just like diabetes or hypertension, if they fall out of care, if they stop taking their medications, we allow them to come back when they're ready to reengage. Just like my patients with HIV, right? So, using words are often the first interaction that we have with our patients. I even say when I get to meet them, “tell me about your journey. Have you ever been in recovery before?” rather than tell me about your addiction. “Have you ever been abstinent?” Have you ever been sober? Did you fall off the wagon? These are all terms that have very negative connotations and really reinforce a lot of the stigma that our patients already feel. My patients come with a lot of stigma to clinic. I have to remind them not to use stigmatizing words to describe themselves. They'll say things like, “I've really been an addict for 20 years.” And I have to say, “you've been a survivor for 20 years. You've been a survivor.” Or, you know, I'm the black sheep of my family. And I remind them. Actually, you have a chronic disease, and didn't you tell me your uncle has the same brain disease it runs in your family? Just reminding them much like the diabetes example again, this is a chronic disease. Those are some of the strategies I use to be really person centered and inclusive. And I do use the survivor language a lot. If they're using opioids in 2024, they are a survivor because we know the substance is out there. I do try to use a lot of empowering language as well. Pathak: I come at a lot of this from the primary care lens. I'm a primary care physician and prevention is the key for what we're always trying to do before we get to treatment and management. If we're talking about red flags or the types of questions we should be asking before we even prescribe these the first time, is it asking about family history? Should our patients be thinking about that? Like, oh, you know, Uncle Jim has had a problem with opioids in the past. That's probably not a medication we want to start in our child. What are some of the other types of questions we can be asking before we even think about that very first prescription or letting your child know that this is something that you need to be thinking about if you're at a party and someone offers you something because this is our family history. What are some of the other things you ask about?   Eaton: Family history is really important. Past experience with opioids. And if you have a patient who is in recovery, many of them will say, I know I have to have my hip replaced. Please do everything you can. Give me blocks. They want to avoid opioids. So, asking about any experience with opioids, how that went.   I would also ask about social support. You know, remind me where you're living these days. Oh, you're in an apartment with your niece. Do you have a safe place to store your medications? Tell me about that. Where do you store your medications? This comes up a lot with our unhoused population, that they are frequently having to move. Their medications are often stolen. That doesn't mean that they don't meet criteria for opioids. It may just mean you need to be more thoughtful. Do you need to go to a boarding care or shelter while we get through this period where you're recovering from your injury and you need opioids to be kept in a locked box? I think those are most of them. And then just appreciating that things like a history of trauma and social determinants of health are really going to put our patients at risk. And a lot of the young people that I see are 30 and 40 year olds who started experimenting with substances in their teens and 20s were in these multi-generational households where mom had substance use. Grandma had substance use. There were always pills around.   So, if you are seeing a patient who has a lack of social structure, living with other people with substance use, without a lot of accountability boundaries, without close follow up with a physician, that may be someone you want to consider alternatives or, you know, give them a three-day supply post op and bring them back. Right? Clinics are so full. We may not have that structure or care model in place, but that's ideal. Giving a short course. Reassess. Maybe it's time to transition something else.   Pathak: Great. Can you help us understand what exactly an overdose is? What does it look like? And what are some of the strategies like naloxone that we should be aware of? Eaton: Yeah. So right now, we're seeing the vast majority of overdoses have opioids as a contributing substance. So many of our decedents who pass away and have toxicology results have multiple substances, including stimulants. But currently, fentanyl is contaminating so many types of street drugs, whether they're a counterfeit, benzodiazepine, or a counterfeit Vicodin, or cocaine.   So, the vast majority of overdoses we're seeing right now, are opioid related, and that usually involves people looking sedated, stuporous, failure to respond to verbal stimuli, tactile stimuli. And in the current setting where we're seeing so many overdoses, I think you should always think opioids first when you're seeing someone like that. It is important to approach them, call their name, shake them if they don't respond. That's when you're going to call 9-1-1 and be looking for naloxone.   I have some in my backpack. I travel on airplanes with naloxone. And my kids who are elementary age know about naloxone. I haven't gotten to the point of educating them. But because these events are more common than cardiac arrest in many, many communities, we're training our Boy Scouts how to do CPR, but we're not necessarily training our Boy Scouts how to do naloxone for overdose reversal. But we should.   These are happening in schools. If you have a young person in your home, if you have a teenager in your home, you should have naloxone, and your teenager should as well and be trained to use. It doesn't mean your teenager is using or experimenting. It just means the people in places that young person is around have a higher likelihood of overdose than a cardiac arrest in many settings. Right? I know a lot of schools. My community schools are getting naloxone because they do appreciate that children are experiencing at school. They've had some adverse outcomes in my state on school property.   I would encourage anyone who is living with young people or older people who have access to opioids, even prescription opioids, to have naloxone. And then obviously if you know your loved one has opioid use disorder, you and they and anyone who is a caregiver for them should have naloxone on their person. Truly. So that's pretty much all of us, right? And whenever I talk to the rotary, I've talked to schools, I talked to clinicians. There are very few people who don't need to know about naloxone in the current day and age. And think of compared to something like an AED or CPR. You know, we're really good about these less stigmatized acute medical events, right?   We feel very comfortable training our Boy Scouts on how to do this, and we feel very comfortable putting an AED on our walking trails and at our gyms. Because of the stigma around substance use, we do not have naloxone in many of those community spaces, and we have not trained our community to respond to overdose in the same way we have cardiac events. Pathak: What would be part of your counseling in a Boy Scout troop or Girl Scout troop or at school to share that part of the information? How do you use something like a naloxone? What are the signs that you're looking for?   Eaton: I think this is a great topic for Boy Scout and Girl Scout troops and for health education courses for middle school. By talking about it, we're normalizing it. And based on the prevalence of substance use, we should all be aware of the signs or symptoms. So that is very appropriate. There are developmentally appropriate ways to talk about this, even to elementary students. I think sharing the statistics on youth who start experimenting, the average age, the prevalence in communities, the types of places where they may be exposed to opioids that are non-medical, the signs or symptoms of overdose, which we discussed, and the fact that there is a safe, over-the-counter reversal. Naloxone that they can and should carry as a good community citizen and community helper.   I know this will be stigmatized in some areas, and some parents will not feel comfortable with that. But I think the more that we have partnerships between pediatricians, public health officers, and schools and coaches, these types of individuals should really feel comfortable talking about this. It is nothing to stigmatize or shame or your kids aren't going to come to you.   What we want is we want these kids looking out for their friends and their parents. We want this to be something we talk about, and we go to a trusted adult when we have concerns. And that's what it will take as we're speaking to prevention. It will take a village of informed adults, trusted individuals. Who our youth can go to early when someone is just starting to experiment. When your friend just brought pills to a party for the first time. Early intervention, right? So, I think the Boy Scout example is a perfect one, but thinking all the touch points for our young people, churches, the faith-based community. And we recently did a pop up with an AME church here in the deep South. Who wanted to have a pop up. It was myself and a community agency that I work with called the Addiction Prevention Coalition. They do great work. I'm delighted that they've included me, and we passed out naloxone and we talked to these church members, many of whom were elderly. They were grandparents. They're worried about their grandkids. They're worried about what they're seeing in the news. They're worried that these kids are going out partying and they know that there are substances involved. So, another great touch point, just thinking across the age continuum, all the people who are part of communities who can be on the prevention arm of substance use. Pathak: That's really helpful and really interesting. So, we've talked a little bit about prevention, overdose prevention. We've talked about substance misuse and what that can look like. What does the process of achieving and maintaining recovery look like? When someone comes to your clinic, because that's really the goal of their treatment, how do you get started? Eaton: So just thinking about the term recovery, we use to describe someone who has reached a point where they're not using any non-medical substances, but it's important that we have each patient define that for themselves. I have many patients who are in recovery from alcohol and opioids. They cannot give up cigarettes and they're not ready to, right? I would never tell them you're not there yet. But I congratulate them on every step, and I remind them you've been in recovery from opioid use for 10 years. You've been in recovery from alcohol use for five years. You don't want to talk about tobacco today. That's fine. Look how far you've come.   And that is part of just supporting them in their journey and encouraging them. There are some people who are going to return to use. I never say fall off the wagon. I never say, you know, other stigmatizing terms. Return to use. There are some of my patients, specifically with opioid use disorder, common triggers, a breakup, a job loss, housing loss, death in the family. I do see patients return to use.   It's less common when they have been on a stable medication for opioid use disorder like buprenorphine and they are engaged in medical care. They have some counseling or group that they can go to for support and accountability, but it still happens. And then once we get them back into our clinic and we initiate the treatment again, and we follow them very, very closely in that very fragile time, you're back in care. Let's start you back on buprenorphine, for example. Let's check in with you in a week. And I have a peer counselor in my clinic who has lived experience with substance use. She's the perfect person. She's been there. She sees them very frequently over that period until we can get them back into recovery. For opioid use disorder, it is pretty clear from their behaviors. It is so physically addictive. It is so disruptive to relationships that I have very few people who can dabble with opioids. Because usually once they return, they are back in active use, is the term we use.   Pathak: And as we close out our episode, I'd love to invite you to share some bite sized action items to help create change in our lives if we are caring for a loved one, a child who may be experiencing some of the symptoms that you described.   Eaton: Absolutely. I think thinking about their survival analogy can be very encouraging and not overwhelming. Just do the next step. I think many of us want to fix our loved one. We may want to fix our child, but what is the next step? The next step may just be getting your loved one to a doctor's appointment, and that's a win. They showed up, right? Then the next step may be getting them to commit to like goals. It's not accomplishing the goals. It's just having them identify what matters to them. You know, so do these baby steps make recovery seem much less overwhelming if recovery is the goal? But I think just viewing caregiving and living with substance use as survival. And being kind to yourself, being kind to your loved ones who's living with this chronic medical condition and taking things one step at a time. Pathak: Thank you so much for being with us today. Eaton: My pleasure. Thanks for having me. Pathak: We've talked with Dr Ellen Eaton today about prevention. How do you even prevent that first use of opioid if it's not necessary? And we've talked about the journey of addiction to recovery. To find out more information about Dr Eaton, we'll have information about her and her clinic in our show notes. But you can check out the Center for Addiction and Pain Prevention page. And again, we'll have that link in our show notes. Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at webmdpodcast@webmd.net.   This is Dr Neha Pathak for the WebMD Health Discovered podcast. 

On this episode of the Real Life Pharmacology podcast, I continue my coverage with the Top 200 Drugs Podcast. Here's the list of medications we will cover. Lorazepam (Ativan) is a benzodiazepine well known for its anxiolytic and anti-seizure properties. Phenazopyridine (Pyridium) is a urinary analgesic that can change the color of the urine to a reddish/orange color as one of its adverse effects. Hydroxychloroquine (Plaquenil) is a DMARD used in rheumatoid arthritis and Lupus. One highly testable and unique nugget to remember is that it can cause retinopathy. Lidocaine patch (Lidoderm) is used topically to help with various types of pain including neuropathy and postherpetic neuralgia. Diclofenac (Cataflam) is an NSAID used as an analgesic and anti-inflammatory. It can increase the risk of GI bleed, edema, renal failure, and thrombosis.

Did you know the over the counter pain killers like Advil, Naproxen and Asprin are literally destroying your gut one layer at a time? Not only that, but they can even affect your brain, leading to leaks in the blood brain barrier, creating cognitive issues and mental health concerns. In thos short episode, we're exposing these extremely dangerous drugs for what they really are. TOPICS DISCUSSED: How NSAIDS like Ibuprofen work The true dangers of them, and how they destroy your gut and your brain What diseases they are well known and documented to create Who should avoid them Alternative options for pain relief   Join the Community: Click here to learn more about how to reverse IBD inside our community!   Contact us: reversablepod.com/tips    Leave us a Review: https://www.reversablepod.com/review   SOCIAL MEDIA: Instagram  Facebook  YouTube  

Topic: New AAFP/ISFM guidelines for chronic NSAID use in cats Part 2Guest: Dr. Kelly StDenis, renowned veterinarianSummary:Discusses signs of chronic pain in cats, often mistaken for normal aging.Explains what NSAIDs are and how they can help manage feline pain.Dives into the recently released AAFP/ISFM guidelines for the safe and effective use of chronic NSAIDs in cats.Provides information for cat owners concerned about their pet's chronic pain.

In the podcast with Dr. Kelly StDenis, she delves into the new guidelines from AAFP regarding the chronic use of NSAIDs in cats. Dr. StDenis discusses the importance of these guidelines in managing feline pain and the potential risks associated with long-term NSAID usage in cats. She provides insights into alternative pain management strategies and emphasizes the need for careful monitoring when using NSAIDs in feline patients.

Topics: The important role topical patches play in prescription pain management   Key Messages:   Pharmacists play a vital role in supporting patients seeking acute, non-opioid pain relief, and their proactive engagement can ensure personalized and effective pain management solutions.  Clinically proven, medicated patches deliver pain relief directly to the site of pain where it is needed most.   One effective prescription-strength option to consider is YARAL Pharma's Diclofenac Epolamine Topical Patch 1.3%.  This option may be covered by the patient's insurance; therefore, patients can access prescription-strength relief while minimizing out-of-pocket costs compared to over-the-counter alternatives.  Product Attributes:   Diclofenac epolamine topical system 1.3%: a nonsteroidal anti-inflammatory drug (NSAID) indicated for the topical treatment of acute pain due to minor strains, sprains, and contusions in adults and pediatric patients 6 years and older.   Accessible and Affordable  The Authorized Generic of the Flector® (diclofenac epolamine) topical system 1.3%. Patients receive a product identical to the brand, at an affordable price.  Targeted Topical Acute Pain Relief  Low systemic exposure. For a wide variety of patients and pain sites  Fast-acting  Significant pain relief within 4 hours after first application. Sustained pain reduction for 7 days with twice-a-day application  Long Lasting  Delivers NSAID power for 12 hours    Lidocaine Patch 5%: Treatment to help relieve pain associated with post-herpetic neuralgia, a complication from shingles, causing a burning painful skin rash.  Fast Acting  Medicated  Numbing Prescription Relief  Odor Free    Guardrails:    While both Lidocaine Patch 5% and Diclofenac Epolamine Topical System 1.3% may be used for pain, the approved indications differ, therefore we cannot say that diclofenac can be used as an alternative to or substitute for lidocaine, or that Lidocaine Patch 5% (FDA approved only for shingles complications) can be used as an alternative to or substitute for other FDA-approved indications for lidocaine pain-relief products.  We will need to stay on label for each product regarding indication, ISI, etc. and cannot make claims specific to YARAL's products.  Diclofenac Epolamine Topical System 1.3%  Diclofenac Epolamine Topical System 1.3% - YARAL Pharma Inc.  diclofenac-PI-8-29-23.pdf (yaralpharma.com)    Lidocaine Patch 5%  Lidocaine Patch 5% - YARAL Pharma Inc.  PI_Lidocaine-13851.pdf (yaralpharma.com)  Ensure products are not positioned for chronic pain.  We cannot make comparisons that YARAL's products can be used as an alternative to opioids because the indications for use and safety profiles are different, and there is no head-to-head study at this time directly comparing the safety/efficacy of YARAL's products to opioids for YARAL's FDA-approved uses.  We cannot make comparative claims to OTC pain relief products or suggest alternatives because the safety profiles differ and the approved indications for use may differ across various products.  Must focus only on monadic (non-comparative) claims for YARAL's products.  Must include fair balance with safety information, including the «major statement« of risks for products discussed.    Questions/Topics:  Introduction:  Can you share a bit about your background and experience in pain management as a pharmacist?  How did you become interested in non-opioid pain management?  Can you speak about the evolution of pain management?   Movement toward topical pain treatment options  How topical patches play a role in pain management  Topical Pain Management:  Could you explain why topical delivery of pain medications is an important option for patients/physicians to consider?  Touch lightly on available options (OTC, prescription)  Make expressly clear that OTCs and Rx drugs are not interchangeable, as the approved uses and the safety profiles differ significantly. Patients must always talk to their doctor about their pain management options.  Identify patient populations most likely to benefit  Long-term care community (reduction in frequency of administration)  What role can pharmacists play in educating patients about topical pain management?  What makes Diclofenac Epolamine Topical Patch 1.3% an option for acute pain relief for minor strains and sprains in adults and children over 6?   How do YARAL Pharma's topical patches for acute pain management benefit the patient's experience?  As an example, let us take YARAL Pharma's product Diclofenac Epolamine Topical System 1.3% - a nonsteroidal anti-inflammatory drug (NSAID) indicated for the topical treatment of acute pain due to minor strains, sprains, and contusions in adults and pediatric patients 6 years and older.   As an authorized generic of IBSA USA's Flector, Diclofenac Epolamine Topical System 1.3% offers patients a non-opioid, topical treatment backed by more than 30 years of clinical experience.   This prescription, medicated patch delivers pain relief directly to the site of pain where it is needed most.   The prescription patches are mess-free, offer localized absorption of active ingredients, and are not habit-forming.  These topical patches provide controlled release of medication, maintaining optimal concentration and reducing the need for frequent administration.  Patches for topical use can release a medicinal product in a controlled manner over periods of up to 12 hours, offering many advantages over oral administration.   Current State of the Topical Patch Market:   What do you feel is driving the explosive growth in the use of topical pain management options?  Future Developments:  Are there any upcoming developments or innovations in pain management that listeners should be aware of?    Major Statements   Diclofenac Epolamine Topical System 1.3%    Diclofenac Epolamine Topical System 1.3% is a nonsteroidal anti-inflammatory drug (NSAID) used for treating acute pain from minor strains, sprains, and bruises in adults and children aged 6 and older.     Serious side effects may include increased risk of cardiovascular and gastrointestinal (GI) events. NSAIDs can raise the risk of heart attack, stroke, gastrointestinal bleeding, ulceration, and perforation of the stomach and intestines, which can be fatal. The risk for serious cardiovascular events may occur early in treatment and may increase with duration of use. Elderly patients and those with a history of peptic ulcer disease or GI bleeding are at higher risk for serious GI events.    Do not use in patients who are allergic to diclofenac or any of its ingredients, or have a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Do not use in the setting of coronary artery bypass graft surgery. Avoid use on broken skin. Discontinue immediately if signs of hypersensitivity occur.      Patients should be informed about the warning signs and symptoms of liver problems. Discontinue use if abnormal liver tests persist or worsen or if signs of liver disease develop. Avoid using Diclofenac Epolamine Topical System 1.3% in patients with severe heart failure unless the benefits are expected to outweigh the risks.    The most common side effects include itching, nausea, and headache. Patients should stop use, and consult their doctor, at the first sign of skin rash or other signs of sensitivity.    Patients should ask their doctor if Diclofenac Epolamine Topical System 1.3% is right for them. For more information and Full Prescribing Information including Boxed Warning and Important Safety Information, visit www.yaralpharma.com.    Lidocaine Patch 5%    Lidocaine Patch 5% is indicated for relief of pain associated with post-herpetic neuralgia, a common complication of shingles. It should only be applied to intact skin.    Lidocaine patch 5% is contraindicated in patients with a known history of sensitivity to local anesthetics of the amide type, or to any other component of the product.     Cases of methemoglobinemia, a rare blood disorder that affects how red blood cells deliver oxygen throughout the body, have been reported in association with local anesthetic use. It is important for patients to store and dispose of Lidocaine Patch 5% out of the reach of children, pets and others. Applying Lidocaine Patch 5% to larger areas or for longer than the recommended wearing time could result in increased absorption of lidocaine and high blood concentrations, leading to serious adverse effects. Patients should avoid contact with water, such as bathing, swimming, or showering.    Reactions may occur at the site of application. These reactions are generally mild and resolve within a few minutes to hours. Allergic and severe allergic reactions associated with lidocaine, although rare, can occur.     Patients with severe hepatic disease are at greater risk of developing toxic blood concentrations of lidocaine because of their inability to metabolize lidocaine normally. Advise patients to discontinue use immediately and seek immediate medical attention if the following signs or symptoms occur pale, gray, or blue-colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue.       Patients should ask their doctor if Lidocaine Patch 5% is right for them. For more information, including Full Prescribing Information and Important Safety Information, visit www.yaralpharma.co  

View all show notes and timestamps on the KoopCast website.Episode overview: In this first of four episodes on drugs in ultramarathon running, Eve Pannone joins the podcast to discuss NSAIDs in endurance sport. The widespread use of NSAIDs like ibuprofen (Advil) and naproxen (Aleve) in ultramarathon running is alarming due to the health risks associated with kidney disease, electrolyte imbalance, and other factors. NSAIDs exacerbate some of the stresses of endurance sport to dangerous levels and have no proven performance benefit, yet changing public perception is a challenge. In this episode we break down why NSAIDs are harmful, what we can do as a community to protect athlete health, and viable alternatives to painkillers. If you enjoy this episode, be sure to check out the next three episodes in this mini-series.Episode highlights:(6:15) Defining NSAIDs: demystifying pain relievers, Non-Steroidal Anti-Inflammatory Drugs, pain relievers that work by reducing inflammation, ibuprofen (Advil), naproxen (Aleve), and others, controversy around Aspirin, Tylenol is not an NSAID(10:28) Why NSAIDs are harmful: NSAIDs do not improve performance, risks and side effects, acute kidney injury, electrolyte imbalances, no positive and all negative effects(40:48) Alternatives to NSAIDs: caffeine, paracetamol (Tylenol) is low risk but medical interventions to reduce pain are generally a bad idea, accept that ultrarunning is going to hurtAdditional resources:What is known about the health effects of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultra-endurance running: a scoping reviewKoop's article on Ironman's Partnership with AlleveSUBSCRIBE to Research Essentials for UltrarunningBuy Training Essentials for Ultrarunning on Amazon or Audible.Information on coaching-www.trainright.comKoop's Social MediaTwitter/Instagram- @jasonkoop

On this podcast episode, I discuss some of the most common antihypertensive drug interactions you need to know. One major interaction I discuss is the trifecta of a diuretic, an ACE or ARB, and an NSAID. This combination significantly increases the risk for acute renal failure. Nitrates aren't classically referred to as an antihypertensive but they can definitely cause some problems when combined with PDE5 Inhibitors. Lithium can interact with 3 blood pressure medication classes. ACEIs, ARBs, and diuretics can all increase the risk for lithium toxicity.