Podcasts about nsaid

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.

Alguna vez quizás hayas llegado a una carrera con molestias o, en mitad de ella, te ha aparecido un dolor. Quizás también hayas recurrido entonces a anti-inflamatorios, como Ibuprofeno, para así hacer frente a esos dolores y poder acometer tu carrera. No obstante, los anti-inflamatorios tienen algunos riesgos potenciales. Uno es que, al enmascarar el dolor, podemos estar agravando una lesión, lo que redundará en un tiempo de recuperación mayor. Por otro lado, una revisión de 30 estudios en participantes en carreras de ultra-distancia ha encontrado asociación entre el uso de Ibuprofeno y el daño renal agudo. En este episodio desarrollamos estas ideas y acabamos apelando al principio de precaución. Ésta es la revisión de estudios, por si quieres conocer los detalles: What is known about the health effects of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultraendurance running: a scoping review https://pubmed.ncbi.nlm.nih.gov/38318269/ --- Si te ha gustado, suscríbete, ponle un Like, comenta, comparte. Gracias ! Sígueme en https://www.instagram.com/correrporsenderos/ donde publico píldoras sobre trail running y deporte endurance a diario en Stories . Puedes mandarme un MD por ahí para plantear dudas o sugerencias. Suscríbete a mi canal YouTube para ver estas explicaciones con apoyo visual: https://www.youtube.com/@C0rrerP0rSender0s Puedes ver mis entrenamientos en Strava: https://www.strava.com/athletes/93325076 --- #running #trailrunning #endurancetraining #aines #antiinflamatorios #fisioterapia

Seminare: https://henningwilts.de/seminare   Kontaktdaten: Henning Wilts: https://henningwilts.de info@henningwilts.de https://www.instagram.com/henningwilts/ https://www.facebook.com/henning.wilts/ www.youtube.com/@HenningWiltsTierarzt https://www.linkedin.com/in/henning-wilts-376a8722b/ https://www.tiktok.com/@henningwilts     Bild: 3. Expertenbuch in Venedig mit Ernst Crameri von Christian Schlenker (Sir Richard Picture)  

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.

In this 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. A must know for cat owners.

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  

On this Episode 454 of Health Solutions, Shawn & Janet Needham R. Ph. discuss if medications are necessary to treat allergies, migraines, Rheumatoid Arthritis (Methotrexate), Biologics for cancer, NSAID and long-term use. 00:00 - Start 01:13 - Allergies & Medications 04:47 - Lifestyle Issues 09:15 - Nutrients, Sleep, & Hydration 13:00 - Listener Comment / Cat Dander 14:39 - Migraines & Medications 16:47 - Short Term Meds & Triggers 18:43 - Caffeine 20:36 - Rheumatoid Arthritis 23:44 - Autoimmune Disease 26:10 - Methotrexate 29:55 - Cancer 32:31 - Navigating Cancer 37:58 - NSAIDs 40:04 - Root Causes & Lifestyle Changes 45:02 - Listener Comment / Trigger Points 45:33 - Overuse Injuries 48:53 - Janet's Final Thoughts 49:53 - Closing Comments EP 454: Are Medications Necessary to Treat Allergies? with Shawn & Janet Needham R. Ph. ~ #allergies #seasonalallergies #medications #naturalmedicine #naturalremedy #natural #migraines #rheumatoidarthritis #cancer #nsaids #podcastshow #podcast #podcastguest #optimalhealth #healthfreedom #MedicalFreedom #medicaleducation #medicalcare #HealthCare #PriceTransparency #freemarket #Liberty #FitAfter50 #FitOver50 #fitover40 #fitafter40 #Boise #IdahoFalls #Tricities #SiouxFalls #Wenatchee #EducateAndEmpower #NeedhamHealthSolutions #TeamNeedham #ShawnNeedham #HealthSolutions #MosesLakeProfessionalPharmacy #MLRX #SickenedTheBook #ShawnNeedhamRPh #ThinkOutsideTheSystem #OptimalHealthMatters #ItsTime ~ *** #BenShapiro & #DaveRamsey Fans. Learn how to be in the driver's seat for your healthcare choices {not the system or doctors!}

Episode 167: Aspirin in PregnancyDr. Marquez explains the use of aspirin during pregnancy to prevent preeclampsia. Dr. Arreaza adds comments and questions and clarifies that aspirin is not used for the treatment of preeclampsia.Written by Verna Marquez, MD, and Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction to the topic: Pregnancy is a special time in a woman's life, and we want to make sure that both the mother and the baby are safe and healthy. 1. What is aspirin? Aspirin is one of the most ancient medications in history, it is known as acetyl-salicylic acid (ASA) and it belongs to the family of non-steroidal anti-inflammatory drugs (NSAID), and it is also an anti-platelet, among other properties that may be unknown. It is widely used for pain, fever, and inflammation, but due to adverse effects during viral illness (i.e. Reye Syndrome), it is used less frequently during viral infections. As we know, aspirin is widely used to treat myocardial infarction and ischemic stroke, and especially for secondary prevention. The use of aspirin for primary prevention of cardiovascular disease has become less popular, but we are going to leave that discussion for another episode because today we will talk about the use of aspirin in pregnancy!2. Why should we use aspirin in pregnancy?Low-dose aspirin in pregnancy is most commonly used to prevent or delay the onset of preeclampsia. Aspirin lowers the risk of preeclampsia by 10% and its consequences (such as growth restriction and preterm birth). Several organizations have agreed on the risk factors we will mention briefly. These organizations are ACOG (American College of Obstetricians and Gynecologists), USPSTF (US Preventive Services Task Force), and SMFM (Society for Maternal-Fetal Medicine).3. Who should we start on aspirin in pregnancy? Aspirin is not for every pregnant patient, for example, a healthy nulliparous or any patient who had an uneventful, full-term delivery previously, is considered low risk and should NOT be started on aspirin because there is no benefit in preventing any condition. Low-dose aspirin is recommended for women who have at least a high-risk factor because the incidence of preeclampsia is about 8% in these patients. The risk factors are:•Previous pregnancy with preeclampsia (especially early onset and with an adverse outcome)•Type 1 or 2 diabetes mellitus.•Chronic hypertension.•Multifetal gestation.•Kidney disease.•Autoimmune disease with potential vascular complications (antiphospholipid syndrome, systemic lupus erythematosus).Your patient only needs 1 high-risk factor to be put on aspirin in pregnancy. 4. What are the moderate risk factors?A patient needs to have more than 1 moderate risk factor to meet the criteria for prenatal aspirin.•Nulliparity.•Obesity (BMI >30).•Family history of preeclampsia in mother or sister.•Age ≥35 years.•Sociodemographic characteristics (Black persons, lower income level [recognizing that these are not biological factors]).•Personal risk factors (for example, previous pregnancy with low birth weight or small for gestational age newborn, previous adverse pregnancy outcome [such as stillbirth], interval >10 years between pregnancies). However, low-dose ASA prophylaxis is not recommended solely for the indication of prior unexplained stillbirth in the absence of risk factor for preeclampsia.•In vitro conception.USPSTF/ACOG may also suggest aspirin in selected patients with only one moderate risk factor, but it would require consultation with a specialist in obstetrics. 5. When should we start aspirin?After 12 weeks of gestation, ideally before 16-20 weeks of gestation. If a patient is more than 16 weeks pregnant, aspirin can be started but most of the benefit has been noted when initiated before 16 weeks because many of the abnormalities that cause preeclampsia are developed early in pregnancy. It is not recommended to start before 11 weeks.It is important to mention also that low-dose aspirin appears to have little or no benefit in patients who already have developed preeclampsia. Starting aspirin in preeclampsia can even cause damage such as bleeding in cases of thrombocytopenia. 6. What is the dose?The dose is between 75 to 162 mg daily. Conveniently, we have an 81 mg presentation in the United States, and it falls within the recommended range. It can be taken in the morning or at night, and adherence of >90% is associated with better prevention.7. When do we stop aspirin?Expert opinion recommends stopping aspirin at the time of delivery. 8. What are the contraindications to ASA use during pregnancy?Absolute contraindications to aspirin: -Patients with a history of ASA allergy (urticaria) or hypersensitivity to other salicylates are at risk of anaphylaxis and should not receive low-dose ASA. -Because of significant cross-sensitivity between ASA and other NSAIDs, low-dose ASA is also contraindicated with known HPS to NSAIDs. -Exposure to low-dose ASA in patients with nasal polyps may result in life-threatening bronchoconstriction and should be avoided.Relative contraindications are history of GI bleed, active peptic ulcer disease, other sources of GI or GU bleeding, and severe hepatic dysfunction.Aspirin is an excellent way to prevent preeclampsia in patients who are at high or moderate risk. Remember to think about the high-risk factors, and if your patient has only 1 positive, then aspirin needs to be started. Mainly, previous preeclampsia, diabetes, hypertension, multifetal gestation, and kidney or autoimmune disease. Look for moderate risk factors and start aspirin if the patient has 2 or more of those risk factors. _________________Conclusion: Now we conclude episode number 167, “Aspirin in Pregnancy.” Dr. Marquez explained that aspirin is started between 12-16 weeks of gestation to prevent preeclampsia in patients with at least 1 high-risk factor or patients with 2 or more moderate-risk factors. Dr. Arreaza also mentioned that aspirin is not for low-risk patients or for patients who already developed preeclampsia. As you know, preeclampsia can result in severe consequences for the fetus and the mother, but by preventing it, we can improve the chances of having a positive outcome in pregnancy. This week we thank Hector Arreaza and Verna Marquez. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:August, Phyllis and Arun Jeyabalan, Preeclampsia: Prevention. UpToDate, Last updated Feb 16, 2024. https://www.uptodate.com/contents/preeclampsia-prevention.Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Preventive Medication, September 28, 2021, United States Preventive Services Taskforce https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication.Royalty-free music used for this episode: Tropicality by Gushito, downloaded on July 29, 2023, from https://www.videvo.net/royalty-free-music/. 

Dr. Penner describes two primary factors of gut health to be absorption and barrier function or permeability. His lab's work on permeability is suggesting that intestinal regions really drive total gut permeability to a much greater extent than ruminal permeability in dairy cows. (7:06)Ms. Bertens is Dr. Penner's Ph.D. student and explains some new methodologies she developed for measuring gut permeability using chromium EDTA and cobalt EDTA. It's common to use an oral dose of chromium EDTA as a marker to measure total tract permeability. Claire's work, using cannulated cows, used a ruminal dose of chromium EDTA for total tract permeability and an abomasal dose of cobalt EDTA for post-ruminal permeability. Both of these markers are indigestible, non-metabolizable and have no transcellular transport mechanisms. Claire is working to publish the new method as a complete validation study has been completed. (9:15)While this method is currently limited to using cannulated animals, Greg and Claire could envision a less sophisticated and more applied on-farm technique to assess permeability. Until then, there are still a lot of management observations that can identify potential issues with gut permeability. The appearance of feces and the presence of mucin casts can both be indicative of gut issues. Certainly dry matter intake is a major influencer on gut health, and Claire also sees potential in new technologies like rumination collars or rumination ear tags. (13:47)Are there certain time points in a dairy cow's life when she is at risk for increased gut permeability? Dr. Penner describes research suggesting if weaning is implemented too abruptly, that really increases the risk for decreased barrier function of the gut. Erratic feed intake patterns resulting from withholding feed for any reason at any age can also increase the risk of leaky gut. For example, depressed intake during the transition phase, along with anything that drives a response through an underlying systemic inflammatory response, probably creates risky situations for leaky gut. Claire is currently running a study looking at the impacts of intramammary LPS infusion on gut function. Greg envisions that learning more about gut function could create a new philosophy for treating sick animals. In the past, only antimicrobials were used to treat mastitis, but now it's common to also treat with a NSAID for pain. Perhaps in the future, we will also provide treatment to accelerate the recovery of the gut to prevent secondary disorders. (16:15)How long does an off-feed event have to last to cause an issue in the gut? It seems a fairly acute time period is all that is needed. Most studies are trying to replicate what happens on-farm, for example during mastitis, heat stress or the transition period. Greg indicates that not only will permeability be impacted, but ruminal absorptive capacity can also decline rapidly in these conditions. In Claire's LPS challenge study, cows' rectal temperatures peak around six hours after the LPS infusion and usually resolve within 12 hours. But most cows do not eat for a solid 12 hours during the challenge, and they are slow to recover feed intake over the next few days. In cows that aren't sick but experience feed restriction in experimental protocols, they tend to overeat when they are allotted the full ration and this can lead to ruminal acidosis. (21:57)Increased incidences of liver abscesses in beef-on-dairy calves are being reported in the industry. Dr. Penner speculates that perhaps these calves are not always achieving adequate passive transfer, and may not be receiving high enough levels of milk replacer to support a more robust immune system. It may be the increased beef cattle genetics in the calves are putting an added requirement on growth or muscle development that may not be met by lower levels of milk replacer or even lower colostrum feeding levels. (34:40)In closing, providing cows with a consistent environment where they can meet their needs by their own behavior such as free access to feed when hungry and to a comfortable stall when it's time to rest. Cows reward consistency with health and production. Gut health in a commercial setting is a relevant issue and it might go undiagnosed or undetected. Research into where in the gut permeability is occurring will help define strategies to modulate response. While off-feed events for individual animals might be harder to recognize in a large dairy environment, new technology may allow for earlier diagnosis. (40:43)Please subscribe and share with your industry friends to bring more people to join us around the Real Science Exchange virtual pub table.  If you want one of our Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll get a shirt in the mail to you.

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

有了對EVE還有LOXONIN的基本知識，就很容易理解BUFFERIN系列了喔。其實日本這些解熱鎮痛的成藥邏輯都滿像的。BUFFERIN系列主成分就是阿斯匹靈，布洛芬還有普拿疼的組合。 EVE A系列止痛藥解說 https://linshibi.com/?p=45191 1.BUFFERIN系列多數的主成分是和EVE是一樣的，就是布洛芬（ibuprofen），這裏就不重複介紹了。 2.阿斯匹靈（Aspirin，正式名稱是乙醯水楊酸，acetylsalicylic acid）則可說是第一個上市的NSAID。1899年，德國拜耳以阿斯匹靈為商標，將本品銷售至全球。 3.NSAID可抑制環氧合酶-1（COX-1）及環氧合酶-2（COX-2），進而減少前列腺素和血栓素的合成。抑制COX-2會有解熱鎮痛、抗發炎的效果，但抑制主要在胃部的COX-1會容易導致腸胃道出血和潰瘍。這是他產生副作用的機制。 4.阿斯匹靈對COX-1的抑制作用比對COX-2更強，因此對疼痛的緩解效果不如布洛芬，卻更容易引發胃腸道出血。近年醫師們多半不會把阿斯匹靈使用於解熱鎮痛，一些其他的場合才會使用他。比方說低劑量用以預防心血管疾病等。 5.普拿疼（這是俗名，正式名稱是乙醯胺酚，Acetaminophen）是非常廣泛用於第一線解熱鎮痛的藥物。他不是NSAID，主要通過抑制分布在中樞神經系統的COX-2，屬於輕度止痛藥，並無明顯抗發炎活性。效果雖沒有NSAID強，但使用起來相對安全，較沒有傷腎傷胃的考慮。兒童和孕婦可以使用。 6.六種BUFFERIN的比較：主要有BUFFERIN A，BUFFERIN PREMIUM，BUFFERIN PREMIUM DX，BUFFERIN Light，BUFFERIN Luna i，BUFFERIN Luna J。 （除了BUFFERIN PREMIUM外，都不含鎮靜成分。其中三種有咖啡因成份） BUFFERIN A 經典款，一劑中含有阿斯匹靈660毫克，最多一日兩回。添加制酸劑Hydrotalcite 200毫克，這也是在台灣大家很常使用的胃藥（常見名稱為Nacid）。雖然加了胃藥，但絕不能說這個藥就不會傷胃了，他可是阿斯匹靈呀！中文官網上寫"不刺激胃部"，我個人無法同意。 BUFFERIN PREMIUM 針對嚴重頭痛。一劑中含有布洛芬130毫克，乙醯胺酚130毫克。添加了和EVE A同樣的兩個成分：Anhydrous Caffeine（無水咖啡因） 80毫克和Allylisopropylacetylurea（丙烯異丙乙酸尿） 60毫克（以上劑量和EVE A一樣）。因此他的注意事項就和EVE A一樣了，會有鎮靜效果所以服用後不建議駕駛車輛或操作機械，且也有可能有血小板減少的副作用。添加了乾燥氫氧化鋁凝膠70毫克，可保護胃黏膜。一天最高建議可服用到三次，這樣布洛芬用量390毫克還是不會超過EVE建議的一天400~450毫克。 且做成容易服用的小顆粒藥錠，藥錠表面有塗層，容易服用。 BUFFERIN PREMIUM DX 針對嚴重頭痛。一劑中含有布洛芬160毫克，乙醯胺酚160毫克，無水咖啡因50毫克。拿掉了丙烯異丙乙酸尿，因此不含鎮靜成份。前兩者劑量調高，咖啡因劑量調低。同樣添加了乾燥氫氧化鋁凝膠70毫克，可保護胃黏膜。此外還有採用獨家技術的「Quick Attack錠」，號稱吸收和作用可以比較快。一天最高建議可服用到三次，這樣布洛芬用量480毫克，會稍稍超過EVE建議的一天400~450毫克。 BUFFERIN Light 相比於BUFFERIN A阿斯匹靈減量的版本。一劑中含有阿斯匹靈440毫克，乾燥氫氧化鋁凝膠200毫克。後者劑量有調高。因此官網寫效果溫和，顧慮到身體的配方。但如果很擔心傷胃，我個人是建議直接選PREMIUM比較實際。 BUFFERIN Luna i 針對生理痛。一劑中含有布洛芬130毫克，乙醯胺酚130毫克，無水咖啡因 80毫克。其實成份和BUFFERIN PREMIUM一樣，只是拿掉了丙烯異丙乙酸尿，因此不含鎮靜成份。同樣添加了乾燥氫氧化鋁凝膠70毫克，可保護胃黏膜。 BUFFERIN Luna J 針對小學，國中高中生的疼痛和發燒，這就是普拿疼啦，一劑含乙醯胺酚100毫克。上面那些藥15歲以下都不建議服用。號稱是沒有水也能服用的咀嚼錠，會在口中溶解，有水果味。七歲以下不建議使用，每個年齡的使用劑量建議不同，請看清楚再服用。 其實另外還有兩種針對3~7歲乙醯胺酚劑量更低的，小兒用BUFFERIN咀嚼錠還有小兒用BUFFERIN CⅡ是水果口味容易服用的退燒止痛藥。 注意事項 ： 1.BUFFERIN PREMIUM因為有丙烯異丙乙酸尿這個EVE A也有的鎮靜成分，服用後請勿駕駛或進行機械類的操作。且有造成血小板低下的風險，所以有相關疾病的人不建議服用。 2.BUFFERIN各種產品的成分不太相同，如果對其中一種過敏，可能要詳細比對可能是對哪個成份過敏，還有是多嚴重的過敏形式，才能判斷是否還可以使用其他類型的解熱鎮痛藥。 3.老話一句，身體如果有任何地方長期疼痛，應該要求助專業醫師，找出病因。特別是越來越壓不住的疼痛，很可能有什麼重要的潛在疾病，不要長期自己買藥吃，長期吃NSAID類止痛藥可能會傷胃造成胃潰瘍，也可能造成腎功能受損。 4.順道提醒大家，入境時單一藥品每人不得超過十二瓶。依照「入境旅客攜帶行李物品報驗稅放辦法」限量規定，非處方藥每種至多十二瓶（盒、罐、條、支），合計以不超過卅六瓶（盒、罐、條、支）為限。 歡迎追蹤林氏璧孔醫師的發聲管道，了解最新的日本旅遊訊息！ 我的電子名片 https://lit.link/linshibi 日本優惠券大平台和近期活動資訊 https://linshibi.com/?p=20443 日本藥妝店優惠券大集合 https://linshibi.com/?p=27381 歡迎贊助04b喝咖啡 https://pay.firstory.me/user/linshibi

LOXONIN止痛藥是上次多慶屋值得回購的好物排行榜第30名。隱性人格孔醫師被大家對於EVE的興趣嚇到了，今天繼續出場來解釋一下第一三共出的這個系列的止痛藥。有了對EVE的基本知識，就很容易理解LOXONIN S系列了喔。 1.LOXONIN的主成分是洛索洛芬（loxoprofen，ロキソプロフェン），和EVE的布洛芬同樣是一種非類固醇抗發炎藥物（NSAID），是臨床上非常廣泛使用來解熱鎮痛的藥物，比常見的普拿疼有效。不同的是布洛芬是個1961年研發的老藥，全世界有廣泛的使用經驗。但洛索洛芬是日本藥廠三共在1986年研發上市，當時使用經驗沒有老藥這麼多，因此一開始侷限在醫院中要醫師才能處方。後來累積比較多年的安全性經驗後，有資料顯示其造成腸胃道副作用的比例似乎比布洛芬為低，因此於2011年成為一般用醫藥品，可以在藥局買到。 2.洛索洛芬是一種前驅藥（prodrug）的形式，他要在身體中經過吸收代謝後才會變成活性藥物，經過腸胃道時還沒有活性，因此號稱學理上可以減少腸胃的副作用。 3.LOXONIN在日本是第一類醫藥品（相對於EVE是第二類），一定要藥師在的時候經過詢問注意事項後才能買到，所以各位可能的確比較少見到（藥師下班的時候可能就會蓋起來）。我想這是日本比較謹慎對待這個相對新的藥的作法。目前此藥有在巴西，墨西哥，中國，泰國等地上市。 4.五種LOXONIN的比較：主要有白色LOXONIN S，桃紅LOXONIN S PLUS，藍色LOXONIN S QUICK，銀色LOXONIN S PREMIUM，粉紅LOXONIN S PREMIUM fine五種。 相同之處：洛索洛芬每次劑量都是60毫克。一天建議服用兩次，至多三次。（除了LOXONIN S PREMIUM外，都不含鎮靜成分和咖啡因。） LOXONIN S 經典款，單純就只有洛索洛芬。故意做得比較小易於吞服。 LOXONIN S PLUS 添加氧化鎂，中和胃酸可保護胃黏膜。 LOXONIN S QUICK 號稱有獨特的錠劑崩壞技術，藥片可以迅速溶解被吸收，作用最快。此外還添加了偏矽酸鋁鎂（magnesium aluminometasilicate），也是一種胃藥，中和胃酸可保護胃黏膜。 LOXONIN S PREMIUM 針對嚴重頭痛，添加了和EVE A同樣的兩個成分：Anhydrous Caffeine（無水咖啡因） 50毫克（比EVE A的80為低）和Allylisopropylacetylurea（丙烯異丙乙酸尿） 60毫克（和EVE A一樣）。因此他的注意事項就和EVE A一樣了，會有鎮靜效果所以服用後不建議駕駛車輛或操作機械，且也有可能有血小板減少的副作用。同樣添加了偏矽酸鋁鎂，可保護胃。 LOXONIN S PREMIUM fine 針對生理痛，2023年3月上市的新品。很特別的是他加了兩個不常見於西藥的成分：芍薬提取物（シャクヤク乾燥エキス）和橙皮苷（ヘスペリジン）。芍薬提取物可以抑制子宮過度收縮；芍藥能養血調經，中醫臨床上常用來治療月經不調、經痛等問題。橙皮苷可促進血液循環，改善因血液循環不良造成的疼痛。以上是第一三共考量生理痛的機制研發的，據稱對於生理痛還有伴隨而來的腰痛和頭痛有效。同樣添加了偏矽酸鋁鎂，可保護胃。 注意事項可以照抄一次，滿類似的。 1.LOXONIN日本規定只有15歲以上的患者才能服用，兒童和預計12周內要生產的孕婦不建議服用。 2.LOXONIN S PREMIUM因為有丙烯異丙乙酸尿這個EVE A也有的鎮靜成分，服用後請勿駕駛或進行機械類的操作。且有造成血小板低下的風險，所以有相關疾病的人不建議服用。 3.如果遇到嚴重藥物不良反應，在國外自行購買的藥物，特別是在台灣沒有藥證的藥，是不能在國內申請藥害救濟的。 4.老話一句，身體如果有任何地方長期疼痛，應該要求助專業醫師，找出病因。特別是越來越壓不住的疼痛，很可能有什麼重要的潛在疾病，不要長期自己買藥吃，長期吃NSAID類止痛藥可能會傷胃造成胃潰瘍，也可能造成腎功能受損。順道提醒大家，入境時單一藥品每人不得超過十二瓶。依照「入境旅客攜帶行李物品報驗稅放辦法」限量規定，非處方藥每種至多十二瓶（盒、罐、條、支），合計以不超過卅六瓶（盒、罐、條、支）為限。 不要迷信日本成藥，不要把它當土產買來送人！ p.s. 外用LOXONIN鎮痛貼布，凝膠，塗液 1.由於口服NSAID止痛藥有其可能的副作用，像是過敏傷胃傷腎等等，我個人自己用藥的原則是如果可以用外用的解決就用外用藥，減少口服用藥的用量。如果只是很局部的部位疼痛，使用軟膏，貼布等在局部使用較高濃度的止痛藥，可能就能解決部分問題，止痛藥就不需要吃太高劑量。且這樣外用的藥物到血中濃度有限，更不太有機會到胃部造成副作用。（雖然機率不是零，還是有機會過敏或是引起副作用的） 2.也因為外用相對安全，雖然內服的LOXONIN在日本是第一類藥品一定需要藥師在才能買到，但外用的LOXONIN就是第二類藥品了，不需要藥師在即可購入，也比較常在藥妝店看到展示。 3.外用藥分成EX和S，EX的止痛藥濃度較高，大家可以看需求選擇。我個人比較喜歡最上面阿部寬拿的這一瓶塗液，直接塗抹比較有感。貼布的話有時候貼在不平整的地方會滿快就掉落，大片的可能會好一點。 EVE A止痛藥系列解說 成分 注意事項 副作用 https://linshibi.com/?p=45191 歡迎追蹤林氏璧孔醫師的發聲管道，了解最新的日本旅遊訊息！ 我的電子名片 https://lit.link/linshibi 日本優惠券大平台和近期活動資訊 https://linshibi.com/?p=20443 日本藥妝店優惠券大集合 https://linshibi.com/?p=27381 歡迎贊助04b喝咖啡 https://pay.firstory.me/user/linshibi

EVE止痛藥系列是上次多慶屋值得回購的好物排行榜第三名。但常有讀者問我，EVE A的幾種品項有何不同？讓好久不見的隱性人格：孔醫師出場來解釋一下。 1.先說有一種最普通的EVE白盒，他就很單純只有止痛藥的成份。EVE A則主要有EVE A錠 白盒，EVE A錠 EX 粉盒，EVE QUICK頭痛藥 藍盒，EVE QUICK 頭痛藥 DX 金盒四款。分別針對各種疼痛，生理痛，後兩者是頭痛。 2.EVE的主成分是布洛芬（ibuprofen，イブプロフェン），是一種非類固醇抗發炎藥物（NSAID），是臨床上非常廣泛使用來解熱鎮痛的藥物，比常見的普拿疼有效，在絕大多數國家都可作為非處方藥銷售。NSAID有很多種，布洛芬是個1961年研發的老藥，專利權早已過期，任何藥廠都能做。台灣常見的商品名是依普，依普芬，普服芬等等。小朋友喝的馬蓋先或是速熱寧也是這個藥。 3.EVE A四種劑型布洛芬含量不同，分別是150，200，150，200毫克（每兩顆）。一般口服布洛芬建議劑量是每4~6小時200-400毫克，一天不要超過1.2g。台灣很常見一顆是400毫克的劑型，一天建議不要超過三顆。而EVE四種劑型是建議兩顆每天最多三次（450毫克/天），兩顆最多兩次（400毫克/天），兩顆最多三次（450毫克/天），兩顆最多兩次（400毫克/天），你可以發現他的布洛芬建議用量其實並沒有特別高，甚至是偏低的。 4.那為何有人會覺得EVE A好像吃起來特別有效呢？姑且不論心理作用，也許是因為四款EVE A中皆有另外兩個成分：Anhydrous Caffeine 80毫克和Allylisopropylacetylurea（丙烯異丙乙酸尿） 60毫克。前者是無水咖啡因，會使血管收縮，輔助緩解頭痛（普拿疼止痛加強錠也有添加咖啡因喔）。後者則是一種1926年就研發的鎮靜劑，可能也有幫助止痛的效果，但全世界幾乎都沒有在用了，因為後續有些案例出現了血小板減少性紫斑症的副作用，所以就停用了。不過日本倒是一直用到現在，似乎也相安無事。也許其中有人種的因素？但也因為有這樣的成分，含此成分的用藥在日本都是第一類或是第二類藥品。 5.至於兩款針對頭痛的，還有加另外一個其實很普通的成分：氧化鎂。氧化鎂就是很常見的制酸劑，可中和胃酸。第一個好處是NSAID有個重要副作用是可能傷胃，加個胃藥可保護胃粘膜，防止胃部不適。第二個好處是布洛芬可以較迅速溶解迅速吸收，這可能是它速效的原因。 最後要來講注意事項了。 1.EVE因為有丙烯異丙乙酸尿這個鎮靜成分，服用後請勿駕駛或進行機械類的操作。也因此日本規定只有15歲以上的患者才能服用，兒童和孕婦不建議服用。 2.丙烯異丙乙酸尿有造成血小板低下的風險。所以有相關疾病的人不建議服用。 3.如果遇到嚴重藥物不良反應，在國外自行購買的藥物，是不能在國內申請藥害救濟的。 4.老話一句，身體如果有任何地方長期疼痛，應該要求助專業醫師，找出病因。特別是越來越壓不住的疼痛，很可能有什麼重要的潛在疾病，不要長期自己買藥吃，長期吃止痛藥可能會傷胃造成胃潰瘍，也可能造成腎功能受損。 順道提醒大家，入境時單一藥品每人不得超過十二瓶。依照「入境旅客攜帶行李物品報驗稅放辦法」限量規定，非處方藥每種至多十二瓶（盒、罐、條、支），合計以不超過卅六瓶（盒、罐、條、支）為限。 不要迷信日本成藥，不要把它當土產買來送人！ 多慶屋值得回購的日本必買好物排行榜 藥品 健康食品篇 合利他命 EVE止痛藥 若元錠 大正百保能 欣表飛鳴 https://linshibi.com/?p=44457 合利他命EX PLUS強效錠 日本買比較便宜有效？價格 金強效錠 日本限定α銀強效錠有何不同？ https://linshibi.com/?p=44508 歡迎追蹤林氏璧孔醫師的發聲管道，了解最新的日本旅遊訊息！ 我的電子名片 https://lit.link/linshibi 日本優惠券大平台和近期活動資訊 https://linshibi.com/?p=20443 日本藥妝店優惠券大集合 https://linshibi.com/?p=27381 歡迎贊助04b喝咖啡 https://pay.firstory.me/user/linshibi

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.

Get Your Custom Training Plan at https://www.mymottiv.com/Sign up at mymottiv.com and Use the Code SMARTER2 for Two Months of FULL Premium AccessHere are the research papers discussed in todays episode:The Effect of Wearable-Based Real-Time Feedback on Running Injuries and Running Performance: A Randomized Controlled TrialHow to activate the glutes best? Peak muscle activity of acceleration-specific pre-activation and traditional strength training exercisesPredictors of Running-Related Injury Among Recreational Runners: A Prospective Cohort Study of the Role of Perfectionism, Mental Toughness, and Passion in RunningEffects of 3 Weeks Yogic Breathing Techniques on Sub-maximal Running ResponsesPlantar Fasciitis: An Updated ReviewLeg length discrepancy is not a risk factor for plantar fasciitisImmediate and Short-Term Effects of In-Shoe Heel-Lift Orthoses on Clinical and Biomechanical Outcomes in Patients With Insertional Achilles TendinopathyWhat is known about the health effects of non-steroidal anti-inflammatory drug (NSAID) use in marathon and ultraendurance running: a scoping review

A metatarsal fracture "non-union" is what doctors call it when you broke the bone, it started to heal, but then the fracture kind of quit healing. Usually it means you got a bunch of scar tissue between the ends of the bone.  Sometimes that happens without you or your doctor realizing it. The problem gets worse if you start running on it.   The question is, "should I take non-steroidal anti-inflammatory drugs (or NSAIDs)?  NSAID's are medications like ibuprofen and naproxen. These drugs are not steroids, but they stop inflammation. Many runners take them for all kinds of aches and pains after training. The question is, is it a good idea or not when you may have a metatarsal fracture non-union? Should a runner take non-steroidal anti-inflammatory medications for a non-union?  Well, that's what we're talking about today on the Doc On The Run Podcast.