FitSugar

During Childbirth, Do You Plan on Getting an Epidural?

FitSugar — Sun, 13 May 2007 02:30:00 -0700

No one needs to tell you that giving birth is a painful experience - we've all heard our fair share of horror stories. Thanks to modern science, an epidural is available if a woman doesn't want to or can't deal with the pain. It's basically a shot given in your spine that makes you have a loss of sensation and pain from your waist down.

Some women see giving birth as a natural experience, and want to be completely aware and in tune with what their body is feeling, so they wouldn't dream of getting drugs. Plus some women may argue that it's bad for the baby, and makes labor longer for everyone involved.

Other women go for the drugs because the pain of labor is way too unbearable not to. They'd equate it to getting a cavity drilled - would you go without Novocaine?

So I want to know...

Source

How Does Novocaine Work?

FitSugar — Fri, 11 May 2007 07:30:00 -0700

When I have a cavity filled all I can say is praise to the Novocaine. When my dad was little, his dentist didn't use local anesthetics, and my poor dad had to sit in the chair knowing he was in for a whole lot of pain. My jaw hurts just thinking about it.

I just learned that prior to the invention of Novocaine, cocaine was used as a local anesthetic. Cocaine constricts blood cells, which reduces bleeding, but as we all know it's also highly addictive.

In the early 1900's scientists created a synthetic version of cocaine, but without the nasty side effects, and christened it Procaine. We know it by its trade name Novocaine, and I have no idea why my dad's dentist didn't use it since it was definitely available to the masses when he was a boy. Since its development, stronger local anesthetics have come along like Lidocaine, Septacaine, and Mepivocaine (most dentists still call the shot "Novocaine" though, so ask what they specifically use if you're interested).

These injectable local anesthetics prevent pain in a specific area by blocking the nerves that sense or transmit pain, so the area feels numb for up to 3-4 hours.

All I can say is that even though the shot stinks and can really pinch your gum (and make your mouth really sore for days after), it's still way better than how much it would hurt with NO shot at all.

Fit's Tip: Ask your dentist to apply a topical anesthesia to your gums to numb the area before the Novocaine shot. It makes getting a cavity filled just a little bit easier to bare.

Source

Procaine (Injection)

admin — Thu, 04 Sep 2008 20:14:13 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Procaine

Used before and during surgery, childbirth, or other procedures to cause numbness or loss of feeling in an area of your body. This medicine is a type of anesthesia.

Brand Name(s)

Novocain

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not receive this medicine if you have had an allergic reaction to procaine, aminobenzoic acid, or certain other types of anesthetics (numbing medicine). You might not be able to receive this medicine if you have severe blood infection, severe infection where the shot is to be given, or active infection of the brain (such as meningitis or syphilis). You may not be able to receive this medicine if you are taking sulfonamides, such as Bactrim®, Cotrim®, or Septra®.

How to Use This Medicine

Injectable

Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin, into a muscle, or into your lower back along your spine.
A nurse or other trained health professional will give you this medicine.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Make sure your doctor knows if you are receiving other anesthetic medicines, if you are using monoamine oxidase (MAO) inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®), medicine to treat depression (such as amitriptyline, doxepin, nortriptyline, imipramine, Elavil®, Pamelor®, Sinequan®), medicine to treat mental illness (such as haloperidol, prochlorperazine, Haldol®, Compazine®, Mellaril®), heart medicines (such as dobutamine), or certain ergot medicines (such as ergonovine).

Warnings While Using This Medicine

Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, heart disease (such as heart rhythm problems or heartblock), or blood pressure problem.
This medicine contains acetone sodium bisulfite. Make sure your doctor knows if you have had an allergic reaction to sulfites in the past or if you have a history of asthma.
Tell your doctor if you start having restlessness, anxiety, lightheadedness, numbness, tingling of the mouth and lips, blurred vision, problem with speech, metallic taste, ringing in the ears, tremors, twitching, or depression. These may be signs that you are already having too much of this medicine in your body.
This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
This medicine may be used in combination with other anesthetics. Make sure your doctor knows if you or a family member have ever had a reaction, such as malignant hyperthermia (a dangerous rise in body temperature) to an anesthetic.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Blurred vision or changes in vision.
Chest pain or discomfort.
Fever.
Headache, stiff neck, back pain.
Lightheadedness or fainting.
Numbness or weakness in your arm or leg, or on one side of your body.
Ringing in the ears.
Seizures, tremors, or muscle twitching.
Severe nervousness, restlessness, anxiety, drowsiness, or dizziness.
Slow, fast, or irregular heartbeat.
Trouble breathing.

If you notice these less serious side effects, talk with your doctor:

Nausea or vomiting.
Sneezing or sweating.

Review Date: 8/4/2008

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Source Doc: 45_5632

Going to the Dentist: What's the Deal With Sedation?

FitSugar — Tue, 18 Sep 2007 13:30:00 -0700

Even if you are one of those people who absolutely dreads going to the dentist, you know it is still really important to go regularly. You need to keep your teeth and gums healthy, so your dentist can prevent small problems from growing into dental disasters.

Now many dentists offer sedation dentistry. To ensure panicked patients make it to the twice yearly visits, many dentists offer sedation dentistry. You can opt for this method if you have sensitive teeth or gums, you don't easily go numb, if you have a lot of dental work that needs to get done, or if you have major dental anxiety or a phobia about going to the dentist. Whatever your reason, there are different degrees of dental sedation that are available.

Here's the run down of sedation methods you can try:

Nitrous Oxide Sedation: Ahh, laughing gas. I used to get this as a kid and it really helps to calm you down. You inhale it and it puts you in a state of complete relaxation, but you are still totally conscious. Since laughing gas doesn't block the pain, your dentist will still need to give you a shot of local anesthesia, aka Novocaine.

Oral Sedatives: Diazepam is one form of medication you can take the night before, or 30-60 minutes before an appointment, depending on the severity of the anxiety. Although you will feel calmer, with this option you will still feel the pain. So with this method you also still need to get a shot of Novocaine to numb you.

There are 2 more methods. To hear what they are read more

Intravenous (IV) Sedation: You basically get anti-anxiety drugs administered into the bloodstream. This also doesn't block the pain, so you'll still need to get a shot of Novocaine. You'll remain conscious and be able to understand and respond to requests from your dentist, but you may not remember much of what happened while you were in the chair. IV sedation makes you feel utterly relaxed and makes you not care about what's going on, and the drugs may also cause full or partial amnesia (only during the period of time when they're in your bloodstream. Time will feel like it passes quickly, almost like you were asleep.

General Anesthesia: This is where you are unconscious and completely pain free, so you don't even need the Novocaine. You won't be able to respond to anything, since you are basically out of it, and you'll need help breathing. This method is used if you need oral surgery, like all 4 of your wisdom teeth pulled. Someone will need to drive you to the office, stay with you during the procedure, and then will need to drive you home. Some people have negative reactions to the anesthesia and experience bouts of vomiting.

These 4 methods can be used to offer different degrees of sedation, ranging from being awake yet calm, to totally unconscious. You and your doctor can figure out what method may be right for you, depending on your level of comfort and the procedures that need to be done.

I think sedation dentistry is a brilliant idea. I don't know anyone who likes going to the dentist, so this can make necessary procedures a lot easier to handle for people who are afraid to have them done.

Fit's Tips: Looking for a dentist in your area who offers sedation? Click here to find one near you.

Source

Which Would You Rather Do?

FitSugar — Sat, 07 Mar 2009 03:30:00 -0800

I just put myself through one hectic health care week. I went to the dentist, my OB/Gyn for my annual visit, and the optometrist. It was busy, but great to check all those appointments off my list. While none of these activities are anything I would consider fun, I am wondering which you would rather do: Get a pap smear, get a shot of novocaine, or get your eyes dilated?

Source

Aminohippurate sodium (Injection)

admin — Thu, 04 Sep 2008 20:06:51 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Aminohippurate Sodium (a-mee-noe-HIP-yoor-ate SOE-dee-um)

Used as part of a test of kidney function.

Brand Name(s)

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not receive this medicine if you have had an allergic reaction to aminohippurate.

How to Use This Medicine

Injectable

Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins.A nurse or other trained health professional will give you this medicine.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Make sure your doctor knows if you are also using a sulfa drug such as Bactrim®, Cotrim®, or Septra®. Tell your doctor if you use probenecid (Benemid®), or if you have received a numbing medicine such as procaine (Novocain®).

Warnings While Using This Medicine

Make sure your doctor knows if you pregnant or breast feeding, or if you have heart disease.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Nausea or vomiting, or muscle cramps.

If you notice these less serious side effects, talk with your doctor:

Feeling like you need to use the bathroom.
Feeling warm.
Mild nausea.
Muscle cramps.
Redness in your face, neck, arms or upper chest.
Tingling feeling in your hands, feet or lips.

Review Date: 8/4/2008

A.D.A.M. Copyright

adam.com

Source Doc: 45_5080

Belladonna/opium (Rectal)

admin — Thu, 04 Sep 2008 20:04:33 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Belladonna Alkaloids (bell-a-DON-a AL-ka-loyds), Opium Alkaloids

Treats moderate to severe pain. Belongs to a group of drugs called narcotic analgesics.

Brand Name(s)

B & O Supprettes 15a, B & O Supprettes 16a

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to belladonna, opium, or to related narcotic pain killers (such as morphine). You should not use this medicine if you have glaucoma, liver disease, kidney disease, asthma or other breathing problems. Do not use this medicine if you have seizures, or a history of drug or alcohol addiction.

How to Use This Medicine

Suppository

Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
Never take rectal suppositories by mouth.
Wash your hands with soap and water before and after using this medicine. Remove the foil or wrapper from the suppository before inserting it.
Wet the suppository and your finger with water before inserting it.
Lie on your left side with your left leg straight or slightly bent, and your right knee bent upward. Gently push the pointed end of the suppository into the rectum about 1 inch.
Keep lying down for about 15 minutes to keep the suppository from coming out before it melts. Then, wash your hands again.

If a dose is missed:

If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

Store at room temperature, away from heat and direct light. Do not refrigerate.
Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine applicator(s), containers, and any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Make sure your doctor knows if you are using medicine for seizures (such as phenobarbital, Depakote®, Dilantin®, Keppra?, Luminal®, Tegretol®), a muscle relaxer (such as Flexeril®), or an anesthetic medicine (such as benzocaine, lidocaine, or novocaine).
Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
Avoid drinking alcohol.

Warnings While Using This Medicine

Tell your doctor if you have had an unusual reaction to atropine or to similar medicines such as dicyclomine (Bentyl®), glycopyrrolate (Robinul®), or scopolamine (Transderm Scop®).
Make sure your doctor knows if you are pregnant or breast feeding, or if you have heart disease, thyroid problems, or an enlarged prostate.
This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
Dizziness may be worse if you get up too quickly from a sitting or lying position. Stand up slowly after you have been sitting or lying down to help decrease dizziness.
This medicine should not be used by a child under 12 years old.
Your eyes may be more sensitive to bright light while you are using this medicine. You may want to wear sunglasses in bright sunlight.
This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
This medicine may cause constipation. This is more common if you use it for a long time. Ask your doctor if you should also use a laxative to prevent and treat constipation.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Fast, or uneven heartbeat.
Urinating less than usual.

If you notice these less serious side effects, talk with your doctor:

Dizziness, drowsiness, or light-headedness.
Dry mouth.
Nausea, vomiting, or constipation.
Vision changes, such as trouble focusing.

Review Date: 8/4/2008

A.D.A.M. Copyright

adam.com

Source Doc: 45_4916

Trimethobenzamide (Rectal)

admin — Thu, 04 Sep 2008 19:52:25 -0700

Overview

Introduction
Brand Name(s)
When This Medicine Should Not Be Used
How to Use This Medicine
How to Store and Dispose of This Medicine
Drugs and Foods to Avoid
Warnings While Using This Medicine
Possible Side Effects While Using This Medicine

HEALTH GUIDE REFERENCE FROM A.D.A.M

Introduction

Benzocaine (BEN-zoe-kane), Trimethobenzamide (trye-meth-oh-BEN-za-mide)

Treats nausea and vomiting. This medicine was withdrawn from the U.S. market on April 6, 2007, because it has not been found to be effective.

Brand Name(s)

Navogan

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to trimethobenzamide or to local anesthetics like novocaine or xylocaine. This medicine should not be given to children unless approved by your doctor.

How to Use This Medicine

Suppository

Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
Never take rectal suppositories by mouth.
Drink plenty of fluids while you are using this medicine to keep from getting dehydrated.
Wash your hands with soap and water before and after using this medicine. Remove the foil or wrapper from the suppository before inserting it.
To make the suppository easier to insert, you may use a lubricating gel such as K-Y® Jelly, but do not use petroleum jelly (Vaseline®).
Lie on your left side with your left leg straight or slightly bent, and your right knee bent upward. Gently push the pointed end of the suppository into the rectum about 1 inch.
Keep lying down for about 15 minutes to keep the suppository from coming out before it melts. Then, wash your hands again.

If a dose is missed:

If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

You may store the suppositories in the refrigerator, but do not freeze them.
Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine applicator(s), containers, and any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

Make sure your doctor knows if you are pregnant or breastfeeding.
This medicine may make you drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
If your vomiting does not stop after taking this medicine for one day, call your doctor.
If your doctor has instructed you to give this medicine to a child, watch carefully for side effects such as vomiting, drowsiness, or unusual behavior. If your child has any of these signs, stop using the medicine and call your doctor right away.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
Dark-colored urine or pale stools.
Hot, dry skin without sweating.
Lightheadedness or fainting.
Problems with balance or walking.
Seizures.
Uncontrollable muscle movements or twitching.
Unusual bleeding, bruising, or weakness.
Yellow skin or eyes.

If you notice these less serious side effects, talk with your doctor:

Blurred vision.
Headache.
Mild diarrhea.
Muscle cramps.

Review Date: 8/4/2008

A.D.A.M. Copyright

adam.com

Source Doc: 45_0559

Neuralgia

admin — Wed, 03 Sep 2008 17:56:19 -0700

Illustrations

Central nervous system and peripheral nervous system

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Neuralgia is pain that follows the path of a specific nerve.

Alternative Names

Nerve pain; Postherpetic neuralgia

Causes, incidence, and risk factors

The causes of neuralgia vary. Chemical irritation, inflammation, trauma (including surgery), compression of nerves by nearby structures (for instance, tumors), and infections may all lead to neuralgia. In many cases, however, the cause is unknown.

Neuralgia is most common in elderly persons, but it may occur at any age.

Trigeminal neuralgia is the most common form of neuralgia. For information on this condition, see the article on trigeminal neuralgia.

A related but rather uncommon neuralgia affects the glossopharyngeal nerve, which provides sensation to the throat. Symptoms of this neuralgia are short, shock-like episodes of pain located in the throat.

Neuralgia may occur after infections such as shingles. Shingles-related neuralgia produces a constant burning pain after the shingles rash has healed. The pain is worsened by movement of or contact with the affected area.

Postherpetic neuralgia may be debilitating long after signs of the original herpes infection have disappeared. Other infectious diseases that may cause neuralgia are syphilis and Lyme disease.

Diabetes is another common cause of neuralgia. Diabetes damages the tiny arteries that supply circulation to the nerves, resulting in nerve fiber malfunction and sometimes nerve loss. Diabetes can produce almost any neuralgia nearly anywhere in the body, including trigeminal neuralgia.

Other medical conditions that may be associated with neuralgias include chronic renal insufficiency and porphyria -- a hereditary disease in which the body cannot rid itself of certain substances produced after the normal breakdown of blood in the body. Certain drugs may also cause neuralgia.

Symptoms

Pain located anywhere, usually on or near the surface of the body
- In the same location for each episode
- Sharp, stabbing pain or constant, burning pain
Pain along the path of a specific nerve
Impaired function of affected body part due to pain, or muscle weakness due to motor nerve damage.
Increased sensitivity of the skin or numbness of the affected skin area (feeling similar to a local anesthetic, such as a Novocaine shot)

Any touch or pressure is interpreted as pain. Movement may also be painful.

Signs and tests

Neurologic examination shows tenderness occurring along a nerve tract. Trigeminal neuralgia usually causes pain along the second and third nerve divisions (lower face and jaw), and rarely involves the first nerve division (temple and forehead). Other signs of altered nerve function may be seen often, such as loss of deep tendon reflexes, local loss of muscle bulk, local lack of sweating (sweating is regulated by nerve function), and abnormal skin sensation.

There may be specific trigger points (areas where even a slight touch triggers pain). A dental examination is used to rule out dental disorders that may cause facial pain. The presence of other symptoms (such as redness or swelling) may indicate disorders causing the pain, such as infections, bone fractures, rheumatoid arthritis, or other disorders.

No tests are specific for neuralgia, but tests may be used to rule out other causes of the pain. Sometimes a nerve conduction study with electromyography (NCS/EMG), which examines the electrical activity of nerves, may confirm the diagnosis.

The first part of the test, the NCS, involves giving small electric shocks to skin areas overlaying specific nerve paths. The physician then determines whether the conduction of electricity is delayed or blocked through the particular nerve that was tested.

The second part of the test, the EMG, involves the careful insertion of a very fine needle into the skin. The needle is attached to an electric probe. This probe measures the electrical activity of a muscle of interest at rest and during motion. EMG indirectly provides useful clues regarding nerve function. Although the procedure sounds rather unpleasant, most patients are able to tolerate it with little discomfort.

There are a number of other laboratory tests doctors use to determine the cause of neuralgia. Blood tests to check blood sugar and kidney function are routinely used. When the diagnosis is not clear, other tests may be helpful -- particularly whenever there is suspicion of an underlying medical problem like arthritis, syphilis, vitamin deficiencies, or other less common disorders. If multiple sclerosis is suspected, the diagnosis usually can be confirmed with an imaging test of the brain such as an MRI.

A lumbar puncture (spinal tap) is often used to confirm the diagnosis of multiple sclerosis and other nerve disorders. It involves taking a sample of cerebrospinal fluid (CSF). Analysis of this fluid may show evidence of inflammation, helping to establish the correct diagnosis.

Treatment

Treatment of neuralgia is aimed at reversing or controlling the cause of the nerve problem (if identified), as well as providing pain relief. Therefore, the treatment varies depending on the cause, location, and severity of the pain, and other factors. Even if the cause of the neuralgia is never identified, the condition may improve spontaneously or disappear with time.

The cause (if known) should be treated. This may include surgical removal of tumors, or surgical separation of the nerve from blood vessels or other structures that compress it. This can be the approach taken for certain cases of carpal tunnel syndrome and trigeminal neuralgia.

Strict control of blood sugar may accelerate recovery in people with diabetes who develop neuralgia.

Mild over-the-counter analgesics such as aspirin, acetaminophen, or ibuprofen may be helpful for mild pain. Narcotic analgesics such as codeine may be needed for a short time to control severe pain. These traditional pain-killers, however, often have disappointing results.

Other types of medications work in different parts of the nervous system and often provide better symptom control. For example, antiseizure medications such as carbamazepine, gabapentin, lamotrigine or phenytoin may be helpful for pain associated with trigeminal neuralgia. The most common side effects of antiseizure drugs are drowsiness, tremor, and incoordination.

Antidepressant medications, such as amitriptyline, may be helpful to control pain in some cases. The topical (local) application of creams containing capsaicin also may help to control pain.

Other treatments may include nerve blocks, local injections of anesthetic agents, or surgical procedures to decrease sensitivity of the nerve. Some procedures involve the ablation (surgical destruction) of the affected nerve using different methods, such as local radiofrequency, heat, balloon compression, and injection of chemicals (such as glycerolysis).

Unfortunately, these procedures do not guarantee improvement and can cause loss of sensation or abnormal sensations.

Another strategy sometimes used for resistant cases of neuralgia is called motor cortex stimulation (MCS), which consists of surgically placing an electrode over the sensory cortex of the brain. The electrode is hooked to a pulse generator pocketed under the skin. Such surgical procedures, however, are tried only when more conservative approaches have failed.

For some patients, post herpetic neuralgia can be treated with a combination of oral (taken by mouth) prednisone and antiviral medication.

Physical therapy may be helpful for some types of neuralgia, especially postherpetic neuralgia. Treatment of shingles with antiviral medication may decrease the incidence of postherpetic neuralgia.

Expectations (prognosis)

Most neuralgias are not life-threatening and do not indicate other life-threatening disorders. However, pain can be severe and, in some cases, incapacitating. For severe pain, be sure to see a pain specialist so that all options for treatment can be explored.

Most neuralgias will respond to treatment. Attacks of pain are usually episodic (occurring in intervals, alternating with relatively pain-free periods of time). However, attacks may become more frequent in some patients as they age.

Complications

Unnecessary dental procedures prior to diagnosis of neuralgia
Disability caused by pain
Complications of surgery
Side effects of medications used to control pain (see the specific medication)

Calling your health care provider

Call for an appointment with your health care provider if symptoms of neuralgia are present, especially if prolonged or unrelieved by over-the-counter analgesics. See a pain specialist for severe pain.

Prevention

Treatment of associated disorders such as diabetes and renal insufficiency may prevent development of some neuralgias. Strict control of blood sugar may prevent diabetic nerve damage.

Review Date: 9/7/2006

Reviewed By: Kenneth Gross, MD, Neurology, North Miami, FL. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_001407

Drug allergies

admin — Wed, 03 Sep 2008 17:52:15 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Drug allergies are a group of symptoms caused by allergic reaction to a drug (medication).

Alternative Names

Allergic reaction - drug (medication)

Causes, incidence, and risk factors

In general, adverse reactions to drugs are not uncommon, and almost any drug can cause an adverse reaction. Reactions range from irritating or mild side effects such as nausea and vomiting to life-threatening anaphylaxis.

True drug allergies occur when there is an allergic reaction to a medication. The first time you take the drug, your immune system launches an incorrect response against a substance that is harmless in most people. The second or next time you take the drug, an immune response occurs, and your body produces antibodies and histamine.

Most drug allergies cause minor skin rashes and hives. However, other symptoms occasionally develop and life-threatening acute allergic reaction involving the whole body can occur. Serum sickness is a delayed type of drug allergy that occurs a week or more after exposure to a medication or vaccine.

Penicillin and related antibiotics are the most common cause of drug allergies. Other common allergy-causing drugs include:

Sulfa drugs
Anticonvulsants
Insulin preparations (particularly animal sources of insulin)
Local anesthetics such as Novocain
Iodine (found in many x-ray contrast dyes)

Some drug reactions are considered idiosyncratic. This means the reaction is an unusual effect of the medication. For example, aspirin can cause nonallergic hives or trigger asthma. Only a small number of these reactions are allergic in nature. Many individuals may confuse an uncomfortable but not serious side effect of a medicine, such as nausea, with a true drug allergy, which can be life threatening.

Symptoms

Hives (common)
Skin rash (common)
Itching of the skin or eyes (common)
Wheezing
Swelling of the lips, tongue, or face
Anaphylaxis, or severe allergic reaction (see below)

Symptoms of anaphylaxis include:

Difficulty breathing with wheeze or hoarse voice
Hives over different parts of the body
Fainting, light-headedness
Dizziness
Confusion
Rapid pulse
Sensation of feeling the heart beat (palpitations)
Nausea, vomiting
Diarrhea
Abdominal pain or cramping

Signs and tests

An examination of the skin and face may show hives, rash, or angioedema (swelling of the lips, face, or tongue). Decreased blood pressure, wheezing, and other signs may indicate an anaphylactic reaction.

Skin testing may confirm allergy to penicillin-type medications. Testing may be ineffective (or in some cases, dangerous) for other medications. A history of allergic-type reaction after use of a medication is often considered proof enough of drug allergy -- no further testing is required. The same applies to other substances that are not considered drugs but are used in hospitals, such as x-ray contrast dyes.

Treatment

The treatment goal is relief of symptoms and preventing a severe reaction.

Treatment may include:

Antihistamines to relieve mild symptoms such as rash, hives, and itching
Corticosteroids applied to the skin
Bronchodilators such as albuterol to reduce asthma-like symptoms (moderate wheezing or cough)
Epinephrine by injection to treat anaphylaxis

The offending medication and similiar drugs should be avoided. Make sure all your health care providers -- including dentists and hospital personnel -- know about any drug allergies that you or your children have.

Identifying jewelry or cards (such as Medic-Alert or others) may be recommended.

Occasionally, a penicillin allergy responds to immunotherapy. Increasing doses of a medicine are given to improve a person's tolerance of the drug. This should only be done by an allergist.

Expectations (prognosis)

Most drug allergies respond readily to treatment. A few cases cause severe asthma, anaphylaxis, or death.

Complications

Asthma
Anaphylaxis (life-threatening)
Death

Calling your health care provider

Call your health care provider if you are taking a medication and seem to be having a reaction to it.

Go to the emergency room or call the local emergency number (such as 911) if you have difficulty breathing or develop other symptoms of severe asthma or anaphylaxis. These are emergency conditions.

Prevention

There is no known way to prevent development of a drug allergy.

If you have a known drug allergy, avoiding the medication is the best way to prevent an allergic reaction. You may also be told to avoid similar medicines. For example, if you are allergic to penicillin, you should also avoid amoxicillin or ampicillin.

In some cases, a doctor may approve use of a drug that causes an allergy if you are pre-treated with corticosteroids (such as prednisone) and antihistamines (such as diphenhydramine). Do not try this without a doctor's supervision.

References

Adkinson NF Jr. Middleton’s Allergy: Principles and Practice. 6th ed. Chapter 92. Philadelphia, Pa: Mosby; 2003.

Review Date: 7/19/2007

Reviewed By: Donald Accetta, MD, MPH, President, Allergy & Asthma Care, PC, Taunton, MA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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