Treatment of Ischemic Stroke

An ischemic stroke is caused by a thrombus (blood clot) occluding blood flow to an artery supplying the brain. Definitive therapy is aimed at removing the blockage by breaking the clot down (thrombolysis), or by removing it mechanically (thrombectomy). The more rapidly blood flow is restored to the brain, the fewer brain cells die.

Other medical therapies are aimed at minimizing clot enlargement or preventing new clots from forming. To this end, treatment with medications such as aspirin, clopidogrel and dipyridamole may be given to prevent platelets from aggregating.

In addition to definitive therapies, management of acute stroke includes control of blood sugars, ensuring the patient has adequate oxygenation and adequate intravenous fluids. Patients may be positioned with their heads flat on the stretcher, rather than sitting up, to increase blood flow to the brain. It is common for the blood pressure to be elevated immediately following a stroke. Although high blood pressure may cause some strokes, hypertension during acute stroke is desirable to allow adequate blood flow to the brain.

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Prevention of Hypoglycemia

The most effective means of preventing further episodes of hypoglycemia depends on the cause.

The risk of further episodes of diabetic hypoglycemia can often (but not always) be reduced by lowering the dose of insulin or other medications, or by more meticulous attention to blood sugar balance during unusual hours, higher levels of exercise, or alcohol intake.

Many of the inborn errors of metabolism require avoidance or shortening of fasting intervals, or extra carbohydrates. For the more severe disorders, such as type 1 glycogen storage disease, this may be supplied in the form of cornstarch every few hours or by continuous gastric infusion.

Several treatments are used for hyperinsulinemic hypoglycemia, depending on the exact form and severity. Some forms of congenital hyperinsulinism respond to diazoxide or octreotide. Surgical removal of the overactive part of the pancreas is curative with minimal risk when hyperinsulinism is focal or due to a benign insulin-producing tumor of the pancreas. When congenital hyperinsulinism is diffuse and refractory to medications, near-total pancreatectomy may be the treatment of last resort, but in this condition is less consistently effective and fraught with more complications.

Hypoglycemia due to hormone deficiencies such as hypopituitarism or adrenal insufficiency usually ceases when the appropriate hormone is replaced.

Hypoglycemia due to dumping syndrome and other post-surgical conditions is best dealt with by altering diet. Including fat and protein with carbohydrates may slow digestion and reduce early insulin secretion. Some forms of this respond to treatment with a glucosidase inhibitor, which slows starch digestion.

Reactive hypoglycemia with demonstrably low blood glucose levels is most often a predictable nuisance which can be avoided by consuming fat and protein with carbohydrates, by adding morning or afternoon snacks, and reducing alcohol intake.

Idiopathic postprandial syndrome without demonstrably low glucose levels at the time of symptoms can be more of a management challenge. Many people find improvement by changing eating patterns (smaller meals, avoiding excessive sugar, mixed meals rather than carbohydrates by themselves), reducing intake of stimulants such as caffeine, or by making lifestyle changes to reduce stress. See the following section of this article.

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Pathophysiology of Hypoglycemia

Like most animal tissues, brain metabolism depends primarily on glucose for fuel in most circumstances. A limited amount of glucose can be derived from glycogen stored in astrocytes, but it is consumed within minutes. For most practical purposes, the brain is dependent on a continual supply of glucose diffusing from the blood into the interstitial tissue within the central nervous system and into the neurons themselves.

Therefore, if the amount of glucose supplied by the blood falls, the brain is one of the first organs affected. In most people, subtle reduction of mental efficiency can be observed when the glucose falls below 65 mg/dl (3.6 mM). Impairment of action and judgment usually becomes obvious below 40 mg/dl (2.2 mM). Seizures may occur as the glucose falls further. As blood glucose levels fall below 10 mg/dl (0.55 mM), most neurons become electrically silent and nonfunctional, resulting in coma. These brain effects are collectively referred to as neuroglycopenia.

The importance of an adequate supply of glucose to the brain is apparent from the number of nervous, hormonal and metabolic responses to a falling glucose level. Most of these are defensive or adaptive, tending to raise the blood sugar via glycogenolysis and gluconeogenesis or provide alternative fuels. If the blood sugar level falls too low the liver converts a storage of glycogen into glucose and releases it into the bloodstream, to prevent the person going into a diabetic coma, for a short period of time.

Brief or mild hypoglycemia produces no lasting effects on the brain, though it can temporarily alter brain responses to additional hypoglycemia. Prolonged, severe hypoglycemia can produce lasting damage of a wide range. This can include impairment of cognitive function, motor control, or even consciousness. The likelihood of permanent brain damage from any given instance of severe hypoglycemia is difficult to estimate, and depends on a multitude of factors such as age, recent blood and brain glucose experience, concurrent problems such as hypoxia, and availability of alternative fuels. The vast majority of symptomatic hypoglycemic episodes result in no detectable permanent harm.

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Treatment of Hypoglycemia

Management of hypoglycemia involves immediately raising the blood sugar to normal, determining the cause, and taking measures to hopefully prevent future episodes.

The blood glucose can be raised to normal within minutes by taking (or receiving) 10-20 grams of carbohydrate. It can be taken as food or drink if the person is conscious and able to swallow. This amount of carbohydrate is contained in about 3-4 ounces (100-120 ml) of orange, apple, or grape juice although fruit juices contain a higher proportion of fructose which is more slowly metabolized than pure dextrose, alternatively, about 4-5 ounces (120-150 ml) of regular (non-diet) soda may also work, as will about one slice of bread, about 4 crackers, or about 1 serving of most starchy foods. Starch is quickly digested to glucose (unless the person is taking acarbose), but adding fat or protein retards digestion. Symptoms should begin to improve within 5 minutes, though full recovery may take 10–20 minutes. Overfeeding does not speed recovery and if the person has diabetes will simply produce hyperglycemia afterwards.

If a person is suffering such severe effects of hypoglycemia that they cannot (due to combativeness) or should not (due to seizures or unconsciousness) be given anything by mouth, medical personnel such as EMTs and Paramedics, or in-hospital personnel can establish an IV and give intravenous Dextrose, concentrations varying depending on age (Infants are given 2cc/kg Dextrose 10%, Children Dextrose 25%, and Adults Dextrose 50%). Care must be taken in giving these solutions because they can be very necrotic if the IV is infiltrated. If an IV cannot be established, the patient can be given 1 to 2 milligrams of Glucagon in an intramuscular injection. More treatment information can be found in the article diabetic hypoglycemia.

One situation where starch may be less effective than glucose or sucrose is when a person is taking acarbose. Since acarbose and other alpha-glucosidase inhibitors prevents starch and other sugars from being broken down into monosaccharides that can be absorbed by the body, patients taking these medications should consume monosaccharide-containing foods such as glucose tablets, honey, or juice to reverse hypoglycemia.

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Abdominal Pain Prevention

Prevention:

For prevention of many types of abdominal pain:

• Avoid fatty or greasy foods.
• Drink plenty of water each day.
• Eat small meals more frequently.
• Exercise regularly.
• Limit foods that produce gas.
• Make sure that your meals are well-balanced and high in fiber. Eat plenty of fruits and vegetables.

For prevention of symptoms from heartburn or gastroesophageal reflux disease:

• After eating, stay upright for at least 30 minutes.
• Elevate the head of your bed.
• Finish eating at least 2 hours before you go to bed.
• Lose weight if you need to.
• Quit smoking.

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For Abdominal Pain, What to expect at your health care provider's office

What to expect at your health care provider's office:

From your medical history and physical examination, your doctor will try to determine the cause of your abdominal pain. Knowing the location of pain and its time pattern will help, as will the presence of other symptoms like fever, fatigue, general ill feeling, nausea, vomiting, or changes in stool.

During the physical examination, the doctor will test to see if the pain is localized to a single area (point tenderness) or whether it is diffuse. He or she will be checking to see if the pain is related to inflammation of the peritoneum (called peritonitis). If the health care provider finds evidence of peritonitis, the abdominal pain may be classified as an "acute abdomen," which may require surgery right away.

Your doctor may ask the following questions about your abdominal pain:

* Is the pain all over (diffuse or generalized) or in a specific location?
* What part of the abdomen is affected? Lower or upper? Right, left, or middle? Around the navel?
* Is the pain severe, sharp or cramping, persistent or constant, periodic and changing intensity over minutes?
* Does the pain awaken you at night?
* Have you had similar pain in the past? How long has each episode lasted?
* How often do you have the pain? Is it constant or does it come and go?
* Does it occur within minutes following meals? Within 2 to 3 hours after meals?
* Is it getting increasingly more severe?
* Does it occur during menstruation (dysmenorrhea)?
* Does the pain go into your back, middle of the back, below the right shoulder blade, or your groin, buttocks, or legs?
* Does the pain get worse after lying on the back?
* Does the pain get worse after eating or drinking? After eating greasy foods, milk products, or alcohol?
* Does the pain get worse after stress? After straining efforts?
* Does the pain get better after eating or a bowel movement?
* Does the pain get better after milk or antacids?
* What medications are you taking?
* Have you had a recent injury?
* Are you pregnant?
* What other symptoms are occurring at the same time?

Source : http://www.umm.edu/ency/article/003120trt.htm

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For Abdominal Pain, Call your doctor if you

Call your doctor if you have:

• Abdominal discomfort that lasts 1 week or longer
• Abdominal pain that does not improve in 24 - 48 hours, or is becoming more severe and frequent
• Bloating that persists for more than 2 days
• Burning sensation when you urinate or frequent urination
• Diarrhea for more than 5 days, or if your infant or child has diarrhea for more than 2 days or vomiting for more than 12 hours -- call right away if a baby younger than 3 months has diarrhea or vomiting
• Fever (over 100°F for adults or 100.4°F for children) with your pain
• Prolonged poor appetite
• Unexplained weight loss

Source : http://www.umm.edu/ency/article/003120trt.htm

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Home Care for Abdominal Pain

Home Care :

For mild pains:

• Sip water or other clear fluids.
• Avoid solid food for the first few hours. If you have been vomiting, wait 6 hours. Then eat small amounts of mild foods such as rice, applesauce, or crackers. Avoid dairy products.
• If the pain is high up in your abdomen and occurs after meals, antacids may provide some relief, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages. You may also try H2 blockers (Tagamet, Pepcid, or Zantac) available over the counter. If any of these medicines worsen your pain, CALL your doctor right away.
• AVOID aspirin, ibuprofen or other anti-inflammatory medications, and narcotic pain medications unless your health care provider prescribes them. If you know that your pain is not related to your liver, you can try acetaminophen (Tylenol).

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How to Care for Hair

Caring for a good hair is not necessarily associated with a costly, complicated and time-consuming. Simply follow the following steps as a guideline for us to realize the dream hair.

Here's How to Care for Hair :

1. Start with the Right Hair Cut
   Not just tidy, proper hair cut can make all kinds of hair texture and look beautiful. A good salon will give us the cutting of hair that "durable" and still look good along with the hair growth itself. And that means, we can be more efficient with no need to every so often to the hairdresser.
   
   Instead of just silence or read a magazine when our hair cut, better use the time to ask things about hair care for hair stylists. Get valuable information on treatment products and styling techniques that fit with our hair type.


2. Keeping the hair so clean and soft
   Use shampoo and conditioner on a regular basis is a habit that can nourish the hair. But that does not mean we are free to use shampoo and conditioner, choose a hair care products specially formulated for your hair type. Then, consider also the intensity of the recommended usage for the condition of our hair. For example, to dry our hair is recommended for routine shampooing apply conditioner every time she finished, and avoid the habit of washing your hair every day. Because of this habit will make the hair dry.


3. Use hair care products carefully
   When used correctly, hair care products will be able to improve performance and protect our hair. Conversely, the wrong usage will only lead to a variety of hair problems, such as dandruff, dry, oily, or limp. Always note the use of hair product label carefully, and start with small quantity first. This is to anticipate the existence of discrepancies between the hair and scalp with products that we use.


4. Caring for natural hair is better
   Do just the opposite. Starting from the use of tools "hot", such as a hairdryer, catokan straight or dry, until the intersection with chemicals from the products curling, straightening, and hair dye, which will contribute to hair damage that we will experience. Where possible, choose the "natural" and the hair will thank us.


5. Routine trimming
   Trimming is one of the hair care routine recommended by experts. Part of damaged ends of your hair and branching if left, they will continue to spread to upper hair shaft and make the damage becomes more severe. Average growth of our hair is about 3 cm per 4-6 months. That is the vulnerable time "reminder" to immediately conduct our regular trimming. The more healthy our hair, the less trimming to be done. So, make the tip of our hair sehatkah signals to determine how our hair.


6. Having a good diet
   Eating a balanced diet containing vitamins and minerals from fruits and vegetables, is crucial in achieving healthy hair. Intake of protein, like fish, poultry, and beef, we are able to make hair stronger and healthier. While Omega-3 fats found in salmon, nuts, and flaxseed oil will provide natural sheen on our crown. Enter the ingredients into the food had our daily menu, and menikmatilah results.
   
   An order can be realized due to undergo a compliance within the existing rules. Same thing with hair care, we are obliged to comply prior to the 6 important rules of hair care above. And seize the crown of a healthy, beautiful and easy to customize.

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Wasp Stings Treatment

Wasp sting treatment, and how to prevent future stings.

At some point, most people are stung by a wasp. These insects give a venomous sting which is rather painful, can itch, and usually swells. If you or a family member is stung by a wasp, take note of the initial reaction. Are the symptoms restricted to the area of the sting, or is there swelling and hives more than 12 inches from the sting? If there is a reaction farther than 12 inches from the sting, see your doctor. This is a systematic reaction, and could be fatal.

Take a cotton ball and apply vinegar (white or apple) or pickle juice to the area. This will reduce swelling. If available, ibuprofen is the suggested over the counter pain medication. It works quickly to reduce swelling and pain.

Other over the counter medications that work well are hydrocortisone 1%, benzocaine spray, or antihistamine creme. These work to reduce swelling, pain and itching. However, the vinegar is just as effective if these are not available.

To avoid wasp stings, do not wear brightly colored clothing in areas known to be home to wasps. You should also avoid wearing perfumes, or strongly scented hair styling products.

If there is a wasp’s nest on your property, call the proper authorities so they can come and destroy the nest. It is not advisable to attempt to destroy a wasp's nest on your own, unless you have a hankering for some stingering.

Source : http://www.essortment.com

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Anti Depression Medication List

DRUG TYPE	BRAND NAME	GENERIC NAME	COMMENTS (additional uses)
SSRI	Celexa	Citalopram	Panic attacks. Eating disorders Impulse control, and Anxiety
	Lexapro	Escitalopram	Panic attacks and Anxiety
	Luvox	Fluoxamine	Panic attacks & Anxiety, Eating Disorders. and Impulse Control
	Paxil	Paroxetine	Social phobia, Panic attacks & Anxiety, Eating Disorders and Impulse Control
	Prozac	Fluoxetine	Panic attacks & Anxiety, Eating Disorders, Impulse control. PMS and OCD
	Zoloft	Sertraline	Panic attacks &Anxiety, Eating Disorders, Impulse Control, and OCD
SNRI	Vestra	Reboxetine	Anxiety
	Effexor	Venlafaxine	Increases energy level Anxiety
NaSSA	Remeron	Mirtazapine	Anxiety (Enhances sleep)
SARI	Desyrel	Trazodone	“Sundowning “, Insomnia and Anxiety
	Serzone	Nefazodone	Severe anxiety (Enhances sleep)
NDRI	Wellbutrin	Bupropion	Anxiety and Smoking cessation, (Increases libido and Increases energy level)
DRUG TYPE	BRAND NAME	GENERIC NAME	COMMENTS (additional uses)
Tricyclic	Adapin	Doxepin	Chronic Fatigue Syndrome
	Anafranil	Clomipramine	OCD and Tourette Syndrome
	Ascendin	Amoxapine	Migraine H/A
	Elavil	Amitriptyline	Nerve Pain, OCD, and Pain
	Norpramin	Desipramine	Tourette Syndrome
	Pamelor	Nortriptyline	Anxiety and Pain
	Sinequan	Doxepin	Pain, Anxiety, and Migraine H/A
	Surmontil	Trimipramine	Pain
	Tofranil	Imipramine	ADHD, Bladder Control, and Anxiety
	Vivactil	Protriptyline	Migraine H/A
Tetracyclic	Ludiomil	Maprotiline	Pain
MAOI	Marplan	Isocarboxazid	Anxiety and Panic Attacks
	Nardil	Phenelzine	Anxiety and Phobias
	Parnate	Tranylcpromine	Anxiety

PSYCHOTROPIC MEDICATIONS LIST

This information has been compiled from sources in the public domain to provide a comprehensive list commonly used medications for the treatment of mood and behavior disorders. Both the brand and generic names of medications are listed. This information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific psychiatric conditions.

Questions about the specific use of any medication for any specific patient or condition should be referred to a licensed physician.

Source : http://www.cncplan.com/antidepressmedicationlist.htm

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MEDICATION OPTIONS FOR THE TREATMENT OF ANXIETY

MEDICATION OPTIONS FOR THE TREATMENT OF ANXIETY

DRUG TYPE	BRAND NAME	GENERIC NAME	COMMENTS (additional uses)
Antihistamine	Atarax	Hydroxyzine	Nausea, & Vomiting, Itching, in Interstitial Cystitis, Itching in Myasthenia Gravis, Tremors in Multiple Sclerosis
	Benadryl Diphenhydramine	Allergies &	Itching, Sedation, and sleep aid in elderly
	Vistaril	Hydroxyzine	Nausea, & Vomiting, Itching, in Interstitial Cystitis, Itching in Myasthenia Gravis, Tremors in Multiple Sclerosis
Benzodiazepine Ativan		Lorazeam Anxiety in Bipolar Disorder, Acute (only) Agitation, Panic Attacks, and Alcohol Withdrawal
	Klonopin	Clonazepam	Seizure, Panic Attacks, Dystonia, and Tremors, and Acute (only) Agitation
	Librium	Chlordiazepoxide	Alcohol withdrawal, Phobias. And Acute (only) Agitation
	Paxipam	Halazepam	Acute (only) agitation in Bipolar Disorder and Schizophrenia,
	Serax	Oxazepm	Acute (only) Agitation and Alcohol Withdrawal
	Tranxene	Clorazepate	Acute (only) Agitation
	Valium	Diazepam	Seizure, Muscle Spasms, Dystonia, and Acute (only) Agitation
	Xanax	Alprazolam	Dystonia, and Acute (only) Agitation
Antianxiety	Buspar	Buspirone	Chronic anxiety, Temors, and Depression (potentiates antidepressants)
Beta Blockers	Corgard	Nadolol	Irregular heart beat, High Blood Pressure, Angina, Migraine H/A
	Inderal	Propranolol	same as above
Lopressor		Metoprolol same as above
	Tenormin	Atenolol	same as above
	Visken	Pindolol	same as above

This information has been compiled from sources in the public domain to provide a comprehensive list commonly used medications for the treatment of Anxiety. Both the brand and generic names of medications are listed. This information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific psychiatric conditions.

Questions about the specific use of any medication for any specific patient or condition should be referred to a licensed physician.

Source : http://www.cncplan.com/anxietymed.htm

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EPS Medication List

DRUG TYPE	BRAND NAME	GENERIC NAME	COMMENTS (additional uses)
Antiparkinsonian	Akineton	Biperiden	Parkinson’s Disease, Dystonia
	Artane	Trihexyphenidyl	Tremors, Drooling in Parkinson’s Disease, Writer’s cramp, Dystonia, and Tourette Syndrome
	Cogentin	Benztropine Mesylate	Parkinson’s Disease, Tremors, Movement Disorders, Writer’s Cramp, and Dystonia
	Dopar	Levodopa	Parkinson’s Disease, Dystonia, Tremors, and Tourette Syndrome
	Kemadrin	Procyclidine	Parkinson’s Disease, Dystonia, and Cerebral Palsy
	Larodopa	Levodopa	Parkinson’s Disease, Dystonia, Tremors, and Tourette Syndrome
	Parlodel	Bromocriptine	Dystonia, Pituitary Disorders ( Prolactinoma (Benign tumor of Pituitary Gland), , and Growth Disorders, Infertility (Ovulation drug,, Parkinson’s Disease, and Cocaine Withdrawal
	Permax	Pergolide Mesylate	Parkinson’s Disease and Dystonia
	Sinemet	Carbidopa-levodopa	Parkinson’s Disease, Dystonia, Tremors, and Tourette Syndrome
	Symmetrel	Amantadine	Fatigue in Multiple Sclerosis, Influenza, Common Cold, Sinusitis, Parkinson’s Disease, and Cocaine Withdrawal
Antihistamine	Benadryl	Diphenhydramine	Allergies, Asthma Sedation

PSYCHOTROPIC MEDICATIONS LIST

This information has been compiled from sources in the public domain to provide a comprehensive list commonly used medications for the treatment of mood and behavior disorders. Both the brand and generic names of medications are listed. This information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific psychiatric conditions. Questions about the specific use of any medication for any specific patient or condition should be referred to a licensed physician.

Source : http://www.cncplan.com/epsmed.htm

READ MORE - EPS Medication List