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F I VEMI NUTE S

CONSULT

I L I NI CAL

Di ar r hea Cons t i pat i on Hemor r hoi d Pept i cUl c er Gas t r oi nt es t i nal Ref l exDi s eas e Res pi r at or y c ondi t i ons


C O N S T I P A T I O N


Constipation

Defi ni ti on:

Cons t i pa t i oni st hedi f f c ul i t y i nf r e que ntpa s s a geofs t ool. OR Nor ma ls t oolf r e que nc y( 23)t i me sda i l yorwe a k.

Dangerofconti pati on:

Pa t i ne t sof t e nc ons i de rc ons t i pa t i ona sas i mp l e c ompl a i ntt ha ti se a s yt oma na ge‌. ! ! ! ! Howe ve ri tc a npr oduc edi r e c tori ndi r e c tmor bi di t y . 1) s t r a i ni ng:l e a dt oi s c he mi ca t t c ksa nds ync ope 2) a c c umi l a t i onoff e a c e s: l e a dt ome ga r e c t um, me ga c ol on. 3) Re ma i ni ng: l e a dt ode hydr a t i noff e a c e s whi c hc a nnotpa s st hr ough t hea nus. 4) pa r a doxi cdi a r r he a .


Constipation

Symptoms:

1)a bdomi na ldi s c of o r t . 2)s we l l i ng. 3)bl oa t i ng. 4)l owba c kpa i n.

Causes:

a)Li f es t y l e : 1)t r a ve l l i ngdi a r r he a 2)i na de qua t ef l ui di nt a ke . 3)i na de qua t ee xe r c i s e 4)i na de qua t ef i be ri nt a ke . 5)l os sofde f e c a t or yr e f l e x.

b) Me di c alc ondi t i ons; 1)pr e gna nc y 2)i r r i t a bl ebowe ls yndr ome . 3)ne r veda ma ge 4)c ol or e c t a lc a r c i noma . 5)a na lf i s s ur e ,a na lf i s t ul a ,he r pe ss i mpl e xa ndhe mor r hoi ds . 6)di a be t e s ,c hr oni cr e na lf a i l ur ea ndpa r ki n os ondi s e a s e . 7)pr ol onge dc ol ont r a ns i tt i mee s pe c i a l l yi nf e ma l e s . c )Me di c at i ons : Opi a t e s ,di ur e t i c s ,NSAI Ds ,a nt i c hol i ne r gi c s , TCA,MAOI ,Ba r bi t ur a t e s ,a nt i hi s t a mi ni c s Fe , Cac ont i ni ngdr ugsa nd a nt a c i ds .


t n e v e Pr n o i t a p i Const NonPharmacologi cal:

1) Ta ke8gl a s s e sofnonc a f i na t e df l ui d. 2)Avoi dSOFTDRI NKS 3) I nc r e a s ef i be ri nt a ke . 3) Exe r c i s e . 4) De f e c a t i onAf t e rbr e a kf a s t . 5)f orPr e gna ntWoma n:a voi dc a s t oroi la sl a xa t i ve Be c a us ei tc a us e si mma t ur el a bour , Themos ta ppr opr i a t e OTCdr ug. f orpr e gna nt i sPSYLLI UM


Const i pat i on LaxeolPI

Pr e c a ut i ons: Be f or eus i ngt hi sme di c i ne ,c ons ul t yourdoc t ororpha r ma c i s ti fyouha ve : a no bs t r u c t i onoft hei nt e s t i ne( gut ) , pa r a l yt i ci l e us( l a c kofbowe lmove me nt s , l e a di ngt obl oc ka geoft hegut ) ,a bdomi na l pa i npl usf e e l i ngs i c k( na us e a )orvomi t i ng, a c t i vea nds e ve r ei nf l a mma t or ybowe ldi s e a s e ( s uc ha sul c e r a t i vec ol i t i s ,adi s e a s eoft he l owe ri nt e s t i ne[ c ol on]c ha r a c t e r i s e dbyope n s or e s[ ul c e r s ]wi t hs ympt omss uc ha sf r e que nt di a r r hoe ami xe dwi t hbl ood) , s ur gi c a la bdomi na l( be l l y)c ondi t i ons ( s uc ha sa ppe ndi c i t i s ) ,ors e ve r ede hydr a t i o n. PREGNANCY So di umpi c os ul f a t ei ss ui t a bl et ot a kedur i ng pr e gna nc y . As kyourdoc t ororpha r ma c i s t i fyouha vea nydoubt sorque s t i onsa boutt hi s . I ti ss e ns i bl et ol i mi tus eofme di c a t i ondur i ng pr e gna nc ywhe ne ve rpos s i bl e . Howe ve r ,yourdoc t orma yde c i det ha t t hebe ne f i t sout we i ght her i s ksi n i ndi vi dua lc i r c ums t a nc e sa nda f t e r ac a r e f ula s s e s s me n tofyours pe c i f i c he a l t hs i t ua t i on.


Const i pat i on LaxeolPI odi umPi cosulfate be c a us ei tha ss a mei ngt e di e nt sS Sa mePr e c a ut i onsof


Const i pat i on Mi nalax

Pr e c a ut i ons: Be f o r et a ki ngt hi sme di c a t i on,t e l lyour doc t ororpha r ma c i s ti fyoua r ea l l e r gi c t oi tori fyouha vea nyot he ra l l e r gi e s . Thi spr oduc tma yc o nt a i ni na c t i vei ngr e di e nt s whi c hc a nc a us ea l l e r gi cr e a c t i onsorot he r pr obl e ms . I fyouha vea nyoft hef ol l owi nghe a l t h pr obl e ms ,c ons ul tyourdoc t ororpha r ma c i s t be f or eus i ngt hi sme di c a t i on:s e ve r ea bdomi na l pa i n,na us e a ,vomi t i ng,s udde nc ha ngei n bowe lha bi t sove rt hepr e vi ous2we e ks . Thi sme di c a t i ons houl dbeus e donl ywh e n c l e a r l yne e de ddur i ngpr e gna nc y . Di s c us st her i s ksa ndbe ne f i t s wi t hyourdoc t or .I ti snot knowni ft hi sdr ugpa s s e s i nt obr e a s tmi l k. Cons ul tyourdoc t or be f or ebr e a s t f e e di ng.


D

I A R R H E A


D i a r r h e a W

hat’ sDi arrhea?!

Di a r r he ai sa ni nc r e a s ei nt hef r e que nc yofbowe l move me nt sorade c r e a s ei nt hef or mofs t ool ( gr e a t e rl oos e ne s sofs t ool ) . Al t houghc ha nge s i nf r e que nc yofbowe lmove me nt sa ndl oos e ne s s ofs t ool sc a nva r yi nde pe nde nt l yofe a c hot he r , c ha nge sof t e noc c uri nbot h.

W hoi satRi skforDi arrhea?! Pe opl ewi t hc ompr omi s e di mmunes ys t e msa r e a tr i s kf orde ve l opi ngdi a r r he a . Tha tpopul a t i oni nc l ude st hos ewhoa r eHI Vpos i t i ve ,pe o pl ewhoha veha dor ga nt r a ns pl a nt sa ndpe opl e unde r goi ngc e r t a i nt ype sc he mot he r a py . Thos ewhoa r el i vi ngort r a ve l i ngi nr e gi ons wi t huns a ni t a r ywa t e rs ys t e msa r ea l s oa tr i s k. Youngc hi l dr e n,e s pe c i a l l yt hos ewhoa r e i nc hi l dc a r ef a c i l i t i e s ,a ndt hee l de r l y , whoma ybeuna bl et opr ope r l yc l e a n t he ms e l v e sc a na l s obes us c e pt i bl et odi a r r he a .


Di arrhea WhatCausesDiarrhea?

Th emo s tc o mmo nc a u s eo fd i a r r h e ai sav i r u st h a t i n f e c t st h eg u t . Th ei n f e c t i o nu s u a l l yl a s t sf o rt wo d a y sa n di ss o me t i me sc a l l e d" i n t e s t i n a lf l u "o r " s t o ma c hf l u . "Di a r r h e ama ya l s ob ec a u s e db y : *I n f e c t i o nb yb a c t e r i a( t h ec a u s eo fmo s tt y p e so ff o o dp o i s o n i n g ) *I n f e c t i o n sb yo t h e ro r g a n i s ms ( e g . Ec o l i ) *Ea t i n gf o o d st h a tu p s e tt h ed i g e s t i ves y s t e m *Al l e r g i e st oc e r t a i nf o o d s *Me d i c a t i o n s ( e g . Ch o l c h i c i n e ) *Di s e a s e so ft h ei n t e s t i n e s( Cr o h n ' sd i s e a s e , u l c e r a t i v ec o l i t i s ) *Ma l a b s o r p t i o n( wh e r et h eb o d yi su n a b l et oa d e q u a t e l ya b s o r b c e r t a i nn u t r i e n t sf r o mt h ed i e t ) *Ra d i a t i o nt h e r a p y *Hy p e r t h y r o i d i s m *Somec a n c e r s *La x a t i v ea b u s e *Al c o h o la b u s e *Di g e s t i v et r a c ts u r g e r y *Di a b e t e s *Co mp e t i t i v er u n n i n g *Somep e o p l eg e td i a r r h e awh i l et r a v e l i n g( t r a v e l e r ' sd i a r r h e a ) .


Di arrhea WhatAboutSymptoms? 1 . Wa t e r y , l i qui ds t o o l s:Th es t o o l sma yb ea n yc o l o r . Th ep a s s a g eo fr e ds t o o l ss u g g e s t si n t e s t i n a lb l e e d i n ga n d c o u l db eas i g no famo r es e v e r ei n f e c t i o n , wh i c hi n d i c a t e t h ep r o b a b i l i t yo fp a r a s i t ei n f e c t i o n s( e . g )Gi a r d i aLa mb l i a 2 . Abdo mi na lc r a mps:Oc c a s i o n a l l yd i a r r h e ai sa c c o mp a n i e d wi t hmi l d t o mo d e r a t e a b d o mi n a lp a i n . Se v e r ea b d o mi n a lo r s t o ma c hp a i ni sn o tc o mmo na n d , i fp r e s e n t , ma ys u g g e s t mo r es e v e r ed i s e a s e . 3 . Fe v e r:Ah i g hf e v e ri sn o tc o mmo n . I fp r e s e n t , t h ea f f e c t e d p e r s o nma yh a v eamo r es e v e r ei l l n e s st h a na c u t ed i a r r h e a , wh i c hi n d i c a t et h ep r o b a b i l i t yo fv i r a li n f e c t i o nwi t h ( Ro t av i r u si ni n f a n t so rNo r wo l kv i r u si na d u l to r Ad e n ov i r u si na l la g eg p ) . 4 . De hy dr a t i o n:I fd i a r r h e al e a d st od e h y d r a t i o n , i ti sas i g no fp o t e n t i a l l ys e r i o u sd i s e a s e .


Pr ev ent Di ar r hea

How topreventDi arrhea?

1-Pr a c t i c egoodha ndwa s hi nghygi e ne ,e s pe c i a l l ywhe nyoua r e a r oundagr oupofc hi l dr e n,ora f t e rus i ngpubl i cba t hr oomsor s hoppi ng. Wa s hyourha ndsa f t e ryouha veabowe lmove me nt , ora f t e rwi pi ngupyourc hi l dr e na f t e rt he i rbowe lmove me nt s . I t ' spos s i bl et os pr e a dba c t e r i a . 2-Avoi dhugedi e t a r yc ha nge s .Fore xa mpl e ,don' tgoona n a l l gr a pe sdi e t .I nt r oduc ene wf oodss l owl yi nt oyourdi e t , e s pe c i a l l yf r ui t s ,ve ge t a bl e s ,gr a i nsa ndmi l kpr oduc t s . 3-Thr owf ooda wa yi fi tdr opsont ot hef l oorort hegr ound. Pa r a s i t e sa ndge r msa r ef ounda tgr oundl e ve l . 4-Wa s hf r ui t sa ndve ge t a bl e st hor oughl ybe f or ee a t i ng. 5-Cookf oodt hor oughl y ,e s pe c i a l l yme a t . 6-Avoi df oodst ha tha veat e nde nc yt ol oos e nbowe l s , l i ket hes or bi t olf oundi nma nydi e tf oods . 7-Pr a c t i c egoods t r e s sma na ge me nt i fyourdi a r r he ai sc a us e dbya nxi e t y . 8-For gomi l kpr oduc t s . . i fyourdi a r r he ai sc a us e dbyal a c t os ei nt ol e r a nc e . 9-Cutba c konc a f f e i ne ,whi c hc a nc a us es t ool st ol oos e n. 10-Re a dyourme di c a t i onl a be l sc a r e f ul l y . I foneoft hes i dee f f e c t si sdi a r r he a ,c he c kwi t hyourphys i c i a n a boutc ha ngi ngme di c a t i ons .


Di ar r hea St rept oqui n

St r e pt oqui ni ss t a bl ea ndc a nbe us e df or14da ysa f t e r r e c ons t i t ut i onorf or7da ys, whe nke pta tr oont e mpe r a t ur e . Pr e c a t i ons: *Thepr oduts houl dbea voi de d i ft hepa t a i nti shype r s e ns i t i ve t oi odi neorwi t hi mpa i r e dl i ve rf unc t i on. *I t sus ei sbe s ta voi de di npa t i a nt s wi t hne ur ol ogi c a ldi s or de r s. *I ts houl dbeus e dc a ut i ous l y f ort h yr oi dpa t i e nt s,pa t i e nt s r e qui r i ngt hyr i odf unc t i ont e s t s, s houl di nf or mt he i rphys i c i a nt ha t t he ya r et a ki ngt hi sme di c i nes i nc e di i odoa ui n–boundi odi ne f orupt o6mout hs.


Di ar r hea Flagyl Cont r a i ndi c a t i on: *Hype r s e ns i t i vi t yt oi ni da z ol de r i va t i ve s. *Pr e gna nta ndbr e a s tf e e di ng wome n. Wa r ni nga nds pe c i a lpr e c a t i ons: -Al c ohol i cdr ugss houl dbe a voi de ddur i ngs e c ni dolt r e a t me nt. -Donota dmi ni s t e rt os ubj e c t s wi t hahi s t or yofbl ooddys c r a s i a. Pr e gna nc y: Not e r a t oge ni ce f f e c t si sobs e r ve d dur i nga ni ma le xpe r i me nt a t i on Howe ve r,i nvi e woft he a bs e nc eofda t ai nhuma ns, i ti snotr e c omme nde dt ot a ke s e c ni da z ol edur i ngpr e gna nc y . La c t a t i on: Se c n i da z oli se xc r e t e di nbr e a s tmi l k.


Di ar r hea Anti nal( Ni furoxazi de) Cont r a i ndc a t i on: Ni f ur oxa z i dei sc ont r a i ndi c a t e d i nc ondi t i onsl i kePa r a l yt i ci l e us , Ne ona t e s ,Hype r s e ns i t i vi t yt oa ny c ompone ntofpr oduc t . I nt e r a c t i on: Ni f ur oxa z i dei sknownt oi nt e r a c t wi t hot he rdr ugsl i keAl c ohol . The s ei nt e r a c t i onsa r es ome t i me s be ne f i c i a la nds ome t i me sma y pos et hr e a t st ol i f e . Al wa ys c on s ul tyourphys i c i a nf or t hec ha ngeofdos e r e gi me nora na l t e r na t i ve dr ugofc hoi c et ha t ma ys t r i c t l y ber e qui r e d.


H E M O R R H O I D


Hemor r hoi d WhatareHemorrhoi ds?

He mor r hoi ds ,a l s oc a l l e dpi l e s ,a r es wol l e na ndi nf l a me dve i ns i nyoura nusa ndl owe rr e c t um

AnatomyofHemorrhoi d.

Thea r t e r i e ss uppl yi ngbl oodt ot hea na lc a na lde s c e ndi nt ot he c a na lf r omt her e c t uma bovea ndf or mar i c hne t wor kofa r t e r i e s t ha tc ommuni c a t ewi t he a c hot he ra r oundt hea na lc a na l . Be c a us eoft hi sr i c hne t wor kofa r t e r i e s ,he mor r hoi da lbl ood ve s s e l sha vear e a dys uppl yofa r t e r i a lbl ood. Thi se xpl a i nswhy bl e e di ngf r omhe mor r hoi dsi sbr i ghtr e d( a r t e r i a lbl ood) r a t he rt ha nda r kr e d( ve nousbl ood) ,a ndwhybl e e di ngf r om he mor r hoi dsoc c a s i ona l l yc a nbes e ve r e . Thebl oodve s s e l st ha t s uppl yt hehe mor r hoi da lve s s e l spa s st hr ought hes uppor t i ng t i s s ueoft hehe mor r hoi da lc us hi ons . Thea na lve i nsdr a i nbl ood a wa yf r omt hea na lc a na la ndt hehe mor r hoi ds . The s eve i nsdr a i ni nt wodi r e c t i ons . Thef i r s tdi r e c t i oni supwa r dsi nt o t her e c t um,a ndt hes e c ondi s downwa r dsbe ne a t ht hes ki n s ur r oundi ngt hea nus . Thede nt a t el i nei sal i newi t hi n t hea na lc a na lt ha tde not e st he t r a ns i t i onf r oma na ls ki n( a node r m) t ot hel i ni ngoft her e c t um.


Hemor r hoi d WhatCausesHemorrhoi ds? 1.i na de qua t ei nt a keoff i be r 2.pr ol onge ds i t t i ngont het oi l e t 3.c hr oni cs t r a i ni ngt oha ve abowe lmove me nt 4.c ons t i pa t i on 5.Pr e gna nc y 6. Tumor si nt hepe l vi sa l s oc a us e e nl a r ge me ntofhe mor r hoi dsby pr e s s i ngonve i nsdr a i ni ng upwa r dsf r omt hea na lc a na l .

WhatAboutSymptoms? •Bl e e di ngdur i ng bowe lmove me nt s •Pr ot r us i ondur i ng bowe lmove me nt s •I t c hi ngi nt hea na la r e a •Pa i n •Se ns i t i vel ump( s )


Hemor r hoi d Whatarethei rTypes?

*I nt e r nalhe mor r hoi ds: Wi t hi nt e r na lhe mor r hoi ds ,youma ys e ebr i ghtr e ds t r e a ksof bl oodont oi l e tpa pe rorbr i ghtr e dbl oodi nt het oi l e tbowla f t e r youha veanor ma lbowe lmove me nt . Youma ys e ebl oodon t hes ur f a c eoft hes t ool . Forc onve ni e nc ei nde s c r i bi ngt hes e ve r i t yofi nt e r na lhe mor r hoi ds , ma nyphys i c i a nsus eagr a di ngs ys t e m: *Fi r s t de gr e ehe mor r hoi ds : He mor r hoi dst ha tbl e e dbutdonotpr ol a ps e . *Se c ondde gr e ehe mor r hoi ds : He mor r hoi dst ha tpr ol a ps ea ndr e t r a c tont he i rown ( wi t horwi t houtbl e e di ng) . *Thi r dde gr e ehe mor r hoi ds : He mor r hoi dst ha tpr ol a ps ebutmus tbepus he dba c ki nbyaf i nge r . *Four t hde gr e ehe mor r hoi ds : He mor r hoi dst ha tpr ol a ps ea ndc a nnotbepus he dba c ki n. *Ext e r nalhe mor r hoi ds: Ext e r na lhe mor r hoi dsc a nge ti r r i t a t e da ndc l otunde rt hes ki n, c a us i ngaha r dpa i nf ull ump. Thi si sc a l l e dat hr ombos e d,orc l ot t e d,he mor r hoi d.


Hemor r hoi d FAKTU Be f o r eyous t a r tt ot a keFa kt u, ma kes ur eyoua r enota l l e r gy t oFa kt uora nyi ngr e di e ntof Ci nc hoc a i ne . Cont r a i ndi c a t i on: dur i ngPr e gna nc y


d i o h r r o m e H Proct oGlyvenol Dr ugI nt e r a c t i on: Noi nt e r a c t i ons ha v ebe e nr e por t e dt oda t e . Whe nPr oc t oGl yve nol mus tnotbeus e d? I nc a s eofhype r s e ns i t i vi t y t oa nyoft hea c t i ves ubs t a nc e s ofPr oc t oGl yve nol .


G

E

R

D


GE RD

Whati sGERD?! !

Ga s t r oe s opha ge a lr e f l uxdi s e a s e( GERD)i samor es e r i ousf or m ofga s t r oe s opha ge a lr e f l ux( GER) ,whi c hi sc ommon. GERoc c ur swhe nt hel owe re s opha ge a ls phi nc t e r( LES)ope ns s pont a ne ous l y ,f orva r yi ngpe r i odsoft i me ,ordoe snotc l os e pr ope r l ya nds t oma c hc ont e nt sr i s eupi nt ot hee s opha gus . GERi sa l s oc a l l e d(a c i dr e f l ux) or (a c i dr e gur gi t a t i on) , be c a us e di ge s t i vej ui c e s —c a l l e da c i ds —r i s eupwi t ht hef ood. Thee s opha gusi st het ubet ha tc a r r i e sf oodf r omt hemout ht o t hes t oma c h. TheLESi sar i ngofmus c l ea tt hebot t omoft he e s opha gust ha ta c t sl i keava l vebe t we e nt hee s opha gusa nds t oma c h. Whe na c i dr e f l uxoc c ur s ,f oodorf l ui dc a nbe t a s t e di nt heba c koft hemout h. Whe nr e f l uxe d s t oma c ha c i dt ouc he st hel i ni ngoft hee s opha gus i tma yc a us eabur ni ngs e ns a t i oni nt hec he s t ort hr oa tc a l l e dhe a r t bur nora c i di ndi ge s t i on. Oc c a s i ona lGERi sc ommona nddoe snot ne c e s s a r i l yme a noneha sGERD.Pe r s i s t e nt r e f l uxt ha toc c ur smor et ha nt wi c eawe e ki s c ons i de r e dGERD,a ndi tc a ne ve nt ua l l yl e a d t omor es e r i oushe a l t hpr obl e ms . Pe opl eofa l la ge sc a nha veGERD.


Gast r oesophageal Ref l exDi sease WhatarethesymptomsofGERD? Thema i ns ympt omofGERDi na dul t si sf r e que nthe a r t bur n, a l s oc a l l e d(a c i di ndi ge s t i on) —bur ni ngt ype2pa i ni nt hel owe r pa r toft hemi dc he s t ,be hi ndt hebr e a s tbone ,a ndi nt he mi da bdome n.Mos tc hi l dr e nunde r12ye a r swi t hGERD, a nds omea dul t s ,ha veGERDwi t houthe a r t bur n.I ns t e a d, t he yma ye xpe r i e nc eadr yc ough,a s t hmas ympt oms ,or t r oubl es wa l l owi ng.


Gast r oesophageal Ref l exDi sease WhatAboutcauses?

Ther e a s ons omepe opl ede ve l opGERDi ss t i l lunc l e a r . Howe ve r ,r e s e a r c hs howst ha ti npe opl ewi t hGERD, t heLESr e l a xe swhi l et her e s toft hee s opha gusi swor ki ng . Ana t omi c a la bnor ma l i t i e ss uc ha sahi a t a lhe r ni ama ya l s o c ont r i but et oGERD. Ahi a t a lhe r ni aoc c ur swhe nt heuppe r pa r toft hes t oma c ha ndt heLESmovea bovet hedi a phr a gm, t hemus c l ewa l lt ha ts e pa r a t e st hes t oma c hf r omt hec he s t . Nor ma l l y ,t hedi a phr a gmhe l pst heLESke e pa c i df r omr i s i ngup i nt ot hee s opha gus . Whe nahi a t a lhe r ni ai spr e s e nt ,a c i dr e f l ux c a noc c urmor ee a s i l y . Ahi a t a lhe r ni ac a noc c uri npe opl eofa ny a gea ndi smos tof t e nanor ma lf i ndi ngi not he r wi s ehe a l t hy pe opl eove ra ge50.Mos toft het i me ,ahi a t a lhe r ni apr oduc e sno s ympt oms . Ot he rf a c t or st ha tma yc ont r i but et oGERDi nc l ude • obe s i t y • pr e gna nc y • s moki ng Commonf oodst ha tc a nwor s e nr e f l uxs ympt omsi nc l ude • c i t r usf r ui t s • c hoc ol a t e • dr i nkswi t hc a f f e i neora l c ohol • f a t t ya ndf r i e df oods • ga r l i ca ndoni ons • mi ntf l a vor i ngs • s pi c yf oods • t oma t oba s e df oods ,l i kes pa ghe t t is a uc e ,s a l s a ,c hi l i ,a ndpi z z a


Gast r oesophage a l Ref l exDi sease Ant odi ne

Pr e c a ut i onsa ndWa r ni ngs: -Fa mot i di nei sc ons i de r e dapr e gna nc y Ca t e gor yBme di c a t i on. Thi sme a nst ha ti ti spr oba bl ys a f ef or us edur i ngpr e gna nc y . -Be c a us et heki dne ysc l e a rf a mot i di nef r om t hebody ,f a mot i di nedos i ngmus tber e duc e d i npe opl ewi t hpoorki dne yf unc t i on, i nc l udi ngki dne yf a i l ur e( r e na lf a i l ur e ) . -Apot e nt i a l l yda nge r ousc ha ngei n t hehe a r tr hyt hm( knowna sQTpr ol onga t i on) ha sbe e nr a r e l yr e por t e di npe opl ewi t hki dne y di s e a s ewhos edos eoff a mot i di newa s nota de qua t e l yr e duc e d. -Someoft hes ympt omsof( GERD) , he a r t bur n,orul c e r sa r es i mi l a rt o s ympt omsofs t oma c hc a nc e r . Thef a c tt ha tf a mot i di nehe l ps r e l i e veyours ympt oms doe snotr ul eoutt he pos s i bi l i t yof s t oma c hc a nc e r .


l a e g a h p o s e o r t s Ga e s a e s i D x e l Ref Gastrolac(Omeprazole) Pr e c a ut i onsa ndWa r ni ngs: St udi e si ndi c a t et ha tpe opl ewhot a ke pr ot onpumpi nhi bi t orme di c a t i ons ( s uc ha some pr a z ol e )ma ybea ta n i nc r e a s e dr i s kf orbr oke nbone s . Ther i s ka ppe a r st obehi ghe s tf orpe opl e whot a kes uc hme di c a t i onsa thi gh dos e sorf orl ongpe r i ods( ove raye a r ) . Youa ndyourhe a l t hc a r epr ovi de rs houl d t a ket hi si nt oa c c ountwhe nde c i di ng i ft hebe ne f i t soft hi sme di c a t i onout we i gh t her i s ksf oryourpa r t i c ul a rs i t ua t i on. Th eus eofpr ot onpumpi nhi bi t or s ( i nc l udi ngt hi sme di c a t i on)ma yi nc r e a s e t her i s kofapot e nt i a l l ys e r i ousc ondi t i on knowna sCl os t r i di um di f f i c i l e a s s oc i a t e ddi a r r he a ( CDAD) .I fyoude ve l op di a r r he at ha tdoe snots e e m t oi mpr ove( e s pe c i a l l yi fi ti s wa t e r ya nda c c ompa ni e dby af e ve ra nda bdomi na lpa i n) , s e e ki mme di a t eme di c a la t t e nt i on.


P E P T I C U L C E R


Pept i cUl cer Whati sPepti cUlcer? i st hemos tc ommonul c e rofa na r e aoft hega s t r oi nt e s t i na lt r a c t t ha ti sus ua l l ya c i di ca ndt huse xt r e me l ypa i nf ul .I ti sde f i ne da s muc os a le r os i onse qua lt oorgr e a t e rt ha n0. 5c m. Asma nya s 70–90% ofs uc hul c e r sa r ea s s oc i a t e dwi t hHe l i c oba c t e rpyl or i , as pi r a l s ha pe dba c t e r i umt ha tl i ve si nt hea c i di ce nvi r onme nt oft hes t oma c h;howe ve r ,onl y40% oft hos ec a s e sgot oadoc t or .


P e p t i c U l c e r WhataboutCauses? Themos tc ommonc a us eofs uc hda ma gei si nf e c t i onoft h e s t oma c hbyba c t e r i ac a l l e dHe l i c oba c t e rpyl or i( H. pyl or i ) . Mos tpe opl ewi t hpe pt i cul c e r sha vet he s eba c t e r i al i vi ngi n t he i rga s t r oi nt e s t i na l( GI )t r a c t . Ye t ,ma nype opl ewhoha ve t he s eba c t e r i ai nt he i rs t oma c hdonotde ve l opa nul c e r . Thef ol l owi nga l s or a i s eyourr i s kf orpe pt i cul c e r s : *Dr i nki ngt oomuc ha l c ohol *Re gul a rus eofa s pi r i n,i bupr of e n,na pr oxe n,orot he r nons t e r oi da la nt i i nf l a mma t or ydr ugs( NSAI Ds ) . Ta ki nga s pi r i n orNSAI Dsonc ei nawhi l ei ss a f ef ormos tpe opl e . *Smoki ngc i ga r e t t e sorc he wi ngt oba c c o *Be i ngve r yi l l ,s uc ha sbe i ngonabr e a t hi ngma c hi ne *Ha vi ngr a di a t i ont r e a t me nt s

Ar a r ec ondi t i onc a l l e dZol l i nge r El l i s ons yndr omec a us e s s t oma c ha ndduode na lul c e r s .Pe r s onswi t ht hi sdi s e a s eha ve at umori nt hepa nc r e a s . Thi st umorr e l e a s e shi ghl e ve l sof aho r monet ha ti nc r e a s e ss t oma c ha c i d.Ma nype opl ebe l i e ve t ha ts t r e s sc a us e sul c e r s .I ti snotc l e a ri ft h i si st r ue ,a tl e a s t f ore ve r yda ys t r e s sa thome .


P e p t i c U l c e r WhataboutSymptoms? Sy mpt omsoful c e rdi s e a s ea r eva r i a bl e . Ma nyul c e rpa t i e nt se xpe r i e nc emi ni ma li ndi ge s t i on, a bdo mi na ldi s c omf or tt ha toc c ur sa f t e rme a l s , or nodi s c omf or ta ta l l .Somec ompl a i nofuppe ra bdomi na l bur ni ngorhunge rpa i nonet ot hr e ehour sa f t e rme a l s ori nt hemi ddl eoft heni ght . The s es ympt omsof t e na r e pr ompt l yr e l i e ve dbyf oodora nt a c i dst ha tne ut r a l i z e s t oma c ha c i d. Thepa i noful c e rdi s e a s ec or r e l a t e s poor l ywi t ht hepr e s e nc eors e ve r i t yofa c t i veul c e r a t i on. So mepa t i e nt sha vepe r s i s t e ntpa i ne ve na f t e ra nul c e ri s a l mos tc ompl e t e l yhe a l e dbyme di c a t i on. Ot he r se xpe r i e nc enopa i na ta l l .Ul c e r sof t e nc omea nd gos pont a ne ous l ywi t houtt hei ndi vi dua le ve rknowi ng t ha tt he ya r epr e s e ntunl e s sas e r i ousc ompl i c a t i on ( l i kebl e e di ngorpe r f or a t i on)oc c ur s .


P e p t i c U l c e r How ArePepti cUlcerDi agnosed? Th ed i a g n o s i so fa nu l c e ri sma d eb ye i t h e rab a r i u mu p p e r g a s t r o i n t e s t i n a lXr a y( u p p e rGIs e r i e s )o ra nu p p e r g a s t r o i n t e s t i n a le n d o s c o p y( EGDo r e s o p h a g o g a s t r o d u o d e n o s c o p y ) . Th eb a r i u mu p p e rGIXr a y i se a s yt op e r f o r ma n di n v o l v e sn or i s k( o t h e rt h a ne x p o s u r e t or a d i a t i o n )o rd i s c o mf o r t . Ba r i u mi sac h a l k ys u b s t a n c et h a t i ss wa l l o we d . I ti sv i s i b l eo nX-r a y s , a n da l l o wst h eo u t l i n e o ft h es t o ma c ht ob es e e no nXr a y s ;h o we v e r , b a r i u mXr a y s a r el e s sa c c u r a t ea n dma ymi s su l c e r si nu pt o2 0 %o ft h et i me . Anu p p e rg a s t r o i n t e s t i n a le n d o s c o p yi smo r ea c c u r a t et h a n Xr a y s , b u ti n v o l v e ss e d a t i o no ft h ep a t i e n ta n dt h ei n s e r t i o n o faf l e x i b l et u b et h r o u g ht h emo u t ht oi n s p e c tt h ee s o p h a g u s , s t o ma c h , a n dd u o d e n u m. Up p e re n d o s c o p yh a st h ea d d e d a d v a n t a g eo fh a v i n gt h ec a p a b i l i t yo fr e mo v i n gs ma l lt i s s u e s a mp l e s( b i o p s i e s )t ot e s tf o rH. p y l o r ii n f e c t i o n . Bi o p s i e sa r ea l s oe x a mi n e du n d e rami c r o s c o p et oe x c l u d e ac a n c e r o u su l c e r . Wh i l ev i r t u a l l ya l ld u o d e n a lu l c e r sa r e b e n i g n , g a s t r i cu l c e r sc a no c c a s i o n a l l yb ec a n c e r o u s . Th e r e f o r e , b i o p s i e so f t e na r ep e r f o r me do ng a s t r i cu l c e r st o e x c l u d ec a n c e r .


P e p t i cU l c e r Zant ac(Ranitidine)

Pr e c a ut i onsa ndWa r ni ngs: -Rani ti di nei sc ons i de r e dapr e gna nc yCa t e gor yBme di c a t i on. Thi sme a nst ha ti ti spr oba bl ys a f ef orus edur i ngpr e gna nc y . -Be c a us et heki dne ysc l e a rRani ti di nef r omt hebody ,Rani ti di ne dos i ngmus tber e duc e di npe opl ewi t hpoorki dne yf unc t i on, i nc l udi ngki dne yf a i l ur e( r e na lf a i l ur e ) . -Apot e nt i a l l yda nge r ousc ha ngei nt hehe a r tr hyt hm ( knowna sQTpr ol onga t i on)ha sbe e nr a r e l yr e por t e di npe opl ewi t hki dne y di s e a s ewhos edos eoff a mot i di newa snota de qua t e l yr e duc e d.


Pept i cUl cer Omepral( Omeprazole) Pr e c a ut i onsa ndWa r ni ngs: St udi e si ndi c a t et ha tpe opl ewhot a ke pr ot onpumpi nhi bi t orme di c a t i ons ( s uc ha some pr a z ol e )ma ybea ta n i nc r e a s e dr i s kf orbr oke nbone s . Ther i s ka ppe a r st obehi ghe s tf orpe opl e whot a kes uc hme di c a t i onsa thi gh dos e sorf orl ongpe r i ods( ove raye a r ) . Youa ndyourhe a l t hc a r epr ovi de rs houl d t a ket hi si nt oa c c ountwhe nde c i di ng i ft hebe ne f i t soft hi sme di c a t i onout we i gh t her i s ksf oryourpa r t i c ul a rs i t ua t i on.


C O M M O N C O L D


RESPIRATORYCONDITIONS Defi ni ti on:

Thec ommonc ol di ss e l f l i mi t i ngi nf l a mma t or y vi r a li nf e c t i onsoft heuppe rr e s pi r a t or yt r a c t . I ti st hemos tf r e que n ta c ut ec ondi t i ont owhi c h ma ni ss ubj e c t e d.Pha r ma c i s t sr e c e i vemor eque s t i o ns r e l a t e dt oc ommonc ol di t st he r a pyt ha na l lot he r me di c a lc ondi t i onsc ombi ne d.


RESPIRATORYCONDITIONS Symptoms

Thes ympt omsoft hec ommonc ol dt ypi c a l l ybe gi nt wot o t hr e eda ysa f t e ra c qui r i ngt hei nf e c t i on( i nc uba t i onpe r i od) . Sy mpt omsa nds i gnsoft hec ommonc ol dva r yde pe ndi ngon t hevi r usr e s pons i bl ef ort hei nf e c t i ona nd ma yi nc l udet hef ol l owi ng: •na s a ls t uf f i ne s sordr a i na ge , •s or eors c r a t c hyt hr oa t ,•s ne e z i ng, •hoa r s e ne s s , •c ough,•wa t e r ye ye s , •l owgr a def e ve r ,• he a da c he ,•bodya c he s ,•f a t i gue . Thec ol dma ybe gi nwi t har unnynos ewi t hc l e a rna s a l di s c ha r ge ,whi c hl a t e rma ybe c omeye l l owi s horgr e e ni s h i nc ol or .I nf a nt sa ndc hi l dr e nma ya l s obe c omemor e f us s ya ndha vede c r e a s e da ppe t i t e . Thes ympt omsoft hec ommonc ol dwi l lt ypi c a l l yl a s t a nywhe r ef r omf ourt o14da ys ,wi t hmos ti ndi vi dua l s i mpr ovi ngi nonewe e k.


RESPIRATORYCONDITIONS Di agnosi s

Thephys i c i a norhe a l t hc a r epr a c t i t i one rwi l lge ne r a l l y di a gnos et hec ommonc ol dba s e dont hede s c r i pt i onof yours ympt omsa ndt hef i ndi ngsonyourphys i c a le xa m. La bor a t or yt e s t i nga ndi ma gi ngs t udi e sa r ege ne r a l l ynot ne c e s s a r yunl e s st he r ea r ec onc e r nsa bouta not he runde r l yi ng me di c a lc ondi t i onorpot e nt i a lc ompl i c a t i ons .

Preventi on

Themos ti mpor t a ntme a s ur et opr e ve ntt hec ommonc ol d i st oa voi di nf e c t e di ndi vi dua l s .Fr e que ntha ndwa s hi ngi s a l s oe xt r e me l yi mpor t a nt ,a st hi sc a nde s t r oyvi r us e st ha t youha vea c qui r e df r omt ouc hi ngc ont a mi na t e ds ur f a c e s . Al s o,t r yt oa voi ds ha r i ngut e ns i l sa ndt r yt ous edi s pos a bl e i t e ms( s uc ha sdi s pos a bl ec ups )i fs ome onei nyourf a mi l y ha sac ol d.Fi na l l y ,l i f e s t yl emodi f i c a t i onss uc ha ss moki ng c e s s a t i ona nds t r e s sma na ge me ntma yde c r e a s eyour s us c e pt i bi l i t yt oa c qui r i ngt hec ommonc ol d. Att hi st i me , a ne f f e c t i veva c c i nea ga i ns tt hec ommonc ol di snota va i l a bl e .


RESPIRATORYCONDITIONS Treatment

An t i b i o t i c sp l a yn or o l ei nt r e a t i n gt h ec o mmo nc o l d . An t i b i o t i c sa r ee f f e c t i v eo n l ya g a i n s ti l l n e s s e sc a u s e db y b a c t e r i a , a n dc o l d sa r ec a u s e db yv i r u s e s . No to n l yd o a n t i b i o t i c sn o th e l p , b u tt h e yc a nr a r e l ya l s oc a u s es e v e r e a l l e r g i cr e a c t i o n st h a tc a ns o me t i me sb ef a t a l Ge n e r a l l y , t h ec o mmo nc o l dc a nb et r e a t e da tho mea n d ma n a g e dwi t ho v e r t h e c o u n t e rme d i c a t i o n s . Ho we v e r , i fy o ud e v e l o pmo r es e v e r es y mp t o mss u c ha s s h a k i n gc h i l l s , h i g hf e v e r( g r e a t e rt h a n1 0 2F) , s e v e r eh e a d a c h e , n e c ks t i f f n e s s , v o mi t i n g , a b do mi n a lp a i n , d i f f i c u l t yb r e a t h i n g , c h e s tp a i n , c o n f u s i o n , o r f a i l u r et oi mp r o v ea f t e r1 0d a y s , y o us h o u l dc o n s u l ty o u r p h y s i c i a no rh e a l t h c a r ep r a c t i t i o n e ri mme d i a t e l y . I n f a n t s3mo n t h so fa g eo ry o u n g e rwh od e v e l o pac o l d o rf e v e rs h o u l dc o n s u l tt h e i rh e a l t h c a r ep r a c t i t i o n e ra swe l l . I fy o uh a v eas o r et h r o a ta n daf e v e rwi t hn oo t h e rc o l d s y mp t o ms , y o us h o u l da l s ob ee v a l u a t e db yy o u rp h y s i c i a n . Th i si l l n e s sma yb es t r e pt h r o a t , ab a c t e r i a li n f e c t i o n r e q u i r i n gt r e a t me n twi t ha n t i b i o t i c s . Fi n a l l y , i fy o un o t i c ef a c i a lp a i no ry e l l o w/ g r e e nd r a i n a g e f r o my o u rn o s ea c c o mp a n i e db yaf e v e r , i ti sp o s s i b l et h a t y o uh a v eas i n u si n f e c t i o n ( s i n u s i t i s )t h a two u l db e n e f i tf r o m ame d i c a le v a l u a t i o na n dap o s s i b l ec o u r s eo fa n t i b i o t i c s .


4 01 1AhmedAbdul l ah 4 01 3AhmedE l s nos y 4 01 4AhmedSak r 4 01 5AhmedAl s hamy 4 01 7AhmedGado 4 025E s r aaE br ahi m 4 026E s r aaOs amaBar ak at 4 027E s r aaOs amaSal eh 4 029E s r aaAdel 4 032E s r aaAl i 4 033E s r aaMohamed 4 034E s r aaMohyE l Dei n

Community Pharmacy Drug Album..  

faculty of Pharmacy - helwan university

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