Archive for January, 2011

Women and Epilepsy

January 31st, 2011
James Pendergraft asked:




Epilepsy is a common neurological disorder that is characterized by recurrent and unprovoked seizures. The seizures are transient signs or symptoms of abnormal and excessive neuronal activity in the brain. A large percentage of people all over the world have epilepsy, and it usually occurs in young children or the elderly. This disease is usually controlled, but it is not fully cured with medication. Surgery can be an option but not for all cases. The syndrome of epilepsy will not occur lifelong; some forms are just confined in the early childhood of the affected person. This disease should not be understood as a single disorder but rather as a group of syndromes that has divergent symptoms but all of them involve electrical activity in the brain.  

Epilepsy and Women’s Hormones

Women with epilepsy are a special case, and it requires some considerations because of the relationship between the female sex hormones—the estrogen and the progesterone—and the seizures. There are some women who experience fluctuating seizures because of the differences in the amount of hormone present in the body. Some significant times in a woman’s life where hormonal changes are observed are during her puberty stage, during pregnancy, and during the menopausal stages.

Estrogen and progesterone regulate the menstrual cycle, and they prepare the women’s body for reproduction. Estrogen can excite the electrical activity of the brain and increase the risks of seizure, while progesterone suppresses the electrical activity and reduces seizure risks. The two can be balanced for most times, but when an imbalance occurs where more estrogen is produced than the progesterone, women with epilepsy will have high risks of seizure.

Epileptic Women and Pregnancy

There are some important things that an epileptic woman should know first before using any birth control pills and planning on a pregnancy. Birth control pills are safe for a woman with epilepsy, but there are also some conditions in which the use of birth control pills are risky because they can be rendered less effective when anti-seizure drugs are also taken. Anti-seizure drugs can increase the risk of birth defects. There are many anti-seizure drugs and medications that can be used as birth control and hormonal pills that have no ill effects on child bearing. These drugs are:

1).One group of anti-seizure drugs is known as “liver enzyme-inducing” drugs. They increase the rate at which the liver breaks down the contraceptive hormones that you get from birth control. This means that the contraception medication will leave your body faster. Liver enzyme-inducing drugs include oxcarbazepine (Trileptal), carbamazepine (Carbatrol, Tegretrol), phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline), and topiramate (Topamax). If you are taking one of these drugs, it can make your hormonal birth control less effective.

2).Two drugs—felbamate (Felbatol) and valproate (Depakote)—can even heighten the hormonal levels. If you are on one of these drugs, your doctor may need to adjust the dosage of your birth control so that you don’t have too much of the contraceptive in your body.

3).Finally, there are “neutral” drugs that do not have any effect on hormone breakdown. Lamotrigine (Lamictal), gabapentin (Neurontin), levetiracetam (Keppra), clobazam, clonazepam, ethosuximide, Lyrica, sodium valproate, Zonegran, and tiagabine (Gabitril) will not interfere with your birth control.



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Allergy Testing Through Skin and Blood Test

January 30th, 2011
Wendy Gorman asked:




In the United States alone, there are already over 50 million of people who are diagnosed with allergies. The very first important step in allergy testing and therefore effective treatment, is to identify what you are allergic to. Current developments in medical technology have made allergy testing more efficient and convenient han used to be the case. Allergy tests are conducted in order to identify what specific things – food, environment, etc., actually trigger one’s allergic reactions and results are compared with a study of the patient’s medical history to obtain more efficient results.

Allergies are exaggerated reactions from our immune system in response to body contact with a particular unfamiliar substance. It is an exaggerated reaction because only people with an allergic condition react to these foreign substances. When our body comes in to contact with allergens or the “unfamiliar substances”, people who are allergic to that substance cause their immune system to develop an allergic reaction. If your body reacts to a substance that is not harmful to others, then you are said to be allergic or atopic. An allergy test is suitable for both adults and children, since all ages can be susceptible to allergic reactions.

Allergy Testing can take two forms – skin test and blood test. Normally, testing is done under the guidance of a specialist in allergy, who are skilled in the best methods for identifying allergies as well as the appropriate methods for treating them.

In the first form, skin testing, a sample of a potential allergen is taken from the surface of the skin. The test is usually carried out on the back or on the forearm. Various suspected allergens are tested at the same time. If you prove to be allergic to a particular test, you are likely to develop a swelling and redness at the test spot. Occasionally, the doctor will suggest a second test procedure. With this process, a small amount of assumed allergen is injected into the skin of the of the forearm. As with first test, many suspected allergens can be tested on the same time.

The result of a skin test is usually available immediately. Positive reactions often appear within 20 minutes for either of the tests. Swelling and redness may occur few hours after the test was completed, but this delayed reaction often fades away within 24 to 48 hours. It should however, always be reported to the doctor or nurse. With both types of skin test, there is usually only minimal pain or indeed no pain at all. A positive reaction on the test however, can be more annoying as it can feel like a mosquito bite and is likely to be accompanied by redness and swelling. On a lighter note, these can be expected to disappear within just a few minutes or hours.

The second form of allergy testing, the blood test, is often used in cases that the patient is undergoing a medication that would hamper skin testing or if the patient is suffering from severe skin conditions such as eczema. Blood testing is also used when dealing with babies or young children as a single needle stick for the test is better than various skin tests. Unlike the skin test, the result of a blood test takes some time as the sample needs to be analysed by a laboratory. It is however more costly to administer than the skin test.

Each test method has its advantages and disadvantages and the test results alone are not enough to completely diagnose an allergy. In all cases, using either type of test, results need to be considered together with the patient’s personal medical history.

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Preventing Errors w/ Neuromuscular Blocking Agents (Aug. 06)

January 30th, 2011
LawsuitGuru asked:


ISMP recently issued a Safety Alert called “Paralyzed by Mistakes,” which warned about inadvertently giving neuromuscular blocking agents such as pancuronium to patients who aren’t receiving ventilator support. This can lead to respiratory arrest. Some patients have died or incurred permanent injuries as a result of these errors. ISMP notes that some of the errors are due to look-alike packaging and labeling. In one case, an ED nurse administered pancuronium instead of flu vaccine because the vials and labeling looked very similar. Look-alike drug names have also caused problems. In one case vancomycin was misread on a faxed medication record as vecuronium. Giving the neuromuscular blocking agent after the patient is extubated has resulted in serious problems, too. In one case, an infusion bag of vecuronium was left in a patient’s room after ventilator support had been removed. The bag was later mistaken as potassium chloride infusion and administered to the patient. Serious patient injuries have also been caused by the opposite problem ie, administering the neuromuscular blocking agent too soon, before the patient is intubated. Some errors have resulted from preparing syringes from a multiple-dose vial and neglecting to label them. In one case, an unlabeled syringe of vecuronium ended up in a supply of saline flush syringes and was given to a 3-year old child. Unsafe storage is another cause of serious mistakes. Seven infants in a hospital nursery received atracurium

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