ExerciseIt is generally believed but not rigorously tested that exercise, even when it causes pain, shortens periods of pain.RelaxationApparently contradictory to exercise, relaxation is intended to correct abnormal postures.Deep massageIt is intended to break tissue free from constriction.Manipulation, osteopathy and chiropracticeThe most organized of complementary therapies, manipulation, osteopathy and chiropractice are designed to force tissue in abnormal locations into a normal position. They use escalating force to achieve this end. Evidence is lacking that the abnormal location existed in the first place and that normality is restored. A large number of so-called trials have been carried out but they are so far uniformly unsatisfactory. The most common problem if one therapy is compared with another is that the differences are so obvious to the patient. For example, chiropractors organized an elaborate trial in which randomly assigned patients received either chiropractic therapy or a course of hospital physiotherapy, and the chiropractic patients did better. But the chiropractic patients were given a series of treatments in the private offices of practitioners who knew their profession was on trial. The other patients went without fanfare to receive routine physiotherapy by unchallenged practitioners who gave fewer and shorter sessions. No wonder chiropractice appeared superior.In another recent analysis of various types of physiotherapy matched against so-called placebos, the only significant result was that the longer the treatment lasted, the better was the outcome. This result applied equally to the designated therapies and their placebos. Whatever the placebo component may be, there is no doubt that these therapies, like many of those we have considered, produce some tissue damage.*59\219\2*
Archive for June, 2011
There are four main types of protease inhibitors. Detailed below are the recommended dosages, interactions with other medicines and the side-effects of protease inhibitors.Indinavir: Eight hundred milligrams of this medicine is recommended either one hour before meals or two hours after meals. Common side-effects include disturbances of the digestive system. Occasionally some people may have headache, blurred vision, rash, dizziness, metallic taste in the mouth and abnormal bleeding or bruising in the body.Indinavir is not recommended with medicines such as rifampicin, cisapride, triazolam and midazolam.Ritonavir: The recommended dose of this medicine is six hundred milligrams twice a day to be taken with meals. This dose is reached by gradually increasing it during fourteen days. The first two days three hundred milligrams of ritonavir is recommended twice day followed by four hundred milligrams twice a day for the next three days. On days six to thirteen, five hundred milligrams is recommended twice a day. Thereafter, six hundred milligrams is recommended twice a day. Ritonavir is often recommended in combination with saquinavir, another protease inhibitor.Common side-effects include nausea, vomiting, diarrhoea, decreased sensation in the limbs, hepatitis and change in the taste sensation. Ritonavir is not recommended with medicines such as cisapride, tranquillisers, quinidine, etc. It can increase the levels of clarithromycin and decrease the levels of zidovudine.Nelfinavir: The recommended dose for adults is seven hundred and fifty milligrams three times a day with meals. Common side-effects include diarrhoea, pain in the abdomen, nausea, rashes and increased gas in the bowels. Medicines such as rifampicin, can reduce the levels of nelfinavir. This medicine is not recommended for use along with tranquillisers, cisapride, etc. It increases the levels of other protease inhibitors such as indinavir and saquinavir.Saquinavir: The recommended dose is six hundred milligrams to be taken three times a day. Some preparations may also be recommended in the dose of twelve hundred milligrams three times a day. Common side-effects include disturbances in the digestive system such as nausea, diarrhoea, pain in the abdomen, headache and indigestion. The levels of saquinavir in the blood are increased by ritonavir and nelfinavir (protease inhibitors) and grapefruit juice. Their levels are reduced by rifampicin, some medicines used for treatment of epilepsy and steroids. It is not recommended along with rifampicin and some tranquillisers. Zidovudine is recommended in almost all combinations of medicines recommended for treatment of HIV infection. This is because its benefits have been observed for a long time and it can enter the brain more effectively than other medicines. HIV not only affects the blood but can also enter the brain. Thus, if a medicine does not enter the brain, it cannot control the infection effectively.*22\288\2*
What is Imuran?Imuran (azathioprine) is an immunosuppressant that changes the DNA structure of certain cells.It is used for rheumatoid arthritis that is difficult to treat and does not respond to other agents.Imuran in a dosage of 1 to 2.5 milligrams is generally given per kilogram of body weight. If your doctor weighs you before beginning this agent, this is why.Nausea, vomiting, belly pain, and occasionally hepatitis or problems with the making of blood cells are seen with this agent. If you also have gout and are taking the drug allopurinal (Zyloprim), make sure you tell your doctor, as your Imuran dosage will have to be adjusted.
What is leflunomide?This drug’s brand name is Arava. It is another drug that acts on the DNA of cells like the T cells. It is new and quite useful in the treatment of RA and is as effective as methotrexate or sulfasalazine.The doctor gives you a loading dose in order to get the blood levels of the drug up to therapeutic levels in your body: The patient is started with 100 milligrams per day for three days. After three days, the dose is lowered to 20 milligrams daily. If the patient tolerates the drug, the dose can be lowered to 10 milligrams per day.Diarrhea is the most frequent side effect. Changes in the liver function tests, reversible hair loss, and a rash are all part of this drug’s side effects.Women who expect to become pregnant and men expecting to father a child should discontinue the drug and replace it with cholestyramine for eleven days to bind up the drug and eliminate it. Your doctor can test your blood levels to make sure that it is out of your system before you get pregnant or father a child.*35/141/5*