Street's Health Discussion. Volume 1 Issue 1

[Street Pharmacist]

Originally Posted by Sr. Mints

After having surgery on my face to remove some skin cancer, I was told to put vaseline or Fucidin on the stitches, but not Polysporin because prolonged use of Polysporin causes a reaction (or something.)

Can you clarify?

Not sure what the reason would be to be honest. Maybe the Dr had some patients report some adverse reactions? It's a pretty lousy antibiotic due to vast override though.

[Street Pharmacist]

Originally Posted by Puxlut

1)Why would taking a daily vitamin give me a wicked headache? I read that it might be the niacin?

2)I take either naproxen or ibuprofen for my back. My doctor said that prolonged use of these are bad for you. True? and How? and What other alternative do I have?

1) niacin can cause a drop in bp and increase cutaneous vadodilation. The drop in bp can cause headaches. It's actually a fairly common reaction to niacin. Maybe stop taking a multivitamin

2) prolonged use of NSAIDS (non-steroidal anti-inflammatory drugs such as aspirin, Advil, Aleve) can lead to ulcer formation. This happens because they decrease how much protective mucus (the stomach's protective "lining") is produced. Over time the acid in the stomach can then burn the actual stomach tissue. NSAIDS also increase blood pressure and have been proven to contribute to cardiovascular events like heart attacks and stroke.
You have three options:
1) Acetaminophen (Tylenol) is a pain killer that does not cause the above effects and at normal doses (<1300mg per dose and <3200mg per day) is very safe. Probably your best option if it works
2) Narcotics are addictive and can cause impairment, dysphoria and constipation among other things. At your age a very poor idea imo.
3) Topical NSAIDS are a good way of getting some anti inflammatory action and minimizing the stomach issue (though not eliminating it entirely)

My suggestion? Take a Tylenol Arthritis (or house brand equivalent) the times daily and add Voltaren Emulgel if needed up to three times daily. Ok to use both together.

All of this is assuming you don't have any allergies or other medical issues I'm not aware of...

[Minnie]

Street, isn't there a new drug on the market in response to the NSAID/stomach issue? Combines the NSAID with a proton pump inhibitor?

In regards to the daily multi-vitamin, I don't take any because most of them contain zinc, which for some reason makes me very nauseated. Interesting about the vasodilation with the niacin. Didn't know that.

[Street Pharmacist]

Originally Posted by Minnie

Street, isn't there a new drug on the market in response to the NSAID/stomach issue? Combines the NSAID with a proton pump inhibitor?

In regards to the daily multi-vitamin, I don't take any because most of them contain zinc, which for some reason makes me very nauseated. Interesting about the vasodilation with the niacin. Didn't know that.

Vimovo is a combination of naproxen and nexium which have both been around a very long time. Oddly enough, Vimovo is literally half the price of nexium alone, which makes no real sense. Other option is Arthrotec which is Diclofenac (NSAID) and misoprostil which actually increases the secretion of the gastric mucosal lining. Essentially though, nothing new, but does lower the chance of ulcer formation significantly. Tylenol with Voltaren is still a better option IMO

[Minnie]

Bump for a question.

Have a friend who is recovering from some surgery and they are using peroxide for cleansing. We were vehemently warned off of that for wound care, by more than one of my daughter's docs, that it is actually bad for wound care (breaks down skin? can't remember exactly what they said) so we have never used it. Said post-surgical friend's incisions keep opening up and I wonder it might be helped along by the peroxide use.

Anything to that, that you've heard of - the peroxide skin issues?

[Street Pharmacist]

Originally Posted by Minnie

Bump for a question.

Have a friend who is recovering from some surgery and they are using peroxide for cleansing. We were vehemently warned off of that for wound care, by more than one of my daughter's docs, that it is actually bad for wound care (breaks down skin? can't remember exactly what they said) so we have never used it. Said post-surgical friend's incisions keep opening up and I wonder it might be helped along by the peroxide use.

Anything to that, that you've heard of - the peroxide skin issues?

Sorry, missed this. Came to bump for an article and came across this. Peroxide oxygenates a wound and also destroys immune cells in the wound helping to fight off infection. It is really on useful if you have no access to sterile water. Not a good idea anyways in my opinion.

[Street Pharmacist]

http://news.nationalpost.com/2013/03...medical-chief/

“Antimicrobial resistance poses a catastrophic threat. If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics,” Davies told reporters as she published a report on infectious disease.

One of the best known superbugs, MRSA, is alone estimated to kill around 19,000 people every year in the United States – far more than HIV and AIDS – and a similar number in Europe.

[Knut]

I tried to clean out my ear wax today with Cerumol. Does this work ? Do you have a good alternative? I have read the 3% Hydrogen Peroxide works well, but i am not sure i trust internet posts for treatments (seen some poor ones for pink eye online).

[Azure]

Originally Posted by Street Pharmacist

http://news.nationalpost.com/2013/03...medical-chief/

This is the #1 reason why health delivery has to be changed ASAP. Way too many doctors simply prescribing antibiotics instead of actually figuring out the problem and fixing it.

[Street Pharmacist]

Originally Posted by Hesla

I tried to clean out my ear wax today with Cerumol. Does this work ? Do you have a good alternative? I have read the 3% Hydrogen Peroxide works well, but i am not sure i trust internet posts for treatments (seen some poor ones for pink eye online).

It works ok. Turns wax water soluble. Trouble is it may take away some lubrication for future wax to escape essentially causing this to happen again.

Not a solution with evidence, but likely works. They are both peroxides doing the same thing, though carbamide peroxide is likely less irritating.

Mineral oil can help decrease the viscosity of the wax helping your ear to clean itself. A drop a couple of times a week can often take care of the problem

[theg69]

Originally Posted by Street Pharmacist

It works ok. Turns wax water soluble. Trouble is it may take away some lubrication for future wax to escape essentially causing this to happen again.

Not a solution with evidence, but likely works. They are both peroxides doing the same thing, though carbamide peroxide is likely less irritating.

Mineral oil can help decrease the viscosity of the wax helping your ear to clean itself. A drop a couple of times a week can often take care of the problem

Just to add to this, DO NOT USE Q-TIPS. For the love of humanity, I still cannot understand why people keep sticking things into their ears. To date, I have had to refer to ENT a couple of times for large hematomas (gigantic blood clot from ear instrumentation) and had to take a pair of tweezers to pull out the cotton tip of a q-tip from some guy's ear.

Generally, just use some Cerumol twice a week. If it still feels plugged, use the Cerumol daily for a few days, book an appointment with a doctor, and he/she will flush it out for you and visualize the tympanic membrane afterwards.

[Sr. Mints]

Is Apo-Cephalexin 500mg supposed to smell rotten and putrid? Picked it up from the pharmacy yesterday...

[boobaloo]

Is there anything better than Rabeprazole? It's not working very well

[Minnie]

Question regarding T3s.

1) Can they make you hyper? Perhaps hyper isn't the right word. Generally they are supposed to cause drowsiness but it's pretty much the opposite.

2) Can they cause chest pain?

3) Can they cause hoarseness?

[Raekwon]

Originally Posted by Minnie

Question regarding T3s.

1) Can they make you hyper? Perhaps hyper isn't the right word. Generally they are supposed to cause drowsiness but it's pretty much the opposite.

2) Can they cause chest pain?

3) Can they cause hoarseness?

T3 has caffeine in it.

[Street Pharmacist]

Originally Posted by Sr. Mints

Is Apo-Cephalexin 500mg supposed to smell rotten and putrid? Picked it up from the pharmacy yesterday...

Yes. Gross

[Street Pharmacist]

Originally Posted by Minnie

Question regarding T3s.

1) Can they make you hyper? Perhaps hyper isn't the right word. Generally they are supposed to cause drowsiness but it's pretty much the opposite.

2) Can they cause chest pain?

3) Can they cause hoarseness?

1) It happens. They have much less caffeine than a can of coke, but codeine itself does weird things to some people. Including 2)

3) I doubt it

[cral12]

Originally Posted by Puxlut

1)Why would taking a daily vitamin give me a wicked headache? I read that it might be the niacin?

2)I take either naproxen or ibuprofen for my back. My doctor said that prolonged use of these are bad for you. True? and How? and What other alternative do I have?

Along with what Street Pharmacist highlighted with respect to naproxen/ibuprofen, long-term regular use can have negative impact on kidney function, which should be monitored closely.

For your back, consider non-pharmacological options first and foremost.

[DuffMan]

I pour peroxide on all of my wounds.

[Sr. Mints]

Broke my back a few years ago, and I've been taking a ton of meds for leg pain, including Nortriptyline. I've been going to the same Pharmacy since the '90s at least, but switched this week to a local Shoppers Drug Mart because it is more convenient.

Anyway, I dropped off my prescriptions on Monday and picked them up on Tuesday. When I got home, I notice instead of Nortriptyline I was given Amitriptyline. I thought it was maybe a generic version or something. Reading online, it sounded to me like it was similar, though it did look quite different.

Yesterday something in my mind had me call Shoppers. They said they'd pull the original prescription and call me back. About an hour later a pharmacist called and his first question was "have you taken any of the Elavil (Amitriptyline)?" I said I didn't think so. Well it's the wrong prescription. Oh, okay. Fine. #### happens. They'd refund me for the Amitriptyline and give me the Nortriptyline for free.

Today I got a call from the owner of that Shoppers, who was profusely apologetic, and again she asked me if I had taken the medication. I honestly forgot to check. I put all my pills in those 7-day sorter things. I told her I'd be in tonight to trade the pills in, and she told me the pharmacist who made the screw up would be working.

Tonight I went in, and he knew who I was and had everything ready. He was apologetic, etc., etc. I told him not to fret it, and I could tell he probably got in deep ####. And again, he asked if I had taken any of the pills. I just lied and said no, even though I still wasn't sure as I went straight from work to the store.

Get home, and it appears I took the two 25 mg Amitriptyline pills two nights ago. No big deal, I'm still alive and my urine isn't fluorescent purple or anything.

But just out of curiosity, I wonder what kind of liability the company would face? I have no plans to call them and tell them I've taken any. The matter is closed in my book. But they kept asking if I'd taken any, and that is nagging in my mind.