colchicine over dose

What is colchicine?
Colchicine is a drug used to treat gout. Gout is an inflammation of joints caused by high levels of uric acid in the blood. We already discussed it here in the past.

Colchicine. Read on about the possible side effects and you might understand the skull drawing on the bottle.

What can it do?
According to web site Epocrates Online, these are the things colchicine can do to you. We explain each medical word in simple terms. Please note: As with each drug, a list of side effects doesn’t mean you will definitely get them all, or even one of them. In the House episode many of them appeared both because the guy had an overdose, and because, well, it’s TV.
Serious reactions:
1. Myelosuppression – This means suppression of your bone marrow, where your blood cells are created. When our bone marrow is suppressed, we can have anemia, be more prone to infections, and we may bleed more easily.
2. Leukopenia (lack of white blood cells – responsible for fighting infections), thrombocytopenia (lack of platelets – responsible for stopping bleeding), granulocytopenia (lack of a type of white blood cells also responsible for fighting infections), pancytopenia (this means lack of all types of blood cells altogether) – All of these can happen when your bone marrow is suppressed.
3. Diarrhea, severe – Well, this doesn’t require any explanation, does it?
4. Myopathy – This means an inflammation in your muscles, causing them to be weak, among other things.
5. Rhabdomyolysis – This means breakdown of muscles.
6. Neuropathy – This is something the guy in the show had at the end, and it means an inflammation of nerves. It can cause tingling, pain or a lack of sensation in our fingers.
7. Hepatotoxicity – This means a toxic effect on our liver.
8. Nephrotoxicity – This means a toxic effect on our kidneys.
9. Multiple organ failure, including fatal – This means that instead of just one organ in our body having problems (like the liver or kidney above), many organs stop working properly altogether.
10. DIC – This means “disseminated intravascular coagulation”. It’s a condition in which blood clots form inside blood vessels throughout the body while at the same time bleeding can happen.
11. Hypersensitivity reaction – This means an allergic reaction to a drug. It can be anything from a rash or fever (seen on the show) to a potentially fatal condition called anaphylaxis. The latter one can show up as a low blood pressure (like the guy on the show had).
12. Azoospermia – This is a condition in which a person doesn’t have enough sperm in the semen.
Common reactions:
1. Diarrhea, nausea/vomiting, cramping, abdominal pain
2. Fatigue
3. Headache
4. Pharyngolaryngeal pain – This means pain in the throat and mouth.
Words marked in orange are symptoms the guy on the show had.

Summary
There you have it. A simple change of a pill, plus overdosing on the new one can certainly kill you. Don’t try this at home kids…

who theme of the year ---antimicrobial resistance

'The arsenal to fight microbes is very weak right now'

Apr 27, 2011, 12.00am IST

Tags:

• World Health Organisation

The World Health Organisation (WHO) has made antimicrobial resistance the theme of this year's World Health Day. The WHO representative to India, Nata Menabde , spoke to Rema Nagarajan on why the issue of growing resistance to antibiotics is a threat to the global fight against infectious diseases and what the Indian government needs to do to address this issue:
How serious is the problem of the irrational use of antibiotics?
It's a very serious problem globally because it endangers human lives when antibiotics don't work. In 80 years, 150 antibiotics have been developed. No new antibiotics are expected for at least 10 years. Hence, the arsenal to fight the microbes is very weak now. Antibiotic resistance in any part of the world is a threat to global health security as the resistant microbes travel and spread fast with global travel and trade.
Why is the problem said to be more serious in India?

It is an even bigger problem in this region because infectious diseases account for 40% of all diseases in Asia. Diseases like malaria, tuberculosis and HIV can only be treated with antibiotics. We don't even know how big the problem is in India because there is no surveillance system. In malaria we know that chloroquine is not working. So far more expensive artemisinin derivatives are being used. Similarly, many people are infected with TB bacteria resistant to first-line drugs. So you're forced to move those patients to more expensive second-line drugs. India carries 20% of the world's TB burden. Of all TB cases being reported, 28% are cases of multi-drug resistant TB. In HIV treatment, the second-line therapy is six times costlier. So, fighting these diseases is not only going to become more difficult but also more expensive.
What is the biggest barrier to implementing a rational antibiotics policy in India?
Antibiotics are available over the counter in India and most people don't complete the full course of antibiotic therapy. Plus, spurious drugs often do not contain the full or correct dosage. Incomplete therapy or dosage gives microbes time to develop resistance. Often people pressurise their doctors to prescribe antibiotics and doctors out of fear of losing business prescribe it even when not needed. There is no monitoring of antibiotics prescription by doctors.
Can India fight growing antibiotic resistance?
Advances in IT and mobile technology means that the solutions are available here. The government has to strengthen the regulatory mechanism, monitor the professional quality of doctors and medical associations need to enforce them. Over-the-counter sale of antibiotics should be stopped. The health ministry is considering labelling antibiotics a different colour and selling them only in hospitals so that they cannot be dispensed without prescription. It is not easy to enforce all this immediately. It is a process. But it has to start and hopefully, things will improve.
What is the role of WHO in promoting rational use of antibiotics?
WHO collaborates with governments and gives a supporting shoulder. We help generate enough evidence to back the policy measures that need to be put in place and also help the government develop appropriate curricula for medical personnel. Antibiotic resistance is under-researched in Asia and WHO has started collecting data to help understand the problem better. It also helps governments put in place proper labs and research facilities and with multi-sectoral coordination that is required to tackle this problem.

10 most weird diseases

1. Elephantiasis

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Lymphatic filiriasis, best known as Elephantiasis is characterized by an awful picture of swollen arms and legs. Mosquitoes are responsible for spreading this disease on over 120 million people currently. With their bite they inject warm larvae, such as Wuchereria bancrofti, Brugia malayi, and B. timori, which actually cause the illness. Unfortunately, the “guests” in the blood can survive there for years. Despite the arms and legs, breasts and genitalia are also enlarged. There are still experiments for finding the cure but it’s not found yet.

2. Pica

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This disorder makes people insatiable for non-food materials, such as soil, clay, feces, paper, glue, gum, coal, etc. It’s not clear yet what causes it, but there are assumptions that it is linked with mineral deficiency, especially iron. There’s no cure for it yet, but there are some medications that could reduce the symptoms to some patients.

3. Alice in Wonderland Syndrome

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Alice was really in Wonderland, sometimes she was seeing small things, sometimes they were much bigger than her, but people with Alice in Wonderland Syndrome look too small and too big whatever the object is. For example, they see their own house with size of their dog’s house, they can see a bird big as dinosaur, etc. This perception disorder is a result of change in perception as opposed to the eyes themselves malfunctioning. There are medicaments that reduce the symptoms significantly.

4. Walking Corpse Syndrome

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Patients are not real walking corpses, they just think they are so. This syndrome is a mix of mental depression and suicidal tendencies. People think they have lost everything, from possessions to parts of their bodies. Most bizarre – most of them believe they’re walking corpses. They often say that they can smell their own flesh and feel worms entering in their bodies. Unfortunately antidepressants don’t help too much in treating this disease and there’s not other usable cure.

5. Vampire Disease

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Although their skin is blistering when the Sun touches it, these people don’t drink blood and are not vampires. However, they prefer to avoid any contact with the Sun, as acute attack of it can be fatal. There are several cure for this disease, every of them is used depending on the causes of it.

6. Aquagenic Urticaria

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Aquagenic Urticaria is commonly known as water allergy, although it’s not allergy at all. It is very rare disease in which the patient becomes sensitive to non-distilled water what means feeling great pain when contact with it. The worst part is that they mustn’t cry if they don’t want their pain to grow, as tears have the same effect. Unfortunately, there’s no cure yet.

7. Necrotizing Fascilitis

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This is a terrible disease. Fortunately it is very rare, but the mortality rate of 73% is another awful characteristic of it. It is caused by eating bacteria that could enter the skin through the smallest paths and once it gets in, it never gets out. The bacteria then start its way and eat whatever finds on its path. The skin looks rusty, but in extreme even losing body parts is possibility.

8. Progeria

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The disease better known as Hutchinson-Gilford progeria syndrome is genetic failure that causes living life on fast forward. Patients die on average of 13 years. Before that they experience some things that later life brings, such as baldness and heart diseases. It happens once in eight million births. As it was mentioned before, genetic failure causes this, so there’s no cure.

9. Exploding Head Syndrome

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If you thought that your head gonna explode when you had a headache, you were wrong. Patients with exploding head syndrome hear explosions, gunshots, screams and other noises, causing anxiety, fear and increasing heart rate. All of this happens 2-3 hours after falling asleep. Although this syndrome’s etiology is still unknown, there are some findings that it is related with stress and fatigue, so there are a lot of medicaments that clear the explosions from head.

10. Human Werewolf Syndrome

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Hypertricosis, or Human Werewolf Syndrome, is disorder which characterize with growth of hair body that is particularly abnormal. There are two types of the disease: the first one covers with hair certain area of the body, the other one – the entire body. There is no cure that prevent the hair grow, all patients can do is to remove the body hair.

Watermelon lowers blood pressure

Amino acids found in watermelon have been shown to lower blood pressure. In addition to healthy vitamins and minerals, watermelon contains two amino acids, L-arginine and L-citrulline, that reduce hypertension.Other Natural Blood Pressure Lowering Foods
Other foods have also been shown to lower blood pressure. Bananas can lower hypertension, as can raisins, beets and even chocolate.
Watermelon Research
Researchers at Florida State University used a concentrated extract of watermelon for the research on nine subjects. The dosage used in the study was six grams of the combined watermelon amino acids. After six weeks, all of the participants, 100 percent, showed reduced blood pressure. The study concluded that watermelon could be used by people who have pre-hypertension to keep the condition from progressing to high blood pressure. This means that eating watermelon may allow those at risk for heart disease to avoid taking preventative blood pressure lowering medications that are usually prescribed.
Blood Pressure Prevention Medication Side EffectsPharmaceutical drugs are frequently prescribed for those with a tendency towards high blood pressure, a condition called pre-hypertension. These medications have been shown to have numerous side effects, including potassium loss that leads to an increased risk of diabetes. Other side effects, reported by Johns Hopkins University, include constipation, frequent urination, headaches, digestive upset, dizziness, and a tendency to dehydration, which causes a number of health issues in itself. Watermelon, on the other hand, has no known side effects. Watermelon Contains Vitamins and Lycopene Watermelon also contains healthy nutrients, such as vitamins A, vitamin C and vitamin B6, along with potassium and fiber. Watermelon also contains lycopene, the nutrient plentiful in tomatoes that has been show to have numerous health benefits. Lycopene is an antioxidant. Eating foods high in lycopene has been shown to reduce the incidence of many types of cancer, including breast cancer and prostate cancer. Lycopene has been shown to prevent heart attacks both in studies at John Hopkins University and in international studies. Though tomatoes were used in the studies, other foods known to be rich in lycopene are watermelons, grapefruits, apricots and guavas. Watermelon Mechanism of Action Watermelon lowers blood pressure because of its action in production of nitric oxide, researchers surmise. This is because L-citrulline in the watermelon is converted into L-arginine, which is then used to make nitric oxide. Nitric oxide, in turn, helps control blood pressure. L-Arginine Alone is Not Enough Taking the amino acids L-arginine by itself is not an effective treatment for high blood pressure, nor is it recommended because the amino acid is not easy to digest and can cause digestive problems, including diarrhea. Watermelon Dosage to Prevent High Blood Pressure The dosage used in the watermelon study was four to six grams of watermelon extract, but a healthier alternative is to add raw watermelon to the diet.

Six body signs you shouldn't ignore

Don’t ignore these tell tale indicators.You body is signaling that there is something wrong…

By Sayoni Sinha for yahoo

There is more hair in your comb than on your head. Your new denims can’t stay buttoned up for long and irritating dust particles float in your eyes. You panic thinking that some dreaded disease has hit you and search the Internet for a quick fix. The search results in ten different diseases and you are not sure which one is more severe. Sounds familiar? Relax. With the help of health experts, we list few unknown symptoms (and solutions) which may strike women.

Rebound headaches: Like heartache, rebound headaches refuse to go. They keep coming back even after you have popped in a few painkillers. Well don’t blame the headache, the culprit here is the pill. Overuse of medication makes the body resistant to its effects. When they don’t work as well, people take stronger doses of the medication. This continues to desensitize the body, triggering yet another rebound headache.
Doc’s Tip: Ride out the rebound headache by avoiding painkillers as much as you can. Never take any painkiller for longer than two consecutive days. Always consult a doctor if the symptoms persist.

Bloating: It is not that time of the month and you feel bloated. Well blame your drinking habits then.Alcohol dehydrates your body and as little as two glasses is risky. When you drink too much, your kidneys go on a panic mode and start conserving water leading to water retention. Even coffee and tea can cause problems if had in excess.
Doc’s tip: Drink at least a glass of water every two hours, which will get your kidneys functioning regularly again. Stay away from salty and sodium-rich processed foods, which will cause you to hold in water longer. The bloating will subside in two days.

Delayed or no Periods: You are not pregnant and still you have skipped your chums twice in a row. You should panic though not much. There can be quite a few reasons and the most common culprit is stress. Stress hinders ovulation and the hormonal changes in your body can wreck havoc on your menstrual system. If there is a delay of eight to ten days, there is nothing to worry about.
Doc’s Tip: Cut back stress by eating a balanced meal and include some form of exercise and yoga to bring your cycle back on track. It is best to visit your gynac for a proper check-up.

Dizziness: Your world goes round every time you stand up. If you think there is something wrong with you then dizziness is just the signal. When the blood supply to the brain is limited or a change in blood pressure is noticed, it results in light headedness. Dehydration can also make your blood pressure drop and make you dizzy.
Doc’s Tip: keep yourself hydrated and have a liquid diet or foods with high water content. Should the faint feeling occur each time you get up or you lose consciousness, see your doctor. It may be due to drop in heaemoglobin and in rare circumstances; it can be a heart problem.

Lumps in breasts: Lately, you have felt several small movable lumps in your breasts. These are nothing but a common and benign condition where your breast tissue retains fluids. The changes are more noticeable in the pre-period week, when hormonal changes cause swelling throughout your body.
Doc’s Tip: Cut back on caffeine heavy foods like coffee, tea and aerated drinks, which causes you to retain fluid and makes the lumps more pronounced. It’s better to avoid salty foods, since they also promote fluid retention.

Floaters in your eyes: There are dark specks, spots and wormlike lines that are perennially in your field of vision. Though harmless, floaters are annoying and there are ways to prevent them through proper diet
Doc’s Tip: While there is no real way to stop the formation of floaters (that is confirmed) the safest way to cure floaters is to ignore them. There are many ways to strengthen one's eyes which will in turn lessen the creation of new floaters. Having a diet rich in fruits and vegetable is necessary. However, consult a doctor if they turn out to be painful.

Metabolic Effects of Atypical Antipsychotics

Metabolic Effects of Atypical Antipsychotics—Implications on Weight Gain and Glucose and Lipid Metabolism

Cindy PY Chiu, MBBS, MRCPsych (UK), FHKCPsych, FHKAM (Psych); Eric YH Chen, MB ChB (Edin), MA (Oxon), MRCPsych (UK), FHKCPsych, FHKAM (Psych), MD (Edin)

Introduction Antipsychotic medication is crucial in the treatment of schizophrenia spectrum disorders and bipolar disorders. It is also widely used in the treatment of conditions with behavioural disturbance, such as dementia and learning disability, as well as tic disorder. In line with the growing emphasis on minimizing potentially disabling side effects, contemporary antipsychotic prescription practice favours atypical agents over conventional antipsychotics.1–3 Conventional antipsychotics, despite their value in terms of clinical efficacy, have a generally higher incidence of side effects, including extrapyramidal symptoms, hyperprolactinaemia and tardive dyskinesia. This poses tolerability problems that affect compliance and, hence, hinder recovery. However, atypical antipsychotics are not without drawbacks. The newer drugs are significantly more expensive, and there is concern over their different profile of side effects. In view of their own advantages and disadvantages, the choice between conventional and atypical antipsychotics cannot simply be a dichotomized exercise. Clinical observation has aroused concern over the development of a metabolic syndrome consisting of weight gain, hyperglycaemia and hyperlipidaemia, which implies an elevated risk of morbidity and mortality. This article attempts to review recent literature on atypical antipsychotics and their relationship with the metabolic syndrome. Metabolic Risk in Schizophrenia Individuals suffering from schizophrenia have a two- to threefold excess in morbidity and mortality when compared with the general population,4 of which physical co-morbidity accounts for 60% of non-suicide premature deaths.5 Such an increase in risk is likely related to a multitude of lifestyle factors, such as lack of exercise, low-fibre diets, excessive alcohol consumption and smoking; social factors, such as unemployment and disadvantaged social conditions; and a higher likelihood of accidents and injuries. A study of Scottish patients with schizophrenia living in the community showed a diet lower in fruit and vegetables, heavier smoking and a higher likelihood of obesity compared with the general population. Cardiovascular risk was also increased to an extent that warranted active intervention.6 In the United States, the prevalence of the metabolic syndrome amongst patients with schizoaffective disorder was higher than that in the general population.7 A case-controlled study comparing drug-naive/drug-free schizophrenic patients and healthy controls showed higher body mass index (BMI) and 3.4 times more intra-abdominal fat in patients than in normal controls, despite comparable total body fat and subcutaneous fat.8 General health status is, therefore, compromised with increased cardiovascular events,9 obesity, hypertension and diabetes mellitus in schizophrenic patients. Family history is also of relevance, as the prevalence of diabetes can be as high as 33% in those patients with a positive family history versus 10% in those without. Thus, even before medication effects become involved, schizophrenia per se predisposes patients to increased risks of cardiovascular morbidity and the metabolic syndrome. Care should be taken in the choice of antipsychotics to achieve maximum benefit and minimal metabolic risk. Metabolic Syndrome The metabolic syndrome is characterized clinically by central obesity, dyslipidaemia, hypertension and elevated fasting sugar. The operational definition of metabolic syndrome according to the National Cholesterol Education Program requires three out of the five criteria of abdominal obesity, elevated fasting triglycerides, decreased high-density lipoprotein, elevated blood pressure and elevated fasting glucose.10 Antipsychotics and the Metabolic Syndrome Baseline data of subjects with chronic schizophrenia treated with various antipsychotics from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) showed a prevalence of metabolic syndrome of 42.7%, doubling that seen in the general population.1 Weight gain and dyslipidaemia are relatively limited with most conventional antipsychotic drugs. Amongst the various conventional drugs in use, weight gain and impaired glucose tolerance have been recognized predominantly with low-potency agents, such as chlorpromazine.12 Despite the relatively lower incidence of neurological side effects, such as extra-pyramidal effects and tardive dyskinesia, there is an increasing awareness of the metabolic effects of atypical antipsychotics, which seem to be more substantial than with conventional agents.13,14 Hyperglycaemia, Diabetic Ketoacidosis and Diabetes Mellitus Current findings are suggestive of an association between atypical antipsychotic use and impaired glucose tolerance, worsening of diabetic control, and higher incidence of diabetes mellitus and diabetic ketoacidosis.15 Amongst outpatients with schizophrenia and major mood disorders receiving antipsychotic treatment, there was a trend towards a higher prevalence of diabetes in those receiving atypical antipsychotics versus those receiving decanoate medication.14 Atypical anti- psychotics may worsen metabolic control in type 2 diabetes mellitus, as reflected by a higher rate of initiation of insulin therapy (‘secondary failure’) in an elderly outpatient population.16 Of the atypical drugs, clozapine and olanzapine are more often found to have an adverse effect on glucose metabolism.17,18 Weight Gain Weight gain may occur to a certain extent with all atypical agents and is most prominent in the first 4 to 6 months of treatment.19 Weight gain with atypical antipsychotics has been recognized, especially with olanzapine and clozapine and to a lesser extent with quetiapine, risperidone and amisulpiride. Ziprasidone may have some reversal effect on weight gain.18,19 Hyperprolactinaemia, 5-HT2c and H1 antagonism and leptin insensitivity are some of the proposed mechanisms,20 as suggested by increased levels of insulin and leptin as well as obesity in mutant mice without functional 5-HT2c receptors.21 Leptin, produced by adipose tissue, is involved in the regulation of food intake by a negative feedback mechanism via receptors at the hypothalamus. High levels of leptin correlate with obesity; proposed mechanisms include leptin deficiency and dysfunctional leptin receptors. Chronic schizophrenic patients with initial leptin levels comparable to those of healthy controls were found to have higher serum leptin as well as weight gain at the end of a period of antipsychotic treatment. Amongst those on atypical antipsychotics, leptin levels were significantly higher in those on olanzapine, intermediate with clozapine and lower with risperidone.22 Drug-naive Chinese patients with first-episode schizophrenia were found to have a threefold increase in leptin and significant increases in both subcutaneous and intra-abdominal fat on MRI after 10 weeks of either risperidone or chlorpromazine treatment.23 As obesity brings considerable morbidity and mortality, weight management is important to prevent and ameliorate the undesirable effects related to weight gain. Attendees of a weight-training programme focusing on nutrition, exercise and motivation had significant reductions of body weight and BMI at the end of 1 year when compared to other patients who received usual care.24 Switching to another antipsychotic with less effect on weight may curb further weight gain and, in some cases, reverse the effect. Agents such as topiramate, orlistat, metformin and reboxetine may be useful in selected cases but are not without side effects of their own. Hyperlipidaemia Amongst atypical antipsychotics, olanzapine and clozapine were more often found to be related to an increase of blood lipid levels.11,25 Clozapine and olanzapine were associated with increased blood cholesterol by the fourth month of treatment. Ziprasidone, risperidone and zotepine, however, had no apparent effect on lipid levels. It was proposed that lipoprotein lipase was involved through a direct drug effect or via down-regulation by hyperinsulinaemia. In some cases at least, antipsychotic-induced hyperlipidaemia is reversible upon withdrawal of the drug.26 Hyperlipidaemia is closely associated with cardiovascular events and should be actively prevented. Awareness and Management Psychiatrists are generally aware of the potential metabolic side effects from atypical antipsychotics. Despite such knowledge and concern, disparity occurred between guideline recommendations for routine monitoring and actual clinical practice. In the Atypical Antipsychotic Therapy and Metabolic Issues Survey, more than 80% of the respondents recognized the increased metabolic risk of patients receiving atypical antipsychotic treatment, but less than half of the patients received regular monitoring of blood pressure, body weight, waist circumference, and lipid and glucose levels.27 Expert groups worldwide have made consensus recommendations for the detection and management of the metabolic syndrome.28 In short, there should be baseline data on body weight, waist circumference, blood pressure, fasting sugar and lipids, and a personal medical history as well as family history. Close monitoring of the physical parameters within the first few months is warranted and is to be repeated at regular intervals thereafter. Prompt referrals should be made for patients who develop metabolic side effects. Conclusion Various factors account for the increased risk of developing metabolic syndrome in patients with schizophrenia. The metabolic syndrome of weight gain, hyperglycaemia and hyperlipidaemia contributes significantly towards cardiovascular disease, bringing about considerable morbidity and mortality, not to mention medical emergencies such as diabetic ketoacidosis. Non-medication factors such as a low-fibre diet, lack of physical exercise, smoking and alcohol consumption are also important. Atypical antipsychotics, in particular olanzapine and clozapine, have a higher predisposition to metabolic effects when compared with typical agents. Management of the metabolic syndrome starts with a physical and personal history; baseline measurements of body weight, BMI, blood pressure, fasting glucose and lipids; and, with that in mind, an appropriate choice of antipsychotic medication. Patients should be counselled prior to the commencement of treatment, with education on a balanced diet and recommendations for dietary restrictions. A healthy lifestyle encouraging exercise should be advocated, and smoking and sedentary habits should be discouraged. Weight-monitoring programmes give structure and quantify changes regularly, which may help with patient perseverance. Physical measurements and blood investigations should be repeated within the first 6 months and performed annually thereafter. The presence of metabolic syndrome warrants adequate intervention. The decision of whether or not to change the antipsychotic agent is dependent upon weighted variables such as clinical response, tolerability of other side effects and response of the metabolic syndrome to treatment. Above all, clinician and patient awareness of the metabolic syndrome is essential for its prevention and amelioration.

Why is it dangerous to combine statins and fibrates? This drug combination significantly increases the risk of rhabdomyolysis.