 1 1000 Drugs - a to z
 2 Generic name drug rules
 3 Refills etc.
 4 foreign (non-US) Pharmaceuticals
 5 ROUTINE contraindications
 6 safe usage of medications
 7 Alkaloids
 8 holistic healing
 9 Mefloquine, Larium
 10 OxyContin
 11 Phenylpropanolamine (PPA)
 12 Prozac (fluoxetine)
 13 Tequin 400 mg Antibiotic
 14 Testosterone
 15 Urocit-K
 16 Viagra
 17 HEALTHCARE ON THE WEB http://www.manslife.com

\1 1000 Drugs - a to z

 DRUG                 Description, Use
-----------------------------------------
222                   Narc/Aspirin, Pain Rel
282                   Narc/Aspirin, Pain Rel
292                   Narc/Aspirin, Pain Relief
4-Way Cold Tablets    Aspirin, Non-Narc Pain Rel.
642                   Narc Analgesic Pain Rel
8-hr Bayer Time Rel   Aspirin, Non-Narc Pain Rel.
\a
A&C with Codeine      Narc & Aspirin, Pain Relief
A'Cenol               Acetaminophen, Non-Narc Pain Rel
A.C.&C.               Narc & Aspirin, Pain Relief
A.P.C.                Aspirin, Non-Narc Pain Rel.
A.P.C. w/Codeine      Narc Analgesic Pain Rel
A.S.A.                Aspirin, Non-Narc Pain Rel.
A.S.A. Codeine Comp   Narc & Aspirin, Pain Rel.
A.S.A. Compound       Aspirin, Non-Narc Pain Rel.
A.S.A. Enseals        Aspirin, Non-Narc Pain Rel.
A/T/S                 Erythromycins, Anti-infective
APAP                  Acetaminophen, Non-Narc Pain Rel.
Accutane              Isotretinoin,  Dermal Med
Ace-Tabs              Acetaminophen, Non-Narc Pain Rel
Acephen               Acetaminophen, Non-Narc Pain Rel
Aceta                 Acetaminophen, Non-Narc Pain Rel
Aceta w/Codeine       Narc Analgesics, Pain Rel
Aceta with Codeine    Narc & Acetamin, Pain Rel
Acetaco               Narc Analgesics, Pain Rel
Acetaminophen/Codeine Narc & Acetamin, Pain Rel
Acetaminophen/Codeine Narc Analgesics, Pain Rel
Acetophen             Aspirin, Non-Narc Pain Rel.
Acetoxyl              Benzoyl Peroxide, dermal med
Acetylsalicylic Acid  Aspirin, Non-Narc Pain Rel.
Acne-Aid              Benzoyl Peroxide, Dermal Med
Actamin               Acetaminophen, Non-Narc Pain Rel.
Actifed-C             Narc Analgesic, pain rel
Adatuss               Narc Analgesic, pain rel
Aero Caine            Anesthetic (Topical) dermal Med
Aero Caine Aerosol    Anesthetic (Topical) dermal Med
Aerotherm             Anesthetic (Topical) Dermal Med
Aldoclor              Methyldopa, High Blood Pressure
Aldoril D50           Methyldopa, High BP
Aldoril-15            Methyldopa, High BP
Aldoril-25            Methyldopa, High BP
Aldoris D30           Methyldopa, High BP
Algisin               Acetaminophen, non-narc Pain Rel.
Algodex               Narcotic Analgesic, Pain Rel
Alka-Seltzer          Aspirin, Non-Narc Pain Rel.
Allercreme Clear-Up   Benzoyl Peroxide, dermal Med
Alpen                 Ampicillin, Penicillin
Alquam-X              Benzoyl Peroxide, dermal Med
Aluminum ASA          Aspirin, Non-Narc Pain Rel.
Amacodone             Narc & Acetamin, Pain Rel
Amaphen               Acetaminophen, Non-Narc Pain Rel.
Ambenyl               Narc Analgesic, Pain Rel
Amcill                Ampicillin, Penicillin
Americaine            Anesthetic, (Topical), dermal Med
Amoxil                Amoxicillin, Penicillin
Amphenol              Acetaminophen, Non-Narc Pain Rel.
Amphicol              Chloramphenicol, anti-infective
Ampicillin            Penicillin
Ampilean              Ampicillin, Penicillin
Amytal                Amobarbital, Sedative-Hypnotic
Amytal and Aspirin    Aspirin, Non-Narc Pain Rel.
Anacin                Aspirin, Non-Narc Pain Rel.
Anacin-3              Acetaminophen, Non-Narc Pain Rel
Anapap                Acetaminophen, Non-Narc Pain Rel.
Anaphen               Narcotic Analgesics, Pain Rel
Anbesol               Anesthetics (Topical), dermal Med
Ancasal               Narc & Aspirin, Pain Relief
Anexsia w/Codeine     Narc & Aspirin, Pain Rel
Anexsia-D             Narc & Aspirin, Pain Rel
Ang-O-Span            Nitrate, Cardiac & Circulatory
Anoquan               Acetaminophen, Non-Narc Pain Rel
Antibiopto            Chloramphenicol      
Anti-infectives       Antivert, Meclizine Anti-emetic
Anuphen               Acetaminophen, Non-Narc Pain Rel.
Anxanil               Hydroxyzine, Antianxiety Drugs
Apamide tablet        Acetaminophen, Non-Narc Pain Rel.
Apo-Acetaminophen     Acetaminophen, Non-Narc Pain Rel.
Apo-Asen              Aspirin, Non-Narc Pain Rel.
Apo-Diazepam          Diazepam, Antianxiety Drugs
Apo-Dipyridamole      Dipyridamole, Cardiac/Circulatory
Apo-Erythro-S         Erythromycin, Anti-infectives
Apo-Flurazepam        Flurazepam, Sedatives-Hypnotics
Apo-Lorazepam         Lorazepam, Antianxiety Drugs
Apo-Meprobamate       Meprobamate, Antianxiety Drugs
Apo-Methyldopa        Methyldopa, High Blood Pressure
Apo-Propranolol       Propranolol, Cardiac & Circulatory
Apo-Sulfatrim         Trimethoprim, Anti-infectives
Apo-metoprolol        Metoprolol, High Blood Pressure
Apresoline            Hydralazine, High Blood Pressure
Aquachloral           Chloral Hydrate, sedative-Hypnotic
Arcoban               Meprobamate, Antianxiety Drugs
Arthralgen            Narc Analgesics, Pain Rel
Arthritis Bayer T/R   Aspirin, Non-Narc Pain Rel.
Arthritis Pain Frmula Aspirin, Non-Narc Pain Rel.
Ascriptin             Aspirin, Non-Narc Pain Rel.
Ascriptin A/D         Aspirin, Non-Narc Pain Rel.
Ascriptin w/Codeine   Narc & Aspirin Pain Rel
Asperbuf              Aspirin, Non-Narc Pain Rel.
Aspergum              Aspirin, Non-Narc Pain Rel.
Aspir-10              Aspirin, Non-Narc Pain Rel.
Aspirin & Codeine     Narc & Aspirin, Pain Rel
Aspirin w/Codeine     Narc Analgesics, Pain Rel
Aspirin, Cod. & Caff. Narc & Aspirin, Pain Relief
Aspirin-Free Excedrin Acetaminophen, Non-Narc Pain Rel.
Aspirjen Jr.          Aspirin, Non-Narc Pain Rel.
Astrin                Aspirin, Non-Narc Pain Rel.
Atarax                Hydroxyzine, Antianxiety Drugs
Ataraxoid             Hydroxyzine, Antianxiety Drugs
Atasol                Acetaminophen, Non-Narco Pain Rel
Atasol w/Codeine      Narc & Acetamin. Pain Rel
Atenolol              Beta-adrenergic, diuretic,for HBP
Ativan                Lorazepam, Antianxiety Drugs
Atozine               Hydroxyzine, Antianxiety Drugs
Augmentin             Amoxicillin, Penicillin
Axotal                Narcotic Analgesic, Pain Rel
Azithromycin          Antibiotic
\b
Bactopen              Cloxacillin, Penicillin
Bactrim               Trimethoprim, Anti-infective      
Bamate                Meprobamate, Antianxiety Drug
Bamo 400              Meprobamate, Antianxiety Drug
Bancap w/Codeine      Narc Analgesic, Pain Rel
Bancap-HC             Narc & Acetamin. Pain Rel
Banesin               Acetaminophen, Non-Narc Pain Rel
Banesin Forte         Narco Analgesic, Pain Rel
Bayapap               Acetaminophen, Non-Narc Pain Rel
Bayapap w/Codeine     Narcotics & Acetamin, Pain Rel
Bayer                 Aspirin, Non-Narc Pain Rel
Bayer T/R Arthritic   Aspirin, Non-Narc Pain Rel
Beepen-VK             Penicillin V, Penicillin
Ben-Aqua              Benzoyl Peroxide, Dermal Med
Benoxyl               Benzoyl Peroxide, Dermal Med
Benzac                Benzoyl Peroxide, Dermal Med
Benzagel              Benzoyl Peroxide, Dermal Med
Benzocaine            Anesthetics (Topical) Dermal Med
Benzocal              Anesthetics (Topical) Dermal Med
Betaloc               Metoprolol, High Blood Pressure
Betaloc Durules       Metoprolol, High Blood Pressure
Betapen-VK            Penicillin V, Penicillin
Bexophene             Narc & Aspirin, Pain Relief
BiCozene              Anesthetics (Topical) Dermal Med
Bonamine              Meclizine, Anti-emetic
Bonine                Meclizine, Anti-emetic
Bristamycin           Erythromycins, Anti-infective
Bromo-Seltzer         Acetaminophen, Non-Narc Pain Rel.
Buf-Oxal              Benzoyl Peroxide, Dermal Med
Buf-Tabs              Aspirin, Non-Narc Pain Rel.
Buff-A                Aspirin, Non-Narc Pain Rel.
Buff-A-Comp           Aspirin, Non-Narc Pain Rel.
Buffaprin             Aspirin, Non-Narc Pain Rel.
Buffered ASA          Aspirin, Non-Narc Pain Rel.
Bfffered Aspirin/Cod  Narc/Aspirin, Pain Rel
Bufferin              Aspirin, Non-Narc Pain Rel.
Buffex                Aspirin, Non-Narc Pain Rel.
Buffinol              Aspirin, Non-Narc Pain Rel.
Burntame              Anesthetic (Top) Dermal Med
Butacaine             Anesthetic (Top) Dermal Med
Butamben              Anesthetic (Top) Dermal Med
Butesin Picrate       Anesthetic (Top) Dermal Med
Butorphanol           Narco Analgesic, Pain Rel
Butyl Aminobenzoate   Anesthetics (Top) Dermal Meds
Butyn Sulfate         Anesthetics (Top) Dermal Meds
\c
C2 with Codeine       Narc/Aspirin Pain Relief
C2A                   Acetaminophen Non-Narc Pain Rel.
Caine Spray           Anesthetics (Topical) Dermal Med
Cal-Vi-Nol            Anesthetics (Topical) Dermal Med
Calcidrine            Narc Analgesics   Narc Pain Rel
Calciphen             Aspirin  Non-Narc Pain Rel.
Cama Arthritis        Aspirin  Non-Narc Pain Rel.
Cama Inlay            Appirin  Non-Narc Pain Rel
Campain               Acetaminophen  Non-Narc Pain Rel
Capital               Acetaminophen  Non-Narc Pain Rel
Capital w/Codeine     Narc Analgesics Pain Rel
Capital w/Codeine     Narc & Acetamin. Pain Rel
Capoten               Captopril   High Blood Pressure
Carbrital             Pentobarbital Sedatives-Hypnotics
Cardilate             Nitrates  Cardiac & Circulatory
Cartrax               Hydroxyzine  Antianxiety Drugs
Catapres              Clonidine HCL High Blood Pressure
Catapres-TTS          Clonidine HCL High Blood Pressure
Causalin              Aspirin  Non-Narc Pain Rel.
Cefinal               Aspirin  Non-Narc Pain Rel.
Centrax               Prazepam  Antianxiety Drugs
Cetacaine             Anesthetics (Topical) Dermal Med
Cetro Cirose          Narc Analgesics Pain Rel
Cheracol              Narc Analgesics Pain Rel
Chiggerex             Anesthetics (Topical) Dermal Med
Chiggertox            Anesthetics (Topical) Dermal Med
Chlorazine            Prochlorperazine  Anti-emetics
Chloromycetin         Chloramphenicol  Anti-infectives
Chloroptic            Chloramphenicol  Anti-infectives
Chlorzone forte       Acetaminophen  Non-Narc Pain Rel.
Cirin                 Aspirin     Non-Narc Pain Rel.
Clear By Design       Benzoyl Peroxide   Dermal Med
Clearasil             Benzoyl Peroxide   Dermal Med
Clearasil BP(M)       Benzoyl Peroxide   Dermal Med
Cleocin               Clindamycin  Anti-infectives
Cleocin-T             Clindamycin  Anti-infectives
Clindaycin            Lincomycin  Anti-infectives
Clinicaine            Anesthetics (Topical) Dermal Med
Clinoril              Sulindac   Non-Narc Pain Rel.
Cloxapen              Cloxacillin    Penicillin
Cloxilean             Cloxacillin    Penicillin
Co-Tylenol            Acetaminophen  Non-Narco Pain Rel
Co-Xan                Narc Analgesics Pain Rel
Co-gesic              Narc & Acetamin Pain Rel
Coastaldyne           Acetaminophen  Non-Narc Pain Rel
Coastaldyne           Narc Analgesics Pain Rel
Coastalgesic          Narc Analgesics Pain Rel
Codalan               Narc Analgesics Pain Rel
Codalex               Narc Analgesics Pain Rel
Codap                 Narc & Acetamin Pain Rel
Codasa                Aspirin  Non-Narcotic Pain Rel.
Codeine               Narc Analgesics Pain Rel
Codeine Sulfate       Narc Analgesics Pain Rel
Codimal PH            Narc Analgesics Pain Rel
Coditrate             Narc Analgesics Pain Rel
Codone                Narc Analgesics Pain Rel
Codoxy                Narc & Aspirin  Pain Rel
Colidrate             Chloral Hydrate sedative-Hypnotic
Colrex                Acetaminophen  Non-Narc Pain Rel
Colrex Compound       Narc Analgesic Narc Pain Rel
Combid                Prochlorperazine  Anti-emetics
Combipres             Clonidine HCL   High Bld Pressure
Compal                Acetaminophen   Non-Narc Pain Rel
Compazine             Prochlorperazine  Anti-emetics
Compocillin VK        Penicillin V    Penicillin
Comtrex               Acetaminophen  Non-Narc Pain Rel
Conacetol             Acetaminophen  Non-Narc Pain Rel
Congespirin           Aspirin        Non-Narc Pain Rel
Copavin               Narc Analgesics   Narco Pain Rel
Coprobate             Meprobamate    Antianxiety Drugs
Coralsone             Aspirin    Non-Narc Pain Rel
Coricidin D           Aspirin    Non-Narc Pain Rel
Coronex               Nitrates  Cardiac & Circulatory
Corutol DH            Narc Analgesics Pain Rel
Coryphen              Aspirin      Non-Narc Pain Rel
Coryphen w/Codeine    Narc & Aspirin  Pain Rel
Cosprin               Aspirin   Non-Narc Pain Rel.
Cotabs                Narc & Acetamin. Narc Pain Rel
Cotrim                Trimethoprim   Anti-infectives
Cotussis              Narc Analgesic  Narc Pain Rel 
Covangesic            Acetaminophen  Non-Narc Pain Rel
Crystodigin           Digitalis Prep. Cardiac & Circ
Crystogin             Digitalis Prep. Cardiac & Circ
Cuticura Acne         Benzoyl Peroxide      Dermal Med
Cyclaine              Anesthetics (Topical) Dermal Med
Cyclomethycaine       Anesthetics (Topical) Dermal Med
\d
D-Sinus               Acetaminophen Non-Narc Pain Rel.
D-Tran                Diazepam    Antianxiety Drugs
Dalacin C             Clindamycin Anti-infectives
Dalmane               Flurazepam  Sedatives-Hypnotics
Damason-P             Narco & Aspirin  Narc Pain Relief
Dapa                  Acetaminophen Non-Narc Pain Rel.
Dapase                Acetaminophen  Non-Narc Pain Rel.
Dapase                Narc Analgesic Pain Relief
Darvocet-N            Narc Acetamin. Pain Relief 
Darvocet-N 100        Narc Analgesic Pain Relief
Darvon                Narc Analgesic Pain Relief
Darvon Compound       Narc & Aspirin Pain Relief
Darvon with A.S.A.    Narc & Aspirin Pain Relief
Darvon-N with A.S.A.  Narc & Aspirin Pain Relief
Dasicon               Aspirin Non-Narc Pain Rel.
Datril                Acetaminophen Non-Narc Pain Rel.
Decagesic             Aspirin   Non-Narcotic Pain Rel.
Demer-Idine           Narc Analgesics Pain Rel
Demerol               Narc Analgesics Pain Rel
Demerol-APAP          Narc & Acetamin Pain Rel
Deprol                Meprobamate  Antianxiety Drugs
Depronal-SA           Narc Analgesics   Narc Pain Relief
Derma-Medicone        Anesthetics (Topical) Dermal Meds
Dermacoat             Anesthetics (Topical) Dermal Meds
Dermo-Gen             Anesthetics (Topical) Dermal Meds
Dermodex              Benzoyl Peroxide      Dermal Meds
Dermoplast            Anesthetics (Topical) Dermal Meds
Desquam-X             Benzoyl Peroxide      Dermal Meds
Detensol              Propranolol  Cardiac/Circulatory
Dexamyl               Amobarbital Sedatives-Hypnotics
Dia-Gesic             Aspirin  Non-Narcotic Pain Rel
Dialog                Narc Analgesic Pain Relief
Dibucaine             Anesthetics (Topical) Dermal Meds
Dicodid               Narc Analgesic Pain Relief
Dihydromorphinone     Narc Analgesic Pain Rel
Dilatrate-SR          Nitrates  Cardiac & Circulatory
Dilaudid              Narc Analgesic Pain Relief
Dimetane-DC           Narc Analgesic Pain Relief
Diothane              Anesthetics (Topical) Dermal Meds
Diperodon             Anesthetics (Topical) Dermal Meds
Dolacet               Narc & Acetamin. Narcotic Pain Rel
Dolanex               Acetaminophen  Non-Narc Pain Rel.
Dolene                Narc Analgesic Pain Relief
Dolene AP-65          Acetaminophen   Non-Narc Pain Rel.
Dolene Compound       Narc & Aspirin Pain Relief
Dolene Compound-65    Aspirin   Non-Narcotic Pain Rel.
Dolene-AP             Narc & Acetamin Pain Rel
Dolo-Pap              Narc & Acetamin Pain Relief
Dolobid               Diflunisal  Non-Narc Pain Rel.
Dolophine             Narc Analgesics Pain Rel
Dolor                 Narc Analgesics Pain Relief
Dolprin               Acetaminophen   Non-Narc Pain Rel.
Dolprn #3             Aspirin         Non-Narc Pain Rel.
Dorcol                Acetaminophen   Non-Narc Pain Rel.
Dorcol Chldrn's Fever Acetaminophen  Non-Narc Pain Rel.
Dowmycin              Erythromycins  Anti-infectives
Doxaphene             Narc Analgesic Pain Relief
Doxaphene Compound    Narc/Aspirin Pain Relief
Doxylamine            Antihistamine, sedative.
Draizine              Hydralazine  High Blood Pressure
Dristan               Acetaminophen  Non-Narc Pain Rel.
Drocode,Asp,Caffeine  Narc/Aspirin Pain Rel
Dromoran              Narc Analgesic Pain Relief
Dry and Clean         Benzoyl Peroxide  Dermal Meds
Dry and Clear         Benzoyl Peroxide  Dermal Meds
Duadacin              Acetaminophen  Non-Narc Pain Rel.
Dularin               Narc Analgesic Pain Relief
Duotrate              Nitrates   Cardiac/Circulatory
Duradyne DHC          Narc/Acetamin Pain Relief
Duramorph PF          Narc Analgesic Pain Rel
Durrax                Hydroxyzine   Antianxiety Drug
Dyclone               Anesthetics (Topical) Dermal Meds
Dyclonine             Anesthetics (Topical) Dermal Meds
Dynosal               Narc Analgesic pain rel
\e
E-Biotic               Erythromycins        Anti-infectives
E-Mycin                  Erythromycins      Anti-infectives
E-Mycin E                Erythromycins      Anti-infectives
E-Pam                    Diazepam           Antianxiety Drugs
E-Vista                  Hydroxyzine        Antianxiety Drugs
E.E.S                    Erythromycins      Anti-infectives
Easprin                  Aspirin            Non-Narcotic Pain Rel.
Econochlor               Chloramphenicol    Anti-infectives
Ecotrin                  Aspirin            Non-Narcotic Pain Rel.
Elder 65 Compound        Aspirin            Non-Narcotic Pain Rel.
Eloxyl                   Benzoyl Peroxide   Dermal Medications
Emagrin                  Aspirin            Non-Narcotic Pain Rel.
Emcodeine                Narcotics & Aspirin   Narcotic Pain Relief
Emex                     Metoclopramide     Anti-emetics
Empirin                  Aspirin            Non-Narcotic Pain Rel.
Empirin with codeine     Narcotics & Aspirin   Narcotic Pain Relief
Empracet with Codeine    Narcotics & Acetamin. Narcotic Pain Relief
Emprazil                 Aspirin            Non-Narcotic Pain Rel.
Emprazil-C               Narcotic Analgesics   Narcotic Pain Relief
Enarax                   Hydroxyzine          Antianxiety Drugs
Encaprin                 Aspirin              Non-Narcotic Pain Rel.
Endecon                  Acetaminophen        Non-Narcotic Pain Rel.
Entrophen                Aspirin              Non-Narcotic Pain Rel.
Ephedrol w/Codeine       Narcotic Analgesics   Narcotic Pain Relief
Epi-Clear                Benzoyl Peroxide      Dermal Medications
Epimorph                 Narcotic Analgesics   Narcotic Pain Relief
Equagesic                Meprobamate          Antianxiety Drugs
Equanil                  Meprobamate          Antianxiety Drugs
Equanil wyseals          Meprobamate          Antianxiety Drugs
Ery-Tab                  Erythromycins        Anti-infectives
Ery-derm                 Erythromycins        Anti-infectives
EryPed                   Erythromycins        Anti-infectives
Eryc                     Erythromycins        Anti-infectives
Erymax                   Erythromycins        Anti-infectives
Erypar                   Erythromycins        Anti-infectives
Erythrityl tetranitrate  Nitrates            Cardiac & Circulatory
Erythrocin               Erythromycins        Anti-infectives
Erythrocin Ethyl Succ.   Erythromycins        Anti-infectives
Erythromid               Erythromycins        Anti-infectives
Erythromycin             Erythromycins        Anti-infectives
Erythromycin Estolate    Erythromycins        Anti-infectives
Erythromycin Ethylsucc.  Erythromycins        Anti-infectives
Erythromycin Gluceptate  Erythromycins        Anti-infectives
Erythromycin LactobionateErythromycins        Anti-infectives
Erythromycin Stearate    Erythromycins        Anti-infectives
Esgic                    Narcotic Analgesics  Narcotic Pain Relief
Eskatrol                 Prochlorperazine     Anti-emetics
Ethril                   Erythromycins        Anti-infectives
Ethyl Aminobenzoate      Anesthetics (Topical) Dermal Medications
Evenol                   Meprobamate          Antianxiety Drugs
Excedrin                 Aspirin              Non-Narcotic Pain Rel.
Exdol                    Acetaminophen        Non-Narcotic Pain Rel.
Exdol with Codeine       Narcotics & Acetamin. Narcotic Pain Relief
\f
FL-Tussex                Narcotic Analgesics   Narcotic Pain Relief
Febrigesic               Acetaminophen        Non-Narcotic Pain Rel.
Fendol                   Acetaminophen        Non-Narcotic Pain Rel.
Fenicol                  Chloramphenicol      Anti-infectives
Florinal                 Aspirin              Non-Narcotic Pain Rel.
Florinal w/Codeine       Narcotic Analgesics   Narcotic Pain Relief
Foille                   Anesthetics (Topical) Dermal Medications
Fortral                  Narcotic Analgesics   Narcotic Pain Relief
Fostex                   Benzoyl Peroxide      Dermal Medications
Fostex BPO               Benzoyl Peroxide      Dermal Medications
\g
G-1                      Acetaminophen        Non-Narcotic Pain Rel.
G-2                      Acetaminophen        Non-Narcotic Pain Rel.
G-3                      Acetaminophen        Non-Narcotic Pain Rel.
Gaysal                   Narcotic Analgesics   Narcotic Pain Relief
Genapap                  Acetaminophen        Non-Narcotic Pain Rel.
Genebs                   Acetaminophen        Non-Narcotic Pain Rel.
Genetabs                 Acetaminophen        Non-Narcotic Pain Rel.
Gitaligen                Digitalis Prep.     Cardiac & Circulatory
Gitalin                  Digitalis Prep.     Cardiac & Circulatory
Glyceryl trinitrate      Nitrates            Cardiac & Circulatory
Gualamine                Acetaminophen        Non-Narcotic Pain Rel.
\h
H-H-R                    Hydralazine          High Blood Pressure
H2Oxyl                   Benzoyl Peroxide      Dermal Medications
Halcion                  Triazolam            Sedatives-Hypnotics
Halenol                  Acetaminophen        Non-Narcotic Pain Rel.
Hasacode                 Narcotic Analgesics   Narcotic Pain Relief
Hexathricin Aerospra     Anesthetics (Topical) Dermal Medications
Hexylcaine               Anesthetics (Topical) Dermal Medications
Hi-Temp                  Acetaminophen        Non-Narcotic Pain Rel.
Hiprin                   Aspirin              Non-Narcotic Pain Rel.
Histadyl & ASA Compound  Aspirin              Non-Narcotic Pain Rel.
Hurricaine               Anesthetics (Topical) Dermal Medications
Hy-Pam                   Hydroxyzine          Antianxiety Drugs
Hyco-Pap                 Aspirin              Non-Narcotic Pain Rel.
Hycodan                  Narcotic Analgesics   Narcotic Pain Relief
Hycodaphen               Narcotics & Acetamin. Narcotic Pain Relief
Hycomine Compound        Acetaminophen        Non-Narcotic Pain Rel.
Hycotuss                 Narcotic Analgesics   Narcotic Pain Relief
Hydralazide              Hydralazine           High Blood Pressure
Hydrocodone              Narcotic Analgesics   Narcotic Pain Relief
Hydrocodone & Acetamin.  Narcotics & Acetamin. Narcotic Pain Relief
Hydrocodone, ASA & Caff. Narcotics & Aspirin   Narcotic Pain Relief
Hydrogesic               Narcotics & Acetamin. Narcotic Pain Relief
Hydromorphone            Narcotic Analgesics   Narcotic Pain Relief
Hydroxacen               Hydroxyzine          Antianxiety Drugs
\i
ICN 65 compound          Aspirin              Non-Narcotic Pain Rel.
Ilosone                  Erythromycins        Anti-infectives
Ilosone Estolate         Erythromycins        Anti-infectives
Ilotycin Gluceptate      Erythromycins        Anti-infectives
Inderal                  Propranolol         Cardiac & Circulatory
Inderal LA               Propranolol         Cardiac & Circulatory
Inderide                 Propranolol         Cardiac & Circulatory
Instantine Plus          Narcotics & Aspirin   Narcotic Pain Relief
Intraderm-19             Benzoyl Peroxide      Dermal Medications
Iso-Bid                  Nitrates              Cardiac & Circulatory
Isobec                   Amobarbital          Sedatives-Hypnotics
Isochron                 Nitrates              Cardiac & Circulatory
Isoclor                  Narcotic Analgesics   Narcotic Pain Relief
Isopto Fenicol           Chloramphenicol      Anti-infectives
Isotraine                Anesthetics (Topical) Dermal Medications
Isotrate                 Nitrates              Cardiac & Circulatory
Ivy-Dry Cream            Anesthetics (Topical) Dermal Medications
\k
Kalmn                    Meprobamate          Antianxiety Drugs
Kaytrate                 Nitrates              Cardiac & Circulatory
Kengesin                 Aspirin              Non-Narcotic Pain Rel.
Kesso-mycin              Erythromycins        Anti-infectives
Klavikordal              Nitrates             Cardiac & Circulatory
Korigesic                Acetaminophen        Non-Narcotic Pain Rel.
\l
Lan-Dol                  Meprobamate          Antianxiety Drugs
Lanacane                 Anesthetics (Topical) Dermal Medications
Lanorinal                Aspirin              Non-Narcotic Pain Rel.
Lanoxicaps               Digitalis Prep.       Cardiac & Circulatory
Lanoxin                  Digitalis Prep.       Cardiac & Circulatory
Larotid                  Amoxicillin           Penicillin
Ledercillin VK           Penicillin V          Penicillin
Levo-Dromoran            Narcotic Analgesics   Narcotic Pain Relief
Levorphan                Narcotic Analgesics   Narcotic Pain Relief
Levorphanol              Narcotic Analgesics   Narcotic Pain Relief
Lida-Mantle              Anesthetics (Topical) Dermal Medications
Lidocaine                Anesthetics (Topical) Dermal Medications
Lignocaine               Anesthetics (Topical) Dermal Medications
Lincocin                 Lincomycin           Anti-infectives
Lincomycin               Lincomycin           Anti-infectives
Liquiprin                Acetaminophen        Non-Narcotic Pain Rel.
Liquix-C                 Acetaminophen        Non-Narcotic Pain Rel.
Liquix-C                 Narcotic Analgesics   Narcotic Pain Relief
Lo-Tussin                Narcotic Analgesics   Narcotic Pain Relief
Lopressor                Metoprolol            High Blood Pressure
Loraz                    Lorazepam            Antianxiety Drugs
Lorcet                   Acetaminophen        Non-Narcotic Pain Rel.
Loroxide                 Benzoyl Peroxide      Dermal Medications
Lortab 5                 Narcotics & Acetamin. Narcotic Pain Relief
Lortab 7                 Narcotics & Acetamin. Narcotic Pain Relief
Lyteca                   Acetaminophen        Non-Narcotic Pain Rel.
\m
M.O.S. Syrup             Narcotic Analgesics   Narcotic Pain Relief
MS Contin                Narcotic Analgesics   Narcotic Pain Relief
MSIR                     Narcotic Analgesics   Narcotic Pain Relief
MST Continus             Narcotic Analgesics   Narcotic Pain Relief
Magnaprin                Aspirin              Non-Narcotic Pain Rel.
Maprin                   Aspirin              Non-Narcotic Pain Rel.
Maprin I-B               Aspirin              Non-Narcotic Pain Rel.
Marax                    Hydroxyzine          Antianxiety Drugs
Maxeran                  Metoclopramide       Anti-emetics
Maxigesic                Narcotic Analgesics  Narcotic Pain Relief
Maxolon                  Metoclopramide       Anti-emetics
Measurin                 Aspirin              Non-Narcotic Pain Rel.
Meclomen                 Meclofenamate        Non-Narcotic Pain Rel.
Meda Cap                 Acetaminophen        Non-Narcotic Pain Rel.
Meda Tab                 Acetaminophen        Non-Narcotic Pain Rel.
Medi-Tran                Meprobamate          Antianxiety Drugs
Medicone                 Anesthetics (Topical) Dermal Medications
Medimet                  Methyldopa            High Blood Pressure
Mejoral w/o Aspirin      Acetaminophen        Non-Narcotic Pain Rel.
Mejoralito               Acetaminophen        Non-Narcotic Pain Rel.
Mep-E                    Meprobamate          Antianxiety Drugs
Mepergan Fortis          Narcotic Analgesics   Narcotic Pain Relief
Meperidine               Narcotic Analgesics   Narcotic Pain Relief
Meperidine & Acetamin.   Narcotics & Acetamin. Narcotic Pain Relief
Mepriam                  Meprobamate          Antianxiety Drugs
Mepro Compound           Meprobamate          Antianxiety Drugs
Meprocon                 Meprobamate          Antianxiety Drugs
Meprospan                Meprobamate          Antianxiety Drugs
Meprotabs                Meprobamate          Antianxiety Drugs
Mercurochrome II         Anesthetics (Topical) Dermal Medications
Meribam                  Meprobamate          Antianxiety Drugs
Methadone                Narcotic Analgesics   Narcotic Pain Relief
Methadose                Narcotic Analgesics   Narcotic Pain Relief
Metrogesic               Narcotic Analgesics   Narcotic Pain Relief
Metronidazole
Meval                    Diazepam             Antianxiety Drugs
Midol PMS                Acetaminophen        Non-Narcotic Pain Rel.
Midrin                   Acetaminophen        NonNNarcotic Pain Rel.
Migralam                 Acetaminophen        Non-Narcotic Pain Rel.
Miltown                  Meprobamate          Antianxiety Drugs
Minims                   Chloramphenicol      Anti-infectives
Minipress                Prazosin             High Blood Pressure
Minotal                  Narcotic Analgesics   Narcotic Pain Relief
Mobidin                  Aspirin              Non-Narcotic Pain Rel.
Morphine                 Narcotic Analgesics   Narcotic Pain Relief
Morphitec                Narcotic Analgesics   Narcotic Pain Relief
Morusan                  Anesthetics (Topical) Dermal Medications
Motion Cure              Meclizine            Anti-emetics
Moxilean                 Amoxicillin           Penicillin
Multipax                 Hydroxyzine          Antianxiety Drugs
Mychel                   Chloramphenicol      Anti-infectives
Mychel-S                 Chloramphenicol      Anti-infectives
\n
N-G-C                    Nitrates              Cardiac & Circulatory
NAPAP                    Acetaminophen        Non-Narcotic Pain Rel.
Nadopen-V                Penicillin V          Penicillin
Nalbuphine               Narcotic Analgesics   Narcotic Pain Relief
Naldegesic               Acetaminophen        Non-Narcotic Pain Rel.
Naptrate                 Nitrates             Cardiac & Circulatory
Natigozine               Digitalis Prep.       Cardiac & Circulatory
Nebs                     Acetaminophen        Non-Narcotic Pain Rel.
Nembutal                 Pentobarbital        Sedatives-Hypnotics
Neo-Calme                Diazepam             Antianxiety Drugs
Neo-Tran                 Meprobamate          Antianxiety Drugs
Neopap                   Acetaminophen        Non-Narcotic Pain Rel.
Neucalm 50               Hydroxyzine          Antianxiety Drugs
Neuramate                Meprobamate          Antianxiety Drugs
Neurate                  Meprobamate          Antianxiety Drugs
Neutrogena Acne Mask     Benzoyl Peroxide     Dermal Medications
Nifedipine               Procardia             Cardiac & Circulatory
Niong                    Nitrates              Cardiac & Circulatory
Nitro-Bid                Nitrates              Cardiac & Circulatory
Nitro-Dur                Nitrates              Cardiac & Circulatory
Nitro-Long               Nitrates              Cardiac & Circulatory
Nitro-Time               Nitrates              Cardiac & Circulatory
Nitrobon                 Nitrates              Cardiac & Circulatory
Nitrocap                 Nitrates              Cardiac & Circulatory
Nitrocap T.D.            Nitrates              Cardiac & Circulatory
Nitrocardin              Nitrates              Cardiac & Circulatory
Nitrodisc                Nitrates              Cardiac & Circulatory
Nitrogard-SR             Nitrates              Cardiac & Circulatory
Nitroglycerin            Nitrates              Cardiac & Circulatory
Nitroglyn                Nitrates              Cardiac & Circulatory
Nitrol                   Nitrates              Cardiac & Circulatory
Nitrolin                 Nitrates              Cardiac & Circulatory
Nitronet                 Nitrates              Cardiac & Circulatory
Nitrong                  Nitrates              Cardiac & Circulatory
Nitrospan                Nitrates              Cardiac & Circulatory
Nitrostablin             Nitrates              Cardiac & Circulatory
Nitrostat                Nitrates              Cardiac & Circulatory
Noctec                   Chloral Hydrate      Sedatives-Hypnotics
Norcet                   Narcotics & Acetamin. Narcotic Pain Relief
Norgesic                 Aspirin              Non-Narcotic Pain Rel.
Norwich Aspirin          Aspirin              Non-Narcotic Pain Rel.
Nova-Phase               Aspirin              Non-Narcotic Pain Rel.
Nova-Phenicol            Chloramphenicol      Anti-infectives
Nova-Rectal              Pentobarbital        Sedatives-Hypnotics
Novahistine DH           Narcotic Analgesics   Narcotic Pain Relief
Novamobarb               Amobarbital          Sedatives-Hypnotics
Novamoxin                Amoxicillin           Penicillin
Novapen V                Penicillin V          Penicillin
Novasen                  Aspirin              Non-Narcotic Pain Rel.
Novo AC&C                Narcotics & Aspirin   Narcotic Pain Relief
Novo Secobarb            Secobarbital         Sedatives-Hypnotics
Novo-Ampicillin          Ampicillin            Penicillin
Novo-Mepro               Meprobamate          Antianxiety Drugs
Novochlorhydrate         Chloral Hydrate      Sedatives-Hypnotics
Novochlorocap            Chloramphenicol      Anti-infectives
Novocloxin               Cloxacillin           Penicillin
Novodigoxin              Digitalis Prep.       Cardiac & Circulatory
Novodipam                Diazepam             Antianxiety Drugs
Novoflupam               Flurazepam           Sedatives-Hypnotics
Novolorazem              Lorazepam            Antianxiety Drugs
Novomepro                Meprobamate          Antianxiety Drugs
Novometoprol             Metoprolol           High Blood Pressure
Novopen-VK               Penicillin V          Penicillin
Novopentobarb            Pentobarbital        Sedatives-Hypnotics
Novopranol               Propranolol          Cardiac &Circulatory
Novopropoxyn             Narcotic Analgesics   Narcotic Pain Relief
Novorythro               Erythromycins        Anti-infectives
Novosorbide              Nitrates             Cardiac & Circulatory
Novotrimel               Trimethoprim         Anti-infectives
Nubain                   Narcotic Analgesics  Narcotic Pain Relief
Numorphan                Narcotic Analgesics   Narcotic Pain Relief
Nupercainal              Anesthetics (Topical) Dermal Medications
\o
Omnipen                  Ampicillin            Penicillin
Onset                    Nitrates              Cardiac & Circulatory
Ophthochlor              Chloramphenicol      Anti-infectives
Ophthocort               Chloramphenicol      Anti-infectives
Opium                    Narcotic Analgesics   Narcotic Pain Relief
Oradrate                 Chloral Hydrate      Sedatives-Hypnotics
Oraphen-PD               Acetaminophen        Non-Narcotic Pain Rel.
Orbenin                  Cloxacillin           Penicillin
Orgatrax                 Hydroxyzine          Antianxiety Drugs
Ornex                    Acetaminophen        Non-Narcotic Pain Rel.
Ossonate-Plus            Narcotic Analgesics   Narcotic Pain Relief
Oxy-10                   Benzoyl Peroxide      Dermal Medications
Oxy-5                    Benzoyl Peroxide      Dermal Medications
Oxycocet                 Narcotics & Acetamin. Narcotic Pain Relief
Oxycodan                 Narcotics & Aspirin   Narcotic Pain Relief
Oxycodone                Narcotic Analgesics   Narcotic Pain Relief
Oxycodone & Acetamin.    Narcotics & Acetamin. Narcotic Pain Relief
Oxycodone & Aspirin      Narcotics & Aspirin   Narcotic Pain Relief
Oxyderm                  Benzoyl Peroxide      Dermal Medications
Oxymorphone              Narcotic Analgesics   Narcotic Pain Relief
\p
P-A-C Compound           Aspirin              Non-Narcotic Pain Rel.
P.E.T.N.                 Nitrates             Cardiac & Circulatory
Panolol                  Propranolol           Cardiac & Circulatory
PHisoAc BP               Benzoyl Peroxide      Dermal Medications
PMB                      Meprobamate          Antianxiety Drugs
PMS Dopazide             Methyldopa           High Blood Pressure
Pabirin Buffered         Aspirin              Non-Narcotic Pain Rel.
Pacaps                   Acetaminophen       Non-Narcotic Pain Rel.
Pain Relief w/o Aspirin  Acetaminophen       Non-Narcotic Pain Rel.
PanOxyl                  Benzoyl Peroxide    Dermal Medications
PanOxyl AQ               Benzoyl Peroxide      Dermal Medications
Panadol                  Acetaminophen        Non-Narcotic Pain Rel.
Panasorb                 Acetaminophen        Non-Narcotic Pain Rel.
Panex                    Acetaminophen        Non-Narcotic Pain Rel.
Pantapon                 Narcotic Analgesics  Narcotic Pain Relief
Panthocal A & D          Anesthetics (Topical) Dermal Medications
Paracetamol              Acetaminophen        Non-Narcotic Pain Rel.
Parafon Forte            Acetaminophen        Non-Narcotic Pain Rel.
Paraphen                 Acetaminophen        Non-Narcotic Pain Rel.
Paregoric                Narcotic Analgesics  Narcotic Pain Relief
Pargesic                 Narcotic Analgesics   Narcotic Pain Relief
Pargesic Compound 65     Aspirin              Non-Narcotic Pain Rel.
Pathibamate              Meprobamate          Antianxiety Drugs
Pavadon                  Narcotic Analgesics   Narcotic Pain Relief
Paveral                  Narcotic Analgesics   Narcotic Pain Relief
Pax 400                  Meprobamate          Antianxiety Drugs
Pediacof                 Narcotic Analgesics   Narcotic Pain Relief
Pediamycin               Erythromycins        Anti-infectives
Pediazole                Erythromycins        Anti-infectives
Pedric                   Acetaminophen        Non-Narcotic Pain Rel.
Peedee Dose Aspirin      Acetaminophen        Non-Narcotic Pain Rel.
Pen-Vee K                Penicillin V, Penicillin Penamox,  Amoxicillin, Penicillin
Penapar VK               Penicillin V          Penicillin
Penbritin                Ampicillin            Penicillin
Pendiamycin              Erythromycins        Anti-infectives
Pentaerythritol          Nitrates             Cardiac & Circulatory
Pentamycetin             Chloramphenicol      Anti-infectives
Pentazocine              Narcotic Analgesics   Narcotic Pain Relief
Pentazocine & Acetamin.  Narcotics & Acetamin. Narcotic Pain Relief
Pentazocine & Aspirin    Narcotics & Aspirin   Narcotic Pain Relief
Pentestan                Nitrates              Cardiac & Circulatory
Pentogen                 Pentobarbital        Sedatives-Hypnotics
Pentol                   Nitrates              Cardiac & Circulatory
Pentraspan               Nitrates              Cardiac & Circulatory
Pentritol                Nitrates              Cardiac & Circulatory
Pentylan                 Nitrates              Cardiac & Circulatory
Percocet                 Narcotics & Acetamin. Narcotic Pain Relief
Percocet-Demi            Narcotics & Acetamin. Narcotic Pain Relief
Percodan                 Narcotic Analgesics   Narcotic Pain Relief
Percodan-Demi            Narcotics & Aspirin   Narcotic Pain Relief
Perifoam                 Anesthetics (Topical) Dermal Medications
Peritrate                Nitrates              Cardiac & Circulatory
Persa-Gel                Benzoyl Peroxide      Dermal Medications
Persadox                 Benzoyl Peroxide      Dermal Medications
Persantine               Dipyridamole          Cardiac & Circulatory
Persistin                Aspirin              Non-Narcotic Pain Rel.
Pethadol                 Narcotic Analgesics   Narcotic Pain Relief
Pethidine                Narcotic Analgesics   Narcotic Pain Relief
Pfizer-E                 Erythromycins        Anti-infectives
Pfizerpen VK             Penicillin V, Penicillin Phenaphen, Acetaminophen        Non-Narcotic Pain Rel.
Phenaphen w/Codeine      Narcotic Aaalgesics   Narcotic Pain Relief
Phenaphen with Codeine   Narcotics & Acetamin. Narcotic Pain Relief
Phendex                  Acetaminophen        Non-Narcotic Pain Rel.
Phenergan                Narcotic Analgesics   Narcotic Pain Relief
Phrenilin                Narcotic Analgesics   Narcotic Pain Relief
Physeptone               Narcotic Analgesics   Narcotic Pain Relief
pms-Propranolol          Propranolol           Cardiac & Circulatory
Poly-Histine w/Codeine   Narcotic Analgesics   Narcotic Pain Relief
Polycillin               Ampicillin, Penicillin Polymox, Amoxicillin           Penicillin
Pontocaine               Anesthetics (Topical) Dermal Medications
Porox 7                  Benzoyl Peroxide      Dermal Medications
Poxy Compound-65         Aspirin              Non-Narcotic Pain Rel.
Pramoxine                Anesthetics (Topical) Dermal Medications
Prax                     Anesthetics (Topical) Dermal Medications
Prssalin                 Narcotic Analgesics   Narcotic Pain Relief
Principen                Ampicillin            Penicillin
Pro-65                   Narcotic Analgesics   Narcotic Pain Relief
Pro-iso                  Prochlorperazine     Anti-emetics
Procardia                Nifedipine           Cardiac & Circulatory
Prochlor-iso             Prochlorperazine     Anti-emetics
Proctodon                Anesthetics (Topical) Dermal Medications
Proctofoam               Anesthetics (Topical) Dermal Medications
Prodolor                 Narcotic Analgesics   Narcotic Pain Relief
Profene                  Narcotic Analgesics   Narcotic Pain Relief
Progesic Compound-65     Aspirin              Non-Narcotic Pain Rel.
Proloprim                Trimethoprim         Anti-infectives
Promethazine w/Codeine   Narcotic Analgesics   Narcotic Pain Relief
Propa P.H.               Benzoyl Peroxide      Dermal Medications
Propa P.H. Porox         Benzoyl Peroxide      Dermal Medications
Propoxychel compound     Aspirin              Non-Narcotic Pain Rel.
Propoxyphene             Narcotic Analgesics   Narcotic Pain Relief
Propoxyphene & Acetamin. Narcotics & Acetamin. Narcotic Pain Relief
Propoxyphene & Aspirin   Narcotics & Aspirin   Narcotic Pain Relief
Protid                   Acetaminophen        Non-Narcotic Pain Rel.
Protran                  Meprobamate          Antianxiety Drugs
Protrin                  Trimethoprim         Anti-infectives
Proval                   Narcotics & Acetamin. Narcotic Pain Relief
Proxagesic               Narcotic Analgesics   Narcotic Pain Relief
Proxene                  Narcotic Analgesics   Narcotic Pain Relief
Proxine                  Anesthetics (Topical) Dermal Medications
Prunicodeine             Narcotic Analgesics   Narcotic Pain Relief
Purodigin                Digitalis Prep.       Cardiac & Circulatory
Pyridamole               Dipyridamole          Cardiac & Circulatory
\q
Q-Pam                    Diazepam             Antianxiety Drugs
Quiess                   Hydroxyzine          Antianxiety Drugs
Quietal                  Meprobamate          Antianxiety Drugs
Quless                   Pentobarbital        Sedatives-Hypnotics
Quotane                  Anesthetics (Topical) Dermal Medications
\r
RMS Uniserts             Narcotic Analgesics   Narcotic Pain Relief
RP-Mycin                 Erythromycins        Anti-infectives
Rectal Medicone          Anesthetics (Topical) Dermal Medications
Reglan                   Metoclopramide       Anti-emetics
Repan                    Acetaminophen        Non-Narcotic Pain Rel.
Repro Compound 65        Aspirin              Non-Narcotic Pain Rel.
Restoril                 Temazepam            Sedatives-Hypnotics
Rhinocaps                Aspirin              Non-Narcotic Pain Rel.
Riphen-10                Aspirin              Non-Narcotic Pain Rel.
Rival                    Diazepam             Antianxiety Drugs
Robam                    Meprobamate          Antianxiety Drugs
Robamate                 Meprobamate          Antianxiety Drugs
Robamox                  Amoxicillin           Penicillin
Robicillin VK            Penicillin V          Penicillin
Robidone                 Narcotic Analgesics  Narcotic Pain Relief
Robigesic                Acetaminophen        Non-Narcotic Pain Rel.
Robimycin                Erythromycins        Anti-infectives
Robitussin A-C           Narcotic Analgesics   Narcotic Pain Relief
Rolazine                 Hydralazine           High Blood Pressure
Ronuvex                  Acetaminophen        Non-Narcotic Pain Rel.
Rovbac                   Trimethoprim         Anti-infectives
Roxanol                  Narcotic Analgesics   Narcotic Pain Relief
Ru-Vert-M                Meclizine            Anti-emetics
\s
S-A-C                    Acetaminophen        Non-Narcotic Pain Rel.
S-A-C                    Narcotic Analgesics   Narcotic Pain Relief
SK-65 APAP               Narcotics & Acetamin. Narcotic Pain Relief
SK-65 Compound           Narcotics & Aspirin   Narcotic Pain Relief
SK-APAP                  Acetaminophen        Non-Narcotic Pain Rel.
SK-APAP with Codeine     Narcotics & Acetamin. Narcotic Pain Relief
SK-Ampicillin            Ampicillin            Penicillin
SK-Bamate                Meprobamate          Antianxiety Drugs
SK-Chloral Hydrate       Chloral Hydrate      Sedatives-Hypnotics
SK-Dipyridamole          Dipyridamole          Cardiac & Circulatory
SK-Erythromycin          Erythromycins        Anti-infectives
SK-Oxycodone & Acetamin. Narcotics & Acetamin. Narcotic Pain Relief
SK-Oxycodone w/Aspirin   Narcotics & Aspirin   Narcotic Pain Relief
SK-Penicillin VK         Penicillin V          Penicillin
SMZ-TMP                  Trimethoprim         Anti-infectives
Safety Coated APF        Aspirin              Non-Narcotic Pain Rel.
Sal-Adult                Aspirin              Non-Narcotic Pain Rel.
Sal-Infant               Aspirin              Non-Narcotic PainRRel.
Salatin                  Narcotic Analgesics   Narcotic Pain Relief
Saleto                   Narcotic Analgesics   Narcotic Pain Relief
Salimeph Forte           Narcotic Analgesics   Narcotic Pain Relief
Salocol                  Aspirin              Non-Narcotic Pain Rel.
Salphenyl                Acetaminophen        Non-Narcotic Pain Rel.
Salsprin                 Aspirin              Non-Narcotic Pain Rel.
Sansert                  Methysergide         Cardiac & Circulatory
Secogen                  Secobarbital         Sedatives-Hypnotics
Seconal                  Secobarbital         Sedatives-Hypnotics
Sedabamate               Meprobamate          Antianxiety Drugs
Sedapap                  Narcotic Analgesics   Narcotic Pain Relief
Septra                   Trimethoprim         Anti-infectives
Ser-Ap-Es                Hydralazine          High Blood Pressure
Seral                    Secobarbital         Sedatives-Hypnotics
Serenack                 Diazepam             Antianxiety Drugs
Serpasil-Apresoline      Hydralazine          High Blood Pressure
Sinarest                 Acetaminophen        Non-Narcotic Pain Rel.
Sine-Aid                 Acetaminophen        Non-Narcotic Pain Rel.
Sine-Off                 Acetaminophen        Non-Narcotic Pain Rel.
Singlet                  Acetaminophen        Non-Narcotic Pain Rel.
Sinubid                  Acetaminophen        Non-Narcotic Pain Rel.
Sinulin                  Acetaminophen        Non-Narcotic Pain Rel.
Sinutab                  Acetaminophen        Non-Narcotic Pain Rel.
Soft-N-Soothe            Anesthetics (Topical) Dermal Medications
Solarcaine               Anesthetics (Topical) Dermal Medications
Som-Pam                  Flurazepam           Sedatives-Hypnotics
Soma Comp. w/Codeine     Narcotic Analgesics   Narcotic Pain Relief
Soma Compound            Aspirin              Non-Narcotic Pain Rel.
Somnal                   Flurazepam           Sedatives-Hypnotics
Sopamycetin              Chloramphenicol      Anti-infectives
Sorate                   Nitrates              Cardiac & Circulatory
Sorbase II               Narcotic Analgesics   Narcotic Pain Relief
Sorbide                  Nitrates              Cardiac & Circulatory
Sorbitrate               Nitrates              Cardiac & Circulatory
Spectrobid               Bacampicillin         Penicillin
St. Joseph               Aspirin              Non-Narcotic Pain Rel.
St. Joseph Aspirin Free  Acetaminophen        Non-Narcotic Pain Rel.
St. Joseph Childrens     Aspirin              Non-Narcotic Pain Rel.
Stadol                   Narcotic Analgesics   Narcotic Pain Relief
Statex                   Narcotic Analgesics   Narcotic Pain Relief
Staticin                 Erythromycins        Anti-infectives
Stemetic                 Trimethobenzamide    Anti-emetics
Stemetil                 Prochlorperazine     Anti-emetics
Stero-Darvon             Aspirin              Non-Narcotic Pain Rel.
Stopayne                 Acetaminophen        Non-Narcotic Pain Rel.
Strascogesic             Narcotic Analgesics   Narcotic Pain Relief
Stress-Pam               Diazepam             Antianxiety Drugs
Sudoprin                 Acetaminophen        Non-Narcotic Pain Rel.
Sulindac                 Clinoril             Non-Narcotic Pain Rel.
Summit                   Acetaminophen        Non-Narcotic Pain Rel.
Sumox                    Amoxicillin           Penicillin
Supac                    Narcotic Analgesics   Narcotic Pain Relief
Supasa                   Aspirin              Non-Narcotic Pain Rel.
Supen                    Ampicillin            Penicillin
Supeudol                 Narcotic Analgesics   Narcotic Pain Relief
Suppap                   Acetaminophen        Non-Narcotic Pain Rel.
Surfacaine               Anesthetics (Topical) Dermal Medications
Susadrin                 Nitrates              Cardiac & Circulatory
Sylapar                  Narcotic Analgesics   Narcotic Pain Relief
Symmetrel                Amantadine           Anti-virals
Synalgos                 Aspirin              Non-Narcotic Pain Rel.
Synalgos-DC              Narcotics & Aspirin   Narcotic Pain Relief
Syraprim                 Trimethoprim         Anti-infectives
\t
T-Gesic Forte            Narcotics & Acetamin. Narcotic Pain Relief
T-Star                   Erythromycins        Anti-infectives
T.E.H. Tablets           Hydroxyzine          Antianxiety Drugs
T.P.I.                   Acetaminophen        Non-Narcotic Pain Rel.
Talacen                  Narcotics & Acetamin. Narcotic Pain Relief
Talwin                   Narcotic Analgesics   Narcotic Pain Relief
Talwin Compound          Narcotics & Aspirin   Narcotic Pain Relief
Tapanol                  Acetaminophen        Non-Narcotic Pain Rel.
Tapar                    Acetaminophen        Non-Narcotic Pain Rel.
Teen                     Benzoyl Peroxide      Dermal Medications
Tega-Caine               Anesthetics (Topical) Dermal Medications
Tega-Dyne                Anesthetics (Topical) Dermal Medications
Tegamide                 Trimethobenzamide    Anti-emetics
Tegopen                  Cloxacillin           Penicillin
Temlo                    Acetaminophen        Non-Narcotic Pain Rel.
Tempra                   Acetaminophen        Non-Narcotic Pain Rel.
Tenlap                   Acetaminophen        Non-Narcotic Pain Rel.
Tenol                    Acetaminophen        Non-Narcotic Pain Rel.
Terpin Hydrate w/Codeine Narcotic Analgesics   Narcotic Pain Relief
Tetracaine               Anesthetics (Topical) Dermal Medications
Theozine                 Hydroxyzine          Antianxiety Drugs
Ticon                    Trimethobenzamide  Anti-emetics h
Tigan                    Trimethobenzamide    Anti-emetics
Tiject-20                Trimethobenzamide    Anti-emetics
Topex                    Benzoyl Peroxide     Dermal Medications
Totacillin               Ampicillin            Penicillin
Tranderm-Nitro           Nitrates              Cardiac & Circulatory
Tranmep                  Meprobamate          Antianxiety Drugs
Trates                   Nitrates              Cardiac & Circulatory
Triaminic                Aspirin              Non-Narcotic Pain Rel.
Triaminic w/Codeine      Narcotic Analgesics   Narcotic Pain Relief
Triaminicin              Acetaminophen        Non-Narcotic Pain Rel.
Triaphen-10              Aspirin              Non-Narcotic Pain Rel.
Tribavirin               Ribavirin            Anti-virals
Tridil                   Nitrates             Cardiac & Circulatory
Trigesic                 Narcotic Analgesics   Narcotic Pain Relief
Trimox                   Amoxicillin           Penicillin
Trimpex                  Trimethoprim         Anti-infectives
Trind Syrup              Acetaminophen        Non-Narcotic Pain Rel.
Tronolane                Anesthetics (Topical) Dermal Medications
Tronothane               Anesthetics (Topical) Dermal Medications
Tuinal                   Amobarbital          Sedatives-Hypnotics
Tussar                   Narcotic Analgesics   Narcotic Pain Relief
Tussend                  Narcotic Analgesics   Narcotic Pain Relief
Tussi-Organidin          Narcotic Analgesics   Narcotic Pain Relief
Two-Dyne                 Acetaminophen        Non-Narcotic Pain Rel.
Ty-Tabs                  Narcotics & Acetamin. Narcotic Pain Relief
Tylenol                  Acetaminophen        Non-Narcotic Pain Rel.
Tylenol with Codeine     Narcotics & Acetamin. Narcotic Pain Relief
Tylox                    Narcotics & Acetamin. Narcotic Pain Relief
\u
Unguentine               Anesthetics (Topical) Dermal Medications
Unipes                   Hydralazine           High Blood Pressure
Uniserp                  Hydralazine           High Blood Pressure
Urolocaine               Anesthetics (Topical) Dermal Medications
Uticillin VK             Penicillin V          Penicillin
Utimox                   Amoxicillin           Penicillin
\v
V-Cillin                 Penicillin V          Penicillin
V-Cillin K               Penicillin V          Penicillin
Valadol                  Acetaminophen        Non-Narcotic Pain Rel.
Valium                   Diazepam             Antianxiety Drugs
Valorin                  Acetaminophen        Non-Narcotic Pain Rel.
Valrelease               Diazepam             Antianxiety Drugs
Vamate                   Hydroxyzine          Antianxiety Drugs
Vanoxide                 Benzoyl Peroxide     Dermal Medications
Vanquish                 Aspirin              Non-Narcotic Pain Rel.
Vaso-80                  Nitrates             Cardiac & Circulatory
Vasodilan                Isoxsuprine           Cardiac & Circulatory
Vasoglyn                 Nitrates              Cardiac & Circulatory
Vasoprine                Isoxsuprine           Cardiac & Circulatory
Veetids                  Penicillin V          Penicillin
Velvacaine               Anesthetics (Topical) Dermal Medications
Verin                    Aspirin              Non-Narcotic Pain Rel.
Vicodin                  Narcotics & Acetamin. Narcotic Pain Relief
Vilona                   Ribavirin            Anti-virals
Viramid                  Ribavirin            Anti-virals
Virazole                 Ribavirin            Anti-virals]
Vistacon                 Hydroxyzine          Antianxiety Drugs
Vistaject                Hydroxyzine          Antianxiety Drugs
Vistaquel                Hydroxyzine          Antianxiety Drugs
Vistaril                 Hydroxyzine          Antianxiety Drugs
Vistazine                Hydroxyzine          Antianxiety Drugs
Vistrax                  Hydroxyzine          Antianxiety Drugs
Vivol                    Diazepam             Antianxiety Drugs
\w
Wehvert           Meclizine          Anti-emetics
Wesprin Buffered  Aspirin            Non-Narco Pain Rel.
Wigraine-PB       Pentobarbital      Seditive-Hypnotics
Wyamycin          Erythromycins      Anti-infectives
Wyamycin E        Erythromycins      Anti-infectives
Wyamycin S        Erythromycins      Anti-infectives
Wygesic           Narcotic/Acetamin  Narcotic Pain Rel
Wymox             Amoxicillin        Penicillin
\x
Xerac BP          Benzoyl Peroxide      Dermal Med
Xylocaine         Anesthetics (Topical) Dermal Med
\z
Zeroxin           Benzoyl Peroxide    Dermal Med
Zorprin           Aspirin             No-Narco Pain Rel.
Zovirax           Acyclovir           Anti-virals
Zovirax Ointment  Acyclovir           Anti-virals


\2  Generic name drug rules

The US FDA requires that generic versions of drugs have the same active ingredents, body absorbsion rate, and other drug characteristics as the original version but IS NOT always the case. Ask doctor or pharmacist. USP label means U.S.Pharmacopeia appoved for sale in U.S.


\3 Refills etc.

* Familiar medications and health products may not be available, or they could be mkted using diff names or formulations. Some medications might not meet the stds for safety, quality and consistency found at home. * Bring along an adequate supply of all over-the-counter and prescription medications you will need. Leave them in their original containers and keep a record of their generic names. * Remember to pack products for skin care, hygiene and birth control if you depend on certain brands.
 Medication by Weight. Doctors often prescribe medication per the patient's body weight. If you lose or gain a few pounds (10%), tell your doctor when getting or renewing medication. A once-correct dosage could be too little or much. You may need to update your prescription.


\4 foreign (non-US) Pharmaceuticals

Many can be bought over the counter abroad. Do not do so without competent medical advice. When you do buy the stuff, check expiration date. Consider that the stuff may not have been stored under ideal conditions, unrefrigerated, in the sun, etc.

Some Third world countries in africa, southeast asia, and oceania reportedly pack expensive capsules with flour, sugar, chalk, talc, and other shit. If you need it bring it with you or check with the embassy.

There is limited EMS in foreign countries.


\5  ROUTINE contraindications

you have advised the medical practitioner of any reason you should not take the medication he is prescribing as: pregnancy, current medications, food or drug allergies, or past adverse reactions to any drugs. Understand why and what is being prescribed, its contra- indications, possible side effects, and how to administer the medication. Read and understand label instructions and warnings before taking medication. Be sensitive to body reactions after taking new medication. If there is a problem consult with a doctor promptly. Do not modify medication or dosage without medical advice.  Should any of the following symtoms appear, advise physican: Dry, scratchy or bloodshot eyes. Dry mouth. Cataracts or cloudy vision. Ringing in the ears. Poor color vision, blurred/dim vision or nearsightedness. Hearing loss. Dizziness or drowsiness. Tender or bleeding gums. Gastro-intestinal distress. Allergies, skin rashes or hives. Decreased sexual ability. CONTRAINDICATED means a medication may have a risk for reasons listed leading to an adverse reaction. 

\6 safe usage of medications

TELL your doctor about all drugs you take (allergy pills, laxatives, vitamins, diet pills, even aspirin and herbs, etc.) before you take any new drug.

Don't take drugs prescribed for someone else--even if your symptoms are the same. Keep your prescription drugs to yourself.Your drugs may be harmful to someone else. Tell your doctor about any symptoms you believe are caused by a drug prescription or non-prescription that you take. Does it change your mood or behavior.

Take only medicines that are necessary. Avoid takingnon-prescription drugs while taking prescription drugs for a medical problem.

Before your doctor prescribes for you, tell him about your previous drug experiences as to reaction or allergies.

Be sure of the medicine you take as to time and dosage. It can be fatal to take the wrong drug at the wrong time.

Don't keep any drugs that change mood, alertness orjudgment as sedatives, narcotics or tranquilizers by your bedside.These have caused many accidental deaths by overdose. You may unknowingly repeat a dose when you are half asleep or confused.

Check all prescriptions to make sure it's correct. Know your medicine color form dosage. Study the labels of all drugs you need and be familar with them. If you have questions, ask the doctor or pharmacist for more details.

If you must deviate from your prescribed dose schedule, tell your doctor. Know what to do if you miss a dose


\7 Alkaloids

Compounds of vegetable origin, some with dietary use. Often from a nitrogen compound as pyradine, quinoline, isoquino- line, or pyrrole, desinated with an ING word ending. eg: morphine, nicotine, quinine, codine, caffine, cocaine, mescaline etc. They are potent and deadly (brucine).

Alkaloids have diverse and important physiological effects on humans and other animals. Well-known alkaloids include morphine, strychnine, quinine, ephedrine, and nicotine. Alkaloids are found primarily in plants and are especially common in certain families of flowering plants. More than 3,000 different types of alkaloids have been identified in a total of more than 4,000 plant species. In general, a given species contains only a few kinds of alkaloids, though both the opium poppy (Papaver somniferum) and the ergot fungus (Claviceps) each contain about 30 different types. Certain plant families are particularly rich in alkaloids; all plants of the poppy family (Papaveraceae) are thought to contain them, for example. The Ranunculaceae (buttercups), Solanaceae (nightshades), and Amaryllidaceae (amaryllis) are other prominent alkaloid-containing families. A few alkaloids have been found in animal species, such as the New World beaver (Castor canadensis) and poison-dart frogs (Phyllobates). Ergot and a few other fungi also produce them. The function of alkaloids in plants is not yet understood. It has been suggested that they are simply waste products of plants' metabolic processes, but evidence suggests that they may serve specific biological functions. In some plants, the concentration of alkaloids increases just prior to seed formation and then drops off when the seed is ripe, suggesting that alkaloids may play a role in this process. Alkaloids may also protect some plants from destruction by certain insect species. The chemical structures of alkaloids are extremely variable. Generally, an alkaloid contains at least one nitrogen atom in an amine-type structure--i.e., one derived from ammonia by replacing hydrogen atoms with hydrogen-carbon groups called hydrocarbons. This or another nitrogen atom can be active as a base in acid-base reactions. The name alkaloid ("alkali-like") was originally applied to the substances because, like the inorganic alkalis, they react with acids to form salts. Most alkaloids have one or more of their nitrogen atoms as part of a ring of atoms, frequently called a cyclic system. Alkaloid names generally end in the suffix -ine, a reference to their chemical classification as amines. In their pure form most alkaloids are colourless, nonvolatile, crystalline solids. They also tend to have a bitter taste. Interest in the alkaloids stems from the wide variety of physiological effects (both wanted and unwanted) they produce in humans and other animals. Their use dates back to ancient civilizations, but scientific study of the chemicals had to await the growth of organic chemistry, for not until simple organic bases were understood could the intricate structure of the alkaloids be unraveled. The first alkaloid to be isolated and crystallized was the potent active constituent of the opium poppy, morphine, in 1805-06. Alkaloids are often classified on the basis of their chemical structure. For example, those alkaloids that contain a ring system called indole are known as indole alkaloids. On this basis, the principal classes of alkaloids are the pyrrolidines, pyridines, tropanes, pyrrolizidines, isoquinolines, indoles, quinolines, and the terpenoids and steroids. Alternatively, alkaloids can be classified according to the biological system in which they occur. For example, the opium alkaloids occur in the opium poppy (Papaver somniferum). This dual classification system actually produces little confusion because there is a rough correlation between the chemical types of alkaloids and their biological distribution. The medicinal properties of alkaloids are quite diverse. Morphine is a powerful narcotic used for the relief of pain, though its addictive properties limit its usefulness. Codeine, the methyl ether derivative of morphine found in the opium poppy, is an excellent analgesic that is relatively nonaddictive. Certain alkaloids act as cardiac or respiratory stimulants. Quinidine, which is obtained from plants of the genus Cinchona, is used to treat arrhythmias, or irregular rhythms of the heartbeat. Many alkaloids affect respiration, but in a complicated manner such that severe respiratory depression may follow stimulation. The drug lobeline (from Lobelia inflata) is safer in this respect and is therefore clinically useful. Ergonovine (from the fungus Claviceps purpurea) and ephedrine (from Ephedra species) act as blood-vessel constrictors. Ergonovine is used to reduce uterine hemorrhage after childbirth, and ephedrine is used to relieve the discomfort of common colds, sinusitis, hay fever, and bronchial asthma. Many alkaloids possess local anesthetic properties, though clinically they are seldom used for this purpose. Cocaine (from Erythroxylon coca) is a very potent local anesthetic. Quinine (from Cinchona species) is a powerful antimalarial agent that was formerly the drug of choice for treating that disease, though it has been largely replaced by less toxic and more effective synthetic drugs. The alkaloid tubocurarine is the active ingredient in the South American arrow poison, curare (obtained from Chondrodendron tomentosum), and is used as a muscle relaxant in surgery. Two alkaloids, vincristine and vinblastine (from Vinca rosea), are widely used as chemotherapeutic agents in the treatment of many types of cancer. Nicotine obtained from the tobacco plant (Nicotiana tabacum) is the principal alkaloid and chief addictive ingredient of the tobacco smoked in cigarettes, cigars, and pipes. Some alkaloids are illicit drugs and poisons. These include the hallucinogenic drugs mescaline (from Anhalonium species) and psilocybin (from Psilocybe mexicana). Synthetic derivatives of the alkaloids morphine and lysergic acid (from C. purpurea) produce heroin and LSD, respectively. The alkaloid coniine is the active component of the poison hemlock (Conium maculatum). Strychnine (from Strychnos species) is another powerful poison. Special methods have been developed for isolating commercially useful alkaloids. In most cases, plant tissue is processed to obtain aqueous solutions of the alkaloids. The alkaloids are then recovered from the solution by a process called extraction, which involves dissolving some components of the mixture with reagents. Different alkaloids must then be separated and purified from the mixture. Chromatography may be used to take advantage of the different degrees of adsorption of the various alkaloids on solid material such as alumina or silica. Alkaloids in crystalline form may be obtained using certain solvents.


\8 holistic healing

THE UNESCO COURIER, CULTURE AND HEALTH
Modern medicine may be coming round to the idea that the sick are not `machines' but people rooted in their cultural and natural environment Medicine, perhaps more than any other of the activities that contribute to our survival, depends on the cultural context in which it is practiced, dealing as it does with birth, suffering and death, those essential features of our human condition. People have been receiving medical attention since long before biology and chemistry came into being, long before the advent of Western-style preventive medicine. Highly efficient therapies--some of them, such as the trepanation and dental surgery performed by the Incas, involving the use of amazing techniques--have been employed for thousands of years. Only recently, however, have such traditional forms of medicine been studied in the West. Their significance and value have been more deeply understood by Westerners thanks to the worldview of modern physics (relativity and quantum theory, thermodynamics)--in which everything is seen in terms of interaction--and decolonization, which has given peoples previously held in contempt an opportunity to make the voices of their cultures heard once more. Western medicine, which had hitherto regarded human beings as "machines", is gradually coming round to the idea of treating "the whole person", in accordance with an outlook that in some respects links up with that held in traditional societies. The medical model that is thus emerging is no longer interested solely in disease but in health in a general sense, and in the psychological and cultural factors from which it stems. Those who extol the virtues of progress are sometimes annoyed by certain "irrational" aspects of traditional forms of medicine, but the fact is that they spring from cultures that firmly believe in the existence of a network of interdependences between human beings and the universe at large; a person's relationship with nature, in the broadest sense, is regarded as that of a humble partner, not a proprietor. The various types of traditional medicine, from shamanism to Ayurveda, reflect widely different ways of thinking, but all of them, as the following examples show, tend to see humans as an integral part of the world as a whole, and science and spirituality as being different points on the same continuum. Shamanism A feature common to the various forms of shamanism found all over the world, from Siberia to Amazonia, is the practice of diagnosis and therapy through an ecstatic state. In addition to possessing a profound, albeit empirical, knowledge of the medicinal properties of plants, the shaman performs also as poet, soothsayer, healer and sometimes magician and ventriloquist as well, but he is above all else an initiate. Initiation, the personal experience of the threefold mystery of suffering, death and resurrection, bestows an aura of the sacred on him. While he is officiating, his body is covered in signs and objects symbolizing his powers. He is able to communicate with spirits that are invisible to the eyes of the uninitiated, and his words translate the murmurs of the deep forest or the windswept steppes. As an initiate, he is able to enter in spirit into his patient's body, to drive out demons and pursue them in the world beyond. The convulsing womb of a woman about to give birth thus becomes a universe peopled with monsters and mythical beasts, metaphorically representing the contractions and fears with which she must contend. The shaman can give the ailment not only a name but also material form, removing, often by sucking, from the patient's body or soul the crystals and blood-soaked down he has chewed. While the shaman is performing his rites, the patient is never isolated from the world. As during voodoo ceremonies in Brazil or Benin, all his kith and kin are on hand during the "therapeutic drama" that helps purge the sick of their ills. The responsibility for coping with suffering is shared. Medicine in ancient Egypt In addition to the meagre information about ancient Egyptian medical practices that can be gleaned from papyri, we can appreciate the anatomical knowledge required by the techniques used in the process of mummification to remove the brain, viscera and eyeballs, and the Egyptians' command of the antiseptic properties of the essential oils, resins, herbs and spices they used not only to embalm the mortal remains of their dignitaries but also to treat many illnesses. Like scribes, sorcerer-physicians were trained in a "house of life" whose supreme master and first initiate was the ibis, symbol of the god of wisdom. When sleeping, the ibis curls itself up into the shape of a heart, just like the hieroglyph which represents "goodness" and which is made up of three signs--vibration (or air), the individual (through whom life on earth is carried on), and the mouth (through which breathing, also manifested in the beating of the heart, passes). As in Chinese medicine, the "heart speaks" throughout the body. Hippocrates, the famous Greek physician of Antiquity, who had studied the healing art in the temples of Egypt, divulged the lessons he had learned. His aphorism "We are what we eat" and his pronouncements on the importance of the interaction between people and their environment tie in with the explanation given in the Ebers Papyrus Treatise on the functioning and knowledge of the heart: "Four vessels (metou) lead to the liver and convey moisture and air to it. They then cause all kinds of illnesses." As well as being the seat of the intelligence, the "heart" is also the organ that powers and steers the body, distributing energy thereto via the metou, which carry air, waste products and blood. Each individual's blood is held to pulsate at its own specific frequency. This pulsatory conception of the human being might explain why so many of the incantations that have been rediscovered were not accompanied by any form of treatment. Others were performed at the same time as particular potions were administered. Rationalists are often put out by the magical aspect of pharaonic medicine, such as the use of sacred sleep in temples. This therapy, probably induced by hypnosis that weakened self-awareness, might have remained a puzzling phenomenon if sleep cures had not come to be used in modern clinics. As disciples and servants of Thoth, the compassionate god entrusted by Ra with the protection of humanity, the sorcerer-physicians did not claim to have invented the spells they intoned or the treatments they prescribed. Their lore came from the gods. Learning alone is not, however, enough to make a good physician, whose status is indissociable from that of priest. Not only must he study while young, work hard and long so that knowledge, as it were, comes naturally and grows of its own accord, but he must live an upright life, since "holy things should be taught only to those who are pure". Aztec angst Underlying the culture of the Aztecs was a sense of dread stemming from their belief that the world they knew was doomed to be wiped out by fearsome earthquakes, just as the four previous worlds had been annihilated by catastrophes. The gods had had to sacrifice themselves in order to overcome death, and humans likewise had to pay the price of their survival in human blood. The Spanish chronicler Bernardino de Sahagun, who arrived in Mexico in 1529, relates that never a day passed but that women were sacrificed to the goddess of salt, or children to the rain gods. Their hearts were torn out in order that the sun might not die. From their earliest years, children were subjected to the severest discipline of a mystical and military hierarchy. Depending on the social class to which they belonged, boys were educated either in local schools which prepared them for the productive work of the community, or in religious schools whose austerity trained them for their future roles as priest-physicians or high officials of the state. Illness was seen as a divine punishment provoked by a disturbance of the cosmic balance resulting from the failure of the sick to conform to the natural order to which everyone should submit on pain of unleashing the wrath of the gods and bringing on further cataclysms. The responsibility of the soothsayer-priest (ticitl), as the humans' go-between with the gods, was therefore not so much to treat ailments that had been sent as punishments as to find out, especially by means of astrology and sacred numerology, what the sick had done to displease the gods. He employed simple forms of divination (recovery was guaranteed if grains of maize thrown down on the ground or into a pot of water did not separate; otherwise the patient would die) but also used hallucinogenic plants such as peyotl (Anhalonium lewini), a small spineless cactus, and sacred mushrooms such as the teonanacatl (Paneolus campanulatus), which were eaten to induce the collective trances that accompanied human sacrifices. The Aztec pharmacopoeia comprised some 12,000 medicinal plants (patli) which were sold in the markets of the main towns and were sometimes grown in the floating gardens known as chinampas. They were used mainly for the purpose of treating minor ailments. Among the Aztecs, where the individual was absorbed bodily into the community, illness was regarded primarily as the sign of some disturbance of the cosmic order, fraught with the dread of a punishment on which their afterlife depended. Sacred medicine and all-round health Although it is clear from these few examples that traditional medicine is indissociable from the spiritual path chosen by the society within which it is practiced, there are certain features common to all forms of such medicine that are absent from modern medicine. These are: a holistic approach to the individual, seen as a multi-dimensional--at once physical, mental, social and spiritual--being who lives in close interdependence with his or her natural environment and with the vast, mysterious cosmos; a view of the physician's role as being close to that of the priest, or indeed the sorcerer, at any event of the initiate who needs to have direct experience of death and suffering. The physician has to be upright and pure, and is held accountable to men and the gods, if not indeed to life itself; learning based upon observation of living reality and a thorough, albeit empirical, knowledge of the natural environment and natural resources, including cosmic rhythms, which are reflected in the fluctuations observable in human health. Traditional medicine's characteristically global approach to life and the human being is attracting growing interest in the West, which nowadays takes a would-be holistic view of the world--holos being the Greek both for "whole" and for "sacred". Hence, the definition of health given by the World Health Organization (WHO) can also serve as a universal definition of the human being considered in all his or her many dimensions: health is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." This definition bids modern society to draw inspiration from the wisdom of traditional medicine. It offers modern medicine an opportunity to find the path of harmony and wisdom.
PHOTO: A man with a peace pipe is silhouetted against the sky in Canyonlands National Park, Utah (U.S.A.). North American Indians traditionally regard smoking the peace pipe as an act symbolizing that they belong to the world. The pipe is ritually presented to the 4 points of the compass before being lit.


\9 Mefloquine, Larium

Don't take w/other medication or if over age 60. Taken prophylactically as antimalarial. It has severe side effects. See lariamusa@aol.com 5/97. se 250mg (1 tablet) weekly for prophylaxis against malaria. Effective against both choroquine and fansidar resistant falciparum malaria, except in parts of Thailand and Cambodia. Do not take on empty stomach, take with 8oz water. Should You Take Lariam?

This may be a very difficult question to answer. The facts are that malaria kills one million people yearly (mostly African children), that falciparum malaria has a mortality rate of up to 2%, and that exposure may not be obvious. The facts are also that there are alternatives, that in many parts of the world with the potential of serious malaria, exposure may be minimal, and that exposure may be prevented by preventing exposure to mosquitoes in the evenings (see sections on insect avoidance and general information on malaria for background information). Whenever available I have included information about the incidence of malaria and the percentage of falciparum (from the latest-available WHO data) under the regional risk pages to facilitate decision-making. Unfortunately the highest-risk countries, in Africa, do not have available such information.

A decision on what to take for malaria prophylaxis, or whether to take anything at all, needs to be based on your expected exposure - meaning night-time outdoor activities and total time spent in risk area. Spending an evening or two having beers at an outdoor bar in Manilla or even Davao in the Philippines is a lot different than spending four hours every night for two weeks watching wildlife in game parks in Africa. About half or more of the imported malaria in the US comes from visitors to Africa.

I calculated crude relative risk for civilian malaria based on one year's study of imported malaria and some rough tourist numbers:

 IMPORTED CIVILIAN MALARIA

 Region:Percent CasesRelative

Risk
 Any Malarious Area 100%  1.0
 Africa 49% 8.1
 Asia33%  0.55
 Central America13% 1.1
 South America3% 0.1
 Caribbean 0.5% 0.08

"Relative Risk" means your risk of malaria during travel to that region, compared to the average risk for travel to any malarious area. So, for example, you are eighty-one times more likely to get malaria on a trip to Africa than on a similar trip to South America (8.1 compared to 0.1).

Remember that in the Caribbean malaria exists essentially only in Haiti and the Dominican Republic.

The above infolmation must be taken with a grain of salt and in consideration of activities and other factors. In many locales - Indonesia, for example, malaria risk may vary extremely between a tourist beach area and a jungle area ten kilometers away (which would be safe to visit in the daytime).

Doesn't Mefloquine Have Bad Side Effects?

The reality of life is that bad news travels much faster than good. While it is true that there are obnoxious side effects from Lariam, most can take it without problems. Some studies show that 85% have no problems with this medication. Of the other 15%, most of the side effects are minor headaches and dizziness, some of which resolve with the help of some acetominophen. A small percentage of those taking Lariam must discontinue it due to side effects. My experience with about 40 employees of a mining company that I have frequent repeated contact with because of their travels leads me to agree with these figures. (Most of our regular travel clients do well and we never hear from them after their trip.) Out of this number a few have minor side effects and one simply cannot take it at all because he gets severe depression when he does. A symptom such as this could be very serious if one did not recognize it as a side-effect and continued taking the medication.

The patient information provided in the U.S. is less detailed than that provided with prescriptions in the U.K.(the following contains excerpts from the Roche package insert, edited by Lariam Action USA): One survey published in the British Medical Journal reports more frequent severe side-effects than previously appreciated. Hospitalization from side effects occurred in about one in 650 lariam-users, and seizures in about one out of 1100. I think it is important to determine the actual risk of malaria based upon your destination, planned activities, and duration of exposure, and then decide whether lariam is an appropriate drug for you. Alternatives such as doxycycline (if you are not pregnant) do exist.

If you are very concerned with possible side effects, (for example, if you plan to scuba dive and figure that an underwater seizure could prove fatal) one option is to either start the tablets three weeks before your trip or even (some have suggested) take three tablets spread out over the first week while at home - thus building up a "steady-state" level before you leave. If side effects occur, they will probably occur at home, and you would have time to discuss changing prophylaxis before you leave. Those pregnant or with known disorders of electrical conduction in the heart, psychosis, seizure disorders, or severe depression should consider alternative drugs (pregnant women should probably avoid areas with Chloroquine-resistant falciparum!). Long-term studies of Peace-Corps volunteers have shown that if you don't have side effects in the short term, you can most likely take this drug for years without problems. Beware of a few studies which quote side-effects in terms of "person-weeks" exposure, because if a person doesn't have side effects in five weeks, they probably won't in 112 weeks, so this statistic skews results in favor of the drug appearing safer. Example - two people took the drug, one quit after three weeks due to a seizure, the other had no problems and continued for two years. You could say there was one seizure out of two people taking the drug, or you could say there was one seizure in 115 person-weeks of drug exposure.....

There is an organization in London and now in several countries which provides assistance to those who believe they have been harmed by lariam - "Lariam Action".To contact the US branch: Lariam Action USA, 1563 Solano Ave., #248, Berkeley, CA 94907 (e-mail at Lariaminfo@aol.com).

A commonly-used alternative to mefloquine is doxycycline, 100mg, taken daily. It must be continued for four weeks after exposure, and cannot be taken by pregnant women and children under eight.

A recent study (full text available) by the Traveller's Medical and Vaccination Centre (TMVC) in Adelaide reveals the following information comparing the two prophylaxis regimens:

Profile of symptoms experienced during medication regimen:

Symptom*MefloquineDoxycycline Crude95% C.I. (285) (383)  Rel.Risk**

dizziness 41 (14.4%) 23 (6.0%)  2.40 1.47-3.90 headache31 (10.9%) 17 (4.4%)  2.45 1.38-4.34 strange 29 (10.2%) 9 (2.3%) 4.33 2.08-9.00 dreams27 (9.5%) 8 (2.1%) 4.54 2.09-9.83 sleep 14 (4.9%) 3 (0.8%) 6.271.82-21.62 disturb. 13 (4.6%) 2 (0.5%) 8.741.99-38.40 mood change 10 (3.5%) 1 (0.3%) 13.44 1.73-104.38 anxiety 10 (3.5%) 5 (1.3%) 2.69 0.93-7.78 palpitations9 (3.2%) 10 (2.6%)  1.21 0.50-2.94 itching 0 (0.0%) 22 (5.7%)  0.06 0.01-0.43 rash 3 (1.8%) 17 (9.3%)  0.19 0.06-0.63 red skin 30(10.5%) 30 (7.8%)  1.34 0.83-2.18 vaginal itch56(19.6%) 47(12.3%)  1.60 1.12-2.29 # 59(20.7%) 57(14.9%)  1.39 1.00-1.94 abdominal pain diarrhoea nausea/vomit

* more than one symptom per traveller ** mefloquine relative to doxycycline # females only, 171 mefloquine users, 183 doxycycline users.

The biggest concern that many have is that the side effects of anxiety and depression may last for many months after taking this drug. Many of these side-effects appear within the three to four doses of the drug. In fact, if you can take it for three or four weeks without problems, you can probably take it longer with no ill-effects (I have heard experts say that this has been the Peace Corps experience). The long-lasting effects have been the ones of most concern expressed by respondents to my lariam survey.

Interestingly, the Adelaide study confirms what I have found through our on-line survey, and that is that most of the serious side-effects occur in women. Their study did not find this to be due to a relationship of body weight, however, as I originally expected.I changed the survey to include weight and also found no difference based upon weight.

What About Doxycycline?

Doxycycline, 100mg taken daily, is an acceptable alternative to lariam. There are problems associated with this drug, but not severe ones. As seen above, red skin (probably a photosensitivity reaction) and vaginal itch are far more common in those using doxycycline. A medicine taken daily is far more likely to be forgotten - this study indeed shows 78% took lariam correctly vs. 68% taking doxycycline correctly. Doxycycline should not be used during pregnancy or by those younger than eight years.

What If I Must Take Lariam?

To minimize risk of sleep disturbance, take it in the morning with food. Women and smaller individuals should think seriously about splitting the dose - half a tablet twice weekly. If you can take an alternative regimen, you might consider taking it along and making the switch if side effects occur. Consider strongly your actual risk - perhaps you might simply be very aggressive with avoiding outdoor night-time activities, using repellents, using bed-nets, etc. For a one-week trip to the Amazon, without major night-time outdoor exposure, your risk of malaria, especially if you use mosquito avoidance techniques, may be far less than your risk of side-effects from mefloquine. Also consider each potential risk because of the risk of blurred vision or seizures the military does not allow pilots to take mefloquine, and likewise, if you are planning a diving trip, you may not want to risk a seizure at 65 feet... Some experts feel that alcohol consumption increases the likelihood of a reaction - so keep the alcohol to a minimum.

Why Are There Problems With Lariam?

I think that Lariam causes more side effects than many drugs. Unfortunately, however, malaria kills about a million people per year in the world, so the usefulness of Lariam cannot be underscored. However, I have had some questions all along. The kinetics of distribution and elimination of Lariam are complex and, I think, not very well understood, even by Hoffman La Roche. The "half-life of this drug is measured in days and the half-life of some of its metabolites is measured in weeks! This means it takes a very long time to clear the body.Originally it was recommended on an every-two-weeks schedule. Some Peace Corps workers in East Africa developed malaria, and it seems they contracted it towards the end of the two-week period. The recommendation to double the frequency to weekly was the result. Why not every ten days? Might there be fewer side-effects? The other concern is that there is only one adult dosage. My wife would be advised to take the same 250mg tablet weekly that I would - even though I weigh about twice what she weighs! In an August 31, 1996 British Medical Journal article most of those with serious confirmed side effects are female (eight out of ten) - could this be because they get a far larger dose per kg of body weight? My survey results confirm the finding of the Adelaide study, above, that weight does not seem to be the difference.Some have suggested that those who drink alcohol while taking this drug are more prone to reactions, so if concerned, you might want to avoid the booze.

I received an e-mail from Sheldon Johnston in Australia who also feels that Lariam is a dangerous drug. His experience was of having bad neurologic side effects which began as disorientation and weakness which went unrecognized and misdiagnosed by physicians in Africa - he was treated for malaria and other things he did not have. After having a seizure he made his way to London where the real problem was diagnosed. This is an awful experience with lariam. This drug should be used cautiously and with alertness for possible side effects. Starting it several weeks prior to departure should be considered, and carefully weighing the risks of medication and of getting malaria is vital. There are other means of avoiding mosquito bites, so for minimal risk activities, repellents, netting, clothing, etc., can all be used. For nighttime activities in Africa or prolonged stays, prophylactic medication is probably still worth considering strongly. For us physicians, it is easier to make a recommendation than to present the risk-benefit situation and let the patient make up their mind - and many patients want to be told what to do... Where available I have put malaria statistics on this site to assist in this decision process. Unfortunately, these statistics are several years old and not available for most of Africa, where the risk is highest, because of inadequate disease reporting and monitoring systems. Mr. Johnson has just put together a very informative website in which he discusses his own bad experiences and has links to a large number of articles and sites both pro and con on Lariam.

Thanks to Mr. Johnston for sharing this information and his unfortunate experience - if others have had bad experiences with lariam or malaria please send me an e-mail describing your experience.

Other sources of information include: The Malaria Debate, or The British Medical Journal news , or Study confirms relative safety of mefloquine prophylaxis . Or simply do a search through Yahoo or one of the other search services.

The Really Bad News

Mosquitoes are developing resistance to more and more insecticides, and the Plasmodium falciparum are becoming resistant to Lariam and proguanil. The newest drug on the horizon, artemesin, and other derivatives of the artemesia annua plant ("sweet annie"), may offer a great deal of promise. Until an effective vaccine is developed, it will be an increasingly vicious cycle...

Presumptive Treatment

If you are traveling in remote areas with falciparum malaria, especially if not taking optimum prophylaxis, you might want to take along a self-treatment medication to take if you think you have malaria (you would still want to get evaluated and head towards a hospital or clinic). This would consist of Fansidar (if you can get it and if not sulfa-allergic - the adult dose is three tablets taken together) or - if you are in Europe and can get it - Malarone. Malarone is taken four tablets daily for three days.

BUT What About the Vaccine?

Dr. Manuel Patarroyo of Colombia has developed over several decades of painstaking research a malaria vaccine which has had some success in clinical trials in South America.The results are not so lcear in Africa. It has been put down by much of the western medical community, has not been heavily funded, and has not been put into distribution. Is this western arrogance? While it is true that it is only about 30% effective in preventing death from malaria, that is about the same effectiveness as typhoid and cholera vaccine - and wouldn't preventing 30% of the million deaths per year be pretty significant? Mr. Luis Guillermo Restrepo Rivas in Medellin, Colombia, passed along some very interesting sites regarding the vaccine: One is a WHO article on intellectual property rights, and who should have ownership to vaccines (Dr. Patarroyo has donated rights to his vaccine to the World Health Organization). Excerpts from a talk by Dr. Patarroyo where he discusses attitudes towards his research is very interesting.

Let's keep the lines of communications open - part of the reason for this site is to share information, so feel free to use the lariam discussion group for a review or to offer your experiences with this drug. Looking at how Lariam is used, and perhaps clarifying what is the right risk/benefit situations, will help all of us.

\10 OxyContin

Use of Painkiller Grows Quickly, Along With Widespread Abuse By BARRY MEIER and MELODY PETERSEN  Mar 5 2001

Dr. Peter Leong recalls the day when he finally snapped at a drug company salesman pressing him to prescribe a powerful narcotic painkiller called OxyContin. The drug's producer, Purdue Pharma, had already failed to persuade Dr Leong with repeated offers of free weekend trips to Florida to discuss pain management. But when the salesman suggested that OxyContin — which is as potent as morphine — was safe enough to treat short-term pain, Dr Leong exploded.

"We threw him out of my office," said Dr Leong, who runs a pain clinic in Bangor, Me. He thinks OxyContin is potentially too dangerous to use for anything but chronic, severe pain. "OxyContin is a good drug," he said. "But the problem was, they were pushing it for everything." If Dr. Leong was not a convert, many others were. In a little over four years, OxyContin's sales have hit $1 billion, more than even Viagra's. Although the drug has helped thousands of people in pain, its success has come at a considerable cost. An official of the Drug Enforcement Administration said no other prescription drug in the last 20 years had been illegally abused by so many people so soon after it appeared.

 OxyContin has been a factor in the deaths of at least 120 people, and medical examiners are still counting, according to interviews with law enforcement officials. And doctors like Dr. Leong, pharmacists and law enforcement officials say part of the problem is that Purdue Pharma often oversold OxyContin's benefits without adequately warning of its potential for abuse. The company also used an often criticized but increasingly common marketing strategy: currying the favor of doctors in private practice with free trips and paid speaking engagements. Purdue Pharma, based in Norwalk, Conn., paid the transportation and hotel costs for hundreds of doctors to attend weekend meetings in spots like Florida to discuss pain management, a company consultant said.

 Doctors were then recruited and paid fees to speak to other doctors at some of the 7,000 "pain management" seminars that Purdue sponsored around the country. Those meetings stressed the importance of aggressively treating pain with potent, long-acting painkillers like OxyContin. Purdue also contributed to foundations supporting research on pain, to pharmacy schools and to Internet sites aimed at educating consumers. As OxyContin's marketing message spread, the drug caught on with many doctors who medical experts said had little experience in prescribing powerful narcotics. As a result, they often could not spot those who intended to abuse the drug or who did not need it in the first place.

 OxyContin, introduced in Dec 1995, has offered patients something different: a tablet that slowly releases its powerful pain medication, permitting patients, for example, to sleep through the night. "It's a good drug in the right situation," said Dr. Art VanZee, a physician in St. Charles, Va.  Purdue officials say they have promoted the drug responsibly and would have disciplined any sales representative who did not. They also said that in informing doctors about the drug, they told them how to spot potential drug abusers, and they have responded quickly to reports of spreading problems. "We don't have strong medicines that don't have abuse potential," said Dr. J. David Haddox, the company's senior vice president for health policy. "What we have to do is walk the balance between helping the greater good, knowing there are always some people who will divert drugs." 

Abuse and addiction involving OxyContin have spread quickly in the last two years, flaring up in at least a dozen states. And while the illegal use of OxyContin took root in rural areas along the East Coast, it has begun moving into cities like Philadelphia. "Nobody is immune from this," said Brantley Bishop, a narcotics investigator in Alabama. "I'm seeing housewives; I'm seeing loggers, nurses, mechanics." OxyContin was originally thought to be less prone to abuse because its narcotic was locked in a time-release formula. That meant it would not produce the quick spike of euphoria that drug abusers crave. 

But abusers quickly discovered how to disarm the time-release formula; they simply crushed the tablet, then swallowed, inhaled or injected the powder to give themselves a high as powerful as heroin's.  Getting OxyContin was often easy. A person simply had to find the right doctor, claim great pain and get a prescription. Others just stole prescription pads and wrote their own. Illegal use of OxyContin mushroomed even though no drug in this country is more tightly regulated. Unlike illegal drugs like cocaine or heroin, OxyContin is monitored by state and federal health officials in its production, marketing and distribution. Now, many of those regulators are trying to figure out how the outbreak occurred and what they might have done to prevent it.

 The Food and Drug Administration, for one, is reassessing how it reviews prescription narcotics for potential abuse. "We've learned something from this," said Dr. Cynthia McCormick, director of the F.D.A.'s division of anesthetics, critical care and addiction drug products. Dr. McCormick acknowledged that the F.D.A. had failed to research all the ways abusers might tamper with OxyContin, an oversight she said her agency did not want to repeat. Last Thursday, officials of five states met in Richmond, Va., to discuss ways to halt illegal traffic in OxyContin. In recent months, Purdue has also stepped up its efforts to halt the drug's abuse, including working with law enforcement officials.

  Selling a `Miracle' Drug OxyContin came to market amid a sea change in how doctors treated pain. For years, terminally ill patients suffered needlessly because doctors resisted prescribing frequent, potent doses of narcotics, fearing that patients might become addicted.  But with new studies showing that doctors undertreated pain, OxyContin provided a breakthrough opportunity for Purdue Pharma. Until then, the company's biggest drug was MS Contin, which had limited appeal, partly because it contained morphine. OxyContin had broader appeal because it contained a synthetic version of morphine called oxycodone, which, among other things, carried less of a social stigma. "If Grandma is placed on morphine it's like, `Oh, my God,' " said Dr. Howard A. Heit, a pain specialist in Fairfax, Va., and a Purdue consultant. "But if Grandma comes home placed on OxyContin — that was O.K." 

Although other pain medicine had long contained oxycodone, OxyContin differed in two key respects: it had a time-release formula, and it could be delivered in larger doses because it did not contain the type of nonprescription pain relievers that in larger quantities could cause liver damage. The F.D.A. approved OxyContin for those with moderate to severe pain lasting more than a few days. OxyContin is often prescribed for people in chronic pain, like those with back problems or severe arthritis, as well as patients with cancer and other painful diseases. For Robert E. Mitchell, OxyContin proved nothing short of a wonder drug. A victim of Guillain-Barré syndrome, a rare nerve disorder that can cause paralysis, Mr. Mitchell said his pain had become so severe he could not walk. But with OxyContin, he can now wear shoes and has learned to walk again. 

"To me, it's like a miracle," he said. Seeing great potential in the drug, the company hatched an ambitious marketing plan. To reach consumers, Purdue financed an Internet site called Partners Against Pain, where OxyContin is promoted. It also contributed to groups like the American Pain Foundation, which championed the need for better pain treatment. Still, most of Purdue's marketing dollars were aimed at doctors. In recent years, Purdue brought in 2,000 to 3,000 doctors to three-day retreats in California, Arizona and Florida, estimated Dr. Heit, the Purdue consultant. At those meetings, doctors were lectured about treating chronic pain, while being recruited to serve as paid speakers at medical meetings sponsored by Purdue. Dr. Susan Bertrand, who treats chronic pain in Princeton, W. Va., became a Purdue speaker. She said that for her, recent studies showing the undertreatment of pain had been "almost a religious experience," making her realize how poorly she and others had been trained to deal with the problem.

To help change that, she said, she gave about a dozen paid speeches sponsored by Purdue. The company also helped her start the Appalachian Pain Foundation, an educational group on pain management. Purdue's marketing campaign quickly began to pay big dividends, with OxyContin sales almost doubling every year, according to IMS Health, a firm that tracks drug sales. OxyContin now earns more in sales than any other narcotic. It also now accounts for 80 percent of Purdue Pharma's revenue, according to court documents filed by Purdue in connection with a patent dispute. Some doctors and pharmacists said they were put off by the company's sales tactics. "All companies market," said Dr. Diane Meier, a pain specialist at the Mount Sinai School of Medicine in New York. "But these people were in your face all the time." 

Others criticized the way Purdue recruited doctors. "Essentially, they bought the doctors' prescriptions," said Steve Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota. "It says to consumers that every time you paid for this drug, you sent your doctor to a nice meeting somewhere." A Growing Concern Purdue Pharma's critics agree that doctors must learn how to manage pain better. But Dr. Ted Parran, an associate professor at Case Western Reserve Univ School of Med in Cleveland, says doctors, in their rush to find a remedy, may have been blinded to another problem: addiction. "Pain medicine docs are on a mission," said Dr. Parran, who teaches doctors how to use narcotics. "In the process, they tend to trivialize addiction." In this regard, pharmacists play an important backup role for doctors. 

They provide the last medical defense for preventing addictive drugs from getting into the wrong hands. For instance, they can choose not to fill suspect prescriptions. Some pharmacists said they, too, found Purdue's safety claims overblown. John Craig, a co-owner of Hancocks Drug Store in Scottsburg, Ind., remembers a Purdue salesman walking into his pharmacy several years ago with reassurances that OxyContin was safer than other narcotics. "They were going around to doctors promoting that this was the answer to all abuse," said Mr. Craig, but he already knew that local people were using OxyContin to get high. Since then, the abuse has become worse.  

Another pharmacist, Samuel A. Okoronkwo, refused to fill an OxyContin prescription for someone he thought might be an abuser. He said a Purdue salesman suggested he could get into trouble for arbitrarily not filling prescriptions. "I told him I didn't have to fill a prescription that I didn't feel was medically necessary," he said. Another druggist, Joseph Yates in Grundy, Va., said simply, "The problem with this drug is the company."


Purdue did not comment when asked about such anecdotes. Concern about Purdue's marketing practices has also reached the D.E.A. An agency official said its investigators had recently interviewed doctors and druggists about their dealings with Purdue. That official said the agency was worried that Purdue was not clearly communicating the drug's serious potential for abuse. "It may take years to repair the damage that this drug has done," said that D.E.A. official, who declined to be identified. Told of the D.E.A. comment, Purdue responded with a statement that said in part: "In 15 years of marketing narcotic analgesics, Purdue Pharma has never been questioned by the Drug Enforcement Administration regarding our marketing practices."

 In May, however, the F.D.A. did question a company advertisement for OxyContin, saying Purdue had improperly implied that OxyContin could be used to treat arthritis patients without first trying milder drugs. A company spokesman said that it disagreed with the F.D.A. but had voluntarily withdrawn the ad. Dr. VanZee, in St. Charles, Va., has seen the destruction the drug has caused in the valleys and small mining towns of the southwestern part of that state. He said he was treating OxyContin overdoses in youngsters he had vaccinated as infants. In the past two years, OxyContin has been a factor in the overdose deaths of 28 people in the area, said an official of the state medical examiner's office.

It is difficult to tell the precise cause of an overdose, however, because more than one drug is often involved and OxyContin's active ingredient is in other drugs. One area clinic, the Life Center of Galax, expected to treat 20 patients in its new methadone program but must now find a way to treat 300, most of them addicted to OxyContin, a clinic official said. To stem this abuse, Dr. VanZee said, he met last fall with Purdue representatives in a bid to persuade them to cut back on their marketing and to issue a nationwide alert about the drug's hazards. 

The officials, Dr. VanZee said, appeared sympathetic, but said they viewed the problem as being limited to just a few areas of the country.  "They are either very naïve about the extent of the problem," Dr. VanZee said, "or they don't understand what it means to have 300 people in your county addicted — the type of pain that causes in a community and in families." Addressing the Problem Purdue officials said they were as surprised as anyone that OxyContin could be abused. Dr. Haddox of Purdue said he thought the time-release formula would make the pill "less desirable to addicts."

That is not the case now. Last Sep, the company gathered 20 consultants to look for better ways for doctors to spot potential abusers, said Dr. Heit, the consultant. Four months later, Purdue asked its sales force to remind doctors that drugs like OxyContin "are common targets for both drug abusers and drug addicts." Purdue said it was now planning to reformulate OxyContin, making it less appealing to abusers. The company is also helping to educate students on the dangers of prescription drugs.

Moves like this have recently earned the company praise from some law enforcement officials. Some health officials think OxyContin abuse might have been more quickly identified had more states closely tracked the prescribing patterns of narcotics; some 17 states do that now. Hospitals are addressing the problem in different ways. Mercy Hospital in Portland, Me., gives OxyContin patients urine screens to verify that they are not taking too much, or that they are obtaining the drug but not taking it and then selling it on the street.

A Cincinnati-based hospital chain, the Health Alliance, decided last month to limit OxyContin to just a few types of patients, like those with cancer, after determining that another painkiller was just as effective, cheaper and less prone to abuse. Purdue Pharma — and some doctors — now worry that media reports on OxyContin abuse are scaring away patients who need the drug. "The publicity, of which you are a part, is causing patients to call us in tears because their physicians are taking them off therapy," said Robin Hogen, a company spokesman. "This is becoming a sad case of patients being abused by drug abusers." 


\11 Phenylpropanolamine (PPA)

The FDA is taking steps to remove phenylpropanolamine (PPA) from all drug products and has requested that all drug companies discontinue marketing products containing PPA.  In addition, FDA has issued a public health advisory concerning phenylpropanolamine hydrochloride. This drug is an ingredient used in many over-the-counter (OTC) and prescription cough and cold medications as a decongestant and in OTC weight loss products.

Scientists at Yale Univ School of Med recently issued a report entitled "Phenylpropanolamine & Risk of Hemorrhagic Stroke:   Final Report of the Hemorrhagic Stroke Project."   This study reports that taking PPA increases the risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women.
 Men may also be at risk.  Although the risk of hemorrhagic stroke is very low, FDA recommends that consumers not use any products that contain PPA.

FDA’s Nonprescription Drugs Advisory Committee recently discussed this study and other information on phenylpropanolamine. The Committee  determined that there is an association between PPA and hemorrhagic stroke and recommended that PPA not be considered safe for over-the-counter use.

For more info on this advisory, see the items below.

FDA Talk Paper on Phenylpropanolamine (PPA). 11/06/2000.  Public Health Advisory.  Subject:  Safety of Phenylpropanolamine (PPA). 11/6/2000. 

Q and A about Phenylpropanolamine (PPA).  11/6/2000.  Science Background Statement on Safety of PPA.  FDA Letter to Manfs of Drug Products Containing PPA.

Nonprescription Drugs Advisory Committee Meeting: Safety Issues of Phenylpropanolamine (PPA) in Over-the-Counter Drug Products, (10/19/00).  This link leads to the meeting agenda, roster, questions, presentation slides, and briefing information, including the Yale Hemorrhagic Stroke Project:  Final Study Report. 

U.S. FDA Subject: Safety of PPA  Nov 6, 2000

The FDA is issuing a public health advisory concerning phenylpropanolamine hydrochloride. This drug is widely used as a nasal decongestant (in over-the-counter and prescription drug products) and for weight control (in over-the-counter drug products). FDA is taking steps to remove phenylpropanolamine from all drug products and has requested that all drug companies discontinue marketing products containing phenylpropanolamine. 

Phenylpropanolamine has been marketed for many years. A recent study reported that taking phenylpropanolamine increases the risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk. Although the risk of hemorrhagic stroke is very low, FDA recommends that consumers not use any products that contain phenylpropanolamine.

FDA’s Nonprescription Drugs Advisory Committee (NDAC) recently discussed this study and other information on phenylpropanolamine. NDAC determined that there is an association between phenylpropanolamine and hemorrhagic stroke and recommended that phenylpropanolamine not be considered safe for over-the-counter use.

Although this risk of hemorrhagic stroke is very low, FDA has significant concerns because of the seriousness of a stroke and the inability to predict who is at risk. FDA does not consider the conditions for which phenylpropanolamine is used (over-the-counter or by prescription) as justifying the risk of this serious event. Other products are available for use.

In the meantime, consumers can identify over-the-counter cough-cold, nasal decongestant, and weight control products containing this ingredient by looking for "phenylpropanolamine" in the list of active ingredients on the label. Consumers can check with their health care provider or pharmacist to see whether their prescription cough-cold or nasal decongestant product contains phenylpropanolamine. We advise consumers to discuss alternative over-the-counter and prescription products with their health care providers or pharmacists. 

1. What action is the FDA announcing today?

The FDA has asked firms that market pharmaceutical or drug products containing phenylpropanolamine (fen-el-pro-pa-nol-a-mine) to voluntarily discontinue marketing them. We are also alerting consumers to the risks associated with the use of products containing phenylpropanolamine.

2. What is phenylpropanolamine?

Phenylpropanolamine is an ingredient used in prescription and over-the-counter (OTC) drug products as a nasal decongestant to relieve stuffy nose or sinus congestion and in OTC weight control drug products to control appetite.

3. Why is phenylpropanolamine unsafe when this product has been in use for many years?

On May 11, 2000, FDA received results of a study conducted by scientists at Yale University School of Medicine that showed an increased risk of hemorrhagic stroke (bleeding of the brain) in people who were taking phenylpropanolamine. Phenylpropanolamine has been used for many years and a very small number of people taking the drug have had strokes. The Yale study helped show that the number of people having strokes when taking phenylpropanolamine was greater than the number of people having strokes who were not taking phenylpropanolamine. Although the risk of hemorrhagic stroke is very low, FDA has significant concerns because of the seriousness of a stroke and the inability to predict who is at risk. Because of continued reports to the FDA of hemorrhagic stroke associated with phenylpropanolamine and the results of the Yale study, we now feel that the risks of using phenylpropanolamine outweigh the benefits and recommend that consumers no longer use products containing phenylpropanolamine.

4. Are there any population groups at higher risk when using products containing phenylpropanolamine?

The Yale University study showed that the risk of hemorrhagic stroke was found mostly in women; however, men may also be at risk.

5. What types of products contain phenylpropanolamine?

Phenylpropanolamine is found in some prescription and OTC nasal decongestants and cough/cold products and OTC products for weight control. 

6. If a patient brings me, a pharmacist, a prescription containing phenylpropanolamine, should I fill it? 

FDA has not said that such prescriptions should not be filled. However, you should make sure that both the prescriber and the consumer are aware that the drug contains phenylpropanolamine and have discussed the risks and benefits of taking the product as prescribed.

7. My family has been using products that contain phenylpropanolamine; is there any danger?

In the Yale study, the increased risk of hemorrhagic stroke was detected, among women using the drug for weight control and for nasal decongestion, in the 3 days after starting use of the medication. While the risk of hemorrhagic stroke is very small, for this reason we suggest you stop taking the drug immediately and use an alternative drug product.

8. Is there another medicine that I can take in place of my medicine that contains phenylpropanolamine?

Yes, there are other products on the market that do not contain phenylpropanolamine. Ask your pharmacist or health care provider what other products are available for your needs.

9. How will I know if my OTC products contain phenylpropanolamine?

OTC drug products containing this ingredient may be identified by looking for "phenylpropanolamine" in the list of active ingredients on the label. If you are still unsure, check with your pharmacist to help you determine if a product contains phenylpropanolamine.

10. How will I know if my prescription nasal decongestant or cough/cold products contains phenylpropanolamine?

If you are using a prescription nasal decongestant or cough/cold product you should talk to your pharmacist or health care provider to determine if phenylpropanolamine is present.

11. If I have questions about drug products whom can I call?

Call 1-888 INFO FDA (1-888-463-6332)


\12 Prozac (fluoxetine)

For mental depression. Works by increasing the specific chemicals (serotonin) necessary for nerve transmission and increases seretonin levels but does not give a narcotic euphoria nor does it alter mood. Omega 3 fish does the same thing.

Cyclic antidepressant in 20mg caps. May be better for coronary problems than Tricylics. Do not refrigerate or store in bathroom.

What is the most important info I should know about fluoxetine?  Do not stop taking fluoxetine unless your doctor tells you to. It may take 4 weeks or more for you to start feeling better. You may experience dizziness when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

At least two recently published books say that Prozac and related antidepressants are often indiscriminately prescribed and pose the risk of serious side effects, but critics of those views call them alarmist and overblown.
 Prozac has never been just any drug. Soon after arriving on drugstore shelves 12 years ago, Eli Lilly's antidepressant transcended simple pilldom, becoming instead a cultural icon.

 Hailed as a wonder drug one minute, cast as evil incarnate the next,
 the green and white capsule has generated multitudes of lawsuits, and garnered more attention than some presidential candidates.
 Perhaps because Prozac treats the ills of the mind, not the complaints of the body, it has also served as a kind of public Rorschach test, a screen upon which Americans project deeply rooted attitudes about illness, character, biology and free will.

So, perhaps predictably, as the drug edges into adolescence and Lilly's exclusive patent on the medication nears expiration, Prozac is once more causing a stir. More or less at the center of the newest squall are two psychiatrists, Dr. Joseph Glenmullen, the author of a recently published book, "Prozac Backlash" (Simon & Schuster), and Dr. David Healy, author of  "The Antidepressant Era" (Harvard University Press, 1998). They claim that Prozac and its chemical cousins are often indiscriminately prescribed and have more serious and more frequent side effects than  the public is aware of or than the package labeling indicates. Many of their assertions are old ones, in particular the notion that  the drugs cause some people to become suicidal or violent, an accusation that Lilly and other antidepressant manufacturers deny and that has so far failed to persuade juries in product liability lawsuits. But Dr. Glenmullen, who is on the staff of the Harvard University Health Services, and Dr. Healy, a lecturer in psychological medicine  at the University of Wales College of Medicine, raise new fears. They suggest that Prozac and similar drugs, like the antipsychotic medications of the 1950's and 1960's, might pose a significant risk of neurological side effects, that long-term use of the drugs might cause brain damage and that future generations might look back on the antidepressants and other psychiatric drugs, in Dr. Glenmullen's words, "as a frightening human experiment." "Too many people have been lulled into thinking that they have no side effects and no risk," he said. The contentions of Dr. Glenmullen, Dr. Healy and other critics, however, have themselves drawn harsh criticism from scientists, psychiatric clinicians and mental health groups, who view them as alarmist and overblown. Some scientists whose studies are cited in "Prozac Backlash" to support its thesis said that the author never contacted them about their work and they strongly disagreed with his conclusions. And many psychiatrists said they worried that the new dispute would discourage people with depression from seeking needed treatment. "Some of the statements that Glenmullen makes are simply outrageous," said Dr. Frederick Jacobsen, a psychopharmacologist in Washington. "He trashes any benefit of the drugs and selectively quotes studies in a  very biased way." The idea that Prozac and its later-arriving relatives are dangerous drugs runs counter to the experience of most psychiatrists and researchers. They see the medications -- which enhance the availability in the brain of serotonin, a neurotransmitter believed to be involved in depression -- as useful, and sometimes lifesaving, tools for treating a variety of psychiatric disorders. In their view, the antidepressants have both advantages and limitations. The drugs, called selective serotonin reuptake inhibitors or S.S.R.I.'s, are far less lethal in overdose than the older generation of so-called tricyclic antidepressants, making them more difficult for depressed patients to use in suicide attempts. And they lack some annoying side effects of the earlier drugs, like dry mouth, constipation and weight gain. Yet 30 percent to 40 percent of patients given the newer antidepressants receive no benefit from them, a weakness they share with earlier medications. Studies indicate the drugs may be less effective than tricyclics for severe depression. And the medications, like all drugs, have side effects of their own, including loss of libido and other sexual difficulties, which occur in anywhere from 36 percent to 75 percent of patients, and a host of other, mostly mild,  adverse reactions. Their long-term side effects, if any, are less clear. No scientist can offer an ironclad guarantee that Prozac and its counterparts -- or for that matter, any other potent drugs -- are absolutely safe when taken continuously for long periods. Yet what is known, scientists say, suggests that the medications are  more benign in their long-term effect on the brain than many other psychoactive drugs. And 12 years of widespread use have convinced most researchers and clinicians of the antidepressants' basic safety. "The S.S.R.I.'s are not innocuous," said Dr. Matthew Rudorfer, associate director for treatment research at the National Institute of Mental Health's Division of Services and Intervention Research, "and  they should not be used casually. But it's a vast overinterpretation  to say that they are dangerous and should be avoided." The Arguments A Calm Critique Amid Strong Claims r. Glenmullen and Dr. Healy said they were not opposed to the use of  Prozac or similar drugs, and that they prescribed them regularly in their own practices. But they deplore their use for people whose complaints are very mild and they criticize physicians who place patients on the drugs for long periods with little or no supervision, a trend that has increased under managed care. Lilly estimates that 38 million people worldwide have taken Prozac since it was introduced in 1988. And 10.3 million new prescriptions for the drug were written in 1999, says IMS Health, a market research firm. "For people with only mild to moderate symptoms whose functioning is  not compromised," Dr. Glenmullen said, alternative approaches, like psychotherapy and exercise, "are preferable forms of treatment." Dr. Glenmullen also educates readers of his book about the withdrawal effects -- including nausea, vertigo, flu-like symptoms, mood swings  and irritability -- that can result if newer antidepressants are stopped too abruptly. (Prozac, which leaves the body more slowly than other S.S.R.I.'s, is an exception). And both he and Dr. Healy criticize the pharmaceutical companies, which they say influence medical research and often minimize adverse side effects in an effort to make their products look good. Yet it is difficult to find scientists or clinicians who support the  more extreme suppositions of Prozac's critics. Dr. Glenmullen and Dr. Healy, for example, argue that neurological side effects -- including muscle spasms, facial tics, Parkinson's diseaselike symptoms, extreme agitation and even tardive dyskinesia, a disabling movement disorder -- are more common in patients taking newer antidepressants than the labeling on the drug packaging indicates, and that their occurrence augurs serious problems to come. Such side effects are frequently produced by older medications used to treat psychosis. But Dr. Glenmullen said it took decades for doctors  to recognize the extent or severity of the reactions. "Do we this time want to ignore the early warning signs of these effects with serotonin boosters?" he asks in "Prozac Backlash." "Even if disfiguring tic disorders turn out to be infrequent, with tens of  millions of people having been on serotonin boosters, hundreds of thousands could be affected." But other scientists say it is misleading to compare antipsychotic drugs, which directly act on the neurotransmitter dopamine, with the  antidepressants, which affect dopamine only indirectly. "If S.S.R.I.'s do in fact cause tardive dyskinesialike syndromes, and that's far from proven," said Dr. William Wirshing, a professor of psychiatry at the University of California at Los Angeles and an expert on neurological problems caused by antipsychotic drugs, "they  do at a rate so low that it's indistinguishable from background noise in the untreated general population." Although some neurological side effects are reported in patients taking Prozac and similar antidepressants, researchers and clinicians say that in their experience the reactions are infrequent; some are so rare that many psychiatrists never see them in years of practice. In  many reported cases patients have used other medications, making cause and effect difficult to determine. The Prognosis Cause for Concern or Reassurance? any scientists said that in their views "Prozac Backlash" also blurred distinctions between newer antidepressants and many other types of drugs. In a discussion of possible long-term effects of Prozac and similar drugs, for example, Dr. Glenmullen drew analogies to cocaine  and MDMA (the recreational drug known as ecstasy), which are known to cause brain damage, and diet drugs like Redux, which was pulled off the market in 1997. Dr. Glenmullen said research was scant on how Prozac and other S.S.R.I.'s affected nerve cells in the brain with long-term use, but  he argued that findings on the effects of ecstasy and other drugs offered reason for concern about the antidepressants. "Surely we already know enough to indicate these drugs should be prescribed far more cautiously than they typically are today," he wrote. But Dr. George Ricaurte, an associate professor of psychiatry at Johns Hopkins University and a leading expert on ecstasy's effects on the brain, said that MDMA and newer antidepressants "are two entirely different classes of drugs." "The toxicity produced by MDMA is not produced by Prozac and related  drugs," Dr. Ricaurte said. "Quite the contrary, they prevent the toxicity of MDMA and related drugs." Dr. Efrain Azmitia, a professor of biology and psychiatry at New York University and an authority on serotonin, said he regarded the newer  antidepressants as "remarkably effective and in a way, remarkably safe," because unlike many drugs their mechanism of action had "a more physiological flavor, more in harmony with the body's natural rhythms," offering the possibility that "you're not going to all of a sudden see something appear that you didn't see at two years." Dr. Glenmullen, asked about other scientists' disparate views, said that in his book, "I'm very careful to be really clear about when I'm talking about S.S.R.I.'s versus other classes of drugs" and his point was that "we badly need more research." The Suicide Question 'A Needle in a Haystack' f all the issues raised by Prozac skeptics, the most difficult for many people to sort out is the accusation that the drug is linked to  suicide, an association that began in 1990 when a Harvard University  researcher, Dr. Martin Teicher, reported on six patients who "developed intense, violent suicidal preoccupation" shortly after starting Prozac. Dr. Teicher's report was followed by a few other case descriptions from other researchers. Some scientists offered hypotheses about how  such an effect, if it existed, might occur. One theory centered on an infrequent reaction to Prozac and other medications, a state of agitation and restlessness known as akathisia. In some cases, researchers suggested, akathisia may be so uncomfortable that it sets off suicidal thoughts, or intensifies existing suicidal impulses. Other investigators proposed that in rare cases the drugs might paradoxically produce a drop in serotonin levels. Lowered serotonin levels have been associated in some studies with suicide and other forms of violence. In the public arena, the suicide question also created a commotion. Of the more than 100 lawsuits filed against Lilly, many have been dismissed, and some -- the drug company will not say how many -- have been settled out of court. Two have come to trial, with both resulting in jury verdicts in favor of the pharmaceutical company. In one case  Lilly paid the plaintiffs an undisclosed amount. By the mid-1990's, however, most scientists had lost interest in the  issue. Several larger studies -- which compared Prozac to other antidepressants or to dummy pills, including a reanalysis of Lilly's  clinical trial data -- concluded that subjects on Prozac showed no increase in suicidal acts or feelings; some reported that the drug reduced suicide risk. In 1991, a Food and Drug Administration advisory committee concluded that there was no persuasive evidence for a suicide link, allaying many people's fears. The consensus of most researchers was that, in any case, disentangling the effects of the antidepressants from the effects of depression itself, a disease that has a high rate of suicide, was difficult or impossible. "It would always be a needle in a haystack," said Dr. Rudorfer, of the National Institute of Mental Health. For its part, Lilly said there was no data supporting the idea that Prozac increased suicidal risk. "On the contrary," said Dr. Steven Paul, a psychiatrist who is a vice president at Lilly Research Laboratories, "all the available data supports the fact that Prozac reduces suicidal risk in depressed patients." In reviving the issue, Dr. Glenmullen and Dr. Healy, like earlier critics, focus on Lilly's role in lawsuits and research. They reprise, for instance, accusations that the F.D.A.'s inquiry was tainted by some scientists' drug company ties. And they criticize the larger studies of Prozac and suicide, citing problems in methodology, and pointing out that they were carried out by scientists financed by Lilly or working for the company. They also recycle excerpts from internal Lilly memos, retrieved by lawyers for plaintiffs in earlier lawsuits. Dr. Healy recently published a study in which 20 normal volunteers, who told researchers they had no history of depression or other psychiatric problems, were alternately given Zoloft, an S.S.R.I., and reboxetene, another antidepressant that has not been approved for use in the United States. Two of the volunteers, Dr. Healy reported, became acutely suicidal while taking Zoloft. Dr. Healy said that compared with the normal suicide rate in Great Britain, the healthy volunteers on Zoloft showed a 2,000-fold increase in suicide risk. He believes the same is true for other S.S.R.I.'s. "My estimates are that Prozac alone has led to 25,000 people committing suicide" who would not have otherwise, Dr. Healy said. But the Zoloft study, published in a British journal, Primary Care Psychiatry, is controversial. Critics said its methodology was flawed -- for example, they said, the study included no placebo control, the subjects were employees of the hospital where Dr. Healy practiced, and no medical records or other independent sources were evaluated to confirm the subjects' reports about their psychiatric histories. To conclude that Zoloft made the subjects suicidal, , said Dr. Wirshing of U.C.L.A., "is ludicrous." Celeste Torello, a spokeswoman for Pfizer Inc., which manufactures Zoloft, Prozac's closest competitor, said the drug's "safety and efficacy has been proven time and again, in more than 180 clinical trials involving more than 10,000 patients worldwide." Meanwhile, some researchers whose early reports on the suicide issue  were cited in "Prozac Backlash" said they did not agree with the way  the issue was characterized in the book. One is Dr. Anthony Rothschild, a professor of psychiatry at the University of Massachusetts in Worcester and the author of a 1991 report of three patients who developed akathisia and became more suicidal on Prozac.
 "Akathisia can occur," Dr. Rothschild said, "and in some people, who have a previous propensity to feel suicidal and are still suffering from depression, this can sometimes push them over the edge. But is it common? No. Can it be easily recognized and treated? Yes." Even Dr. Teicher, author of the original suicide report, said he
 viewed the risk for suicide as something "that clinicians need to be aware of but it's generally not a huge problem."
 Dr. Teicher, who along with others holds the patent on R-fluoxetene, a refined version of Prozac that Lilly has licensed and is testing in
 clinical trials as a potential successor to the drug, speculated that patients who became suicidal on Prozac and other drugs in the early
 1990's might have done so as a result of the higher doses prescribed by physicians. Lilly's exclusive patent on Prozac expires in December 2003.

Dr. Glenmullen has written to the F.D.A. requesting that stronger warnings about akathisia and suicides be added to labels for antidepressants.

But the federal agency, a spokesman said, is satisfied that current warning labels, which mention both akathisia and suicidal thoughts as having been reported since the drugs reached the market, are sufficient. The agency said it had no plans to begin another official investigation into the issue, although it would review any new data that emerged, as it does routinely on topics of public concern.
 In the end, the message for anyone contemplating taking Prozac, Zoloft, Paxil, Luvox or other antidepressants, scientists said, may be simply that drugs have side effects, and the decision to take medication always involves the weighing of benefit against risk.
 "No one should really be on any type of medication for long periods of time unless they have to," said Dr. Azmitia, of NYU "But some people really can't function unless they are on these drugs."

Picking the Right Antidepressant By Claudia Morain  May 09, 2000

Three years ago, Cincinnati Reds pitcher Pete Harnisch began losing interest in food, sleeping fitfully and withdrawing from his friends and teammates. His strength and confidence crumbled, and he quit pitching. "It was a real tough time for me," the ball player says.

A doctor diagnosed depression and put Harnisch on Prozac. But the side effects of that drug were too much for him. So next, the doctor prescribed Paxil. In a matter of weeks, Harnisch felt better. After six months, he was able to go off the medication. Today the 33-year-old ball player is back to his fighting weight -- 228 pounds -- and back on the pitcher's mound.

All too often, recovering from depression demands an
 athlete's courage, stamina and persistence. No more than half the people who try a given antidepressant see improvement. Like Harnisch, the rest must try one or more other drugs before they find a medication that works.

In the process, they're likely to experience side effects like weight gain and sexual dysfunction. "All of the antidepressants work. They just don't all work for everybody," says Lydia Lewis, executive director of the National Depressive and Manic-Depressive Association, herself a chronic depression sufferer. "You have to have the courage to continue to try until you find the drug, or the combination of drugs, that works for you."
 Dr. Madhukar Trivedi, a psychiatrist at the University of Texas, Dallas, agrees. "If the first treatment doesn't work, a second should be tried. If the second doesn't work, a third should be tried. If you only rely on the first treatment, you're selling yourself short," says Dr. Trivedi, who served on a federal committee that developed depression treatment guidelines for primary-care physicians.
 A key factor for many turns out to be finding the drug with the least troublesome side effects. "Because all of the antidepressants are equally effective, choice should be determined by side-effect profile," says Dr. Brian Doyle, a psychiatry professor at Georgetown University Medical School in Washington, D.C. "You try to match the side-effect profile to the patient's needs."
 For example, if you're depressed, anxious, irritable and can't sleep, you might do better on Paxil than Prozac. Paxil tends to be sedating, while Prozac can have the opposite
 effect. If, on the other hand, you're depressed, lethargic and have trouble getting out of bed, Prozac may make more sense.
 Types of Side Effects There are three main classes of antidepressants, known as tricyclic antidepressants, MAO inhibitors and SSRIs. In addition, several new, chemically unique drugs don't fit into any of these categories. The drugs have similar effectiveness and similar rates of side effects. But there are profound differences in the types of side effects.
 All classes of antidepressants act on neurotransmitter receptors -- not just in the brain, but throughout the body, including the gastrointestinal tract and the genitourinary tract. Even among drugs in the same class, these effects can differ tremendously. Compared with other SSRIs, for example, Zoloft tends to cause more nausea and diarrhea. "So I stay away from Zoloft in patients with a sensitive gut, irritable bowel syndrome or colitis," Dr. Doyle says.
 Sexual dysfunction can be among the most troubling side effects of depression treatment. Just when the therapy seems to be improving many other aspects of life, some people begin to experience diminished desire for sex, find it difficult to become sexually aroused or have trouble achieving orgasm. The problems can occur with MAO inhibitors, tricyclics, SSRIs and Effexor, affecting up to 20 percent of men and 2 percent to 3 percent of women. Sexual side effects are infrequent with Serzone, Wellbutrin and Remeron.

 Antidepressant therapy may also lead to weight gain, defined as a 7 percent gain over your usual weight. Paxil and Remeron appear to be among the worst offenders, while Effexor and Wellbutrin do not seem to cause weight gain, and may result in some weight loss. But even if you're taking a medication that may cause weight gain, you have no more than about a 20 percent chance of experiencing this side effect.

 "When Prozac first came out, people thought patients would actually lose weight," Dr. Doyle says. "But we've found the typical pattern is to lose a couple of pounds, then return to baseline, or even gain weight. When weight gain occurs, it tends to be significant, 10 to 20 pounds over the course of a year or more."

 Co-existing health problems sometimes help to guide the choice of an antidepressant. Wellbutrin, for example, is an alternate medication for attention deficit disorder. Marketed under the brand name Zyban, the drug is also used to help smokers give up tobacco. If you're depressed and smoke or have ADD, therefore, Wellbutrin may be a good choice.
 If you grind your teeth, you might want to avoid an SSRI. Earlier this year, a Mayo Clinic psychiatrist described four patients who experienced jaw clenching, headaches, tooth grinding and broken teeth after starting Zoloft for relief of depression and anxiety. Three other recent reports in the literature describe similar side effects in patients taking Paxil and Prozac.

But if you suffer from obsessive-compulsive tendencies, panic attacks or extreme shyness, an SSRI may be in order. SSRIs have proven effective in treating each of these disorders, in addition to depression.
 The Course Ahead Antidepressant therapy should produce some improvement in four to six weeks. If you don't improve, talk with your doctor about switching to another drug. (If your health plan doesn't cover that new drug, talk with the plan's customer service office and consider filing an appeal.)
 If you don't improve on a second drug, consider asking for a referral to a psychiatrist. "There are tricks a psychiatrist knows that a primary-care physician wouldn't know to try," says Dean MacKinnon, a psychiatrist at The Johns Hopkins Univ School of Med.
 "It's worth it to hang in there," Dr. Doyle says. "When you find the right treatment, it's fabulous. The patient's life is just revolutionized."

For a first episode of depression, the Amer Psychiatric Assoc recommends continuing antidepressant therapy for at least nine months after depression symptoms have improved. For a second episode, therapy should continue for 18 months to two years. Three to five years of treatment is needed for a third episode, and lifelong therapy may be needed for patients who experience more than three episodes, according to the APA.
 "There is definitely a light at the end of the tunnel," pitcher Harnisch says. "No matter what it may seem." ALSO How to Reduce Side Effects of Antidepressants and Which Drug Does What?  Luvox, Nardil, Norpramin, Pamelor, Paxil, Prozac, Serzone, Surmontil, Tofranil, Wellbutrin, Vivactil, Zoloft


\13 Tequin 400 mg Antibiotic

A broad-spectrum 8-methoxy fluoroquinolone antibiotic, has been approved by the U.S. FDA for safe and effective treatment of approved indications due to susceptible strains of bacteria including community-acquired respiratory tract infections. Tequin has been shown in clinical trials to be safe and effective in the treatment of patients with acute bacterial exacerbation of chronic bronchitis (ABECB), acute sinusitis and community- acquired pneumonia (CAP) caused by indicated susceptible strains of gram-positive and gram-negative bacteria.

The mechanism of action of fluoroquinolones, including Tequin, is different from that of penicillins, cephalo- sporins, aminoglycosides, macrolides and tetracyclines. There is no cross-resistance between Tequin and these other drugs.  The recommended dose for Tequin is 400 mg once daily, for all individuals with normal renal function. Dosage adjustment is required in patients with impaired renal function (creatinine clearance, < 40 mL/min). Tequin is available in bioequivalent oral or IV forms.  Tequin is primarily excreted through the kidneys and less than 1% is metabolized by the liver.

In clinical trials, Tequin has been found to be a well-tolerated treatment in 15 international clinical trials at 500 study sites. In a clinical study (n=48), 12 patients for each of three drugs, Tequin demo a lower potential for producing delayed photosensitivity skin reactions than ciprofloxacin or lomefloxacin, and was comparable to placebo in causing these same reactions.
  The most common side effects assoc with Tequin in clini- cal trials were gastrointestinal. Adverse reactions considered to be drug related and occurring in greater than three percent of patients were: nausea (8%), vagin- itis (6%), diarrhea (4%), headache (3%) & dizziness (3%).

Oral doses of Tequin should be admin at least four hours before the admin of ferrous sulfate, dietary supplements containing zinc, magnesium, or iron (such as multivi- tamins), aluminum/magnesium-containing antacids or Videx (didanosine). Concomitant admin of Tequin and probencid significantly increases systemic exposure to Tequin. Concomitant admin of Tequin and digoxin did not produce significant alteration of the pharmacokinetics of Tequin; however, patients taking digoxin should be monitored for signs and/or symptoms of digoxin toxicity.

Concomitant admin of Tequin (as with other quinolones) in diabetic patients taking oral antidiabetic agents, with or without insulin, may produce symptomatic disturbances in blood sugar levels. Blood sugar levels in these patients should be carefully monitored during treatment with Tequin. If a hypoglycemic reaction occurs, initiate appropriate therapy immediately and discontinue Tequin.  

Tequin has been found to be a well-tolerated treatment in 15 intl clinical trials at 500 study sites.             
                 - Gatifloxacin is an antibiotic in the class of drugs called fluoroquinolones. It fights bacteria in your body and is used to treat bacterial infections of the lungs, sinuses, and urinary tract and certain sexually transmitted diseases. It may also be used for purposes other than those listed in this medication guide. 

What is the most important info I should know about gatifloxacin?   Take all of the gatifloxacin that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated.  Do not take gatifloxacin without first talking to your doctor if you or any member of your family have a heart condition known as prolongation of the QT interval.

Also, do not take gatifloxacin if you are being treated for heart rhythm disturbances with drugs such as quinidine (Cardioquin, Quinidex, Quinaglute, others), procainamide (Pronestyl, Procan SR, others), amiodarone (Cordarone, Pacerone, others), sotalol (Betapace), and others.  • Take gatifloxacin at least 4 hours before antacids that contain magnesium or aluminum (e.g. Rolaids, Maalox, others); vitamin or mineral supplements that contain zinc, magnesium or iron; or didanosine chewable/buffered tablets or pediatric powder for oral solution (ddI, Videx, Videx Pediatric, others). These medicines may decrease the effectiveness of gatifloxacin.

What should I avoid while taking gatifloxacin? 
 • Avoid prolonged exposure to sunlight. Although it has not been reported with the use of gatifloxacin, other similar medicines have increased the sensitivity of the skin to sunlight. Severe sunburn has resulted, even with minimal sun exposure. If exposure to the sun is unavoidable while taking gatifloxacin, wear protective clothing and use sunscreen. Call your doctor if you experience severe burning, redness, itching, rash, or swelling after exposure to the sun. 

 • Use caution when driving, operating machinery, or performing other hazardous activities. gatifloxacin may cause dizziness. If you experience dizziness, avoid these activities. 

 IMPORTANT SAFETY INFO - Tequin may have the potential to prolong the QTc interval of the electrocardiogram in some patients, and, due to limited clinical experience, Tequin should be avoided in patients with known prolongation of the QTc interval, patients with uncorrected hypokalemia and patients receiving Class IA (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic agents. Tequin should be used with caution when given together with drugs that may prolong the QTc interval (e.g., cisapride, erythromycin, antipsychotics, tricyclic antidepressants), and in patients with ongoing proarrhythmic conditions (e.g., clinically significant bradycardia or acute myocardial ischemia).

The safety and efficacy of Tequin (gatifloxacin) in children, adolescents (under 18), pregnant women and nursing mothers have not been established. Tequin is contraindicated in persons with a history of hypersen- sitivity to gatifloxacin or any member of the quinolone class of antimicrobial agents. As with other quinolones, Tequin should be used with caution in patients with known or suspected central nervous system disorders or patients who have a predisposition to seizures. Take 1/day wen extremely necessary


\14 Testosterone

It Could Have You Feeling Like a New Man Low testosterone can deplete a man's libido, bone density and energy levels. The makers of AndroGel say the drug could be a boon to those lacking in the hormone, but there are fears of misuse.  By SHARI ROAN, Times Health Writer

A new medication arriving in pharmacies this month is raising the possibility of widespread hormone replacement therapy for men--much like for post-menopausal women--even as it raises fears about misuse. The product, a gel form of testosterone called AndroGel, is approved for use in men with abnormally low levels of testosterone. AL SEIB / Los Angeles Times
 Currently, only about 150,000 to 200,000 men are being treated for low testosterone, although the advent of AngroGel could boost that number to 5 million. But because AndroGel represents the first simple and relatively safe form of testosterone replacement therapy, it is also generating discussion on testosterone as a major component of health and well-being throughout a man's life span.

"Just as Viagra provided a simple way to deal with erectile dysfunction and brought the whole issue out in the open, I think a similar thing is going to happen by having an easily available testosterone preparation," says Jed Diamond, a Willits, Calif., psychotherapist and expert on changes in men's health at midlife. "It will extend this dialogue on men's health."

Testosterone is a naturally occurring steroid produced by the bodies of both men and women. But it's best known for supplying men with the classic, predominantly male traits of strength, aggression and virility.

Low testosterone, called hypogonadism, has numerous causes, including the loss of the testicles to testicular cancer, pituitary disorders, a genetic disorder called Klinefelter syndrome and normal aging.

Low testosterone causes diminished interest in sex, impotence, reduced lean body mass, decreased bone density and lowered mood and energy levels. In short, it can make a man feel like a greatly dimmed version of his former self, says Robert E. Dudley, chief executive of Unimed Pharmaceuticals in Deerfield, Ill., the manufacturer of AndroGel.

"A lot of men have learned to live with being hypogonadal" because of a limited array of treatment options, Dudley says.

Until now, men with hypogonadism were treated with deep-muscle injections, which are painful and cause the hormone level to peak after three days and then decline erratically during the two weeks before the next shot. Hormone Gel May Make Steroid's Misuse Easier Experts warn that making testosterone accessible through the Internet could put teenagers at risk. 

Skin patches that release testosterone into the blood have been the most popular treatment option. But about 20% of men have allergic reactions to the patches. And the patches sometimes do not adhere well.

AndroGel, approved by the U.S. Food and Drug Administration in February, uses the skin as a reservoir to release a steady amount of testosterone into the bloodstream. It is a colorless, topical gel that men apply once daily to the shoulders, upper arms or abdomen. The price for AndroGel has not been set, but it is expected to cost about $100 a month, similar to the cost of skin patches, Dudley says.

Steroid May Ward Off Osteoporosis Studies showed that, besides alleviating the typical symptoms of hypogonadism, AndroGel might help prevent male osteoporosis, which affects about one in five men in old age and can be devastating to very elderly men. Those who suffer hip fractures have a higher death rate than women with the same injury.

"Much to our delight and surprise, within six months [of treatment] we were able to show an improvement in bone mineral density, which was particularly pleasing because many of the subjects had been on other testosterone products [which had not produced evidence of new bone growth]," says Dr. Ronald S. Swerdloff, chief of endocrinology at Harbor-UCLA Medical Center and the principal researcher on the clinical trials of AndroGel.

There are risks associated with AndroGel, however, including the possibility that the substance could be transferred to another person by vigorous skin-to-skin contact, causing side effects such as hair growth or acne in the untreated person. Testosterone can also cause fetal harm if absorbed by a pregnant woman.

While those complications are rare and can be avoided if the gel is used carefully, men receiving any long-term testosterone therapy face other risks, including higher rates of prostate enlargement and prostate cancer. Testosterone replacement therapy is not recommended for men with breast or prostate cancer.

Men without prostate cancer can take testosterone but should have their prostates checked on a regular basis.

"There is no evidence to this point that testosterone causes prostate cancer," Swerdloff says. "But if you have prostate cancer, the testosterone will cause it to grow."

There is also mixed evidence on whether testosterone replacement therapy is good or bad for the heart. AndroGel is not recommended for men with heart disease.

The topical supplement AndroGel is approved for men with low testosterone. AL SEIB / Los Angeles Times
 "Does it improve strength and bone, but then men will die of heart attack or prostate cancer? We don't know the answers to that," Swerdloff says. "This requires larger scale studies to answer that."

For middle-age men who are not at high risk for prostate disease, replacement therapy makes sense, doctors say.

Allan Smaul, a Reseda businessman, was among the first to try AndroGel as part of the clinical trials directed by Swerdloff. Smaul, 61, was diagnosed with diabetes two years ago, but still felt exhausted even after getting his diabetes under control.

"I went to the doctor and said that there was something else wrong with me," Smaul recalls. "My whole well-being--physically, mentally, emotionally--was run down. I just was not myself."

Smaul was diagnosed with low testosterone and volunteered to enter the AngroGel study. Now, he says: "I could sell this stuff on the street. I noticed an improvement in my strength. I wasn't as tired. I wasn't depressed. Sexually, it has done wonders. It really has done a tremendous amount of good for me and my family, because they notice the difference in me too."

Experts like Swerdloff are both thrilled and worried about such delighted reactions to testosterone gel. Although patients like Smaul need it, other men who do not have clear-cut hypogonadism may benefit as well.

"The question that it leaves is, who do you treat? And if you treat people, what will be the balance of good and bad [effects]?" Swerdloff says.

Measuring Baseline Levels Can Be Tricky That question is difficult to answer, because doctors don't even have a good idea of what "normal" testosterone levels are, or how the decline of the hormone, beginning around age 30, contributes to the loss of bone, muscle, libido and energy by the time a man reaches retirement age.

Testosterone increases in puberty and peaks at about age 20 to 30 in the "normal" range of about 300 to 1,200 nanograms per deciliter (ng/dL) of blood and then begins to decline, especially after age 50. Testosterone levels vary widely among individuals, and even an individual's levels will vary somewhat from day to day, even hour to hour.

An estimated 20% to 30% of men over age 65 have low levels of testosterone, says Dr. Steven Petak, a Houston endocrinologist and chairman of the American Assn. of Clinical Endocrinologists' committee on hypogonadism.

"Most older men may have levels at what we could consider marginal but still in the normal range," he says. "How do we identify those men who would benefit as they get older? The majority of men will be borderline cases. There are widely varying estimates of the number of men who have low enough levels to justify treatment."

What may be more important than the actual testosterone level is the change in levels from their peak. But many men have never been tested and do not know what their peak testosterone levels were around age 25 or 30, says Unimed's Dudley.

"At age 60, my level might be 400. What was it when I was 40? Was it 800? That's a 50% decrease, and I might notice that. That's a question that we don't have a lot of data on."

And, adds Diamond, author of the 1997 book "Male Menopause": "We haven't measured testosterone in men, so we don't know that much about what is a normal level. What we need to be doing is have men get their testosterone levels checked at age 30 or 35 so we know at 45, 50, 60 what is going on with them. That [change] is a much more significant number."

Until there is more research on testosterone, AndroGel will not--and should not--become the Grecian Formula of men's health, something everyone over 45 is using to feel a little younger, experts say.

"I think it's very clear that AndroGel is only approved for use in men with low testosterone concentrations. And that is appropriate," Swerdloff says.

But will men demand more research to clarify the many questions surrounding testosterone replacement therapy the way women have for estrogen replacement therapy? A 1998 survey of 1,000 men found that 68% could not name a single symptom associated with low testosterone.

The baby boom generation, the first of whom are nearing retirement age, may r
well embrace the idea of hormone replacement therapy for men, Swerdloff says.

"We have an older population that is not wanting to retire. They want to be active and vigorous and do all the things they want to do."


\15 Urocit-K

Urinary alkalizer, antiurolithic. Citrate salt of potssium. Two tabets three times a day after meals. Drink water. To make urine less acid.

Contraindicated for hyperkalemia and may cause cardiac arrest. 

Precautions: Take dose w/o crushing, chewing, sucking. Note tarry stools or GI bleeding. VA 96/97

Citrates are used to make the urine more alkaline (less acid). This helps prevent certain kinds of kidney stones. Citrates are sometimes used with other medicines to help treat kidney stones that may occur with gout. They are also used to make the blood more alkaline in certain conditions.

Citrates are available only with your doctor's prescription, in the following dosage forms: Potassium Citrate Tablets (U.S.) 

 Before Using This Medicine.  In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For citrates, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to potassium citrate or potassium. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of citrates in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking citrates, it is especially important that your health care professional know if you are taking any of the following:

Amiloride (e.g., Midamor) or  Benazepril (e.g., Lotensin) or  Captopril (e.g., Capoten) or  Digitalis glycosides (heart medicine) or  Enalapril (e.g., Vasotec) or  Fosinopril (e.g., Monotril) or  Heparin (e.g., Panheprin) or  Lisinopril (e.g., Prinivil; Zestril) or  Medicines for inflammation or pain (except narcotics) or  Potassium-containing medicines (other) or  Quinapril (e.g., Accuprol) or  Ramipril (e.g., Altase) or  Salt substitutes, low-salt foods or milk or  Spironolactone (e.g., Aldactone) or  Triamterene (e.g., Dyrenium)—Use with potassium-containing citrates may further increase potassium blood levels, possibly leading to serious side effects.
  Antacids, especially those containing aluminum or sodium bicarbonate—Use with citrates may increase the risk of kidney stones; also, citrates may increase the amount of aluminum in the blood and cause serious side effects, especially in patients with kidney problems.  Methenamine (e.g., Mandelamine)—Use with citrates may make the methenamine less effective.  Quinidine (e.g., Quinidex). Use with citrates may cause quinidine to build up in the bloodstream, possibly leading to serious side effects. 

Other medical problems. The presence of other medical problems may affect the use of citrates. Make sure you tell your doctor if you have any other medical problems, especially: Addison's disease (underactive adrenal glands) or Diabetes mellitus (sugar diabetes) or  Kidney disease—The potassium in potassium-containing citrates may worsen or cause heart problems in patients with these conditions. 

Diarrhea (chronic). Treatment with citrates may not be effective; a change in dose of citrate may be needed  Edema (swelling of the feet or lower legs) or  High blood pressure or Toxemia of pregnancy. 

The sodium in sodium-containing citrates may cause the body to retain (keep) water. Heart disease. The sodium in sodium-containing citrates may cause the body to retain (keep) water; the potassium in potassium-containing citrates may make heart disease worse. Intestinal or esophageal blockage. Potassium citrate tablets may cause irritation of the stomach or intestines. Stomach ulcer or other stomach problems. Potassium citrate-containing products may make these conditions worse. Urinary tract infection—Citrates may make conditions worse 

 Proper Use: For patients taking the tablet form of this medicine: Swallow the tablets whole. Do not crush, chew, or suck the tablet. Take with a full glass (8 ounces) of water. If you have trouble swallowing the tablets or they seem to stick in your throat, check with your doctor at once . If this medicine is not completely swallowed and not properly dissolved, it can cause severe irritation. 

Take each dose immediately after a meal or within 30 minutes after a meal or bedtime snack . This helps prevent the medicine from causing stomach pain or a laxative effect.

Drink at least a full glass (8 ounces) of water or other liquid (except milk) every hour during the day (about 3 quarts a day), unless otherwise directed by your doctor . This will increase the flow of urine and help prevent kidney stones.

Take this medicine only as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. This is especially important if you are also taking a diuretic (water pill) or digitalis medicine for your heart .

Dosing: The dose of these single or combination medicines will be different for different patients. Follow your doctor's orders or the directions on the label . The following info includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take or of teaspoonfuls or ounces of solution that you drink depends on the strength of the single or combination medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking this single or combination medicine .

For potassium citrate, For oral dosage form (tablets):  To make the urine more alkaline (less acidic) and to prevent kidney stones: Adults At first, 1.08 to 2.16 grams three times a day with meals. Some people may take 1.62 grams four times a day with meals or within thirty minutes after a meal or bedtime snack. Your doctor may change your dose if needed. However, most people usually will not take more than 10.8 grams a day. 

For potassium citrate and citric acid - For oral dosage form (solution): To make the urine or blood more alkaline (less acidic) and to prevent kidney stones: Adults: At first, 2 to 3 teaspoonfuls of solution, mixed with water or juice, four times a day, after meals and at bedtime. Your doctor may change the dose if needed. 

To make the urine more alkaline (less acidic):  Children—At first, 1 to 3 teaspoonfuls of solution, mixed with water or juice, four times a day after meals and at bedtime. Your doctor may change the dose if needed.  For oral dosage form (crystals for solution):  To make the urine or blood more alkaline (less acidic) and to prevent kidney stones: Adults: At first, 3.3 grams of potassium citrate, mixed with water or juice, four times a day, after meals and at bedtime. Your doctor may change the dose if needed. 

For potassium citrate and sodium citrate - For oral dosage form (tablets): To make the urine more alkaline (less acidic) and to prevent kidney stones: Adults—At first, 1 to 4 tablets after meals and at bedtime. 

Missed dose: If you miss a dose of this medicine, take it as soon as possible if remembered within 2 hours. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If storing this medicine: Store away from heat and direct light. Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. 

 Precautions: It is important that your doctor check your progress at regular visits. This is to make sure the medicine is working properly and to check for unwanted effects.

Do not eat salty foods or use extra table salt on your food while you are taking citrates. This will help prevent kidney stones and unwanted effects.

Check with your doctor before starting any strenuous physical exercise, especially if you are out of condition and are taking any other medication. Exercise and certain medications may increase the amount of potassium in the blood.

For patients taking potassium citrate-containing medicines: Do not use salt substitutes and low-salt milk unless told to do so by your doctor. They may contain potassium. Check with your doctor at once if you are taking the tablet form and notice black, tarry stools or other signs of stomach or intestinal bleeding . 

Do not be alarmed if you notice what appears to be a whole tablet in the stool after taking potassium citrate tablets. Your body has received the proper amount of medicine from the tablet and has expelled the tablet shell. However, it is a good idea to check with your doctor also. 

If you are on a potassium-rich or potassium-restricted diet, check with your health care professional. Potassium citrate-containing medicines contain a large amount of potassium. 

 Side Effects - Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Stop taking this medicine and check with your doctor immediately if any of the following side effects occur: Rare - Abdominal or stomach pain or cramping (severe); black, tarry stools; vomiting (severe), sometimes with blood. Also, check with your doctor as soon as possible if any of the following side effects occur:

Confusion; convulsions (seizures); dizziness; high blood pressure; irregular or fast heartbeat; irritability; mood or mental changes; muscle pain or twitching; nervousness or restlessness; numbness or tingling in hands, feet, or lips; shortness of breath, difficult breathing, or slow breathing; swelling of feet or lower legs; unexplained anxiety; unpleasant taste; unusual tiredness or weakness; weakness or heaviness of legs.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Less common - Abdominal or stomach soreness or pain (mild); diarrhea or loose bowel movements; nausea or vomiting.  Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

 DESCRIPTION - Urocit-K is a citrate salt of potassium. Potassium citrate is a white granular powder that is soluble in water at 154 g/100 ml, almost insoluble in alcohol, and insoluble in organic solvents.  Urocit-K is supplied as wax matrix tablets, containing 5 meq (540 mg) potassium citrate and 10 meq (1080 mg) potassium citrate each, for oral administration. 

CLINICAL PHARMACOLOGY - When Urocit-K is given orally, the metabolism of absorbed citrate produces an alkaline load. The induced alkaline load in turn increases urinary pH and raises urinary citrate by augmenting citrate clearance without measurably altering ultrafilterable serum citrate. Thus, Urocit®-K therapy appears to increase urinary citrate principally by modifying the renal handling of citrate, rather than by increasing the filtered load of citrate. The increased filtered load of citrate may play some role, however, as in small comparisons of oral citrate and oral bicarbonate, citrate had a greater effect on urinary citrate. 

In addition to raising urinary pH and citrate, Urocit®-K increases urinary potassium by approximately the amount contained in the medication. In some patients, Urocit®-K causes a transient reduction in urinary calcium. 

The changes induced by Urocit®-K produce a urine that is less conducive to the crystallization of stone-forming salts (calcium oxalate, calcium phosphate and uric acid). Increased citrate in the urine, by complexing with calcium, decreases calcium ion activity and thus the saturation of calcium oxalate. Citrate also inhibits the spontaneous nucleation of calcium oxalate and calcium phosphate (brushite). 

The increase in urinary pH also decreases calcium ion activity by increasing calcium complexation to dissociated anions. The rise in urinary pH also increases the ionization of uric acid to more soluble urate ion. 

Urocit®-K therapy does not alter the urinary saturation of calcium phosphate, since the effect of increased citrate complexation of calcium is opposed by the rise in pH-dependent dissociation of phosphate. Calcium phosphate stones are more stable in alkaline urine. 

In the setting of normal renal function, the rise in urinary citrate following a single dose begins by the first hour and lasts for 12 hours. With multiple doses the rise in citrate excretion reaches its peak by the third day and averts the normally wide circadian fluctuation in urinary citrate, thus maintaining urinary citrate at a higher, more constant level throughout the day. When the treatment is withdrawn, urinary citrate begins to decline toward the pre-treatment level on the first day. 

The rise in citrate excretion is directly dependent on the Urocit®-K dosage. Following long-term treatment, Urocit®-K at a dosage of 60 meq/day raises urinary citrate by approximately 400 mg/day and increases urinary pH by approximately 0.7 units. 

In patients with severe renal tubular acidosis or chronic diarrheal syndrome where urinary citrate may be very low (<100 mg/day), Urocit®-K may be relatively ineffective in raising urinary citrate. A higher dose of Urocit®-K may therefore be required to produce a satisfactory citraturic response. In patients with renal tubular acidosis in whom urinary pH may be high, Urocit®-K produces a relatively small rise in urinary pH. 

INDICATIONS AND USAGE - Potassium citrate is indicated for the management of renal tubular acidosis (RTA) with calcium stones, hypocitraturic calcium oxalate nephrolithiasis of any etiology, and uric acid lithiasis with or without calcium stones. 

CONTRAINDICATIONS - Urocit-K is contraindicated in patients with hyperkalemia (or who have conditions predisposing them to hyperkalemia), as a further rise in serum potassium concentration may produce cardiac arrest. Such conditions include: chronic renal failure, uncontrolled diabetes mellitus, acute dehydration, strenuous physical exercise in unconditioned individuals, adrenal insufficiency, extensive tissue breakdown, or the administration of a potassium-sparing agent (such as triamterene, spironolactone or amiloride). 

Urocit-K is contraindicated in patients in whom there is cause for arrest or delay in tablet passage through the gastrointestinal tract, such as those suffering from delayed gastric emptying, esophageal compression, intestinal obstruction or stricture or those taking anticholinergic medication. Because of its ulcerogenic potential, Urocit®-K should not be given to patients with peptic ulcer disease. 

Urocit-K is contraindicated in patients with active urinary tract infection (with either urea-splitting or other organisms, in association with either calcium or struvite stones). The ability of Urocit®-K to increase urinary citrate may be attenuated by bacterial enzymatic degradation of citrate. Moreover, the rise in urinary pH resulting from Urocit®-K therapy might promote further bacterial growth. 

Urocit-K is contraindicated in patients with renal insufficiency (glomerular filtration rate of less than 0.7 ml/kg/min), because of the danger of soft tissue calcification and increased risk for the development of hyperkalemia. 

WARNINGS - HYPERKALEMIA: In patients with impaired mechanisms for excreting potassium, Urocit-K admin can produce hyperkalemia and cardiac arrest. Potentially fatal hyperkalemia can develop rapidly and be asympto- matic. The use of Urocit®-K in patients with chronic renal failure, or any other condition which impairs potassium excretion such as severe myocardial damage or heart failure, should be avoided. 

INTERACTION WITH POTASSIUM-SPARING DIURETICS-Concomitant admin of Urocit-K and a potassium-sparing diuretic (such as triamterene, spironolactone or amiloride) should be avoided, since the simultaneous administration of these agents can produce severe hyperkalemia. 

GASTROINTESTINAL LESIONS - Because of reports of upper gastrointestinal mucosal lesions following administration of potassium chloride (wax-matrix), and endoscopic exam of the upper gastrointestinal mucosa was performed in 30 normal volunteers after they had taken glycopyrrolate 2 mg. p.o. t.i.d., Urocit®-K 95 meq/day, wax-matrix potassium chloride 96 meq/day or wax matrix placebo, in thrice daily schedule in the fasting state for one week. Urocit-K and the wax-matrix formulation of potassium chloride were indistinguishable but both were signifi- cantly more irritating than the wax-matrix placebo. In a subsequent similar study, lesions were less severe when glycopyrrolate was omitted. 

Solid dosage forms of potassium chloride have produced stenotic and/or ulcerative lesions of the small bowel and deaths. These lesions are caused by a high local concen- tration of potassium ions in the region of the dissolving tablets, which injured the bowel. In addition, perhaps because wax-matrix preparations are not entericcoated and release some of their potassium content in the stomach, there have been reports of upper gastrointestinal bleeding associated with these products. The frequency of gastrointestinal lesions with wax-matrix potassium chloride products is estimated at one per 100,000 patient-years. Experience with Urocit-K is limited, but a similar frequency of gi lesions should be anticipated. 

If there is severe vomiting, abdominal pain or gastro- intestinal bleeding, Urocit-K should be discontinued immediately and the possibility of bowel perforation or obstruction investigated. 

PRECAUTIONS - Info For Patients: Physicians should consider reminding the patient of the following: To take each dose without crushing, chewing or sucking the tablet. To take this medicine only as directed. This is especially important if the patient is also taking both diuretics and digitalis preparations. To check with physician if there is trouble swallowing tablets or if the tablet seems to stick in the throat. To check with the doctor at once if tarry stools or other evidence of gastrointestinal bleeding is noticed. Lab Tests: Regular serum potassium determinations are recommended.

Careful attention should be paid to acid-base balance, other serum electrolyte levels, the electrocardiogram, and the clinical status of the patient, particularly in the presence of cardiac disease, renal disease or acidosis. 

Drug Interactions: POTASSIUM-SPARING DIURETICS: See WARNINGS section. DRUGS THAT SLOW GASTROINTESTINAL TRANSIT TIME (such as anticholinergics) can be expected to increase the gastrointestinal irritation produced by potassium salts. (See CONTRAINDICATIONS section). 

ADVERSE REACTIONS - Some patients may develop minor gastrointestinal complaints during Urocit®-K therapy, such as abdominal discomfort, vomiting, diarrhea, loose bowel movements or nausea. These symptoms are due to the irritation of the gastrointestinal tract, and may be alleviated by taking the dose with meals or snack, or by reducing the dosage. Patients may find intact matrices in feces. (See also CONTRAINDICATIONS , WARNINGS ) 

OVERDOSAGE - The admin of potassium salts to persons without predisposing conditions for hyperkalemia (see CONTRAINDICATIONS ) rarely causes serious hyperkalemia at recommended dosages. It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum potassium concentration and characteristic electrocardiographic changes (peaking of T-wave, loss of P-wave, depression of S-T segment and prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest. 

Treatment measures for hyperkalemia include the following: (1) elimination of potassium-rich foods, medications containing potassium, and of potassium-sparing diuretics, (2) intravenous administration of 300-500 ml/hr of 10% dextrose solution containing 10-20 units of insulin/1000 ml, (3) correction of acidosis, if present, with intravenous sodium bicarbonate, and (4) use of exchange resins, hemodialysis or peritoneal dialysis. 

In treating hyperkalemia, it should be recalled that in patients who have been stabilized on digitalis, too rapid a lowering of the serum potassium concentration can produce digitalis toxicity. 

DOSAGE AND ADMIN - Treatment with Urocit®-K should be added to a regimen that limits salt intake (avoidance of foods with high salt content and of added salt at the table) and encourages high fluid intake (urine volume should be at least two liters per day). The objective of treatment with Urocit®-K is to provide Urocit®-K in sufficient dosage to restore normal urinary citrate (greater than 320 mg/day and as close to the normal mean of 640 mg/day as possible), and to increase urinary pH to a level of 6.0 to 7.0. 

In patients with severe hypocitraturia (urinary citrate of less than 150 mg/day), therapy should be initiated at a dosage of 60 meq/day (20 meq three times/day or 15 meq four times/day with meals or within 30 minutes after meals or bedtime snack). In patients with mild-moderate hypocitraturia (>150 mg/day), Urocit®-K should be initiated at a dosage of 30 meq/day (10 meq three times/day with meals). Twenty-four hour urinary citrate and/or urinary pH measurements should be used to determine the adequacy of the initial dosage and to evaluate the effectiveness of any dosage change. In addition, urinary citrate and/or pH should be measured every four months. 

Doses of Urocit-K greater than 100 meq/day have not been studied and should be avoided. 

Serum electrolytes (sodium, potassium, chloride and carbon dioxide), serum creatinine, and complete blood count should be monitored every four months. Treatment should be discontinued if there is hyperkalemia, a significant rise in serum creatinine, or a significant fall in blood hematocrit or hemoglobin. 

HOW SUPPLIED - Urocit-K is available for oral admin in tablet form in the following sizes: (NDC 0178-0600-01) 5 meq potassium citrate and (NDC 0178-0610-01) 10 meq potassium citrate, packaged in bottles of 100 each. Store in tight container. Rev. 08980 


\16 Viagra

Prescription (Pfizer) drug approved 3/98 for erectile dysfunction, $10/pill. Used an hour before you wanna fuck.  Not to be taken with nitrate medications (nitro- glycerin), Sorbitrate, or some antibiotics. It causes abrupt drops in blood pressure.

NB: Risky for men with heart problems, blood pressure of  170/110. 130 men died in the first six mths 11/98.

FDA recommended dose: 50 milligrams, NYT 5/06/98. Comes in 50 and 100 mg. 

Femagro (squaw root/yohimbe) for women.

- Viagra Viagra doesn't seem to increase the risk of death by heart  attack. That's according to a study that included more than  5,600 men in England who were prescribed the anti-impotence  drug sildenafil, better known as Viagra. "The study is  reassuring that most men with cardiovascular disease can  safely take Viagra if they have erectile dysfunction," said  Dr. Adolph Hutter, professor of medicine at Harvard Medical  School/Massachusetts General Hospital in Boston. But Hutter  warned that any patient taking nitroglycerine or other  nitrate drugs to control chest pain must not take those  drugs and Viagra because the combination has proven lethal. In a report Monday at the annual scientific session of the  American College of Cardiology in Orlando, Fla., Dr. Saad

Shakir of Britain's Southampton University said that among  the men prescribed Viagra for erectile dysfunction 10 died  in the following six-month period. "When compared with  death rates in the general population in England in 1998,

there was no evidence of a higher mortality in this group,"  he said. "Although no single study can be taken as  conclusive evidence for the safety of any medicine, our  study provides reassurance with regard to the cardiac  safety of sildenafil." Hutter said that as sildenafil  approaches its third anniversary on the market, "we are  learning that sildenafil has some beneficial effects."  Studies have shown that use of sildenafil makes blood  vessels more elastic, increases heart artery blood flow  and improves exercise tolerance in people with heart  failure -- all positive points. Viagra was approved by  the FDA in March 1998 and in Europe in September 1998.  It has since been licensed in 100 countries and more than

10 million men have taken the drug.

 USES: This medication is used to treat male sexual function problems (erection problems).
  HOW TO USE THIS MEDICATION: This drug is taken by mouth as needed between four hours and one-half hour before sexual activity (about one hour before is most effective). Take only as directed, usually once daily as needed. Sildenafil works along with sexual stimulation to help achieve an erection.
  SIDE EFFECTS: Headache, flushing, stomach upset, nasal stuffiness, diarrhea and dizziness might occur. If these effects persist or worsen, notify your doctor promptly.
  PRECAUTIONS: Before using this drug, tell your doctor your medical history, including any allergies (especially drug allergies), any penis conditions such as fibrosis/scarring, history of painful/prolonged erection (priapism), sickle cell anemia, blood system cancers (such as leukemia or myeloma), or Peyronie's disease, eye problems (retina diseases). kidney or liver disease, bleeding disorders or active stomach ulcers, heart diseases, stroke or severe high or low blood pressure. Limit alcohol intake, as it may aggravate side effects of this drug. To avoid dizziness and lightheadedness when rising from a seated or lying position, get up slowly. The elderly may be more sensitive to the side effects of this drug, therefore caution is advised in this group.
  DRUG INTERACTIONS: Tell your doctor of all nonprescription and prescription medication you may use, especially any nitrate medications (e.g., nitroglycerin, isosorbide dinitrate), nitroprusside (any "nitric oxide donor" medicines), cimetidine, erythromycin, azole antifungals (e.g., itraconazole, ketoconazole), mibefradil, rifamycins (e.g., rifampin) or high blood pressure medicines.
  NOTES: Do not share this med with others, since they may have a problem that is not effectively treated by this drug. Use of this drug does not protect against sexually transmitted diseases (eg, HIV, Hep-B, gonorrhea).
  MISSED DOSE: Not applicable.
  STORAGE: Store at room temp between 59-86 deg F (15-30 deg C) away from light and moisture. Keep this and all meds out of the reach of children.

 WASHINGTON (Reuters Health) Oct 10 - Results from a post-marketing study of Viagra (sildenafil citrate) found no evidence that men with erectile dysfunction who were taking the drug were at an increased risk of heart attack or death due to a cardiovascular event, according to the drug's manufacturer Pfizer. 

"The independently-conducted observational study of 5391 men in the UK found no evidence of increased risk of heart attack or death from ischemic heart disease, Pfizer said. The subjects, who had a mean age of 57 years, had been taking Viagra for an aver of 5 months. Pfizer also noted that "no cases of heart attack, stroke or death [were] reported during the first month after treatment was prescribed."  

Pfizer added a warning to labeling shortly after the drug was first approved in 1998 at the request of the FDA that states, "There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease." 

This action was taken after 128 people died after taking the medication, including 77 due to cardiovascular events. The drug was later determined to potentiate the hypotensive effect of nitrates, such as nitroglycerin patches or nitroglycerin tablets, which are used to treat certain heart conditions. 

Viagra now contraindicated in patients taking nitrates. "With availability of Viagra now having passed the two- year mark, this study provides important confirmation that Viagra has an excellent safety profile and is well tolerated in the wide variety of men who suffer from [erectile dysfunction]," Pfizer's senior vp for med and regulatory operations Dr Joe Feczko said. 

The drug is approved in the US and 100+ other countries. 

Adverse effects assoc with Viagra include changes in vision, erections lasting longer than 4 hours and chest pain.

- Jul 30 1998  A natural rival to Viagra may come from Lebanon  Taher Abou Hamdan   RASHAYA, (Lebanon), July 29: Businessmen are competing to sell on the international market a wild root known since the dawn of time in Lebanon for having Viagra-like properties, only without the side-effects. The Shirsh Zallouh has long been timidly used against frigidity and impotence, But since the popular worldwide launch of the Viagra pill the Lebanese wild root has become all the rage. 

"I've had hundreds of clients, men and women, from across Lebanon, Gulf countries and the Americas," said Ali Faour. "They mostly come in complete secrecy to cure their frigidity, impotence or those of their sons who cannot deflower their brides," said the 70-year-old peasant who takes pride in having been selling the root since his youth. 

Faour gives his clients a stock from the root, but refuses to take money from them before securing positive results. ``They come back stunned by the miracles achieved and which they would have never dared to dream of! They also pay me sums that I would never have dared to askfor!'' he said with a cunning smile.  The small shrub, with thin leaves and little white or yellow flowers, has a ``male' taproot or a ``female'' forked root and grows at more than 2,500 meters (8,000 feet) on Mount Hermon, at the joint borders of Lebanon, Syria and Israel. ``This is its home,'' said a resident of a village at the foot of Mount Hermon in SE Lebanon.

When snow melts at the end of winter, the villagers ride their mules to gather the root at the top of Mount Hermon and even reach Aarneh, a tiny hamlet on the Syrian side of the mountain.  ``In northern Lebanon, we also call it Hashishat al-Kattira, or the herb of abundance. I saw it last Saturday at 3,000 meters (10,000 feet) at Qornet as-Sawda,'' Lebanon's highest mountaintop, said ecologist Aref Qodaih.Qodaih, a former Pilot turned mountain lover, said ``the root has always helped Cauterize human wounds, heal animal infections, increase the milk of cows and give energy to goats at the mating season.'' ``They say that it wasoriginally discovered by goatherds who saw its strong effect on goats, way before the mating season in September, in certain pastures,'' said nurseryman Dib Abou-Rjeili.  Qoftan Jamal, a businessman from Rashaya in southeast Lebanon, wants to market the product in three months under the name of `Sex Roots' in the form of pills, powder and liquid solution. Jamal said he carried out tests for five years on a sample of 500 people from both sexes, divided into two groups: under 50 years and between 50 years and 80 years.  ``It takes effect in half an hour. We obtained dazzling results with 96 per cent success rate and without any negative effects,'' he said. ``It is a natural product, without chemical ingredients, more powerful than Viagra and without its side effects. It is also fortifying for the heart, the nervous system, the brain and helps more than Ginseng for cell regeneration,'' he said.  But Jamal is not the only one to think about marketing the product in Lebanon and Abroad. Ali Abu Hammein, adoctor from the nearby village of Shebaa, said he planned to do the same within three months. ``The root's name in Latin is `Serila Harmoni' from the Apiaceae family and I have been testing it for 20 years. It increases sexual energy and could also be used as a tranquilizer,'' said Abu Hammein.  ``The powers of this root were already known at the time of King Solomon and the queens of Sheba, especially Balqis, who built a still-visited palace on the side of Mount Hermon for their summer bouts,'' said Jamal.  Copyright © 1998 Indian Express Newspapers (Bombay) Ltd.


\17 HEALTHCARE ON THE WEB http://www.manslife.com 

Health issues, not weather or stock reports, are a major reason people now log on to the Internet. But chances are that much of the information and advice they glean from the computer screen will be biased, inaccurate and, in some cases, downright dangerous. 

Good, Bad and Ugly. Typical Internet users have no assurance that medical advice dispensed on the World Wide Web has been properly tested for effectiveness or safety, and most people lack the expertise to assess the validity of what they find. Unlike peer-reviewed reports in medical journals, information on the Web is not screened by independent experts who can determine whether the conclusions and recommendations are warranted by the available evidence. There are no quality standards for statements posted on the Web, and anyone with some computer savvy -- from ordinary patients and purveyors of products to top medical experts and government agencies -- can set up a Web site and promulgate "facts" for you and me to find. 

As the editors of The Journal of the AMA put it: "When it comes to med info, the Internet too often resembles a cocktail conversation rather than a tool for effective health care communication and decision making. The problem is not too little information but too much, vast chunks of it incomplete, misleading, or inaccurate." 

Some physicians are concerned with the tantalizing reports on the Internet of unproven "nontoxic" remedies for serious health problems, which may prompt patients to abandon established treatments. "Seriously ill people, such as cancer patients, are particularly vulnerable to unsubstantiated claims about less toxic therapies and better overall outcomes," noted Dr. Maurie Markman, chairman of hematology and medical oncology at the Cleveland Clinic Cancer Center. 

At the same time, the Internet can be an invaluable source of facts and guidance for people with all kinds of health problems, including rare diseases that have baffled their personal physicians. For example, Jeff Newman, a commodity trader in Chicago, suddenly lost his voice to an incurable viral condition called recurrent respiratory papilloma, which caused polyps to form repeatedly on his larynx. After three operations, Mr. Newman sent out an E-mail query on the Web that led him to a remedy his doctor had never heard of -- one cup of cabbage juice a day -- and six months later another computer message directed him to Indole-3 powder derived from the active ingredient in cabbage, which aborted the growth of his polyps. 

Likewise, a friend of mine suffering from plantar fasciitis, a painful inflammation of the tendon that connects the toes to the heel, derived far more valuable tips on treatment from patients who posted their own findings on the Web than from his doctor. His newly found Web friends, not his doctor, eventually cured him. Search for Quality any of the Web sites uncovered when searching for useful health information have been established by commercial sources, especially pharmaceutical companies and producers of vitamins, herbals and homeopathic remedies. While this does not automatically mean the info is biased, Web browsers must be constantly on guard against being steered toward this or that product, which may or may not be appropriate for the condition in question. As the medical magazine Patient Care recently noted, "Web sites are used by unscrupulous marketers to sell various medications, books and devices." 

Another common danger is information that is outdated. Unless Web sites are continually updated with the latest facts and findings, what you download may be too old to be useful. While there is no guaranteed route to quality information on the Web, there are some guidelines that can increase the likelihood that what you are finding is both factual and useful. 

First and foremost, check the source of the info. Who put it together? Whom does that person work for? What are his or her credentials? Who is the sponsor of the site? If it is a business, what kind of business? Might the tail of potential profits be wagging the dog? You are most likely to get reliable information from leading med ctrs, univ hosps and govt health agencies, like the National Inst of Health, Centers for Disease Control or the Food and Drug Admin. But keep in mind that even these sources have potential biases. 

Next, check whether the information is based on reports published in leading med journals. If all the references are to foreign or obscure publications you never heard of, be suspicious. And, of course, if there are no references, the statements may be based more on opinion than on fact. 

Try to assess the objectivity and comprehensiveness of the information presented. Keep in mind that there is no way to stop someone from posing as a medical expert and dispensing erroneous advice. How many opinions does the advice reflect? A reliable source is likely to present various perspectives on a health matter. No one org has all the answers, and even reputable sources reflect opinions that may be disputed by other experts. 

Is the info current? A Web site on health should be updated monthly and should state the date of the most recent update. Don't believe everything you read. Maintain a healthy skepticism. Check out Internet advice with your doctor, and don't start taking meds recommended on the Web without first consulting your doctor. 

Be very careful about the growing practice of on-line med. A doctor who cannot see or examine you physically necessarily lacks vital info about the state of your health, and is totally dependent on what you choose to report. This can easily result in misdiagnosis or improper or even dangerous treatment recommendations. 

The same caution should apply to ordering drugs on-line. Unless someone is checking you out for potential contra- indications or interactions with other drugs you take, the consequences can be disastrous.

	SITES:

Achoo Achoo Online Healthcare Services acts as a starting point and information resource for anyone interested in health care. It connects you to thousands of related sites through its Internet directory and includes a list of journals and pubs, a site of the week, and headline health news categorized into more than 150 topics. http://www.achoo.com 

Acupuncture Welcome to the world of Eastern medicine. Get answers to questions about acupuncture and how it can be used to treat varicose veins, diabetes, and other conditions. In addition to acupuncture, this site looks at common ailments from an Oriental medical perspective and introduces topics such as Chinese nutrition, Tuina, herbology, QiGong, and more. http://www.acupuncture.com Alcoholics Anonymous Those suffering from the disease of alcoholism can learn more about Alcoholics Anonymous' world-famous 12-step program at its Web site. Available in English, Spanish, and French versions, the site provides fact files, questions to ask yourself to learn if AA is for you, and contact information for your state or country. http://www.alcoholics-anonymous.org The Alternative Medicine Homepage As the Webmaster describes it, this is "a jump station for information on unconventional, unorthodox, unproven, or alternative, complementary, innovative, integrative therapies." Originating from the University of Pittsburgh, it provides hyperlinks to numerous resources covering treatment methods such as herbal medicine, massage, and acupuncture. http://www.pitt.edu/~cbw/altm.html American College of Physicians Do you have a question about medical computing? From software to hardware, this site provides information along with helpful hyperlinks. You also can find out about ACP membership, read selected articles from ACP journals and newsletters, and browse a catalog of products and services. Members also can access annual session information. http://www.acponline.org American Family Physician The American Academy of Family Physicians publishes this journal to provide information to the general public on a wide range of medical issues. For example, a recent issue contained articles on everything from skin cancer prevention to recognizing occupational diseases. You'll also find a newsletter with articles on medical issues, information on subscribing to the print version of the publication, and a "what's coming" section that previews future issues of the publication. http://home.aafp.org American Gastroenterological Association Aren't you glad the full name isn't in the URL address? Although it contains some general information for the general public, this site is primarily designed for physicians, researchers, and educators whose focus involves the functions and disorders of the digestive system. It contains AGA news, publications, clinical guidelines, public policy notes, research awards, message boards, and hyperlinks to other sites. http://www.gastro.org American Hyperlexia Association This is a resource for parents, special education teachers, and health-care professionals involved with speech and language disorders. The focus is on hyperlexia, a disability that involves early reading development combined with abnormal social skills and learning difficulties. The site provides articles, schooling information, events, networking, materials you can order, and information about the AHA. http://www.hyperlexia.org American Lung Association "When you can't breathe, nothing else matters." The American Lung Association has been working to prevent lung disease and promote lung health since 1904. Its online presence provides easy access to information on asthma and other lung diseases, tobacco control, and environmental health. Included are news, medical, and legislative updates, and an E-mail-based Breathe Easy/Asthma Digest. http://www.lungusa.org/index.html American Academy of Dermatology Itching for information on skin conditions? This site has material on a variety of topics, including acne, warts, eczema, vitiligo, and sun protection. The skin cancer section offers the latest news on prevention and detection. There also are resources for professionals, organizational and support group contacts, and related news and press releases. http://www.aad.org American Psychiatric Association Even if you aren't a member, you can access helpful information here. The Public Information section includes an overview of mental illness, advice on choosing a psychiatrist, details on community activities and outreach programs, and information on psychiatric medications. There are clinical and research resources, APA information, news, events, publications, and hyperlinks to other sites. http://www.psych.org Ash Web Page When did cigarette advertising on TV become illegal? When did non-smokers first get discounts on life insurance? Action on Smoking and Health has led the fight against smoking, and its site features a timeline to remind you of the significant events in this long struggle. It also tracks late-breaking news and medical studies. http://ash.org Asthma FAQ This site is an FAQ for people interested in finding out more about asthma and who would like to take part in the alt.support.asthma newsgroup. The FAQ was compiled originally by Patricia Wrean and is maintained by Marie Goldenberg. It offers comprehensive data on a wide-variety of asthma-related symptoms, terms, and related illnesses. There is also information on the different medical treatments that are available. http://www.radix.net/~mwg/asthma-gen.html Blind Links This site quickly puts you in touch with more than 100 resources in areas such as advocacy groups, training and assistance, adaptive technology, books and magazines, employment, medical, Braille, and the U.S. government. It includes hyperlinks to libraries for the blind and the Braille Monitor as well as many other related sites. http://www.seidata.com/~marriage/rblind.html Breast Cancer Answers Sponsored by the University of Wisconsin Comprehensive Cancer Center, this site provides current and archived articles about breast cancer prevention, screening, and treatment. Submit an E-mail inquiry to get a personal reply from a trained specialist about any breast cancer-related question. The site includes hyperlinks and a list of questions to ask during your next doctor's appointment. http://www.medsch.wisc.edu/bca
 Breastfeeding Information This site provides hyperlinks to breastfeeding information, including nutrition tips for pregnancy and breastfeeding. You can find articles, useful products, books and publications, videos, newsgroups, mailing lists, and organizations. There are descriptive links to related sites, organized by subject area, including Midwifery Today and the Online Birth Center. http://www.efn.org/~djz/birth/breastfeeding.html Center for Science in the Public Interest The CSPI is a nonprofit education and advocacy organization that promotes health through public education about nutrition and alcohol. You'll find lots of advice, recipes, and information to share. http://www.cspinet.org Children With Diabetes This online service is for children and families with Type 1 juvenile diabetes. It contains information from the American Diabetes Association, the Juvenile Diabetes Association, and other sources. Subject areas include diet and nutrition, medical advice, diabetes camps, and publications. Message boards and chat rooms are available to exchange information and share experiences. http://www.childrenwithdiabetes.com Chiro-Web This is a good starting point for information regarding chiropractic resources on the Internet. In addition to historical and general information, Dr. Andrew Bayuk covers topics such as licensure, associations, products and services, research, networking, and education. Hyperlinks to health and fitness pages are included. http://pages.prodigy.com/CT/doc/doc.html Consumer 

Info Catalog Food and Nutrition This site connects you to descriptions and ordering information on publications about food and nutrition from the Consumer Information Catalog. The pubs are free or inexpensive and include tips on kitchen food safety tests, purchasing food, dietary guidelines, preventing heart disease, food preservatives, dairy products, low sodium diets, and food labels. http://www.pueblo.gsa.gov/food.htm Deaf World Web This resource is for both deaf and hearing people. Information can be listed for the entire international database or by specific country and includes medical resources and socio-cultural materials. Find deaf-related literature, events of interest, news, sign language, organizations, services, arts and entertainment, technology, and materials from research groups from around the world. http://dww.deafworldweb.org Down Syndrome This site is compiled by members of the Down Syndrome listserv and contains contributions from health care providers and parents regarding the various aspects of raising children with Down Syndrome. Articles include medical facts and educational information as well as encouragement and inspiration. Organizations and support groups are listed with telephone numbers and addresses. http://www.nas.com/downsyn/index.html 

Dr. Greene's House Calls This sophisticated site provides complete, easy-to-locate answers for all kinds of pediatric medical questions. Without drowning visitors in medical jargon, Dr. Alan Greene, F.A.A.P., provides the help worried parents need. In addition to search topics, Greene takes questions from online users. You'll find a visit to this site a relief when after-hour problems lay your child low. http://www.drgreene.com 

ErgoWeb Is your computer workstation ergonomically healthy? Check out ErgoWeb, an info delivery system that contains ergonomic standards and guidelines, background info, job review and analysis tools and checklists (including computer workstations), case studies, pubs, surveys, conference schedules, and other ergonomic resource info. http://www.ergoweb.com 

Eye Care FAQs Are you worried about the eyestrain caused by too many hours surfing the 'Net? You can find some answers here. The physician members of the American Academy of Ophthalmology have developed detailed answers to questions about eye diseases and eye health and safety. Topics include eye conditions of the young and old as well as refractive surgery, sports injuries, and UV exposure. http://www.eyenet.org 

Eye Inst This site offers no-nonsense info for patients, researchers, health-care professionals, educators, and the media. You will find comprehensive info about eye diseases, including diagrams of healthy and diseased eyes. There are numerous links to other eye-care organizations and resources. http://www.nei.nih.gov 

Facts For Families The American Academy of Child and Adolescent Psychiatry provides Facts For Families sheets in English, French, and Spanish covering issues such as depression, bed wetting, adoption, stepfamily problems, and sexual abuse. It includes information on the group, legislative alerts, upcoming meetings and events, hyperlinks to related resources, and a catalog of publications. http://www.aacap.org Family's Web misc.kids FAQ Many of us know someone who has been through a miscarriage. If you're having a hard time knowing how to help, check out this site. This site's FAQs section contains medical information and collections of sympathy messages to help you or someone you know cope with this loss. http://www.familyweb.com/faqs FAQs About Coffee and Caffeine OK, it's not supposed to be good for you, but you're addicted to it. Grab a cup of coffee and browse this site. It contains details on the chemistry of caffeine, a discussion of caffeine and health, tips on how to brew coffee, recipes, and lists of the quantities of caffeine in various foods and products. http://daisy.uwaterloo.ca/~alopez-o/caffaq.html Foot and Ankle Web Index Are you experiencing the agony of the feet? This index is your gateway to free information about foot ailments, patient referrals for podiatrists, specific product recommendations for patients and podiatrists, and hyperlinks to many related sites. Ask the Foot Doctor about your problems and search the alphabetical and geographical index of medical providers for a doctor near you. http://www.footandankle.com Go Ask Alice Do you have a question about nutrition? Health? Sex? Emotions? Drugs and alcohol? Just ask Alice, a question-and-answer line created by the Health Education division of Columbia University Health Services. Designed for educational purposes, it contains an archive of previous questions and answers and the current week's new questions. http://www.cc.Columbia.edu/cu/heathwise/alice.html GriefNet Sponsored by Rivendell Resources, a nonprofit foundation based in Ann Arbor, Mich., this site connects you to a variety of resources related to death, dying, bereavement, and major physical and emotional losses. In addition to articles, books, poetry, bulletin boards, mailing lists, and hyperlinks, there are discussion and support groups available. http://rivendell.org Health World Online This is a comprehensive health and wellness resource. It contains volumes of information in categories such as nutrition, self-care, health legislation, health foods, health news, consumer and professional health education, and health organizations. Get your questions answered by Dr. Tom or participate in health forums. http://www.healthy.net The HIV InfoWeb This page provides information about HIV and AIDS treatments and related issues for consumers, health-care providers, and other concerned groups. Sections include treatment information, clinical trials and reviews, prevention and education, newsletters and other publications, legal resources, housing services, advocacy, agencies, newsgroups, mailing lists, and job and volunteer opportunities. http://www.infoweb.org Home Birth The site provides thoughtfully presented arguments for childbirth at home. There are home birth FAQs, personal testimonials, lists of published studies, and links to Midwifery sites. This is a good resource for both expectant mothers and midwives. If you're expecting, or planning to have children, take a look. http://www.thelaboroflove.com/forum/home/index.html

Hospital Web In addition to a growing list of hospitals on the Web (searchable by state and country), this site provides hyperlinks to medical companies and orgs, med schools, residency programs, and related sites. The author also reviews medically oriented sites that catch his eye and provides a link with his commentary. http://neuro-www.mgh.harvard.edu/hospitalweb.shtml

Johns Hopkins Center for Hearing and Balance The university's center researches auditory (hearing) and vestibular (balance) functions and provides information about its case studies. You also can take a vestibular system quiz (if you are unfamiliar with terms such as perilymphatic fistula or nystagmus, check its glossary first), get answers to common questions about dizziness (why did that beer make you so woozy?), and link to related sites. http://www.bme.jhu.edu/labs/chb Join Together This resource center provides information on the harms associated with tobacco, excessive alcohol, and illegal drugs. It has newsletters and publications, guides for community action programs, funding tips and announcements, survey results, a news update section, and a national drug abuse forum plus hyperlinks to related resources. http://www.jointogether.org Kids Health Organization The Nemours Foundation Center for Biomedical Communication has an extensive index of topics on children's health, accompanied by great graphics. The information is categorized for kids, parents, and professionals. Topics include common childhood illnesses, mental health, bed wetting, car safety, nutrition, and exercise. Games provide a fun learning experience for kids and adults alike. http://KidsHealth.org/index2.html Leukemia Society of America Concerned about cancer, particularly in children? This nonprofit, voluntary health agency provides educational brochures, fact sheets, quizzes, publications, and educational videos about leukemia, lymphoma, Hodgkin's disease, and multiple myeloma. You also can learn more about the Leukemia Society, patient service programs, medical research, educational programs, and other cancer-related resources. http://www.leukemia.org LifeMatters Proponents of holistic health methods will find a wealth of information here, covering topics such as fitness and exercise, an introduction to biofeedback methods, homeopathic medicine, nutrition, coping with stress, communication, and positive parenting. Learn more about techniques such as yoga and T'ai Chi and how to cope with stress. Hyperlinks to related sites are included. http://lifematters.com Managing Your Diabetes Although this is a commercial site for drug manufacturer Eli Lilly & Co., you can access a lot of information about diabetes ranging from basic issues to a lengthy reference manual. The site also includes questions from the public and health professionals, diabetes news and events, and diabetes games such as crossword puzzles and word searches. http://www.lilly.com/diabetes Mayo Clinic This provides a lot of information about the Mayo Foundation and its clinics. Ask questions about its services, learn about the communities its clinics are located in, view maps, get a tour of Mayo, access educational and research information, read news and press releases, and find out more concerning Mayo medical imaging and telemedicine programs. http://www.mayo.edu Medscape If you don't know what cytomegalovirus polyradiculomyelitis is, this site may be too technical for you. Produced by SCP Communications, Medscape primarily is designed for medical practitioners and students. It contains original, full-text medical articles, case studies, tables, and medical journal abstracts. Very informative and up-to-date. http://www.medscape.com National Breast Cancer Coalition The National Breast Cancer Coalition is a grassroots effort to eradicate breast cancer through action and advocacy. It works on access to health-care and cancer research, and tries to influence decisions regarding breast cancer. Learn about its goals and accomplishments, how to join, and current programs, including Project Lead. http://www.natlbcc.org The National Clearinghouse for Alcohol and Drug Info This is the Web's primary resource center to distribute information about the treatment and prevention of drug and alcohol abuse. Treatment organizations are also listed. http://www.health.org National Foundation for Infectious Diseases Learn more about the NFID and scan its databases for information about AIDS, hepatitis, ebola, and other infectious diseases. Get fact sheets on chicken pox, influenza, travel diseases, strep throat, Lyme disease, and more. Includes information on immunization programs and clinical updates on various diseases, plus hyperlinks to related sites. http://www.medscape.com/Home/Topics/ID/ InfectiousDiseases.html 
National Health Information Center This national health information referral service puts health professionals, organizations, and consumers in touch with each other. Its Health Information Resource database includes more than 1,000 organizations and government agencies that provide health information upon request. There also are materials on the Healthy People 2000 initiative. http://nhic-nt.health.org National Hospice Organization This organization serves the needs of the terminally ill and their families. The site contains general information concerning hospice care, finding a hospice program, discussion groups, answers to common questions, information on specific diseases, and hyperlinks to related sites. It also has information on conferences, education, and the National Hospice Foundation. http://www.nho.org National Institute for Occupational Safety and Health Interested in occupational safety and health video tapes? In addition to information on ordering NIOSH training tapes, you can access fact sheets on indoor air quality, backbelts, carpal tunnel syndrome, and homicide in the workplace. Databases, information sources, descriptions of workplace hazards, and lists of training centers also are available. http://www.cdc.gov/niosh/homepage.html The National Neurofibromatosis Foundation The Neurofibromatoses are a set of genetic disorders that causes the growth of tumors along certain nerves and are often characterized by birthmarks. This site provides information about the disease for patients and health professionals, including details on genetics. Details about the Foundation and its programs and publications are included. http://www.neurofibromatosis.org National Organization for Rare Disorders You might not have heard of Prader Willi syndrome or primary amyloidosis, but these disorders are very real for those who suffer from them. This site is sponsored by a federation of voluntary health organizations dedicated to helping people with rare disorders and provides detailed information on more than 1,000 ailments. http://www.pcnet.com/~orphan Net Vet Animal health is important too! This large directory connects you to a variety of veterinary-related topics, services, and veterinarians on the Internet. Topic sections include career, education, organizations, meetings, mailing lists, publications and references, laws and regulations, commerce and business, and a veterinary directory. http://netvet.wustl.edu/vet.htm New England Journal of Medicine The online version of the New England Journal of Medicine contains the complete text of many features of the print journal and partial text of others. You can access the current issue and past issues, as well as hyperlinks to medical resources on the Web. You also can read abstracts of original clinical research and research on health policy, with the ability to order the full article. http://www.nejm.org ParenthoodWeb Parents take heart, there is a site that can help. This huge site offers information on just about every baby-related topic you can imagine. And if you're in a hurry for answers to your questions, and don't have time to peruse category listings the site offers a feature that lets you move to the page you need-from adolescence to potty training to vaccinations-in mere seconds. Want more? Sign up for the free weekly E-mail newsletter. http://www.parenthoodweb.com Parents Place.com-Pregnancy and Birth Center This section of ParentsPlace provides hyperlinks that branch off from a long list of about every question you could think of asking about the various stages of pregnancy, including before and after. There also are book excerpts, details about pregnancy care, birth stories, sibling issues, and midwifery information. When it comes to helpful information, this site delivers. http://www.parentsplace.com/genobject.cgi/readroom/ pregnant.html ParentTime This extensive site offers tons of information and tries to answer the questions of expecting or new parents. Departments include: Ask An Expert (professionals answering reader questions), Pregnancy Primer (preparing Mom for the months ahead), Parenting A-Z (lots of advice on raising a child), and Health Guide. There's also links to bulletin boards and chat areas, all focusing on questions and topics important to new parents. http://www.pathfinder.com/ParentTime/homepage/homepage. all.html Psychiatry On Line This is the online version of the International Journal of Psychiatry and is designed for mental health professionals. It presents articles of concern to the profession as well as a side-effect registry, news, reviews, surveys, letters, a notice board, case studies, and a bookshop. Manuscript submissions are accepted and hyperlinks to related sites are provided. http://www.priory.co.uk/psych.htm 

RenalNet Information Service If "renal" or "nephrology" doesn't sound familiar to you, kidney disease might. That is the focus of this Web page, which provides information on the cause, treatment, and management of kidney disease and End Stage Renal Disease (ESRD). There is a guide to kidney-related pages, case reviews, articles, research data, funding information, and access to a variety of publications. http://www.renalnet.org/renalnet/renalnet.cfm Reuters Health Information Services Designed primarily for health care professionals, this site includes the top health news stories of the day with the option of searching the site's archives for topics of interest. A clinical challenge case lets you try your hand at a medical diagnosis. Contains hyperlinks to other health-related sites. http://www.reutershealth.com Robert Wood Johnson Foundation This foundation, whose namesake built the firm Johnson & Johnson, is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grants on health service access, improving health services, reducing the harm caused by substance abuse, and controlling rising health costs. You can read news, grant information, details on programs and projects, and articles on U.S. health care changes. http://www.rwjf.org/main.html Skin Cancer Zone Find out how much sun is too much for your skin type. This Web site provides tips about protecting yourself from the sun's rays, facts about skin cancer, treatment options, links to online resources, and a daily UV index from 50 geographical areas in the United States. http://www.skin-cancer.com Sleep Medicine Home Page This collection of sleep-related sites provides information about sleep disorders, clinical sleep medicine, sleep research, and the physiology of sleep. There are newsgroups, discussion groups, FTP sites, Web pages, professional associations, publications, meetings, foundations, and centers, along with a section of FAQs regarding sleep issues. http://www.cloud9.net/~thorpy SleepNet If you suffer from a sleep disorder, you are not alone. About 40 million other Americans do, too. This site provides information about insomnia and sleep disorders such as narcolepsy, sleep apnea, and restless legs syndrome. The site includes descriptions, support groups, research and news, and hyperlinks to information about sleep centers and related sites. http://www.sleepnet.com The Smokers Health And Nutrition Page Life Plus For many people, smoking has changed from a "cool" habit to both a health threat and a social problem when dining out or traveling by plane or train. This site offers nutritional advice and products that may help you if you're trying to cut down on smoking or quit outright. Check the hyperlinks for details about antioxidants and more. http://www.lifeplusvitamins.com/smoking.html Society for the Autistically Handicapped Find answers to common questions about autism along with an in-depth introduction to this developmental disability. Access lists of related publications and learning resources, diagnostic information, details on workshops, seminars, and other events, briefs on various treatment methods and approaches, and information about the Society and other organizations. http://giraffe.rmplc.co.uk/eduweb/sites/autism Sudden Infant Death Syndrome- American SIDS Institute This helpful site contains easy-to-understand information about Sudden Infant Death Syndrome. It includes facts about SIDS, prevention, and reducing risks; answers to frequently asked questions; the latest research findings and publications; discussion areas; and links to other online resources. http://sids-network.org Texas Cancer Data Center The Texas Cancer Data Center provides online information such as updated cancer statistics, population and community resources, health professionals, and health facilities and services for Texans. You'll find guidelines for cancer education materials, some targeted for specific ethnic groups, and a Telnet site for more information. http://tcdc.uth.tmc.edu Tooth Fairy Dental hygienist Megan says, "Be true to your teeth or they'll be false!" She offers basic dental hygiene information and tips on proper oral hygiene. Her Pillow Stops connect you to other dental sites, which are alternately informative and strange. http://www.asis.com/toothfairy Travel Health Information The Medical College of Wisconsin provides preventive health-care services for travelers planning trips abroad. Travel resources include maps and other travel information, directories of clinics and physicians, access to a world factbook and other handbooks, health advice, travel warnings, descriptions of tropical diseases, and information about emergency medical services. http://www.intmed.mcw.edu/travel.html 

The UCI Willed Body Program This site provides information about donating your body to science and includes a sample of a wallet card indicating the carrier's wish to donate his body to a particular university or medical school. The site also offers links to other resources on Organ Donation Facts, Dealing with Grief, sociology of death and dying, and mortuary sciences. http://www.com.uci.edu/~anatomy/willed_body/index.html Virtual Hospital The University of Iowa College of Medicine provides this continually updated digital health science library primarily for patient care and distance learning by health care professionals. Some of the information is restricted to University of Iowa students, faculty, and affiliates, but the general public can learn a lot from patient instructional materials in the "Iowa Health Book." http://vh.radiology.uiowa.edu VOLC-R Primary Care Resources on the Internet Sponsored by the North American Primary Care Research Group, this site provides information on the group and carries out its mission of fostering development of primary care research. There are hyperlinks to health organizations and associations, university family practice programs, hospitals, electronic mailing lists, nursing, and educational materials. http://views.vcu.edu/~dimlist World Federation of Hemophilia Hemophilia, a common hereditary blood disorder, is a painful and crippling illness that can lead to death. Learn more about it at this site, which contains information and contacts from around the world. Sections include family and medical news, a general introduction to hemophilia, a resource library and hyperlinks, and worldwide events and organizations. http://www.wfh.org Worldguide Health and Fitness Forum Use this international health forum to learn simple lessons in human anatomy, obtain descriptions of how to perform exercises for strength training and cardiovascular fitness, and get advice about how to eat well. Much of the information is not particularly in-depth, but the site provides hyperlinks to related publications, resources, and software. http://www.worldguide.com/Fitness/hf.html World Health Organization This site provides click-on access to information about a variety of world health topics and statistics, vaccination requirements, and health advice. Learn more about WHO programs, download an executive summary of the World Health Report, search for WHO information by disease or topic, educate yourself about disease outbreaks, and find out how to order WHO's current list of publications. http://www.who.ch
