Posts Tagged ‘chest pain’

Type of Drug
Carbonic-Anhydrase Inhibitors,
Eyedrops (kar-BON-ik an-HYE-drase)
Brand Names
Generic Ingredient: Dorzolamide Trusopt
Generic Ingredient: Brinzolamide Azopt
Combination Product
Generic Ingredients: Dorzolamide + Timolol Cosopt
Prescribed For  Glaucoma.
General Information
These drugs are similar to acetazolamide, a carbonic-anhydrase inhibitor taken by mouth. Carbonic anhydrase is an enzyme found in many parts of the body, including the eyes. By blocking the effects of this enzyme, dorzolamide and brinzolamide slow the production of fluid inside the eye, reducing pit:ssure. This cffc,, i3 usetul in ir83t
ino, open-angle glaucoma because the disease is characterized by elevated eye pressure. Dorzolamide and brinzolamide are sulfonamides, or sulfa drugs, and although they are administered topically, they affect the body systemically.
Cautions and Warnings
Do not use these drugs if you are allergic or sensitive to any of their ingredients or to other sulfa drugs. Small amounts of these drugs enter the bloodstream. Rarely, people using them experience side effects or allergies associated with sulfa drugs.
These drugs have not been studied in people with very poor kidney or liver function. Since these drugs are eliminated via the kidneys, people with impaired kidney function should use an alternate glaucoma medication.
These drugs have not been studied in people with acute angle-closure glaucoma.
See Timolol, page 1129, for more information on the combination product Cosopt.
Possible Side Effects
Dorzolamide
✓    Most common: eye burning, stinging, or discomfort and a bitter taste in the mouth immediately after administering the eyedrops.
✓    Less common: allergic reactions, conjunctivitis (pinkeye), blurred vision, tearing, dry eye, and increased sensitivity to bright light.
♦    Rare: headache, nausea, weakness, tiredness, rash, and kidney stones. Dorzolamide can cause the same types of side effects as other sulfa drugs, but this is very unlikely. Contact your doctor if you experience any side effects not listed above.
Brinzolamide
♦    Common: blurred vision and a bitter, sour, or unusual taste in the mouth.
♦    Less common: eyelid inflammation; conjunctivitis (pink-
eyeY, nsh; dry eye; sensation of something in the eye;
headache; eye redness, itching, discharge, or pain; and
runny nose.
✓    Rare: allergic reactions, hair loss, chest pain, diarrhea, nausea, sore throat, tearing, itchy rash, double vision, dizziness, Possible Side Effects (continued)
dry mouth, breathing difficulties, upset stomach, tired eyes, kidney pain, cornea problems, and formation of a crust or sticky sensation around the eyelid. Brinzolamide can cause the same types of side effects as other sulfa drugs, but this is very unlikely. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• If you are using more than 1 eyedrop product, separate doses of these drugs by at least 10 minutes.
Usual Dose
Adult: 1 drop in the affected eye 3 times a day. Overdosage
Accidental ingestion of a bottle of dorzolamide or brinzolamide may affect blood levels of potassium and other electrolytes. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor and stop using your eyedrops if you develop any unusual eye reaction or condition, including swollen eyelids and conjunctivitis (pinkeye).
Vision may be temporarily blurred when using the eyedrops. Use caution when driving or operating machinery.
If you wear soft contact lenses, take them out before using the eyedrops and put them back in 15 minutes after a dose.
To prevent infection, do not allow the eyedropper tip to touch your fingers, eyelids, or any surface. Wait at least 10 minutes before using any other eyedrops.
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Very high dosages of dorzolamide or brinzolamide caused birth defects in animal studies. While the risks of using these drugs during pregnancy are small in people, pregnant women should use dorzolamide or brinzolamide only after discussing its potential benefits and risks with their doctors.
it is not known if these drugs pass into breast milk. Nursing mothers who must use either drug should use infant formula.
Seniors: Seniors may be more sensitive to side effects.

Chemical Intolerance
`To start with, I just used to get this irritation in my throat when I was reading a magazine. Over the years it got much worse, and there was a dreadful burning feeling, not

just in my throat now, but also in my eyes and nose. Sometimes I could scarcely breathe. My doctor said it couldn’t be magazines and diagnosed asthma. Twenty years on, I can’t

look at a magazine, even for a few minutes, and other things affect me now too. If I go in a room with a photocopier running I start to choke and can’t breathe. Whenever I

describe this problem to anyone — apart from the doctor, that is — they almost always say they know someone else who has a similar problem. But the doctors still say that what

happens to me can’t happen.’
Mary has chemical intolerance, which is also known as chemical sensitivity, environmental Illness or idiopathic environmental intolerances. It is a condition that arouses more

passionate controversy than any other described in this book. Many believe that it simply does not exist, or rather that people who claim to have chemical intolerance are

actually victims of psychological problems, which express themselves as physical symptoms. Careful studies show that, while some people with supposed chemical intolerance do

fall into this category, others do not – they have no psychiatric problems, but they do appear to have valid symptoms when exposed to certain synthetic chemicals.
`People with MCS are desperate. They will go to great lengths and do almost anything to find a doctor, anyone, who believes them.’ So speaks one sufferer from MCS (Multiple

Chemical Sensitivity), the most extreme form of chemical intolerance. It is often severely disabling, with symptoms such as exceptional fatigue, nausea, headaches, poor memory

and concentration, dizziness. muscle aches, joint pain, chest pain and digestive problems. Those with MCS react to a very wide range of chemicals, and very often to foods and

food additives as well.
These severely affected patients are a small minority, however, and many more people are like Mary, with sensitivity to just one or two types of chemical exposure. Surveys in

the United States suggest that about 30% of the population are affected in this way. The authors of one such survey note that ‘the widespread idea that chemical sensitivity is a

condition of educated, urban housewives was not supported by our study. The region surveyed was rural… and individuals who reported chemical sensitivity were found in all age,

gender, income, race and employment groups.’
The chemical exposures that are identified as triggering symptoms include:
• perfumes
• pesticides
• cigarette smoke
• paint fumes
• petrol
• exhaust fumes
• cleaning products
• newspaper ink
• plastics, especially those with a strong smell
• glossy paper (e.g. In magazines).
Typical symptoms, in those with sensitivity to just one or two chemical products, are:
• a blocked or runny nose
• sore throat
• irritation of the eyes
• sinus pain and congestion
• headache
• breathlessness and wheezing
• nausea
• skin rashes
• extreme fatigue
• dizziness.
How does chemical intolerance begin?
For some of those with MCS, the problems began with a sudden over-exposure to a toxic chemical, such as a chemical spill, or pesticides from a crop-spraying plane. Others are

first affected by regular doses of pesticide at lower levels, such as spray drift from nearby fields or from a neighbour’s garden. It seems as if, for these people, their inborn

ability to detoxify both natural and manmade toxins is overwhelmed by an unusually heavy exposure, and never fully recovers. Although there have been no systematic studies of

this – it is difficult to imagine how they could be done –the wealth of well-documented cases is convincing. And studies of those exposed to high levels of pesticides in

accidents at work support the idea that this can cause lifelong sensitivity to very small doses of some synthetic chemicals. Sensitivity to alcohol and caffeine usually

increases enormously too.
In some cases, classical allergies also feature in the range of symptoms for those with MCS. If they had an allergic tendency before the accidental exposure to pesticides, this

is especially likely: after the accident, along with chemical intolerance, they have far more pronounced allergic reactions to common allergens.
The loss of tolerance to everyday chemicals may be related to some kind of damage to the enzymes in the liver that carry out the important task of detoxifying toxins that enter

the bloodstream. This detoxification system evolved to deal with natural toxins, such as those in plant foods, and those produced by bacteria living naturally in the gut. These

enzymes can also detoxify the widely used synthetic chemicals, when these are encountered in relatively small amounts, but the enzymes are overwhelmed by large doses.
Chronic Fatigue Syndrome (CFS)
This is a disease that probably has multiple causes rather than a single cause. The main symptom is fatigue that is not relieved by rest. Many people with CFS also have a

slightly raised temperature, problems with concentration and memory, headaches, sore throat and swollen lymph nodes (’swollen glands’). The lymph nodes are part of the immune

system, so this symptom suggests some disturbance of immune function. Other findings, related to immune cells in the blood, also support this idea. However, there are often

minor abnormalities in the brain as well, with some loss of the insulating material around the nerves (myelin).
For many patients, the disease develops in the wake of a viral infection, but for others the origin may be unclear. Whatever the origin of the disease, avoiding synthetic

chemicals is very helpful in many cases. Some sufferers also find an elimination diet helpful (see pp. 194-7). Doctors working in this area say that there is no sharp

demarcation between patients with Chronic
Fatigue Syndrome (CFS) and those with MCS.
Autism
In the search for a cause of autism, many possibilities are being investigated. The consensus now is that there is a genetic predisposition which, when combined with certain

trigger factors, leads to autism.
What are those trigger factors? Some researchers suggest that autistic children have poorly performing detoxification enzymes and are therefore sensitive to synthetic chemicals,

both in food and the environment. The suspicion is that these chemicals affect the developing nervous system.
Other researchers pinpoint food as the culprit. They believe that children who develop autism are affected by exorphins (see p. 76) produced from the proteins in wheat and/or

milk, and that these damage the child’s developing nervous system. There are claims that a dairy-free and gluten-free diet can help, but that it must be ultra-strict to work,

and may need to continue for at least six months before any improvement occurs. You must have your doctor’s approval for this.
Before starting them on such a diet, some doctors also give a course of anti-fungal drugs to those autistic children who have been treated repeatedly with antibiotics. This

combined treatment is reported to have very good effects for some children.
Treatment
Assuming that you really do have chemical intolerance rather than some deep-rooted psychological problem – and you have to be honest with yourself here, because otherwise you

will never get better – then careful avoidance of the offending synthetic chemicals is the only effective treatment. If you have eliminated everything that obviously affects you

and are not much improved, then try tackling common indoor pollutants (see pp. 128-30) as well.
Such measures are of value to some with chemical intolerance but may not be adequate for those most severely affected. If you need to take more radical steps, you may benefit

from the bedding, paints and other household items manufactured for those with chemical sensitivity. Once you reduce the level of synthetic chemicals in your everyday

environment, you may find that you can tolerate occasional exposures much more.
Some doctors recommend taking supplements of vitamins and minerals to speed your recovery. These (especially antioxidants – see p. 206) may be helpful for some people, but be

sure to get nutritional advice from someone with good medical qualifications, rather than a self-styled ‘nutrition therapist’.
Neutralisation therapy (see p. 211) seems to be effective for some people with chemical intolerance, but you will still need to avoid the offending substances. Hyperventilation

(see p. 236) can make chemical intolerance much worse.