Posts Tagged ‘Medical’

Generic Name
Clotrimazole (kloe-TRIM-uh-zole) 0
Brand Name Mycelex
The information in this profile also applies to the following drug:
Generic Ingredient: Sertaconazole Ertaczo
Type of Drug Antifungal.
Prescribed For
Fungal infections of the mouth, skin, and vaginal tract.
General Information
clotrimazole is useful against a variety of fungal organisms that other drugs do not affect. The exact way in which clotrimazole works is unknown. Sertaconazole is used for athlete’s foot in people age 12 and older with compromised immune systems.
Cautions and Warnings
Do not use this product if you are allergic or sensitive to any of its ingredients.
If clotrimazole causes local itching or irritation, stop using it. Do not use clotrimazole in your eyes.
Proper diagnosis is essential for effective treatment. Do not use this product without first consulting your doctor.
Possible Side Effects
Side effects are infrequent and usually mild.
Cream and Solution
V Most common: redness, stinging, blistering, peeling, itching, and swelling of local areas.
Vaginal Tablets
♦ Most common: mild burning, rash, mild cramps, and frequent urination. Your sexual partner may also experience some burning or itching.
Lozenges
V Most common: stomach cramps or pain, diarrhea, nausea, and vomiting.
Drug Interactions
None known.
Food %%ractions
The oral form of clotrimazole is best taken on an empty stomach, at least 1 hour before or 2 hours after meals. However, you may take it with food as long as you allow the lozenge to dissolve fully in your mouth.
Usual Dose
Topical Cream and Solution
Adult and Child (over age 2): Apply to clean, dry, affected areas morning and night for 7 consecutive days or as needed. For athlete’s foot and ringworm, use daily for 4 weeks. For jock itch, use daily for 2 weeks.
Vaginal Cream
Adult: 1 applicator’s worth at bedtime for 3-7 consecutive days.
Vaginal Tablet
Adult: 1 tablet inserted into the vagina at bedtime for 3 days, or 2 tablets a day for 3-7 consecutive days.
Lozenge
Adult and Child (over age 3): 1 lozenge 5 times a day for 2 weeks or more.
Overdosage
Little is known about the effects of clotrimazole overdose or accidental ingestion. Call your local poison control center for more information. If you seek treatment, ALWAYS bring the prescription bottle or container.
Special Information
If treating a vaginal infection, you should refrain from sexual activity. Call your doctor if burning or itching develops or if the condition does not improve within 7 days.
If you are using the vaginal cream, you may want to wear a sanitary napkin to avoid staining your clothing. Do not use a tampon during treatment.
Dissolve the lozenge slowly in the mouth. This may take up to 30 minutes.
This medicine must be taken on consecutive days. If you forget a dose of oral clotrimazole, take it as soon as you remember. Do not double your dose.
When using clotrimazole for skin infections, do not cover the area with any kind of bandage unless directed to do so by your doctor. For athlete’s foot, wear well-fitting, ventilated shoes, and change your socks at least once a day.
clotrimazole is not effective on scalp or nails.
Special Populations
Pregnancy/Breast-feeding: Women who are or might be pregnant should talk to their doctor about the medication’s risks and benefits. Women who are in the first 3 months of pregnancy should use this drug only if directed to do so by their doctor. If you are pregnant, your doctor may want you to insert vaginal tablets by hand rather than use a vaginal applicator.
It is unknown whether the drug passes into breast milk. Use with caution or use infant formula.
Seniors: Seniors may use this medication without special precaution.

Generic Name
Clozapine (KLOE-zuh-pene) 03
Brand Names
Clozaril    FazaClo Orally Disintegrating Tablets
Type of Drug  Antipsychotic.
Prescribed For  Severe schizophrenia.
General Information
Clozapine is a unique antipsychotic that has the capacity to treat people who do not respond to or cannot tolerate other drugs. It works by a mechanism that differs from those of other antipsychotic drugs.
A very small number of people who take clozapine develop a rapid drop in their white-blood-cell count, known as agranulocytosis. This effect usually reverses itself when the drug is stopped, but the drug must be stopped as soon as it is discovered. An unusually large number of people who have developed clozapine algllaTwlocytosis in the United States are of Eastern European Jewish descent, but the association is not very strong. Most cases of agranulocytosis occur between week 4 and week 10 of treatment. It is essential that blood samples be taken approximately every week and for 4 weeks after the drug is stopped to watch for this effect. Because of the risk of agranulocytosis, clozapine should not be tried until at least 2 other antipsychotic medicines have failed.
Some people taking antipsychotic drugs develop tardive dyskinesia, a potentially irreversible condition marked by uncontrollable movements. Tardive dyskinesia has not been seen in patients taking clozapine, a major advantage of this drug over other antipsychotic medicines. However, there is still a risk that this set of symptoms could occur with clozapine.
Cautions and Warnings
Do not take clozapine if you are allergic or sensitive to any of its ingredients.
Women, seniors, people with serious illnesses, those who are emaciated. those with a history of diseases affecting the white blood cells, or those who are taking other medication that could affect white blood cells may be more susceptible to clozapine agranulocytosis.
Clozapine has been associated with increased mortality in seniors with dementia or Alzheimer’s disease. The specific causes of death related to clozapine and other atypical antipsychotic drugs were either due to a heart-related event or infection, mostly pneumonia. Clozapine should not be taken by those with dementia-related psychosis.
About 5% of people taking the drug experience a seizure in the first year of treatment. Seizure is most likely to occur at higher drug doses.
People with heart disease should be carefully monitored while on clozapine because of possible cardiac risks.
Clozapine may cause low blood pressure, especially at the beginning of therapy.
Clozapine has been associated with obesity, high cholesterol, high blood sugar, and diabetes. Diabetics and pre-diabetics (people with elevated blood sugar and a family history of diabetes) should be carefully monitored.
A serious set of side effects, known as neuroleptic malignant syndrome (NMS), includes a high lever and has been associated With clozapine when it is used together with lithium or other drugs. The symptoms that constitute NMS include muscle rigidity, mental changes, irregular pulse or blood pressure, increased sweating, and abnormal heart rhythm. NMS is potentially fatal and requires immediate medical attention.
Use this drug with caution if you have glaucoma, prostate
problems, or liver or kidney disease.
clozapine may interfere with mental or physical abilities because of the sedation it usually causes during the first few weeks
of treatment.
Possible Side Effects
✓    Most common: rapid heartbeat, low blood pressure, dizziness, fainting, drowsiness or sedation, salivation, and constipation.
✓    Less common: headache, tremor, sleep disturbance, restlessness, slow muscle motions, absence of movement, agitation, convulsions, rigidity, restlessness, confusion, sweating, dry mouth, visual disturbances, high blood pressure, nausea, vomiting, heartburn or abdominal discomfort, fever, and weight gain.
♦    Rare: agranulocytosis (symptoms include fever with or without chills, sore throat, and sores or white spots on the lips or mouth), tardive dyskinesia (symptoms include lip smacking or puckering, puffing of the cheeks, rapid or wormlike tongue movement, uncontrolled chewing motions, and uncontrolled arm and leg movements), and NMS (see “Cautions and Warnings”). Other rare side effects can occur in almost any part of the body. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
•    Clozapine’s anticholinergic effects—blurred vision, dry mouth, and confusion—may be enhanced by interaction with other anticholinergics, such as tricyclic antidepressants like amitriptyline.
•    Drugs that reduce blood pressure may enhance the bloodpressure-lowering effects of clozapine.
•    Alcohol and other nervous system depressants, including benzQUIQOmrn and other antianxiety drugs, may enhance clozapine’s sedative action. At least 1 person has died as a result of combining diazepam and clozapine.
•    Combination contraceptive drugs may increase blood levels of clozapine leading to toxic side effects. Women starting on a combination contraceptive may need to have their clozapine dose adjusted.
•    Clozapine should not be used with ritonavir.
•    Cimetidine, caffeine, citalopram, ciprofloxacin, erythromycin, and ketoconazole may increase blood levels of clozapine resulting in increased side effects. Caution should be used with combining clozapine with paroxetine, fluvoxamine, or sertraline as similar reactions may occur, although these interactions are less well-defined.
•    Clozapine may increase blood levels of digoxin, warfarin, heparin, and phenytoin.
•    Use of clozapine with phenytoin, carbamazapine, and rifampin may cause decreases in blood levels of clozapine, reducing its effectiveness.
•    The combination of lithium and clozapine may cause seizures, confusion, and NMS (see “Cautions and Warnings”).
•    Cigarette smoking may alter clozapine dosage requirements.
•    Combining selective serotonin receptor inhibitors (SSRls) with clozapine may require a lower clozapine dosage.
Food Interactions None known.
Usual Dose
Tablets
Starting dose: 25 mg in divided doses twice a day; maintenance dose    generally, 300-450 mg a day in divided doses. Dosage may be increased gradually to a daily maximum of 900 mg in divided doses if required.
Orally Disintegrating Tablets
Starting dose: 12.5 mg once or twice a day increasing to 300450 mg a day in divided doses by the end of 2 weeks. Dosage may then be increased up to 900 mg a day in divided doses if required.
Overdosage
Symptoms of overdose are delirium, drowsiness, changes in heart rhythm, unusual excitement, nervousness, restlessness, hallucinations, excessive salivation, dizziness or fainting, slow or irregular breathing, and coma, Overdose victims must be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Clozapine may cause a fever during the first few weeks of treatment. Generally, the fever is not important, but it may occasionally be necessary to stop treatment due to a persistent fever.
Regular blood tests are necessary to monitor blood composition for any changes that might be caused by clozapine.
Call your doctor at once if you develop lethargy or weakness, a flu-like infection, sore throat, feelings of ill health, fever, sweating, muscle rigidity, mental changes, irregular pulse or blood pressure, mouth ulcers, or dry mouth that lasts for more than 2 weeks.
Dry mouth, a common side effect of clozapine, may be countered by using gum, candy, ice, or a saliva substitute such as Orex or Moi-Stir.
Do not stop taking clozapine without your doctor’s knowledge and approval, because a gradual dosage reduction may be necessary to prevent side effects.
Avoid alcohol or any other nervous system depressants while taking clozapine.
Some of the side effects of clozapine    drowsiness, blurred vision, and seizures—may interfere with the performance of complex tasks like driving or operating hazardous equipment.
While taking clozapine, rapidly rising from a sitting or lying position may cause you to become dizzy or faint.
If you take clozapine twice a day and forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose as soon as you remember and another in 5 or 6 hours, then go back to your regular schedule. If you take clozapine 3 times a day and forget a dose, take it as soon as you remember. If it is almost time for your next dose, take 1 dose as soon as you remember and another in 3 or 4 hours, then go back to your regular schedule. Never take a double dose.
Orally disintegrating tablets should be left in the unopened blister until time of use. They should not be pushed through the foil. Just prior to use, peel the foil from the blister and gently remove the orally disintegrating tablet. Immediately place the tablet in the mouth, allow it to disintegrate and then swallow with saliva. No water is needed.
Special Populations
Pregnancy/Breast-feeding: This drug Should be used during PM Only if your doctor determines that it is absolutely necessary.
clozapine may pass into breast milk. Nursing mothers who must take this drug should use infant formula.
Seniors: Seniors may be more sensitive to the side effects of clozapine, such as dizziness on rapidly rising from a sitting or lying po-sition, confusion, and excitability. Older men are also more likely to have prostate problems, a reason to be cautious with clozapine. Seniors with psychosis due to dementia who take clozapine are more likely to die from heart disorders and infections than those not taking it.

Generic Name
Codeine (KOE-deep) 0
Brand Name
Only available in generic form.
The information in this profile also applies to the following drugs: Generic Ingredient: Fentanyl
Actiq Lozenge on a Stick    Fentora Buccal Tablet
Duragesic (Patch)    lonsys (Patch)
Generic Ingredient: Morphine Sulfate 10
Avinza    Oramorph SR
Kadian    RMS Suppositories
MS Contin    Roxanol MSIR
Generic Ingredient: Oxycodone Hydrochloride RE
Combunox    OxyFAST
Endocodone    OxylR
M-Oxy    Percolone
OxyContin    Roxicodone Oxydose
Generic Ingredient: Oxymorphone Opana
Type Q( UTUg  Narcotic.
Prescribed For
Mild to severe pain, breakthrough cancer pain, and cough. Long-acting narcotics are meant only for people with chronic pain. Also prescribed for pain and anxiety in pediatric burn patients.
General Information
Codeine relieves pain and suppresses cough. The pain-relieving effect of 30-60 mg of codeine is equal to approximately 650 mg, or 2 tablets, of aspirin. Codeine may be less effective than aspirin for pain associated with inflammation because aspirin reduces inflammation and codeine does not. Codeine suppresses the cough reflex but does not cure the underlying cause of the cough. Other narcotic cough suppressants are stronger pain relievers, but codeine remains the best cough medication available.
Morphine sulfate is a pure narcotic that has been in use for many years. In addition to pain relief, morphine’s effects include drowsiness, mood changes, breathing difficulty, slowed movement of the gastrointestinal tract, nausea, vomiting, and changes in the endocrine and autonomic nervous systems. Morphine sulfate liquid, immediate-release tablets, and suppositories must be taken several times a day. The medication they contain is released immediately for absorption into the bloodstream. Extended- and controlled-release morphine products are designed to release some of the narcotic right away and the rest over a 24-hour period, allowing for less-frequent dosage.
Fentanyl is a potent pain reliever that can be substituted for other narcotic drugs. The patch form, which must be replaced about every 3 days, delivers fentanyl to the bloodstream at a steady rate. The lozenge has a shorter length of action than any other narcotic pain reliever, which makes it useful when given to children before surgery because it provides doctors with the flexibility to obtain maximum benefit with minimal side effects. The lozenge on a stick is used for breakthrough cancer pain as a booster for people already taking narcotic pain relievers. These forms should only be used under controlled circumstances because of the risk of side effects or overdose. Low dosages of fentanyl relieve pain—larger amounts cause loss of consciousness and breathing difficulties.
Oxycodone is a narcotic used to control moderate to severe pain. Most people take it together with aspirin (Percodan) or acetaminophen (Percocet), but it can be used by itself. This is a potent pain reliever that carries a risk (31 addiction with continued use.
Cautions and Warnings
Do not take narcotics if you are allergic or sensitive to any of their ingredients.
Long-term use of narcotics may cause drug dependence or addiction.
Use narcotics with extreme caution if you suffer from asthma or other breathing problems.
Narcotics may make it difficult to monitor the progress of people who have suffered head injuries and acute abdominal conditions.
Actiq contains fentanyl in an amount that can be fatal to children. Keep used and unused lozenges and lozenges on a stick out of reach of children.
Possible Side Effects
♦    Most common: lightheadedness, dizziness, sleepiness, nausea, vomiting, appetite loss, and sweating. If these occur, ask your doctor about lowering your dosage. Most of these side effects disappear if you lie down.
♦    Less common: euphoria (feeling “high”), headache, agitation, uncoordinated muscle movement, minor hallucinations, disorientation and visual disturbances, dry mouth. constipation, flushing of the face, rapid heartbeat, palpitations, faintness, urinary difficulties or hesitancy, reduced sex drive or impotence, itching, rash, anemia, lowered or raised blood sugar, and yellowing of the skin or whites of the eyes. Narcotic analgesics may aggravate convulsions in those who have had them.
More serious side effects of codeine are shallow breathing or breathing difficulties.
Drug Interactions
•    Avoid combining narcotics with alcohol, sleeping medications, sedatives, other depressant drugs, or non-prescription drugs that have alcohol as an ingredient. Alcohol speeds the release of morphine from Avinza. The mixture can result in a deadly narcotic overdose.
•    Narcotic analgesics should not be used at the same time as monoamine oxidase inhibitor antidepressants. Separate usage by at least 14 days.
•    Combining a narcotic pain reliever with an anticholinergic medication may result in severe constipation.
•    Combining a narcotic pain reliever with any other medication that lowers blood pressure can lead to excessive blood-pressure lowering. Avoid this combination.
•    Combining cimetidine with a narcotic pain reliever may cause confusion, disorientation, breathing difficulties, and seizure.
•    Reserpine, rifampin, and remifentanil may decrease the pain-relieving effects of morphine.
•    Fentanyl should be used with caution with azole antifungals (e.g. ketoconazole).
Food Interactions
Codeine may be taken with food to reduce upset stomach. Morphine capsules and the fentanyl patch may be used without regard to food.
Usual Dose
Dosing of narcotic pain medications is highly individualized based on patient tolerance and response to medication.
Codeine
Adult: 15-60 mg every 4-6 hours for relief of pain; 10-20 mg every few hours as needed to suppress cough.
Child: 1 mg per lb. of body weight every 4-6 hours for relief of pain; 2.5-10 mg every 4-6 hours to suppress cough.
Fentanyl Lozenge and Lozenge on a Stick
Adult: 200-1600 mcg. Dosage may be repeated up to 4 times daily. Allow the lozenge to dissolve in your mouth. DO NOT CHEW. Child: not recommended.
Fentanyl Patch: Apply to a clean and non-irritated patch of skin as directed, usually once every 3 days.
Morphine Extended-release and Controlled-release
Tablets and Capsules
Adult: 1-3 capsules a day, depending on the specific product and individual need.
Morphine Oral Liquid and Immediate-release Tablets Adult: 5-30 mg every 4 hours.
Morphine Suppositories
Adult: 5-30 mg several times a day.
Oxycodone
Adult: 10-30 mg every 4 hours as needed. OxyContin should be swallowed whole and not broken.
Child: not recommended.
Overdosage
Symptoms include breathing difficulties or slowing of respiration, extreme tiredness progressing to stupor and then coma, pinpointed pupils, no response to pain stimulation, cold and clammy skin, slowing of heartbeat, lowering of blood pressure, convulsions, and cardiac arrest. The victim should be taken to a hospital emergency room immediately. ALWAYS bring the prescription bottle or container.
Special Information
Codeine is a respiratory depressant and affects the central nervous system (CNS), producing sleepiness, tiredness, or inability to concentrate. Be careful when driving or doing any task that requires concentration. Avoid alcohol.
Call your doctor if you develop breathing difficulties, constipation, dry mouth, or any bothersome or persistent side effect.
Apply the fentanyl patch only to non-irritated skin on a flat surface of the upper body. Hair at the application site should be clipped or cut, not shaved, before applying the patch. Do not use oils, soaps, lotions, alcohol, or anything else that might irritate the skin before applying the patch.
If you are taking a controlled-release narcotic product, do not crush, chew, or break the tablet or lozenge. Rapid release may result in a potentially fatal dose of the drug.
If you forget a dose of codeine, take it 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. Never take a double dose.
Special Populations
Pregnancy/Breast-feeding: Narcotics pass into the fetal circulation. Excessive use of them during pregnancy may cause drug dependence in newborns. Narcotics may also cause breathing difficulties in infants during delivery. Animal studies show that codeine may cause fetal harm. If given to a pregnant woman before cesarean section, fentanyl may cause drowsiness in newborns. When either of these drugs is considered crucial by your doctor, its potemt(a1 bel)elft must be carefully weighed against its risks.
Narcotics pass into breast milk. Nursing mothers who must take codeine should use infant formula.
Seniors: Seniors are more likely to be sensitive to side effects and should be treated with the smallest effective dosage.

HEADACHES AND MIGRAINES
• Take aspirin or acetaminophen for an occasional tension headache
• Don’t overuse headache medication
• Consult a doctor if headaches are frequent or severe
• Experiment with riboflavin or feverfew for natural migraine prevention
• Try acupuncture treatments to reduce migraine frequency
• Treat a migraine as early as possible
• Use Excedrin Migraine for mild migraines ****
• Ask your doctor about a W Aan for more severe
• Discuss topiramate (Topamax) with your MD if you suffer frequent migraines
• Prevent menstrual migraines with NSAIDs
• Prevent sex headaches with NSAIDs
Headaches are extraordinarily common,number seven on the list of reason-, why people see their doctor taking of wellbutrin xl and zoloft . It is estimated that 45 million people suffer from ChTonic’head pain cortico steroids negatively affect male testosterone .That doesn’t begin to include those who have occasional headaches zyprexa quick dissolve . Yet for all that, the exact causes of head pain are not all that clear hydroxyzine pamoate and faq .
According to Joel Saper, MD, director of the Michigan Head Pain and Neurological Institute, the brain itself doesn’t feel pain premarin hair loss . That’s why neurosurgeons can operate on the brain tissue while a patient is wide awake carbatrol kidney . So, a headache isn’t exactly the result of pain in the brain direction flomax taking . We perceive head pain that may originate from the scalp, the skull, or the coverings of the brain buspar wiki . Muscles and nerves in the neck can also create discomfort that is perceived as a headache buying valtrex .
An occasional mild headache does not usually pose a serious problem prilosec and bone loss . But a more severe headache, even if it occurs only once in a while, or a chronic headache, even if it is not extremely painful, deserves medical evaluation terazosin cns distribution . Popping a couple of aspirin or acetaminophen pills just isn’t a good idea when the headache occurs several times a week prevacid gastroesophageal reflux diease . In fact, Dr maxalt and high blood pressure . Saper says that using such over-the-counter (OTC) analgesics too frequently can actually cause the headaches you’re trying to treat who makes cytoxan . It takes an experienced headache doctor to help someone out of such a vicious cycle imuran and pancytopenia .
I have suffered from headaches all my life zovirax solution dosing information . For the past 30 years, I’ve taken from 25 to 35 aspirins daily, in addition to sinus medication creative and lithium batteries . My doctor doesn’t know about these large doses, but regular checkups reveal no damage to my liver or kidneys levothyroxine at night .
The trouble is that many physicians are not aware of how serious this problem can be dissolving penicillin powder . John Edmeads, MD, editorializing in the journal Headache, noted that “the daily use (or, more accurately, abuse) of analgesics actually worsened and perpetuated headaches,” He bemoaned the fact that so few physicians “know that chronic analgesic abuse causes chronic headaches natural viagra alternative review .”328
The diagnostic dilemma for doctors is that they must distinguish between headaches brought on by overuse of pain relievers, headaches caused by some other medical condition, and headaches caused by a change in brain chemistry buy wellbutrin 300 xl . If the headache is a consequence of an underlying condition like the flu, it will go away when the infection runs its course equate gas relief with infant motrin . Celiac disease is one condition that can cause recurrent headaches, among many other symptoms, although the underlying issue is actually a reaction to gluten in the small intestine side effects from ramipril tablets .The treatment is to avoid any foods that contain gluten (wheat, barley, and rye) prednisone and lysodren for do .
I suffered from migraine headaches for more than 10 years topamax side eftects . I saw several neurologists, but my intense headaches forced me to take early retirement viagra chemist nottingham .
In the fall 02002, 1 went from three headaches a week to almost nonstop compare prices nexium . That November, I had only 3 days without headaches fun facts about lithium . I took migraine meds like Frova, Maxalt, and Imitrex, but I mostly lay in bed in a dark room my doctor prescribed .3 premarin .
I was at my wit’s end fsh estradiol fertility . Then illy family doctor suggested a gluten-free diet viagra in india by mail order . Gradually my headaches became less frequent and after several months I was 98 percent headache-free buy famvir . I feel I have been given a new life!
Caffeine Withdrawal Headache
By now, many people recognize that daily use of caffeine can lead to a dependence on it zoloft stuffed animal . Stopping the caffeine—for example, by not drinking coffee on the weekends—can lead to a caffeine withdrawal headache, accompanied by irritability and fatigue plavix and diclofenac sodium contraindications . Probably the best way to deal with this type of headache in the short term is to get a little caffeine buy 200 mg generic lamotrigine . In the longer term, though, a more gradual withdrawal from coffee, soda, or caffeine-containing medications will allow a person to drop the use of the drug without the wicked headache hydrochlorothiazide and libido .
Q lamictal and weekness . 1 am a healthy person and rarely take any medicine loow priced nexium . I quit smoking 14 months ago and am trying to stop drinking coffee lithium polymer battery hyperion . Lately I’ve had trouble with fatigue and on headaches in the afternoon sarafem directons on usage . If I take Extra Strength Excedrin with a Coke on my break, the headache goes away like magic brethine licensing . Regular aspirin doesn’t work as well using hibiclens while on accutane . Why is Excedrin more effective?
A actos sales 2005 . Each Extra Strength Excedrin contains aspirin (250 mg), acetaminophen (250 mg), and 65 mg of caffeine lotrel drug interactions . That means that a standard two-caplet dose will pro-vide you with 130 mg of caffeine what is element lithium used for . Together with your cola, this probably provides as much caffeine as two mugs of coffee dangerous testosterone supplements .
It is conceivable that your afternoon slump and headaches are due to caffeine withdrawal finasteride 2 . People who customarily drink as little as 21/2 cups of coffee can experience symptoms such as lethargy, headache, and anxiety when they stop jaw necrosis actonel .
By taking a pain reliever that contains caffeine, you could be easing your withdrawal college pharmacy sublingual testosterone . An alternate solution is to try to reduce your caffeine intake gradually until you are completely weaned symptoms of prednisone overdose .
Tension Headache
Experts used to pigeonhole headaches into separate categories: tension headache, sinus headache, migraine, and so forth 18 takes viagra . While some categories may be useful, the separations between them have blurred should procardia be taken with food . Trying to tell a tension headache from a migraine is not for amateurs trileptal medication .
Although tension headaches are said to be far more common than migraines, much of the research lately has focused on migraine prevention and treatment oily skin returned accutane . How should you handle recurrent tension headaches, then?
As long as the headache does not occur more often than once a week, there is no problem with using the regular OTC headache pills or powders fsh levels decrease taking clomid .These may contain aspirin, acetaminophen, or a nonsteroidal anti-inflammatory drug (NSAID), usually ibuprofen took motrin while pregnant . All of these have been shown to ease headache pain minoxidil vs propecia . For this type of occasional use, the only reason to prefer one instead of another is based on your own experience of pain relief testimonials of zithromax healing polymyositis . If aspirin doesn’t seem to help but Tylenol does, go with the acetaminophen—and vice versa serum depakote level lab test .
Adding caffeine to the analgesic may help it work better side effects of soma . You can buy a pill that already contains caffeine, or you could take your aspirin, acetaminophen, or ibuprofen with iced tea or a cup of coffee what happens if you snort amitriptyline .
Readers have suggested a few unique approaches that might be worth consideration, though we don’t have any good evidence that they work blurred vision cymbalta . They are, at least, inexpensive and low risk and will not perpetuate headache even if someone gets carried away and uses them too often interpret ir spectra of caffeine .
People have tried applying a dab of peppermint oil to the forehead cheap depakote . Others have put Vicks VapoRub on their temples diovan hair loss . Using Vicks for a headache is strictly an “off label” use, just like so many of the other creative uses people have invented for VapoRub increasing amoxicillin dosage during . It contains menthol as one of its ingredients-, peppermint oil also contains menthol pseudoephedrine overdose symptoms . We’re not aware that menthol has special properties to help ease headaches, but it has been shown to alleviate the pain of sore muscles tadalafil generic . Perhaps it is doing something similar fora tension headache cialis western open .
I have enjoyed your columns about Vicks VapoRub fora variety of uses diflucan prescription without . Here’s one you may not have heard before clindamycin diarreah . A friend had a headache that would not go away testosterone levels in childhood . I told her to rub a dab of Vicks on her forehead prochlorperazine for migraines . She thought I was nuts, but it worked effexor success . She has been using it ever since cialis tadalafil tablets .
Some headache specialists have used relaxation training for people who suffer from chronic or recurrent headaches cymbalta use with bipolar disorder . This can help individuals who are willing to practice the technique, including teenagers who have frequent headaches at school singulair patent expiration .121
One very important point for people who suffer frequent Aspirin
Plain old generic aspirin, 650 milligrams (two tablets), will ease the pain of an occasional tension headache in most cases quitting seroquel . The danger is if the headache becomes more frequent crushed ibuprofen . Aspirin overuse increases the possibility of stomach irritation or ulcers and can also be associated with “rebound headache ibuprofen and miscarriage .” Regularly using aspirin (or acetaminophen) at least 2 days B week may increase the risk that the headache will become chronic because of the medication prozac works grat .
Side effects: Digestive tract upset, including ulcers Downside: People who are allergic to aspirin must avoid it completely itraconazole estrogenic effects .
Cost: Inexpensive, about 5 cents a dose aygestin in uterine bleeding . More if you buy a brand name misoprostol monograph .
headaches of any sort: Overusing pain relievers can actually cause chronic headache d nolvadex . This is a very difficult problem to handle alone, so a person who is using painkillers for a headache more than 2 days a week on a regular basis should get help from a headache specialist wellbutrin for adult adhd add .
Migraine Headache
Experts estimate that 28 million to 30 million Americans suffer from migraines pentoxifylline description .330 Many more migraine sufferers are women than men evista and cervical cancer . As we have pointed out, trying to distinguish between a migraine headache and some other cause of head pain is generally a job for an expert risperdal herb interactions . Usually, though, if the headache is accompanied by exceptional sensitivity to light or noise or by nausea, or if it is preceded by an aura of flashing lights or blind spots, a person should be evaluated for migraine effexor and monopoly . Other tip-offs might be pain on just one side of the head or pain that throbs, especially when you move soma holiday cd greenwheel .
We tend to think of migraines as crushingly painful can lasix hurt you . That’s not always the case response to accutane . But if it is a migraine, there are ways to treat it that should help get the pain under control, whether it is simply annoying or completely incapacitating cheap fluoxetine online order fluoxetine now .
Q tylenol and motrin interaction . 1 am 20 years old and have suffered with severe headaches for as long as I can remember wellbutrin and neurontin . Recently I asked my doctor about them, and he told me as long as / could stop them with an OTC pain medicine / shouldn’t worry about them migraine treatment natural imitrex .
/ am concerned about the frequency of the headaches and the fact that the pain is always on the left side of my head buy cheap generic prilosec . / suffer from at least one a week, usually more keflex suspension flavor . Which pain reliever is best?
A diflucan and nystatin and comparison . Please check in with a headache center alcohol and ampicillin . A one-sided headache could be a symptom of migraine premature ejaculation trazodone . If that is your problem, a prescription migraine medication might be helpful superiority of ofloxacin over ciprofloxacin .
According to Joel Saper, MD, one of the country’s leading experts on headache, using any OTC pain reliever more than 2 days a week might aggravate the problem by causing rebound headaches clomid out of system .
MIGRAINE TRIGGERS
Alcohol (including but not limited to red wine)
Aspartame (found in many “light” sugar-free foods) Caffeine withdrawal
Chocolate
MSG (monosodium glutamate, found in many processed foods, including peanuts)
Nitrates (found in processed meats like hot dogs and salami)
Tyramine (found in aged cheese, chocolate, nuts, sour cream, and yogurt)
0 0 0
If you are diagnosed with migraines, you will want to know what stimuli jump-start them so you can avoid them to the extent possible apri stock pick free high rollers . The migraine-prone brain likes to have a certain amount of routine avalide eps manchester . Disrupted sleep, dehydration, missed meals, secondhand smoke, perfume, and a number of different foods or ingredients are common triggers medication lawsuits norvasc . 33 1 Keeping a headache diary is a good way to figure out what things get your migraine going avodart diflucan . In it, you record details like meals, exercise, sleep schedule, and so forth, as well as your migraines, so you can track back for any patterns discontinue clomiphene citrate .
The validity of some of these suspected triggers has been questioned overdose and children’s motrin . The manufacturer of aspartame has produced data demonstrating that aspartame does not cause headaches doryx prescription . One double-blind study using carob candy as a placebo for chocolate found that women with recurrent migraines were no more likely to develop headaches when given chocolate than when given placebo depakote levels in children . 112 This news was greeted with relief bordering on glee in some circles luvox withdrawl symptoms .
0 * 0
Q usc estradiol study . My wife loves chocolate, but she read that it can trigger headaches panasonic lithium ion cordless wood combo . Now she won’t eat it, even on special occasions side effects with taking prednisone 10mg . I used to buy her great chocolate for Valentine’s Day and her birthday and she really enjoyed it sniffing risperdal .
I never remember her getting a headache right after eating chocolate, but she does occasionally suffer from migraines effects of caffeine on parkinson’s disease . Can you tell me why chocolate is a problem? -
A uses of sertraline . Chocolate has long been blamed for triggering headaches because it is high in tyramine which is better caduet or altace . This substance is thought to release serotonin and make blood vessels contract and expand clozapine and weight gain . But research shows that most headache sufferers may not be susceptible to chocolate atacand hct tablet .
In a carefully designed study, 63 female headache sufferers were given either carob or chocolate bars (both mint flavored to disguise the obvious difference) penicillin alchohol . There was no significant association of headaches with chocolate bar consumption metformin hdl .
Your wife might perform her own experiment to see if she really is sensitive to chocolate doxazosin 6mg . She may be depriving herself needlessly generic versions of zocor .
0 0 0
Some scientists doubt that cheese, chocolate, and nuts are actually migraine triggers was is nortriptyline used for . Even if they are not migraine triggers for most people, some individuals may react to aspartame, chocolate, cheese, or any of a number of other foods hypertension and drugs and accupril .
Have you ever heard of sipping beer to stop a migraine? I went to a doctor in a little town in Louisiana, and he asked if I get an aura carmen allegra md . Before my head starts to hurt, my vision changes and I see little blinky lights levitra in women .
The doctor said / should drink a can of beer (not wine or liquor) as soon as I start to see the lights exelon web mail . Over the last 20 years, this remedy has worked almost every time bactrim prostate specific . / thought some other migraine sufferers would like to know fenofibrate 10 mg .
The 10 predict what foods will trigger a migraine for one person or be helpful for another caffeine and gluten-free diet . Beer is thought to cause headaches for some people warfarin in bulk . But we heard from one woman that if she drank a beer at the very first sign of trouble, the headache never materialized buying generic viagra . She even traveled with an emergency can for medicinal purpose-, The headache diary we mentioned will help you sort out what foods create problems for you depakote er effects on learning .
I have suffered with migraines all my life, but in the Iasi few years they got worse zanaflex snort . My medicine stopped working and I had headaches
every day buy caffeine free dr pepper .
I was desperate, so when someone suggested I see an allergist
did ibm thinkpad x lithium battery . I discovered I am allergic to a lot of foods I ate every day, includ-
ing coffee, wheat, rice, oats, eggs, and tomatoes dr robert bae in lithium .
Now that I have changed my diet, my head is much better seroquel recreational . Some
recurrent migraines warrant seeing an allergist doxycycline stomach pain .
Natural Remedies
The real action in migraine treatment is with the “triptan” prescription drugs that have been developed over the past decade coming off of cymbalta . There is also an interesting advance in a prescription drug to be taken preventatively by those who suffer chronic migraines zoloft and ginseng . But some herbal remedies and dietary supplements have shown promise in preventing migraines, too simvastatin teva side effects .
RIBOFLAVIN
I’ve had migraines for many years atarax 10 ml . I think I’ve taken every migraine drug on the market and even ended up in the emergency room a few times quinapril 0.5 mg .
I was finally sent to a neurologist who told me to take vitamin B complex (B-100) comprar el viagra gen rico .1 can honestly say I have not had a migraine headache in 2 years vytorin lawsuit north carolina . I couldn’t believe after so much time taking drugs that all I needed to do, was take a vitamin ibuprofen and water retention .
Riboflavin, a B vitamin (B), has been reported to help prevent migraine recurrences the mefloquine antiparasitic . One study found that 400 milligrams of riboflavin per day was able to reduce headache frequency markedly, from 4 days a month to 2 days a month synthroid drip .333 This is a very high dose, however lithium battery aa . Another study compared a product that combined 400 milligrams of riboflavin with 300 milligrams of magnesium and 100 milligrams of feverfew extract to a “placebo” of 25 milligrams 01 Tibofiavin lisinopril bactrim harmful interaction .31The researchers found no difference between the placebo and the combination product dexamethasone acoustic trauma . Nevertheless, the scientists weren’t disappointed because both groups had fewer migraines and less overall discomfort than they had had before starting the study naproxen risks .The investigators hypothesized that 25 milligrams of riboflavin might have been enough to help reduce migraines, which would have explained the lack of difference between the placebo and the tested preparation allegra-d dissolve .
Q valsartan hctz . I’ve read that riboflavin, feverfew, and magnesium can help prevent migraines pravachol effects sex drive . But finding all these things and taking multiple products can be difficult seroquel drug information . All three are contained in an OTC product called MigreLief prednisolone weight gain .
I am a 31-year-old female who has suffered from migraines for many years pharmacy glucophage . Two or three migraines a week really interfered with my life clemastine and betamethasone . I would make plans and then at the last minute I would have to cancel due to another migraine soma sujanani .
This was an ongoing problem what is celebrex for depression . Even after numerous doctor visits and many prescription medicines, I never got relief celexa ocd .
When I decided to try MigreLief as a more natural approach, I had fewer headaches within a month cipro side effecs . In a couple of months my migraines disappeared almost completely eye bleeding coumadin .
A metformin avandia . Thank you for bringing this product to our attention prednisone porstate cancer . The manufacturer, Quantum, points out that MigreLief is intended only for headache prevention and not for immediate pain relief the side effects for lexapro . We have not seen a placebo-controlled trial of this combination product, although there is some research to support the use of each of the ingredients for migraine prevention indian cialis .

Egg-Free Diets
Tempura-style vegetables
There is nothing quite like an egg, especially when it comes to baking. Egg protein is the magical

ingredient that holds together a pancake, and creates the light and delicate structure of sponge cakes,

batter, souffles, mousses and meringues.
Unfortunately, egg protein is also a potent allergen for some people, and a source of intolerance

reactions for others.
Egg replacers, designed mainly for cake making, are one answer. They can be purchased from specialist

suppliers (see p. 255) or ordered via your local health-food shop. These are protein-rich mixes which

aim to simulate the structural properties of eggs, not the flavour. Recipes are usually supplied with

the replacer, and it is best to follow these recipes at first, for guaranteed results. Once you have

got the feel of using the egg replacer, you can experiment with substituting it for eggs in other cake

recipes.
Note that these egg replacers make no attempt to simulate the richness and characteristic taste of

eggs. You may need to add extra butter or other fats to your cake mix if using egg replacers. Vanilla

extract can also improve the flavour of an egg-free cake.
Can cooking make eggs safe?
Cooking changes proteins, as eggs illustrate vividly. When a hot oven turns liquid egg white into a

hard meringue, or a sloppy cake mix into a firm sponge, the visible effect is due to the egg protein

being fundamentally changed.
Heating changes the basic molecular structure of the egg protein, in a process called denaturing.

Whereas natural egg protein is liquid, denatured egg protein is solid.
Denaturing egg protein has subtle effects, as well as these obvious ones. When the structure of the

molecule changes, some of the epitopes (the key features recognised by allergy antibodies — see box on

p. 15) are obliterated. For a few allergy sufferers — those who react only to the epitopes affected by

denaturing — thorough heating can therefore turn the egg allergen into a harmless substance.
If eggs are hard-boiled, the denaturing process occurs to the fullest possible extent. Consequently,

some people with egg allergy can eat hard-boiled eggs without ill-effects. However, the same people

still react badly to lightly cooked eggs, such as those in a souffle or omelette because, with partial

cooking, the denaturing process is incomplete.
Cakes made with eggs pose an interesting question — given that the cooking process for cakes is

prolonged and at a high temperature, could they too be safe? This is something that allergists have not

so far investigated.
If you want to test your response to hard-boiled eggs, you must do so under full medical supervision

with resuscitation equipment available. Those who find that they can tolerate hard-boiled eggs might

then want to test their reaction to cakes made with eggs. Again, there must be medical supervision for

the test, in case of severe life-threatening reactions. You will, of course, have to convince your

allergist that such a test is worthwhile.
Egg protein is not unique in being susceptible to denaturing — most proteins can be denatured, some by

heat, some by other means. But only in a few cases (tuna fish, and fresh fruits and vegetables — see p.

110) does denaturing tend to destroy the allergenic epitopes.
Very rarely, changing the structure of a protein by cooking may actually create an allergenic epitope

where none exists in the raw protein. There have been cases of individuals with an allergy to cooked

fish but not raw fish, and to pecan nuts in
biscuits but not uncooked pecans. Roasting peanuts makes them much more allergenic.
Tempura-style vegetables
Beer is a good alternative to eggs for making a batter and gives this Japanese batter a wonderfully

light crisp texture. Have all the vegetables ready prepared so you can cook and eat the tempura as

quickly as possible.
PREPARATION TIME: about 45 minutes MAKES: 4-6 servings
400-500g (14oz-11b 2oz) prepared vegetables cut into bite-sized pieces -choose from red pepper,

asparagus, broccoli, spring onion or red onion, carrot, courgette, baby corn, button mushrooms,

aubergine
150g (5/oz) self-raising flour, sieved,
plus extra for coating vegetables
1 tsp salt
2 tbsp sesame seeds
250ml (9fl oz) lager or Japanese beer vegetable oil for deep-frying
To serve:
equal quantities soy sauce and dry sherry
mixed together, or sweet chilli sauce
Toss the prepared vegetables in flour until lightly coated then shake off the excess. Heat the oil in a

large saucepan over medium heat until a cube of bread dropped in turns brown in 30 seconds.
Mix the measured flour, salt and sesame seeds and quickly stir in the beer - don’t worry if the mixture

is slightly lumpy. Dip the vegetables in the batter, a few pieces at a time, and then immediately into

the hot oil. Cook until crisp and golden.
Drain on kitchen paper and keep warm in a hot oven. Continue in the same way until all the vegetables

are cooked.
Serve with a dipping sauce made of soy sauce and dry sherry, or dip in sweet chilli sauce.
Caramelised onion tart
Caramelised onion tart
This makes a good substitute for quiche and other egg-based flans. The long, slow cooking of the onions

is important to bring out their natural sweetness.
PREPARATION TIME: 45 minutes COOKING TIME: 30 minutes MAKES: 6-8 servings
1 k (21b 4oz) onions, halved then thinly sliced
4 tbsp olive oil
125g (41/2oz) streaky bacon, finely chopped
1 tsp caraway seeds
salt and freshly ground black pepper 350g (1 2oz) bread dough or puff pastry
Place the onions in a very large saucepan with the oil, bacon and caraway seeds and cook over medium

heat, stirring occasionally, for about 30 minutes until the onions are softened and lightly

caramelised. Season generously.
Roll out the dough thinly and use to line a deep 24cm (91/2in) fluted flan tin. Prick the base with a

fork then fill with the onion mixture. Cook on a baking sheet in a preheated oven at 230°C/450°F/gas

mark 8 for 30 minutes until the dough or pastry is crisp and golden.
Feta in a crisp polenta jacket
Variations: replace the bacon with 125-1758 (41/2-6oz) crumbled goat’s cheese or 125-175g (4/,2-6oz)

diced smoked tofu, for a vegetarian version; or add a handful of pitted olives.
Feta in a crisp polenta jacket
The oil must be really hot to ensure a crisp crust for these delicious cheese croquettes.
PREPARATION TIME: 15 minutes MAKES: 4 servings
vegetable oil
200g (7oz) feta cheese, cut in 8 fingers 40g (I Y2oz) cornmeal
To serve:
salad of your choice, e.g. tomato, cucumber, red onion and flat-leaf parsley, or skinned and charred

red peppers with rocket
Pour the oil into a saucepan and set over a high heat. Meanwhile, dip the cheese fingers in Iced water

for about 1 minute then roll in the cornmeal until evenly coated. Deep-fry for 1-2 minutes until crisp

and golden. Drain on kitchen paper and serve at once on top of the salad.
Egg-free pancakes
Tofu filling for a savoury flan
This very simple savoury flan filling makes an egg-free, milk-free substitute for quiche. This recipe

makes enough filling for a 20cm (Bin) pastry case.
PREPARATION TIME: 5 minutes COOKING TIME: about 25 minutes
250g (9oz) tofu, natural or smoked 1 tbsp wine vinegar or lemon juice 1 tbsp dried mixed herbs
200ml (7fi oz) soya milk
Combine all the ingredients in a blender and pour into a pre-baked flan case. Cook in a preheated oven

at 190′C/375′F/gas mark 5 for about 25 minutes until set.
Variations., add either sauteed chopped onion; chopped cooked ham with spring onion; roasted

vegetables, such as carrot, peppers and tomatoes; or cooked spinach, beetroot or broccoli.
Tofu mayonnaise
This mayonnaise can be flavoured with chopped herbs, roasted garlic puree or tomato puree. It will

keep, covered, in the fridge for 3-4 days.
PREPARATION TIME: 5 minutes MAKES: approx. 250ml (9fl oz)
Lemon cake
100g (3%oz) soft tofu
100g (3%zoz) Greek yoghurt
1 tsp English mustard
1 tbsp Dijon or wholegrain mustard
iced water
salt and pepper
Blend all the ingredients except the water, salt and pepper in a liquidiser. Season to taste and thin

as required with iced water.
Avocado dressing
This dressing is delicious with tomato salads, prawns or grilled steak. Keep it tightly covered

otherwise it will discolour quickly.
PREPARATION TIME: 5 minutes MAKES: approx. 250ml (9fl oz)
1 medium-sized ripe avocado
4 tbsp vegetable oil
2 tbsp white wine vinegar or lemon or lime juice
iced water
salt and pepper
Halve, stone, peel and chop the avocado and blend in a liquidiser with all the remaining ingredients

except the water, salt and pepper until smooth. Season to taste and thin as required with iced water.
Egg-free pancakes
These pancakes can be served with either savoury or sweet fillings.
PREPARATION TIME: 25 minutes MAKES: 10
100g (3V2oz) plain flour
2 tbsp arrowroot powder
300ml (V2 pint) milk
vegetable oil or melted butter for frying
To serve:
golden syrup, jam or lemon juice and caster sugar
Mix the flour and arrowroot, then stir in the milk to give a smooth batter. Leave to rest, ideally for

20 minutes.
Heat 1 tsp oil in an 18cm (7in) nonstick frying pan and pour in 2-3 tbsp batter, enough to just cover

the base of the pan, swirling it as it falls into the pan to give a thin layer. Cook until golden on

one side then carefully turn and cook the other side. Repeat until all the batter is used up. To ensure

a crisp result every time, make sure the fat is hot.
For a sweet pancake, serve with golden syrup, jam, or lemon juice and caster sugar.
For savoury pancakes, fill with a white sauce flavoured with smoked fish and prawns, or ham and

parsley, or ratatouille and cheese.
Raspberry and sherry syllabub trifle
Syllabub makes an unusual topping for this trifle with its egg-free shortbread base, but if you prefer,

make a custard with custard powder and top with whipped cream. Vary the fruit with the seasons -

poached pears, fresh orange, and cooked cranberries are all suitable.
PREPARATION TIME: 15 minutes MAKES: 6-8 servings
I 75g (6oz) butter shortbread
6 tbsp medium or sweet sherry
225g (8oz) fresh or frozen raspberries 284ml carton whipping cream
50g (13/4oz) caster sugar
To serve:
25g (1oz) toasted flaked almonds
Roughly break the shortbread and put in the bottom of a trifle bowl or any decorative serving bowl.

Sprinkle with 2 tbsp sherry then top with the raspberries. Whip the cream and sugar with the remaining

sherry until it holds its shape, then pile on top of the raspberries. Chill until required, then, just

before serving, sprinkle the top with flaked almonds.
Lemon cake
This cake has a tangy lemon flavour and a slightly dense texture. Serve it plain or with fresh berries

and whipped cream or creme fraiche. Try replacing the lemon with orange.
PREPARATION TIME: 15 minutes
COOKING TIME: about 1 hour
MAKES: 1 x 19-20cm (71/2-8in) cake
100g (3112oz) butter, melted
200g (7oz) caster sugar
250g (9oz) self-raising flour, sieved 1 tbsp baking powder
250g (9oz) natural yoghurt
finely grated zest and juice of 1 small unwaxed lemon
1-2 tbsp milk (optional)
To serve:
icing sugar
Butter a 19-20cm (71/2-8in) spring-release tin and line the base with greaseproof paper. Place all the

ingredients in a large bowl and beat well to a firm dropping consistency. You may need to add 1-2 tbsp

milk, depending on the type of yoghurt you have used. Transfer to the prepared tin, level the surface

then bake in a pre-
heated oven at 180′C/350′F/gas mark 4 for 50-60 minutes until risen and just firm to the touch. Cool in

the tin for about 30 minutes, then transfer to a cooling rack until completely cold. Dust with icing

sugar.
Fig, orange and pear shortcake
PREPARATION TIME: 20 minutes COOKING TIME: 45 minutes MAKES: 8-10 servings
250g (9oz) chopped dried figs
finely grated zest and juice of 1 medium
unwaxed orange 1 ripe pear, chopped
250g (9oz) plain flour, sieved
1758 (6oz) butter
100g (3112oz) light muscovado or soft brown sugar
1 tsp ground cinnamon To serve:
icing sugar (optional)
Place the figs, orange zest and juice and the chopped pear in a saucepan and cook over medium heat

until the figs and pear are soft and all the juice has been absorbed. Place the flour, butter, sugar

and cinnamon in a food processor and blend. Alternatively, rub in by hand until the mixture resembles

fine crumbs. Add 1 tbsp cold water and stir until the mixture forms rough lumps. Press half the cake

mixture onto the oiled base of a 19cm (71/2in) spring-release tin. Spread the fruit mixture on top,

then finish with the remaining cake mixture, pressing it down lightly.
Cook in a preheated oven at 180°C/350°F/gas mark 4 for 45 minutes. Cool in the tin. Dust with icing

sugar, if wished, and serve in wedges.
Variations: replace the figs and pear with dried apricots and an apple; or replace the figs with

prunes, dried pineapple or dried mango.
Date and walnut loaf
Dates give this egg-free cake a wonderfully moist texture that is even better after a day or two. Store

in a cool place in an airtight container.
PREPARATION TIME: 15 minutes COOKING TIME: about 45 minutes MAKES: 1 large loaf
250g (9oz) chopped dried dates
100g (3′12oz) light muscovado or soft
brown sugar 25g (1 oz) butter
2 tsp ground mixed spice
1 tsp bicarbonate of soda
275g (93/4oz) self-raising flour, sieved
1008 (3′12 oz) walnut pieces
To serve:
butter (optional)
Place the dates in a large bowl with the sugar, butter, spice and bicarbonate of soda. Mix well, then

pour on 250ml (9fl oz) boiling water. Leave to cool slightly then beat in the flour followed by the

walnuts. Transfer the mixture to an oiled and base-lined 900g (21b) loaf tin. Level the surface and

cook in a preheated oven at 180°C/350°F/gas mark 4 for about 45 minutes, until risen and just firm to

the touch.
Cool in the tin for about 30 minutes, then transfer to a wire rack to cool completely. Serve in slices,

with or without butter.

Allergies and Pregnancy
Great care is taken in prescribing drugs during pregnancy. This is something that doctors are now exceedingly cautious about, but do tell the doctor as soon as you decide to try for a baby. The foetus is most vulnerable to damage by drugs during the first three months, and especially the first few weeks after conception.
Your prescription will be changed if the drugs you are currently taking could pose any threat to the unborn child. A drug that has not had sufficiently rigorous testing for safety during pregnancy, or lacks a long track record, will probably be withdrawn. New drugs are generally considered to be slightly more risky than the tried-and-true older drugs: rare side effects may not come to light during the testing which precedes release of a drug, but they do become apparent once the drug is in widespread use for a long time (see pp. 136-7).
If you are already pregnant as you read this, don’t worry too much. With a few notable exceptions – certain antihistamines and antibiotics – most of the drugs used for allergic diseases do not pose any major risk to the unborn child. There is probably nothing to worry about, but see your doctor as soon as you can – and talk to a pharmacist, in the meantime, if you are concerned. Don’t panic, and don’t stop taking your drugs unless you are absolutely sure that you can do without them. Do not stop taking your drugs if you have asthma.
Some non-prescription medicines are best avoided during pregnancy. Read the packet carefully, and talk to your pharmacist if you have any doubts.
From the moment you start trying for a baby, remember to tell any medical personnel who treat you, and any pharmacist you buy medicines from, that you could be pregnant.
Immunotherapy and skin testing
Immunotherapy should not begin during pregnancy, because of the risk of anaphylaxis (see below), but pregnant women who are already undergoing immunotherapy can continue.
The safety procedures described on p. 166-7 should be followed with meticulous care.
Most doctors continue immunotherapy at a steady ‘maintenance dose’ because there is always a small risk of anaphylaxis with immunotherapy when the dose is increased. Some doctors are even more cautious and reduce the maintenance dose during pregnancy, but give more frequent injections – this minimises the chance of bad reactions.
Many doctors do not give skin tests for allergy during pregnancy, as these also carry a very small risk of anaphylaxis. If you do have skin tests, there must be resuscitation equipment available. Intradermal tests (see p. 92) are best avoided.
Severe allergic reactions (anaphylaxis)
Special care should be taken to avoid anaphylaxis during pregnancy as this may increase the chance of a miscarriage.
Injecting adrenaline during the first three months of pregnancy may carry some small risk of malformation of the baby. But the evidence here is uncertain, whereas the danger to your own life, if you don’t use adrenaline when you need it, is both certain and substantial. If you have an adrenaline self-injection kit, talk to your doctor now about what you should do in an emergency. The best policy is to be ultra-careful about avoiding your allergen, so that anaphylaxis does not happen.
Women who suffer from exercise-induced anaphylaxis (see p. 59) generally play safe by exercising less strenuously while pregnant. The problem can get worse during pregnancy, but it does not usually do so. Labour itself is very strenuous of course, but problems during the birth are uncommon. If anaphylaxis does occur, the reaction is usually quite mild – nettle rash only – and the baby is delivered alive and well. However, many women find that the attacks of exercise-induced anaphylaxis are more frequent and severe when they start exercising again after the baby is born. It is best to resume exercise very gradually.
Eczema and other skin problems
Atopic eczema may improve during pregnancy, probably because the body produces slightly more of its own natural steroid, hydrocortisone. Contact dermatitis may either improve or flare up.
Stretch marks often itch a great deal, and widespread itchy skin, with or without a rash, is a common problem during pregnancy. These are not usually allergic reactions, and no cause can be identified in most cases. The skin tends to recover a few days after the birth.
If there is itching in the vulva) area, this could be due to a Candida infection (your doctor can prescribe a safe treatment) or it might be just another of those unexplained itches of pregnancy.
Hayfever and other nasal allergies
The natural hormone changes of pregnancy affect the nose, which can become more blocked. If you have allergic rhinitis this will add to your woes. See your doctor and make sure that your drug treatment is adequate (see p. 29). The nose-clearing exercises on pp. 230-31 might also help.
Asthma
Severe asthma can be bad for both the pregnant mother and the unborn child. Uncontrolled asthma increases the risk of the baby being born prematurely – and premature babies are more likely to develop asthma themselves. The death rate for newborn babies is also higher if the mother has poorly controlled asthma.
Treating a severe asthma attack promptly helps to prevent any damage to the baby, so don’t hesitate to call an ambulance –and tell the operator you are pregnant. The ambulance should be carrying oxygen which is particularly important for helping the unborn baby through the attack.
If you have asthma, don’t stop using your drugs or reduce the dose unless advised to do so by a doctor. Because it is so important to keep asthma under control during pregnancy, your doctor may want to add, or increase, preventer drugs such as inhaled corticosteroids or sodium cromoglycate (see p. 148). It
also makes sense to monitor your peak flow twice a day (see p. 97) so that you have advance warning of serious attacks.
Unfortunately, some asthmatics – usually those who have severe asthma to begin with – get much worse during their pregnancy. In such cases, careful monitoring and increased use of preventer medicines are essential. The symptoms usually increase from week 24 to week 36 of the pregnancy. The last four weeks tend to be much better, and things are back to normal by about three months after the birth.
Some women with asthma have fewer symptoms while they are pregnant, and for others their asthma stays about the same.
Asthma can also appear for the first time during pregnancy, and may be quite severe. However, a relatively mild breathlessness can be due simply to the fact that, as the pregnancy advances, the chest cavity, and therefore the lungs, become compressed. This is not necessarily asthma.
This simple physical effect can also add to the difficulties experienced by women who were already asthmatic before they became pregnant.
GER (acid reflux) – see p. 38 – can contribute to asthma during pregnancy, and treating this problem may help.
Asthma attacks during the birth
Severe asthma attacks very rarely occur during labour, but it is still important that all the medical staff in attendance know you have asthma. They should also be told if you have taken steroid tablets during the previous two years. A record of when you took steroids, how long for, and at what dose, will be valuable. You may need a low dose of steroid to get you through the physical stress of labour (see p. 142). Some doctors believe that patients who have been using high-dose inhaled steroids should be treated in the same way.
Smoking
Smoking is a bad idea if you have allergies or any allergic tendency in the family. Smoking is a very bad idea indeed if you are pregnant, or a parent. This is the moment, if ever there was one, to give up.
Enlist your doctor’s help, and ask if counselling, psychotherapy or other forms of support are available. If you have tried all this before, and failed, then talk to your doctor about the possibility of using nicotine patches. Some doctors believe that, for pregnant women who smoke 20 cigarettes or more a day, the advantages of nicotine patches outweigh the risks to the foetus. Nicotine levels in the blood are lower with patches than with heavy smoking, and your baby is not enduring the hundreds of other toxins found in cigarette smoke.