Posted by ed_uk on May 3, 2006, at 10:33:59
In reply to Re: Went to pdoc today ... what do you think? » ed_uk, posted by yxibow on May 3, 2006, at 1:00:23
Hi J
>Sudafed is not very effective for some but its better than Sudafed PE.
OK, but neither med is particularly useful. Pseudoephedrine is minimally effective as best. Other, more effective treatments are available for allergic rhinitis. If you have a cold, buy some tissues and drink some hot lemon :) The cold will go away on its own. Medication is not required!
>True, for severe depression, I agree that an MAOI can be useful, but its a last resort, at the level of ECT
MAOIs should be tried before ECT in all severely depressed patients who are able to understand the restrictions, assuming that they have no contra-indications. Don't forgot Jay, that ECT involves the application of a large electric shock to the head.....repeatedly. When used carefully, MAOIs are relatively safe. The only time things start to go wrong is when patients are not properly informed RE the diet and drug interactions etc.
http://www.thymatron.com/main_home.asp
>The thought of a medication in your body that could cause hypertensive crisis.....
Right, so don't take the meds which interact. Ensure that all care-providers understand that you are taking an MAOI and that drug interactions may occur. Although MAOIs have some very major drug interactions (eg. with SSRIs), many of the alleged drug interactions do not exist. MAOIs do not, for example, interact with the epinephrine used in local anesthetic mixtures in dentistry.
>You just don't start there
No, you can try several other meds first. Patients should not, however, be forced to try every other drug in existence before being prescribed an MAOI. Nardil and Parnate are too effective to be ignored.
>we don't have the luxury any more unlike you in England of going into a pharmacy and getting codeine for a bad cough. The last time that was available was in the late 60s in some of the states here. So DXM is all there is, to be able to get into work and function at half capacity.
Dextromethorphan is minimally effective. In most people it is probably completely ineffective, it is highly unlikely to help you get to work. Dextromethorphan is not an especially valuable medication. Severe coughs due to bacterial pneumonia require antibiotics. Cough suppressants like dextromethorphan should not be used in pneumonia. Mild coughs not associated with pnemonia do not benefit from antibiotics - medication is not required. The cough will go away on its own. Back to the hot lemon......
OTC codeine is rarely used in the UK. Not a great loss. Low doses of codeine are relatively ineffective as a cough supressant. As is the case with dextromethorphan, codeine must not be used in patients with pneumonia. Mild coughs are best left untreated. They don't normally last long anyway.
Ed
poster:ed_uk
thread:639045
URL: http://www.dr-bob.org/babble/20060429/msgs/639578.html