Author: Manasvi Specialists

Be Breast Aware

Be Breast Aware

OBG

Be Breast Aware

be-breast-aware

What is breast awareness?

Breast awareness is a part of general body awareness. It is a process of getting to know your own breasts and becoming familiar with their appearance. Learning how your breasts feel at different times will help you to know what is normal for you.

You can become familiar with your own breast tissue by looking and feeling- in any way that is best for you (e.g. in the bath, shower, when dressing).

Being breast aware and knowing what is normal for you will help you to be aware of any changes from normal, should these happen.

The normal breast.

Before the menopause normal breasts feel different at different times of the month. The milk- producing tissue in the breast becomes active in the days before a period starts. In some women, the breast at this time feels tender and lumpy, especially near the armpits.

After a hysterectomy the breasts usually show the same monthly differences until the time when your periods would have stopped.

After the menopause activity in the milk- producing tissue stops. Normal breasts feel soft, less firm and not lumpy.

Changes to look out for.

Appearance. Any change in the outline or shape of the breast, especially those caused by arm movements, or by lifting the breasts. Any puckering or dimpling of the skin.

Feelings.  Discomfort or pain in one breast that is different from normal, particularly if new and persistent.

Lumps.  Any lumps, thickening or bumpy areas in one breast or armpit which seem to be different from the same part of the other breast and armpit. This is very important if new.

Nipple change. Nipple discharge, new for you and not milky. Bleeding or moist reddish areas which don’t heal easily. Any change in nipple position- pulled in or pointing differently. A nipple rash on or around the nipple.

What to do if you find a change.

There can be many reasons for changes in the breast. Most of them are harmless but all of them need to be checked as there is a small change they could be the first sign of cancer.

If you see any change in your breast from what is normal for you, tell your doctor without delay. Remember, you are not wasting anyone’s time. If there is a cancer present, the sooner it is reported, the more simple treatment is likely to be. This offers greater prospects of benefit in terms of quality of life.

Breast cancer is very rare in women under the age of 40. The likelihood of developing breast cancer increases with age.

Breast screening.

If you are aged 50 and over it is strongly recommended three- yearly mammography, this is an X- ray procedure which can detect breast changes at a very early stage. 

Routine X- ray breast screening is not available for women under 50 as it has not been shown to be of benefit. If you have any cause for concern about your breasts tell your doctor.

Breast awareness five- point code.

  1. Know what is normal for you.
  2. Look and feel.
  3. Know what changes to look for.
  4. Report any changes without delay.
  5. Attend for breast screening if aged 50 or over.

Medical Specialists

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Disulfiram

Disulfiram

Psychiatry

Disulfiram

PATIENT INFORMATION ON DISULFIRAM

Use

Disulfiram is primarily used as a deterrent to alcohol use/abuse.

How quickly will the drug start working?

Disulfiram inhibits the breakdown of alcohol in the body, resulting in a build-up of a chemical called acetaldehyde; this results in an unpleasant reaction when alcohol is consumed. This reaction can occur 10-20 minutes after drinking alcohol and may last up to 2 hours.

The reaction consists of: flushing, choking, nausea, vomiting, increased heart rate and decreased blood pressure (dizziness). At times the reaction could be fatal.

How long should you take this medication?

Disulfiram is usually prescribed for a set period of time to help the individual stop the use of alcohol. Do not decrease or increase the dose without discussing this with the doctor.

Side effects

Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. They may sometimes occur before beneficial effects of the medication are noticed . If a side effect continues, speak to your doctor about appropriate treatment.

Common side effects that should be reported to your doctor at the next appointment include:

  • Drowsiness, lethargy, depression-This problem goes away with time. Use of other drugs that make you drowsy will worsen the problem. Avoid driving a car or operating machinery if drowsiness persists.
  • Energizing/ agitated feeling-Some individuals may feel nervous or have difficulty sleeping for a few days after starting this medication.
  • Headache-Temporary use of analgesics (e.g., acetaminophen, ASA).
  • Skin rash- Contact your doctor.
  • Garlic-like taste

Rare side effects you should report to your doctor IMMEDIATELY include:

  • Yellow tinge in the eyes or to the skin; dark-colored urine
  • Soreness of the mouth, gums, or throat
  • Skin rash or itching, swelling of the face
  • Nausea, vomiting, loss of appetite, lethargy, weakness, fever, or flu- like symptoms

What should you do if you forget to take a dose of your medication?

If you take your total dose of the drug in the morning and you forget to take it for more than 6 hours, skip the missed dose and continue with your schedule the next day. DO NOT DOUBLE THE DOSE.

Interactions with other medication

Because disulfiram can change the effect of other medication, or may be affected by other medication, always check with your doctor or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies. Always inform any doctor or dentist that you see that you are taking this medication.

Precautions

  1. Do not increase or decrease your without consulting your do
  2. Report to your doctor any changes in sleeping or eating habits or changes in mood or behavior.
  3. Avoid all products (food and drugs) containing alcohol, including tonics, cough syrups, mouth washes and alcohol-based sauces. A delay in the reaction may be as long as 24 hours.
  4. Exposure to alcohol-containing rubs or solvents (e.g., after-shave) may trigger a reaction.
  5. Carry an identification card stating the name of the drug you are taking.
  6. Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children.

If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse

Medical Specialists

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Carbamazepine

Carbamazepine

Psychiatry

Carbamazepine

PATIENT INFORMATION ON CARBAMAZEPINE

Carbamazepine is classified as a mood stabilizer and anticonvulsant agent.

Uses

Carbamazepine is used primarily in the treatment of acute mania and in the long-term control prophylaxis of Manic Depressive Illness (Bipolar Disorder). 

It is also used in the treatment of seizure disorders as well as certain pain syndromes ( e. g., trigeminal neuralgia).

Though not approved for these indications, carbamazepine has also been found to be useful in the treatment of withdrawal reactions from alcohol or sedative/hypnotics, and in behavior disturbances, such as chronic aggression or impulsivity.

How does the doctor decide what dose (how many milligrams) to prescribe?

The dose of carbamazepine is different for every patient and is based on how much carbamazepine is in the blood, as well as the response to treatment. The doctor will measure the drug level in the blood on a regular basis during the first few months. The carbamazepine level that is usually found to be effective for most patients is between 17 and 50 micro mol/L (4-12 microgm/ml).

You may initially take your medication several times a day (2 or 3); after several weeks, the doctor may decide to prescribe the drug once daily.

On the morning of your blood test, take the morning dose of carbamazepine after the test to avoid inaccurate results.

How quickly will the drug start working?

Control of manic symptoms may require up to 14 days of treatment. Because carbamazepine takes time to work , do not decrease or increase the dose or stop the medication without discussing this with your doctor. Improvement in seizures, pain symptoms, as well as aggression/impulsivity also occur gradually.

How long should you take this medication?

Following the first episode of mania it is recommended that carbamazepine be continued for a minimum of one year; this decreases the chance of being ill again. The doctor may then decrease the drug slowly and monitor for any symptoms; if none occur, the drug can gradually be stopped. For individuals who have had several episodes of mania or depression, carbamazepine should be continued indefinitely. Long-term treatment is generally recommended for recurring depression , seizure disorder and aggression/impulsivity.

Side effects

Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. They may sometimes occur before beneficial effects of the medications are noticed. If a side effect continues, speak to your doctor about appropriate treatment. 

Common side effects that should be reported to your doctor at the next appointment include:

  • Drowsiness and lethargy, difficulty concentrating-This problem goes away with time. Use of other drugs that make you drowsy will worsen the problem. Avoid driving a car or operating machinery if drowsiness persists.
  • Dizziness-Get up from a lying or sitting position slowly; dangle your legs over the edge of the bed for a few minutes before getting up. Sit or lie down if dizziness persists or if you feel faint-then call the doctor.
  • Ataxia or unsteadiness-Discuss this with your doctor as this may require an adjustment in your dosage.
  • Blurred vision-This usually occurs at the start of treatment and tends to be temporary. Reading under a bright light or at a distance may help; a magnifying glass can be of temporary use. If the problem continues, advise your doctor.
  • Dry mouth-Sour candy and sugarless gum help increase saliva in your mouth; try to avoid sweet, calorie-laden beverages. Drink water and brush your teeth regularly.
  • Nausea or heartburn-If this happens , take the medication with food . If vomiting or diarrhea occur and persist for more than 24 hours, call your doctor.
  • Muscle tremor-Speak to your doctor as this may require an adjustment in your dosage.
  • Changes in sex drive or sexual performance-Discuss this with your doctor.
  • Weight changes-Monitor your food intake; avoid foods with high fat content (e. g., cakes and pastry).

Rare side effects you should report to your doctor IMMEDIATELY include:

  • Soreness of the mouth, gums, or throat, mouth lesions
  • Skin rash or itching, swelling of the face
  • Nausea, vomiting, loss of appetite, lethargy, weakness, fever, or flu-like symptom
  • Easy bruising, bleeding, appearance of splotchy purplish darkening of the skin
  • Confusion or disorientation

Let your doctor know as soon as possible if you miss your period or suspect you may bepregnant.

What should you do if you forget to take a dose of your medication?

If you take your total dose of carbamazepine in the morning and you forget to take it for more than 6 hours, skip the missed dose and continue with your schedule the next day. DO NOT DOUBLE THE DOSE. If you take the drug several times a day take the missed dose when you remember, then continue with your regular schedule.

Interactions with other medication

Because carbamazepine can change the effect of other medication, or may be affected by other medication, always check with your doctor or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies. Always inform any doctor or dentist that you see that you are taking this drug.

Precautions

  1. Do not increase or decrease your without consulting your doctor.
  2. Avoid drinking grapefruit juice while on carbamazepine as it can affect the level of carbamazepine in your body.
  3. If your are on liquid carbamazepine, do not mix it with any other liquid medication.
  4. This drug may impair the mental and physical abilities and reaction time required for driving a car or operating other machinery. Avoid these activities if you feel drowsy or slowed down.
  5. Do not stop your drug suddenly as this may result in withdrawal symptoms such as anxiety, irritability and emotional liability.
  6. Report any changes in mood or behavior to your physician.
  7. Tablets or capsules of carbamazepine should be swallowed whole; do not crush them.
  8. Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children.

If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse

Medical Specialists

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Lithium

Lithium

Psychiatry

Lithium

PATIENT INFORMATION ON LITHIUM

Lithium is classified as a mood stabilizer. It is a simple element, found in nature in some mineral waters, and is also present in small amounts in the human body.

Uses

Lithium is used primarily in the treatment of acute mania and in the long-term control or prophylaxis of Manic Depressive Illness (Bipolar Disorder).

Though not approved for these indications, lithium has also been found to augment the effects of antidepressants in depression and obsessive compulsive disorder, and is useful in the treatment of cluster headaches, as well as chronic aggression or impulsivity. 

How does the doctor decide what dose (how many milligrams) to prescribe?

The dose of lithium is different for every patient and is based on how much lithium is in the blood, as well as the response to treatment. The doctor will measure the lithium level in the blood on a regular basis during the first few months. The lithium level that is usually found to be effective for most patients is between 0.6 and 1.2 mmol/L (mEq/L).

You may initially take your medication several times a day (2 or3); after several weeks, the doctor may decide to prescribe the drug once daily. It is important to drink 8-12 cups of fluid daily when on lithium (e. g., water, juice, milk, broth, etc.)

On the morning of your lithium blood test, take the morning dose of lithium after the test to avoid inaccurate results.

How quickly will the drug start working?

Control of manic symptoms may require up to 14 days of treatment. Because lithium takes time to work, do not decrease or increase the dose or stop the medication without discussing this with your doctor.

Improvement in symptoms of depression, obsessive compulsive disorder, cluster headaches, as well as aggression/ impulsivity also occur gradually.

How long should you take this medication?

Following the first episode of mania it is recommended that lithium be continued for a minimum of one year ; this decreases the chance of being ill again. The doctor may then decrease the drug slowly and monitor for any symptoms; if none occur, the drug can gradually be stopped.

For individuals who have had several episodes of mania or depression, lithium should be continued indefinitely.

Long-term treatment is generally recommended for recurring depression, obsessive-compulsive disorder, cluster headaches or aggression/impulsivity.

Side effects 

Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. They may sometimes occur before beneficial effects of the medication are noticed. If a side effect continues, speak to your doctor about appropriate treatment.

Common side effects that should be reported to your doctor at the next appointment include:

  • Lethargy, difficulty concentrating-This problem usually goes away with time. Use of other drugs that make you drowsy will worsen the problem. Avoid driving a car or operating machinery if drowsiness persists.
  • Nausea or heartburn-If this happens, take the medications with food. If vomiting or diarrhea occur and persist for more than 24 hours, call your doctor.
  • Muscle tremor, weakness, shakiness, stiffness-Speak to your doctor as this may require an adjustment in your dosage.
  • Changes in sex drive or sexual performance-Discuss this with your doctor.
  • Weight changes-Monitor your food intake; avoid foods with high fat content (e. g., cakes and pastry).
  • Increased thirst and increase in frequency of urination-Discuss this with your doctor.
  • Skin changes, e.g., dry skin, acne, rashes.

Side effects you should report IMMEDIATELY, as they may indicate the amount of lithium in the body is higher than it should be, include:

  • Loss of balance
  • Slurred speech
  • Visual disturbances (e. f., double-vision)
  • Nausea, vomiting, stomach ache
  • Watery stools, diarrhea (more than twice a day)
  • Abnormal general weakness or drowsiness
  • Marked trembling (e. g., shaking that interferes with holding a cup), muscle twitches, jaw shaking

IF THESE OCCUR CALL YOUR DOCTOR RIGHT AWAY. If you cannot reach your doctor, stop taking the lithium until you get in touch with him. Drink plenty of fluids and snack on salty foods (e. g., chips, crackers). If symptoms continue to get worse, or if they do not clear within 12 hours , go to the Emergency Department of the nearest hospital. A clinical check-up and a blood test will show the cause of the problem.

Rare side effects you should report to your doctor IMMEDIATELY include:

  • Soreness of the mouth, gums or throat
  • Skin rash or itching, swelling of the face
  • Nausea, vomiting, loss of appetite, lethargy, weakness, fever, or flu-like symptoms
  • Swelling of the neck (goiter)
  • Abnormally frequent urination and increased thirst (e. g., having to get up in the night several times to pass urine)

Let your doctor know as soon as possible if you miss your period or suspect you may be pregnant.

What should you do if you forget to take a dose of your medication?

If you take your total dose of lithium in the morning and you forget to take it for more than 6 hours, skip the missed dose and continue with your schedule the next day. DO NOT DOUBLE THE DOSE. If you take the drug several times a day, take the missed dose when you remember, then continue with your regular schedule.

Interactions with other medication

Because lithium can change the effect of other medication, or may be affected by other medication, always check with your doctor or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies. Always inform any doctor any doctor or dentist that you see that you are taking lithium.

Precautions

  1. Do not increase or decrease your dose without consulting your doctor.
  2. This drug may impair the mental and physical abilities and reaction time required for driving a car or operating other machinery. Avoid activities if you feel drowsy or slowed down.
  3. Do not stop your drug suddenly as this may result in withdrawal symptoms such as anxiety, irritability and emotional liability.
  4. Report any changes in mood or behavior to your physician.
  5. It is important to drink 8-12 cups of fluids daily ( e. g., water , juice, milk, broth, etc.)
  6. Do not change your salt intake during your treatment, without first speaking to your doctor ( e. g., avoid no-salt or low-salt diets).
  7. If you have the flu, especially if vomiting or diarrhea occur, check with your doctor regarding your lithium dose.
  8. Use extra care in hot weather and during activities that cause you to sweat heavily (e. g., hot baths, saunas, exercising). The loss of too much water and salt from your body may lead to changes in the level of lithium in your body.
  9. Tablets or capsules of lithium should be swallowed whole; do not crush them.
  10. Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children. 

If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse

Medical Specialists

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Cognition Enhancers

Cognition Enhancers

Psychiatry

Cognition Enhancers

PATIENT INFORMATION ON COGNITION ENHANCERS

The name of your medication is- Donepezil hydrochloride

Use

Cognition enhancers primarily used in the symptomatic treatment of mild to moderate Alzheimer’s disease, dementia. 

How quickly will the drug start working?

Improvement in concentration and attention is noted is noted over a period of several weeks. Because these drugs take time to work do not decrease or increase the dose without discussing this with the doctor.

How does the doctor decide on the dosage?

The drug is started at a low dose to minimize the chance of side effects. The dose can be increased after several weeks if minimal improvement is seen. The dose of the drug tacarine is determined by the results of tests of liver function, which the physician performs on a regular basis.

How long should you take this medication?

Cognition enhancers are usually prescribed for a period several years.

Side effects

Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. They may sometimes occur before beneficial effects of the medication are noticed. If a side effect continues, speak to your doctor about appropriate treatment. 

Common side effects that should be reported to your at the next appointment include:

 

  • Energizing/ agitated feeling, excitability-Some individuals may feel nervous or have difficulty sleeping for a few days after starting this medication. If you are taking the medication in the evening, the physician may decided to prescribe it earlier in the day.
  • Headache-This tends to be temporary and can be managed by taking analgesics (aspirin, acetaminophen, paracetamol ) when required.
  • Nausea, vomiting, heartburn-If this happens, take the medication with food or milk.
  • Diarrhea or constipation, flatulence.
  • Loss of appetite, weight loss- Taking the medication after meals, eating smaller meals more frequently or drinking high calorie drinks may help.
  • Muscle aches or cramps-Can be managed by taking analgesics when required.
  • Nasal congestion.
  • Hot flushes.

Rare side effects you should report to your doctor IMMEDIATELY include:

  • Yellow tinge in the eyes or to the skin; dark-colored urine
  • Soreness of the mouth, gums, or throat
  • Skin rash or itching, swelling of the face
  • Nausea, vomiting, loss of appetite, lethargy, weakness, fever, or flu-like symptoms
  • Severe agitation or restless

What should you do if you forget to take a dose of your medication?

If you take your total dose of the drug in the morning and you forget to take it for more than 6 hours, skip the missed dose and continue with your schedule the next day. DO NOT DOUBLE THE DOSE. If you take the drug several times a day, take the missed dose when you remember, then continue with your regular schedule.

Interactions with other medication

Because these drugs can change the effect of other medication, or may be affected by other medication, always check with your doctor or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies. Always inform any doctor or dentist that you see that you are taking a cognition enhancer.

Precautions

  1. Do not increase or decrease your dose without consulting your doctor
  2. Report to your doctor any changes in sleeping or eating habits or changes in mood or behavior.
  3. Do not stop your drug suddenly as this may result in changes in behavior and/or concentration.
  4. This drug may interact with medication prescribed by your dentist, so let him/her know the name of the drug you are taking.
  5. Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children.

If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse

Medical Specialists

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Psychostimulants

Psychostimulants

Psychiatry

Psychostimulants

PATIENT INFORMATION ON PSYCHOSTIMULANTS

The name of your medication is methylphenidate

Use

Psycho stimulants are primarily used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. These drugs are also approved for use in Parkinson’s Disease and Narcolepsy (a sleeping disorder). Though they are currently not approved for this indication, psycho stimulants have been found useful in the treatment of refractory depression.

How quickly will the drug start working?

Some response to psycho stimulants is usually noted within the first week of treatment of ADHD and tends to increase over the next 3 weeks.

How does the doctor decide on the dosage?

Psycho stimulants come in various preparations including short-acting and slow release forms. The dose is based on the body weight and is usually given several times a day. Take the drug exactly as prescribed; do not increase or decrease the dose without speaking to your doctor.

How long should you take this medication?

Psycho stimulants are usually prescribed for a period of several years. Some clinicians may decide to prescribe “ drug holidays” to individuals on this medication, I. e., the drug is not taken at certain times (e. g., week-ends, vacations, etc.).

Side effects

Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. They may sometimes occur before beneficial effects of the medication are noticed. If a side effect continues, speak to your doctor about appropriate treatment.

Common side effects that should be reported to your doctor at the next appointment include:

  • Energizing/agitated feeling , excitability-Some individuals may feel nervous or have difficulty sleeping for a few days after starting this medication. If you are taking the medication in the evening, the physician may decided to prescribe it earlier in the day.
  • Increased heart rate and blood pressure-Speak to your doctor.
  • Headache-This tends to be temporary and can be managed by taking analgesics (aspirin, acetaminophen) when required. Blood pressure should be checked.
  • Nausea or heartburn- If this happens, take medication with food or milk.
  • Dry mouth-Sour candy and sugarless gum help increase saliva in your mouth; try to avoid sweet, calorie-laden beverages. Drink water and brush your teeth regularly.
  • Loss of appetite, weight loss-Taking the medication after meals, eating smaller meals more frequently or drinking high calorie drinks may help.
  • Blurred vision-This usually occurs at the start of treatment and may last 1-2 weeks. Reading under a bright light or at a distance may help; a magnifying glass can be of temporary use. If the problem continues, advise your doctor.
  • Mild hair loss-Inform your doctor.

Rare side effects you should report to your doctor IMMEDIATELY include:

  • Muscle twitches, tics or movement problems
  • Fast or irregular heart beat
  • Persistent throbbing headache
  • Soreness of the mouth, gums, or throat
  • Skin rash or itching, swelling of the face
  • Any unusual bruising or bleeding, appearance of splotchy purplish darkening of the skin
  • Nausea, vomiting, loss of appetite, lethargy, weakness, fever, or flu-like symptoms
  • Yellow tinge in the eyes or to the skin; dark-colored urine
  • Severe agitation or restlessness
  • A switch in mood to an unusual state of happiness or irritability; fluctuations in mood

Let your doctor know as soon possible if you miss your period or suspect you may be pregnant.

What should you do if you forget to take a dose of your medication?

If you take the psycho stimulant 2-3 times a day forget to take a dose by more than 4 hours, skip the missed dose and continue with your regular schedule. DO NOT DOUBLE THE DOSE.

Interactions with other medication

Because psycho stimulants can change the effect of other medication, or may be affected by other medication, always check with your doctor or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies. Always inform any doctor or dentist that you see that you are taking a psycho stimulant drug. 

Precautions

  1. Do not increase or decrease your dose without consulting your doctor.
  2. Do not chew or crush the tablets or capsules.
  3. Use caution while driving or performing tasks requiring alertness as these drugs can mask symptoms of fatigue and impair concentration.
  4. Report to your doctor any changes in sleeping or eating habits or changes in mood or behavior.
  5. Do not stop your drug suddenly as this may result in withdrawal symptoms such as insomnia and changes in mood and behavior.
  6. This drug may interact with medication prescribed by your dentist, so let him/her know the name of the drug you are taking.
  7. Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children.

If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse

Medical Specialists

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