Doctor insights on:
C1 Esterase Inhibitor
Can you tell me in myasthenia gravis why do you give an acetylcholine esterase inhibitor instead of a direct receptor agonist?
C1 Esterase Inhibitor Panel had two functional and one protein level. The protein level was 11 (20-40 ml/dL). What does that mean? Other two normal.
Makes no sense: C1INH assays may show low C1INH (which you appears to have) or normal C1INH level with impaired functioning if you are looking for the typical cases of hereditary edema. If the quantity is low, there cannot be normal functioning. If you do have HAE, treatment should be started promptly to prevent throat swelling. ...Read more
Can CH50 & C1 Esterase Inhibitor be WNL with decreased C3/C4 levels? I've been diagnosed with Anemia, Gatroparesis, SLE & MCTD to date
Yes, 2 different : Conditions, and low C3/C4 is due to complement consumption in autoimmune diseases as SLE or MCTD. CH50 is the mean of hemolytic complement, and is low in complement defiency, rare, while C1 Esterase is deficient manly in Hereditary Angioedema, all not related to SLE / MCTD, wish you all the best ...Read more
Is a consistantly low C4 complement level but normal c1 inhibitor and functional level normal for hae if not in a flare?
Yes: The C4 and c1inh level are usually low even in the absence of an exacerbation. ...Read more
If u get a steroid tendon inj & r taking a cyp450 3a4 inhibitor at the same time is it like getting 3 steroid injections?
No: It is still one steroid injection. Biotransformation in liver is important for drugs given trough mouth, im and IV since those effect depend on concentration of drug in blood. Liver (and p450 enzyme system) has relatively little effect on drugs injected in joints, epidural space, tendons, body cavities. ...Read more
Not enough amounts: Quantity and concentration related, and you get nasty foul smelling greasy stools. ...Read more
Maybe but for what?: All medications, prescription & otc, as well as all dietary supplements, have potential side effects. There is no free lunch, no side effect free pill, whether medication or supplement. Aromatase inhibitors are approved for use in breast cancer in which case the potential risk of liver damage, hypertension, etc probably outweighs risk of recurrent breast cancer. So talk to your doc re what's right. ...Read more
Evidence says not: One meta-analysis* (a study pooling results from multiple other studies) suggested that reboxetine is ineffective & may be harmful. *(eyding d et. Al. "Reboxetine for acute treatment of major depression: systematic review &meta-analysis of published &unpublished placebo &selective serotonin reuptake inhibitor controlled trials."bmj. 2010; 341:c4737). ...Read more
Severe Interaction: This combination phosphodiesterase inhibitor (pde5) + nitrate has been shown to cause a drastic drop in blood pressure (hypotension) a medical emergence that can result to death. Really deaths have been reported with this combination. Pde5 (some drugs in this class include viagra, (sildenafil) cialis, levitra). ...Read more
TCA/SSRI: Both are, depending on what they are prescribed for. The difference is in tolerability & side-effects. ...Read more
Liver enzyme: The cyp2c8 enzyme contributes to the metabolism of many drugs. This enzyme consists of less than 10% of the total cytochrome components in the liver, though has also been found in other organs. Even if inhibited, other pathways are available to metabolize drugs which helps the body avoid toxic build- up of drug metabolites. ...Read more
Block aldosterone: The primary mechanism of action of an ace inhibitor is to interrupt the renin angiotensin system. One of the results is reduced aldosterone synthesis. Aldosterone is an important hormone responsible for regulating potassium excretion by the kidney. Thus blocking aldosterone reduces the capacity of the kidney to excrete potassium. ...Read more
You can: You can, in fact they make combination pills that contain both. ...Read more
Grooming: Unfortunately the doctors here on health tap do not endorse or promote any products. And, second, one does not go to the doctor to learn how to groom. Maybe your girlfriends will have some opinions on this. But, medicine will remain neutral on your question. ...Read more
PPI's treat ulcers: Antacids neutralize acid that has already been produced, & as such has value in providing immediate relief of indigestion. H2 blockers & proton pump inhibitors block acid production & are best used to heal peptic disease & address acid reflux. Ppi's also protect against nsaid-related injury. ...Read more
In rheum. arthritis?: Osteoporosis is a known complication of rheumatoid arthritis (ra). The bone loss is related to features of the patient (usually a postmenopausal woman), corticosteroid therapy, and the underlying arthritis disease. May have a beneficial effect on bone loss through the medication's strong anti-inflammatory effect. ...Read more
Orlistat: Orlistat is lipase inhibiter and is used to lose weight in over weight individuals with low fat, low calorie diet and exercise. So fat is in not absorped in its entirity and is passed undigested in stools. So total calorie absorption is reduced and because of the side effects which are not pleasant people cut down on their fat intake and that helps too. ...Read more
Weening: Possibly start by going every other day for 1-2 weeks, then 1 every 2 days for 1-2 weeks. If you get rebound reflux, you can use Pepcid (famotidine) or Tums as needed. Finally, you may be able to be off it. Also, if you can change your diet and eat smaller meals that may help some. Always refer to your physician for proper instructions. ...Read more