Doctor insights on:
Can Patient On Avonex Take Mefloquine Chemoprophylaxis
Only shot form flu: Patients on Revlimid (lenalidomide) cannot receive the nasal spray form of flu vaccine because this is a "live" attenuated form of the flu. They can receive the shot form of flu vaccine because it contains only a particle of the actual flu virus and cannot, therefore, give them the illness. They would be wise, in fact, to get the flu shot since influenza can make them very, very sick. ...Read more
A patient on chronic mao inhibitor's given sublingual nifedipine for hypertensive emergencies (never used in medicine!). Opinions?
Can you tell me for prevent HIV , taking zidovudine & lamivudine ( or combivir ) and isentress (raltegravir) it isenough as pep medicine?
Can diabetic patient take antibiotic pills like augmentin (amoxicillin and clavulanate) 625 mg without consulting doctor? Is there any side effects?
Not advised: you should never take an antibiotic without consulting your doctor. Augmentin (amoxicillin and clavulanate) has may side effects associated with it (diarrhea, rash, yeast infections). Your doctor needs to assess whether you have a bacterial infection that should be treated with an antibiotic, and then decide which antibiotic is best for you. ...Read moreSee 1 more doctor answer
Antiplatelet agent : Clopidogrel (plavix) is an anti platelet medication given to patients with coronary or other vascular disease. Platelets are commonly involved in coronary and other acute vascular events. So you could say it is somewhat of a "blood thinner". As far as potential side effects, rarely it can cause a severe rash--if this occurs then your doctor would switch to another antiplatelet medication. ...Read moreSee 2 more doctor answers
Can TB be treat with rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB) only???Just stop INH due the high enzymes waiting for the next treat
Yes: Santa Clara TB control is very good and will advise you and your doctor of any further changes based on nature of the TB infection (lung vs other sites), duration of treatment so far, susceptibility of the TB isolates, and other factors. However, if lab abnormality is with liver enzymes, usually rifampin is held as well. ...Read more
Vasodilator: Dipyridamole is a vasodilator -- that means it dilates and relaxes the blood vessel through its indirect action on the vessel smooth muscle. In the past, it has been used for chest pain and cardioprotection -- but these days it has gone by the wayside because of the extensive use of nitroglycerin. It is still used in combination with Aspirin for stroke prevention. ...Read moreSee 1 more doctor answer
Can you take lovenox, (enoxaparin) plavix & cumadin at the same time. ( older patient with heart history?
Blood thinners: Lovenox and Coumadin (warfarin) are started together but once Coumadin (warfarin) is therapeutic, Lovenox is stopped. Plavix can be taken with Coumadin (warfarin) or combo of lovenox/coumadin. The risk of bleeding and the use of different anticoagulants and anti platelet drugs should be carefully decided by the physicians and is done on a case by case basis. ...Read moreSee 1 more doctor answer
What dosage of potassium should be taken to prevent parenthesis when taking 25 mg qd topomax? Used for migraine prevention in a healthy individual.
Not much: The dose of topamax (topiramate) is trivial. Usually at least 50 mg twice a day are necessary for good migraine control. Even at that dose there is minimal side effect. Most regular meals contain plenty of potassium. A banana should be sufficient source. Plenty of liquids and rest and appropriate exercise is also important. ...Read more
Question for rheumatologists : we can give nsaids and low dose corticostiroids together for patient on RA waiting for dmards to take its efficacy ?
Yes and no: This type of combination is common, but since each class of medication increases risk for GI side effects, caution is important. Using a medication such as Omeprazole to protect the stomach is a good idea, and minimizing the dose and duration of the corticosteroid is very important. ...Read moreSee 1 more doctor answer
Coumadin (warfarin): There are different anticoagulants out there with different indications. I will just make the assumption you are talking about warfarin. In which case foods that are high in vitamin K like liver, leafy green vegetables, or vegetable oils can make Coumadin less effective. ...Read more
The larger issues =: flecainide & warfarin. Suggest Google "flecainide mortality rates". In the CAST trial those for whom flecainide was effective & continued taking had 3 times the mortality rate of those randomized back to placebo. While amiodarone stimulates dose related pulmonary fibrosis long term, it is the only agent which does not ? mortality short term. Once PFO endothelialized, Xarelto likely better/safer. ...Read more
Any experience with using naltraxone for pt w/ stiff person syndrome w/ no response to rituxan, (rituximab) plasmapheresis, and already on Valium and baclofen?
How can you treat a fever on someone who has hepatitis C & the flu & is taking tamiflu, z pack, zutipro, klonopin, inderal, (propranolol) and remeron?
Careful: elderly are more prone to side effects. please stick to prescription ...Read more
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