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    Default Dr The End clinic

    Hello

    Some members around know I am a doctor of Clinical Pharmacology and Internal diseases. After some of them contacted me for a consultation considering their medical case or particular medicines, I decided to open this thread, so If someone needs consultation, information regarding medicine, a particular case, wants advice regarding, or information regarding any medical issue, he/she can simply post in this thread

    I might post daily medical information in this thread


  2. 4 users say Thank You to The End for this useful post.

    global20 (11-08-2021), heart of stone (11-08-2021), loaded-prof (11-08-2021), Youcefstyles (11-08-2021)

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    Hello, doc!

    Please can one combine amoxicillin capsules with ciprofloxacin in the treatment of moderate typhoid fever?

    Thanks.
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    The End (11-08-2021)

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    Quote Originally Posted by loaded-prof     
    Hello, doc!

    Please can one combine amoxicillin capsules with ciprofloxacin in the treatment of moderate typhoid fever?

    Thanks.
    Hello, bro

    For typhoid fever, It's not appropriate to combine Ciprofloxacin with Amoxicillin. The core point is the resistance of the salmonella typhi to various types of antibiotics according to the geographical distribution and how people use antibiotics in their daily medical cases

    So I recommend starting with a single antibiotic therapy for 14 days according to the patient's status. Ciprofloxacin 500 mg is the first choice, but make sure the patient is above 18 years and if a woman, make sure she is not pregnant or planning for being pregnant. The second choice if Ciprofloxacin is not appropriate for resistance or the previous reasons I have indicated is Azithromycin 500 mg, the last choice is a third-generation cephalosporin like Ceftriaxone given as IV injection, not a beta-lactam Amoxicillin

    So, avoid combination in general, If you don't have information about how resistant is salmonella typhi to a particular antibiotic, start ciprofloxacin 500 mg unless contraindicated for pregnancy or the patient is below 18 years old, and send the patient to perform a culture to know the antibiotics the salmonella typhi is sensitive to. Make sure the patient receives appropriate hydration and supportive nutritional meals during and after the course of treatment


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    Quote Originally Posted by The End     
    Hello, bro

    For typhoid fever, It's not appropriate to combine Ciprofloxacin with Amoxicillin. The core point is the resistance of the salmonella typhi to various types of antibiotics according to the geographical distribution and how people use antibiotics in their daily medical cases

    So I recommend starting with a single antibiotic therapy for 14 days according to the patient's status. Ciprofloxacin 500 mg is the first choice, but make sure the patient is above 18 years and if a woman, make sure she is not pregnant or planning for being pregnant. The second choice if Ciprofloxacin is not appropriate for resistance or the previous reasons I have indicated is Azithromycin 500 mg, the last choice is a third-generation cephalosporin like Ceftriaxone given as IV injection, not a beta-lactam Amoxicillin

    So, avoid combination in general, If you don't have information about how resistant is salmonella typhi to a particular antibiotic, start ciprofloxacin 500 mg unless contraindicated for pregnancy or the patient is below 18 years old, and send the patient to perform a culture to know the antibiotics the salmonella typhi is sensitive to. Make sure the patient receives appropriate hydration and supportive nutritional meals during and after the course of treatment
    Oh, thanks so much, doc! God bless you. I appreciate your prompt response.
    Thanks for visiting my Trading Journal. Your contributions are highly appreciated. Thanks, friends!
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    Hello

    I have decided to start a series regarding the use of analgesics, how to use, when, and some other precautions

    Analgesics

    Analgesics are known for the name of pain killers. Meaning that once you feel pain at any region in your body like your head, knee, back, and so on, the first thing you think about is getting an analgesic to kill the pain so you could continue your daily practices with no or even the lowest degree of disturbance

    But before I start talking about Analgesics, let me explain to you briefly how a tablet or a capsule of analgesic you take or even an injection work.



    Most common analgesics are taken by swallowing, you swallow a tablet or a capsule to kill the pain you are feeling. the journey of the analgesic starts from your stomach once you have swallowed it. The gastric juice works on dissolving the contents of the tablet or the capsule you have taken, then it's absorbed through the stomach or intestine to enter the bloodstream, it reaches the liver where it's detoxified then continues with the bloodstream to the site of action, finally, it comes to your kidneys, where it's eliminated renally

    You exactly noticed that the burden is on your liver and your kidney since they are the responsible organs for detoxification and elimination of your drug to avoid toxicity, so you must have concluded that you can harm these organs if you abused analgesics

    You may now think about taking your analgesic as an injection to stop harming your organs, but you are lost here. Because if you save the liver with your Iv injection, you will have the same burden on your kidney



    So should you stop using analgesics and medications since they are eliminated in the same way?

    To be followed


  10. 4 users say Thank You to The End for this useful post.

    grasper (23-08-2021), heart of stone (12-08-2021), loaded-prof (12-08-2021), Unregistered (1)

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    Hello, doc,

    Kindly shed some light on the use of Franol for asthma patients.

    1. How best/often should it be used?
    2. Is the use of inhaler recommended for every asthma patient?

    Thanks for being there, doc!
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    Quote Originally Posted by loaded-prof     
    Hello, doc,

    Kindly shed some light on the use of Franol for asthma patients.

    1. How best/often should it be used?
    2. Is the use of inhaler recommended for every asthma patient?

    Thanks for being there, doc!
    Good Afternoon
    Due to brand names differences among the world countries and differences of every country suppliers. I have searched for the active ingredients of Franol. I found 2 active ingredients, theophylline, and ephedrine, and that's it. I will tell you how both of them work, but let me explain to you how Asthma develops to be more clear

    Asthma: It's a condition where the airway is narrowed, bronchioles are inflamed, so the net result is a difficulty of breathing with a horrible sensation of suffocation

    Causes: The real causes are still unknown, but some attempts from many doctors were made, and they established a relation between Asthma and environmental conditions like people who live near factories, who are more exposed to smoke, and so on, they are more likely to have Asthma

    So, theophylline is a bronchodilator, so it permits more air to enter the bronchioles and thus increases the total lung capacity of air, while ephedrine widens the airway.

    There are many other drugs used for relieving Asthma symptoms and the most common here is the family of Montelukast. The choice among different agents depends on the severity of the disease and how the patient tolerates the drug.

    Franol for mild to moderate cases can be used 2 or 3 times daily for at least 1 week, with checking if there is a bacterial or a virus infection that may cause false Pseudo-Ashtma symptoms.

    That was about Franol



    For inhalers, most contain a cortisone substance with Salbutamol or Salmeterol. Inhalers are used mainly for resolving acute Asthma attacks, so for patients who get frequent Asthma attacks, It's a must to carry their inhaler everywhere they go and make sure they get themself away from any stress


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    Hello

    This is my second post in the series of analgesics. I decided to write about this class of medicines before, and here I am going to add a new post to this series. If you like or find this useful or you have a particular question concerning any medical case, support this thread

    Analgesics

    When you go to a pharmacy, you will find tons of brand names representing analgesics, but you will find much fewer active ingredients that represent the drug itself, so analgesics are classified and used depending on different and various methods like, mechanism of action, mechanism of elimination, the effect and so on.

    So, since you don't know much about mechanisms and efficiency. Your guide is a doctor in a clinic or a pharmacist in a pharmacy, but you are still able to take some analgesics for minor problems like headache, minor bone pain, minor trauma, and so on

    Your first choice ever should be Paracetamol. It's considered the safest drug in the family of analgesics with a wide therapeutic index. You are allowed to take up to 4 grams of Paracetamol daily depending on how much pain you feel and how your feeling of pain is improving. Paracetamol is the safest ever analgesic for a pregnant woman and children because it's a drug that nearly has zero side effects including a lower load on your kidney and liver regarding elimination.

    So, when you feel a pain that you can't take anymore, make Paracetamol your first choice for killing your headache, bone pain, etc.

    Note: I am always referring to Active Ingredients, not brand names

    to be followed


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    Hello, sir, Please I want to inquire about radioactive iodine,Yesterday I had a 10mg dose given by my doctor because I have hyperthyroidism. Please tell me about the side effects. Thank you, Dr End.


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    Quote Originally Posted by heart of stone     
    Hello, sir, Please I want to inquire about radioactive iodine,Yesterday I had a 10mg dose given by my doctor because I have hyperthyroidism. Please tell me about the side effects. Thank you, Dr End.
    Hello

    I am so sorry regarding that late comment. I didn't get a notification that you posted a comment in that thread. If you still need any help, leave a comment, and I would like to see your last Thyroid function test and the Lipid profile test.


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