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Possible food and drug interactions when taking this medicationCombining Prozac with MAO inhibitors or Mellaril (thioridazine) is dangerous buy cheap glipizide 10 mg line diabetes symptoms type 2 diabetes symptoms. If Prozac is taken with certain other drugs glipizide 10mg with mastercard diabetes mellitus type 1 symptoms, the effects of either could be increased buy cheap glipizide 10mg online joslin diabetes diet, decreased, or altered. It is especially important to check with your doctor before combining Prozac with the following:Carbamazepine (Tegretol)Drugs that impair brain function, such as sleep aids and narcotic painkillersOther antidepressants (Elavil)Special information if you are pregnant or breastfeedingThe effects of Prozac during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. This medication appears in breast milk, and breastfeeding is not recommended while you are taking Prozac. The usual starting dose is 20 milligrams per day, taken in the morning. Your doctor may increase your dose after several weeks if no improvement is observed. People with kidney or liver disease, the elderly, and those taking other drugs may have their dosages adjusted by their doctor. Dosages above 20 milligrams daily should be taken once a day in the morning or in 2 smaller doses taken in the morning and at noon. The usual daily dose for depression ranges from 20 to 60 milligrams. For obsessive-compulsive disorder the customary range is 20 to 60 milligrams per day, though a maximum of 80 milligrams is sometimes prescribed. For bulimia nervosa, the usual dose is 60 milligrams, taken in the morning. Your doctor may have you start with less and build up to this dosage. The usual dose for premenstrual dysphoric disorder is 20 milligrams a day. For depression, it may take up to 4 weeks before the full effects of the medication are seen. For obsessive-compulsive disorder, treatment can take 5 weeks or more to be effective. If you are taking a 20-milligram daily dose of Prozac for depression, the doctor may switch you to a delayed-release formulation called Prozac Weekly. The usual starting dose for depression is 10 or 20 milligrams a day. After 1 week at 10 milligrams a day, the doctor may increase the dose to 20 milligrams. It may take up to 4 weeks before the full effects of the medication are seen. For obsessive-compulsive disorder, the usual starting dose is 10 milligrams a day. After 2 weeks, the doctor may increase the dose to 20 milligrams. If no improvement is seen after several weeks, the dosage may be increased as needed, up to a maximum of 60 milligrams a day. Children who are underweight, have kidney or liver problems, or are taking multiple medications may need their dosages adjusted by their doctor. Any medication taken in excess can have serious consequences. In addition, combining Prozac with certain other drugs can cause symptoms of overdose. If you suspect an overdose, seek medical attention immediately. Common symptoms of Prozac overdose include: Nausea, rapid heartbeat, seizures, sleepiness, vomitingOther symptoms of Prozac overdose include: Coma, delirium, fainting, high fever, irregular heartbeat, low blood pressure, mania, rigid muscles, sweating, stuporWhat is the most important information I should know if my child is being prescribed an antidepressant? Parents or guardians need to think about 4 important things when their child is prescribed an antidepressant:There is a risk of suicidal thoughts or actionsHow to try to prevent suicidal thoughts or actions in your childYou should watch for certain signs if your child is taking an antidepressantThere are benefits and risks when using antidepressantsChildren and teenagers sometimes think about suicide, and many report trying to kill themselves. Antidepressants increase suicidal thoughts and actions in some children and teenagers. But suicidal thoughts and actions can also be caused by depression, a serious medical condition that is commonly treated with antidepressants. Thinking about killing yourself or trying to kill yourself is called suicidality or being suicidal. A large study combined the results of 24 different studies of children and teenagers with depression or other illnesses. In these studies, patients took either a placebo (sugar pill) or an antidepressant for 1 to 4 months. No one committed suicide in these studies, but some patients became suicidal. On the antidepressants, 4 out of every 100 patients became suicidal. For some children and teenagers, the risks of suicidal actions may be especially high. These include patients with-Bipolar illness (sometimes called manic-depressive illness)-A family history of bipolar illness-A personal or family history of attempting suicideIf any of these are present, make sure you tell your health care provider before your child takes an antidepressant. To try to prevent suicidal thoughts and actions in your child, pay close attention to changes in her or his moods or actions, especially if the changes occur suddenly. The changes to look out for are listed in Section 3, on what to watch for. Whenever an antidepressant is started or its dose is changed, pay close attention to your child. Stopping an antidepressant suddenly can cause other symptoms. Antidepressants are used to treat depression and other illnesses. In some children and teenagers, treatment with an antidepressant increases suicidal thinking or actions. It is important to discuss all the risks of treating depression and also the risks of not treating it. You and your child should discuss all treatment choices with your health care provider, not just the use of antidepressants. Other side effects can occur with antidepressants (see section below).

We are talking about sharing the news of your eating disorder with significant others cheap glipizide 10 mg online diabetic ketoacidosis complications, how to do it cheap glipizide 10 mg metabolic disease ga-1, and why cheap glipizide 10mg visa diabetes type 1 mayo. Here are some audience questions Monika:Gage: What happened to make Monika enter the hospital? How long had she gone without eating and what symptoms did she have? I was weak, shaky, and had begun passing out, particularly when trying to walk up the stairs. At the time, I was eating only a couple hundred calories a day and I would purge anything over that so my potassium level was frighteningly low. I was also in the midst of law school exams and unable to think very clearly. All of that, coupled with a trip to the doctor, sent me to the hospital. Monika Ostroff: Aaah yes, weight that I wanted kept changing. First it was 105, then 100, then 98, then 97, and so on. Nothing was ever low enough and I was never satisfied with my goal. Violette: How exactly did you tell your family members about your eating disorder? Monika Ostroff: Well, my mother had been "nagging" me about food for awhile. I think I was finally just scared enough to say "I think I have a problem and I want to do something about it. Monika Ostroff: I would suggest a step before the actual "coming out" and that is a little fear reduction exercise. I think a lot of people are afraid that once they tell someone that that person will then try to make them do things that they are not ready, or even willing, to do. Fear reduction then, would consist of telling ones self that you are asking someone for support which is different from asking someone to "fix it" for you. The most important aspect of this is realizing that we have to teach others how to support us by communicating clearly what it is that we need. With that in mind, I would approach the family member or friend I trust the most and say "I have something really important that I would like to talk to you about, and this is hard for me... If you are going to give someone "the news," be prepared for those reactions too. And then, remember to also reassure them and tell them explicitly that you are asking for their support and professional help. Here are more audience questions:Ack: How did you get others to understand? Whenever I found a particularly good article or book excerpt, I tried to photocopy it and give it to people and that seemed to help a lot. I also tried to get people to go to panels of recovered people speaking. The person that I need to tell, but is the most difficult to tell, is my parents. My parents have already been through a lot with me like date rape, drug addiction, and alcoholism. I think sitting down with your parents for a true heart-to-heart would be perhaps the best thing. Sometimes doing that armed with some information in the form of books and articles can help. And as Bob said earlier, reassuring them will be helpful too. I think that the human spirit is very strong and very resilient. You have been struggling with this almost all alone for a long time. They will be able to handle it with you and you can all help each other... Eating disorders are mosaics made up of all different kinds of things. It sounds like you might be worried that they will doubt you or look at you critically. Be willing to educate people along the way of your journey. Bob M: Our guest is Monika Ostroff, author of Anorexia Nervosa: A Guide to Recovery. You can click on this book link: Anorexia Nervosa: A Guide to Recovery ($11. I think I literally said, "I have an eating disorder. My father is the sort of "give it to me straight" kind of person. I think I may have a problem with food and my obsessions with weight and exercise. Monika Ostroff: My father said something like, "you have a what?! Of course, neither one of those reactions was terribly helpful and hence I lost more weight, got into medical trouble and ended up in the hospital. Not the brightest story, but one I can look back on and use as a marker for how much we have all grown and changed since those days. Monika Ostroff: The literal turning point came with a memory.

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The link between marijuana and depression then buy generic glipizide 10 mg on-line diabetes in dogs and cats, appears to be dose dependant buy 10 mg glipizide with amex diabetes mellitus type 2 article pdf. Because low-dose marijuana appeared to improve depression purchase glipizide 10mg online diabetes insipidus renal, the researchers are hoping to develop a new drug similar to the idea of medical marijuana for depression. When some people use marijuana, they experience a relaxation and a reduction in anxiety symptoms. Some with anxiety disorders feel marijuana treats anxiety or panic attacks but medical evidence shows marijuana causes anxiety in new users, chronic users and during marijuana withdrawal. Additionally, when using marijuana, anxiety-coping skills can be difficult to learn and use. Because the "high" of marijuana causes anxiety to decrease for many people, those with anxiety disorders sometimes "self-medicate" their anxiety with marijuana. Then, users often increase their dose of marijuana to again decrease anxiety symptoms. Unfortunately, with increased dosescomes increased tolerance and the greater likelihood of marijuana addiction. Nearly 7% - 10% of regular marijuana users become dependent on marijuana. Those dependent on marijuana often feel anxiety during marijuana withdrawal, or periods of abstinence, regardless as to preexisting anxiety conditions. Marijuana highs can also produce extreme anxiety and paranoia. Marijuana is a preparation of the cannabis plant and cannabis-induced anxiety disorder is a recognized illness in the Diagnostic and Statistical Manual (DSM IV) of mental illness. This marijuana-anxiety disorder can appear in new or chronic users of marijuana. Addressing the fact that marijuana causes anxiety, here are some criteria for a cannabis-induced anxiety disorder:Anxiety, panic attacks, obsessions or compulsionsMarijuana is also known to cause psychotic and delusional disorders which can worsen anxiety. Use of marijuana and anxiety are linked, as is withdrawal from marijuana and anxiety. Marijuana withdrawal can occur when marijuana tolerance is achieved or when a user abuses marijuana. While withdrawal symptoms vary from person to person, anxiety and marijuana withdrawal are closely linked. Anxiety-related marijuana withdrawal symptoms include: While being the most popular legal drug in North America, there are many short-term and long-term effects of alcohol. Some effects of alcohol can be seen as desirable, such as euphoria and increased self-confidence at lower amounts, or unpleasant - dizziness, vomiting and blurred vision at larger amounts. The effects of alcohol are felt more or less depending on circumstance and physiology. Women become intoxicated after drinking less alcohol than men, and consuming alcohol after a heavy meal will lessen the physical effects of alcohol. Consumed in moderation, the short-term effects of alcohol are typically safe and pleasant, in fact, one 12 ounce beer is known to increase sleep time and reduce awakening during the night. This beneficial physical effect of alcohol is not seen when more than one beer is consumed. The effects of alcohol when consumed in excess of one drink disrupts sleep cycles and causes daytime fatigue. The short-term effects of alcohol are dependent on how much alcohol is consumed, and thus how much alcohol is in the blood (the blood alcohol level). The effects of mild drinking (1 - 4 drinks depending on gender and size):Increased mood and possible euphoriaIncreased self-confidence, sociabilityShortened attention spanImpaired fine muscle coordinationMore negative effects of alcohol are seen in moderate to heavy drinking (5 - 12 drinks depending on gender and size):Impaired memory and comprehension, profound confusionBalance difficulty; unbalanced walk; staggeringBlurred vision; other senses impairedDizziness often associated with nausea ("the spins")Once more than 12 drinks are consumed, only the negative effects of alcohol are present:Lapses in and out of consciousnessVomiting (possibly life-threatening if done while unconscious)Respiratory depression (potentially life-threatening)Depressed reflexes (i. Consuming alcohol in larger than these quantities show the negative effects of alcohol. Long-term effects of heavy alcohol consumption can lead to brain shrinkage, dementia, alcoholism and even death. The long-term negative effects of alcohol include cancer; 3. The more alcohol is consumed, the more negative effects of alcohol are seen. Negative effects of alcohol include:Increased risk of heart failureLiver damage and multiple liver diseasesElectrolyte deficienciesLoss of sexual desire, impotenceMultiple types of cancerFetal alcohol syndrome in babies born to women who drank during pregnancyLearning how to deal with an alcoholic is something no one is taught in school. Denial is a term used to indicate the unwillingness or inability of a person to admit to some truth, in this case alcoholism. For example, an alcohol addict may vehemently disagree with concerns of those living with the alcoholic that he is drinking too much, in spite of the fact that he has been charged with driving under the influence of alcohol three times in one month. But denial is not just something seen in the alcoholic, denial is also common in those living with an alcoholic. One of the reasons alcoholics continue to function while drinking and stay in denial is because the family and friends refuse to admit to dealing with an alcoholic. Because there is stigma attached to the term "alcoholic," loved ones want to deny that they are living with an alcoholic. However, admitting to a problem is the only way to start dealing with an alcoholic. Admit that you are living with an alcoholic and that it is a problem. Clearly look at the behaviors, emotions and physical symptoms of the alcoholic. Admit that they are due to alcoholism and not another ailment. Do not deny the destructive actions of the alcoholic. Understand there is nothing you can do to stop alcoholic behaviors - alcoholism is a disease and not a character flaw or poor judgment on the part of the alcoholic. A huge amount of harm comes from living with an alcoholic. Refusing to deny the alcoholism also means admitting to the effects that living with an alcoholic, or caring for an alcoholic, has on you and your family. How to deal with the effects of living with (or caring for) an alcoholic:Admit that living with an alcoholic is hurting you and your family.

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This may occur either because of a diminished responsiveness to the medication or a worsening of the diabetes purchase glipizide 10 mg on line diabetes medications without insurance. If Micronase is taken with certain other drugs buy glipizide 10 mg on-line diabetes test during pregnancy symptoms, the effects of either could be increased buy glipizide 10mg on-line diabetic friendly snacks, decreased, or altered. It is especially important to check with your doctor before combining Micronase with the following:Airway-opening drugs such as albuterolAnabolic steroids such as testosterone and danazolBeta blockers such as the blood pressure medications atenolol and propranololBlood thinners such as warfarinCalcium channel blockers such as the blood pressure medications diltiazem and nifedipineCertain antibiotics such as ciprofloxacinMajor tranquilizers such as trifluoperazine and thioridazineMAO inhibitors such as the antidepressants phenelzine and tranylcypromineNonsteroidal anti-inflammatory drugs such as diclofenac, ibuprofen, and naproxenThiazide diuretics such as the water pills chlorothiazide and hydrochlorothiazideBe careful about drinking alcohol, since excessive alcohol consumption can cause low blood sugar. The effects of Micronase during pregnancy have not been adequately studied in humans. This drug should be used during pregnancy only if the benefit outweighs the potential risk to the unborn baby. Since studies suggest the importance of maintaining normal blood sugar (glucose) levels during pregnancy, your physician may prescribe insulin injections during pregnancy. While it is not known if Micronase appears in breast milk, other oral diabetes medications do. Therefore, women should discuss with their doctors whether to discontinue the medication or to stop breastfeeding. If the medication is discontinued, and if diet alone does not control glucose levels, then your doctor may consider insulin injections. Your doctor will tailor your dosage to your individual needs. Usually the doctor will prescribe an initial daily dose of 2. Daily doses greater than 20 milligrams are not recommended. In most cases, Micronase is taken once a day; however, people taking more than 10 milligrams a day may respond better to twice-a-day dosing. The safety and effectiveness of Micronase have not been established in children. Older, malnourished or debilitated individuals, or those with impaired kidney and liver function, usually receive lower initial and maintenance doses to minimize the risk of low blood sugar (hypoglycemia). An overdose of Micronase can cause low blood sugar (hypoglycemia). Symptoms of severe hypoglycemia include:Coma, pale skin, seizure, shallow breathingIf you suspect a Micronase overdose, seek medical attention immediately. GLYSET Tablets contain miglitol, an oral alpha-glucosidase inhibitor for use in the management of non-insulin-dependent diabetes mellitus (NIDDM). Miglitol is a desoxynojirimycin derivative, and is chemically known as 3,4,5-piperidinetriol, 1-(2-hydroxyethyl)-2-(hydroxymethyl)-, [2R-(2~a,3~b,4~a, 5~b)]-. It is a white to pale-yellow powder with a molecular weight of 207. Its empirical formula is C8H17NO5 and its chemical structure is as follows:GLYSET is available as 25 mg, 50 mg and 100 mg tablets for oral use. The inactive ingredients are starch, microcrystalline cellulose, magnesium stearate, hypromellose, polyethylene glycol, titanium dioxide, and polysorbate 80. Miglitol is a desoxynojirimycin derivative that delays the digestion of ingested carbohydrates, thereby resulting in a smaller rise in blood glucose concentration following meals. As a consequence of plasma glucose reduction, GLYSET Tablets reduce levels of glycosylated hemoglobin in patients with Type II (non-insulin-dependent) diabetes mellitus. Systemic nonenzymatic protein glycosylation, as reflected by levels of glycosylated hemoglobin, is a function of average blood glucose concentration over time. In contrast to sulfonylureas, GLYSET does not enhance insulin secretion. The antihyperglycemic action of miglitol results from a reversible inhibition of membrane-bound intestinal ~a-glucoside hydrolase enzymes. Membrane-bound intestinal ~a-glucosidases hydrolyze oligosaccharides and disaccharides to glucose and other monosaccharides in the brush border of the small intestine. In diabetic patients, this enzyme inhibition results in delayed glucose absorption and lowering of postprandial hyperglycemia. Because its mechanism of action is different, the effect of GLYSET to enhance glycemic control is additive to that of sulfonylureas when used in combination. In addition, GLYSET diminishes the insulinotropic and weight-increasing effects of sulfonylureas. Miglitol has minor inhibitory activity against lactase and consequently, at the recommended doses, would not be expected to induce lactose intolerance. Absorption of miglitol is saturable at high doses: a dose of 25 mg is completely absorbed, whereas a dose of 100 mg is only 50% - 70% absorbed. For all doses, peak concentrations are reached in 2-3 hours. There is no evidence that systemic absorption of miglitol contributes to its therapeutic effect. The protein binding of miglitol is negligible ( < 4. Miglitol is not metabolized in man or in any animal species studied. No metabolites have been detected in plasma, urine, or feces, indicating a lack of either systemic or pre-systemic metabolism. Miglitol is eliminated by renal excretion as unchanged drug. Thus, following a 25-mg dose, over 95% of the dose is recovered in the urine within 24 hours. At higher doses, the cumulative recovery of drug from urine is somewhat lower due to the incomplete bioavailability. The elimination half-life of miglitol from plasma is approximately 2 hours. Because miglitol is excreted primarily by the kidneys, accumulation of miglitol is expected in patients with renal impairment. Dosage adjustment to correct the increased plasma concentrations is not feasible because miglitol acts locally.

By C. Roy. Polytechnic University of New York.