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Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

<p><em><a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a></em></p> <p>Equipped with the latest gear and a thirst for adventure, mountaineers embrace the perils that come with conquering the world’s highest peaks. Yet, even those who tread more cautiously at high altitude are not immune from the health hazards waiting in the thin air above.</p> <p>Altitude sickness, which most commonly refers to <a href="https://medlineplus.gov/ency/article/000133.htm">acute mountain sickness</a>, <a href="https://doi.org/10.1016/j.pcad.2010.02.003">presents a significant challenge</a> to those traveling to and adventuring in high-altitude destinations. Its symptoms can range from <a href="https://doi.org/10.1089/ham.2017.0164">mildly annoying to incapacitating</a> and, in some cases, may progress to more <a href="https://doi.org/10.1183/16000617.0096-2016">life-threatening illnesses</a>.</p> <p>While <a href="https://doi.org/10.18111/9789284424023">interest in high-altitude tourism is rapidly growing</a>, general awareness and understanding about the hazards of visiting these locations <a href="https://doi.org/10.1089/ham.2022.0083">remains low</a>. The more travelers know, the better they can prepare for and enjoy their journey.</p> <p>As an <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/36740">emergency physician specializing in high-altitude illnesses</a>, I work to improve health care in remote and mountainous locations around the world. I’m invested in finding ways to allow people from all backgrounds to experience the magic of the mountains in an enjoyable and meaningful way.</p> <h2>The science behind altitude sickness</h2> <p>Altitude sickness is rare in locations lower than 8,200 feet (2,500 meters); however, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">it becomes very common</a> when ascending above this elevation. In fact, it affects about <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">25% of visitors to the mountains of Colorado</a>, where I conduct most of my research.</p> <p>The risk rapidly increases with higher ascents. Above 9,800 feet (3,000 meters), up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">75% of travelers</a> may develop symptoms. Symptoms of altitude sickness are usually mild and consist of <a href="https://doi.org/10.1089/ham.2017.0164">headache, dizziness, nausea, fatigue and insomnia</a>. They usually <a href="https://doi.org/10.1016/j.rceng.2019.12.009">resolve after one to two days</a>, as long as travelers stop their ascent, and the symptoms quickly resolve with descent.</p> <p>When travelers do not properly acclimatize, they can be susceptible to life-threatening altitude illnesses, such as <a href="https://doi.org/10.1016/j.resp.2007.05.002">high-altitude pulmonary edema</a> or <a href="https://doi.org/10.1089/1527029041352054">high-altitude cerebral edema</a>. These conditions are characterized by fluid accumulation within the tissues of the lungs and brain, respectively, and are the <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">most severe forms of altitude sickness</a>.</p> <p>Altitude sickness symptoms are thought to be caused by <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">increased pressure surrounding the brain</a>, which results from the failure of the body to acclimatize to higher elevations.</p> <p>As people enter into an environment with lower air pressure and, therefore, <a href="https://doi.org/10.1001/jamanetworkopen.2023.18036">lower oxygen content</a>, their <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">breathing rate increases</a> in order to compensate. This causes an increase in the amount of <a href="https://doi.org/10.1016/s1357-2725(03)00050-5">oxygen in the blood as well as decreased CO₂ levels</a>, which then increases blood pH. As a result, the <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">kidneys compensate</a> by removing a chemical called bicarbonate from the blood into the urine. This process makes people urinate more and helps correct the acid and alkaline content of the blood to a more normal level.</p> <figure><iframe src="https://www.youtube.com/embed/iv1vQPIdX_k?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Tips for preventing or reducing the risk of altitude sickness.</span></figcaption></figure> <h2>The importance of gradual ascent</h2> <p>High-altitude medicine experts and other physicians <a href="https://doi.org/10.1016/s0140-6736(76)91677-9">have known for decades</a> that <a href="https://doi.org/10.1089/ham.2010.1006">taking time to slowly ascend is the best way</a> to prevent the development of altitude sickness.</p> <p>This strategy gives the body time to complete its natural physiologic responses to the changes in air pressure and oxygen content. In fact, spending just <a href="https://doi.org/10.1089/ham.2010.1006">one night at a moderate elevation</a>, such as Denver, Colorado, which is at 5,280 feet (1,600 meters), has been shown to <a href="https://doi.org/10.7326/0003-4819-118-8-199304150-00003">significantly reduce the likelihood of developing symptoms</a>.</p> <p>People who skip this step and travel directly to high elevations are <a href="https://doi.org/10.1093/jtm/taad011">up to four times more likely</a> to develop altitude sickness symptoms. When going to elevations greater than 11,000 feet, multiple days of acclimatization are necessary. Experts generally recommend ascending <a href="https://doi.org/10.1089/ham.2010.1006">no more than 1,500 feet per day</a> once the threshold of 8,200 feet of elevation has been crossed.</p> <p>Workers at high altitude, such as <a href="https://doi.org/10.1089/ham.2020.0004">porters in the Nepali Himalaya</a>, are at <a href="https://doi.org/10.1016/j.wem.2018.06.002">particular risk of altitude-related illness</a>. These workers often do not adhere to acclimatization recommendations in order to maximize earnings during tourist seasons; as a result, they are more likely to experience <a href="https://www.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">severe forms of altitude sickness</a>.</p> <h2>Effective medications</h2> <p>For more than 40 years, <a href="https://doi.org/10.1056/nejm196810172791601">a medicine called acetazolamide</a> has been used to <a href="https://medlineplus.gov/druginfo/meds/a682756.html">prevent the development of altitude sickness</a> and to treat its symptoms. Acetazolamide is <a href="https://www.ncbi.nlm.nih.gov/books/NBK557838/">commonly used as a diuretic</a> and for the <a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma">treatment of glaucoma</a>, a condition that causes increased pressure within the eye.</p> <p>If started <a href="https://doi.org/10.1378/chest.09-2445">two days prior</a> to going up to a high elevation, acetazolamide can <a href="https://doi.org/10.1378/chest.09-2445">prevent symptoms of acute illness</a> by speeding up the acclimatization process. Nonetheless, it does not negate the recommendations to ascend slowly, and it is <a href="https://doi.org/10.1016/j.wem.2019.04.006">routinely recommended only</a> when people cannot slowly ascend or for people who have a history of severe altitude sickness symptoms even with slow ascent.</p> <p>Other medications, including ibuprofen, have <a href="https://doi.org/10.1016/j.wem.2012.08.001">shown some effectiveness</a> in treating acute mountain sickness, although <a href="https://doi.org/10.1016/j.amjmed.2018.10.021">not as well as acetazolamide</a>.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/2028586/">steroid medication called dexamethasone</a> is effective in both treating and preventing symptoms, but it does not improve acclimatization. It is <a href="https://doi.org/10.1016/j.wem.2019.04.006">recommended only when acetazolamide is not effective</a> or cannot be taken.</p> <p>Additionally, it is important to <a href="https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes">avoid alcohol during the first few days at higher altitudes</a>, as it impairs the body’s ability to acclimatize.</p> <h2>Unproven therapies and remedies are common</h2> <p>As high-altitude tourism becomes increasingly popular, multiple commercial products and remedies have emerged. Most of them are not effective or provide no evidence to suggest they work as advertised. Other options have mixed evidence, making them difficult to recommend.</p> <p>Medications such as <a href="https://doi.org/10.1089/ham.2007.1037">aspirin</a>, <a href="https://doi.org/10.1183/13993003.01355-2017">inhaled steroids</a> and <a href="https://doi.org/10.1089/ham.2011.0007">sildenafil</a> have been proposed as possible preventive agents for altitude sickness, but on the whole they have not been found to be effective.</p> <p><a href="https://doi.org/10.1093/qjmed/hcp026">Supplements and antioxidants have no proven benefit</a> in preventing or treating altitude sickness symptoms. Both normal and high-altitude exercise are popular ways to prepare for high elevations, especially among athletes. However, beyond <a href="https://doi.org/10.1097/jes.0b013e31825eaa33">certain pre-acclimatization strategies</a>, such as brief sojourns to high altitude, <a href="https://doi.org/10.1016/j.tmaid.2013.12.002">physical fitness and training is of little benefit</a>.</p> <p><a href="https://missouripoisoncenter.org/canned-oxygen-is-it-good-for-you">Canned oxygen</a> has also exploded in popularity with travelers. While <a href="https://doi.org/10.1016/0140-6736(90)93240-p">continuously administered medical oxygen</a> in a health care setting can alleviate altitude sickness symptoms, portable oxygen cans <a href="https://doi.org/10.1016/j.wem.2019.04.006">contain very little oxygen gas</a>, casting doubt on their effectiveness.</p> <p>Some high-altitude adventure travelers sleep in <a href="https://doi.org/10.2165/00007256-200131040-00002">specialized tents</a> that simulate increased elevation by lowering the quantity of available oxygen in ambient air. The lower oxygen levels within the tent are thought to accelerate the acclimatization process, but the tents aren’t able to decrease barometric pressure. This is an important part of the high-altitude environment that induces acclimatization. Without modifying ambient air pressure, these <a href="https://doi.org/10.1016/j.wem.2014.04.004">tents may take multiple weeks</a> to be effective.</p> <p>Natural medicines, such as <a href="https://doi.org/10.1580/08-weme-br-247.1">gingko</a> and <a href="https://doi.org/10.1186/s40794-019-0095-7">coca leaves</a>, are touted as natural altitude sickness treatments, but few studies have been done on them. The modest benefits and significant side effects of these options makes their use <a href="https://doi.org/10.1016/j.wem.2019.04.006">difficult to recommend</a>.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/8469948/">Staying hydrated</a> is very important at high altitudes due to fluid losses from increased urination, dry air and increased physical exertion. <a href="https://doi.org/10.1186%2Fs12889-018-6252-5">Dehydration symptoms</a> can also mimic those of altitude sickness. But there is <a href="https://doi.org/10.1580/1080-6032(2006)17%5B215:AMSIOF%5D2.0.CO;2">little evidence that consuming excessive amounts of water</a> can prevent or treat altitude sickness.</p> <p>The mountains have something for visitors of all interests and expertise and can offer truly life-changing experiences. While there are health risks associated with travel at higher elevations, these can be lessened by making basic preparations and taking time to slowly ascend.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222057/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/brian-strickland-1506270"><em>Brian Strickland</em></a><em>, Senior Instructor in Emergency Medicine, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/altitude-sickness-is-typically-mild-but-can-sometimes-turn-very-serious-a-high-altitude-medicine-physician-explains-how-to-safely-prepare-222057">original article</a>.</em></p>

Travel Trouble

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Drinking alcohol this Christmas and New Year? These medicines really don’t mix

<p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>A glass or two of champagne with Christmas lunch. A cool crisp beer at the beach. Some cheeky cocktails with friends to see in the New Year. There seem to be so many occasions to unwind with an alcoholic drink this summer.</p> <p>But if you’re taking certain medications while drinking alcohol, this can affect your body in a number of ways. Drinking alcohol with some medicines means they may not work so well. With others, you risk a life-threatening overdose.</p> <p>Here’s what you need to know if you’re taking medication over summer and plan to drink.</p> <h2>Why is this a big deal?</h2> <p>After you take a medicine, it travels to the stomach. From there, your body shuttles it to the liver where the drug is metabolised and broken down before it goes into your blood stream. Every medicine you take is provided at a dose that takes into account the amount of metabolism that occurs in the liver.</p> <p>When you drink alcohol, this is also broken down in the liver, and it can affect how much of the drug is metabolised.</p> <p>Some medicines are metabolised <em>more</em>, which can mean not enough reaches your blood stream to be effective.</p> <p>Some medicines are metabolised <em>less</em>. This means you get a much higher dose than intended, which could lead to an overdose. The effects of alcohol (such as sleepiness) can act in addition to similar effects of a medicine.</p> <p>Whether or not you will have an interaction, and what interaction you have, depends on many factors. These include the medicine you are taking, the dose, how much alcohol you drink, your age, genes, sex and overall health.</p> <p>Women, older people and people with liver issues are more likely to have a drug interaction with alcohol.</p> <h2>Which medicines don’t mix well with alcohol?</h2> <p>Many medicines interact with alcohol regardless of whether they are prescribed by your doctor or bought over the counter, such as <a href="https://www.drugs.com/article/herbal-supplements-alcohol.html">herbal medicines</a>.</p> <p><strong>1. Medicines + alcohol = drowsiness, coma, death</strong></p> <p>Drinking alcohol and taking a medicine that depresses the <a href="https://adf.org.au/drug-facts/depressants/">central nervous system</a> to reduce arousal and stimulation can have additive effects. Together, these can make you extra drowsy, slow your breathing and heart rate and, in extreme cases, lead to coma and death. These effects are more likely if you use more than one of this type of medicine.</p> <p>Medicines to look out for include those for depression, anxiety, schizophrenia, pain (except <a href="https://www.nps.org.au/australian-prescriber/articles/alcohol-and-paracetamol">paracetamol</a>), sleep disturbances (such as insomnia), allergies, and colds and flu. It’s best not to drink alcohol with these medicines, or to keep your alcohol intake to a minimum.</p> <p><strong>2. Medicines + alcohol = more effects</strong></p> <p>Mixing alcohol with some medicines increases the effect of those medicines.</p> <p>One example is with the sleeping tablet zolpidem, which is <a href="https://www.tga.gov.au/news/product-recalls/zolpidem-stilnox">not to be taken with alcohol</a>. Rare, but serious, side effects are strange behaviour while asleep, such as sleep-eating, sleep-driving or sleep-walking, which are more likely with alcohol.</p> <p><strong>3. Medicines + craft beer or home brew = high blood pressure</strong></p> <p>Some types of medicines only interact with some types of alcohol.</p> <p>Examples include some medicines for depression, such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid, the Parkinson’s drug selegiline, and the cancer drug procarbazine.</p> <p>These so-called <a href="https://www.mydr.com.au/medicine/monoamine-oxidase-inhibitors-maois-for-depression/">monoamine oxidase inhibitors</a> <a href="https://www.health.qld.gov.au/__data/assets/pdf_file/0020/145802/oncol_maoi.pdf">only interact with</a> some types of boutique and artisan beers, beers with visible sediment, Belgian, Korean, European and African beers, and home-made beers and wine.</p> <p>These types of alcohol contain high levels of tyramine, a naturally occurring substance usually broken down by your body that doesn’t ordinarily cause any harm.</p> <p>However, monoamine oxidase inhibitors prevent your body from breaking down tyramine. This increases levels in your body and can cause your blood pressure to rise to dangerous levels.</p> <p><strong>4. Medicines + alcohol = effects even after you stop drinking</strong></p> <p>Other medicines interact because they affect the way your body breaks down alcohol.</p> <p>If you drink alcohol while using such medicines you may you feel nauseous, vomit, become flushed in the face and neck, feel breathless or dizzy, your heart may beat faster than usual, or your blood pressure may drop.</p> <p>This can occur even after you stop treatment, then drink alcohol. For example, if you are taking metronidazole you should avoid alcohol both while using the medicine and for at least 24 hours after you stop taking it.</p> <p>An example of where alcohol changes the amount of the medicine or related substances in the body is acitretin. This medication is used to treat skin conditions such as severe psoriasis and to prevent skin cancer in people who have had an organ transplant.</p> <p>When you take acitretin, it changes into another substance – <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2017-CMI-02034-1&amp;d=20221221172310101">etretinate</a> – before it is removed from your body. Alcohol increases the amount of etretinate in your body.</p> <p>This is especially important as etretinate can cause birth defects. To prevent this, if you are a woman of child-bearing age you should avoid alcohol while using the medicine and for two months after you stop taking it.</p> <h2>Myths about alcohol and medicines</h2> <p><strong>Alcohol and birth control</strong></p> <p>One of the most common myths about medicines and alcohol is that you can’t drink while using <a href="https://youly.com.au/blog/sexual-reproductive-health/does-alcohol-make-the-pill-less-effective/">the contraceptive pill</a>.</p> <p>It is generally safe to use alcohol with the pill as it <a href="https://www.healthline.com/health/womens-health/birth-control-and-alcohol#:%7E:text=There's%20a%20bit%20of%20good,a%20less%20effective%20birth%20control.">doesn’t directly affect</a> how well birth control works.</p> <p>But the pill is most effective when taken at the same time each day. If you’re drinking heavily, you’re more likely to forget to do this the next day.</p> <p>Alcohol can also make some people nauseous and vomit. If you vomit within three hours of taking the pill, it will not work. This increases your risk of pregnancy.</p> <p>Contraceptive pills can also affect your response to alcohol as the hormones they contain can change the way your body <a href="https://americanaddictioncenters.org/alcoholism-treatment/birth-control">removes alcohol</a>. This means you can get drunk faster, and stay drunk for longer, than you normally would.</p> <p><strong>Alcohol and antibiotics</strong></p> <p>Then there’s the myth about not mixing alcohol with any <a href="https://theconversation.com/mondays-medical-myth-you-cant-mix-antibiotics-with-alcohol-4407">antibiotics</a>. This only applies to <a href="https://www.healthdirect.gov.au/medicines/medicinal-product/aht,21161/metronidazole">metronidazole</a> and <a href="https://www.healthdirect.gov.au/medicines/brand/amt,1011571000168100/linezolid-apo">linezolid</a>.</p> <p>Otherwise, it is generally safe to use alcohol with antibiotics, as alcohol does not affect how well they work.</p> <p>But if you can, it is best to avoid alcohol while taking antibiotics. Antibiotics and alcohol have similar side effects, such as an upset stomach, dizziness and drowsiness. Using the two together means you are more likely to have these side effects. Alcohol can also reduce your energy and increase how long it takes for you to recover.</p> <h2>Where can I go for advice?</h2> <p>If you plan on drinking alcohol these holidays and are concerned about any interaction with your medicines, don’t just stop taking your medicines.</p> <p>Your pharmacist can advise you on whether it is safe for you to drink based on the medicines you are taking, and if not, provide advice on alternatives.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/196646/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/nial-wheate-96839"><em>Nial Wheate</em></a><em>, Associate Professor of the Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drinking-alcohol-this-christmas-and-new-year-these-medicines-really-dont-mix-196646">original article</a>.</em></p>

Caring

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Taking an antidepressant? Mixing it with other medicines – including some cold and flu treatments – can be dangerous

<p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>In the depths of winter we are more at risk of succumbing to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522168/">viral respiratory infections</a> – from annoying sore throat, common cold and sinusitis, to the current resurgence of respiratory syncytial virus (RSV), influenza and COVID.</p> <p>Symptoms of upper respiratory tract infection range in severity. They can include fever, chills, muscle or body aches, cough, sore throat, runny or stuffy nose, earache, headache, and fatigue. Most antibiotics target bacteria so are <a href="https://pubmed.ncbi.nlm.nih.gov/32495003/">not effective</a> for viral infections. Many people seek relief with over-the-counter medicines.</p> <p>While evidence varies, guidelines suggest medicines taken by mouth (such as cough syrups or cold and flu tablets) have a <a href="https://pubmed.ncbi.nlm.nih.gov/25420096/">limited but potentially positive</a> short-term role for managing upper respiratory infection symptoms in adults and children older than 12. These include:</p> <ul> <li>paracetamol or ibuprofen for pain or fever</li> <li>decongestants such as phenylephrine or pseudoephedrine</li> <li>expectorants and mucolytics to thin and clear mucus from upper airways</li> <li>dry cough suppressants such as dextromethorphan</li> <li>sedating or non-sedating antihistamines for runny noses or watery eyes.</li> </ul> <p>But what if you have been prescribed an antidepressant? What do you need to know before going to the pharmacy for respiratory relief?</p> <h2>Avoiding harm</h2> <p>An audit of more than 5,000 cough-and-cold consumer enquiries to an Australian national medicine call centre found questions frequently related to drug-drug interactions (29%). An 18-month analysis showed 20% of calls <a href="https://pubmed.ncbi.nlm.nih.gov/26590496/">concerned</a> potentially significant interactions, particularly with antidepressants.</p> <p>Australia remains in the “<a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-%20prescriptions#Prescriptionsbytype">top ten</a>” antidepressant users in the <a href="https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_PHMC">OECD</a>. More than <a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions">32 million</a> antidepressant prescriptions are dispensed on the Pharmaceutical Benefits Scheme each year.</p> <p>Antidepressants are commonly prescribed to manage symptoms of anxiety or depression but are also used in chronic pain and incontinence. They are classified primarily by how they affect chemical messengers in the nervous system.</p> <p>These classes are:</p> <ul> <li><strong>selective serotonin reuptake inhibitors (SSRI)</strong> such as fluoxetine, escitalopram, paroxetine and sertraline</li> <li><strong>serotonin and noradrenaline reuptake inhibitors (SNRI)</strong> such as desvenlafaxine, duloxetine and venlafaxine</li> <li><strong>tricyclic antidepressants (TCA)</strong> such as amitriptyline, doxepin and imipramine</li> <li><strong>monoamine oxidase inhibitors (MAOI)</strong> such as tranylcypromine</li> <li><strong>atypical medicines</strong> such as agomelatine, mianserin, mirtazapine, moclobemide, reboxetine and vortioxetine</li> <li><strong>complementary medicines</strong> including St John’s wort, S-adenosyl methionine (SAMe) and L-tryptophan</li> </ul> <p>Medicines within the same class of antidepressants have similar actions and side-effect profiles. But the molecular differences of individual antidepressants mean they may have different interactions with medicines taken at the same time.</p> <h2>Types of drug interactions</h2> <p>Drug interactions can be:</p> <ul> <li><strong>pharmacokinetic</strong> – what the body does to a drug as it moves into, through and out of the body. When drugs are taken together, one may affect the absorption, distribution, metabolism or elimination of the other</li> <li><strong>pharmacodynamic</strong> – what a drug does to the body. When drugs are taken together, one may affect the action of the other. Two drugs that independently cause sedation, for example, may result in excessive drowsiness if taken together.</li> </ul> <p>There are many <a href="https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.429">potential interactions</a> between medications and antidepressants. These include interactions between over-the-counter medicines for upper respiratory symptoms and antidepressants, especially those taken orally.</p> <p>Concentrations of nasal sprays or inhaled medicines are generally lower in the blood stream. That means they are less likely to interact with other medicines.</p> <h2>What to watch for</h2> <p>It’s important to get advice from a pharmacist before taking any medications on top of your antidepressant.</p> <p>Two symptoms antidepressant users should monitor for shortly after commencing a cough or cold medicine are central nervous system effects (irritability, insomnia or drowsiness) and effects on blood pressure.</p> <p>For example, taking a selective SSRI antidepressant and an oral decongestant (such as pseudoephedrine or phenylephrine) can cause irritability, insomnia and affect blood pressure.</p> <p>Serotonin is a potent chemical compound produced naturally for brain and nerve function that can also constrict blood vessels. Medicines that affect serotonin are common and include most antidepressant classes, but also decongestants, dextromethorphan, St John’s wort, L-tryptophan, antimigraine agents, diet pills and amphetamines.</p> <p><a href="https://reference.medscape.com/drug-interactionchecker">Combining drugs</a> such as antidepressants and decongestants that both elevate serotonin levels can cause irritability, headache, insomnia, diarrhoea and blood pressure effects – usually increased blood pressure. But some people experience orthostatic hypotension (low blood pressure on standing up) and dizziness.</p> <p>For example, taking both a serotonin and SNRI antidepressant and dextromethorphan (a cough suppressant) can add up to high serotonin levels. This can also occur with a combination of the complementary medicine St John’s Wort and an oral decongestant.</p> <p>Where serotonin levels are too high, <a href="https://pubmed.ncbi.nlm.nih.gov/15666281/">severe symptoms</a> such as confusion, muscle rigidity, fever, seizures and even death have been reported. Such symptoms are rare but if you notice any of these you should stop taking the cold and flu medication straight away and seek medical attention.</p> <h2>Ways to avoid antidepressant drug interactions</h2> <p>There are a few things we can do to prevent potentially dangerous interactions between antidepressants and cold and flu treatments.</p> <p><strong>1. Better information</strong></p> <p>Firstly, there should be more targeted, consumer-friendly, <a href="https://www.webmd.com/interaction-checker/default.htm">online drug interaction information</a> available for antidepressant users.</p> <p><strong>2. Prevent the spread of viral infections as much as possible</strong></p> <p>Use the non-drug strategies that have worked well for COVID: regular hand washing, good personal hygiene, social distancing, and facemasks. Ensure adults and children are up to date with immunisations.</p> <p><strong>3. Avoid potential drug interactions with strategies to safely manage symptoms</strong></p> <p>Consult your pharmacist for strategies most appropriate for you and only use cold and flu medications while symptoms persist:</p> <ul> <li>treat muscle aches, pain, or a raised temperature with analgesics such as paracetamol or ibuprofen</li> <li>relieve congestion with a nasal spray decongestant</li> <li>clear mucus from upper airways with expectorants or mucolytics</li> <li>dry up a runny nose or watery eyes with a non-sedating antihistamine.</li> </ul> <p>Avoid over-the-counter cough suppressants for an irritating dry cough. Use a simple alternative such as honey, steam inhalation with a few drops of eucalyptus oil or a non-medicated lozenge instead.</p> <p><strong>4. Ask whether your symptoms could be more than the common cold</strong></p> <p>Could it be influenza or COVID? Seek medical attention if you are concerned or your symptoms are not improving. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208662/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-an-antidepressant-mixing-it-with-other-medicines-including-some-cold-and-flu-treatments-can-be-dangerous-208662">original article</a>.</em></p>

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Which medicines don’t go well with flying?

<p>Every day, <a href="http://www.iata.org/pressroom/pr/Pages/2012-12-06-01.aspx">more than 10 million people</a> take a flight somewhere in the world. While flying is relatively safe, the unique environmental conditions can put passengers at risk if they’re taking certain medications.</p> <p>These include any hormone-based drugs, like the contraceptive pill and some fertility medicines, and drugs used to prevent heart attack and stroke. Antihistamines should also not be used to help passengers sleep during a flight.</p> <h2>What makes flying different from other forms of travel?</h2> <p>While flying is <a href="https://theconversation.com/whats-most-likely-to-kill-you-measuring-how-deadly-our-daily-activities-are-72505">one of the safest forms of travel</a>, there are specific risks that come with air travel, regardless of the length of the flight. </p> <p>Passenger planes are typically pressurised to the same atmospheric conditions that are found at 10,000 feet altitude. <a href="https://www.ncbi.nlm.nih.gov/pubmed/6823572">At that level</a>, <a href="https://www.higherpeak.com/altitudechart.html">the effective oxygen level is only 14.3%</a>, which is much lower than the 20.9% found at ground level.</p> <p>An additional risk is reduced blood flow from a lack of movement and sitting in cramped conditions, unless of course you’re fortunate enough to be in business or first class. And finally, dehydration is also a common side effect of flying due to the lack of humidity in the air.</p> <p>When these conditions are combined, it results in an increased risk of <a href="https://www.healthdirect.gov.au/deep-vein-thrombosis">deep vein thrombosis</a>, which is also known as DVT. This is a type of blood clot that occurs in the veins deep in the body and occurs most often in the legs. The development of a blood clot can result in blocked blood flow to the lungs, heart, or brain, which in turn can cause a heart attack or stroke.</p> <h2>Contraceptive pill and other hormone-based medicines</h2> <p>Given the inherent risk of a blood clot when flying, a passenger should use with caution any medication that can further increase the risk of a clot.</p> <p>Some brands of contraceptive for women (tablet or implant formulation) are <a href="http://www.theaustralian.com.au/national-affairs/health/new-bloodclot-alerts-added-to-diane35-eds-product-information/news-story/eaa0b596541a760e9c6cf89b37900c42">known to increase the chances of a blood clot</a>, although the overall increase in risk is small. While it’s thought the major risk comes from the hormone <a href="http://www.healthywomen.org/condition/estrogen">estrogen</a>, <a href="http://www.cochrane.org/CD010813/FERTILREG_contraceptive-pills-and-venous-thrombosis">a review of all the medical evidence in 2014</a> showed there’s a risk of blood clot from all contraceptive medicines.</p> <p>Likewise, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hormone-replacement-therapy-hrt-and-menopause">hormone replacement therapy</a>, particularly those that include estrogen, or some fertility medicines, such as <a href="https://www.babycenter.com/0_fertility-drug-gonadotropins_6188.bc">gonadotrophins</a>, can increase the risk of a blood clot.</p> <p>If you take one of these medicines, it does not mean you cannot fly, nor that you should necessarily stop taking the drug. Many millions of women fly while taking these medicines and suffer no ill effects.</p> <p>But the risk is also increased if you have an underlying health condition that includes type II diabetes, heart disease, and prior heart attacks or strokes. As such, passengers who also take medications to help prevent heart attacks and strokes should consult their doctor or pharmacist before flying.</p> <p>If you’re at increased risk of a blood clot, then an anti-platelet medication may be suitable for you. These medicines act by stopping the blood cells from sticking together and include prescription medicines such as <a href="http://www.melbournehaematology.com.au/fact-sheets/warfarin.html">warfarin</a> and <a href="https://www.nps.org.au/australian-prescriber/articles/clopidogrel">clopidogrel</a>, and over-the-counter medicines such as <a href="https://www.healthdirect.gov.au/medicines/brand/amt,34661000168102/aspirin-low-dose-pharmacy-action">low dose aspirin</a>.</p> <h2>Antihistamines</h2> <p>Many passengers can have trouble sleeping when flying, especially on long-haul flights. Parents flying with young children can also be concerned about them not sleeping or being unsettled and annoying other passengers.</p> <p>In these instances, many will turn to <a href="https://www.healthdirect.gov.au/antihistamines">sedating antihistamines</a>, like <a href="https://www.healthdirect.gov.au/medicines/brand/amt,22661000168108/phenergan">promethazine</a> to try to induce sleep. But this is a bad option.</p> <p>The Australian Medical Association specifically recommends <a href="http://www.smh.com.au/national/australian-medical-association-warns-against-sedating-children-on-long-journeys-20150405-1mesd0.html">parents do not do this</a>, as sometimes it can have the reverse effect and make children less sleepy and more active. These types of <a href="http://www.medsafe.govt.nz/profs/PUArticles/Mar2013ChildrenAndSedatingAntihistamines.htm">antihistamines are also known to depress breathing</a>, and in the low oxygen environment of the aircraft this can be especially dangerous.</p> <p>If you feel you or another family member will need sedation when flying, don’t use an antihistamine. Consult your doctor or pharmacist for a more suitable medication. Examples include prescription sleeping tablets, such as <a href="https://sleepfoundation.org/sleep-topics/melatonin-and-sleep">melatonin</a>, or natural remedies, such as <a href="https://www.webmd.com/vitamins-supplements/ingredientmono-870-valerian.aspx?activeingredientid=870">valerian</a>.</p> <h2>What to do before and during your flight</h2> <p>Before you fly, if you’re taking any form of medication, it’s recommended you meet with your doctor or pharmacist to discuss the suitability of your medicines. They may advise you there’s little risk for you, or if there is a risk, they may recommend a different medicine for the trip or recommend a new medicine to reduce the risk of blood clots.</p> <p>During your flight, don’t take antihistamines, and reduce your chance of a blood clot by drinking lots of water, stretching in your seat, and moving about the cabin as much as is appropriate.</p> <p>Finally, the effects of alcohol can be increased when flying – so drink in moderation, and try to avoid tea, coffee, and other caffeinated drinks as these can have dehydrating effects and make it harder to sleep.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/which-medicines-dont-go-well-with-flying-90222" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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Is my medicine making me feel hotter this summer? 5 reasons why

<p>If you’re really feeling the heat this summer, it might be down to more than the temperature outside.</p> <p>Some types of medicines can increase your core body temperature or make you feel hotter than you really are. Some can affect your body’s ability to cool down.</p> <p>Here’s what you need to know about heat intolerance and medicines.</p> <h2>What is heat intolerance?</h2> <p>Some people simply dislike the feeling of feeling hot, while others feel hot at temperatures most people find comfortable. Both are examples of <a href="https://www.medicalnewstoday.com/articles/325232#symptoms">heat intolerance</a>.</p> <p>Typical symptoms during warm weather include excessive sweating (or not sweating enough), exhaustion and fatigue, nausea, vomiting or dizziness, and changes in mood.</p> <p>A number of factors can cause heat intolerance.</p> <p>This includes the disorder <a href="https://my.clevelandclinic.org/health/diseases/6004-dysautonomia">dysautonomia</a>, which affects people’s autonomic nervous system – the part of the body that regulates the automatic functions of the body, including our response to heat. </p> <p>Conditions such as diabetes, alcohol misuse, <a href="https://theconversation.com/what-causes-parkinsons-disease-what-we-know-dont-know-and-suspect-57579">Parkinson’s disease</a>, the autoimmune disease <a href="https://theconversation.com/explainer-what-is-guillain-barre-syndrome-and-is-it-caused-by-the-zika-virus-53884">Guillain-Barré syndrome</a> and <a href="https://theconversation.com/explainer-what-are-mitochondria-and-how-did-we-come-to-have-them-83106">mitochondrial disease</a> can cause dysautonomia. People in old age, those with some neurological conditions, or people less physically fit may also have it.</p> <p>But importantly, medications can also contribute to heat intolerance.</p> <h2>1. Your body temperature rises</h2> <p>Some medicines directly increase your body temperature, which then increases the risk of heat intolerance. </p> <p>These include <a href="https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1111/bph.15465">stimulant medications</a> to treat ADHD (attention deficit hyperactivity disorder), such as methylphenidate, dexamfetamine and lisdexamfetamine.</p> <p><a href="https://www.healthdirect.gov.au/antipsychotic-medications">Antipsychotic medications</a> (such as clozapine, olanzapine and quetiapine) used to treat mental health conditions, such as schizophrenia and bipolar disorder, are other examples. </p> <p>These ADHD and antipsychotic medicines raise your temperature by acting on the hypothalamus, the region of the brain essential for cooling.</p> <p>The drug levothyroxine, used to treat an under-active thyroid, also increases your body temperature, this time by <a href="https://www.ncbi.nlm.nih.gov/books/NBK500006/">increasing your metabolism</a>.</p> <h2>2. Your blood flow is affected</h2> <p>Other medicines constrict (tighten) blood vessels, decreasing blood flow to the skin, and so prevent heat from escaping this way. This means your body can’t regulate its temperature as well in the heat. </p> <p>Examples include <a href="https://www.healthdirect.gov.au/beta-blockers">beta-blockers</a> (such as metoprolol, atenolol and propranolol). These medications are used to treat conditions such as high blood pressure, angina (a type of chest pain), tachycardia (fast heart rate), heart failure, and to prevent migraines. </p> <p><a href="https://www.nhs.uk/conditions/decongestants/">Decongestants</a> for blocked noses (for example, pseudoephedrine and phenylephrine), triptans for migraines (such as sumatriptan and zolmitriptan) and the ADHD medications mentioned earlier can also act to decrease blood flow to the skin.</p> <h2>3. You can get dehydrated</h2> <p>Other medicines can cause dehydration, which then makes you more susceptible to heat intolerance. The best examples are <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/diuretics/art-20048129">diuretics</a> such as furosemide, hydrochlorothiazide, acetazolamide and aldosterone.</p> <p>These are used to control high blood pressure and heart failure by forcing your kidneys to remove more fluid from your body. </p> <p>Laxatives, such as senna extract and bisacodyl, also remove water from your body and so have a similar effect.</p> <h2>4. You can sweat less</h2> <p>Other medicines have a drying effect. This can be needed for medicines to do their job (for instance, to dry up a runny nose). For others, it is an unwanted side effect. </p> <p>This drying reduces the amount you sweat, making it harder to lose heat and regulate your core temperature. A number of medicines have these effects, including:</p> <ul> <li>some antihistamines (such as promethazine, doxylamine and diphenhydramine)</li> <li>certain antidepressants (such as amitriptyline, clomipramine and dothiepin)</li> <li>medicines used to treat <a href="https://www.healthdirect.gov.au/urinary-incontinence#:%7E:text=Urinary%20incontinence%2C%20or%20poor%20bladder%20control%2C%20is%20very%20common%20in,to%20cure%20or%20improve%20it.">urinary incontinence</a> (for example, oxybutynin and solifenacin) </li> <li>nausea medicine (prochlorperazine)</li> <li>medicines for stomach cramps and spasms (for instance, hyoscine) </li> <li>the antipsychoptics chlorpromazine, olanzapine, quetiapine and clozapine.</li> </ul> <h2>5. You don’t feel thirsty</h2> <p>Finally, some medicines, such as the antipsychotics haloperidol and droperidol, can aggravate heat intolerance by reducing your ability to feel thirsty. </p> <p>If you don’t feel thirsty, you drink less and are therefore at risk of dehydration and feeling hot.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/is-my-medicine-making-me-feel-hotter-this-summer-5-reasons-why-199085" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Body

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Support is the best medicine

<p>Sharing your experience and talking with others when ill can be very good for your wellbeing. Here’s why support groups are great.</p> <p>Good friends may help your life last longer as they’ll boost your self-esteem, offer companionship and provide support when you need it. A study by the Centre for Ageing Studies at Flinders University backed this up by following 1500 older Aussies for 10 years and found that those who had a large network of friends outlived those with fewer friends by 22 per cent.</p> <p>When you know you can count on someone to help or provide support when you most need it, it can make the world of difference. However, sometimes people may not live near close friends or have found it difficult to develop a strong community group around them. When a person becomes ill, a good network can be the best medicine for helping to keep a person’s spirits up, so joining a support group could be the perfect solution.</p> <p>Another study, completed in 2005 and published in health journal <em>Cancer</em>, found that out of the 61 women who had advanced ovarian cancer those with support networks had much lower levels of a protein linked with more aggressive types of cancer. Women who didn’t have as much social support around them had levels of the protein that were a whopping 70 per cent higher!</p> <p>Support groups can bring people together who are facing similar issues, ranging from major life changes to illness. Many people join support groups because sharing experiences with people who are going through the same battles can be incredibly helpful and make a person feel like they’re not alone.</p> <p>Well-known Australian cancer survivor, Dr Ian Gawler, who was diagnosed with bone cancer, had his right leg amputated and then had to battle the disease again later that same year, believes having a positive and practical attitude can help in many ways when battling disease.</p> <p>According to a 2005 study by The Cancer Council, there are health benefits associated with being part of a health support group. These include: improvements in coping and adaptation, reductions in psychological stress, enhanced self-esteem and even positive effects on immunological response.</p> <p>Just ask Terri-Ann Carter, a Queenslander who underwent surgery and chemotherapy for a lump on her neck. She started an online support group called Gladstone Cancer Friends as a way to cope with the isolation and stress of going through cancer treatment. For cancer sufferers, two big fears are one of relapse and social isolation. Whether online or in person, a support group can help a person cope with these two alienating factors.</p> <p>When it comes to your health, nothing should be taken for granted. Together with surrounding yourself with the love and support of family, friends or new acquaintances from a support group, it’s always worth getting good health insurance.</p> <p><strong>How to find a support group:</strong></p> <p><strong>Ask your doctor or health care provider.</strong> They may be able to point you in the right direction of a support group near you.</p> <p><strong>Go online.</strong> There are many over-60s who live in rural or regional areas, so more people are turning to the internet to connect with others for support and advice. Social media sites, such as Facebook, have become very popular for people to comfortably share their stories and experience in an open and supportive forum.</p> <p><strong>Get in touch with local centres.</strong> Look to your local community halls, libraries and even supermarket notice boards for possible support groups in your area.     </p> <p><strong>Look to state or national bodies.</strong> Organisations for a particular illness or issue usually have a directory of the support groups in various local communities for people to be redirected to. Take a look and find one that’s close to you.</p> <p><strong>Can’t find one? Start your own.</strong> If there’s no support group near you, why not start your own? Look to start an online group via Facebook or post announcements on a board in your local medical centre or hospital to spread the word.</p> <p><em>Image: Getty</em></p>

Caring

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Drugs – 4 essential reads on how they’re made, how they work and how context can make poison a medicine

<p>Pandemics and disease outbreaks put a spotlight on the hurdles researchers face to get a drug on the shelves. From finding prospective drug candidates to balancing time and financial pressures with ensuring safety and efficacy, there are many aspects of drug development that determine whether a treatment ever makes it out of the lab.</p> <p>Broadening the definition of “medicine” and where it can be found, however, could help expand the therapeutic options available for both researchers and patients.</p> <p>Here are four facets of how drugs are developed and how they work in the body, drawn from stories in The Conversation’s archive.</p> <h2>1. Matching drug to target</h2> <p>The most effective drugs are, in a sense, the product of good matchmaking – they bind to a specific disease-causing receptor in the body, elicit a desired effect and ideally ignore healthy parts of the body.</p> <p>Drugs <a href="https://theconversation.com/how-do-drugs-know-where-to-go-in-the-body-a-pharmaceutical-scientist-explains-why-some-medications-are-swallowed-while-others-are-injected-182488" target="_blank" rel="noopener">travel through the bloodstream</a> to reach their targets. Because of this, most drugs circulate throughout the body and can bind to unintended sites, potentially causing undesired side effects.</p> <p>Researchers can increase the precision and effectiveness of a drug by designing different ways to take it. An inhaler, for example, delivers a drug directly to the lungs without its having to travel through the rest of the body to get there.</p> <p>Whether patients take drugs as prescribed is also essential to ensuring the right dose gets to where it needs to be often enough to have a desired effect. “Even with all the science that goes into understanding a disease well enough to develop an effective drug, it is often up to the patient to make it all work as designed,” writes pharmaceutical scientist <a href="https://www.researchgate.net/profile/Thomas-Anchordoquy" target="_blank" rel="noopener">Tom Anchordoquy</a> of the University of Colorado Anschutz.</p> <h2>2. Searching for drug candidates</h2> <p>Researchers have discovered a number of drugs by chance, including <a href="https://www.pbs.org/newshour/health/the-real-story-behind-the-worlds-first-antibiotic" target="_blank" rel="noopener">penicillin</a> for bacterial infections, <a href="https://www.bbc.com/future/article/20200928-how-the-first-vaccine-was-born" target="_blank" rel="noopener">vaccines for smallpox</a> and <a href="https://doi.org/10.1038/nrcardio.2017.172" target="_blank" rel="noopener">warfarin</a> for blood clots. While serendipity still plays a role in modern drug discovery, most drug developers take a systematic approach.</p> <p>Scientists typically start by identifying a particular molecular target, usually receptors that trigger a specific response in the body. Then, they look for chemical compounds that react with that target. Technology called <a href="https://theconversation.com/discovering-new-drugs-is-a-long-and-expensive-process-chemical-compounds-that-dupe-screening-tools-make-it-even-harder-175972" target="_blank" rel="noopener">high-throughput screening</a> allows researchers to quickly test thousands of potential drug candidates at once. Compounds that match screening criteria advance to further development and refinement. Once optimized for their intended use, compounds go on to safety and efficacy testing in animals and people.</p> <p>One way to ease the search for optimal drug candidates is to work with compounds that are already optimized to work in living beings. <a href="https://theconversation.com/nature-is-the-worlds-original-pharmacy-returning-to-medicines-roots-could-help-fill-drug-discovery-gaps-176963" target="_blank" rel="noopener">Natural products</a>, derived from organisms like microbes, fungi, plants and animals, share similar structures and functions across species. Though not without their own development challenges, they could aid the search for related compounds that work in people.</p> <p>“There are thousands of microorganisms in the ocean left to explore as potential sources of drug candidates, not to mention all the ones on land,” writes medical chemist <a href="https://scholar.google.com/citations?user=8_T1ueYAAAAJ&amp;hl=en" target="_blank" rel="noopener">Ashu Tripathi</a> of the University of Michigan. “In the search for new drugs to combat antibiotic resistance, natural products may still be the way to go.”</p> <h2>3. A drug by any other name may be just as effective</h2> <p>Existing drugs can find a second (or third, fourth and fifth) life through repurposing.</p> <p>Most drugs <a href="https://theconversation.com/many-medications-affect-more-than-one-target-in-the-body-some-drug-designers-are-embracing-the-side-effects-that-had-been-seen-as-a-drawback-184922" target="_blank" rel="noopener">have many functions</a> beyond what researchers originally designed them to do. While this multifunctionality is often the cause of unwanted side effects, sometimes these results are exactly what’s needed to treat a completely unrelated condition.</p> <p>Sildenafil, for example, failed to treat severe chest pain from coronary artery disease, but proved to be potent at inducing erections as Viagra. Similarly, thalidomide, a compound that caused birth defects in thousands of infants around the world as a morning sickness drug, found redemption as a cancer treatment.</p> <p>Because drugs inherently have more than one function in the body, <a href="https://theconversation.com/repurposing-generic-drugs-can-reduce-time-and-cost-to-develop-new-treatments-but-low-profitability-remains-a-barrier-174874" target="_blank" rel="noopener">repurposing existing drugs</a> can help fill a gap where pharmaceutical companies and other developers cannot or will not. <a href="https://scholar.google.com/citations?user=iDKZaA4AAAAJ&amp;hl=en" target="_blank" rel="noopener">Gregory Way</a>, a researcher at the University of Colorado Anschutz, uses artificial intelligence to predict the various effects a drug can have and believes that this lack of specificity is something to explore rather than eliminate. Instead of trying to home in on one specific target, he suggests that scientists “embrace the complexity of biology and try to leverage the multifaceted effects drugs can offer.”</p> <h2>4. Poison as medicine</h2> <p>If so many drugs can have toxic effects in the body, be it through side effects or taking the wrong dose or for the wrong condition, what determines whether a drug is a “medicine” or a “poison”?</p> <p>Biomedical scientists evaluate drugs based on their active ingredient, or a specific compound that has a specific effect in the body. But reducing medicines to just a single molecule ignores another important factor that determines whether a drug is therapeutic – the context in which it is used. Opioids treat intractable pain but can lead to debilitating and lethal addiction when improperly administered. Chemotherapy kills tumors but causes collateral damage to healthy tissues in the process.</p> <p>Another pharmaceutical paradigm, <a href="https://theconversation.com/poison-or-cure-traditional-chinese-medicine-shows-that-context-can-make-all-the-difference-163337" target="_blank" rel="noopener">traditional Chinese medicine</a>, has historically acknowledged the malleability of drugs through the use of poisons as therapeutics.</p> <p><a href="https://scholar.google.com/citations?user=4q0hYSwAAAAJ&amp;hl=en" target="_blank" rel="noopener">Yan Liu</a>, a medical historian at University of Buffalo who studies this practice, notes that ancient texts did not distinguish between poisons and nonpoisons – rather, Chinese doctors examined drugs based on a continuum of potency, or ability to harm and heal. They used different processing and administration techniques to adjust the potency of poisons. They also took a personalized approach to treatment, aware that each drug works differently based on a number of different individual factors.</p> <p>“The paradox of healing with poisons in traditional Chinese medicine reveals a key message: There is no essential, absolute or unchanging core that characterizes a medicine,” Liu writes. “Instead, the effect of any given drug is always relational – it is contingent on how the drug is used, how it interacts with a particular body and its intended effects.”</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/drugs-4-essential-reads-on-how-theyre-made-how-they-work-and-how-context-can-make-poison-a-medicine-192590" target="_blank" rel="noopener">The Conversation</a> and is a roundup of of articles from The Conversation’s archives.</strong></p> <p><em>Image: Shutterstock</em></p>

Books

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14 medicinal herbs you can grow in your backyard

<p><strong>Basil</strong></p> <p>This medicinal herb can help with flatulence, lack of appetite, cuts and scrapes. Harvest the young leaves of this annual plant as needed.</p> <p><strong>Chamomile</strong></p> <p>Use the flower heads of this medicinal herb for infusions and salves to relieve conditions such as indigestion and colic, anxiety and tension, and skin inflammations and irritations.</p> <p><strong>Echinacea</strong></p> <p>If you suffer from a cold or the flu, try this medicinal herb to ease the severity of your symptoms. It also helps provide relief to your immune system.</p> <p><strong>Feverfew</strong></p> <p>Use the leaves and flowers of this medicinal herb for teas; chew leaves to ease headache pain (including migraines). It’s also been shown to be one of the most effective natural remedies for arthritis, as well as a treatment for various skin conditions.</p> <p><strong>Wild pansy</strong></p> <p>With anti-inflammatory properties, this medicinal herb is a good home remedy for eczema and skin blemishes, as well as to help loosen phlegm.</p> <p><strong>Lavender</strong></p> <p>Is there anything lavender can’t do? Even smelling this medicinal herb has been shown to calm and relax. It also eases pain, and when applied to cuts and bruises functions as an antiseptic.</p> <p><strong>Lemon balm</strong></p> <p>A relative of mint, lemon balm is a versatile medicinal herb that helps relieve anxiety, insomnia, wounds, herpes, insect bites, flatulence and an upset stomach.</p> <p><strong>Marigold</strong></p> <p>Good for easing sunburn, acne, and blemishes, this medicinal herb also soothes ulcers and digestive problems.</p> <p><strong>Parsley</strong></p> <p>Don’t think of it as decorative on your plate; this medicinal herb is loaded with nutrients as well as healing powers to help with flatulence and bad breath.</p> <p><strong>Peppermint</strong></p> <p>If you have digestion issues or gas, sipping tea made of this medicinal herb might provide relief. It’s also been shown to help soothe headaches.</p> <p><strong>Rosemary</strong></p> <p>This medicinal herb helps memory and concentration, improves mood – and sweetens breath.</p> <p><strong>Sage</strong></p> <p>Sage’s genus name, Salvia, means “to heal,” reflecting its early use as a medicinal, not culinary, herb. It can help provide relief for mouth and throat inflammations.</p> <p><strong>Thyme</strong></p> <p>The active principle in thyme, thymol, is a strong antiseptic. If you suffer from coughs, congestion, indigestion or gas, consider using this medicinal herb.</p> <p><strong>St. John's wort</strong></p> <p>Talk to your doctor if you suffer from mild to moderate depression; she may suggest St. John’s wort. The glossy leaves and yellow flowers are this medicinal herb’s active parts.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/food-home-garden/14-medicinal-herbs-you-can-grow-in-your-backyard?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Home & Garden

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New type of gel helps the medicine go down

<p class="spai-bg-prepared">Swallowing tablets can be a challenge for most children and some adults, but scientists have come to the rescue with a new drug-delivering oleogel that can make it easier to consume a variety of medicines.</p> <p class="spai-bg-prepared">According to a <a class="spai-bg-prepared" href="https://www.science.org/doi/10.1126/sciadv.abm8478" target="_blank" rel="noreferrer noopener">new study</a>, the gels are made from plant-based oils and can be prepared in a variety of textures – from a thickened drink to a gel with yogurt-like consistency. This could help adults who have difficulty swallowing pills, such as older people or those who have suffered a stroke.</p> <p class="spai-bg-prepared">The gels have also been designed to remain stable at 40°C for two weeks, and even up to 60°C for one week. This could make them especially helpful for children in developing nations, where the gels might be transported in vehicles without refrigeration. </p> <p class="spai-bg-prepared">“Given the simplicity of the system and its low cost, it could have a tremendous impact on making it easier for patients to take medications,” says senior author Giovanni Traverso, assistant professor of mechanical engineering at Massachusetts Institute of Technology (MIT) and a gastroenterologist at Brigham and Women’s Hospital, US.</p> <p class="spai-bg-prepared">Existing strategies for people unable to swallow pills have relied on dissolving drugs in water, but this requires a water-soluble medicine, as well as access to clean water and refrigeration. It can also be difficult to achieve the right dosage for children if the pills used are meant for adults.</p> <p class="spai-bg-prepared">To avoid these issues, the interdisciplinary research team focused on the potential of oil-based gels, also known as oleogels, for drug delivery.</p> <p class="spai-bg-prepared">The researchers explored several different types of plant-derived oils, including sesame, cottonseed and flaxseed oil. By combining these oils with edible gelling ingredients – such as beeswax and rice bran wax – they found they could control the texture depending on the type of oil and gelling agent, and their concentrations.</p> <div class="newsletter-box spai-bg-prepared"> <div id="wpcf7-f6-p193139-o1" class="wpcf7 spai-bg-prepared" dir="ltr" lang="en-US" role="form"> </div> </div> <p class="spai-bg-prepared">To identify the most palatable oleogels, the researchers worked with a consulting firm specialising in consumer sensory experiences to narrow down the oleogels to those made from oils with a neutral or slightly nutty flavour.</p> <p class="spai-bg-prepared">“That approach gave us the capacity to deliver very hydrophobic drugs that cannot be delivered through water-based systems,” says lead author Ameya Kirtane, former MIT postdoctoral researcher and current instructor in medicine at Brigham and Women’s Hospital. “It also allowed us to make these formulations with a really wide range of textures.”</p> <p class="spai-bg-prepared">They then tested delivering three oil-soluble (hydrophobic) drugs from the World Health Organization’s (<a class="spai-bg-prepared" href="https://www.who.int/" target="_blank" rel="noreferrer noopener">WHO</a>) list of <a class="spai-bg-prepared" href="https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.03" target="_blank" rel="noreferrer noopener">essential medicines for children</a>: praziquantel, used to treat parasitic infections; lumefantrine, used to treat malaria; and azithromycin, used to treat bacterial infections.</p> <p class="spai-bg-prepared">The tests showed that in pigs the oleogels were able to deliver doses of these medicines equal to or greater than the amounts absorbed from tablets, and that a water-soluble <a class="spai-bg-prepared" href="https://cosmosmagazine.com/health/medicine/antibiotic-resistance-millions-years/" target="_blank" rel="noreferrer noopener">antibiotic</a> (moxifloxacin hydrochloride) could also be successfully delivered.</p> <p class="spai-bg-prepared">“Based on that list, infectious diseases really stood out in terms of what a country needs to protect its children,” Kirtane says. “A lot of the work that we did in this study was focused on infectious-disease medications, but from a formulation standpoint, it doesn’t matter what drug we put into these systems.”</p> <p class="spai-bg-prepared">A phase I clinical trial of the oleogel formulation of azithromycin should be underway within the next few months.</p> <p><img id="cosmos-post-tracker" class="spai-bg-prepared" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=193139&title=New+type+of+gel+helps+the+medicine+go+down" width="1" height="1" /></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/oleogels-alternative-medicine-delivery/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto" target="_blank" rel="noopener">Imma Perfetto</a>. Imma Perfetto is a science writer at Cosmos. She has a Bachelor of Science with Honours in Science Communication from the University of Adelaide.</em></p> <p><em>Image: Getty Images</em></p> </div>

Body

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The medicines to pack for your overseas holiday

<p>When travelling overseas, we all want a comfortable and pleasurable stay. This involves packing the right clothes for the right conditions and bringing a good book or music playlist. But what medicines should you take?</p> <p>The medicines you need will depend on what your expected needs are and what is available in the country being visited. Common medicines you may need to take include those for sleep, diarrhoea, malaria, pain and anxiety.</p> <p>When deciding what to take, it’s also important to remember that even if a medicine is available at home, its supply may be restricted or even prohibited in the country you are visiting. So, you should check beforehand.</p> <h2>Medicines for sleep</h2> <p>Sleeping on an aeroplane, while wedged in a tiny chair listening to a crying baby in the distance, can be very difficult for many people. As such, prescription sleeping medicines may be recommended by a doctor for short-term use. </p> <p>Alternatively, over-the-counter sleeping medicines, like the sedating antihistamine <a href="https://www.nps.org.au/medical-info/medicine-finder/restavit-tablets">doxylamine</a> are available from a pharmacy. But sedating antihistamines should not be used for <a href="http://www.smh.com.au/national/australian-medical-association-warns-against-sedating-children-on-long-journeys-20150405-1mesd0.html">children</a> when flying. </p> <p>You should also consider whether you actually need to sleep. If the flight is too long, then being asleep or sedated may prevent you from moving around while flying. Leg movement and stretching is <a href="https://www.cdc.gov/ncbddd/dvt/travel.html">recommended</a> when flying to improve blood flow and protect against blood clots. </p> <h2>Medicines for diarrhoea</h2> <p>Diarrhoea poses the <a href="https://www.racgp.org.au/afp/2012/october/parasitic-causes-of-prolonged-diarrhoea-in-travellers/">highest infectious risk</a> for travellers overseas, depending on where you are going. Diarrhoea is associated with <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/travellers-diarrhoea">symptoms</a> of stomach cramps, runny poo and nausea. </p> <p><a href="https://www.nps.org.au/medical-info/medicine-finder/buscopan-tablets">Hyoscine</a> is a medicine that may help relieve cramps by relaxing the stomach muscles. </p> <p><a href="https://www.tga.gov.au/otc-medicine-monograph-loperamide-hydrochloride">Loperamide</a> is useful in helping to stop diarrhoea, altogether. This may be particularly important if you’re stuck on a ten-hour flight, or have just set off on that once-in-a-lifetime jungle safari.</p> <p>Otherwise, medical advice often recommends not stopping the diarrhoea. Why? Because this stops your body from flushing out the pathogen that is causing the problem, and keeps the runny poo in, neither of which is a good thing. </p> <p>It’s best to let the diarrhoea pass and remain hydrated, which may include drinking more than just plain water; <a href="https://travel.gc.ca/travelling/health-safety/rehydration">oral rehydration</a> products may also be needed. These work by replacing all the lost sugars and salts in your body due to diarrhoea. They are available in sachets or effervescent tablets which can be mixed with water, making them easy to carry and use.</p> <p>Sometimes, treatment of diarrhoea will require additional medicines such as antibiotics. Either way you should consult a doctor or pharmacist before using medicines for diarrhoea, especially if it is persistent, if you experience fever, or if you see pus or blood in your wee or poo. </p> <h2>Medicines for malaria</h2> <p>For particular countries, there are medicines you may need to take before your journey to prevent you from getting sick while on vacation. </p> <p>If you are going to <a href="https://www.cdc.gov/malaria/travelers/country_table/a.html">certain areas</a> in Africa, India and Central America, for example, you may need to take an antimalarial medicine, such as the antibiotic <a href="https://www.nps.org.au/medical-info/medicine-finder/doxylin-tablets">doxycycline</a>. To be effective, these types of drugs need to be taken before, during, and after your travels, so it’s advisable to plan in advance with your doctor when travelling to areas with malaria.</p> <h2>Medicines for pain</h2> <p>Many of us use <a href="https://www.tga.gov.au/otc-medicine-monograph-paracetamol-oral-use">paracetamol</a> and <a href="https://www.tga.gov.au/otc-medicine-monograph-ibuprofen-oral-use">ibuprofen</a> for short-term pain relief. Even though they may be available from a pharmacy in some countries, like Australia, they can sometimes be hard to obtain overseas due to language barriers or different rules about how they can be supplied. </p> <p><a href="https://www.healthdirect.gov.au/codeine">Codeine</a> is also often found in pain relief preparations. Some countries have restrictions placed on the supply of codeine. For example, in Australia, codeine-based medicines can only be obtained with a <a href="https://www.nps.org.au/medical-info/clinical-topics/over-the-counter-codeine-changes-to-supply">prescription</a></p> <h2>Medicines for anxiety</h2> <p>Some people experience anxiety when flying. A doctor may recommend prescription medicines like <a href="https://www.nps.org.au/medical-info/medicine-finder/valium-tablets">diazepam</a>, along with psychological therapy for those who experience anxiety when flying. A side effect of diazepam is sedation, but this may be welcomed by travellers trying to sleep on a flight. </p> <h2>Restrictions on medicines when travelling</h2> <p>Some countries require documentation if travelling with certain medicines. </p> <p>For example, in <a href="http://www.hsa.gov.sg/content/hsa/en/Health_Products_Regulation/Consumer_Information/Personal_Import_Regulations/bringing_personal_medication_into_Singapore.html">Singapore</a>, a license is needed for larger quantities or doses of codeine. If travelling to Indonesia with codeine, you may need to apply for a <a href="https://www.kbri-canberra.go.id/menu-customs/taking-prescribed-medicine-to-indonesia#requirements">letter</a> from the embassy or high commission to bring such medicines into the country.</p> <p>Restrictions placed on medicines are not limited to those that require a prescription. In Singapore, nicotine chewing gum that is not <a href="http://www.hsa.gov.sg/pub/faq/faq/faqcategory/bringing-personal-medication-into-singapore.aspx">Singapore-registered</a>is a <a href="http://www.hsa.gov.sg/content/hsa/en/Health_Products_Regulation/Consumer_Information/Personal_Import_Regulations/bringing_personal_medication_into_Singapore.html">prohibited</a> substance. </p> <h2>What to remember</h2> <p>It’s important to check with your doctor or pharmacist if a medicine is suitable for your needs. Each person is different and not all medicines are safe, especially among children, pregnant or breastfeeding women, and the elderly. </p> <p>It is also a good idea to ask your pharmacist about the storage requirements for any medicines you’re taking with you. </p> <p>And remember, regardless of how you purchase the medicine back home, it’s important to check the requirements in your destination. As a general rule, it’s advisable to check with the relevant embassy or high commission and to take your doctor’s prescription or letter, as well as the labelled medicine box with you when travelling.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/the-medicines-to-pack-for-your-overseas-holiday-90930" target="_blank" rel="noopener">The Conversation</a>. </em></p>

International Travel

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Music as medicine – can music and sound be used to treat anxiety?

<div class="copy"> <p class="has-drop-cap"><strong>Music can profoundly affect our mood</strong>. Now that technology has enabled us to set our own personal soundtracks wherever we go, we commonly match our beats to our activities – heavy on the drums while we smash through a workout session, upbeat pop to see us through the dreariest of the household chores, and something smooth and sultry to set the tone of a candlelit dinner.</p> <p>But what if our response to music runs far deeper than we realise? Publishing their <a href="https://doi.org/10.1371/journal.pone.0259312" target="_blank" rel="noreferrer noopener">findings</a> in <em>PLOS ONE</em>, researchers from Ryerson University, Canada, say that personally tailored music programs could effectively treat the symptoms of anxiety – an affliction that has been steadily growing in adolescent and young adult populations over recent decades.</p> <p>We’re not just talking about putting on your favourite playlist to help soothe your jangled nerves. In this study, researchers used a machine learning algorithm developed by <a href="https://www.thelucidproject.ca/science" target="_blank" rel="noreferrer noopener">LUCID</a> to generate a personalised music sequence designed to manipulate an individual’s mental state.</p> <p>The algorithm first matches the current emotional state of the user, then predicts the optimal sequence of tracks – all instrumental compositions or nature sounds – that will most effectively begin to gradually shift the listener’s mental state towards tranquillity.</p> <p>Alongside these <a href="https://cosmosmagazine.com/people/musicians-networked-brains/" target="_blank" rel="noreferrer noopener">mellowing melodies</a>, the researchers tested the effectiveness of a technique known as auditory beat stimulation (ABS) that uses sound waves to produce tones and beats at highly specific frequencies that trigger changes in <a href="https://cosmosmagazine.com/science/biology/the-buzz-around-brain-stimulation/" target="_blank" rel="noreferrer noopener">brain activity</a>.</p> <p>In the current study, the researchers randomly assigned participants who were taking anti-anxiety medications to treatments involving LUCID music therapy, ABS, a combination of both, or pink noise – background noises similar to white noise. For each treatment, participants were asked to close their eyes and listen to 24 minutes of their assigned audio program.</p> <p>For participants with moderate anxiety, a combination of both tailored music and ABS most successfully quelled the physical symptoms of anxiety, as well as helping to tone down the damaging thoughts and feelings associated with this unsettled mental state. For those with more severe anxiety, music alone proved to be the most therapeutic.</p> <p>Given the troubling times we find ourselves in, the researchers believe the demonstrated effectiveness of such a simple and easily distributable method of treating anxiety disorders is welcome news.</p> <p>“With the pandemic and remote work, there has been a remarkable uptick in the use of digital health tools to support mental health,” the authors say. “The results of this clinical trial indicate great promise for the use of digital health tools, such as LUCID’s digital music therapy, in the management of anxiety and other mental health conditions.</p> <p>“The findings from this research are exciting as they indicate that personalised music shows great promise in effectively reducing anxiety in specific segments of the population that suffer from anxiety. Hopefully, with additional research, we can help build a solid evidence base which further supports the use of personalised music as an additional tool in the clinician’s toolbox that can be used to help reduce anxiety in the patient population.”</p> <p><em>Image credits: Getty Images</em></p> <p><em><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=184619&amp;title=Music+as+medicine+%E2%80%93+can+music+and+sound+be+used+to+treat+anxiety%3F" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em></div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/body-and-mind/music-affect-mental-health/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Jamie Priest. </em></p> </div>

Mind

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Instantly organise your medicine cabinet in a few simple steps

<p><strong>Bathroom organisation hacks</strong></p> <p>Closets, drawers, kitchen cabinets: your home organisation project might focus on these big basics – but, especially considering the times we’re in, your medicine cabinet is a smaller nook-and-cranny that deserves to be meticulously on-point these days.</p> <p>With advice from an infectious disease doctor and a professional organiser, we’ve got your step-by-step medicine cabinet makeover. This organisation process will empower you with streamlined mornings, immune support, and Covid-preventive essentials – and for those unpleasant occasions that creep up, like the common sniffles or sleepless nights.</p> <p>Reset your bathroom game by following this plan that’s loaded with pro tips.</p> <p><strong>Clean and sanitise</strong></p> <p>A good wipedown with warm water and a rag will get off visible goo… but it’s important to follow it up by sanitising every surface, inside and out, advises Dr Margaret Khoury, an infectious disease specialist. Keep in mind that the warm, moist environment of the bathroom is germ heaven, and pathogens can even grow on soap and other hygiene products. Yeah, ew.</p> <p>Pick a product that kills viruses, bacteria and fungi, and follow the directions on the label. Antibacterial products don’t work against viruses, and even cleaners that claim to kill most germs can miss COVID-19. So when choosing cleaning products, like wipes or sprays, go with a<span> </span><a href="https://www.tga.gov.au/disinfectants-use-against-covid-19-artg-legal-supply-australia">TGA-registered disinfectant</a>.</p> <p>Be sure to take out everything (yes, every single thing – bottles, makeup containers and the shelves they sat on) and wipe all of it down. Don’t forget to clean the knob or handle! Think of every surface fingers touch, and go there with that cleaner.</p> <p><strong>Toss like a boss</strong></p> <p>An easy next step is to throw away any expired over-the-counter meds and dried-out makeup. (That beloved eye shadow compact you’ve used since university? Zero judgment – but it’s time to throw it out, stat.)</p> <p>Toss used-up, broken, or non-functional items. It’s OK to purge ruthlessly – you have limited space there, so only necessary items can stay. “If you don’t love it or use it, lose it,” says Rachel Rosenthal, a professional organiser.</p> <p><strong>Supplies to fight COVID-19</strong></p> <p>Got a supply of at-home rapid Covid test kits? Bonus points for being proactive! Don’t store them in your medicine cabinet, nor in your bathroom at all. The CDC recommends storing self-administered Covid tests in their unopened box in a cool, dry place. Improper storage or exposure to heat or moisture can make the test malfunction.</p> <p>Help prevent Covid-19 by stocking up on alcohol prep pads or a fresh bottle of rubbing alcohol and cotton pads. Then, keep the whole house healthier by using these regularly to clean high-touch surfaces like kitchen cabinet knobs, your microwave’s buttons, door knobs around the house, your phone and keyboard, keys and more.</p> <p><strong>Prioritise your shelves</strong></p> <p>Ready to sort out what goes where? Rosenthal says you should start by assigning each category its own shelf and try to keep all the items in that group together within that designated space. You may want to label each shelf with a piece of tape or a sticky note to help you and your family put things away properly going forward.</p> <p>Keep the items you use every day in easy reach on one of the lowermost shelves. If you’re not using an item at least once a week, move it to a longer-term storage space.</p> <p>Have kiddos? Rosenthal suggests: “If you have little ones, dedicate the bottom shelf to keep their items where they can easily reach them and grab what they need.”</p> <p><strong>Safety first</strong></p> <p>The medicine cabinet is a common place to put medications, sharp objects like razors and needles and toxic cleaners, so safety should be a top consideration in your organisation, says Dr Khoury. If you have children that use the medicine cabinet, this is the perfect time to take inventory and remove all unsafe items and put them well out of their reach. (Don’t forget: Kids will climb onto benchtops!)</p> <p>Put sharp objects in closed containers so you don’t accidentally hurt yourself. Toxic cleaners should be stored in tightly sealed unbreakable containers, so even if they fall, they won’t break open and spill.</p> <p><strong>Move your meds to a smarter spot</strong></p> <p>Oh, the irony: Turns out, the medicine cabinet is actually one of the worst places to store prescription and over-the-counter drugs, says Gina Harper, PharmD, BCPS. “Moisture, temperature, oxygen and light – all things found in bathrooms – can degrade medications faster than normal,” this pharmacist explains.</p> <p>Unless the packaging indicates otherwise, most medicine should be stored at cool room temperature, in a dry, dark place, and in the original package… so, not in your bathroom. This is true for many skin care products, vitamins and supplements as well.</p> <p>Note: If you really want to keep your meds in your bathroom, consider buying a small medicine fridge for your counter. This allows you to control the temperature, humidity and exposure to light and air.</p> <p><strong>Do not toss expired prescription drugs</strong></p> <p>Throwing prescribed medications in the garbage can help someone searching for narcotics get their hands on them. Flushing them down the toilet? Also not a wise option – this can pollute the water supply. Your best bet is to take them to your local community pharmacy participating in the Return Unwanted Medicines (RUM) scheme.</p> <p>If for any reason you have to throw medicine away, it’s suggested you should “ruin” the drugs by mixing them with coffee grounds or kitty litter in a sealed plastic bag.</p> <p><strong>Store big items first</strong></p> <p>Ideally, your cabinet has adjustable shelves to allow your tallest or bulkiest essentials to fit within easy reach, like toothbrushes, toothpaste tubes, or large ointment bottles. Then you can see just how much space you have to work with for the rest of your stuff.</p> <p>If something takes up too much room and it’s not an item you access daily, it might be better stored in a cupboard elsewhere.</p> <p><strong>Next, insert your lesser-used items</strong></p> <p>Prioritise by setting the things you use the most toward the front of your medicine cabinet, on the shelves that are the easiest to see and access, says Rosenthal.</p> <p>Place lesser-used items in the back or corners. If you’re not using an item at least once a week, move it to a longer-term storage space, like a cupboard or a box under your sink.</p> <p>Employ this system for the remainder of your items, discerning how prominently and accessibly each one should be placed based on how often you use it. Rosenthal says just remember: Your goal is to keep it safe, clean, and functional.</p> <p><strong>Don't lose loose items</strong></p> <p><span>Stray cotton buds or lip balm tubes adding to the clutter? Put them in a clear glass container. They’ll fit the vertical space better, and you’ll be able to see exactly what’s inside.</span></p> <p><strong>Try magnetic strips for metal trinkets</strong></p> <p><span>What do nail clippers, tweezers and hair clips have in common? They all stick to magnets! Put a magnetic strip on the back of the cabinet door or behind the shelves, and never think twice about where those small tools might be hiding.</span></p> <p><strong>Don't ignore the door</strong></p> <p><span>Your cabinet door is prime storage real estate that often goes untouched, but there are a number of ways you can customise it for your storage needs. Stick on hooks to hold small scissors or plastic pockets to hold makeup supplies, for example. There also are a number of DIY storage solutions that help you use hidden nooks around your shower, sink, and cabinets too.</span></p> <p><strong>Watch what rolls</strong></p> <p><span>Nothing sticks a landing squarely on the foot like a runaway rolling object the second the cabinet door opens. Invest in some mini shelves (also called vertical risers) to keep objects in place and maximise your storage space.</span></p> <p><strong>Label, label, label</strong></p> <p>Small bins are perfect for makeup and toiletries, but not all of them are see-through. Create your own colourful labels to stay organised in style. These easy tricks will also instantly organise other small areas of your home.</p> <p>One tip? Forget Instagram – make a real-life plan. “Getting organised does not mean that you have to invent a complex colour-coded system or invest in a million matching bins,” Rosenthal says. “The goal is to create a place for everything in a way that complements how your life operates.”</p> <p>For instance, if you normally toss your toothbrush in the bottom of the medicine cabinet, add a small open box there to keep it contained with the toothpaste and floss. You’re not going to magically transform your movements throughout the day – so plan for what you actually do, not what you wish you’d do (or what someone on social media claims to do), she says.</p> <p>Gotta love real talk.</p> <p><em><span style="font-weight: 400;">Written by Claire Nowak and Charlotte Hilton Anderson. This article first appeared in </span><a rel="noopener" href="https://www.readersdigest.co.nz/food-home-garden/home-tips/instantly-organise-your-medicine-cabinet-in-a-few-simple-steps" target="_blank"><span style="font-weight: 400;">Reader’s Digest</span></a><span style="font-weight: 400;">. For more of what you love from the world’s best-loved magazine, </span><a rel="noopener" href="http://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA87V" target="_blank"><span style="font-weight: 400;">here’s our best subscription offer.</span></a></em></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p> <p><img style="width: 100px !important; height: 100px !important;" src="https://oversixtydev.blob.core.windows.net/media/7820640/1.png" alt="" data-udi="umb://media/f30947086c8e47b89cb076eb5bb9b3e2" /></p>

Home & Garden

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Why it's never too late to explore alternative and holistic medicine

<p><span style="font-weight: 400;">With the growing popularity of alternative and holistic medicine, you may be wondering if it’s something you should try. Science is showing that alternative medicine is a great way to maintain your health and relieve chronic pain. Many types of alternative treatments can also help to keep relieve certain medical conditions and they can often be used in conjunction with your current treatment plan. Here’s why it’s never too late to explore alternative and holistic medicine, no matter what stage of life you’re in.</span></p> <h2>Reasons to consider alternative and holistic medicine</h2> <p><span style="font-weight: 400;">There are many reasons to consider making the switch to alternative and holistic medicine. First, it may help you manage your medical expenses by reducing your need for expensive prescription medications. With alternative therapies, you may even be able to reduce the frequency of your visits to your conventional doctor.</span></p> <p><span style="font-weight: 400;">Generally, alternative care focuses on one-on-one appointments that are much more personal than seeing a conventional doctor. Alternative practitioners usually treat the patient holistically, which means they work to improve physical symptoms, their underlying causes, and your mental health.</span></p> <h2>Types of alternative medicine to try</h2> <p><span style="font-weight: 400;">There are several forms of alternative and holistic medicine that can be very helpful at any stage of life. Here are some you may want to consider:</span></p> <ul> <li style="font-weight: 400;"> <h3><span style="font-weight: 400;">Herbal and Nutritional Supplements</span></h3> </li> </ul> <p><span style="font-weight: 400;">Many people are familiar with herbal and nutritional supplements and they can be very helpful for a variety of conditions. Herbs can often be used in conjunction with or in place of certain prescription medications. Nutritional supplements may also help to prevent diseases that become more prevalent as you get older, including diabetes, heart disease, and high blood pressure. In fact, </span><a href="https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol-lowering-supplements/art-20050980"><span style="font-weight: 400;">experts at the Mayo Clinic</span></a><span style="font-weight: 400;"> report that dietary supplements can even be used to lower your cholesterol levels.</span></p> <ul> <li style="font-weight: 400;"> <h3><span style="font-weight: 400;">Chiropractic Care</span></h3> </li> </ul> <p><span style="font-weight: 400;">Chronic back and neck pain are a major issue for people of all ages. Conventional treatments often involve medications that have harmful side effects or even invasive surgery. As you age, the risk of surgery and anesthesia increases, especially if you have kidney or liver problems, so trying alternative treatments first only makes sense. </span></p> <p><span style="font-weight: 400;">Chiropractic care is a hands-on therapy that involves manipulating the spine and joints to realign the body. It can be a safe and non-invasive way to get relief for neck and back pain, headaches and chronic pain issues.</span></p> <ul> <li style="font-weight: 400;"> <h3><span style="font-weight: 400;">Acupuncture</span></h3> </li> </ul> <p><span style="font-weight: 400;">Acupuncture has been used to treat maintain health, treat a variety of diseases, and treat chronic pain for centuries. </span><a href="https://www.yinovacenter.com/"><span style="font-weight: 400;">The Yinova Center acupuncture in New York City</span></a><span style="font-weight: 400;"> recommends acupuncture treatments for people of all ages who want to relieve pain or treat medical conditions without pharmaceuticals or invasive treatment. </span></p> <p><span style="font-weight: 400;">The treatment works by encouraging the release of certain chemicals into the bloodstream by inserting ultra-fine needles into the skin. Acupuncture is also great for relieving stress, anxiety, and depression.</span></p> <ul> <li style="font-weight: 400;"> <h3><span style="font-weight: 400;">Massage Therapy</span></h3> </li> </ul> <p><span style="font-weight: 400;">Massage therapy, much like acupuncture and chiropractic care, is a type of hands-on, safe, and non-invasive alternative medicine. Massage is great for improving circulation and relieving pain. It’s especially beneficial for people who can’t be active due to certain medical conditions. </span></p> <p><span style="font-weight: 400;">Massage can also be extremely beneficial for reducing stress. It’s a very relaxing experience and the health benefits can be boosted by the addition of certain essential oils. For example, peppermint and lavender essential oils are extremely helpful for relieving headaches, relaxing muscles, and reducing stress.</span></p> <ul> <li style="font-weight: 400;"> <h3><span style="font-weight: 400;">Naturopathy</span></h3> </li> </ul> <p><a href="https://www.lifestylephysicians.com/six-incredible-benefits-of-naturopathic-medicine"><span style="font-weight: 400;">Naturopathy</span></a><span style="font-weight: 400;"> is a form of lifestyle medicine that focuses on restoring the physical, psychological, and structural balance of the patient. They focus on using the healing powers of nature, such as sunshine and fresh air, to improve the health of the patient. </span></p> <p><span style="font-weight: 400;">Naturopathic physicians utilize a variety of therapies depending on the patient’s needs, which may include nutrition, herbs, acupuncture, massage and much more. Although naturopathy isn’t as mainstream as some other forms of alternative medicine, it has been successfully used to reduce the symptoms of fatigue, stress, headaches, chronic back pain and more.</span></p> <ul> <li style="font-weight: 400;"> <h3><span style="font-weight: 400;">Yoga</span></h3> </li> </ul> <p><span style="font-weight: 400;">While it’s true that yoga isn’t technically a form of medicine, it is an alternative therapy that has significant benefits as you age. If you struggle with joint pain, arthritis, balance issues, or stress, yoga can be especially beneficial. Practicing yoga regularly will improve your balance and stability by strengthening your muscles and improving your flexibility. It can also lower your blood pressure and improve your heart healthy by </span><a href="https://www.ncbi.nlm.nih.gov/pubmed/25177555"><span style="font-weight: 400;">reducing oxidative stress</span></a><span style="font-weight: 400;">, which is one of the leading risk factors of heart attacks.</span></p> <h2>Choosing an alternative healthcare provider</h2> <p><span style="font-weight: 400;">If you decide to give alternative medicine a try, be sure to talk with your doctor first. Certain nutritional or herbal supplements can interfere with prescription medications and there may be other things to consider as well. Your doctor will know what’s safe and what isn’t, depending on your current health condition.</span></p> <p><span style="font-weight: 400;">When choosing an alternative healthcare provider, be sure they are properly licensed to work in your state. Ask for recommendations from friends and family to see if they have any recommendations. It’s very important that you’re comfortable talking to the practitioner that you choose because alternative medicine is very personalized.</span></p> <h2>Final thoughts</h2> <p><span style="font-weight: 400;">Alternative and holistic medicine can be a safe and effective way to complement your current healthcare regimen at any age. As acupuncture, massage therapy, and chiropractic care all become more mainstream, they are more likely to be covered by your health insurance as well. If you want to improve your health without pharmaceuticals or invasive treatments, these therapies are certainly worth trying.</span></p> <p><em><span style="font-weight: 400;">Donna Maurer is a content creator and a former writer for an alternative medicine clinic.</span></em></p>

Body

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What time of day should I take my medicine?

<p>Whether you need to take a drug at a specific time of day depends on the medication and the condition you are treating. For some medicines, it doesn’t matter what time you take it. And for others, the pharmacist may recommend you take it at the same time each day.</p> <p>But we estimate that for around 30% of all medicines, the time of day you take it <em>does</em> matter. And a <a href="https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehz754/5602478">recent study</a> shows blood pressure medications are more effective if you take them at night.</p> <p>So, how do you know if the timing of your medication is critical?</p> <p><strong>When timing doesn’t matter</strong></p> <p>In most cases, it’s not important when you take your medicine. For instance, you can take non-drowsy antihistamines for hay fever, or analgesics for pain when you need them. It doesn’t matter if it is morning, noon or night.</p> <p>What is more important is the time interval between each dose. For instance, paracetamol needs to be taken at least four hours apart, any closer and you run the risk of taking a toxic dose.</p> <p>Even when a medication <em>doesn’t need</em> to be taken at a particular time, the pharmacist may still recommend you take it at the same time every day anyway.</p> <p>This daily pattern helps remind you to take it. An example is taking the oral contraceptive at the same time each day, simply out of habit.</p> <p>For the <a href="https://www.nps.org.au/medicine-finder/microlut-tablets">mini pill</a>, taking it at the same time is actually necessary. But the actual time of day can be whatever works best for you.</p> <p><strong>When does it matter?</strong></p> <p>It may seem fairly obvious to take some medicines at particular times. For example, it makes sense to taking sleeping medications, such as <a href="https://www.healthdirect.gov.au/temazepam">temazepam</a>, at night before you go to bed.</p> <p>Some antidepressants, such as <a href="https://www.nps.org.au/medicine-finder/endep-tablets">amitryptyline</a> or <a href="https://www.nps.org.au/medicine-finder/avanza-tablets">mirtazapine</a>, have drowsy side effects. So it also makes sense to take them at night.</p> <p>For other medicines, taking them in the morning is more logical. This is true for diuretics, such as <a href="https://www.nps.org.au/medicine-finder/lasix-tablets">furosemide</a>, which helps you get rid of excess fluid via your urine; you don’t want to be getting up in the night for this.</p> <p>For other medications, it’s not obvious why they have to be taken at a particular time of day. To understand why, we have to understand our circadian rhythm, our own internal body clock. Some systems in our body work at different times of day within that rhythm.</p> <p>For instance, the enzymes controlling cholesterol production in your liver are most active at night. So there may be some benefit to taking lipid (cholesterol) lowering drugs, such as <a href="https://www.nps.org.au/medicine-finder/zocor-tablets">simvastatin</a>, at night.</p> <p>Finally, sometimes it’s important to take medications only on particular days. <a href="https://www.nps.org.au/medicine-finder/dbl-methotrexate-tablets">Methotrexate</a> is a medicine used for rheumatoid arthritis and severe psoriasis, and the timing of this medication is critical.</p> <p>You should only take it on the same day once a week, and when taken this way it is quite safe. But if you mistakenly take it daily, as happened recently with <a href="https://www.meridianlawyers.com.au/insights/medication-misadventure-methotrexate-reminder-pharmacists-exercise-independent-judgment-safety-prescribed-medicine/">a patient in Victoria</a>, then it can cause serious illness or even <a href="https://www.smh.com.au/healthcare/worrying-rise-in-accidental-overdose-of-prescription-drug-methotrexate-20160606-gpcaz3.html">death</a>.</p> <p><strong>What about blood pressure medicines?</strong></p> <p>One of the ways the body regulates blood pressure is through a pathway of hormones known as the <a href="http://pharma.bayer.com/en/innovation-partnering/research-and-development-areas/cardiovascular/the-raas-system/#targetText=The%20renin%2Dangiotensin%2Daldosterone%20system%20(RAAS)%20is%20a,release%20an%20enzyme%20called%20renin">renin, angiotensin and aldosterone system</a>.</p> <p>This system responds to various signals, like low blood pressure or stressful events, and controls blood volume and the constriction of blood vessels to regulate your blood pressure.</p> <p>Importantly, this system is more active while you’re asleep at night. And a <a href="https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehz754/5602478">recent study</a>, which found blood pressure medication is more effective at night, may change the way we use medicines to treat high blood pressure.</p> <p>Two types of drugs typically prescribed to lower blood pressure are <a href="http://www.bloodpressureuk.org/BloodPressureandyou/Medicines/Medicinetypes/ACEInhibitors">angiotensin converting enzyme (ACE) inhibitors</a>, such as <a href="https://www.nps.org.au/medicine-finder/apo-perindopril-arginine-tablets">perindopril</a>, and <a href="http://www.bloodpressureuk.org/BloodPressureandyou/Medicines/Medicinetypes/ARBs">angiotensin receptor blockers</a> (known as ARBs), such as <a href="https://www.nps.org.au/medicine-finder/irbesartan-an-tablets">irbesartan</a>. These drugs dilate blood vessels (make them wider) to reduce your blood pressure.</p> <p>Until now, doctors and pharmacists have often advised patients to take these medications in the morning, assuming it’s good to have a hit of the drugs when you’re up and about.</p> <p>But this study found taking blood pressure medications at night produced a significant reduction (45%) in heart disease, including fewer strokes, heart attacks and heart failure compared to taking them in the morning.</p> <p>Taking them at night also meant people’s blood pressure was better controlled and their kidneys were healthier.</p> <p>So if you take one of these drugs to control your blood pressure and aren’t sure what you should do, talk to your pharmacist or doctor. While evidence is building to support taking them at night, this might not be appropriate for you.</p> <p><em>Written by <span>Nial Wheate, Associate Professor | Program Director, Undergraduate Pharmacy, University of Sydney and Andrew Bartlett, Associate Lecturer Pharmacy Practice, University of Sydney</span>. Republished with permission of </em><a rel="noopener" href="https://theconversation.com/what-time-of-day-should-i-take-my-medicine-125809" target="_blank"><em>The Conversation</em></a><em>. </em></p>

Body

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Which medicines don't go well with flying?

<p>Every day, <a href="http://www.iata.org/pressroom/pr/Pages/2012-12-06-01.aspx">more than 10 million people</a> take a flight somewhere in the world. While flying is relatively safe, the unique environmental conditions can put passengers at risk if they’re taking certain medications.</p> <p>These include any hormone-based drugs, like the contraceptive pill and some fertility medicines, and drugs used to prevent heart attack and stroke. Antihistamines should also not be used to help passengers sleep during a flight.</p> <p><strong>What makes flying different from other forms of travel?</strong></p> <p>While flying is <a href="https://theconversation.com/whats-most-likely-to-kill-you-measuring-how-deadly-our-daily-activities-are-72505">one of the safest forms of travel</a>, there are specific risks that come with air travel, regardless of the length of the flight.</p> <p>Passenger planes are typically pressurised to the same atmospheric conditions that are found at 10,000 feet altitude. <a href="https://www.ncbi.nlm.nih.gov/pubmed/6823572">At that level</a>, <a href="https://www.higherpeak.com/altitudechart.html">the effective oxygen level is only 14.3 per cent</a>, which is much lower than the 20.9 per cent found at ground level.</p> <p>An additional risk is reduced blood flow from a lack of movement and sitting in cramped conditions, unless of course you’re fortunate enough to be in business or first class. And finally, dehydration is also a common side effect of flying due to the lack of humidity in the air.</p> <p>When these conditions are combined, it results in an increased risk of <a href="https://www.healthdirect.gov.au/deep-vein-thrombosis">deep vein thrombosis</a>, which is also known as DVT. This is a type of blood clot that occurs in the veins deep in the body and occurs most often in the legs. The development of a blood clot can result in blocked blood flow to the lungs, heart, or brain, which in turn can cause a heart attack or stroke.</p> <p><strong>Contraceptive pill and other hormone-based medicines</strong></p> <p>Given the inherent risk of a blood clot when flying, a passenger should use with caution any medication that can further increase the risk of a clot.</p> <p>Some brands of contraceptive for women (tablet or implant formulation) are <a href="http://www.theaustralian.com.au/national-affairs/health/new-bloodclot-alerts-added-to-diane35-eds-product-information/news-story/eaa0b596541a760e9c6cf89b37900c42">known to increase the chances of a blood clot</a>, although the overall increase in risk is small. While it’s thought the major risk comes from the hormone <a href="http://www.healthywomen.org/condition/estrogen">estrogen</a>, <a href="http://www.cochrane.org/CD010813/FERTILREG_contraceptive-pills-and-venous-thrombosis">a review of all the medical evidence in 2014</a> showed there’s a risk of blood clot from all contraceptive medicines.</p> <p>Likewise, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hormone-replacement-therapy-hrt-and-menopause">hormone replacement therapy</a>, particularly those that include estrogen, or some fertility medicines, such as <a href="https://www.babycenter.com/0_fertility-drug-gonadotropins_6188.bc">gonadotrophins</a>, can increase the risk of a blood clot.</p> <p>If you take one of these medicines, it does not mean you cannot fly, nor that you should necessarily stop taking the drug. Many millions of women fly while taking these medicines and suffer no ill effects.</p> <p>But the risk is also increased if you have an underlying health condition that includes type II diabetes, heart disease, and prior heart attacks or strokes. As such, passengers who also take medications to help prevent heart attacks and strokes should consult their doctor or pharmacist before flying.</p> <p>If you’re at increased risk of a blood clot, then an anti-platelet medication may be suitable for you. These medicines act by stopping the blood cells from sticking together and include prescription medicines such as <a href="http://www.melbournehaematology.com.au/fact-sheets/warfarin.html">warfarin</a> and <a href="https://www.nps.org.au/australian-prescriber/articles/clopidogrel">clopidogrel</a>, and over-the-counter medicines such as <a href="https://www.healthdirect.gov.au/medicines/brand/amt,34661000168102/aspirin-low-dose-pharmacy-action">low dose aspirin</a>.</p> <p><strong>Antihistamines</strong></p> <p>Many passengers can have trouble sleeping when flying, especially on long-haul flights. Parents flying with young children can also be concerned about them not sleeping or being unsettled and annoying other passengers.</p> <p>In these instances, many will turn to <a href="https://www.healthdirect.gov.au/antihistamines">sedating antihistamines</a>, like <a href="https://www.healthdirect.gov.au/medicines/brand/amt,22661000168108/phenergan">promethazine</a> to try to induce sleep. But this is a bad option.</p> <p>The Australian Medical Association specifically recommends <a href="http://www.smh.com.au/national/australian-medical-association-warns-against-sedating-children-on-long-journeys-20150405-1mesd0.html">parents do not do this</a>, as sometimes it can have the reverse effect and make children less sleepy and more active. These types of <a href="http://www.medsafe.govt.nz/profs/PUArticles/Mar2013ChildrenAndSedatingAntihistamines.htm">antihistamines are also known to depress breathing</a>, and in the low oxygen environment of the aircraft this can be especially dangerous.</p> <p>If you feel you or another family member will need sedation when flying, don’t use an antihistamine. Consult your doctor or pharmacist for a more suitable medication. Examples include prescription sleeping tablets, such as <a href="https://sleepfoundation.org/sleep-topics/melatonin-and-sleep">melatonin</a>, or natural remedies, such as <a href="https://www.webmd.com/vitamins-supplements/ingredientmono-870-valerian.aspx?activeingredientid=870">valerian</a>.</p> <p><strong>What to do before and during your flight</strong></p> <p>Before you fly, if you’re taking any form of medication, it’s recommended you meet with your doctor or pharmacist to discuss the suitability of your medicines. They may advise you there’s little risk for you, or if there is a risk, they may recommend a different medicine for the trip or recommend a new medicine to reduce the risk of blood clots.</p> <p>During your flight, don’t take antihistamines, and reduce your chance of a blood clot by drinking lots of water, stretching in your seat, and moving about the cabin as much as is appropriate.</p> <p>Finally, the effects of alcohol can be increased when flying – so drink in moderation, and try to avoid tea, coffee, and other caffeinated drinks as these can have dehydrating effects and make it harder to sleep.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/90222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em>Written by <span>Nial Wheate, Associate Professor | Program Director, Undergraduate Pharmacy, University of Sydney</span>. Republished with permission of </em><a href="https://theconversation.com/which-medicines-dont-go-well-with-flying-90222"><em>The Conversation</em></a><em>. </em></p>

International Travel

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The medicines to pack for your overseas holiday

<p>When travelling overseas, and in 2016 <a href="http://cf.cdn.unwto.org/sites/all/files/pdf/annual_report_2016_web_0.pdf">1.2 billion</a> of us did this, we all want a comfortable and pleasurable stay. This involves packing the right clothes for the right conditions and bringing a good book or music playlist. But what medicines should you take?</p> <p>The medicines you need will depend on what your expected needs are and what is available in the country being visited. Common medicines you may need to take include those for sleep, diarrhoea, malaria, pain and anxiety.</p> <p>When deciding what to take, it’s also important to remember that even if a medicine is available at home, its supply may be restricted or even prohibited in the country you are visiting. So, you should check beforehand.</p> <p><strong>Medicines for sleep</strong></p> <p>Sleeping on an aeroplane, while wedged in a tiny chair listening to a crying baby in the distance, can be very difficult for many people. As such, prescription sleeping medicines may be recommended by a doctor for short-term use.</p> <p>Alternatively, over-the-counter sleeping medicines, like the sedating antihistamine <a href="https://www.nps.org.au/medical-info/medicine-finder/restavit-tablets">doxylamine</a> are available from a pharmacy. But sedating antihistamines should not be used for <a href="http://www.smh.com.au/national/australian-medical-association-warns-against-sedating-children-on-long-journeys-20150405-1mesd0.html">children</a> when flying.</p> <p>You should also consider whether you actually need to sleep. If the flight is too long, then being asleep or sedated may prevent you from moving around while flying. Leg movement and stretching is <a href="https://www.cdc.gov/ncbddd/dvt/travel.html">recommended</a> when flying to improve blood flow and protect against blood clots.</p> <p><strong>Medicines for diarrhoea</strong></p> <p>Diarrhoea poses the <a href="https://www.racgp.org.au/afp/2012/october/parasitic-causes-of-prolonged-diarrhoea-in-travellers/">highest infectious risk</a> for travellers overseas, depending on where you are going. Diarrhoea is associated with <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/travellers-diarrhoea">symptoms</a> of stomach cramps, runny poo and nausea.</p> <p><a href="https://www.nps.org.au/medical-info/medicine-finder/buscopan-tablets">Hyoscine</a> is a medicine that may help relieve cramps by relaxing the stomach muscles.</p> <p><a href="https://www.tga.gov.au/otc-medicine-monograph-loperamide-hydrochloride">Loperamide</a> is useful in helping to stop diarrhoea, altogether. This may be particularly important if you’re stuck on a ten-hour flight, or have just set off on that once-in-a-lifetime jungle safari.</p> <p>Otherwise, medical advice often recommends not stopping the diarrhoea. Why? Because this stops your body from flushing out the pathogen that is causing the problem, and keeps the runny poo in, neither of which is a good thing.</p> <p>It’s best to let the diarrhoea pass and remain hydrated, which may include drinking more than just plain water; <a href="https://travel.gc.ca/travelling/health-safety/rehydration">oral rehydration</a> products may also be needed. These work by replacing all the lost sugars and salts in your body due to diarrhoea. They are available in sachets or effervescent tablets which can be mixed with water, making them easy to carry and use.</p> <p>Sometimes, treatment of diarrhoea will require additional medicines such as antibiotics. Either way you should consult a doctor or pharmacist before using medicines for diarrhoea, especially if it is persistent, if you experience fever, or if you see pus or blood in your wee or poo.</p> <p><strong>Medicines for malaria</strong></p> <p>For particular countries, there are medicines you may need to take before your journey to prevent you from getting sick while on vacation.</p> <p>If you are going to <a href="https://www.cdc.gov/malaria/travelers/country_table/a.html">certain areas</a> in Africa, India and Central America, for example, you may need to take an antimalarial medicine, such as the antibiotic <a href="https://www.nps.org.au/medical-info/medicine-finder/doxylin-tablets">doxycycline</a>. To be effective, these types of drugs need to be taken before, during, and after your travels, so it’s advisable to plan in advance with your doctor when travelling to areas with malaria.</p> <p><strong>Medicines for pain</strong></p> <p>Many of us use <a href="https://www.tga.gov.au/otc-medicine-monograph-paracetamol-oral-use">paracetamol</a> and <a href="https://www.tga.gov.au/otc-medicine-monograph-ibuprofen-oral-use">ibuprofen</a> for short-term pain relief. Even though they may be available from a pharmacy in some countries, like Australia, they can sometimes be hard to obtain overseas due to language barriers or different rules about how they can be supplied.</p> <p><a href="https://www.healthdirect.gov.au/codeine">Codeine</a> is also often found in pain relief preparations. Some countries have restrictions placed on the supply of codeine. For example, in Australia, codeine-based medicines can only be obtained with a <a href="https://www.nps.org.au/medical-info/clinical-topics/over-the-counter-codeine-changes-to-supply">prescription</a></p> <p><strong>Medicines for anxiety</strong></p> <p>Some people experience anxiety when flying. A doctor may recommend prescription medicines like <a href="https://www.nps.org.au/medical-info/medicine-finder/valium-tablets">diazepam</a>, along with psychological therapy for those who experience anxiety when flying. A side effect of diazepam is sedation, but this may be welcomed by travellers trying to sleep on a flight.</p> <p><strong>Restrictions on medicines when travelling</strong></p> <p>Some countries require documentation if travelling with certain medicines.</p> <p>For example, in <a href="http://www.hsa.gov.sg/content/hsa/en/Health_Products_Regulation/Consumer_Information/Personal_Import_Regulations/bringing_personal_medication_into_Singapore.html">Singapore</a>, a license is needed for larger quantities or doses of codeine. If travelling to Indonesia with codeine, you may need to apply for a <a href="https://www.kbri-canberra.go.id/menu-customs/taking-prescribed-medicine-to-indonesia#requirements">letter</a> from the embassy or high commission to bring such medicines into the country.</p> <p>Restrictions placed on medicines are not limited to those that require a prescription. In Singapore, nicotine chewing gum that is not <a href="http://www.hsa.gov.sg/pub/faq/faq/faqcategory/bringing-personal-medication-into-singapore.aspx">Singapore-registered</a> is a <a href="http://www.hsa.gov.sg/content/hsa/en/Health_Products_Regulation/Consumer_Information/Personal_Import_Regulations/bringing_personal_medication_into_Singapore.html">prohibited</a> substance.</p> <p><strong>What to remember</strong></p> <p>It’s important to check with your doctor or pharmacist if a medicine is suitable for your needs. Each person is different and not all medicines are safe, especially among children, pregnant or breastfeeding women, and the elderly.</p> <p>It is also a good idea to ask your pharmacist about the storage requirements for any medicines you’re taking with you.</p> <p>And remember, regardless of how you purchase the medicine back home, it’s important to check the requirements in your destination. As a general rule, it’s advisable to check with the relevant embassy or high commission and to take your doctor’s prescription or letter, as well as the labelled medicine box with you when travelling.</p> <p><em>Written by Sarira El-Den and Nial Wheate. Republished with permission of </em><a href="https://theconversation.com/the-medicines-to-pack-for-your-overseas-holiday-90930"><em>The Conversation.</em></a></p>

Travel Tips

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The medicines to pack for your overseas holiday

<p>When travelling overseas, and in 2016 <a href="http://cf.cdn.unwto.org/sites/all/files/pdf/annual_report_2016_web_0.pdf">1.2 billion</a> of us did this, we all want a comfortable and pleasurable stay. This involves packing the right clothes for the right conditions and bringing a good book or music playlist. But what medicines should you take?</p> <p>The medicines you need will depend on what your expected needs are and what is available in the country being visited. Common medicines you may need to take include those for sleep, diarrhoea, malaria, pain and anxiety.</p> <p>When deciding what to take, it’s also important to remember that even if a medicine is available at home, its supply may be restricted or even prohibited in the country you are visiting. So, you should check beforehand.</p> <p><strong>Medicines for sleep</strong></p> <p>Sleeping on an aeroplane, while wedged in a tiny chair listening to a crying baby in the distance, can be very difficult for many people. As such, prescription sleeping medicines may be recommended by a doctor for short-term use.</p> <p>Alternatively, over-the-counter sleeping medicines, like the sedating antihistamine doxylamine are available from a pharmacy. But sedating antihistamines should not be used for children when flying.</p> <p>You should also consider whether you actually need to sleep. If the flight is too long, then being asleep or sedated may prevent you from moving around while flying. Leg movement and stretching is recommended when flying to improve blood flow and protect against blood clots.</p> <p><strong>Medicines for diarrhoea</strong></p> <p>Diarrhoea poses the highest infectious risk for travellers overseas, depending on where you are going. Diarrhoea is associated with symptoms of stomach cramps, runny poo and nausea.</p> <p>Hyoscine is a medicine that may help relieve cramps by relaxing the stomach muscles.</p> <p>Loperamide is useful in helping to stop diarrhoea, altogether. This may be particularly important if you’re stuck on a ten-hour flight, or have just set off on that once-in-a-lifetime jungle safari.</p> <p>Otherwise, medical advice often recommends not stopping the diarrhoea. Why? Because this stops your body from flushing out the pathogen that is causing the problem, and keeps the runny poo in, neither of which is a good thing.</p> <p>It’s best to let the diarrhoea pass and remain hydrated, which may include drinking more than just plain water; oral rehydration products may also be needed. These work by replacing all the lost sugars and salts in your body due to diarrhoea. They are available in sachets or effervescent tablets which can be mixed with water, making them easy to carry and use.</p> <p>Sometimes, treatment of diarrhoea will require additional medicines such as antibiotics. Either way you should consult a doctor or pharmacist before using medicines for diarrhoea, especially if it is persistent, if you experience fever, or if you see pus or blood in your wee or poo.</p> <p><strong>Medicines for malaria</strong></p> <p>For particular countries, there are medicines you may need to take before your journey to prevent you from getting sick while on vacation.</p> <p>If you are going to <a href="https://www.cdc.gov/malaria/travelers/country_table/a.html">certain areas</a> in Africa, India and Central America, for example, you may need to take an antimalarial medicine, such as the antibiotic doxycycline. To be effective, these types of drugs need to be taken before, during, and after your travels, so it’s advisable to plan in advance with your doctor when travelling to areas with malaria.</p> <p><strong>Medicines for pain</strong></p> <p>Many of us use paracetamol and ibuprofen for short-term pain relief. Even though they may be available from a pharmacy in some countries, like Australia, they can sometimes be hard to obtain overseas due to language barriers or different rules about how they can be supplied.</p> <p>Codeine is also often found in pain relief preparations. Some countries have restrictions placed on the supply of codeine. For example, in Australia, codeine-based medicines can only be obtained with a prescription.</p> <p><strong>Medicines for anxiety</strong></p> <p>Some people experience anxiety when flying. A doctor may recommend prescription medicines like diazepam, along with psychological therapy for those who experience anxiety when flying. A side effect of diazepam is sedation, but this may be welcomed by travellers trying to sleep on a flight.</p> <p><strong>Restrictions on medicines when travelling</strong></p> <p>Some countries require documentation if travelling with certain medicines.</p> <p>For example, in Singapore, a license is needed for larger quantities or doses of codeine. If travelling to Indonesia with codeine, you may need to apply for a letter from the embassy or high commission to bring such medicines into the country.</p> <p>Restrictions placed on medicines are not limited to those that require a prescription. In Singapore, nicotine chewing gum that is not <a href="http://www.hsa.gov.sg/pub/faq/faq/faqcategory/bringing-personal-medication-into-singapore.aspx">Singapore-registered</a> is a <a href="http://www.hsa.gov.sg/content/hsa/en/Health_Products_Regulation/Consumer_Information/Personal_Import_Regulations/bringing_personal_medication_into_Singapore.html">prohibited</a> substance.</p> <p><strong>What to remember</strong></p> <p>It’s important to check with your doctor or pharmacist if a medicine is suitable for your needs. Each person is different and not all medicines are safe, especially among children, pregnant or breastfeeding women, and the elderly.</p> <p>It is also a good idea to ask your pharmacist about the storage requirements for any medicines you’re taking with you.</p> <p>And remember, regardless of how you purchase the medicine back home, it’s important to check the requirements in your destination. As a general rule, it’s advisable to check with the relevant embassy or high commission and to take your doctor’s prescription or letter, as well as the labelled medicine box with you when travelling.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/90930/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em>Written by <span>Sarira El-Den, Lecturer at the Faculty of Pharmacy, University of Sydney and Nial Wheate, Associate Professor | Program Director, Undergraduate Pharmacy, University of Sydney</span>. Republished with permission of <span><a href="https://theconversation.com/the-medicines-to-pack-for-your-overseas-holiday-90930">The Conversation</a></span>. </em></p>

International Travel

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Why laughter really is the best medicine

<p>It’s commonly said that laughter is the best medicine, and we’ve got some interesting facts to show you that it’s true. We’ve also got some tips on how to bring more laughter into your life.</p> <p><strong>Laughter is good for your body</strong></p> <p>There are so many ways in which laughter is good for you. We’ve chosen just a few:</p> <ul> <li>Laughter relaxes your whole body, relieves physical tension and stress, and keeps your muscles relaxed for up to 45 minutes.</li> <li>Laughter releases endorphins, which is our body’s natural feel-good chemical.</li> <li>Laughter improves blood flow and the function of blood vessels.</li> <li>Laughter boosts the immune system by decreasing stress hormones, and increasing immune cells and antibodies.</li> </ul> <p><strong>Laughter is good for your mind</strong></p> <p>Aside from the physical benefits of a hearty laugh, it can also help your mental health:</p> <ul> <li>Laughter reduces stress, increases energy, allowing you to relax, recharge, and stay focused.</li> <li>Humour can help you see things in a different light. If you feel overwhelmed, looking at the situation in a humorous perspective can give you psychological distance.</li> <li>Laughter can sweep away distressing emotions like anxiousness, sadness, and anger.</li> </ul> <p><strong>Laughter is good for your social life</strong></p> <p>Seeing or hearing someone else laugh makes them more attractive to us, and readies us to join in the fun ourselves.</p> <ul> <li>Laughing together with others helps form a close, positive bond. Having this laughter bond helps shield your relationship against disagreements and stress.</li> <li>Social humour allows us to be more spontaneous and express ourselves more honestly.</li> </ul> <p><strong>How to laugh more</strong></p> <p>It’s not always easy to find the funny in life. Like a lot of things, being able to laugh often can take practice. Here are a few tips on how to bring more laughter into your life:</p> <ul> <li>Smile more – laughter is a smile that exploded, so when you see something that makes you happy, or even just pleases you, practice smiling about it.</li> <li>If you hear laughter, go towards it. More often than not, people love sharing a good joke, so if you hear a group of people having a good laugh together, try and join in.</li> <li>Take yourself less seriously. Try to find the funny in everyday occurrences, even the ones that annoy or frustrate you. Laugh at yourself and keep things in perspective.</li> <li>Keep things around you that are reminders to stay happy – amusing toys, funny pictures or calendars, etc.</li> <li>Do as children do – kids are the ones to go to if you want to learn how to laugh and play more.</li> <li>Get a pet – not only are pets always there for a cuddle when you need one, they are a great source of joy and laughter.</li> </ul> <p><a href="/finance/insurance/2014/12/exercise-and-alzheimers/" target="_blank"><span style="text-decoration: underline;"><strong>We ask: can exercise reducuce the reduce of Alzheimer's?</strong></span></a></p>

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