Thursday, May 22, 2008
Aspirin remains a wonder drug in preventing heart attacks and strokes
The medicinal effect of plants containing aspirin-like compounds has been known since the days of the ancient Greek physician Hippocrates.
But it was in 1899 that a Bayer chemist purified the chemical known as acetylsalicylic acid. This new acid was given the medicinal name Aspirin and the “wonder drug” was born.
Despite the amazing medical advances in the last 100+ years, no drug has been proven better at preventing strokes and heart attacks.
Along with reducing pain, fever, and inflammation, aspirin has proven effective at preventing certain types of blood clots that can be caused by platelets, which are small cell fractions that float around in our blood stream ready to activate whenever damage occurs to a blood vessel.
When activated they stick together to form a plug, or clot, which stops the bleeding that occurs when you get a cut. A heart attack or stroke can occur when the cholesterol plaques inside the arteries that supply the brain and heart muscle rupture and activate any platelets floating by. The platelets then form a plug inside the artery and further reduce or completely block blood flow causing tissue damage.
Aspirin decreases the stickiness of platelets so they cannot clump together as easily to form a clot. How powerful is aspirin? If given as soon as a heart attack is suspected it can reduce the risk of death by as much as 23%. In people with cardiovascular disease, aspirin can reduce the risk of stroke and heart attack by as much as 30%. It may be old, but it’s still the best.
The power of aspirin also extends to its side effects; aspirin is one of the leading causes of gastrointestinal bleeds. Even though it is available over the counter, it still must be used with caution. Enteric coated or buffered aspirin may protect you from an upset stomach that some people experience shortly after taking aspirin, but the special coatings do not decrease the risk of a serious bleed in any way.
Aspirin therapy is the mainstay of drug treatment to prevent stroke and heart attacks, but many life-style changes are effective as well. A diet rich in fruits, vegetables and fiber, regular exercise, control of high blood pressure and diabetes all have beneficial effects at preventing many diseases. If you smoke cigarettes, quitting may be the best possible change you can do for your health. Within only a few years after quitting, your risk of many diseases drops to those who have never smoked.
Aspirin therapy usual consists of taking one or two baby-aspirins (80 or 81mg) or a full strength aspirin (325 mg) once a day. This simple regimen along with the very low-cost of aspirin helps make it the drug of choice to prevent strokes and heart attacks. If you are allergic to aspirin or have a history of stomach ulcers or bleeds, other anti-platelet medications are available that can be just as effective.
If you believe you could benefit from an aspirin a day you should talk to your doctor first. A cardiovascular risk assessment that includes weight, blood pressure, and cholesterol levels will guide the physician in deciding if aspirin is right for you. Your individual risk for stomach ulcers and bleeding also need to be assessed to determine if stomach protective agents are needed along with aspirin therapy.
Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at www.backushospital.org or E-mail Smith and all of the Healthy Living columnists at healthyliving.org.
But it was in 1899 that a Bayer chemist purified the chemical known as acetylsalicylic acid. This new acid was given the medicinal name Aspirin and the “wonder drug” was born.
Despite the amazing medical advances in the last 100+ years, no drug has been proven better at preventing strokes and heart attacks.
Along with reducing pain, fever, and inflammation, aspirin has proven effective at preventing certain types of blood clots that can be caused by platelets, which are small cell fractions that float around in our blood stream ready to activate whenever damage occurs to a blood vessel.
When activated they stick together to form a plug, or clot, which stops the bleeding that occurs when you get a cut. A heart attack or stroke can occur when the cholesterol plaques inside the arteries that supply the brain and heart muscle rupture and activate any platelets floating by. The platelets then form a plug inside the artery and further reduce or completely block blood flow causing tissue damage.
Aspirin decreases the stickiness of platelets so they cannot clump together as easily to form a clot. How powerful is aspirin? If given as soon as a heart attack is suspected it can reduce the risk of death by as much as 23%. In people with cardiovascular disease, aspirin can reduce the risk of stroke and heart attack by as much as 30%. It may be old, but it’s still the best.
The power of aspirin also extends to its side effects; aspirin is one of the leading causes of gastrointestinal bleeds. Even though it is available over the counter, it still must be used with caution. Enteric coated or buffered aspirin may protect you from an upset stomach that some people experience shortly after taking aspirin, but the special coatings do not decrease the risk of a serious bleed in any way.
Aspirin therapy is the mainstay of drug treatment to prevent stroke and heart attacks, but many life-style changes are effective as well. A diet rich in fruits, vegetables and fiber, regular exercise, control of high blood pressure and diabetes all have beneficial effects at preventing many diseases. If you smoke cigarettes, quitting may be the best possible change you can do for your health. Within only a few years after quitting, your risk of many diseases drops to those who have never smoked.
Aspirin therapy usual consists of taking one or two baby-aspirins (80 or 81mg) or a full strength aspirin (325 mg) once a day. This simple regimen along with the very low-cost of aspirin helps make it the drug of choice to prevent strokes and heart attacks. If you are allergic to aspirin or have a history of stomach ulcers or bleeds, other anti-platelet medications are available that can be just as effective.
If you believe you could benefit from an aspirin a day you should talk to your doctor first. A cardiovascular risk assessment that includes weight, blood pressure, and cholesterol levels will guide the physician in deciding if aspirin is right for you. Your individual risk for stomach ulcers and bleeding also need to be assessed to determine if stomach protective agents are needed along with aspirin therapy.
Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at www.backushospital.org or E-mail Smith and all of the Healthy Living columnists at healthyliving.org.
Friday, May 16, 2008
Simple test can help identify, respond to victim of a stroke
Stroke is the leading cause of long-term disability in the United States and the number three killer of Americans.
Every year 700,000 people nationwide will suffer a stroke and 160,000 will die from that stroke. It is because of these sobering facts that The American Academy of Neurology, The American Society of Emergency Physicians and the American Stroke Association have come together to form the Brain Attack Coalition.
May is “Stroke Awareness Month” and coalition members are emphasizing the need for early recognition of a stroke. Once recognized, intervention can begin and there is greater chance of full recovery.
In today’s column, we will review some ways to identify a stroke-in-progress, as well as early treatment. Tomorrow’s Healthy Sports column will describe the brain attack and rehabilitation of a famous athlete who suffered a stroke.
Up until now, public awareness efforts have centered on three signs of stroke. This has now been expanded into a campaign called “Give Me 5 for Stroke.” There are five questions if a stroke is suspected:
• Walk: Ask the person to take several steps. Is their balance off? Are they slumping to one side? Are they dragging one leg?
• Talk: Ask them to repeat a phrase such as “You can’t teach an old dog new tricks.” Is their speech slurred? Are the words used appropriately?
• Reach: Have the person extend both arms in front of them. Can they raise both arms? Does one arm drift downward?
• See: Is their vision clear or blurred? Do they have double vision?
• Feel: Ask the person if they are in any pain. Specifically, do they have a headache? Is it the worst headache of their lives?
If any of these warning signs exist, there is a high probability the person is suffering a stroke. Emergency services should be called immediately.
Now that there are new treatments for acute stroke, recovery and survival are measured in minutes. Prompt action is imperative.
If you’d like more information about stroke, view my video at backushospital.org or contact the American Stroke Association at www.strokeassociation.org.
nthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org.
Every year 700,000 people nationwide will suffer a stroke and 160,000 will die from that stroke. It is because of these sobering facts that The American Academy of Neurology, The American Society of Emergency Physicians and the American Stroke Association have come together to form the Brain Attack Coalition.
May is “Stroke Awareness Month” and coalition members are emphasizing the need for early recognition of a stroke. Once recognized, intervention can begin and there is greater chance of full recovery.
In today’s column, we will review some ways to identify a stroke-in-progress, as well as early treatment. Tomorrow’s Healthy Sports column will describe the brain attack and rehabilitation of a famous athlete who suffered a stroke.
Up until now, public awareness efforts have centered on three signs of stroke. This has now been expanded into a campaign called “Give Me 5 for Stroke.” There are five questions if a stroke is suspected:
• Walk: Ask the person to take several steps. Is their balance off? Are they slumping to one side? Are they dragging one leg?
• Talk: Ask them to repeat a phrase such as “You can’t teach an old dog new tricks.” Is their speech slurred? Are the words used appropriately?
• Reach: Have the person extend both arms in front of them. Can they raise both arms? Does one arm drift downward?
• See: Is their vision clear or blurred? Do they have double vision?
• Feel: Ask the person if they are in any pain. Specifically, do they have a headache? Is it the worst headache of their lives?
If any of these warning signs exist, there is a high probability the person is suffering a stroke. Emergency services should be called immediately.
Now that there are new treatments for acute stroke, recovery and survival are measured in minutes. Prompt action is imperative.
If you’d like more information about stroke, view my video at backushospital.org or contact the American Stroke Association at www.strokeassociation.org.
nthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org.
Allergy season has arrived, but symptoms can be controlled
In our part of the country the onset of spring is a great time of year. It brings flowers, green trees, warm weather, and – for an estimated 36 million Americans – allergies.
Seasonal allergic rhinitis (SAR) is a predictable group of symptoms that include nasal congestion, sneezing, postnasal drip and watery, itchy eyes. The most common cause of seasonal allergies is pollen.
Seasonal allergies can be very troublesome for many individuals, but rarely does it cause serious medical problems. Because it is a self-limiting condition, many people can safely manage their allergy symptoms using medications available over the counter. The anti-allergy medications generally fall into one of two categories: antihistamines and decongestants.
Antihistamines are considered first-line treatment for SAR. Over the counter preparations include tablets, capsules, liquids, and thin strips. Older antihistamines such as diphenhydramine (sold as Benadryl and other generic versions) and chlorpheniramine (sold as Chlor-Trimeton and other generic versions) are very effective at treating and preventing sneezing, itching, and a runny nose.
But these medications also cause drowsiness in most people who take them.
Newer “non-sedating” antihistamines are also available over the counter and tend to cost a bit more. Non-sedating antihistamines include Zyrtec (cetirizine) and Alavert and Claritin (loratadine). Be aware that even the non-sedating antihistamines may make some people drowsy.
Whenever taking an antihistamine for the first time, be sure to not drive or perform any activities that need you to be highly alert until you know how the new medications will affect you.
Decongestants include phenylephrine and pseudoephedrine (now kept behind the counter) and the nasal spray oxymetazoline (sold as Afrin and other generic versions).
Decongestants can ease coughing due to postnasal drip as well as that “stuffy” feeling many allergic people experience. Decongestants must be used with caution because they can worsen common medical conditions such as high blood pressure, diabetes, and glaucoma. The nasal spray should not be used for more than 3-5 days or rebound congestion can occur.
Pharmacy shelves are also stocked with many combination products. Combination products can make allergy treatment more convenient but need to be chosen wisely. Combinations of medications you don’t need only increase your risk of medication side effects with out adding any additional symptom relief.
Treatment can begin a week or more before you expect the pollen count to rise in order to prevent symptoms from occurring.
Seasonal allergies can often be managed by the use of over the counter medications alone without the need for a physician office visit. But to do so safely requires you to follow a few guidelines:
Be sure to read the labels closely and take as directed without exceeding the recommended doses.
Check with your pharmacist to make sure your allergy medications do not interact with other prescription or OTC medications you may be taking.
People with pre-existing medical conditions should speak to their doctor before choosing a decongestant.
If you find the OTC medications do not provide you with relief, seek your physician to discuss prescription medications that are available to treat SAR.
Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at backushospital.org or E-mail Smith and all of the Healthy Living columnists at healthyliving@wwbh.org.
Seasonal allergic rhinitis (SAR) is a predictable group of symptoms that include nasal congestion, sneezing, postnasal drip and watery, itchy eyes. The most common cause of seasonal allergies is pollen.
Seasonal allergies can be very troublesome for many individuals, but rarely does it cause serious medical problems. Because it is a self-limiting condition, many people can safely manage their allergy symptoms using medications available over the counter. The anti-allergy medications generally fall into one of two categories: antihistamines and decongestants.
Antihistamines are considered first-line treatment for SAR. Over the counter preparations include tablets, capsules, liquids, and thin strips. Older antihistamines such as diphenhydramine (sold as Benadryl and other generic versions) and chlorpheniramine (sold as Chlor-Trimeton and other generic versions) are very effective at treating and preventing sneezing, itching, and a runny nose.
But these medications also cause drowsiness in most people who take them.
Newer “non-sedating” antihistamines are also available over the counter and tend to cost a bit more. Non-sedating antihistamines include Zyrtec (cetirizine) and Alavert and Claritin (loratadine). Be aware that even the non-sedating antihistamines may make some people drowsy.
Whenever taking an antihistamine for the first time, be sure to not drive or perform any activities that need you to be highly alert until you know how the new medications will affect you.
Decongestants include phenylephrine and pseudoephedrine (now kept behind the counter) and the nasal spray oxymetazoline (sold as Afrin and other generic versions).
Decongestants can ease coughing due to postnasal drip as well as that “stuffy” feeling many allergic people experience. Decongestants must be used with caution because they can worsen common medical conditions such as high blood pressure, diabetes, and glaucoma. The nasal spray should not be used for more than 3-5 days or rebound congestion can occur.
Pharmacy shelves are also stocked with many combination products. Combination products can make allergy treatment more convenient but need to be chosen wisely. Combinations of medications you don’t need only increase your risk of medication side effects with out adding any additional symptom relief.
Treatment can begin a week or more before you expect the pollen count to rise in order to prevent symptoms from occurring.
Seasonal allergies can often be managed by the use of over the counter medications alone without the need for a physician office visit. But to do so safely requires you to follow a few guidelines:
Be sure to read the labels closely and take as directed without exceeding the recommended doses.
Check with your pharmacist to make sure your allergy medications do not interact with other prescription or OTC medications you may be taking.
People with pre-existing medical conditions should speak to their doctor before choosing a decongestant.
If you find the OTC medications do not provide you with relief, seek your physician to discuss prescription medications that are available to treat SAR.
Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at backushospital.org or E-mail Smith and all of the Healthy Living columnists at healthyliving@wwbh.org.
Medical staff has casino patrons covered from all angles
If pulling a slot machine handle or throwing dice is your sport, rest assured there is an experienced group of medical professionals ready to help if you “go down.”
Thousands of patrons travel long distances to Connecticut’s casinos each year. Many are sleep deprived from their journey. On arriving they subject themselves to the stress of gambling and sometimes the excitement of winning. Some elderly folks may become disoriented while being in unfamiliar surroundings. Fortunately, the medical care at both the Foxwoods and Mohegan Sun casinos is outstanding.
Video surveillance at casinos may be rivaled only by Fort Knox. Aside from security, these systems are important in locating an injured or lost patron. Emergency Medical Services (EMS) staff are stationed in key locations throughout the casinos so that there is no delay in administering first aid to an injured party. If necessary, EMTs and paramedics can initiate treatment protocols and transport to the Backus Hospital emergency department via one of the ambulances which are always onsite.
Over the course of the past fifteen years, Backus Hospital has provided emergency care for both casinos. This experience has resulted in a wealth of information, resulting in more effective care.
Drs. Fred Fenton and Kyle McClain are staff physicians at the Backus Emergency Department. They report that approximately 15 of the 180 daily ED visits are casino patrons. Many of these are related to heart and brain disorders including stroke, heart attack, and seizures. Approximately one quarter are linked to missed doses of medication.
Both physicians advise all travelers to carry a list of medications, medical conditions, and information to contact their physicians. In an emergency, this can be lifesaving.
Some helpful hints to make a casino visit safer:
• Take all prescribed medications on schedule
• Get plenty of rest before your visit
• Moderation is key; don’t try to pack too much activity into one visit
• Always carry a list containing vital health information
If you are not in good health and still want to enjoy a trip to the casino, rest assured there is an excellent medical network covering you at all times.
Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org.
Thousands of patrons travel long distances to Connecticut’s casinos each year. Many are sleep deprived from their journey. On arriving they subject themselves to the stress of gambling and sometimes the excitement of winning. Some elderly folks may become disoriented while being in unfamiliar surroundings. Fortunately, the medical care at both the Foxwoods and Mohegan Sun casinos is outstanding.
Video surveillance at casinos may be rivaled only by Fort Knox. Aside from security, these systems are important in locating an injured or lost patron. Emergency Medical Services (EMS) staff are stationed in key locations throughout the casinos so that there is no delay in administering first aid to an injured party. If necessary, EMTs and paramedics can initiate treatment protocols and transport to the Backus Hospital emergency department via one of the ambulances which are always onsite.
Over the course of the past fifteen years, Backus Hospital has provided emergency care for both casinos. This experience has resulted in a wealth of information, resulting in more effective care.
Drs. Fred Fenton and Kyle McClain are staff physicians at the Backus Emergency Department. They report that approximately 15 of the 180 daily ED visits are casino patrons. Many of these are related to heart and brain disorders including stroke, heart attack, and seizures. Approximately one quarter are linked to missed doses of medication.
Both physicians advise all travelers to carry a list of medications, medical conditions, and information to contact their physicians. In an emergency, this can be lifesaving.
Some helpful hints to make a casino visit safer:
• Take all prescribed medications on schedule
• Get plenty of rest before your visit
• Moderation is key; don’t try to pack too much activity into one visit
• Always carry a list containing vital health information
If you are not in good health and still want to enjoy a trip to the casino, rest assured there is an excellent medical network covering you at all times.
Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org.
