Gastric Acid Meds

Hello it's Medical Tuesday! Today I'm gonna talk about meds for gastric pain. There are few types of medicines for gastric pain, the main classes including Proton Pump Inhibitor (PPI), H2 Antagonist (H2A) and antacids.

To easily differentiate them, PPI and H2A are mostly taken half an hour before food. Antacids are more effective when taken after food. Why?

PPI and H2A function by reducing the gastric acid production in the stomach, therefore they will stop the secretion of acids in the stomach. In result of that, when food is taken, the stomach will not produce too much acids which can result in gastric pain.

Antacids work by neutralizing the acids in the stomach. In this case, it will be more effective when gastric acids present. When food is taken, the stomach will secrete gastric acids to breakdown the food. So after eating, there will be more gastric acid compared to before eating. As a result of that, antacids will neutralize more acids when taken after food, in another word it will be more effective.

Antacids also have a few cautions to look for:

1) There are Magnesium based and Calcium based solution. Magnesium based antacid can cause diarrhoea while Calcium based antacid can cause constipation. Therefore the side effects will differ quite widely depends on the formulation of the antacids.

2) People with high blood pressure will need to be cautious about the content of the antacids. It will be better if you do not take antacids with Sodium content as it will cause the blood pressure to raise.

Lastly, some other medications can also cause overproduction of gastric acid therefore consult a doctor or pharmacist when you are not sure about the reason why, e.g. NSAIDS.

The Following

Am gonna talk about a tv series today as i don't think i'll have time to do so tomorrow.

The tv series i'm introducing today is The Following. Ya, pretty dark and violent drama again lol.

The story is about how a serial killer manages to manipulates other people and make them do things including killings for him even when he's in jail. The main protagonist is a ex-FBI agent who caught the serial killer and put him into the jail. Very organised and structured drama, lots of good actings. I would say it can become the next best thriller drama tv series.

Although it only has one season now, the 2nd season is already in plan and gonna be released next year i think. I'm now at the episode 8 season 1 and is totally drawn into the plot and amazed by how detailed and brilliant the serial killer is. Well, he obviously has no empathy for people and is so good at giving people what they want, which makes him a total psychopath. A charismatic one.

I think they did a good job in recruiting the actors and actresses. They are all great for their characters and performed amazingly, especially the killer.

The story makes me think about how a religion can affect someone and the belief in the wrong thing can be deathly. Oh well, i can't really judge people in what they believe in but i have to say the followers of the killer definitely put in lots of faith in him to treat him as a god.

Cool drama but i guess it's for 18 and above since it's quite violent.

Puppy Adoption

Sorry for the late updates. I hope i can do some fashion post soon after i go shopping on Friday =)

As for today, there's not much happening around therefore i didn't know what i should talk about.

Well what i'm trying to do recently is to get a puppy to accompany me at home. Have been searching for quite some time through my neighbours, and my mum's social network (well i'm not exactly sure if she knows what i'm looking for, but she offer to help so i guess i can only hope for some nice surprise). And of cos, i look through the dog adoption website, in particular petfinder.my. It's a great website as they have lots of advert on available dogs for sale or adoption.

Well i'm not very into buying a puppy so i just look at the adoption adverts. Still kinda hard to find the puppy i like as i'm more into small breed and possibly bright colour. Most of the adverts are big dogs, the one you can see at the roadside. Those are kinda hard to be trained as they have already fully grown into adult dogs. I guess it will not be the best choice for me as i'm still a learner. Therefore a puppy will be great as it can be trained from small which is easier.

Searching process continue and i hope i can find the puppy i want soon =)

Painkillers

Well, after a few thoughts, i decided to talk about medicines on Tuesday, which are something i am more familiar with. Also, it might help me to refresh my memory on the stuff i learnt in school. I guess i can treat it as a revision session haha.

Anyway, i'm gonna talk about painkillers today, which is one of the Top 10 medicines people buy in pharmacies. There are many types of painkillers available, including the well known Paracetamol and NSAIDs (Non-steroidal anti-inflammatory drugs).

Paracetamol is more known as Panadol, which is actually it's brand name. It's like laptop, you have Acer, HP, Toshiba etc while Paracetamol, you have Panadol and a lot of other brands. Well, i normally tell the customers that they all do the same thing because they are the same medicine, just with different names produced by different pharmaceutical companies. This applies to most of the other medicines. Some medicines are extremely pricey because of the fact that it is imported from overseas, however you can actually get a relatively cheaper version that is produced locally. They are generally the same medicines. If the brands do make a difference, they will specify it. But for most of the over-the-counter (OTC) medicines, the brands just indicate the companies that produced them.

NSAIDs on the other hand, is a class of medicine. And a lot of medicines are under this class, including Ibuprofen, Naproxen, Mefenamic acid, Diclofenac Sodium/Potassium etc. They are all painkillers. However, there are some differences in effect among these medicines. In this case, the doctor might give you different types of painkillers according to your situations.

Today, i'm gonna tell you guys how to choose between painkillers at different situations.

Situation 1: You had a cold and is having muscle ache. 
Paracetamol is probably the first choice as you might have a fever as well. As most people might know, paracetamol is very effective in fever. Well actually, i would say that Paracetamol is mainly for fever rather than pain. However, due to the lesser side effects, people normally use it first and only look for other options when it doesn't work.

Situation 2: You have tooth ache. Your gum is red and inflammed.
In this situation, we will say that your gum is having a inflammatory reaction. Probably due to the growth of wisdom tooth if you are a teenager. The inflammatory reaction includes 3 main symptoms: RED, PAIN, SWOLLEN (RPS). In this case, NSAIDs will be more useful as it will help to reduce the inflammation therefore resolving the pain. I myself used to take Ibuprofen and it takes about 1-2 hours for the effect to kick in. Very effective.

Situation 3: You have a gastric pain.
Ok, this is one of the situation that you DO NOT take painkillers especially the NSAIDs class. The reason that you have gastric pain is normally because you skip your regular meals or you have gastric problem in the past. In this case, you have too much gastric acid in your stomach that irritates the lining of the stomach. So you will need something to neutralize the acid or reduce the production of the acid. Neither paracetamol nor NSAIDs help. You will need something like Antacids or PPIs or H2 Antagonist which i will discuss other time. The point here is that you should not take painkillers as they will not help and might even exaggerate the pain.

The main counselling points for both medicines are summarized as below:

Paracetamol
1. Take 2 tablets (each 500mg) every 4-6 hours for adult. Do not take more than 8 tablets (4 grams) a day.

It is very important to not exceed the amount taken a day as paracetamol is metabolised in the liver. And as some of you might know, overdose can cause liver problem even death.

2. Take it only when you have fever or mild to moderate pain.

3. Do not take the medicines if you have history of allergy to this medicine.

This is important as well. Allergy can be life-threatening. Watch out for any swollen lips or eyes, rashes, itchiness, breathing difficulties etc after taking the medicines if you have never take it before.

4. Consult the doctor/pharmacist if you have other medical condition or is currently taking other medicines such as Warfarin.

This is to prevent the incidents of drug interactions.

NSAIDs
1. Take it AFTER food and do not take more than directed.

This is because NSAIDs can cause gastric irritation which is commonly known as gastric pain. As all the medicines, overdose can make the medicine becomes poison which is a serious medical issue.

2. Take the medicines only when necessary for moderate to strong pain.

3. Do not take the medicines if you have allergy to any drugs from NSAIDs class. Consult a doctor/pharmacist if you are not sure.

4. Do not take the medicines if you have gastric, kidney or heart problem. Also consult a doctor/pharmacist if you are taking any other medicines, including Aspirin, warfarin and even some of the supplements which help with blood flow.

This is a crucial point for people who want to get NSAIDs medicine. I have explained about the relationship between gastric problem and the drug. As for the kidney problem, NSAIDs are cleared by kidney which means if your kidney is not functioning well, the medicines will accummulate in the body which will cause serious problem. 

Also some of the NSAIDs they are marketed as Selective COX-2 inhibitor, e.g. Celecoxib and Etoricoxib, which claims they have minimal gastric side effects. That is actually reasonable as they selectively not acting on the receptor that is responsible for the gastric effect. However, studies have shown that this type of NSAIDs might induce heart attack or stroke in people who have heart problem. Therefore consultation with the doctor or pharmacist is very crucial to avoid using Celecoxib or other similar medicines in people who have heart problem.

Wow, this is totally like writing for an assignment even though i just briefly introduce the medicines. I think this is the longest post i have ever written haha. Anyway hope you guys find it helpful and please do leave comments if you need any clarification or other informations =)

Honey Flavoured Ice Cream

New week, new month, 2nd half of the year! Time flies isn't it? It's half way through year 2013 and we are still alive =) I guess it won't be end of the world anytime soon. Well, that's what i hope anyway haha.

Today, i'm gonna talk about the handmade ice cream i did last week. The reason i made it is because i need ice cream to eat with my chocolate mousse. As you know the mousse is super rich so i can't really just eat the mousse alone.

Anyway, i use Honey as my flavouring agent. The recipe is as below:

4 Tablespoon milk powder
~150mL of full cream milk (3/4 ramen bowl)
1 Tablespoon honey

So, i boil the milk and add milk powder. Stir until fully mixed and lastly add in the honey. Then, what you need to do is cool down the mixture for a while and put into freezer. After about 2-3 hours, check out the mixture. It should be frozen halfway. Now what i did was i stir it and whisk it until fluffy. Like how you make whipped cream. As from what i understand, ice cream means frozen cream, with extra creamy taste. So, that's what i did. After that, put back into the fridge and do the same thing in about half and hour or 1 hour. It will be smoother if you can stir the mixture as frequent as possible until it is completely frozen. This is to mimic the process in ice cream machine. What they did is they continually stir the mixture until it becomes ice cream.

It tasted great but i think i can improve the recipe by adding in more milk powder. That can make the ice cream more milky and rich. As i only stir for 2 times for this batch, it is still a little bit rough and not smooth enough. But the texture is alright.

Well hope i can make a better batch next time =)