What does alcohol do to your brain?🍸🍸🍸

We always know alcohol is harm for the brain and memory, but what does alcohol actually do to your brain? This time, we will discuss about it. 

1. Gray matter is decreasing

An article published in the American Journal of Psychiatry (AJP) studied the effects of alcohol consumption on brain growth and development in adolescents aged 12-21. They tracked the brains of the participants before and after the study via magnetic resonance imaging (MRI) and it was found that the volume of gray matter in the participants who drank a lot of alcohol decreased more quickly. The growth of central white matter was slower than the low-drinking group.

During the maturation of the brain, the gray matter of the cerebral cortex will normally increase during the first ten years of life and then it will continue to decline. Throughout adolescence stage, the volume of white matter increases and only slows down in the third decade. The results of the study show that alcohol clearly deviates the teenagers' brains from normal developmental rules. Because the prefrontal area of the brain is the latest to mature, the prefrontal cortex gray matter has the most obvious effect. The frontal cortex is the brain area responsible for cognitive function. The accelerated decline of the prefrontal cortex will lead to accelerated impairment of cognitive function. The damage caused by alcohol to these areas may also affect their  self-control, decision-making ability and judgment.

2. Hippocampus is shrinking

A study published in the British Medical Journal (BMJ), 550 adult participants repeatedly measured cognitive performance, weekly alcohol consumption and performed MRI. 

Participants who consumed 30 units of alcohol per week (1 unit is about 8g of alcohol) had the highest risk of hippocampal atrophy. It was 5.8 times non-drinkers. Moderate drinkers (male: 7-21 units/week, female: 7-14 units/week) have 3.4 times the risk of hippocampal atrophy to non-drinkers. Light drinking (1-7 units/week) cannot still prevent hippocampal atrophy.

3. The brain is shrinking and it is not far from dementia

Researchers believe that heavy drinking is the most important risk factor for dementia, especially early-onset dementia. They found more than 1 million cases of dementia, ruled out patients with rare forms of dementia and early mental disorders. They finally found that there are over nine hundred thousand people actually suffer from alcohol use disorders. It can be seen that there is a strong correlation between alcohol and dementia. In early-onset dementia, 57% of patients under 65 years of age have a history of alcohol abuse suffer from dementia.

4. There may be gender differences, men are probably more serious

The long-term effects of alcohol on the brain are mediated by 𝛾-aminobutyric acid and brain potential changes are caused by transcranial magnetic stimulation of the motor cortex. A study compares with the brain potential changes between drinkers and non-drinkers. It was found that the amplitude of brain potential changes in men was more obvious. This indicates that the harm of long-term drinking in men may be higher than that in women. The changes of brain function are more likely to occur.

😣For your health, don't drink too much at least.😣

For more detail, click the links below👇👇👇

https://www.medscape.com/viewarticle/888268#vp_4

https://www.medscape.com/viewarticle/882497

https://www.medscape.com/viewarticle/892918

https://www.medscape.com/viewarticle/885290

Read More

Use body signals to alert for diabetes complications👴👵

Diabetes is a chronic metabolic disorder based on genetics and the environment, which can cause damage to capillaries, large blood vessels, eyes, feet, heart, brain and other organs. The patient will produce some corresponding symptoms due to persistent hyperglycemia. If doctors and patients can recognize these changes early and intervene in time. It can effectively delay the development of diabetes to a more severe degree.

1. Skin: Abnormal sweat secretion and pigmentation

Skin lesions can occur in the skin of the whole body and occurring in various periods of diabetes. It is manifested as hyperhidrosis on the trunk, less sweat on the limbs, dry skin and itching, cracked hands and feet, erythema on the anterior tibia of the calf, and gradually progressing to a circular pigmented area (anterior tibial spot).
Mechanism: Autonomic nerves can not regulate sweat glands normally. It result in abnormal sweat gland secretion. Coupled with long-term metabolic disorders, it causes neuropathy, microvascular disease, arteriosclerosis and skin infections, which in turn leads to skin lesions.

2. Eyes: pain and blurred vision

Diabetic retinopathy can cause blurred vision, decreased vision. Some patients may have color recognition disorders or eye pain.
Mechanism: Eye basement membrane thickened, capillary capillaries, and impaired blood retinal barrier function caused abnormal penetration. It would lead to retinal edema and the formation of new blood vessels over a period time.

3. Oral: periodontal abscess and periodontitis

Patients with poor blood sugar control lead to severe inflammation of the periodontal tissue, red and swollen gingival margins can be granulomatous hyperplasia, easy to bleed, periodontal pockets often have pus and periodontal abscesses. In severe cases, multiple periodontal abscesses and rapid destruction of alveolar bone can occur.
Mechanism: Diabetes and periodontitis affect each other. The high-sugar environment of diabetic patients will cause the microbes grow rapidly in the oral and causing a variety of oral diseases. The failure of effective control of oral diseases will further worsen the condition of diabetes.

4. Foot: infection and ulceration

Diabetic feet are manifested by infections of varying severity, ulcers, neurological disorders, damage or lesion of soft tissues and bones and joints of the foot. Severe cases may require amputation. The probability of foot ulceration or necrosis in diabetic patients is 20~30%.
Mechanism: Diabetic foot is caused by peripheral neuropathy, infection and vascular stenosis or occlusion.

5. Bone: bone pain and osteoporosis

Diabetes combined with osteoporosis will cause bone pains. Convulsions of the limbs may occur due to increased urinary calcium excretion. People with severe osteoporosis are prone to fractures. If there is a significant compression fracture of the spine, there will be a hunchback, height shorter and a reduction in the distance between the costal margin and the iliac ridge.
Mechanism: Poor blood sugar controlling caused increaseing urinary sugar excretion, a large loss of blood calcium with urine, inhibition of bone formation, bone transformation at a low level. The end products of glycosylation may increase bone fragility.

6. Joints: pain and limited mobility

It shows joint pain, swelling, tenderness, joint morning stiffness, rub of joint and limited joint movement.
Mechanism: Diabetes can cause joint neuropathy. It result in vascular nutritional dysfunction, hypoesthesia, bone destruction, articular cartilage damage and even fractures.

7. Lower limbs: pain and numbness

Diabetes more than 10 years are prone to obvious peripheral neuropathy. The clinical manifestations are pain, numbness, burning or needle sensation in the limbs. The symptoms are often bilaterally symmetrical and are more obvious at the ends of the hands and feet. Severe pain at the proximal end of one lower extremity is more common and it can be involved with both distal motor nerves at the same time. It accompanied by rapidly progressing muscle weakness and muscle atrophy.
Mechanism: The risk of occurrence is related to factors such as the level of blood sugar control and the course of diabetes. The occurrence of pathology involves multiple mechanisms such as oxidative stress, polyols and microcirculation disorders.

8. Gastrointestinal: hiccups, diarrhea and constipation

Patients will have stomach symptoms such as hiccups, dysphagia, stomach upset, full upper abdomen, constipation, diarrhea and bowel disorders.
Mechanism: Diabetic autonomic neuropathy can manifest in multiple systems of the human body and then appear corresponding symptoms.

9. Urine: special smell and foamy urine

There is an increase in foam in the urine which looks like beer foam. The urine appears a special smell, frequent and incomplete urination.
Mechanism: Foamy urine is due to increased urine albumin excretion. It results in increased urine tension and foam. The special smell in urine is due to the increased amount of ketones produced by the body under the influence of high blood sugar. It is always seen in diabetic ketosis or ketoacidosis.

10. Cardiovascular: syncope and orthostatic hypotension

It manifests as syncope, orthostatic hypotension, painless myocardial infarction, abnormal coronary systolic function, cardiac arrest or sudden death.
Mechanism: Diabetes is a cardiovascular complication caused by increased blood sugar and blood lipids. High blood pressure and lipid and calcium deposits in the coronary arteries of the heart. These make hardening and stenosis of the arteries.

11. Peripheral large blood vessels: cold skin and walking weakness

The pulsation of the dorsal artery of the foot disappeared, the skin of the lower extremities was cold and the walking fatigue disappeared after 2 to 3 minutes of rest. Then the calf pain during walking may appear which relieved after rest.
Mechanism: Diabetes leads to peripheral vascular disease which is stenosis and occlusion of blood vessels except coronary arteries and cerebral blood vessels. There are corresponding ischemic spasm or necrosis of distal tissues. It is mainly involving lower extremity arteries.

12. Sexual dysfunction

Men are manifested as retrograde ejaculation, erectile dysfunction, delayed ejaculation, premature ejaculation, non-ejaculation and so on. Women present with symptoms such as decreased vaginal lubrication, low libido, female orgasm disorders and dyspareunia.
Mechanism: In men, erectile and ejaculation disorders are caused by autonomic nervous diseases. Erectile disorders are caused by vascular diseases. In women, because women are in a state of chronic hyperglycemia, antioxidant defense effectiveness is reduced. It is leading to aggravation of the disease and various sexual dysfunctions.

Read More

The impact of COVID-19 pneumonia on children may be seriously underestimated👪👪👪

Long-term symptoms of COVID-19 refer to a series of symptoms appearing after infection with COVID-19, including organ inflammation, shortness of breath, fatigue, behavior changes and so on. Studies have shown that about 30% of people infected with the COVID-19 will have long-term symptoms, even though most people can recover quickly. A recent study in the United Kingdom showed that only 4.4% of children with COVID-19 pneumonia will have symptoms for more than 4 weeks. Only 2% will last for more than 8 weeks. However, another study pointed out that 14% of 11 to 17-year-old children still have symptoms after 15 weeks. The child is older, the situation seems more serious.

Compared with adults, it is more difficult to diagnose long-term symptoms of COVID-19 pneumonia in children. Although most symptoms are similar between adults and children, it is just more difficult to detect. Experts believe that children's bodies have a lot of functional reserves. Therefore, if a 5-year-old child loses 20% of his physical functions, it is hard to find out. Some children with long-term symptoms of COVID-19 suffer from multisystem inflammatory syndrome in children (MIS-C), which may cause organ damage. There are also adolescents with long-term symptoms of COVID-19 who have developed Tourette's syndrome, which is characterized by convulsions and sometimes involuntarily cursing. These are very serious symptoms, not only for the children, but also for their family and related people around them will cause great mental stress. 

Risk and benefit balance

However, some experts believe that the benefit of unblocking is greater than that. They think that infections in children are not unacceptable because their symptoms are usually not serious. 

Without fully understanding the mechanism of this disease, and if its consequences may not slowly appear until many years later, it seems a bit reckless to risk the children. Although it is necessary of reopening the economy, it should adopt certain simple measures, such as wearing masks in schools and enhancing ventilation. Taking these measures can effectively protect the next generation. 

Protect the children from COVID-19

The risk of long-term symptoms of COVID-19 does exist. Schools should improve their preventive measures to protect their students from infecting the COVID-19 virus. It is recommended to provide vaccines to all suitable children. It is not mandatory. Their parents can choose if their children received the vaccines. Doctors need to recognize the severity of the long-term symptoms of COVID-19, rather than just treating it as a psychological problem and asking patients to see a psychologist. This is a physiological problem, so there must be some methods of physiological solution. People often ignore related issues. 

Read More

The COVID-19 epidemic is far from over😷😷😷

Recently, the counter-attack of COVID-19 epidemic will cause schools to be forced to close and classes to be suspended. People received the COVID-19 vaccine will still face a new round of infection. When the hospital is overwhelmed again, office workers will also weigh whether they need to continue working at home. 
Scientists believe that before the end of COVID-19 epidemic, almost everyone has either been infected with the COVID-19 virus or vaccinated with the COVID-19 vaccine or maybe both. A few unlucky people may be infected with COVID-19 more than once. Before all human beings are infected with the virus, the race between the virus mutation and vaccination will not end.
Dr. Michael Osterholm, American Covid-19 consultant, he said that the cases around the world continue to rise and then decline. It may be a sharp decline. However, he think it is likely that there will be a sharp rise again in the autumn and winter of this year. There are still billions of people in the world who have not been vaccinated and there is currently very little chance of eradicating the virus. Then, as the economy reopens, it is expected that more new cases will appear in public transportation, workplaces  schools in the coming months. Even if the immunization rate rises, there will still be people who are vulnerable to COVID-19: newborns, people who are unable or unwilling to receive the vaccine and people have been vaccinated with the vaccine but have breakthrough infections because of the reduced protection of the vaccine. 

COVID-19 vs. Other epidemics

An Epidemiologist pointed out that there were 5 well-documented epidemics in the past 130 years, they provide some inspiration for the future development of COVID-19 epidemic. Although the longest global flu has lasted for five years, the average cycle is two to three years with two to four rounds of infection. However, COVID-19 may not follow the development pattern of past epidemics. This is a new type of pathogen that is potentially more infectious. So far, the death toll from the new crown epidemic has exceeded 4.7 million. Vaccination can effectively reduce the rate of severe illness and mortality.  The vaccination rate continues to increase, but the rise in infection means that the virus is infecting teenagers and other people who have not been vaccinated. It is leading to an increase in the rate of severe illness in these groups. Countries with low COVID-19 vaccination rates are facing the largest outbreak so far due to the emergence of the delta variant strain. With the delta variant strains raging in many countries, another new variant strain is likely to emerge.

Experience has shown that people usually think that the pathogenicity of the virus will diminish over time, so that all hosts will not be completely wiped out, but this idea is not correct. Although the pathogenicity of new mutant strains is not necessarily more serious, as the virus is constantly adapting to new hosts during the epidemic. Its fatality rate may actually be higher.

Some researchers said that the new coronavirus may be completely resistant to the first-generation new coronavirus vaccine. As the virus continues to evolve, we may need to be vaccinated regularly to effectively deal with the new coronavirus just like preventing the flu.

When will the COVID-19 epidemic end?

Experts generally believe that only when most people (approximately 90% to 95% of the global population) have gained a certain degree of immunity through COVID-19 vaccination or infection, the current epidemic can be controlled. They believe that the key to controlling the epidemic should be the vaccination of COVID-19 vaccine. If people are not vaccinated, the virus may spread widely in the autumn and winter of this year and almost everyone will be infected by that time. 

An associate professor of medical history at Oxford University believes that the end of the COVID-19 epidemic will vary in different regions, just like the time of the outbreak. Governments will have to make decisions about the extent to which they can tolerate coexistence with the virus. The response measures taken vary greatly. Although some countries strive to achieve zero cases of COVID-19, it is unlikely that the world will completely eradicate the virus.

🔑We must remain alert and treat the COVID-19 epidemic with caution. If anyone thinks that we will be able to resolve the pandemic in the next few days or months, that would be a big mistake.

Read More

Do the season and temperature affect blood pressure??⛄⛄⛄

Blood pressure is affected by many factors, including season and temperature. A study
has found that the average blood pressure in winter is 12/6mmHg (systolic/diastolic  blood pressure) higher than the average blood pressure in summer. For every 1°C decreases in temperature, the systolic blood pressure rises by 1.3mmHg and diastolic blood pressure rises by 0.6mmHg. 

In winter, the decreasing of temperature and the cold weather lead to increase sympathetic nerve excitement. It causes increasing heart rate, the release of catecholamines, increasing cardiac systolic function and myocardial oxygen consumption, peripheral vasoconstriction, increasing peripheral vascular pressure and blood pressure. At the same time, less sweating in winter lead the blood volume higher.  Those are also the causes of blood pressure fluctuations in winter. 

In summer, as the temperature gradually rises, the blood vessels dilate and blood pressure gradually decreases. The amount of sweating is more than in winter. The water in the body is lost more. The blood volume decreases. In some patients, the blood pressure declines or is close to normal.

Therefore, season and temperature changes may cause blood pressure fluctuations. Patients with hypertension should regularly monitor their blood pressure according to changes in temperature. Based on the changes in blood pressure, consult the doctor to adjust the medicine in time. Make sure to feel relax, avoid anxiety and excitement, eat lightly and avoid complications of hypertension.

👀Winter is here, keep yourself warmer~~

Read More

Can all drugs be taking by breaking or chewing❓❓❓

In clinical, most patients only care about the usage, dosage and side effects of drugs. In fact, except these aspects, some drugs also need special notices, especially for children or the elderly who have difficulty swallowing. For example, whether the drugs can be crushed to take, whether the capsule shell can be opened and mixed drug powder with water to drink. This requires additional instructions from the doctor or pharmacist. Different drugs are made into different dosage forms according to the characteristics of the drugs and clinical requirements. If the drugs are used incorrectly without following the requirements, it may cause no treatment efficacy and even some serious adverse effects.

Which oral drugs have the special usage?

1. Sustained and controlled release dosage

    Sustained-release dosage form refers to a dosage form that can continuously release the drug for a long time to achieve a long-acting effect after drug administration. 

    Controlled-release dosage form refers to a dosage form that can automatically release the drug at a predetermined rate within a predetermined period of time, so that plasma concentration of a drug is constantly maintained within the effective concentration range for a long time.

    The principles of sustained or controlled release include dissolution, diffusion, dissolution, osmotic pressure difference, ion exchange and so on. According to different principles, It can be made into microcapsule type, osmotic pump type, framework type, etc. For osmotic pump type sustained or controlled release preparations, breaking or chewing will destroy the semipermeable membrane and fail to achieve the effect of releasing drugs. For a few number of framework type or microcapsule type drugs containing multiple independent units, it can be breaking to take. But it should be splitted according to the scratches on the tablet. 

2. Enteric-coated tablet

    Enteric-coated tablet refers to a tablet that does not disintegrate in the gastric juice, but can be disintegrated and absorbed in the intestinal juice. It is generally coated with an enteric coating on the outside of ordinary tablets. Therefore, only by maintaining the integrity of coat can make the drug be released at a set speed and location to achieve the purpose of slow and controlled release. That make the tablet must be swallowed as a whole, not broken or chewed. If it is broken, it will cause a sudden release of the drug and lead to adverse reactions.

3. Effervescent tablet

    Effervescent tablet uses organic acid and basic carbonate/bicarbonate salt to react as effervescent disintegrant. When placed it in water, an effervescent reaction occurs immediately. It will generate and release a large amount of carbon dioxide. Effervescent tablet must be dissolved in water before it can be taken. It can't be directly taken.

4. Chewable tablet

    Compared with general tablets, chewable tablet does not contain disintegrant. The drug is difficult to disintegrate when swallowed as a whole tablet. The dissolution of the active ingredients is reduced and the drug may not achieve the therapeutic concentration.

Due to different preparation processes, the same kind of medicine produced by distinct manufacturers may require different methods of administration. Read the instruction carefully before taking the medicine, and do not determine by yourself.

Read More

The knowledge of Povidone-iodine for using disinfect wound👀

Povidone-iodine is the most common sterilizer in clinical practice. Its bactericidal effect is excellent and it has almost no irritation to the skin and mucous membranes. It is also painless when patients are using it, so it is a common self-prepared medicine in many families. However, not all wounds are suitable for sterilize with povidone-iodine. In some cases, the chronic wounds are aggravated when the patients had dressing change.

Here are a clinical doctor summarized a few advices for povidone-iodine:

1. Use povidone-iodine less 

Povidone-iodine disinfect acute and chronic wounds and surrounding skin is very common in clinical. Although povidone-iodine has almost no irritation to the skin and mucous membranes, it is also some harmful to the tissue. It will affect the growth of tissues in a relatively short period of time. If povidone-iodine stays in the wound surface, this effect may be further aggravated. 

In most patients with strong self-healing ability, this short-term stimulation may not lead to delayed wound healing. However, for some elderly patients, their skin barrier became weak and healing ability worse. At this time, the side effects of povidone-iodine become prominent and even make the patient painful and unable to sleep.

2. Use saline

Because of the presence of acidic substances such as urea, salt, amino acids, uric acid, free fatty acids and lactic acid on the surface of human skin, the surface of the skin is always performed weakly acidic. The characteristics of the pH value of the skin surface: ①The pH value of the normal skin surface is about 5.0～7.0. ②The lowest pH value can reach 4.0 and the highest pH value can reach 9.6. ③The average skin pH value is about 5.8. Only when the skin is in the normal pH range which is weakly acidic, it can be in the best state of absorbing nutrients. At this time, the skin stay in the best state to resist external erosion. 

Due to the impregnation of wound exudate and topical drugs, the skin around chronic wounds is destroyed the original pH. If it is not washed with saline after povidone-iodine disinfects the skin, the residual povidone-iodine may destroy the pH and humidity of the skin. This will weaken skin resistance.

3. Use antibiotics with caution

People should use antibiotics strictly in accordance with the indications. For infectious wounds, the anti-infective treatment should be adjusted in time based on drug sensitivity. 

For limited wounds, if the patient is generally in good condition, no systemic infection, no osteomyelitis, it is not necessary to take antibiotics intravenously or even orally. It can be considered using topical antibacterial drugs or antibacterial dressings.

Read More

Inventory of various new discoveries of metformin😎😎😎

Metformin is an anti-diabetic drug and a classic oral hypoglycemic agent. Since its inception in 1957, it has been used clinically for more than 60 years. It is currently one of the most widely used oral hypoglycemic drugs in the world. Even though there are many new hypoglycemic drugs, metformin is still the primary drug for type 2 diabetes.

Metformin was born in 1929 and originated from galega officinalis. In 1957, French diabetologist professor Jean Sterne first used metformin for clinical hypoglycemic reduction. Then its application value is still being discovered. Let us take a look at what new discoveries have been made recently.

1. Cancer

Acidic phospholipids play an important role in regulating electrostatic membrane association of programmed cell death ligand 1 cytoplasmic domain (PD-L1-CD). Metformin can competitively dissociate PD-L1-CD from the membrane and affect the stability of PD-L1. This revealed that the molecular mechanism of metformin's anti-tumor effect and provided new ideas for related immunotherapy targeting PD-L1.

There are many studies that supporting metformin can decrease the risk or improve the symptoms of cancer patients. Such as esophageal squamous cell cancer, pancreatic cancer, primary bone cancer.

2. Obstetrics & Gynecology

a. Improve neonatal obesity

    Metformin has many benefits for mother's blood glucose and neonatal obesity, including improved blood glucose, reduced caesarean section, reduced mother's weight, lower insulin requirements,  lower birth weight and obesity measurements of newborns.

b. Prevent adverse pregnancy outcomes in patients with polycystic ovary syndrome

    Metformin can prevent late period abortion and premature birth in women with polycystic ovary syndrome.

3. Metabolic diseases

Metformin can improve the metabolic status of patients treated with systemic glucocorticoids. It can not only reverse the metabolic complications caused by the use of systemic glucocorticoids, but also reserve the anti-inflammatory effects of glucocorticoids. It benefits many patients taking systemic glucocorticoids.

4. Cardiovascular System

 a. Heart failure

    Non-diabetic heart failure patients with reduced ejection fraction (HFrEF) use metformin to reduce myocardial oxygen consumption and improve myocardial efficiency.

b. Left ventricular hypertrophy

    Metformin treatment significantly reduced the left ventricular mass index. Patients taking metformin reduced left ventricular thickening by two time less. In addition, metformin also reduced blood pressure, oxidative stress, and weight. Metformin has the potential to improve cardiovascular health.

c. Air-pollution-induced thrombosis

    Atmospheric particulate matter can induce alveolar macrophages to release pro-inflammatory factors including interleukin 6 (IL-6), leading to arterial thrombosis and death.

    Metformin blocks the mitochondrial electron transport and inhibits the production of reactive oxygen species, thereby blocking the release of IL-6 and inhibiting the formation of arterial thrombosis. This confirms that metformin can be used as a potential therapeutic drug to prevent cardiovascular diseases caused by air pollution.

5. Nervous system

a. Cognitive and nerve recovery after brain tumor surgery

    For children with brain tumor patients who have received craniocerebral radiotherapy, metformin can significantly improve their statement memory and working memory function, repairing white matter damage. Metformin is also safe and tolerable in this population.

b. Multiple Sclerosis

    After treatment with metformin, oligodendrocyte precursor cells can restore their response to the signal of promoting-differentiation, promote the regeneration of nerve myelin. This is useful for the treatment of central nerve demyelination such as multiple sclerosis.

c. Cognitive decline and dementia

    Patients with type 2 diabetes who take metformin have slower cognitive decline and a lower risk of dementia.

6. Locomotor system

a. Osteoarthritis

    Metformin can prevent the occurrence and development of osteoarthritis, alleviate the pain sensitivity associated with osteoarthritis in mice. Its protective effect on cartilage is mainly through the activation of AMPK signals.

b. Intervertebral disc degenerative disease

    Metformin can promote the release of small extracellular vesicles of mesenchymal stem cells, increase the level of proteins that regulate cell proliferation in the vesicles, and can optimize the application effect of extracellular vesicles in the regeneration and repair of intervertebral discs.

7. Digestive system

Metformin stimulates bile secretion in the intact liver, but this drug can also cause severe damage to bile acid secretion.

8. Infection

a. COVID-19

   Metformin inhibits the activation of NLRP3 inflammasomes and the production of IL-1β in cultured macrophages and alveolar macrophages, as well as the secretion of inflammasome-independent IL-6, thereby attenuating lipopolysaccharide and COVID-19 induced acute respiratory distress syndrome. Metformin can be a potential treatment for severely patients with COVID-19 and other induced acute respiratory distress syndrome.

b. HIV

    Metformin reacted on mitochondrial respiratory chain complex-I and inhibit the oxidative phosphorylation (OXPHOS) pathway. It inhibited the replication of human CD4⁺ T cells and HIV-1 virus in humanized mouse models. It revealed that metformin and others OXPHOS pathway inhibitors may be an adjunct to treat AIDS.

👉Metformin has also anti-aging effect. Most effects still are at the research stage and may not be used on treatment. Therefore, metformin still deserves more in depth research.

Read More

The recommended use of probiotics treat gastrointestinal diseases😈😈😈

There are many products content probiotics in the supermarket. You can easy to buy products to supplement probiotics. Those products always claim that is good for both people with/without gastrointestinal diseases.

Probiotics are active microorganisms that can produce health benefits when consumed in sufficient quantities. As an effective method to change the intestinal microbes, probiotics are used more and more widely in the treatment of gastrointestinal diseases.

Although there were a large number of studies on probiotics in various gastrointestinal diseases, the microbial strains, route of administration, doses and research methods of studies were various. 

In order to provide clear and reasonable guidance for the proper use of probiotics in specific gastrointestinal diseases, the American Gastroenterological Association (AGA) has proposed some recommendations for the role of probiotics in the management of gastrointestinal diseases.

Here is the summary of the recommendations:

1. The AGA guidelines recommended that probiotics be used to patients with ulcerative colitis, Clostridium difficile infection and Crohn's disease, or symptomatic patients with irritable bowel syndrome only in clinical trials.

2. It is recommended to use probiotics to prevent C. difficile infection of the patients taking antibiotics. (Low quality of evidence)

3. Advise patients with pouchitis to use a combination of probiotics. (Very low quality of evidence)

4. Premature low birth weight infants with necrotizing enterocolitis are recommended to use a combination of probiotics. (Medium to high quality of evidence)

5. Probiotics are not recommended for North American children with acute transmissible gastroenteritis.

More high-quality clinical trials are needed to provide supporting in the use of probiotics to treat gastrointestinal diseases.

For more detail, click on the link below👇

https://www.gastrojournal.org/article/S0016-5085(20)34729-6/fulltext

Read More

Some advices prevent the recurrence of peptic ulcer disease👍👍👍

The gastric juice (gastric acid, pepsin) makes the mucosal tissue loss and  shedding in the gastrointestinal tract which is covered by the juice. It call Peptic Ulcer Disease.  That mucosal ulcers always occur in the stomach or duodenum (gastric ulcer and duodenal ulcer). The causes and treatments of them are similar. It is about one-tenth of the population has suffered from peptic ulcer, which shows that the incidence is very high.

There was no effective drugs to treat peptic ulcers before the 1970s. There was used to drink soda or milk to treat stomach pains, and even treated them by surgical removal of their stomachs. After the doctors figured out the cause of peptic ulcer which is believed causing by excessive gastric acid production. Then they have invented the gastric acid secretory inhibitors (such as ranitidine, cimetidine, omeprazole.). Taking oral medicine to cure peptic ulcer has become very easy.

However, there are another problem arising. Although most patients can heal their ulcer within 1 to 2 months after taking the medicine, they will recur easily. Over 70% of patients relapse ulcers within one year after stopping the drug. Some patients even recurred every year.

Until the 1990s, the peptic ulcer was understood further more. It was discovered that in addition to excessive gastric acid. The cause of ulcer was also infected with a special kind of bacteria (Helicobacter pylori) in the stomach. Afterward there was explored to eliminate Helicobacter pylori in the stomach. 

Studies have found that over 70% of patients with gastric ulcers and over 95% of duodenal ulcers are infected with Helicobacter pylori. After regular treatment and removal of bacteria in the gastrointestinal tract, the recurrence rate of peptic ulcer has dropped from more than 70% to less than 5%. Therefore, the key to solving the recurrence of peptic ulcer is to eliminate Helicobacter pylori for most patients.

The following advices should be noticed in the treatment of peptic ulcer and prevent the recurrence:

1. Clarify the etiological diagnosis of peptic ulcer via gastroscopy and standardized treatment. Without the gastroscopy, it is difficult to distinguish peptic ulcer, chronic gastritis, dyspepsia and cholecystitis based on symptoms alone. The treatment ways for each disease are different. 

2. After the diagnosis is confirmed, the patient should adhere to the course of treatment (generally 6 to 8 weeks for gastric ulcer and 4 to 6 weeks for duodenal ulcer). The gastric acid secretory inhibitors are effective. The symptoms are eliminated by taking the drugs once or twice. Many patients will stop taking the medicines when the symptoms disappeared. In fact, the course of treatment is insufficient and the ulcer is not healed.

3. Determine the presence of Helicobacter pylori infection as soon as possible and prevent the treatment mistakes. Using standardized and effective antibacterial treatment plan to avoid causing bacterial resistance.

4. Long-term medication is not recommended. There are some patients take the gastric acid secretory inhibitors for many years to prevent the recurrence of ulcers. However, there is no evidence that prolonging the medication time can prevent the recurrence of ulcers. As long as Helicobacter pylori is present, it is still easily relapse after stopping the drug.

5. Patients should change their bad lifestyle. Such as tobacco and alcohol habits, irregular meals, staying up late,  long-term emotional stress and anxiety. There is no clear evidence show that spicy foods will aggravate ulcers. The patient's diet is kept soft and easy to digest.

6. Using the drugs (such as NSAIDs) that induce or aggravate the ulcer carefully.

Read More

Some knowledge about scar removal products 😍😍😍

Scar is the appearance and pathological changes of normal skin tissue caused by various traumas, such as after burns, surgery, skin inflammation (such as folliculitis, acne.). It is an unavoidable product in the process of human wound repair. Scars influences the appearance of the patient and easily influences the patient's psychology. There are many methods (such as laser therapy, surgery, external scar removal products) to treat scar. Here will introduce a few external scar removal products.

Dermatix®

It is composed of polysiloxane, silicon dioxide and silicone resin. It can inhibit the growth of scars, flatten the scars on the skin, and relieve itching or pain of scars. It is not suitable for the unhealed wounds. 

Clean and dry the scar. Use appropriate amount of gel applying along the scar. Do not apply back and forth on the scar.

Kelo-Cote®

Its effective ingredients are polydimethylsiloxane and cyclopentasiloxane. It can prevent the appearance of scars, repair scars that have formed, and regenerate the skin. 

Clean and dry the scar. Apply a thin layer on the scar 1-2 times a day. 

Hirudoid®

Its effective ingredient is Mucopolysaccharide Polysulphate. It is used to treat varicose veins, remove blood stasis, relieve swelling and pain, inhibit scar formation and soften scars. 

When it is used to soften scars, it needs to be massaged forcefully so that it can fully penetrate into the skin.

Cica-Care®

It is a silicon gel sheet and is made of medical polymer materials. It is suitable for adjuvant treatment of hypertrophic scar due to body surface trauma, burns and after surgical healing.

It should be used for at least 12 hours a day, preferably 24 hours, and continue to use it for 2 to 4 months. Apply it for 4 hours a day for the first two days and 8 hours a day for the next two days, then increase by 2 hours a day until it can be applied 24 hours a day. This using method can avoid skin allergies. Each sheet can be used repeatedly for 14 to 28 days. When it becomes difficult to clean or stick, it needs to be replaced a new one. Do not use on the unhealed wounds.

Read More

Is the COVID-19 drug better than vaccine??? 😲😲😲

On October 1st, Merck and Ridgeback Biotherapeutics reported the results from their COVID-19 drug Molnupiravir from phase 3 study in patients with mild to moderate COVID-19. 

In their study, the risk of hospitalization or death are reduced by about 50%. Only 7.3% patients who got Molnupiravir were either hospitalized or died during the research. And the placebo group is 14.1%. The Molnupiravir group is no one dead and the placebo group is reported 8 people dead. 

But after a few days of that announcement, a source with the drug controller general of India reported that Molnupiravir is no significant efficacy toward the moderate COVID-19 and that effective effect is only against the mild COVID-19.

Although Merck said that no significant safety issues have been observed in the study, some scientists have expressed doubts about the safety of Molnupiravir. The structure of Molnupiravir is similar to the nucleotide of RNA. That makes the virus produce ineffective RNA to stop virus replication. Those scientists believe that this function will have adverse effects on the human too.

So, is the COVID-19 drug better than vaccine?

It is hard to say which one is better. The vaccine is always being the first way for diseases. It can protect people to avoid getting sick. The treated drugs will be used when the people get sick. Therefore, we should not compare with drug and vaccine. You can think that they are two different things.

Although Molnupiravir is highly cheaper than other COVID-19 treatment methods, it is still much more expensive than the widely vaccinated COVID-19 vaccine.

As the first oral small molecule antiviral drug supported by clinical data, Molnupiravir has obvious advantages over the current neutralizing antibody treatment of COVID-19: 

1. It does not require low-temperature storage and transportation.

2. It can be taken orally.

3. It provides a life defense for people who cannot or refuse to receive the COVID-19 vaccine.

The convenience and price of Molnupiravir make it more approachable for the early-stage patients or high-risk groups.

The FDA will discuss for an emergency es authorization for Molnupiravir to treat COVID-19 on 30th November 2021. Let's look forward about it.

Read More

Can we smoke when taking medicines???💣💣💣

 Smoking (Most drugs)

For most drugs, we should not smoke at least 30 minutes before and after taking the drug. For some drugs, such as aminophylline, the dosages need to be adjusted after you quit smoking.

In flue-cured cigarettes, The amount of tar is about 11mg. Some substances in tar can induce the drug-metabolizing enzymes in liver, such as CYP1A1, CYP1A2, CYP2E1. It will promote the metabolism of drugs (For example, it increases the clearance rate of aminophylline by 58-100%), and significantly reduce the efficacy of drugs.

The amount of nicotine is about 1mg in flue-cured cigarettes. Nicotine is mainly metabolized by the drug-metabolizing enzymes in liver (CYP2A6). And the drugs (such as Methoxsalen) reduce the metabolism of nicotine by inhibiting CYP2A6. It causes dizziness, headache, nausea, vomiting, and even severe arrhythmia.

Especially when you are taking below drugs:

Antipyretic analgesics: such as Acetaminophen

Anticoagulants: such as Warfarin

Antipsychotics: such as Mirtazapine

Antiarrhythmic drugs: such as Mexiletine

Antiasthmatic drugs: such as Theophylline

Adrenergic receptor agonists and blockers: such as Metoprolol

Antihypertensive drugs: such as Nifedipine

Hypoglycemic drugs: such as Insulin

Other drugs

For women who taking oral contraceptives, the incidence and death rate of myocardial infarction in smokers are 10 times higher than non-smokers of the same age.

***For your health, quit smoking please~😁

Read More

Should we avoid to drink alcohol/tea/milk when taking medicine??💣💣💣

Not only the oral drugs have food contraindications, but also injections and transdermal absorption preparations. The drugs enter the gastrointestinal tract through oral administration. They can interact with food in the gastrointestinal tract. The drugs enter the blood through veins and muscles, they also interact with the chemical components of food, beverages, tobacco and alcohol in the blood.

1. Alcohol (All drugs)

For all drug, alcohol is forbidden within 2 hours before and after taking the drug. For some drugs, alcohol is forbidden 1 day before taking the drug and 3 days after the drug is stopped. Some drugs, such as cefmetazole, cefpiramide, and cefmino are prohibiting to drink alcohol for 1 week after drug withdrawal.

In the gastrointestinal tract, The ethanol contained in the alcohol will release the sustained-release drugs and controlled-release drugs in a short period of time (burst release). It will lead to a sudden increasing the drug concentration in the blood and causing drug poisoning;

Ethanol can also induce drug-metabolizing enzymes in the liver. It will accelerate the metabolism of some drugs (such as phenobarbital and phenytoin) in the body, thereby reducing the efficacy of these drugs and causing seizures.

Cephalosporin antibiotics can inhibit acetaldehyde dehydrogenase and cause acetaldehyde accumulation in the body. It causes a "disulfiram-like reaction", which can be fatal in severe cases.

Ethanol has the effects of central depression, gastrointestinal mucosal stimulation, liver damage, lowering blood pressure and blood glucose. It can also aggravate the adverse reactions of sedatives, non-steroidal anti-inflammatory drugs and other drugs.

Especially when you are taking below drugs:

Cephalosporins: Cefuroxime, Cefoperazone, Ceftazidime, Cefoxitin, Cefmenoxime, Cefmendole, Laoxycephalosporin, Cefmetazole, Cefpiam, Cefminox, etc.

Nitroimidazoles: Metronidazole, Tinidazole, Secnidazole.

Sulfonamides: Trimethoprim/sulfamethoxazole.

Sulfonylurea hypoglycemic drugs: Glyburide, Glipizide, Glimepiride. 

We should not drink alcohol in 2 days before medication and at least 7 days after drug withdrawal.

2. Tea (Most drugs)

People should not drink tea within 2 hours before and after taking most drugs. Tea contains about 10% tannin, which is decomposed into tannic acid in the human body. Tannic acid will comprise precipitates with alkaloid drugs and metal salt drugs (iron, calcium, bismuth, zinc, etc.). This will greatly reduce the absorption of the drug.

Caffeine and theophylline in tea will inhibit the central nervous system depressants such as phenobarbital and chlorpromazine. It can greatly reduce or reverse the efficacy of the drug.

The caffeine in tea can also stimulate the secretion of gastric acid, aggravate the gastrointestinal side effects of drugs, and even induce gastric bleeding and gastric perforation.

Especially when you are taking below drugs:

Alkaloid drugs: such as Berberine

Antibacterial drugs: such as Tetracyclines

Non-steroidal anti-inflammatory drugs: such as Aspirin, Ibuprofen

Cardiac glycosides: such as Digoxin

Sedative hypnotics: such as Zopiclone, Estazolam

3. Milk (Antibacterial drugs, metal ion-containing drugs)

Antibacterial drugs and drugs containing polyvalent metal ions (antacids, gastric mucosal protective drugs, iron, calcium, and trace elements) should not be taken with milk.

The metal ions (such as calcium and iron) in milk are consisted of the complexes or insoluble salts with these drugs. This makes the drugs difficult to absorb.

The drugs containing polyvalent metal ions can comprise precipitates with the protein in milk. It is not only affecting the drug absorption, but also greatly reduces the absorption of nutrition in milk.

Especially when you are taking below drugs:

Quinolones drugs: such as Ofloxacin

Gastric drugs: such as Bismuth subcarbonate, Aluminum hydroxide

Metal element supplement drugs: such as Zinc gluconate, Calcium carbonate, Ferrous fumarate

Other drugs 

People should not drink milk before and after 1 hour of taking above drugs.

Normal food has no effect on the bioavailability of ciprofloxacin, but the metal ions in milk products can reduce the bioavailability of ciprofloxacin by 30% to 36% due to the chelation. It may lead to treatment failure. The metal ions in enteral nutrition can also chelate with quinolones.

Doxycycline and minocycline have lower binding power with calcium ions compared with tetracycline. Although they can be taken with food and milk, they still cannot be taken with drugs containing aluminum, bismuth, calcium, magnesium, and zinc ions.

Read More

How to take the stomach medicines???😵😵😵

Use the medicine to treat gastric disease, the time of taking is very important!!!

There are many kinds of medicines for treating gastric diseases. Due to different pharmacological effects and dosage forms, the time of taking each kind of medicine is very important.

1. Promoting gastric motility drugs

    Such as Mosapride and Domperidone tablets should be taken 15-30 minutes before meals. Trimebutine can be taken before or after meals.

2. Antacids

    Such as aluminum hydroxide, magnesium oxide, magnesium trisilicate, etc., can neutralize gastric acid directly, and should generally be taken half an hour to one hour before a meal or when stomach pain occurs.

3. Antisecretory drugs

    Such as cimetidine, ranitidine, and famotidine can be taken before going to bed or after breakfast and dinner. Omeprazole, lansoprazole, and rabeprazole are best taken in the morning or on an empty stomach before going to bed.

4. Anti-helicobacter pylori requires combined medication.

    Proton pump inhibitors are taken half an hour before meals. Colloidal bismuth should be taken between meals. Antibacterial drugs should be taken according to the interaction with food, the possible digestive tract discomfort, etc., and the time of taking according to the drug instructions.

5. Gastric mucosal protective drugs

    They are best taken between meals or before going to bed.

Read More

Follow the doctor's advice and use sleeping pills scientifically😷😷😷

To treat insomnia, we should follow the doctor's advice and use sleeping pills scientifically.

Using the hypnotic drugs requires detailed analysis and evaluation by doctors. The patients with insomnia should not use the hypnotic drugs by themselves without the prescriptions. They should have a comprehensive treatment method under the guidance of doctors and pharmacists.

The hypnotic drugs should start with a small dose and the dose should not be easily adjusted after achieving the effective dose. It should be administered as required, intermittently and in sufficient amount. For the special populations such as children, pregnant women, lactating women, as well as patients with liver or kidney damage, severe sleep apnea syndrome or myasthenia gravis, it is not suitable to use sleeping medications.

The treatment program of hypnotic drugs is generally shorter than 4 weeks. If the drug intervention is over 4 weeks, the patient need to go to the hospital for the regular evaluation at least every month.

Read More

Highly processed foods will harm memory in the elderly~~👴👵

A new research found that after only four weeks of a highly processed food diet , the brains of aging rats have a strong inflammatory response, accompanied by behavioral signs of memory loss.

In the study, the diet mimics ready-to-eat product, which are usually packaged for a long time and have a long shelf life (such as potato chips and other snacks), frozen food (such as pasta and pizza), and cooked meats containing preservatives. Highly processed diets are also associated with obesity and type 2 diabetes, which suggests that it is best for elderly to reduce eating ready-to-eat products. 

Eating highly processed foods can cause severe memory deficits. In the elderly, rapid memory decline is more likely to develop into neurodegenerative diseases such as Alzheimer's disease.

The researchers also found that the intake of omega-3 fatty acid dietary supplements can prevent memory problems and almost completely reduce the effects of inflammation in elderly rats. 

Maybe people should limit to eat highly processed foods in the diet and increase the intake of foods rich in omega-3 fatty acids to prevent or slow down this deterioration.

Reference：

Michael J. Butler, Nicholas P. Deems, Stephanie Muscat, Christopher M. Butt, Martha A. Belury, Ruth M. Barrientos. Dietary DHA prevents cognitive impairment and inflammatory gene expression in aged male rats fed a diet enriched with refined carbohydrates. Brain, Behavior, and Immunity, 2021; 98: 198 DOI: 10.1016/j.bbi.2021.08.214

Read More

What functions do the electrolytes do in the body (Part 3.) ?😤

Finally, here is the last part about the electrolutes. 

Chlorine

Cl^- is one of the most important anions in the extracellular fluid, which can regulating the osmotic pressure and acid-base balance of the cell body.

Chlorine is mainly came from sodium chloride in the food. Therefore, the change of chlorine in the body is basically equaled to the sodium. However, there is an opposite relationship between the level of chlorine and the level of bicarbonate. It is because the anions in the body also need to be maintained at a certain concentration. As the two most important anions in the body, chlorine and bicarbonate are normally keeping at a balance way.

Normal serum Cl^- is 96-108 mmol/L. Increased serum Cl^- is common in hypernatremia and high chlorine metabolic acidosis.

In clinical, decreased serum Cl^- is more common and its cause is insufficient intake or increased loss of sodium chloride.

Read More

What functions do the electrolytes do in the body (Part 2.) ?😤

This time will talk about the other important electrolytes in the body: 

Sodium

Na⁺ is the main cation in the extracellular fluid, and it plays a vital role in maintaining many important physiological activities in the body, such as maintaining the osmotic pressure of the extracellular fluid. 

Adult normal serum sodium is 135.0-145.0 mmol/L. Changing the concentration of Na⁺ in the extracellular fluid may caused by changes in the content of sodium and water, so sodium balance disorders are often accompanied by water balance disorders.

The balance of Na⁺ is mainly regulated by changes the volume of extracellular fluid and the concentration of plasma sodium. When the volume of extracellular fluid decreases or the concentration of plasma sodium decreases, it can activate the renin-angiotensin-aldosterone system to promote the reabsorption of Na⁺.

When the amount of extracellular fluid or the concentration of Na⁺ increases, it can lead to increase secreting the natriuretic peptides, reduce the re-collection of Na⁺ by the kidneys, increase sodium excretion, and cause increasing urine output and promote the water excretion.

Read More

What functions do the electrolytes do in the body (Part 1.) ?😤

Electrolytes have the ability to maintain the osmotic pressure of body fluids the normal distribution of body fluids. There are composed of various anions and cations. Potassium, sodium, and chlorine are the three important electrolytes that are most relevant to the diseases and are most closely connected to the patient's life. Firstly, let's talk about potassium and the others will talk in the next two issue.

Potassium

Potassium is the most important cation distributed in the intracellular fluid. It has important physiological functions in maintaining the osmotic pressure of the intracellular fluid, acid-base balance, and maintaining the irritability of muscles and nerves.

1. Normal blood K⁺ concentration

The normal concentration of serum  K⁺  is about 3.5-5.5 mmol/L, the plasma K⁺ is about 0.5 mmol/L lower than the serum K⁺, because when the blood coagulates, K⁺ in platelets and other blood cells will release a few number to the serum.

2. Hyperkalemia and its causes

    a.) The cells are dismantled and potassium ions are forced to flow out to the external fluid. 

The K⁺ concentration of the intracellular fluid is 150.0 mmol/L, which is about 40 times the serum K⁺ concentration. When tissue cells are destroyed (such as    large-area burns, crush injuries), the K⁺ ions in the cells will be flow out to the serum, it result the increasing in blood K⁺. If the upper limit (5.5 mmol/L) is exceeded, it is hyperkalemia. It can lead to heart block, circulatory failure, cardiac arrest in diastole and finally die. 

There are some reasons lead to hemolysis. It can cause false increasing in blood K⁺ which is quite common. Therefore, when the samples with elevated K⁺, it is necessary to check whether the patient's sample is hemolyzed.

    b.) Potassium ions from the outside

Too much K⁺ input from the outside can also cause hyperkalemia, such as the input of a large amount of potassium solution or a large amount of stored blood.

    c.) In acidosis, potassium ions are used to exchange protons

Based on the acid-base balance,  in acidosis, there are many pumps on the cell membrane that can pump a H⁺ of the external fluid into the cell, and then pump a K⁺ out in addition to the regulation of lungs and kidneys. Therefore, patients with acidosis are often accompanied by hyperkalemia. Similarly, when patients have hyperkalemia, there will be a reverse operation, K⁺ is pumped back, and H⁺ is pumped out, and acidosis occurs. Interestingly, hyperkalemia not only leads to metabolic acidosis, but also abnormal alkaline urine.

3. Hypokalemia and its causes

Hypokalemia is also very common in clinical. In hypokalemia, patients may have mental abnormalities, increased heart rate, heart failure, and cardiac arrest in systole. The main causes of hypokalemia are insufficient intake, excessive loss, and potassium from outside the cell into the cell.

Glucose and insulin can drive potassium into the cell. When too much glucose with insulin is input, insulin promotes glucose to enter the cell then synthesize glycogen, it also brings potassium in.

OH^- also has this ability. In alkalosis, H⁺ is needed to neutralize, it pump H⁺ out of the cell and K⁺ back to the cell. Alkalosis is accompanied by hypokalemia, which can also lead to metabolic alkalosis and abnormal aciduria.

Read More

Why some doctors prescribe levothyroxine tablets to the hyperthyroidism or hypothyroidism patient?😨😨😨

Do you see the doctor do that? Do you feel confused? Let's see why the doctor do it~~

Levothyroxine

It is a thyroid medicine that can substitute hormone normally produced by the thyroid gland to regulate the body's metabolism and energy. 

So, it is easy to understand why the doctor prescribes it to the hypothyroidism patient. It will supply the patient enough material to transform into thyroxine.

But why the hyperthyroidism patient is also prescribed it?

Clinically, the hyperthyroidism patients with exophthalmos or goiter, can be given appropriate amount of levothyroxine. The purpose is to inhibit thyroid stimulating hormone (TSH). Because when the antithyroid drugs are given to treat hyperthyroidism, the patient's thyroxine will gradually decrease, the inhibition of TSH gradually weakens. The increasing TSH will aggravate exophthalmos or goiter.

In another case, some patient will have hypothyroidism when the antithyroid drugs are a little more, and they will have hyperthyroidism when the antithyroid drugs are slightly reduced. It is difficult to adjust the dosage. Using levothyroxine and antithyroid drugs can better balance the level of thyroid hormones.

Read More

What should you do if you forget to take your oral diabetes drug??😨😨

It is very common to see that the patient forget to take his diabetes drug. But what should you do if you forget to take it? Today will talk about that and how the medicine taken.

Metformin

General and sustained-release dosage form are taken during or after meal. Enteric-coated dosage form is taken before meals.

If you forget to take the medicine, take it as soon as possible. If the time is close to the next dose, do not take it and must not double the next dose!

Acarbose

Take the tablets with meal (chew together with the food and then swallow). Capsule form should be swallowed the whole immediately before meals. Do not take acarbose if you do not have a meal!!!

If you forget to take acarbose while eating, you can chew it during or immediately after the meal. If it is close to the next dose, do not take it and must not double the next dose!

Gliclazide sustained-release tablets / Glipizide controlled-release tablets

Take it before breakfast. If you haven't breakfast, take the medicine before the first meal.

If you forget to take the medicine before breakfast, you can take it during or immediately after breakfast.  If it is close to the next dose, do not take it and must not double the next dose!

Nateglinide / Repaglinide

Take the medicine immediately before meal. Do not take medicine if you do not have a meal.

If you forget to take the medicine before a meal, you can take it immediately during or after a meal. If it is close to the next dose, do not take it and must not double the next dose!

Rosiglitazone Tablets / Pioglitazone Dispersible Tablets

Take the medicine before or after meal. 

If you forget to take the medicine, take it as soon as possible. If it is close to the next dose, do not take it and must not double the next dose!

Sitagliptin / Saxagliptin / Alogliptin / Vildagliptin / Linagliptin

These medicines are not affected by food. They can be taken with or without food

If you forget to take the medicine, take it as soon as possible. If it is close to the next dose, do not take it and must not double the next dose!

Dapagliflozin

Take medicine in the morning. Can be taken with or without food. 

If you forget to take the medicine, take it as soon as possible. If it is close to the next dose, do not take it and must not double the next dose!

Canagliflozin

Take it before the first meal every day.

If you forget to take the medicine, take it as soon as possible. If it is close to the next dose, do not take it and must not double the next dose!

***Summary, metformin and acarbose will irritate intestine, so they should be taken during or after meal. And if you forget to take your diabetes drugs, take it as soon as possible. But if the time is close to the next dose, just take the next dose and must not double the dose!!!!!

Read More