Category Archives: Healthy, Wealthy, and Wise….

Neem & Margosa Oil

Margosa or Neem Oil

Margosa or Neem oil is a yellow oil with a disagreeable smell and bitter taste that has been used as a medical remedy in India and Southeast Asia for several centuries.  In recent years, there have been rare reports of acute onset of severe metabolic acidosis, hepatic and multiorgan failure and death following ingestion of margosa oil.

Background

Margosa oil is an extract of the seeds of Azadirachta indica, commonly known as the Neem tree native to India and

NOT FOR CHILDREN!!

NOT FOR CHILDREN!!

Sri Lanka.  In low doses, margosa oil has been a traditional remedy for centuries in India and Southeast Asia used in treating asthma, intestinal parasites, arthritis and leprosy.  It is also an insecticide.  The oil has a disagreeable smell and bitter taste attributable to volatile sulphur compounds and fatty acids.   The bitters are secondary products formed during storage of the oil or the seeds and concentrations can vary in different commercial samples.

Hepatotoxicity

Margosa oil can cause severe metabolic acidosis and death, particularly in young children.  Symptoms of nausea, vomiting and progressive stupor develop within hours of consumption, followed by severe metabolic acidosis, coma, and progressive hepatic dysfunction, similar to Reye Syndrome.  Serum aminotransferase levels are generally normal or minimally elevated initially, but then rise to high levels accompanied by increases in LDH and CPK levels.  Progressive hepatic encephalopathy and cerebral edema develop within days.   This product contains high levels of salicylates – the same as aspirin.  Therefore, this product could trigger Reye’s Syndrome and should not be given or used by children under the age of 19.

Again, we urge extreme caution in using herbal remedies, and always check for salicylates in any product given to children under the age of 19.

NOT FOR CHILDREN!

NOT FOR CHILDREN!

 

 

 

 

 

 

 

 

Mechanism of Injury

The mechanism of hepatotoxicity of margosa oil appears to be related to mitochondrial dysfunction and poisoning of the electron transport pathway by a component of margosa oil or a contaminant.  A similar syndrome has been induced in laboratory animals with samples of the implicated oil.

 Other Names:  Neem oil

Other links:

What is Reye’s Syndrome

Aspirin Containing Products

Other Names for Aspirin

Pepto-Bismol and Children

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September is Reye’s Syndrome Awareness Month!

Just in time for school, September of each year is designated as Reye’s Syndrome Awareness Month!

Just in time for Reye’s Syndrome Awareness Month, the National Reye’s Syndrome Foundation is offering some great tee’s in 3 fabulous colors to help spread the word that Kids and Aspirin Products Don’t Mix!

We hope you care enough about eradicating this child-killing disease to support our programs and help us get the word out by purchasing and wearing a “Be Wise About Reye’s” tee-shirt.  RS Awareness Month Tees

Tee’s on sale for $15.00 now include:

Ash  — Light Blue  — Bright Green

Tees can be ordered until August 20, 2013 so they can be shipped to you before September.

This is a crowd sourced awareness campaign and we have to sell at least a total of 10 tees in the color you choose in order to have them printed.  If you order a tee, and we don’t meet the goal of selling 10 tees in that color, you will not be charged and your tee will not be printed.  If you need more information about how this works, email the foundation at: nrsf(at)reyessyndrome(dot)org

We will take credit card orders over the phone also at: 800.233.7393

Join us in eliminating the incidence of this child-killing disease! Order Your Tee Today!!  It’s tax-deductible, too!

Thank You!

National Reye’s Syndrome Foundation
501(c)3 Charity – est. 1974
www.reyessyndrome.org

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Antibiotics – Don’t Take This With That!

Antibiotics are medicines that help stop bacterial infections. Protect yourself and your family by taking them correctly. There are times when you should and when you should not take antibiotics.

In children, antibiotics are the most common cause of emergency department visits for adverse drug events. Rest, fluids, and over-the-counter products may be your or your child’s best treatment option.

And NEVER give a child under the age of 19 aspirin or aspirin containing products, as it could trigger Reye’s Syndrome, a deadly disease!

The main types of germs that cause infections:antibiotics_dttwt

Viruses and bacteria are the two main types of germs that cause infection.

Antibiotics cannot kill viruses but can kill bacteria. Viral infections should not be treated with antibiotics.

Viral illnesses include:

  • Common cold – stuffy nose, sore throat, sneezing, cough headache.
  • Influenza (flu) – fever, chills, body aches, headache, sore throat, dry cough.
  • Many coughs.
  • Acute bronchitis (cough, fever) – almost always caused by viruses.
  • Pharyngitis (sore throat) – most sore throats are caused by viruses and are not effectively treated with an antibiotic.
  • Viral gastroenteritis.

Bacterial infections should be treated with antibiotics. Bacterial infections can include:

  • Ear infections – antibiotics are used for most, but not all ear infections.
  • Severe sinus infections – lasting two or more weeks.
  • Strep throat.
  • Urinary tract infection.

Antibiotics can sometimes interact with other medicines or other substances. This means that the effects of one of the medicines can be altered by the other.

Some of the more common interactions are listed below. However, this is not a complete list.

If you want to check that your medicines are safe to take with your antibiotics, ask your GP or local pharmacist. You should also always carefully read the patient information leaflet that comes with your medicine.

Combined oral contraceptives

Antibiotics may cause your combined oral contraceptive pill to be less effective at preventing pregnancy.

Women taking combined oral contraceptives should use an extra method of contraception (for example, condoms) while taking the antibiotics and, in some cases, for seven days after finishing the course. Your GP will be able to advise you.

Medications To Avoid:

Penicillin

It is usually recommended that you avoid taking penicillin at the same time as a medication called methotrexate, which is used to treat some types of cancers and severe autoimmune conditions such as the skin condition psoriasis. This is because combining the two medications can cause a range of unpleasant and sometimes serious side effects.

You may experience a skin rash if you take penicillin and a medication called allopurinol, which is used to treat gout.

Cephalosporins

Cephalosporins may not be suitable to take if you are also taking blood-thinning medications such as heparin and warfarin.

If you need treatment with cephalosporins, you may temporarily have to stop taking the blood-thinning medication.

Aminoglycosides

The risk of damage to your kidneys and hearing is increased if you are taking one or more of the following medications:

  • antifungals – used to treat fungal infections
  • cyclosporin – used to treat autoimmune conditions such as Crohn’s disease and given to people who have had an organ transplant
  • diuretics – used to remove water from the body
  • muscle relaxants

However, the risk of kidney and hearing damage has to be balanced against the benefits of using aminoglycosides to treat life-threatening conditions such as meningitis.

Tetracyclines

You should check with your GP or pharmacist before taking a tetracycline if you are currently taking any of the following medications:

  • vitamin A supplements
  • retinoids such as acitretin, isotretinoin and tretinoin used to treat severe acne
  • blood-thinning medication
  • diuretics
  • kaolin-pectin and bismuth subsalicylate (Pepto Bismol) used to treat diarrhea
  • medicines to treat diabetes such as insulin
  • atovaquone used to treat pneumonia
  • antacids used to treat indigestion and heartburn
  • sucralfate used to treat ulcers
  • lithium used to treat bipolar disorder and severe depression
  • digoxin to treat heart rhythm disorders
  • methotrexate
  • strontium ranelate used to treat osteoporosis
  • colestipol or colestyramine used to treat high cholesterol
  • ergotamine and methysergide used to treat migraines

Macrolides

It is highly recommended that you do not combine a macrolide with any of the following medications (unless directly instructed to by your GP), as the combination could cause heart problems:

  • terfenadine, astemizole and mizolastine – which are all antihistamines used to treat allergic conditions such as hay fever
  • amisulpride – used to treat episodes of psychosis
  • tolterodine – used to treat urinary incontinence
  • simvastatin – used to treat high cholesterol

Fluoroquinolones

You should check with your GP or pharmacist before taking a fluoroquinolone if you are currently taking any of the following medications:

  • theophylline, which is used to treat asthma and also found in some cough and cold medicines
  • the non-steroidal anti-inflammatory drug (NSAID) painkillers such as ibuprofen
  • ciclosporin
  • probenecid used to treat gout
  • clozapine used to treat schizophrenia
  • ropinirole used to treat Parkinson’s disease
  • tizanadine used to treat muscle spasms
  • glibenclamide used to treat diabetes
  • cisapride used to treat indigestion, heartburn, vomiting or nausea
  • tricyclic antidepressants, such as amitriptyline, steroid medications (corticosteroids)

Some fluoroquinolones can intensify the effects of caffeine (a stimulant found in coffee, tea and cola), which could make you feel irritable, restless and cause problems falling asleep (insomnia).

Finally, you may need to avoid taking medication that contains high levels of minerals or iron as this can block the beneficial effects of fluoroquinolones. This includes:

  • antacids
  • zinc supplements
  • some types of multivitamin supplements

Antibiotics that can cause Sun Sensitivity include:  Doxycycline, tetracycline, ciprofloxacin, ofloxacin, levofloxacin, trimethoprim. In some people, the sensitivity can last long after the antibiotic regimine is complete.

Phototoxicity. This is the most common type of sun-sensitivity drug reaction. It can occur when skin is exposed to the sun after certain medications are injected, taken orally, or applied to the skin. The drug absorbs the UV light, then releases it into the skin, causing cell death. Within a few days, symptoms appear on the exposed areas of the body. In some people, symptoms can persist up to 20 years after the medication is stopped. Among the most common phototoxic drugs are the tetracycline family, NSAIDs (nonsteroidal anti-inflammatory drugs such as ibuprofen), and amiodarone (Cordarone, a heart medication).

It’s important to note that not every person who uses these drugs has a reaction. If it does happen, it can be a one-time occurrence, or it can happen each time the drug is taken and sun exposure occurs. People with HIV are among the most likely group to experience sun sensitivity to drugs.

Can I drink alcohol when on an antibiotic?

Alcohol is a drug and in combination with other drugs including antibiotics, can cause an interaction with undesirable results. Ask your doctor about your specific medication, but in general, you should avoid combining alcohol with any medication.

A list of ingredients to avoid, (other names for aspirin) can be downloaded here, or you can email the NRSF for a wallet size card(s) you can carry with you when shopping for medications.

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Multiple Combination Medicines and Your Child

Know Active Ingredients in Children’s Meds

childrensdrugs

If your child is sneezing up a storm, it must be allergy season once more.

And if your child is taking more than one medication at the same time, there could be dangerous health consequences if those medicines have the same active ingredient, according to Hari Cheryl Sachs, M.D., a pediatrician at the Food and Drug Administration (FDA).

A medicine is made of many components. Some are “inactive” and only help it to taste better or dissolve faster, while others are active. An active ingredient in a medicine is the component that makes it pharmaceutically active—it makes the medicine effective against the illness or condition it is treating.

Active ingredients are listed first on a medicine’s Drug Facts label for over-the-counter (OTC) products. For prescription medicines, they are listed in a patient package insert or consumer information sheet provided by the pharmacist.

Many medicines have just one active ingredient. But combination medicines, such as those for allergy, cough, or fever and congestion, may have more than one.

Take antihistamines taken for allergies. “Too much antihistamine can cause sedation and—paradoxically—agitation. In rare cases, it can cause breathing problems, including decreased oxygen or increased carbon dioxide in the blood, Sachs says.

“We’re just starting allergy season,” says Sachs. “Many parents may be giving their children at least one product with an antihistamine in it.” Over-the-counter (OTC) antihistamines (with brand name examples) include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), fexofenadine (Allegra), loratadine (Claritin, Alavert), and cetirizine (Zyrtec).

multiple_combination_medicinesBut parents may also be treating their children for a separate ailment, such as a cough or cold. What they need to realize is that more than one combination medicine may be one too many.

“It’s important not to inadvertently give your child a double dose,” Sachs says.

Other Health Complications

The same goes for other active ingredients, often found in combination products for allergies but also used to treat other symptoms, such as fever, headache or nasal congestion:

  • Acetaminophen (in Tylenol and many other products), a pain reliever often used to treat fevers, mild pain or headache. Taking too much can cause liver damage.
  • Ibuprofen (for example, Advil or Motrin), another common medicine for relieving mild to moderate pain from headaches, sinus pressure, muscle aches and flu, as well as to reduce fever. Too much ibuprofen can cause nausea, vomiting, diarrhea, severe stomach pain, even kidney failure.
  • Decongestants such as pseudoephedrine or phenylephrine (found in brand name drugs such as Actifed and Sudafed) taken in large amounts can cause excessive drowsiness in children. They can also cause heart rhythm disturbances, especially if combined with products and foods containing caffeine. In the form of nasal sprays and nose drops, these products, as well as oxymetazoline (the active ingredients in products such as Afrin), can cause “rebound” congestion, in which the nose remains stuffy or gets even worse.

Never give a child aspirin or aspirin containing products, as you risk triggering Reye’s Syndrome, a deadly disease!

Any of the above symptoms may indicate a need for immediate medical attention. “The bottom line is that neither you, nor your children, should take multiple combination medicines at the same time without checking the active ingredients and consulting your health care professional first,” recommends Sachs.

Furthermore, two different active ingredients may serve the same purpose, Sachs says. For example, both acetaminophen and ibuprofen help reduce pain and fever. So there’s generally no need to give your child both medicines for the same symptoms.

Write It All Down

Whether you’re treating your child’s condition with OTC medicines from the drug store or ones prescribed by your doctor, it’s essential that you keep track of every medicine and the active ingredients each contains, Sachs says.

“It’s easy to forget which medicines you’re giving your child,” Sachs says. “And if you have more than one child, it can get even more complicated.” She recommends making it a habit to write down the name of any medicine you give your child, whether it’s OTC or prescription (download a daily medicine records template).

“It’s really a good idea to carry that list with you when you go to see your pediatrician or even when you go to the pharmacy,” she adds. You should also note whatever vitamins or supplements your child is taking, as these can interact unfavorably with certain medicines, too.

Most importantly, Sachs says parents should always read the Drug Facts label on OTC products, and the patient package insert or consumer information sheet that comes with prescription medicines, every time they’re considering a medication for their child, even if they think they already know the ingredients. They should know that the ingredients can change without an obvious change in the packaging. And they should contact their health care professional with any questions.

A list of ingredients to avoid, (other names for aspirin) can be downloaded here, or you can email the NRSF for a wallet size card(s) you can carry with you when shopping for medications.

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Grapefruit, Drug Interactions

Don’t take this with that! Seriesgrapefruit

Grapefruit causes problems when taken with certain medications

Sometimes the juice just isn’t worth the squeeze…especially when combining grapefruit with medicines.

While it can be part of a balanced and nutritious diet, grapefruit can have serious consequences when taken with certain medications. Currently, there are more than fifty prescription and over-the-counter drugs known to the U.S. Food and Drug Administration that can have negative interactions with grapefruit.

As little as one cup of juice or two grapefruit wedges can alter the way your medicines work. When taken with medicine, grapefruit can delay, decrease, or enhance absorption of certain drugs; as a result, the patient does not receive the prescribed dosage of the medication. If the label on your medicine reads “DO NOT TAKE WITH GRAPEFRUIT” or has similar words, heed the warning. It can save you a bushel of problems.

How it does or doesn’t work

pills

Depending on the active ingredient, grapefruit can reduce the effectiveness of a drug or worse, create potentially dangerous drug levels in the body. Grapefruit can interfere with transporters in the intestine that help absorb drugs. When this happens, less of the drug reaches the bloodstream and the patient receives no benefit.

Grapefruit can also interfere with enzymes that break down drugs in your digestive system. This can result in the body absorbing too much of the drug, which can potentially cause serious problems.

Help may be on the way

Scientists are currently working on breeding hybrid grapefruits that will be safe to mix with medications. In the near future you may be able to enjoy these tasty mounds without compromising your safety. But until the new fruit containers start to arrive, follow these tips:

  • Ask your pharmacist or other health care professional if you can have fresh grapefruit or grapefruit juice while using your medication. If you can’t, you may want to ask if you can have other juices with the medicine.
  • Read the Medication Guide or patient information sheet that comes with your prescription medicine to see if it interacts with grapefruit juice. Some information may advise not to take the drug with grapefruit juice. If it’s OK to have grapefruit juice, there will be no mention of it in the guide or information sheet.
  • Read the Drug Facts label on your non-prescription medicine, which will let you know if you can have grapefruit or other fruit juices with it.
  • If you can’t have grapefruit juice with your medicine, check the label of bottles of fruit juice or drinks flavored with fruit juice to make sure they don’t contain grapefruit juice.
  • Seville oranges (often used to make orange marmalade) and tangelos (a cross between tangerines and grapefruit) affect the same enzyme as grapefruit juice, so avoid these fruits as well if your medicine interacts with grapefruit juice.

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