Saturday, October 27, 2007
Patients, healthcare professionals, and pharmacists all have roles in preventing misuse and addiction to prescription medications. For example, when a doctor prescribes a pain relief medication, CNS depressant, or stimulant, the patient should follow the directions for use carefully, learn what effects the medication could have, and determine any potential interactions with other medications. The patient should read all information provided by the pharmacist. Physicians and other healthcare providers should screen for any type of substance abuse during routine history-taking, with questions about which prescriptions and over-the-counter (OTC) medicines the patient is taking and why. Providers should note any rapid increases in the amount of a medication needed or frequent requests for refills before the quantity prescribed should have been used, as these may be indicators of abuse.
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Muscle relaxants are not really a class of drugs, but rather a group of different drugs that each has an overall sedative effect on the body. These drugs do not act directly on the muscles, rather they act centrally (in the brain) and are more of a total body relaxant.
Typically, muscle relaxants are prescribed early in a course of back pain, on a short-term basis, to relieve low back pain associated with muscle spasms. There are several types of muscle relaxant medications that are commonly used to treat low back pain:
Carisoprodol (Soma). This drug’s dosage is 350mg every eight hours as needed for muscle spasm. Soma is typically prescribed on a short-term basis and may be habit-forming, especially if used in conjunction with alcohol or other drugs that act on the mind.
Cyclobenzaprine (Flexeril). This medication can be used on a longer-term basis and actually has a chemical structure related to some antidepressant medications, although it is not an antidepressant. Usually it is prescribed as 10mg every six hours as needed to relieve low back pain associated with muscle spasm, or it can also be prescribed as 10mg at night as needed to help with difficulty sleeping. Flexeril can impair mental and physical function, and may lead to urinary retention in males with large prostates.
Diazepam (Valium). Valium is usually limited to one to two weeks of use, and the typical dosage is 5-10mg every six hours as needed to relieve low back pain associated with muscle spasm. Because of its habit-forming potential, and because it changes sleep cycles and makes it very difficult to sleep after stopping the drug, Valium should not be used long term. Patients should also note that Valium is a depressant and can worsen depression associated with chronic pain.
Paxil relieves a variety of emotional problems. It can be prescribed for serious, continuing depression that interferes with your ability to function. Symptoms of this type of depression often include changes in appetite and sleep patterns, a persistent low mood, loss of interest in people and activities, decreased sex drive, feelings of guilt or worthlessness, suicidal thoughts, difficulty concentrating, and slowed thinking.
Paxil is also used to treat obsessive-compulsive disorder (OCD), a disease marked by unwanted, but stubbornly persistent thoughts, or unreasonable rituals you feel compelled to repeat.
In addition, Paxil is prescribed for panic disorder, a crippling emotional problem characterized by sudden attacks of at least four of the following symptoms: palpitations, sweating, shaking, numbness, chills or hot flashes, shortness of breath, a feeling of choking, chest pain, nausea or abdominal distress, dizziness or faintness, feelings of unreality or detachment, fear of losing control, or fear of dying.
Paxil can be prescribed for generalized anxiety disorder, a disease marked by excessive anxiety and worry that persists for at least 6 months and can't be easily controlled. True cases of generalized anxiety disorder are accompanied by at least three of the following symptoms: restlessness or a keyed-up or on-edge feeling, a tendency to tire easily, difficulty concentrating or spells when the mind goes blank, irritability, muscle tension, or sleep disturbance.
Paxil can be used in the treatment of social anxiety disorder (also known as social phobia), a condition marked by shyness or stage fright so intense that it interferes with an individual's work and social life.
Paxil is also prescribed for post-traumatic stress disorder—a crippling condition that sometimes develops in reaction to a disastrous or horrifying experience. Symptoms, which stubbornly refuse to abate, include unwanted memories and dreams, intense distress when confronted with reminders of the event, a general numbing of interest and enjoyment, jumpiness, irritability, poor sleep, and loss of concentration.
Paxil CR, the controlled-release version, is prescribed for major depression, panic disorder, social anxiety disorder, and severe premenstrual symptoms classified as premenstrual dysphoric disorder.
Paxil belongs to the class of drugs known as selective serotonin reuptake inhibitors (SSRIs). Serotonin is one of the chemical messengers believed to govern moods. Ordinarily, it is quickly reabsorbed after its release at the junctures between nerves. Reuptake inhibitors such as Paxil slow this process, thereby boosting the levels of serotonin available in the brain.
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