Xenical in the complex therapy of metabolic syndrome

Interest in the metabolic syndrome in recent years has increased dramatically from various specialists, due to the discovery of subtle molecular mechanisms of interaction of insulin and other factors in various target tissues. G.M. Reaven [5] associates the development of clinical signs of this complex syndrome with insulin resistance, so many suggest the name of the disease – “insulin resistance syndrome”. Indeed, numerous studies [1, 2, 4] proved the presence of hyperinsulinemia, as a compensatory state of the organism in response to insulin resistance. Insulin resistance is the disturbed sensitivity of peripheral tissues (liver, muscles, adipose tissue, etc.) to insulin. Insulin resistance is an inherited condition. The genetic predisposition to insulin resistance is associated with a gene mutation:

  • Insulin receptor substrate I (insulin receptor tyrosine kinase),
  • Glycogen synthase,
  • Glucose transporters II or IV,
  • Hexokinase II,
  • Protein binding the FFA (FABP-II).

At the same time, a hypothesis is advanced according to which insulin resistance is not the cause of the development of this syndrome, but also its one component [4]. The author came to this conclusion on the basis of studying the prevalence of components of the metabolic syndrome in different ethnic groups (black, white population of the USA and Americans of Mexican origin). Analysis of the data obtained suggested the presence of a different genetic factor in the etiology of the metabolic syndrome. Such a hypothetical factor was called “factor Z”, which, interacting with insulin sensitive tissues, endothelium, regulating system of arterial pressure and lipid and lipoprotein exchange, causes, respectively, insulin resistance, atherosclerosis, arterial hypertension, dyslipidemia.

The WHO working group constituting the components of the metabolic syndrome recognized the following symptom complex (1998): visceral (abdominal) obesity, insulin resistance, hyperinsulinemia, impaired glucose tolerance (STH) or type 2 diabetes, arterial hypertension, dyslipidemia, hemostasis disorders, hyperuricemia, microalbuminemia.

The clinical sign of insulin resistance is considered to be the abdominal type of obesity, in which the ratio of the waist to the hip volume exceeds 0.95 in men and 0.85 in women.

The developed therapeutic approach to the treatment of the metabolic syndrome has not been found to date. As a rule, antidiabetic therapy occupies a central place in treatment activities. In the fight against insulin resistance in clinical practice, metformin is widely used in an individually selected dosage. When metformin is ineffective, its combination with sulfonylurea preparations, a-glycosidase inhibitors or nonsulfonylurea secretinogens is used. In complex therapy, hypolipidemic and antihypertensive drugs are recommended, along with diet therapy. However, the fact of the close dependence of insulin resistance on the degree of obesity is known. According to Amos et al. [3], insulin resistance is associated, more likely, with obesity than with diabetes mellitus. Therefore, an urgent requirement is weight reduction in patients with metabolic syndrome. A decrease in body weight of only 5% of the initial weight leads to improved glycemic control, lower blood pressure, improved lipid profile, and a 20% reduction in the risk of premature death.

Given the presence of insulin resistance and, as a consequence, hyperinsulinemia – antilipolytic factor, in the metabolic syndrome, it is natural to assume the difficulty of reducing weight in this category of patients. The presence of arterial hypertension in these patients is an obstacle for the appointment of anorektiky, oppressing appetite by inhibiting the reverse neuronal capture of catecholamines from the intersynaptic gap.

Among the drugs that contribute to weight loss, a special place belongs to orlistat (Xenical Online) – a drug that does not have a systemic effect, acting inhibitory to the gastrointestinal lipase. Xenical has a high lipophilicity and is readily soluble in fats. Due to this, getting into the body with food containing fats, Xenical mingles with drops of fat in the stomach, blocks the active center of the lipase molecule, not allowing the enzyme to split fats (triglycerides). Unclosed triglycerides can not enter the blood and are excreted with feces.

Suppressing the activity of gastrointestinal lipases reduces the absorption of fats, which creates a deficit of energy and helps to reduce body weight. Simultaneously, the number of free fatty acids and monoglycerides in the lumen of the gut decreases, which reduces the solubility and subsequent absorption of cholesterol, contributing to the reduction of hypercholesterolemia. In a placebo-controlled study of 52 weeks duration in patients with diabetes mellitus and visceral obesity (metabolic syndrome), when Xenical was used at a dose of 120 mg 3 times a day, the body weight was reduced by 6.2% from the baseline (Figure 1), at 4.3% In the placebo group (p <0.001). The use of Xenical in patients with metabolic syndrome contributes to the compensation of carbohydrate metabolism (by the end of 1 year of treatment a good SD compensation was achieved in 67% of patients, compared with 31% on a diet). A similar trend was observed and at the end of 2 years of treatment (Figure 2). At the same time, the daily requirement for oral hypoglycemic drugs in patients receiving Xenical decreased by 23%, compared with 9% in patients on a diet (Figure 3). Treatment with Xenical was accompanied by a decrease in insulin levels by 18% (8.7% on a diet). In cases of a metabolic syndrome with impaired tolerance to carbohydrates, a two-year therapy with Xenical reduced the risk of NTG and type 2 diabetes (Fig. 4). The study of the lipid profile showed a significant decrease in the level of cholesterol and lipoprotein compared to placebo (Table 1). After 1 year of Xenical therapy, the diastolic blood pressure decreased by 10.6 mm. Gt; Art. (3.6 mm Hg in the placebo group). The waist circumference (OT) after two years of therapy decreased by 5.8 cm (in the group receiving a placebo – 2.9 cm).

Thus, Xenical is an effective drug for treating patients with metabolic syndrome, and a decrease in hyperinsulinemia indicates a pathogenetically justified approach to the treatment of insulin resistance. Data from questionnaires of patients at the 52nd and 104th weeks of treatment indicated that patients receiving Xenical were:

  • More satisfied with treatment
  • More satisfied with the dynamics of their state
  • Less concerned about the fact of being overweight.

In 31% of patients taking Xenical, excessive fat release was observed, and the rate of defecation increased in 20.4% of cases. However, only 0.3% of patients discontinued treatment for this reason. Oily discharge from the rectum was noted in 17.5% of patients at 1.2% in the placebo group. It should be noted that these side effects were the result of excessive consumption of fat and, of course, indicate a high effectiveness of the drug. Xenical should be used with a moderately hypocaloric diet containing 30% of calories in the form of fats. In this case, discomfort from the intestine, as a rule, is not observed.

 

Le rôle de tadalafil (Cialis) dans la rééducation des patients après prostatectomie préservant les filets nerveux

Un nombre croissant de patients atteints d’un cancer de la prostate est actuellement réalisée prostatectomie, et devient donc préservation des nerfs problème particulièrement aigu de leur réadaptation, y compris la restauration d’une érection. Un moyen de traitement de première ligne de la dysfonction érectile chez ces patients sont des inhibiteurs de la phosphodiestérase-5 (PDE-5), en particulier médicament à action prolongée acheter cialis en ligne.

le cancer de la prostate est un problème grave de la médecine moderne. En 2007, il a servi en Russie à la quatrième place (8,9%) au niveau de la maladie et le premier (60%) – sur sa croissance parmi toutes les tumeurs malignes chez les hommes [1]. En même temps, grâce à l’introduction du taux de PSA de dépistage au cours de la dernière décennie a changé de manière significative la structure de la morbidité dans la direction plus tôt, les formes localisées. Cela a conduit au fait qu’un nombre croissant de patients sont maintenant effectué une prostatectomie radicale, y compris la chirurgie préservation des nerfs [2].

La dysfonction érectile après prostatectomie radicale est détermine en grande partie la qualité de vie des patients. Même dans le cas de l’exécution d’opérations de préservation nerveuse dysfonction érectile divers degrés de gravité est observée dans 65-75% des patients [3]. Ceci est particulièrement important pour les patients plus jeunes qui sont plus intéressés à maintenir une érection, qui sont de plus en plus de se porter candidat pour prostatectomie en raison de la détection précoce de la maladie.

Médicaments de première ligne pour la restauration de la fonction érectile après prostatectomie préservant les filets nerveux sont des inhibiteurs de la PDE5, car ils sont assez le plus commode, sûr et efficace chez les patients de ce groupe [2]. Dans une vaste étude récente randomisée multicentrique dans l’exemple vardénafil été montré que les inhibiteurs de la PDE-5 ont été aussi efficaces quel que soit le moment du traitement (immédiatement ou dans un an après la chirurgie) [4].

L’un des médicaments dans ce groupe – Cialis – est apparu en 2003 dans un grand essai randomisé multicentrique, à la réception de la demande après prostatectomie préservant les filets nerveux bilatéral Cialis a amélioré la fonction érectile chez 71% des patients, contre 24% dans le groupe placebo, le pourcentage de rapport sexuel était de 52% à la prise de Cialis et 26%, à savoir, deux fois moins de placebo [5].

Tadalafil, l’ingrédient actif Cialis, la structure chimique différente des deux autres médicaments actuellement utilisés de ce groupe (sildénafil et vardénafil). La vitesse et l’ampleur de l’absorption du tadalafil dans le tractus gastro-intestinal ne dépend pas de la prise de nourriture et de l’alcool. Son temps de demi-vie était de 17,5 heures, alors que le sildénafil et le vardénafil, il est égal à 4-5 h. La réalisation à la fois uniques et multiples érections après la prise de Cialis possible dans les 36 heures [6]. Cela vous permet de prendre le médicament non seulement immédiatement avant les rapports sexuels, mais aussi devant lui.

Durée des concentrations d’action et de la persistance tadalafil dans le sang sont également l’occasion de prendre Cialis sur une base quotidienne, non seulement sur demande. Merci à ces caractéristiques Cialis est un médicament de choix dans des situations où il est difficile de prédire l’heure exacte des rapports sexuels, ainsi que la fréquence des rapports deux fois par semaine ou plus. Dans certains cas, ces caractéristiques contribuent patients tadalafil une plus grande certitude et moins leurs craintes au sujet du temps écoulé depuis le moment de l’ingestion. Ceci est également confirmé par les recherches existantes sur le choix d’un inhibiteur de la PDE5, dans la majorité des patients qui ont préféré est Cialis [7-11].

Le médicament est administré à une dose de 20 mg pas plus d’une fois par jour. Les effets secondaires lors de la prise de Cialis généralement modérément exprimé et les réceptions subséquentes sont réduits ou disparaissent. Parmi eux le diagnostic des maux de tête et dyspepsie. Encore plus rare sont les maux de dos, myalgie, des étourdissements, la congestion nasale. Dans les essais cliniques, le nombre de patients cesser de prendre Cialis en raison des effets secondaires était le même que le nombre a renoncé à un placebo [12]. Comme cela est le cas avec d’autres inhibiteurs de la PDE5, Cialis ne doit pas être pris en même temps que les nitrates, il ne devrait pas y être utilisé par les patients atteints de maladies cardiaques et cardio-vasculaires, qui est contre-exercice.

Par conséquent, Cialis est un moyen pratique et efficace pour le traitement de la dysfonction érectile, même dans un groupe complexe de patients que les patients ayant subi une prostatectomie nerveuse. Il a tous les avantages des inhibiteurs de la PDE-5, mais en raison des particularités de pharmacodynamie permet d’étendre le temps et le mode d’administration du médicament, donnant aux patients une plus grande liberté de choix et la confiance dans le résultat.

A propos de Cialis

Cialis – un médicament qui a longtemps gagné en popularité parmi les hommes qui ont l’érection faible ou instable. Ce fut une énorme quantité d’études et des essais cliniques, impliquant plusieurs milliers de personnes souffrant de dysfonction érectile. L’efficacité du médicament était de 81%, c’est le pourcentage d’hommes a pu rétablir complètement érections « normales », d’autres se sont débarrassés de leurs maux, selon le degré de complexité de la maladie. D’accord, cela est un excellent résultat!

La principale caractéristique est la possibilité de restaurer l’érection Cialis pendant 36 heures après administration du comprimé, ce qui ne se produit que lors de l’excitation sexuelle. Cela permet à des partenaires ne règlent pas un certain temps d’action du médicament et mener une vie normale avant la montée des désirs naturels. En outre, l’efficacité du médicament n’affectera pas un dîner copieux ou bu de l’alcool, qui est aussi un atout certain pour les hommes de tout âge.

Effet de la drogue

Tout ce que nous comprenons que l’effet principal de l’action de Cialis devrait être une seule – pour augmenter la puissance chez les hommes. C’est ce qui se passe après le traitement, au cours de l’excitation sexuelle: les vaisseaux sanguins du pénis se dilatent, après quoi il pénètre dans un flux sanguin renforcé crée ainsi une érection « normale ». Une nette amélioration de la puissance peut être observée déjà au bout de 20 minutes après l’administration du médicament.

L’utilisation et le dosage

Les comprimés sont utilisés à l’intérieur et se laver avec de l’eau, indépendamment des repas. Délai minimum de rapports putatif doit être de 20 minutes. Dans la plupart des cas, les médecins recommandent la dose de 20 mg. Après cela, pendant 36 heures, vous pourrez à tout moment être pleine préparation sexuelle. Fréquence maximale de l’administration ne doit pas dépasser 1 par jour. Pour les patients âgés Aucune modification de la posologie et l’application n’existe pas.

Recommandations et contre-indications

Assurez-vous de consulter votre médecin avant d’utiliser des pilules de Cialis. Selon vos antécédents médicaux, il déterminera les risques auxquels vous pourriez être exposé après l’application du médicament. Voici les règles les plus importantes à suivre:

  1. Comme toute autre formulation telle action, Cialis contre-indiqué en co-application avec des nitrates (qui sont des médicaments pour le traitement des maladies cardio-vasculaires).
  2. Le corps, qui touche sensible à l’un des composants du médicament, Cialis est strictement contre-indiquée.
  3. Il ne peut pas être appliquée aux personnes de moins de 18 ans.
  4. L’hypertension, l’insuffisance hépatique ou rénale, troubles du cœur – est l’un des plus importants pour contre-indication utilisation de Cialis.

Les effets secondaires et surdosage

Merci à l’expérience bien étudiée de l’utilisation des médicaments, les effets secondaires sont rares. Mais il y a des exceptions aux règles, vous devez donc être préparé pour les symptômes suivants:

  1. Maux de tête faibles
  2. Vertiges et vomissements
  3. Afflux de sang au visage
  4. La congestion nasale

En cas de surdosage, le risque d’obtenir l’un des effets secondaires augmente. , Vous devez donc contacter immédiatement un médecin pour effectuer un traitement symptomatique norme.

What is Avodart

Avodart, otherwise known as dutasteride is a drug used for the treatment of benign prostatic hyperplasia (BPH) a disease that is also known as an enlarged prostrate. Avodart is a member of the class of the drugs referred to as 5-alpha-reductase inhibitors.

The enlargement of the prostate gland is caused by male hormone dihydrotestosterone (DHT). In this situation, the testosterone is converted into DHT by the activities of 5-alpha reductase enzyme. Avodart is used in this situation to prevent the conversion of testosterone into dihydrotestosterone. It does this by shrinking prostrate tissue and prevent further prostate enlargement.

Men with an enlarged prostrate can use Avodart to treat benign prostatic hyperplasia (BPH). This health condition causes difficulty in urinating and may lead to some urine dribbling. Avodart helps to improve urinary flow and can as well lead to reduction in the need for prostate surgery later on.

Avodart was certified and approved for use by Food and Drug Administration (FDA) in 2001. It is manufactured by GlaxoSmithKline. This drug is sometimes given with another drug known as tamsulosin (Flomax) for optimal performance.

Avodart Warning: What You Should Know About Avodart

  • Pregnant Women and Children

Avodart is not meant for use by a child or a woman and they should never take it on any condition. This drug has the ability to be absorbed through the skin; it is therefore advisable for women and children to stay away from handling the capsules. Avodart can lead to birth defect if a woman is exposed to it during pregnancy. On no occasion should a woman who is pregnant or planning to become pregnant in future handle Avodart. A woman or a child that comes in contact with Avodart should immediately wash the area affected immediately with soap and water.

  • Avoid Chewing

Avodart can irritate your mouth, lips or throat if you swallow a broken or an opened capsule. Avoid chewing, opening or crushing this drug. Instead, you should swallow it directly.

  • Cancer Risk

Let your doctor know if you have ever had an allergic reaction to Avodart. This drug may increase the risk of developing prostate cancer. It is important that your doctor perform test to ensure that you do not possess other health conditions that can lead to developing prostate cancer as a result of taking dutasteride.

Avodart Dosage

Dutasteride (Avodart) usually comes in capsules which contains 0.5 milligrams (mg) of dutasteride.

It is highly advisable that you take Avodart as exactly prescribed by your doctor. Avoid taking larger or smaller amount or taking this drug for a longer period than recommended by your doctor. Ensure that you strictly follow the instructions at your prescription label at all times.

Avodart can be taken with or without food. However, avoid crushing, chewing or opening the capsule to avoid irritation of the mouth, lips and throat. Swallow the capsule whole.

Note: Unless your doctor tells you otherwise, avoid taking more than one, 0.5 mg capsule of dutasteride a day.

To preserve Avodart well; store in a room temperature away from heat and moisture. If affected by heat, the capsules may become leaky and soft or even stick together. Avoid using any of the Avodart capsules that is leaking or cracked.

What to do when you miss your dose?

If there is still enough time between your next doses, take the missed dose immediately. However, avoid taking the dose if it is almost time for your next dose.

Note: On no occasion should you take extra medicine to make up for the dose you missed.

Avodart Overdose

Too much of Avodart is very risky. Quickly call an emergency room at 911 if you think you may have taken too much of Avodart. You can as well call your local Poison Help line at 1-800-222-1222.

What To Avoid When Taking Avodart

  • Donating Blood

Traces of Avodart can still remain in your blood during treatment and even 6 months after your treatment. During this period, do not donating blood. It can cause a serious birth defect if a pregnant woman receives it through blood transfusion

  • Alcohol

Avoid taking alcohol when treating yourself with Avodart. Alcohol has the potential to leave you dehydrated and make urinating quite difficult for you. When you have a BPH condition; taking alcohol while treating yourself with Avodart can worsen your symptoms.

  • Grapefruit Juice

Avoid taking grapefruit juice while taking Avodart. The juice reduces the speed the body breaks down Avodart. This could lead to Avodart blood levels to rise to a dangerous level.

Avodart Side Effects

The common Side effects of Avodart includes

  • Reduced sex drive
  • Breast tissue changes
  • Erectile dysfunction
  • Reduced sperm count
  • Decreased amount of semen released during sex

The serious side effects include;

  • Impotence
  • Fast-growing prostrate cancer
  • Allergic reaction to Avodart such as hives and other serious skin reactions
  • Birth defects in male fetuses

There have also been some rare occasions where Avodart causes some side effect such as

  • Dizziness
  • Heart failure
  • Pain and swelling of the testicles

Avodart Interaction

Before taking Avodart, let your doctor know about other drugs you are taking. Whether it is prescription, over-the-counter or just supplements, you doctor must know about it.

Ask your doctor if it is safe to Avodart along with the following drugs;

  • Cimetidine (Tagamet)
  • Imatinib (Gleevec)
  • Nefazodone (Serzone)
  • An antidepressant such as nefazodone
  • Conivaptan (Vaprisol);
  • HIV/AIDS medications, such as tipranavir (Aptivus) and ritonavir (Norvir)

What is Zoloft

Zoloft as a Revolutionary Antidepressant

Zoloft, also known as Sertraline, is an effective antidepressant that is classified as a selective serotonin reuptake inhibitor. The active ingredients of the preparation affect the brain chemicals balancing them, thus, providing a desirable effect. The treatment is commonly recommended for patients suffering from depression, premenstrual dysphoric disorder, anxiety, panic attacks and other disorders. Additionally, Zoloft can be used for other purposes that are not mentioned in the information leaflet.

Safety Concerns: Zoloft Precautions, Contraindications and Drug Interactions 

It is inevitable to see a doctor before starting the medication treatment course, since multiple factors, such as wrong usage, bigger or smaller dose, prolonged duration of the intake and others, may cause severe complications and side effects. Inform your healthcare specialist about all the details concerning your general health condition, medications you are taking and other vital points. Pay exceptional attention to health problems including epilepsy, liver or kidney disorders, bipolar disorder, bleeding issues and other concerns. This information will help to make your treatment course safe and effective.

Do not take Zoloft if you are allergic to its active ingredients or similar drugs. Avoid the preparation administration in case you have used a MAO inhibitor within the last 14 days. People under 18 years old are not allowed to take the drug. Besides, the pharmaceutical is not approved for children suffering from OCD and depression.

How to Use Zoloft Safely without Side Effects 

Take Zoloft according to the instructions and recommendations of your healthcare provider once you wish to benefit from its effect and experience no related complications. Try to administer the preparation at the same time each day. The pills can be used with or without food, though with a full glass of water. Do not stop Zoloft intake even if your symptoms improve, but undergo a full treatment course.

Do not miss the medication doses, though if it happened, take the dose as soon as possible, or skip if the following scheduled one should be taken soon. Call your doctor if you have noticed any side effects. Seek emergency medical assistance in case the symptoms include severe allergic reactions, convulsions, high serotonin level in the organism, low sodium levels, manic episodes, etc.

What is Doxycycline

Doxycycline – Innovative Formula of Antibiotics 

Doxycycline is a revolutionary antibiotic that belongs to a group of tetracyclines, potent to treat diverse infections caused by bacteria. The preparation is recommended mainly for gonorrhea, periodontitis, urinary tract infections, chlamydia and others. Besides, the drug is actively used as a treatment for bumps, blemishes and lesions that are caused by rosacea. However, it does not improve related facial redness. Additionally, some types of Doxycycline are approved to be reliable ways to warn or treat malaria, anthrax and different infections caused by ticks, mites, etc.

Primarily to Doxycycline Intake: Precautions and Contraindications 

Using the medication you should be very careful and concerned about possible complications related to Doxycycline misuse and overuse. Do not administer the drug if you are allergic to its active components or similar pharmaceuticals. Children under 8 years old are not recommended to undergo Doxycycline treatment course.

Talk to your doctor about the medication intake to make sure the treatment course will be completely safe and beneficial. Inform your healthcare provider about other health problems you have, including kidney or liver disease, sulfite allergy, asthma, etc. Besides, provide a full list of other medications, herbal treatments and supplements you are taking to avoid drug interactions and negative consequences.

Recommendations for Use 

Doxycycline should be taken following all the doctor’s recommendations and instructions. Do not take the drug in larger or smaller quantities or longer than necessary. Administer the pill with a full glass of water with or without food. Never crush, break or chew the tablet, swallow it whole. Once you have missed Doxycycline dose, take it when possible, but skip it if the next scheduled one should be taken soon. Medicine overuse can lead to severe side effects.

Possible Doxycycline Side Effects 

As any other pharmaceutical, Doxycycline may cause a range of minor side effects, including vomiting, nausea, itching, skin rashes, diarrhea, etc. However, the symptoms should disappear in a few days. Call your healthcare provider immediately if the symptoms do not improve, but instead aggravate. Seek emergency medical assistance in case of more severe complications, such as fever, blurred vision, watery or bloody diarrhea, chest pain, confusion, reasonless weight gain and others.