Yes, Decadron is the Brand Name, while Dexamethasone is the generic version.
No, it's a corticosteroid.
It's the Generic name for the Brand name Decadron, a chemotherapy drug.
December, decadron, decorate, decade, decerebrate, decorticate, decent, declare, decode
Injections are medical treatment beyond first aid, so if the other criteria for recordability are met, getting an injection can make an injury OSHA recordable.
ld take 23 quantity of 0.65mg to make a 15mg dose 0.65*23=14.95 rounded is 15mg
If the swelling is a result of an allergic reaction, epinephrine is the drug of choice. Benadryl will also most likely be given. A steroid such as decadron, kenalog or prednisone would decrease the swelling.
This is not a valid conversion. Milliliters (mL or ml) and liters (L) are measures of volume. Grams (g), kilograms (kg) and milligrams (mg) are measures of weight or mass.
Rheumatoid Vasculitis, it's an unusual complication of severe, long term rheumatoid arthritis. It causes inflammation of the blood vessels in the brain. Vasculitis can lead to headaches, brain fog and stroke like symptoms. it is usually treated with corticosteroids drugs like prednisone or decadron and methotrexate or azathiaprine
Generally speaking, this is nonsensical. However, there may be exceptions when a highly trained specialist would use combinations of drugs which otherwise seem to be inappropriate. If the two prescriptions are coming from two different doctors, the patient should clarify with each to determine which should be used. Take all prescriptions (singly or in combination) only as prescribed.
The best treatment for streptococcal pharyngitis, commonly called "strep throat" is Bicillin (an injection of penicillin) and Decadron (an injectable steroid). The bacterium responsible for this illness, Streptococcus pyogenes, has not demonstrated significant resistance to penicillin, so this treatment continues to the first-line choice for the moment. A recent study in the Annals of Emergency Medicine indicated that the common practice of also giving a single injected dose of dexamethasone (Decadron) is also helpful in decreasing the severity and duration of the symptoms of strep throat.Of course, there are people who are allergic to penicillin, and for those individuals, it is standard practice to give erythromycin instead. For people who are not penicillin-allergic but refuse injections, a 10-day course of penicillin VK is also effective, but is a bit difficult to take correctly, as it requires four doses each day. Due to this difficulty, and the public health implications of failing to treat strep throat completely (it is extremely contagious), I usually strongly recommend the injection.
Cortisone (Cortone)Prednisone (Deltasone)Dexamethasone (Decadron)Topical: Valisone, Kenalog, Caldicort, LanacortInhalers: BeclomethasoneGlucocorticoids mechinism of action: Anti-inflammatory, antiallergic, suppression of immune system (immunosuppressant).Uses:Replacement therapyDiseases: ulcerative colitis, lupus, thyroiditis, collagen disease, asthma, COPD Allergic conditions: hives, bee stings for anaphylactic shockBrain injury: cerebral edema .Organ Transplantationsteroid hormones that bind to the glucocorticoid receptor (GR). Synthetic glucocorticoid GCs: prednisone, dexamethasone, and hydrocortisone.
For the brain, the cause or etiology of the swelling will obviously be a factor, as controlling the cause is as important as treating the effect. For instance, bacterial infection will call for antibiotics. That said, various drugs like Decadron (dexamethazone -- a glucosteroid) can be used to reduce swelling of the brain. If it's not controllable with medication, placement of a shunt may be required. In extreme cases, trepanation or removal of a circular bone plug from the skull may be called for. In the case of post-drowning cerebral edema, inducing coma by reducing the body;'s core tmerpature, and then slowly raising it over days has been effective at reducing swelling. There is no first aid procedure I can think of that addresses this issue. Inflamation of the lungs is less critical and is usually controlled with the application of steroids. This again is not typically a first aid situation, and very few first responders are able to make this diagnosis, allowed to prescribe this medical course, or even carry this medication.
This response is based upon an assumption that the query is about 'prednisolone,' (not Predisolone), a steroidal medication. If your query is not about Prednisolone, please ignore this response and modify your query please. Discontinuation of steroid medications should be done on a gradual basis (i.e. tapered), except if they have been given over a very short period of time. The time of use necessitating taper may vary per prescribing doctor. Steroids include: prednisone (Deltasone), prednisolone (Prelone), methylprednisolone (Medrol), betamethasone (Celestone), cortisone (Cortone), hydrocortisone (Cortef), dexamethasone (Decadron), and triamcinolone (Kenacort) Tapering Reduces Prednisone Withdrawal Symptoms: If you have taken the medication for more than 3 days. The main reason for a gradual taper is that you may experience symptoms of steroid withdrawal. These symptoms include: joint pain, muscle pain, fatigue, headache, fever, low blood pressure, nausea and vomiting. Abrupt discontinuation of treatment in patients who have been on steroids for a prolonged period of time may cause severe symptoms due to the fact the normal production of steroids by the body has been turned off. Some steroids are prescribed in a pre-schedule dispensing pack which takes the medication through its anticipated prescribed doses, then gently tapers off the strength, allowing the body to adjust. In every instance, it is best to seek professional advice from a doctor or dispensing chemist.
Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. While there is no cure for multiple sclerosis, there are a number of treatment options available that can both alleviate symptoms and slow down the progression of this debilitating disease. Treatment takes the form of medication, physical and alternative therapy.Immune-modulating medicationThere are three main types of immune-modifying drugs that are used to slow down the frequency of symptoms; interferon beta-1a (Avonex), interferon beta-1b (Betaseron) and glatiramer acetate (Copaxone). They are commonly referred to as the ABCs and are most effective in patients with a mild to moderate form of relapsing remitting MS. These drugs are self-administered by injection either subcutaneously or into the muscle. Frequency of treatment varies from once daily to weekly, depending on the drug. There are a number of mild side effects including redness and itching at the injection site, fatigue and soreness.If the cost of immune-modulating medication makes it prohibitive to utilizing these treatments, MS sufferers can contact drug companies directly. Most drug companies provide necessary medications at no cost to those who are uninsured or have financial constraints. CorticosteroidsSolu-Medrol and Decadron are powerful steroids which are administered by IV. They are used after an acute attack of symptoms and help to ease inflammation and relieve symptoms.Physical therapyWhile physical therapy does not cure primary symptoms, it is helpful in treating secondary symptoms, such as muscle weakness, pain, balance, coordination issues and fatigue. Care is necessary to not overdo any form of exercise as this can increase core body temperature, causing fatigue and temporarily worsening of other symptoms. That being said, physical therapy is very beneficial for both body and mind.Alternative treatmentsAlternative treatments, such as supplements and herbal medication, are very popular among MS sufferers. In states where it is legal, medical marijuana is often prescribed.While a multiple sclerosis diagnosis is devastating, with the correct medication and suitable physical therapy, the symptoms of the disease are manageable. Talk to your doctor and discuss all therapies before deciding on an effective MS plan that can help you live life to the fullest.
The first thing many people do is to lay down in a dark room. Keeping still, in the dark, in a comfortable room - will help to avoid any increases in pain. If you can try and sleep off the migraine, it may be in your best interest. If you are unable to sleep, relax in the dark and remain hydrated. If you are vomiting, slowly ingest water or Gatorade, a tablespoon every 2-5 minutes. Besides this, here's what else you can do... Natural prevention. From food triggers, to anything else under the sun (including the sun), there are many, many things you can try to manage in your daily life to avoid migraine headaches. Getting consistent hours of sleep, drinking enough water, eating consistent meals are all simple things you can do. Medical prevention: Once you cross the threshold of having two or more migraines a month, you qualify for preventive medications. Medications such as SSRIs, tricyclic anti-depressants, anti-epileptic medications, beta-blockers, and calcium channel blockers all can play a part in reducing the frequency and severity of migraines. If you haven't reach that magic number yet, you can try prevention with the following things: * ** Oral magnesium ** B-complex supplement, in particular B2 ** Petadolex It happens to everyone, even those who manage their migraine triggers superbly, and have found their magic preventative method: sometimes we still get them. What do we do then?It is extremely important to recognize the prodrome or aura phase of the migraine. If you don't, begin your abortive therapy as SOON as you begin to experience pain. This includes pain medication, as pain medication works much better if it can get its foot in the door before the attack is in full swing.Abortive Therapies (Medical): * ** Over the counter medications like Excedrin, two doses of Aleve (Naproxen) ** Other strong prescription NSAIDs, like Toradol, Ketoprofen, Diclofenac, Indomethacin ** The triptans are the major abortive medication prescribed. (You have not tried all the triptans, until you have tried ALL seven. Each one works slightly differently with serotonin receptors) ** DHE nasal spray (Migranal) ** Steroid tapers ** Midrin ** Certain anti-nausea medications, namely Reglan and Compazine, can abort migraines because they affect the re-uptake of dopamine. Dopamine excess is thought to be a component of migraine in some people. ** Caffeine - for some caffeine is a trigger, for others it is a blessing. ** Lidocaine nasal spray or drops ** Benadryl, Periactin or other histamine reducing allergy medicines.Nausea/Vomiting: Nausea and vomiting is often one of the more miserable migraine symptoms aside from the pain. You can try at home methods, like ginger, REAL Coke (not diet), and simple carbohydrates - like crackers. You can take an OTC nausea medicine, like Dramamine/Gravol. Or you can be prescribed a medication, such as Reglan, Phenergan, or Compazine. If you are vomiting too much to take an oral form, you can ask for all three in suppository form.Pain Management: * Once again, OTC medications like Excedrin and Aleve, sometimes even just plain aspirin, can dull the pain of migraines. Stronger NSAIDs can help as well. * Narcotic medications* Ice pack on the back of the neck or direct ice rubbed over the painful side of the head for no more than 10 minutes (limited to once every 2 hours)* Biofeedback * TENS Unit or Interferential StimulatorOther methods of management:* Botox injections (an injection to paralyze the nerve from sending pain signals) * Greater Occipital Nerve Block (an injection of local anesthetic and a steroid to temporarily freeze the nerve and reduce inflammation) * NTI Oral Appliance (a dental mouthpiece worn overnight to prevent jaw clenching and teeth grinding) * Surgery for Patent Foramen Ovale * Myofascial Therapy * Craniosacral Therapy * Acupuncture * Chiropractic Care* Massage* Microvascular Decompression Surgery * Medtronic Occipital Nerve Stimulation (implanting electrodes)If you end up in the ER, there are many things they can do for you besides just narcotic relief. * ** IV Saline (because dehydration is a trigger) ** IV Benadryl ** IV Decadron ** IV Lidocaine ** IV Magnesium ** IV Depakote ** IV Compazine ** IV Keppra ** IV Propofol ** IV Ketamine ** IV Robaxin
DefinitionCorticosteroids are a type of anti-inflammatory medicine. Corticosteroid overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.Corticosteroids come in many forms, including:Creams and ointments that are applied to the skinInhaled forms that are breathed into the nose or lungsPills or liquids that are swallowedInjected formulas delivered to the skin, joints, muscles, or veinsMost corticosteroid overdoses occur with pills and liquids.This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.Poisonous IngredientAlclometasone dipropionateAmcinonideAugmented betamethasone dipropionateBeclomethasone dipropionateBetamethasoneBetamethasone benzoateBetamethasone dipropionateBetamethasone sodium phosphateBetamethasone valerateClobetasol propionateClocortolone pivalateCortisoneDesonideDesoximetasoneDexamethasoneDexamethasone acetateDexamethasone sodium phosphateDiflorasone acetonideDiflorasone diacetateFlunisolideFluocinolone acetonideFluocinonideFluocinolone acetonideFlurandrenolideFluticasone propionateHalcinonideHalobetasol propionateHydrocortisoneHydrocortisone acetateHydrocortisone butyrateHydrocortisone sodium phosphateHydrocortisone valerateMethylprednisoloneMethylprednisolone acetateMethylprednisolone sodium succinateMometasone furoatePrednisolone acetatePrednisolone sodium phosphatePrednisolone tebutatePrednisoneTriamcinoloneTriamcinolone acetonideTriamcinolone diacetateTriamcinolone hexacetonideNote: This list may not be all inclusive.Where FoundAlclometasone dipropionate (Delonal)Augmented betamethasone dipropionate (Deprolene)Beclomethasone dipropionate (Diprosone)Betamethasone sodium phosphate (Celestone)Betamethasone valerate (Valisone)Clobetasol propionate (Temovate)Clocortolone pivalate (Cloderm)Desonide (DesOwen, Tridesilon)Desoximetasone (Topicort)Dexamethasone (Decadron)Fluocinonide (Lidex)Flunisolide (AeroBid)Fluocinolone acetonide (Synalar)Flurandrenolide (Cordran)Fluticasone propionate (Cutivate)Halcinonide (Halog)Hydrocortisone (Cortef)Hydrocortisone sodium phosphate (Solu-Cortef)Hydrocortisone valerate (Westcort)Methylprednisolone (Medrol)Methylprednisolone sodium succinate (Solu-Medrol)Mometasone furoate (Elocon)Prednisolone sodium phosphate (Pred Fonte)Prednisone (Deltasone)Triamcinolone acetonide (Aristocort)Note: This list may not be all inclusive.SymptomsSymptoms of corticosteroid overdose can include:Burning or itching skinConvulsionsDeafnessDepressionDry skinHigh blood pressureMuscle weaknessNervousnessPsychosisSleepinessStopping of menstrual cycleSwelling in lower legs, ankles, or feetWeaknessWorsening of health conditions such as ulcers, diabetesBefore Calling EmergencyDetermine the following information:Patient's age, weight, and condition (for example, is the person awake or alert?)Name of the product (ingredients and strengths, if known)Time it was swallowedAmount swallowedHowever, DO NOT delay calling for help if this information is not immediately available.Poison Control, or a local emergency numberThe National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.See: Poison control center - emergency numberWhat to expect at the emergency roomThe health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:Activated charcoalEKGFluids through a vein (by IV)LaxativeMedications to treat fluid and electrolyte changesTube through the mouth into the stomach to wash out the stomach (gastric lavage)Expectations (prognosis)Most cases of corticosteroid overdose result in relatively minor fluid and electrolyte changes. If the problem is severe enough to cause heart rhythm disturbances, the outlook may be more grave.ReferencesNikkanen HE, Shannon MW. Endocrine toxicology. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 16.
DefinitionAcute mountain sickness is an illness that can affect mountain climbers, hikers, skiers, or travelers at high altitude (typically above 8,000 feet or 2,400 meters).Alternative NamesHigh altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edemaCauses, incidence, and risk factorsAcute mountain sickness is brought on by the combination of reduced air pressure and lower oxygen concentration that occur at high altitudes. Symptoms can range from mild to life-threatening, and can affect the nervous system, lungs, muscles, and heart.In most cases the symptoms are mild. In severe cases fluid collects in the lungs (pulmonary edema) causing extreme shortness of breath. This further reduces how much oxygen enters the bloodstream and reaches vital organs and tissue. Brain swelling may also occur (cerebral edema). This can cause confusion, coma, and, if untreated, death.The chance of getting acute mountain sickness increases the faster a person climbs to a high altitude. How severe the symptoms are also depends on this factor, as well as how hard the person pushes (exerts) himself or herself. People who normally live at or near sea level are more prone to acute mountain sickness.Approximately 20% of people will develop mild symptoms at altitudes between 6,300 to 9,700 feet, but pulmonary and cerebral edema are extremely rare at these heights. However, above 14,000 feet, a majority of people will experience at least mild symptoms. Some people who stay at this height can develop pulmonary or cerebral edema.SymptomsSymptoms generally associated with mild to moderate altitude illness include:Difficulty sleepingDizziness or light-headednessFatigueHeadacheLoss of appetiteNausea or vomitingRapid pulse(heart rate)Shortness of breath with exertionSymptoms generally associated with more severe altitude illness include:Bluish discoloration of the skin (cyanosis)Chest tightness or congestionConfusionCoughCoughing up bloodDecreased consciousness or withdrawal from social interactionGray or pale complexionInability to walk in a straight line, or to walk at allShortness of breath at restSigns and testsListening to the chest with a stethoscope (auscultation) reveals sounds called crackles (rales) in the lung, which can mean pulmonary edema.A chest x-raymay be performed.TreatmentThe main form of treatment for all forms of mountain sickness is to climb down (descend) to a lower altitude as rapidly and safely as possible. Extra oxygen should be given, if available.People with severe mountain sickness may be admitted to a hospital.Acetazolamide (Diamox) is a drug used to stimulate breathing and reduce mild symptoms of mountain sickness. This drug can cause increased urination. When taking this medication, make sure you drink plenty of fluids and do not drink alcohol.Pulmonary edema, the build-up of fluid in the lungs, is treated with oxygen, the high blood pressure medicine nifedipine or phosphodiesterase inhibitors (sildenafil), and, in severe cases, a breathing machine (respirator).The steroid drug dexamethasone (Decadron) may help reduce swelling in the brain (cerebral edema).Portable hyperbaric chambers have been developed to allow hikers to simulate their conditions at lower altitudes without moving from their location on the mountain. These new devices are very important if bad weather or other factors make climbing down the mountain impossible.Expectations (prognosis)Most cases are mild, and symptoms improve promptly with a return to lower altitude. Severe cases may result in death due to respiratory distress or brain swelling (cerebral edema).In remote locations, emergency evacuation may not be possible, or treatment may be delayed. These conditions could adversely affect the outcome.ComplicationsComaHigh altitude cerebral edema (brain swelling)Pulmonary edemaCalling your health care providerCall your health care provider if you have or had symptoms of acute mountain sickness, even if you felt better when you returned to a lower altitude.Call 911 or your local emergency number, or seek emergency medical assistance if severe difficulty breathing develops, or if you notice a lower level of consciousness, coughing up of blood, or other severe symptoms. If unable to contact emergency help, descend immediately, as rapidly as is safely possible.PreventionEducation of mountain travelers before ascent is the key to prevention. Basic principles include: gradual ascent, stopping for a day or two of rest for each 2,000 feet (600 meters) above 8,000 feet (2,400 meters); sleeping at a lower altitude when possible; and learning how to recognize early symptoms so you can return to lower altitude before symptoms get worse.Mountaineering parties traveling above 9,840 feet (3,000 meters) should carry an oxygen supply sufficient for several days.Acetazolamide (Diamox) helps speed the process of getting used to higher altitudes, and reduces minor symptoms. This drug should be taken starting one day before the ascent and continue one to two days into the excursion. This is recommended for those making a rapid ascent to high altitudes.Those who may be prone to anemia (particularly women) should consult a doctor regarding an iron supplement to correct the condition before traveling at high altitudes. People with anemia have a reduced red blood cell count, and therefore a lower amount of oxygen carried in the blood.Drink enough fluids, avoid alcohol, and eat regularly. Foods should be relatively high in carbohydrates.People with underlying heart or lung diseases should avoid high altitudes.ReferencesAuerbach PS, ed. Wilderness Medicine. 4th ed. St. Louis, Mo: Mosby; 2001:12-19.Schoene RB, Swenson ER. High Altitude. In: Mason RJ, Murray JF, Broaddus VC, Nadel JA, eds. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 65.Wright A, Brearey S, Imray C. High hopes at high altitudes: pharmacotherapy for acute mountain sickness and high-altitude cerebral and pulmonary oedema. Expert Opin Pharmacother. 2008;9(1):119-127.Yaron M, Honigman B. High-altitude medicine. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa : Mosby Elsevier; 2006: chap 142.
DefinitionImmunodeficiency disorders occur when the body's immune response is reduced or absent.See also: Autoimmune disordersAlternative NamesImmunosuppressionCauses, incidence, and risk factorsThe immune system is made up of lymphoid tissue in the body, which includes the bone marrow, lymph nodes, thymus, tonsils, and parts of the spleen and gastrointestinal tract. In addition, there are proteins and cells in the blood that are part of the immune system.The immune system helps protect the body from harmful substances called antigens. Examples of antigens include bacteria, viruses, toxins, cancer cells, and foreign blood or tissues from another person or species.When the immune system detects an antigen, it responds by producing proteins called antibodies that destroy the harmful substances. The immune system response also involves a process called phagocytosis. During this process, certain white blood cells swallow and destroy bacteria and other foreign substances.Immune system disorders occur when the immune system does not fight tumors or harmful substances as it should. The immune response may be overactive or underactive.Immunodeficiency disorders may affect any part of the immune system. Most commonly, such a condition occurs when specialized white blood cells called T or B lymphocytes (or both) do not work as well as they should, or when your body doesn't produce enough antibodies.Inherited immunodeficiency disorders that affect B cells include:Hypogammaglobulinemia, which usually causes respiratory and gastrointestinal infectionsAgammaglobulinemia, which results in frequent severe infections early in life, and is often deadlyInherited immunodeficiency disorders that affect T cells may cause increased susceptibility to fungi, resulting in recurring Candida (yeast) infections. Inherited combined immunodeficiency affects both T cells and B cells. It may be deadly within the first year of life if it isn't treated early.People are said to be immunosuppressed when they have an immunodeficiency disorder due to medicines that affect the immune system (such as corticosteroids). Immunosuppression is also a common side effect of chemotherapy given to treat cancer.Acquired immunodeficiency may be a complication of diseases such as HIV infectionand malnutrition (particularly with a lack of protein). Many cancers may also cause immunodeficiency.People who have had their spleen removed have an acquired immunodeficiency, and are at higher risk for infection by certain bacteria that the spleen would normally help fight. Patients with diabetes are also at higher risk for certain infections.Increasing age reduces the effectiveness of the immune system to some degree. Immune system tissues (particularly lymphoid tissue such as the thymus) shrink, and the number and activity of white blood cells drop.The following conditions and diseases can result in an immunodeficiency disorder:Ataxia-telangiectasiaChediak-Higashi syndromeCombined immunodeficiency diseaseComplement deficienciesDiGeorge syndromeHypogammaglobulinemiaJob syndromeLeukocyte adhesion defectsPanhypogammaglobulinemia Bruton diseaseCongenital agammaglobulinemiaSelective deficiency of IgAWiscott-Aldrich syndromeSymptomsThe symptoms vary with the specific disorder.Signs and testsYour doctor might think you have an immunodeficiency disorder if you have:Persistent, recurrent infectionsSevere infection by microorganisms that do not usually cause severe infectionOther signs include:Poor response to treatment for infectionsDelayed or incomplete recovery from illnessCertain types of cancers (such as Kaposi's sarcoma or non-Hodgkin's lymphoma)Certain infections (including some forms of pneumonia or recurrent yeast infections)Tests used to help diagnose an immunodeficiency disorder may include:Complement levels in the blood, or other tests to measure substances released by the immune systemImmunoglobulin levels in the bloodProtein electrophoresis (blood or urine)T (thymus derived) lymphocyte countWhite blood cell countTreatmentThe goal of treatment is to prevent infections and treat any disease and infections that do develop.If you have a weakened immune system, you should avoid contact with persons who have infections or contagious disorders. You may have to avoid people who have been vaccinated with live virus vaccines within the past 2 weeks.If you develop an infection, your doctor will treat you aggressively. This may involve long-term use of antibiotic or antifungal medications and preventive (prophylactic) treatments.Interferon is used to treat viral infections and some types of cancer. It is an immunostimulant drug, a medicine that makes the immune system work better.Persons with HIV or AIDS may take combinations of drugs to reduce the amount of virus in their immune systems and improve their immunity.Patients who are going to have a planned splenectomy should be vaccinated two weeks before the surgery against bacteria such as Streptococcus pneumonia and Hemophilus influenzae.Bone marrow transplants may be used to treat certain immunodeficiency conditions.Passive immunity (receiving antibodies produced by another person or animal) may occasionally be recommended to prevent illness after exposure to a microorganism.Patients with hypogammaglobulinemia are treated with periodic immunoglobulin infusions through a vein to raise blood immunoglobulin levels toward the normal range and protect against many infections.Expectations (prognosis)Some immunodeficiency disorders are mild and result in occasional illness. Others are severe and may be fatal. Immunosuppression that results from medications is often reversible once the medication is stopped.ComplicationsDisease developmentFrequent or persistent illnessIncreased risk for certain cancers or tumorsOpportunistic infectionsCalling your health care providerCall your health care provider immediately if you are on chemotherapy or corticosteroids (such as prednisone, Medrol, or Decadron) and you develop a fever greater than 100.5 degrees Fahrenheit or have a cough with shortness of breath.Go to the emergency room if you have a stiff neck and headache with the fever.Contact your health care provider if you have repeated yeast infections or oral thrush.PreventionThere is no known way to prevent congenital immunodeficiency disorders. Genetic counseling should be offered to people who want to have children and who have a family history of immunodeficiency disorders.Practicing safe sex and avoiding the sharing of body fluids may help prevent HIV infection and AIDS. Good nutrition may prevent acquired immunodeficiency caused by malnutrition.ReferencesAzar AE. Evaluation of the adult with suspected immunodeficiency. Am J Med. 2007;120:764-768.Ballow M. Primary immunodeficiency diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 271.Morimoto Y. Immunodeficiency overview. Prim Care. 2008;35:159-173.
Answer: A way that works in half of cases is to rub lidocaine (WITHOUT EPHINEPHRINE) in either liquid or gel form, on the inner part of the middle of the nose. (Lidocaine as used for migraines or trigeminal neuralgia is prescribed as an 4-8% intranasal solution, studies have shown it as both an abortive and possible preventative)AnswerAt the start of a migraine, take the presription Relpax. It is truly a life saver!!! Some migraines are triggered by stress, in particular the building up of anger. So, one method of relieving the pain is to relax. Let all your anger go, as it is hurting only you.Turn out the lights, pull shades and close the curtains. Turn off and otherwise eliminate all noise. Lay down comfortably, whether that means flat on your back with no pillow or on your side with two pillows. Simply relaxing in a dark, quiet room is often enough to quickly alleviate your pain.Intake caffeine. While caffeine can sometimes trigger a migraine, it can also be used to relieve it.Move to a different environment. Smells, noise and even colors may have triggered your headache. You may actually be able to get rid of the pain simply by moving away from the trigger.AnswerFirst off, be sure it IS a migraine. Consult your physician; you should be referred to a specialist in migraines or to a neurologist. After ruling out more serious possibilities, you may be prescribed Imitrex or any of numerous other medications that treat migraines with great success.If you cannot obtain these medications because of their cost (Imitrex, for example, is roughly forty dollars per 50 mg. tablet!), try this: lie down in a darkened room with your head propped up and a cold compress over your eyes and forehead. Stay very still and rest, keep your mind clear. Stay hydrated.Some migraines can take up to three days to go away.ANY headache that will not go away and that severely impairs your ability to function should be considered a medical emergency. This is particularly true if numbness or loss of muscular control on one side accompanies the headache.A "migraine" is NOT the same thing as a "tension headache" -- they are completely unrelated. I have seen many articles saying sex and aerobics help tension headaches; I have never seen one claiming those things help migraines. I'd be interested in seeing the clinical studies that back that claim.Many Pronged ApproachNatural prevention. From food triggers, to anything else under the sun (including the sun), there are many, many things you can try to manage in your daily life to avoid migraine headaches. Getting consistent hours of sleep, drinking enough water, eating consistent meals are all simple things you can do. Medical prevention:Once you cross the threshold of having two or more migraines a month, you qualify for preventive medications. Medications such as SSRIs, tricyclic anti-depressants, anti-epileptic medications, beta-blockers, and calcium channel blockers all can play a part in reducing the frequency and severity of migraines. If you haven't reach that magic number yet, you can try prevention with the following things:** Oral magnesium B-complex supplement, in particular B2PetadolexCoQ10Fish oil5-HTPIt happens to everyone, even those who manage their migraine triggers superbly, and have found their magic preventative method: sometimes we still get them. What do we do then?It is extremely important to recognize the prodrome or aura phase of the migraine. If you don't, begin your abortive therapy as SOON as you begin to experience pain. This includes pain medication, as pain medication works much better if it can get its foot in the door before the attack is in full swing.Abortive Therapies (Medical):** Over the counter medications like Excedrin, two doses of Aleve (Naproxen) Other strong prescription NSAIDs, like Toradol, Ketoprofen, Diclofenac, IndomethacinThe triptans are the major abortive medication prescribed. (You have not tried all the triptans, until you have tried ALL seven. Each one works slightly differently with serotonin receptors)DHE nasal spray (Migranal)Steroid tapersMidrinCertain anti-nausea medications, namely Reglan and Compazine, can abort migraines because they affect the re-uptake of dopamine. Dopamine excess is thought to be a component of migraine in some people.Caffeine - for some caffeine is a trigger, for others it is a blessing.Lidocaine nasal spray or dropsBenadryl, Periactin or other histamine reducing allergy medicines.Nausea/Vomiting: Nausea and vomiting is often one of the more miserable migraine symptoms aside from the pain. You can try at home methods, like ginger, REAL Coke (not diet), and simple carbohydrates - like crackers. You can take an OTC nausea medicine, like Dramamine/Gravol. Or you can be prescribed a medication, such as Reglan, Phenergan, or Compazine. If you are vomiting too much to take an oral form, you can ask for all three in suppository form.Pain Management:Once again, OTC medications like Excedrin and Aleve, sometimes even just plain aspirin, can dull the pain of migraines. Stronger NSAIDs can help as well.Narcotic medicationsIce on the back of the neck or Direct ice rubbed over the painful side of the head for no more than 10 minutes (limited to once every 2 hours)BiofeedbackTENS unit or Interferential StimulatorOther methods of management:Botox injections (an injection to paralyze the nerve from sending pain signals)Greater Occipital Nerve Block (an injection of local anesthetic and a steroid to temporarily freeze the nerve and reduce inflammation)NTI Oral Appliance (a dental mouthpiece worn overnight to prevent jaw clenching and teeth grinding)Surgery for Patent Foramen OvaleMyofascial TherapyCraniosacral TherapyAcupunctureMicrovascular Decompression Surgery (helpful for migraines that occur with occipital neuralgia)Surgery for Chiari MalformationOccipital Nerve Implant (implanting of electrodes into the scalp)If you end up in the ER, there are many things they can do for you besides just narcotic relief.** IV Saline (because dehydration is a trigger) IV BenadrylIV DecadronIV LidocaineIV MagnesiumIV DepakoteIV CompazineIV KeppraIV PropofolIV KetamineIV RobaxinAlternative to hiding the pain!Try seeing a chiropractor, my mom used to get migraines, she would take something for the pain, we would turn off all the lights and then she would cry until the migraine went away. After my dad became a chiropractor and my mom started getting adjustments she stopped getting migraines, she still gets stress headaches sometimes, but she takes a little Tylenol and she's good to go. The migraine could be caused by something as simple as a rib being out of alignment. Cupping & Blood letting For Migraine ReliefMigraine is the most popular complaints of patients who goes for cupping and blood letting treatment. The treatment involves removing damaged blood (fast clotting) that is found at painful sites in a headache i.e. temple, back of neck, scapular area and on the head. In the olden days, the patient needs to shave their heads before the treatment can be done but modern methods like Akubekam treatment doesnt need the patient to shave. Unfortuntely akubekam can only be found in Malaysia. The result of akubekam treatment for migraine is excellent. It relieves the acute attack and reduces the severity and frequency of future attacks. It also causes the patient to be more resistant towards trigger factor i.e. constipation, heat, change of weather, caffeine/chocolate intakes, stress and lack of sleep.
The question I am asked most often is "How long?" While the end stage path varies from person to person, there do tend to be commonalities thatcan help us to "see what we're seeing," and often, to estimate how much time might remain.First of all, how do you know "it's really time"? There are a few points that tend to help families realize that the disease is truly progressing and thatpreparations are in order. This discussion can be found on the page entitled The Hospice Decision.Many of us are late to call in hospice---there's no shame in that---and we don't realize until later, with 20-20 vision, that the help probably couldhave been used earlier. It seems that most brain tumor patients tend to average 1 month or so under hospice care, though the disease may havebeen progressing well before that time. Our community, then, offers hospice workers little exposure to and experience with this disease, so it'simportant to know that unless your specific hospice nurse has worked with end-stage brain tumor patients before, his or her answer to the "Howlong?" question almost always tends to be a longer-than-actual prognosis.Why? Death to other forms of cancer tends to be much different. There is likely to be a longer period of weakening and decline, and more of aheads-up from the vital signs. With other cancers, there tends to be an organ-by-organ alert that the body is losing the battle. In contrast, somebrain tumor patients---especially those in their 20s and 30s---might still be conversing or even walking themselves into the bathroom just a coupleof days before their passing. Nurses whose experience has been largely earned with other cancer care aren't always aware of one critical point: thebrain, as a master circuit breaker, has the capacity to shut down the body in one motion, without taking it organ by organ.So...how long? This list is a very, very loose guideline based on what has happened to other people, but it may be helpful in beginning importantdiscussions with the patient's doctor and family. In order to serve as a helpful guide, most of what's listed under each time heading would needto be occurring. Remember, though, that everyone is different. Too, patients in their 20s and 30s as well as those whose brain tumor journeyshave already been quite long tend to spend longer in each of these stages.3-6 Weeks Prior to DeathMotorIncreasing weakness on the affected sideFalling due to resistance to accept helpNeed for more assistance with walking, transfersUrinary/BowelUrinary/bowel incontinence may beginCognitive/Personality/SpeechConfusion and memory lossHarder to sustain a conversationMay say some odd things that make you think "Where did that come from?"May ask less about the next treatments or appointmentsMay ask clear, rational questions about death, arrangements, etc.PhysicalIncreasingly tired, more easily "wiped out" after simple activities or outingsHeadaches may indicate increased swellingMore likely to nap or to phase in and out of sleep2-3 Weeks Prior to DeathMotorMay begin to see weakness starting on the non-affected sideAffected hand may curl in or be kept close to the center of the bodyLegs begin to buckle, eventually leading to dead weight when attempting to standIf still walking, may wander around the house a little, as if restlessMay find it difficult to hold the head up straight or may slump overUrinary/BowelUrine becomes dark (often described as "tea-colored")Less warning before urination (more urgency)Cognitive/Personality/SpeechLess interest in matters of the home and family, hobbies, or world at largeDetached, without curiosityHarder to have an effective adult-peer conversationGeneral restlessness/agitationWord-finding difficulties (conversation may be very slow)Confusion over what time of day it is (sundowner's syndrome)Speech may be slurring or trailing off, unfinishedMay begin saying things that sound like awareness that time is growing shortMay begin to seem more "childlike"Confused by choices; yes/no questions seem to work bestPhysicalLosing interest in transferring or leaving the houseSeems to feel safest on one particular piece of furnitureBegins to have problems swallowing, if not alreadyAppetite may become sporadicMay be sleeping 20+ hours a day, with short alert times between sleepMay doze back off after eatingMay describe vision changes such as double vision, loss of peripheral vision, or black spotsNo longer interested in activities that require close vision, such as reading1-2 Weeks Prior to DeathMotorOften, completely bedriddenYounger patients may still be stubborn about getting up, though requiring assistanceMay hold on to the bedrail or to a caregiver's hand, hair, or clothing very tightlyUrinary/BowelUsually incontinent by nowMay continue to express urinary urgency, without producing anythingCognitive/Personality/SpeechMay find loud or multiple sounds irritatingAfter waking, seems confused for several minutesStaring across the room, up toward the ceiling, or "through" youMay look at TV but seem not to be watching itMay make mention of "getting ready" or "having to go," without knowing whereMay refer to travel, packing, or gathering clothesMay talk about tying up loose ends (specific to the individual)May mention seeing visions in the room (I've heard everything from horses to angels to deceased mothers-in-law)Communication seems to take more effort and makes the patient winded or tiredDoesn't initiate conversation as much, though still giving brief responses to questionsAgitation may buildLikes to keep the primary caregiver in sight and may panic when he or she is not in the roomMay seem especially irritable with large groups of visitors or young children (probably because understanding conversations requires more work)PhysicalSleeping "almost all the time"Can sleep even in a room full of activity and noiseHarder to rouse from sleepBrief, scattered periods of alertnessIncreased difficulty swallowing pills or liquidsVision deficits increaseEyes may look glassy, milky, cloudy, like "elderly eyes" or "fish eyes"May reach toward the head during sleep (may indicate headache pain)May have a distended abdomenVital signs are likely to still be goodMay begin to have need for pain management5-7 Days Prior to DeathMotorMay restlessly move the legs, as though uncomfortableMost patients would no longer be leaving the bed by this stageMay reach up or out with the armsMay pick at the bed linens as if covered with small objectsUrinary/BowelAs liquid intake decreases, output also decreasesThe bowel becomes quite sluggish and there may be few/no bowel movementsCognitive/Personality/SpeechMinimally responding to caregiver's questionsMay begin sentences but not be able to finish themMay say things that are impossible to make out or things that don't make senseMay chant something ("Ohboyohboyohboy..." or "Ohmyohmyohmy...")May continue to seem restless and fidgety, as if late for somethingMay be irritated by strong sounds or odorsPhysicalMay be taking only minimal amounts of food (a spoonful or two, here and there); some, however, continue to eat well until about 48 hoursbefore deathDecreasing intake of fluidsAdministration of meds becomes harder or impossibleDosing of meds becoming sporadic due to sleep scheduleMay find it hard to clear the throat as mucus increasesThe voice may lower and deepenMay have a wet coughVital signs often still goodNearly always sleeping or restingMay be uncomfortable being moved during clothing or linen changesDramatic withering of the legs due to inactivity (skin 'n' bones)May have a low-grade fever2-5 Days Prior to DeathMotorMotor movements (eg, waving or hugging) are likely to appear weakUnable to help the caregiver by leaning or moving during linen changesUrinary/BowelBowel activity likely will have stoppedUrine output will lessen considerablyUrine color usually lightensCognitive/Personality/SpeechVery little interaction, often no initiationSpeech may be quite slurred and hard to understandMay sit in the room with others and say nothing for hoursCould be described as "neither here nor there"Restlessness and agitation give way to calmPhysicalHands and feet may become coolForehead and cheeks may be warm or hotThighs and abdomen may be warm or hotHard to keep the eyelids open, even when awakeMay spend a couple of days with the eyes closed, even though still slightly responsiveMinimal interest in foodMay turn or clench lips to indicate refusal of food or pillsMay seem unaware of how to use a strawMay have had last decent fluid intakeMay bring mucus up into the mouth with a productive coughLast Decadron dose may be administered (either intentionally or due to difficulty of administration)Some drugs may be given only by suppository or dropper nowVital signs often still normal, but some report cardiac changes (eg, racing heart)Final 8-48 HoursVery difficult to rouse from sleep or elicit a response fromMay have no response or only nonverbal communication (eg, winks, waves, or nods)May seem relaxed and comfortableUsually very minimal or no urine outputReaches a point of unresponsive sleep (coma), which can last from 1 hour to most of the dayNo longer any involuntary movement during sleep (no fidgets or eye movements)Mouth may slacken and eyes may remain partially open during sleep, as voluntary muscle control is lostVital signs may be OK until just hours before deathBlood pressure may drop significantlyHeart rate may be twice-normal (120-180 beats per minute)Just HoursNo response whatsoever from the patientNo movementBreathing changes (of any kind at all)---sometimes faster, sometimes slower; sometimes harder, sometimes more faint; sometimes loudersometimes inaudibleMucousy breathing (the "death rattle"; harmless echo of air over mucus)Time of DeathMay let out a sighRespiration may slow so much that caregivers believe the last breath was taken, but a few more reflex breaths may followMay open the eyes as they pass onWill appear very relaxedShortly AfterwardMany have commented that the face looks younger, the forehead looks free from wrinkles and cares, and the steroid bloating begins to disappear.
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