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Where you get Midodrine Hydrochloride Oral tablet in India?
Brandnames: HYPTRON,GUTRON , ProAmatine & Orvaten 1.Nath pharma , marina arcade , connaught place, New Delhi 2.Order online HYPTRON.com or jollyhealthcare.org sold under brandname HYPTRON
Can you mix hydrocortisone midodrine and Ambien?
I would recommend against this for many reasons; primary being that the mixture of opiates and Valium are notoriously lethal, even at lower doses. The ambien and Valium will cause you to run rampant doing crazy things without a firm grip on consequence or passage of time. The other downfall is that Benzo's like Valium cause you to forget what you were doing just moments before. Ambien, having these traits of it's own, will multiply the effect greatly. Avoid these three, they don't play nice.
Hepatorenal syndrome?
DefinitionHepatorenal syndrome is a condition in which there is progressive kidney failure in a person with cirrhosis of the liver. It is a serious and often life-threatening complication of cirrhosis.Causes, incidence, and risk factorsHepatorenal syndrome occurs when there is a decrease in kidney function in a person with a liver disorder. Because less urine is removed from the body, nitrogen-containing waste products build up in the bloodstream (azotemia).The disorder occurs in up to 10% of patients hospitalized with liver failure. It is caused by the mounting effects of liver damage and leads to kidney failure in people with:Acute liver failureAlcoholic hepatitisCirrhosisRisk factors include:Blood pressure that falls when a person rises or suddenly changes position (orthostatic hypotension)Diuretic useGastrointestinal bleedingInfectionRecent abdominal fluid tap (paracentesis)SymptomsAbdominal swelling due to fluid (called ascites, a symptom of the underlying liver disease)Change in mental status ConfusionDeliriumDementiaCoarse muscle movements or mucle jerksDark-colored urine (a symptom of the underlying liver disease)Decreased urine productionNausea and vomitingWeight gainYellow skin(jaundice, a symptom of the underlying liver disease)Signs and testsThis condition is diagnosed when other causes of kidney failure are ruled out by the appropriate tests.A physical examination does not directly reveal kidney failure. However, the exam will usually show signs of chronic liver disease:Confusion (often due due to hepatic encephalopathy)Excess fluid in the abdomen (ascites)JaundiceOther signs of liver failureOther signs include:Abnormal reflexesDecreased testicle sizeDull sound in the abdomen when tapped with the tips of the fingers, and visible fluid wave when examined by feelIncreased breast tissue (gynecomastia)Sores (lesions) on the skinThe following may be signs of kidney failure:Absent or low urine production, less than 400 cc/dayFluid retention in the abdomen or extremitiesIncreased BUNand serum creatinine levelsIncreased urine specific gravity and osmolalityLow serum sodiumVery low urine sodium concentrationThe following may be signs of liver failure:Abnormal prothrombin time (PT)Increased serum ammonia levelsLow serum albuminParacentesisshows ascitesSigns of hepatic encephalopathy (an EEG may be performed if such signs are present)TreatmentTreatment aims to improve liver function and ensure that there is enough blood volume in the body and that the heart is pumping it adequately.The disorder is generally treated in the same way as kidney failure from any other cause.All unnecessary medicines should be stopped, especially the antibiotic neomycin, ibuprofen and other NSAIDs, and diuretics ("water pills").Dialysis may improve symptoms.Medications such as octreotide plus midodrine, albumin, or dopamine may be used temporarily to improve kidney function.A nonsurgical shunt (known as TIPS) is used to relieve the symptoms of ascites and may help kidney function. Surgery to place a shunt (called a Levine shunt) from the abdominal space (peritoneum) to the jugular vein may also relieve some of the symptoms of kidney failure. Both procedures are risky and proper selection of patients is very important.Expectations (prognosis)The predicted outcome is poor. Death usually occurs as a result of secondary infections or hemorrhage.ComplicationsBleedingDamage to, and failure of, many organ systemsEnd-stage kidney diseaseFluid overload with congestive heart failure or pulmonary edemaHepatic comaSecondary infectionsCalling your health care providerThis disorder most often is diagnosed in the hospital during treatment for a liver disorder.ReferencesGarcia-Tsao G. Cirrhosis and its sequellae. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 157.Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838-851.
What are some treatments for chronic fatigue?
According to the Mayo Clinic, (which is what they profess) there is no 'specific' chronic fatigue syndrome treatment. -However, here is some advice that I have found that may help.ANY COMBINATION OF:* Moderating daily activity. Your doctor may encourage you to slow down and to avoid excessive physical and psychological stress. However, too much rest can make you weaker, worsening your long-term symptoms. Your goal should be to maintain a moderate level of daily activity and gently increase your stamina over time.* Gradual but steady exercise. Often with the help of a physical therapist, you may be advised to begin an exercise program that slowly becomes more challenging. Research has proved that gradually increasing exercise can improve the symptoms of chronic fatigue syndrome.* Cognitive behavior therapy. This treatment, often used in combination with graduated exercise, also has been found to improve the symptoms of chronic fatigue syndrome. In cognitive behavior therapy, you work with a mental health professional to identify negative beliefs and behaviors that might be delaying your recovery and replace them with healthy, positive ones.* Treatment of depression. If you're depressed, medications, such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs), may help. Antidepressants may also help improve sleep and relieve pain.* Treatment of existing pain. (For what it's worth) Acetaminophen (Tylenol, others) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin, others), may be helpful to reduce pain and fever.* Treatment of low blood pressure (hypotension). The drugs fludrocortisone (Florinef), atenolol (Tenormin) and midodrine (ProAmatine, Orvaten) may be useful.* Treatment for problems of the nervous system. Symptoms such as dizziness and extreme skin tenderness can sometimes be relieved by clonazepam (Klonopin). Your doctor may prescribe medications to relieve symptoms of anxiety.??? HERBAL REMEDIES ???* Intramuscular magnesium for people with low red blood cell magnesium, a combination of fish oil and evening primrose oil, melatonin, NADH, propionyl-L-carnitine, and ribose - have be known to show encouraging results.* From what I have gathered, there is insufficient evidence of benefit to recommend any specific dietary or herbal supplements as a treatment for chronic fatigue, (other than what I mentioned). === === === === === === Chronic pain can be cured with different types of massage therapies, physical therapy meditation, yoga, acupuncture and acupressure. People suffer from chronic pain because of several reasons: it could be an injury from an accident, diseases like arthritis, stiffness, aging, or, muscle damage. Yoga is one way to deal with chronic pain. While attending a class with other people might have several benefits. According to yoga chronic pain is purely psychosomatic syndrome. Pranayama breathing techniques in yoga can help relieve pain. Generally, when we are in pain, we tend to hold our breaths, thus building up toxins in our body. So people who have pain, generally have poor circulation, and contracted muscles. Yoga breathing can combat this and help you overcome the problem.
Multiple system atrophy?
DefinitionMultiple system atrophy (MSA) is a rare condition that causes symptoms similar to Parkinson's disease. However, patients with MSA have more widespread damage to the autonomic nervous system. This is the part of the nervous system that controls important organ functions such as heart rate, blood pressure, digestive system muscles, and sweating.Alternative NamesShy-Drager syndrome; Neurologic orthostatic hypotension; Shy-McGee-Drager syndrome; Parkinson's plus syndromeCauses, incidence, and risk factorsThe cause is unknown. MSA develops gradually and is most often diagnosed in men older than 60.SymptomsMSA damages the nervous system, which can cause the following symptoms:Changes in facial expression "Mask" appearance to faceMay be unable to close mouthReduced ability to show facial expressionsStaringDifficulty chewing or swallowing (occasionally)Disrupted sleep patterns (especially during rapid eye movement (REM) sleep late at night)Dizziness or fainting when standing up or after standing stillFrequent fallsImpotenceLoss of control over bowels or bladderLoss of fine motor skills Difficulty eatingDifficulty with any activity that requires small movementsWriting that is small and hard to readLoss of sweating in any part of the bodyMild decline in mental function (may occur)Movement difficultiesLoss of balanceShufflingWalking pattern (gait) changesMuscle achesand pains (myalgia)Muscle rigidityDifficulty bending arms or legsStiffnessNausea and problems with digestionPosture difficulties: may be unstable, stooped, or slumped overSlow movements Difficulty beginning to walk or starting any voluntary movementFreezing of movement when the movement is stopped, unable to start moving againSmall steps followed by the need to run to keep balanceTremors May become severe enough to interfere with activitiesMay be worse when tired, excited, or stressedMay occur at rest or at any timeMay occur with any action, such as holding a cup or other eating utensilsFinger-thumb rubbing (pill rolling tremor)Vision changes, decreased or blurred visionVoice and speech changes Difficulty speakingMonotoneSlow speakingVoice is low volumeOther symptoms that may occur with this disease:ConfusionDementiaDepressionSleep-related breathing difficulties, especially sleep apnea and a blockage in the air passage that leads to a harsh vibrating soundSeborrheic dermatitisSigns and testsThe health care provider may perform the following:Blood pressuremeasurement, lying and standingEye examinationNerve and muscle (neuromuscular) examinationThere are no specific tests to confirm this disease. A neurologist can make the diagnosis based on:History of symptomsFindings during a physical examinationRuling out other causes of symptomsTesting to help confirm the diagnosis may include:MRI of headPlasma norepinephrine levelsUrine examination for norepinephrine breakdown products (urine catecholamines)TreatmentThere is no cure for MSA, and there is no known way to prevent the disease from getting worse. The goal of treatment is to control symptoms.Anticholinergic medications may be used to reduce early or mild tremors. Levodopa may improve movement and balance.Carbidopa may reduce the side effects of Levodopa and make it work better. However, the response to medications may be disappointing. Many people respond poorly to treatment with anticholinergics or Levodopa.Medications that may be used to treat low blood pressure include:Beta-blockersFludrocortisone (Florinef)MAO inhibitorsVasoconstrictors (midodrine)VasopressinA pacemaker that is programmed to stimulate the heart to beat at a rapid rate (faster than 100 beats per minute) may increase blood pressure for some people.Constipation can be treated with a high-fiber diet and laxatives. Impotence may be treated with drugs that enhance erections.Expectations (prognosis)The outcome is poor. Loss of mental and physical functions slowly get worse. Early death is likely.ComplicationsProgressive loss of ability to walk or care for selfDifficulty performing daily activitiesInjuries from falls/faintingSide effects of medicationsCalling your health care providerCall your health care provider if you develop symptoms of this disorder.Call your health care provider if you have been diagnosed with MSA and your symptoms return or get worse. Also call if new symptoms appear, including possible side effects of medications:Changes in alertness/behavior/moodDelusional behaviorDizzinessHallucinationsInvoluntary movementsLoss of mental functioningNausea/vomitingSevere confusion or disorientationContact your health care provider if you have a family member with this disorder and his or her condition deteriorates to the point that you are unable to care for the person at home.ReferencesLang A. Parkinsonism. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 433.
Parkinson's disease?
DefinitionParkinson's disease is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination.Alternative NamesParalysis agitans; Shaking palsyCauses, incidence, and risk factorsParkinson's disease was first described in England in 1817 by Dr. James Parkinson. The disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly. Sometimes Parkinson's disease occurs in younger adults, but is rarely seen in children. It affects both men and women.In some cases, Parkinson's disease occurs in families. When a young person is affected, it is usually because of a form of the disease that runs in families.Nerve cells use a brain chemical called dopamine to help control muscle movement. Parkinson's disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the nerve cells in that part of the brain cannot properly send messages. This leads to the loss of muscle function. The damage gets worse with time. Exactly why the brain cells waste away is unknown.Parkinson's in children may occur because the nerves are not as sensitive to dopamine. Parkinson's is rare in children.The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders (such as secondary parkinsonism) or certain medications.SymptomsThe disorder may affect one or both sides of the body. How much function is lost can vary.Symptoms may be mild at first. For instance, the patient may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging.Symptoms include:Automatic movements (such as blinking) slow or stopConstipationDifficulty swallowingDroolingImpaired balance and walkingLack of expression in the face (mask-like appearance)Muscle achesand pains (myalgia)Problems with movement Difficulty starting or continuing movement, such as starting to walk or getting out of a chairLoss of small or fine hand movements (writing may become small and difficult to read, and eating becomes harder)Shuffling gaitSlowed movementsRigid or stiff muscles (often beginning in the legs)Shaking, tremors Tremors usually occur in the limbs at rest, or when the arm or leg is held outTremors go away during movementOver time, tremor can be seen in the head, lips, tongue, and feetMay be worse when tired, excited, or stressedFinger-thumb rubbing (pill-rolling tremor) may be presentSlowed, quieter speech and monotone voiceStooped positionOther symptoms:Anxiety, stress, and tensionConfusionDementiaDepressionFaintingHallucinationsMemory lossOily skin (seborrhea)Signs and testsThe health care provider may be able to diagnose Parkinson's disease based on your symptoms and a physical examination. However, the symptoms can be difficult to assess, particularly in the elderly. The signs (tremor, change in muscle tone, problems walking, unsteady posture) become more clear as the illness progresses.An examination may show:Difficulty starting or finishing voluntary movementsJerky, stiff movementsMuscle atrophyParkinson's tremorsVariation in heart rateReflexes should be normal.Tests may be needed to rule out other disorders that cause similar symptoms.TreatmentThere is no known cure for Parkinson's disease. The goal of treatment is to control symptoms.Medications control symptoms, mostly by increasing the levels of dopamine in the brain. At certain points during the day, the helpful effects of the medication often wears off, and symptoms can return. Your doctor need to be change the:Type of medicationDoseAmount of time between dosesHow the medications are takenWork closely with your doctors and therapists to adjust the treatment program. Never change or stop taking any medications without talking with your doctor.Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important.Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.Medications used to treat symptoms of Parkinson's disease are:Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Atamet)Pramipexole (Mirapex), ropinirole (Requip), bromocriptine (Parlodel)Selegiline (Eldepryl, Deprenyl), rasagiline (Azilect)Amantadine or anticholinergic medications -- to reduce early or mild tremorsEntacapone -- to prevent the breakdown of levodopaLifestyle changes that may be helpful for Parkinson's disease:Good general nutrition and healthExercising, but adjusting the activity level to meet changing energy levelsRegular rest periods and avoiding stressPhysical therapy, speech therapy, and occupational therapyRailings or banisters placed in commonly used areas of the houseSpecial eating utensilsSocial workers or other counseling services to help you cope with the disorder and get assistance (such as Meals-on-Wheels)Less commonly, surgery may be an option for patients with very severe Parkinson's disease who no longer respond to many medications. These surgeries do not cure Parkinson's, but may help some patients:In deep brain stimulation (DBS), the surgeon implants electrical stimulators in specific areas of the brain to help with movement.Another type of surgery destroys brain tissues that cause Parkinson's symptoms.Support GroupsSupport groups may help you cope with the changes caused by the disease.See: Parkinson's disease - support groupExpectations (prognosis)Untreated, the disorder will get worse until a person is totally disabled. Parkinson's may lead to a deterioration of all brain functions, and an early death.Most people respond to medications. How much the medications relieve symptoms, and for how long can be very different in each person. The side effects of medications may be severe.ComplicationsDifficulty performing daily activitiesDifficulty swallowing or eatingDisability (differs from person to person)Injuries from fallsPneumonia from breathing in (aspirating) salivaSide effects of medicationsCalling your health care providerCall your health care provider if:You have symptoms of Parkinson's diseaseSymptoms get worseNew symptoms occurAlso tell the health care provider about medication side effects, which may include:Changes in alertness, behavior or moodDelusional behaviorDizzinessHallucinationsInvoluntary movementsLoss of mental functionsNausea and vomitingSevere confusion or disorientationAlso call your health care provider if the condition gets worse and home care is no longer possible.ReferencesLang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009;72(7 Suppl):S39-43.Miyasaki JM, Shannon K, Voon V, Ravina B, Kleiner-Fisman G, Anderson K, et al. Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson's disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;66:996-1002.Pahwa R, Factor SA, Lyons KE, Ondo WG, Gronseth G, Bronte-Stewart H, et al. Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;66:983-995.Suchowersky O, Reich S, Perlmutter J, Zesiewicz T, Gronseth G, Weiner WJ. Quality Standards Subcommittee of the American Academy of Neurology. Practice Parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006.66:968-975.Weaver FM, Follett K, Stern M, et al. Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA. 2009;301(1):63-73.
How many generic prescription drugs exist?
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