Eat Happy!

Eat Happy!

Disclaimer

**The information provided in this BLOG is in no way intended to diagnose, treat, or cure any illness. This information should never replace the advice of a doctor. Please use this information as you see fit. This information will pertain differently to each child, each adult, and each family.**

**Resources are listed to support information associated with this BLOG. These resources support copyrights and are permissible. Information presented outside of this BLOG needs to incorporate resource sites to maintain legal status.**

**This BLOG and its information may be shared at no request; photographs will need permission from the blogger.**

Monday, May 12, 2014

“Alleviation of Retching and Feeding Intolerance After Fundoplication” ARTICLE

I have something huge to share with all of you! I have spent a long time talking about the reasons, causes, treatments for retching and post-fundo troubles. Ian has visited the Surgical Reflux Clinic at The Children’s Hospital of Philadelphia for a couple years now. While he is now managed by the Motility clinic there, the doctors at the reflux clinic are still a valuable part of his team.

The Children's Hospital of Philadelphia


Ian’s doctors have just published an incredible article which is almost like reading Ian’s medical history! The article is “Alleviation of Retching and Feeding Intolerance After Fundoplication.”





The article covers:
  • Surgical treatments for reflux
  • Symptoms of retching, failure to thrive, diarrhea, bloat, post-prandial hypoglycemia, and other intolerances due to fundoplications
  • Causes of retching such as osmolarity of food, boluses, overfeeding, fluid, venting, infection, dumping syndrome, medications, hypersensitivity/allergy, whey vs casein, surgeries, etc.
  • Respecting the new limits of the stomach and how fundo changes accommodating and compliance
  • Treatment options for each cause and each symptom

The abstract is available for free on PubMed

The abstract is available for free on Nutrition of Clinical Practice on SAGE journal's site


Most hospitals have subscriptions for these journals/sites and have access to the articles. However; I would *HIGHLY* recommend any parent with a retcher, or post fundo-troubled child invest in the $15.00 article for a download:

You can purchase the download from SAGE for $15.00 here

I feel strongly that this article can create a new wave of knowledge and treatments across the country to help children struggling with post-surgical feeding intolerance and retching. Please read this article and share it with your doctors, nurses, and therapists. I can only hope that others can benefit from these theories the same way Ian has. They are amazing clinicians with astonishing theories and success. We are so happy to have them on Ian’s team!!!

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They have also published another article (in 2009) called "The Case of the Wretched Retcher."  The article was published in ICAN: Infant, Child, and Adolescent Nutrition.

















Wednesday, May 7, 2014

Why is "Pharmacology" a Foreign Language?

A large goal of my BLOG is to explain complex medical concepts in simple terms. Many of these concepts come very easy for me due to my medical classes and extensive medical background. It often occurs to me that these concepts can be very difficult to understand, especially if the terminology used is complex. How can we be expected to understand concepts that use languages we don’t speak? The focus of this post is to present information on pharmacology so we can all better understand our drug doses, usages, and effects.

At the end of the post, I have included most parts of a drug’s prescription pamphlet. Most of the topics are discussed in detail in the post. My personal favorite interest is Pharmacokinetics. I like to know how fast a medication reaches peak therapeutic levels and how long it keeps working before it wears off. No one likes to wait for medications to start working.





DEFINITIONS:

Suffixes
  1. (-ology): the study of a particular subject 
  2. (-ceutical): a range of products that are designed to work in or on the body 
Prefixes
  1. (pos-): comes from Greek poso meaning “how much” 
  2. (toxi-): poisonous 
Root Words
  1. Kinetics: the turnover rate of a change of a specific factor in the body 
  2. Genomics: study of all neucleotides, genes, sequences, DNA, and chromosomes (ics- organized knowledge of something) 
  3. Vigilance: a state of being attentive or alert in a sense of being watchful for something to occur 
  4. Clinical: of or relating to the observation and treatment of actual patients rather than theoretical or lab studies 
  5. Neuro-: pertaining to nerves 
  6. Dynamics: of or relating to objects and their ability to create change 
  7. Pharma or Pharmaco: drug 
*Combining form: a combination of a word root and a vowel to make pronunciation easier


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TERMINOLOGY


Pharmacology: The medical branch of medical biology concerned with the study of drug actions. It is the study of interactions occurring between organisms and chemicals and how they affect normal or abnormal biochemical function. It also studies drug composition, properties, synthesis and design, organs systems and applications.
Pharmacology: Wikipedia


Clinical Pharmacology: The study of drugs and their use for the treatment of real patients (not animal or laboratory testing).
Clinical Pharmacology: Wikipedia


Pharmaceuticals: Substances that have medical properties.






BRANCHES OF CLINICAL PHARMACOLOGY

Pharmacokinetics:
(Branch of clinical pharmacology) Studies the time course of liberation (release), drug absorption, distribution, metabolism, and excretion. Studies “how fast the drug works.”

**It also studies how fast the drug reaches therapeutic levels.**

Studies the application of principles for the safe and effective therapeutic management of drugs in individual patients. Goals of clinical pharmacokinetics include enhancing efficacy and decreasing toxicity of drug therapy. Drug effects are often related to concentration at the site of action.
Pharmacokinetics: Wikipedia
Introduction to Pharmacokinetics and Pharmacodynamics

Pharmacodynamics:
(Branch of clinical pharmacology) Studies what the drug does to the body. The study of the relationship between drug concentration at the site of action and the resulting effect, including time course and intensity of therapeutic and adverse effects. The study of biochemical and physiological effects of drugs on the body and the mechanisms of drug action...... **how it works**. It studies both the desirable and undesirable effects as well as the therapeutic window and duration of action. When studying the effects it looks at stimulating effects, depressing effects on the nervous system.
Pharmacodynamics: Wikipedia


Comparison.......

Pharmacokinetics and Pharmacodynamics Comparison

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FIELDS OF STUDY

Neuropharmacology:
The study of how drugs affect the nervous system both behavioral and molecular. Behavioral neuropharmacology focuses on how drugs affect human behavior, including drug dependence and addiction. Molecular neuropharmacology focuses on the study of neurons and neuro-chemical interactions with a goal of developing drugs that have beneficial effects on neurological function.
Neuropharmacology: Wikipedia


Pharmacogenomics:
The study of how genes affect a person’s response to a drug.  It is a combination of pharmacology and genomics to help develop effective and safe medications and doses that will be tailored to a person’s genetic makeup. Drugs do not work the same way for everyone, but are often designed as a “one-size-fits-all.” It is difficult to see who will benefit, who will not respond, and who will have negative side effects (adverse drug reactions). It is also the study of how genetic differences affect responses to medications. This is a brand new field of study.
Posology:
The study of therapeutic dosages and also the determination of appropriate drug dosages. This also includes the suggested duration of use, maximum recommended dose, titration, when to discontinue, advice to do when missing a dose, intake of food and drink, and interactions requiring dose adjustments, along with repeat therapeutic therapy use.
Posology: European's Medical Agency Presentation


Toxicology:
The study of adverse effects of chemicals on living organisms. Toxicologists are scientists who specialize in the study of symptoms, mechanisms, treatments, and detection or toxins, especially when it comes to poisoning. It also studies harmful effects of chemical, biological, and physical agents in biological systems that establishes the extent of damage in living organisms. It is the study of the reationship between dose and effects. Factors influencing chemical toxicology are: dose, route of exposure (ingestion, inhalation, or skin absorption), species, age, sex, health, environment, individual. Studied in the field of animal testing. Studies the dose response curve and how threshold effect response levels.
Toxicology: Wikipedia


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Drug Tolerance:
A reduced response to repeated administration of the same dose or increase in the dose are required to produce the same magnitude of response. When a person’s reaction to a specific drug is reduced and an increase in concentration is required to achieve the desired effect. Includes physiological and psychological drug tolerance. It can be reversible depending on the drug. A rapid tolerance is called tachyphylaxis. Pharmacokinetic tolerance occurs because of a decreased quantity of the substance reaching the site it needs to produce an effect. Pharmacodynamic tolerance is when the response to the substance is decreased by cellular mechanisms caused by a down regulation of receptor numbers. Drug tolerance is different then physical dependence.
Drug Tolerance: Wikipedia

Pharmacovigilance:
Relating to drug safety. The science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problems. The aim is to enhance patient care and patient safety in relation to the use of medicines. It also aims to support public health programs by providing reliable, balanced information for the effective assessment of the risk-benefit profile of medicines.
Pharmacovigilance: World Health Organization (WHO)


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PARTS OF A LABEL
(highlighted sections are discussed in detail above)

  • Description: usage, what to know, who should use the medication 
  • Instructions: how to use the medication 
  • Chemical Composition: what is the molecular make-up of the medication 
  • Forms and Strengths / How Supplied 
  • Indications and Usage 
  • Contraindications 
  • Warnings and Precautions 
  • Laboratory Tests and Clinical Studies 
  • Clinical Pharmacology 
  • Pharmacokinetics 
  • Dosage and Administration (Posology)
  • Toxicology: Pregnancy and Nursing 
  • Overdose 
  • Special Populations: Pregnancy/Nursing, Pediatrics, etc. 
  • Adverse Reactions (pharmacodynamics) 
  • Drug Interactions 
  • Storage