Posts for tag: naproxen

             A new type of therapy called immunotherapy Is increasingly being used  to 

fight cancer.In essence,this therapy utilizes the body's own cancer-killing cells

as a defense mechanism against the cancer cells.To begin with, cancerous

tissue is biopsied and tested for genetic mutations. Then, medications called

monoclonal antibodies which are specific for each of these genetic mutations

in a given cancer are then used to enlist the body's own cancer-fighting cells

to destroy the cancer.

              Recently,a former president who suffered from malignant melanoma

which had already spread to his liver and brain was given the drug pembrolizumab.

This medication is one of a new class of drugs called immune checkpoint inhibitors.

These drugs target certain proteins in the immune system known as checkpoint 

proteins which prevent cancer cells from being attacked by the  immune system.

Therefore,they allow the body's own immune system to attack and kill the cancer.

             In a recent study of 67 patients utilizing this therapy,about 17 (ie,25 %)

developed a skin condition  on certain body areas known as vitiligo which is

the absence of pigment. 

             However,not only is this, in my opinion,a very small price to pay for

curing melanoma cancer which has already spread throughout the body,

but this potential side effect and others can be managed by the use of

steroids and aspirin type drugs such as ibuprofen and naproxen.

               

 

 

 

 

Coming soon.

The following list of medications is certainly not all-inclusive since many different classes of

prescription and over-the-counter drugs can make the skin more sensitive to ultraviolet rays.

Some of the more popular photosensitizing medications include:

          Antibiotics: tetracycline,doxycycline hyclate(not the smaller-dose doxycycline found

in the brand name product "Oracea.") and sulfa-containing antibiotics such as trimethoprim/

sulfamethoxazole.

         Arthritis drugs: ibuprofen, naproxen

        Blood pressure/"water pill" drugs: hydrochlorthiazide(more a blood pressure drug than

a water pill) furosemide(more a water pill than a blood pressure drug).Both of these contain

sulfa,which is a photosensitizer.

       A recent study indicated that the calcium channel blocker nifedipine and the ACE

inhibitor lisinopril both increased sun-sensitivity and made users more likely to develop

lip cancer.

       Diabetes drugs: glipizide,glyburide, and chlorpropamide all contain sulfa and,therefore,

are more likely to be sun-sensitizers.

      Antihistamine:  the popular diphenhydramine

     Acne medications: include those related to Vitamin A such as  isotretinoin,tretinoin,and

acetretin.

    Anti-cancer(chemotherapy) drugs:  5-fluorouracil  and dacarbazine

    Psychiatric drugs such as the major tranquilizers chlorpromazine and the tricyclic 

antidepressants  desipramine and imipramine.

   External (topical) products such as scented or deordorant soaps, toiletries, cosmetics or fragrances

         In summary,  the benefit of these drugs probably outweighs the potential sun-senitivity side

effects (especially with the judicious use of sunscreens and sun exposure time). If not,they

should only be discontinued with the consent of the health care practitioner prescribing

them.

 

 

 

By Robert J Weiss MD PC
February 15, 2015
Category: Uncategorized

Many of us have had the uncomfortable itching experience of hives or wheals(the medical term is urticaria)in

our lives. Hives result from the release  of a body chemical called histamine from mast cells.Ordinary individual hives

typically last 24 hours or less. However,the coming and going of hives persisting for more than 6 weeks is called

chronic.And,from my clinical experience in the office it becomes much more difficult to elicit their cause.

               The etiology of hives can be divided into several classifications: these include:

                  1)anti-inflammatory medications such ibuprofen,naproxen,and aspirin as well as narcotic medications

including codeine,hydrocodone,and oxycodone.

                  2)the ingestion of certain foods as well as the diluents and preservatives they contain. These foods include

shellfish,strawberries,chocolate,etc.

                 3)physical causes such as heat and cold,water and pressure,sun and cholinergic(due to physical exertion

and sweating)

                 4)chronic causes of hives such as the autoimmune diseases of lupus and the thyroid gland(Grave's disease).

In addition,chronic infections including dental cavities,urinary tract and vaginal infections.

                5)stress and nerves-I have listed this last since it is easy to blame everything on this.

               But,patients with chronic hives in particular need a complete  history,physical exam,and lab work to rule out

internal causes (comorbidities).

             The mainstay of treatment is to correct any underlying medical disorder and the use of non-sedating 

antihistamines whenever possible.However,in my clinical experience acute exacerbations sometimes require

sedating antihistamines(especially for patients kept awake all night from the itching)and/or a short course

of corticosteroids for the worse flare-ups.

             The injectible drug omalizumab initially approved for moderate to severe persistent and allergic

asthma is now available for chronic recalcitrant and idiopathic(ie,cause unknown)urticaria.The drug opposes

the immunoglobulin antibody in the blood known as IgE which mediates allergic reactions.It is approved

for patients over 12 years old.

             However,when the monthly injections are stopped the hives recur.The good news is that the drug is still effective

when restarted.

 

 



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