Tuesday, January 19, 2010
How should this medicine be used ?
Take Tadalafil Tablets by mouth. Follow the directions on the prescription label. The dose is usually taken 30 minutes to 1 hour before sexual activity. You should not take this dose more than once per day. Swallow the tablets with a drink of water. You may take Tadalafil with or without meals. Do not take double or extra doses. Do not change your dose without talking to your prescriber. Your prescriber may lower or raise your dose, depending on how your body reacts to Tadalafil. If you have kidney or liver problems or are taking certain medications, your prescriber may limit your dose of Tadalafil.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. At this time, this medicine is not for use in children.
What if I miss a dose ?
This does not apply. However, do not take double or extra doses.
What drug(s) may interact with Tadalafil?
Do not take Tadalafil if you are taking the following medications:
•alpha blockers, such as alfuzosin (UroXatral®), doxazosin (Cardura®), prazosin (Minipress®), or terazosin (Hytrin®), used to treat high blood pressure or an enlarged prostate. Flomax® (tamsulosin) 0.4 mg daily may be taken with Cialis.
•nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally
Tadalafil may also interact with the following medications:
•certain antibiotics such as clarithromycin, erythromycin, troleandomycin
•certain drugs used for seizures such as carbamazepine, phenytoin, and phenobarbital
•medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)
•certain medicines for the treatment of HIV infection or AIDS
•rifabutin, rifampin or rifapentine
•some drugs for treating depression, anxiety or other mood problems (examples: fluoxetine, fluvoxamine, nefazodone)
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What side effects may I notice from receiving Tadalafil ?
Side effects that you should report to your prescriber or health care professional as soon as possible:
•changes in vision
•chest pain or palpitations
•difficulty breathing, shortness of breath
•prolonged erection (lasting longer than 4 hours)
•skin rash, itching
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
•stuffy or runny nose
What should I watch for while taking Tadalafil ?
Contact your physician immediately if the erection lasts longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated immediately to prevent permanent damage.
If you experience symptoms of nausea, dizziness, chest pain or arm pain upon initiation of sexual activity after Cialis use, you should refrain from further activity and should discuss the episode with your prescriber or health care professional as soon as possible.
Do not drink alcohol to excess (examples, 5 glasses of wine or 5 shots of whiskey) when taking Cialis. When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate or lowering your blood pressure.
If you notice any changes in your vision while taking this drug, notify your prescriber or health care professional as soon as possible.
Do not change the dose of your medication. Please call your prescriber or health care professional to determine if your dose needs to be reevaluated.
Using Cialis does not protect you or your partner against HIV infection (the virus that causes AIDS) or other sexually transmitted diseases.
Where can I keep my medicine ?
Keep out of reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.
Wednesday, September 16, 2009
It is already known that Antidepressants can help stroke survivors by improving their mood. Now researchers at the University of Iowa reveal that the benefits of antidepressants extend beyond this. The study involved 47 patients who had had a stroke within the previous six months. They were assigned to one of two antidepressants, fluoxetine or nortriptyline, or placebo. The researchers carried out standard tests of cognitive functioning at the end of the 12 weeks of treatment and again two years after the start of the study.
No differences were found between the Antidepressant groups and placebo at 12 weeks. But at the second evaluation, the placebo group showed continued worsening of their executive function - the ability to think and plan - while those in the antidepressant group showed considerable improvement. It would appear that the effect of antidepressants on brain tissue not affected by the stroke is positive - but slow. The researchers now plan to look at any possible brain changes, through imagery, which may have been fostered by the antidepressant treatment.
Tuesday, September 15, 2009
Most pet owners consider their four-legged friends as members of the family. Owners tell funny stories to friends about their pets amusing antics. Some pet owners even celebrate the birthdays of their feline and canine companions. Like other family members, owners cuddle with pets, talk to them, nurse them when they are sick, and punish them when they do things that are against the rules. Yet, while most pets are well-behaved, many owners have come home to find things ripped to shreds by their dog or that their cat soiled a favorite comforter. As much as owners may react harshly by yelling at or otherwise punishing their furry friends, consider the likelihood that these pets are reacting out of boredom, loneliness, and separation anxiety.
The reality is that many pets are subject to boredom, loneliness and separation anxiety just as children are. Although it is difficult to rationalize the destruction of property, pet owners should be careful not to anthropomorphize (to ascribe human characteristics to things not human) pet behavior. It is essential to realize that animals need mental and physical stimulation to prevent boredom and loneliness. Pets enjoy the company of their fellow pack animals to alleviate loneliness, for example, and an owners patient and compassionate help in overcoming separation anxiety is critical.
Researchers and veterinarians are not really sure what causes separation anxiety in some pets and not in others. Lately, the theory is that some pets have experienced a traumatic separation experience and/or may be genetically predisposed to anxious behavior. Animals that are separated from their mothers too early, or have been in and out of animal shelters, appear to be prone to anxious behavior. It is easy to understand why these experiences may dispose pets to continuing anxiety about becoming separated from those to whom they have formed attachments. Pets are creatures of habit, just as humans are.
Many dogs know that it's time for a walk when they see owners grab the leash. Cats salivate when tea is made. They react to the sound of the spoon hitting the side of the cup, expecting a dab of milk as a treat. And, most importantly to this discussion, pets know that they will soon be left alone when you begin to wrap up your morning routine and prepare to leave for the day.
You may have noticed that your happy go lucky dog or cool as a cucumber cat become agitated or tense as you brush your teeth or put your shoes on. This agitation becomes near panic as you reach for your keys and grab your coat. And the panic becomes aggravated when you leave the house. Perhaps the tension doesn't begin until you open the closet door and reach for your coat. "How cute," you think, "Rex wants to go outside." Yet, candidly, dogs and cats know the difference between going for a walk and their owners abandoning them for the day. Your pet is asking to go with you; and, when you appear to be ignoring his needs, he becomes anxious at the thought that you are leaving and may never return.
Have you ever returned home to find that the kitchen cabinets have been opened and all of your dried, boxed food has been ripped open and strewn haphazardly on the floor? Even worse than the actual mess, you recall that you put your dog in the crate before you left for work. The door to the crate is still closed; but your pet is sitting in the middle of the living room floor, surrounded by what's left of your shredded wedding photo album, innocently wagging his tail. The neighbors have started complaining that your pet has been barking and howling constantly and your door frames have been chewed to bits.
A pet that suffers from loneliness, separation anxiety or boredom may display only one undesirable behavior. It is just as likely, however, that your pet is reacting only when you are not home. And unfortunately, this behavior is wreaking havoc on your relationship with your beloved pet. Observe your pet for signs of impending trouble as you go about your morning routine. A dog that is exhibiting signs of separation anxiety will often whimper or whine when they sense you may be preparing to leave.
Pacing the floors, shaking or shivering, and even aggressively trying to prevent your departure are not uncommon behaviors when your pet knows your departure is imminent. In fact, some pets have even taken to gnawing at his paws in an effort to alleviate anxiety - much like humans chew their own fingernails. An pet in the throes of extreme anxiety will occasionally injure himself or herself as a result of their behavior. These are extreme cases and need to be taken very seriously and solved immediately. A chewing behavior often extends to objects, doorways, and your pet may even dig and scratch at windows in an effort to find you.
Some animals may become depressed when they feel their humans have abandoned them. Depression in animals often takes the form of anorexia (refusal to eat) or vomiting. If an owner is leaving for the day, and a pet refuses to eat for eight or nine hours, this is not a significant issue. However, if an owner leaves for an extended period of time, say for a vacation or a job that involves traveling for more than a day at a time, a pet may become malnourished and may require medical treatment. Extreme cases may end with the death of your beloved pet. Incessant barking and howling is also common behavior for a dog that feels abandoned.
Cats who suffer from separation anxiety display many of the same behaviors as dogs. Many pet owners are fooled into thinking that cats have no apparent reaction to their comings and goings. However, just because cats are not known to cause major property damage, there is no reason to ignore their suffering, or to believe they are not bothered by your absence. A cat that is suffering from separation anxiety will pace, and often becomes nervous and clingy when an owner is preparing to leave for the day.
A cat suffering from separation anxiety can also display noisy protests to his owners departure. Cats may also urinate or defecate in inappropriate places and scratch doorways and furnishings. While it was thought that cats did not suffer from separation anxiety, the most recent research indicates that cats, like dogs, form strong bonds with humans, and may become anxious and overwhelmed when their masters leave. In fact, like dogs, cats may groom themselves to the point of baldness or sores.
While there is a tendency of a pet within a specific breed to suffer from boredom, loneliness or separation anxiety - often pure bred dogs and cats, mixed breeds suffer from the same emotional afflictions. Dogs and cats are social creatures. When deprived of the security of their natural mother and siblings, a new pet becomes attached to his new human family members. This is normal social animal behavior. Problems arise, however, when the attachment to the human family becomes excessively dependent. The pressing questions are how do we identify this behavior, and, subsequently, correct the resulting problems. Pets that form intense attachments to their masters are the likeliest candidates to suffer from boredom, loneliness or separation anxiety. Pets need to learn that we will be coming back soon and are not abandoning them forever, especially since animals have no real concept of time.
Soon after an owner departs, a pet begins to miss this attention, likely believing that the owner will be gone for a very long time. Those of us with children have learned that playing peek-a-boo teaches children that parents disappear, but return immediately. Animal experts do not suggest that you play peek-a-boo with your pets. They do, however, know that pets need to learn their owners will return. A dog that practically looses his mind with joy upon the return of his owner is likely suffering from separation anxiety. This is not to say that an emotionally healthy pet should ignore you when you walk in the door after a long day; but, he should definitely not act as if they have been deprived of all human contact for the last decade.
The lessons that reassure pets that their masters will return are best begun while they are young. Leaving animals with their biological mother until they are at least eight weeks old can go a long way toward eliminating feelings of separation. If you have a canine or feline companion that is no longer young, and he is not adjusting appropriately to your absences, you will need to put forth the effort to correct the situation yourself. However daunting the task seems, don't lose hope! Regressive behavior that is a result of boredom, loneliness or separation anxiety can usually be remedied at any age. Old dogs can learn new tricks! Old cats, however, can be a different case altogether. Cats that have learned undesirable behavior are difficult to retrain. As a matter of fact, cat owners know full well that the word "train" often does not apply to cats. Cats are often immune to behavior modification. Yet, take heart, change is still possible.
Curiously enough, some pet owners and experts alike swear by the use of punishment to "break" an animal of an undesirable behavior. Although one must wonder why an owner would want a broken companion, the fact is that punishment is often counterproductive. A fostering of trust with any animal is imperative to building a sound relationship. For the purposes of this discussion, punishment is not a recommended course of action to rid your pet of undesirable behavior; and it is certainly not the way to teach your animal to trust that you have not abandoned him. It is important to remember that your pet is not attempting to punish you for abandoning them by gnawing on everything in sight or urinating on the floor. They are merely afraid that you will not return home. The resulting destructive behavior is the product of their fear of isolation.
Providing a pet with the services of a daycare center is an option, but not always feasible, and prohibitively expensive at that. In lieu of a pet sitter, owners should begin their campaign to reform their pet's behavior by never making a big deal out of leaving their pet alone. Although many owners themselves experience separation anxiety, especially when a pet is new to a home, it is important that owners do not reveal guilt for leaving a new pet. The coming and going of pet owners is simply a fact of life, and a pet cannot always come along. The earlier pets come to accept this fact, the better they will fit into the family. Desensitizing your pet is the first step in helping him or her accept that an owner is not available.
Leave your pet for short periods of time and increase to longer periods. Actually leave the house when you do this exercise, as some pets are not easily fooled. When crate training a dog, use the same process. Leave the dog in the crate for short periods of time, gradually building up to longer stretches. Contrary to what some pet owners believe, crates are not cruel devices for dogs. Dogs are den animals. They often prefer the security of feeling like they are in a warm, safe den-like enclosure. Many dogs that have been crate trained are often found relaxing in their wired den with the door open, happily chewing on a bone or taking a nap. Remember, however, that you should never use the crate as a form of punishment. The crate is a safe haven for your dog, not a time-out room and should always retain positive associations. Additionally, upon returning to home or upon removing a pet from the crate, owners should actually ignore their pet for a short while. Remember, your comings and goings are not a big deal. The idea is that there is no cause for alarm or excitement when you depart or arrive.
In extreme cases of separation anxiety, the process of desensitizing a pet will need to be undertaken in very small steps. Using a variation of the process described above, owners of an anxious pet must approach the desensitizing procedure carefully. Approach your morning routine as you normally would, but in small steps that are easy understand.
1 Begin by putting your coat or jacket on, then sit down on the couch. After a minute or two, remove your coat and put it away. Repeat this action until your pet does not become anxious.
2 Next, put your coat on and grab your keys (purse, bag, lunchbox, or whatever else you may take with you when you leave for the day), then sit on the couch again. After a moment, put your keys and coat away. Repeat this action until your pet does not become anxious during this process.
3 When your pet becomes comfortable with what you are doing so far, you can take the process a step further. Put your coat on, grab your keys and then open the door. Close the door, replace your keys and put your coat away. Repeat until your pet becomes comfortable.
4 You will now repeat everything you have previously done, but now you will actually step out of the house (but don't close the door). You will then re-enter the house and reverse your actions. Do this until your pet is comfortable.
5 Then further the process by actually closing the door for a few seconds or so. Re-enter the house, reverse your actions and repeat until your pet accepts these actions also.
6 The final steps in the process involve closing the door and leaving the house for longer periods of time. Once you are able to leave the house for an hour and a half or so, you should be able to leave your pet alone for a work day. (Make sure that you put your favorite shoes in a secure spot - now is not the time to tempt him.)
Take it slowly. Be consistent. The steps detailed above are a guideline. The actual formula that you use should include pieces of your personal getting-ready-to-leave routine. The idea is to teach your pet that there is no cause to worry. Your pet will soon learn that his human pack members have not disappeared off the face of the earth.
In very extreme cases, there are medications that may help; but, they should be only used as a last resort, and only in combination with desensitization training. To use them alone would doom your pet to a lifetime of medication while ignoring the actual root of the separation anxiety problem. Your vet can prescribe medications such as clomipramine (Clomicalm), fluoxetine (Prozac), or buspirone (Buspar) for a cat or dog who is clearly suffering from the effects of separation anxiety. These medications have been used successfully for separation anxiety in pets and are readily available for use.
Research has shown that pets will often display anxious behavior soon after the departure of owners. Experts believe that occupying a pet during the crucial twenty to thirty minute period after initially being left alone will alleviate any undesirable behavior resulting from boredom, loneliness or separation anxiety. Some dog owners have had success with a "kong". A kong is a hollow rubber toy into which the owner slathers peanut butter, cheese or soft dog food. The theory is that the dog will be so occupied with the yummy kong or bone treat that he or she will not even notice that his master has disappeared. And by the time he or she does notice, the period during which separation anxiety often occurs will have passed. Kongs have been known to work great for some pet owners. Others have discovered that the kong is still full of peanut butter when they come home and pets have instead opted to devour other significant household items. Generally, this is the sign of a dog that is not anxious, but is instead bored and/or lonely.
Providing your cat and dog with appropriate playthings can ensure comfort and entertainment when you are not at home. Make sure that your pet has plenty of bones, a kong, or balls, and offer your cat a catnip mouse and balls with bells inside. Additionally, know that a sleeping pet is a well-behaved pet. It's difficult to cause trouble when tired. Therefore, make sure that your pet gets sufficient exercise. Take walks regularly and allow your dog to interact with other canines. The purchase of a laser light can provide hours of exercise and fun for your cat. Cats love to chase a dot on the wall, and this amusing exercise will keep him fit and out of trouble.
Changing the environment of your pet may also make him feel more secure. Your dog knows that you turn off the television or radio when you leave; so change it up a bit. Dog owners have had some success with leaving the television or radio on while they are gone. For pets, environmental noise is something that occurs only when you are home, and. therefore, alleviates the anxiety that occurs when he thinks you are not in the vicinity. Providing visual or audio stimulation is very successful. Providing a window perch where a cat can observe birds that fly by the house is an example, or you can take advantage of videotapes or DVD's that show birds.
Unlike dogs, when cats misbehave, you cannot march him off to obedience class. Correcting unacceptable feline behavior can be significantly different than correcting canine behavior patterns. A bored or lonely cat may display many of the same behaviors as a cat suffering from separation anxiety. Yelling at him usually generates little response. Inappropriate urination is a very common reaction for cats and can be eliminated using a combination of patience and ingenuity.
For a cat that insists that he must urinate on your clothing or bedroom floor, you must first make sure that there is a litter box nearby. Cats tend to make the decision as to where they want their box located. If your cat is using your laundry hamper as a litter box, try placing his box near the hamper. Gradually move the box to the location comfortable to you. Make sure that the box is filled with the litter that your cat prefers. Cats can be quite finicky about what they put their feet into. Generally, cats prefer clumping litter to clay. Additionally, make sure that the litter is kept clean. By clean, the litter must be clean according to your cat's standards, not yours. Cats are fastidious animals and the difference between a box that has recently been urinated in and a box that is freshly scooped may well be the difference for success.
There certainly are options for pet owners to rid both their canine and feline companions of undesirable behavior. Changing behaviors in both cats and dogs takes patience, planning and lots of rewards. The trick is to make the offensive behavior unpleasant for your dog or cat. Doing so will make both the pets, and their owners, happier and far more comfortable.
In the final analysis, while most pets do not suffer from separation anxiety, all pets suffer from boredom and loneliness. It is a fact. The question becomes how to reverse this perpetual condition. It is an inescapable reality that pets, especially indoor pets, are alone with little stimulation for 10 to 12 hours at a time. There are alternative and creative ways to combat this syndrome. A pet that is hampered with boredom may become restless and destructive. A pet that is lonely has a greater chance of suffering from depression.
With the prevalence of technology today, it is economically possible to engage and befriend your pet during the day, while you are away. Take the time and effort to research those ways that will brighten and liven the days of your pet. Doing so will not only demonstrate that you care, but bolster the health and happiness of your pet. This in turn will only benefit you as a pet owner. You will get more satisfaction of having a healthier and happier pet. You will have peace of mind and reduce sense of guilt of not completely abandoning your pet.
Fibromyalgia has many symptoms but some of the most difficult for those with this illness are pain, stiffness of the joints, difficulty in concentrating and for many, depression. It is a debilitating illness and the current treatments include painkillers, anti-inflammatory drugs and graded exercise. But for many sufferers medication can actually make their symptoms worse and not better.
If you suffer from Fibromyalgia would taking an Omega 3 fish oil help to relieve some of these symptoms and generally help you feel better on a day to day basis? Research into the health benefits of Omega 3 in treating Fibromyalgia would seem to say yes, and anecdotal reports from Fibromyalgia patients confirms that this supplement helps them to feel better.
Omega 3 fish oil has been used for some time in the treatment of arthritis. It relieves pain in the joints and reduces stiffness. Many Fibromyalgia suffers find that a regular daily dose works well, making the trademark early morning stiffness less severe and reducing the general pain from which they suffer.
The beneficial effects of fish oil on improving concentration are well documented. The production of every cell in the body needs Omega 3 including the brain. Tests show that the correct levels of EPA (eicospentaenoic acid) which is found in large amounts in Omega 3 fish oil improves concentration in both children and adults.
While it would be ideal to have sufficient Omega 3 in our diet it would involve eating huge portions of fish and this not really practical. Also, because of pollutants in the oceans of the world, many fish contain heavy metals i.e. mercury, that are certainly detrimental to our health. Thus, to get a sufficient amount each day, a dietary supplement is the easiest option for many.
This supplement has also been shown to be effective in the reduction of depression, which many with Fibromyalgia also suffer. In trials where subjects in one group were given 1 gm of Fluoxetine, a regularly prescribed antidepressant, and the other given 1 gm of EPA, the fish oil was found to be just as effective as the drug. Even better, it can still be taken even if you are taking prescribed antidepressants. Thus, there is no dilemma arising from taking natural supplements versus prescribed medicine.
While many with Fibromyalgia find that some prescribed medicines make their symptoms worse and many more suffer from symptoms similar to IBS (irritable bowel syndrome), fish oil does not seem to have any adverse effects on them. So the evidence suggests that taking Omega 3 fish oil would be beneficial to sufferers of Fibromyalgia.