Tamoxifen Citrate
Indication:
This hormonal agent is used for the treatment of breast cancer.
Side effects:
Transient fall in the white blood cell or platelet counts, nausea, vomiting, loss of appetite, vaginal discharge, vaginal bleeding, weight gain, increased blood calcium, rash, temporary bone pain and hot flashes.
Interactions :
1. Using with antacids may decrease tamoxifen effect. Separate dosing by at least three hours.
2. Monitor FBC closely.
3. Using with oestrogens can decrease tamoxifen effect.
4. Using with famotidine, ranitidine, or cimetidine, can decrease tamoxifen effect.
5. Using with Warfarin can increase anticoagulant effect.
Dose:
Adults: oral, 10 or 20 mg once a day.
Lung biopsy
Lung biopsy involves removal of small piece of lung tissue to check for any conditions such as sarcoidosis, pulmonary fibrosis and lung cancer. It is essential to keep the physician informed if the patient is pregnant or taking medications such as warfarin or anticoagulants. Do not eat or drink for 8 to 10 hours before the lung biopsy. The secretions in the mouth and airways is dried up with some medications.
Needle lung biopsy is done with a long needle that is inserted through the chest wall. Ultrasound, fluoroscopy or CT scan are used to aid locating the abnormal lung tissue.
Open lung biopsy may need hospitalization for a couple of days. This procedure involves making an incision between the ribs to take a sample of lung tissue. This is preferred when a larger sample is required and is done under anesthesia. An endotracheal tube is passed through the airways to take a sample of lung tissue.
Bronchoscope lung biopsy is done in cases of suspected infection. The bronchoscope is inserted through the nose or mouth into the airways. This type of lung biopsy is used when abnormal tissue is near the breathing tubes.
VATS Video assisted thorascopic surgery involves use of thorasope to remove a sample of lung tissue.
Mediastinoscopy is conducted under general anesthesia. The mediastinoscope is inserted through an incision made between the lungs. Any abnormal tissues or lymph nodes are examined.
Cardiac Arrhythmia
Cardiac arrhythmia refers to a disturbance of the heart rhythm. When the regular heart rhythm is disturbed, it can lead to symptoms that can range from mild to life-threatening. The heart may have slower beats or there may be a blockage of the electrical pathway of the heart. One of the most common form of cardiac arrhythmia is atrial fibrillation. This occurs in older persons when the upper atrial chambers of the heart do not pump correctly. This can lead to blood clots. Heart failure or electrolyte imbalance can bring on cardiac arrhythmia.
Tachycardia is a condition where there is rapid heartbeat due to inefficiency in the blood circulation. Tachycardia is a condition where the heart rhythm is more than 100 beats/minute. This can happen due to stress, hyperthyroidism or alcohol. On the other hand, Bradycardia is a condition where the heart rhythm is less than 60 beats/min. A ventricular arrhythmia can be life-threatening. This happens when there is ventricular fibrillation. It is essential to treat this condition and restore the rhythm within minutes to prevent heart damage and death. Allergic reactions can trigger arrhythmias.
Some persons suffering from cardiac arrhythmia notice symptoms such as dizziness, fainting and lightheadedness. There may be a fluttering or pounding sensation in the chest. Antiarrhythmic agents such as amiodarone and sotalol are prescribed to maintain the normal rhythm of the heart. In cases of atrial fibrillation, warfarin is used to prevent blood clots. Medication for cardiac arrhythmia includes beta blockers such as metoprolol and atenolol to reduce the heart rhythm. An electronic cardiac pacemaker may be implanted to regulate the heart beat.
Bibliography / Reference
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