Saturday, January 29, 2011

Does Metformin Hydrochloride contain Harmful Side Effects?

While I was cleaning up my room from piles of scrap paper, I chanced upon old news clippings by my Dad. One was about a diabetes drug that has a potential to kill. I remembered Dad discussed it with me before. I could not determine the newspaper where Dad had cut the clippings and when it was written except that the article was from Chicago.

This is an image of metformin tablet.
It is said to potentially cause lactic
acidosis, which could be fatal if the
patient has heart or kidney disease.
Otherwise, it is safe and effective.

The article was about a research study made that time regarding diabetic patients with kidney or heart failure being inappropriately prescribed with a drug (which is metformin) that could potentially kill them.

According to the article, “metformin could cause a rare side effect called lactic acidosis, a build up of lactic acid in the blood that is fatal in about 50% of cases. Patients with heart disease or kidney failure are especially prone”.

In fact, the article said that the drug package insert contains a black-box warning- required by the US government for drugs with potentially serious side effects- and said that it should not be used by patients with kidney disease or on drug treatment for heart failure.

Although, in their study, none of the 100 patients developed lactic acidosis however, the study “may underestimate the frequency of contraindications and it is difficult to determine whether clinicians are aware they are prescribing metformin against a black-box warning,” the researchers said.

Cheryl Holden, lead researcher said, “the problem isn’t unique to the University of North Carolina Chapel Hill hospital pharmacy where the study was done”. The University of Pittsburgh researchers and European studies found the same rate of inappropriate use according to the article.

Metformin helps the body use insulin and control blood glucose levels. Holden, emphasized though that patients should not stop taking the medicine without consulting their doctors.

This should remind people not to self-medicate. Never take drugs without consulting a licensed physician first because there are drugs that may cause adverse side effects and could aggravate a patient’s condition if inappropriately taken. Metformin poses no serious danger if the patient has no heart or kidney problem.

When I learned about this article, I wanted to discuss the matter with Mom’s doctor especially after I observed that Mom’s condition seemed deteriorating. Mom had been suffering from a heart disease and I thought that metformin could be causing more trouble. However, I didn’t get a chance to talk to her doctor about it.

In her next check up, I observed however, that her doctor replaced metformin with gliclazide. Noticeably, after that second check up, Mom’s condition improved remarkably. It would be presumptuous to conclude that metformin was the culprit but it was the only difference in the prescription.

Mom still has episodes of moderate to high to very high blood pressure. She would have hypertension attack whenever she would get tired or under stress. It is important to note that treatment of hypertension goes beyond medicines. Important factors are diet, exercise and a happy environment.

Image above courtesy of:

What is Hypertensive Heart Disease?

In 1997, Mom had to undergo a cataract operation but before it proceeded, she had to get a clearance from a cardiologist. After a thorough check up by her physician, Dr. Anthony Leachon, he found out that Mom had Hypertensive Heart Disease and Type II Diabetes Mellitus.

We had no idea that she already had a heart ailment that time because she did not feel or show any symptom.  We did not know that her blood pressure was hitting 220/110 mmHg already. Her operation was a blessing in disguise. If not by it, she would not have gone to a doctor.

According to medical specialists, hypertensive heart disease pertains to heart problems that occur because of high blood pressure like coronary artery disease or chronic heart failure. These are complications that arise from arterial hypertension that affects the heart. Symptoms may vary from feeling of fatigue or weakness, irregular pulse, swelling of feet or bloating, weight gain, shortness of breath, more frequent urination at night and enlargement of the heart.

After, a month or two of treatment, her heart condition improved and her diabetes was controlled so her doctor gave a clearance for her operation. However, after her operation, she did not come back to her cardiologist for check up. For one, she felt she was cured and second, Dr. Leachon’s clinic was too far from where we live.

Perhaps, because we were not able to monitor her condition, by 2002, the disease recurred. She started to feel chest pain and frequent urination especially at night. She went to a nearby hospital for check up. Her heart was not that bad but her diabetes was shooting up to more than 200 mg/dl, which was way above from the normal: 80-120 mg/dl.

Her doctor gave her Imidapril Hydrochloride for her hypertension and Metformin Hydrochloride and Glibenclamide to control her diabetes.

From then on, Mom had been under medical treatment. Her doctors had prescribed different types of medicine. Mom had been complaining about headache and chest pain associated with high blood pressure, and weakness. Recently, she went to an internist, Dr Jonathan Latonio. Her ECG showed signs of heart enlargement. Her doctor has prescribed candesartan, ameodarone, carvedilol, clopidogrel, isosorbide mononitrate and clonidine sublingually as needed.  The doctor retained metformin to control her diabetes.

Sources:

Image above courtesy of:

Thursday, January 27, 2011

Seven Habits of a Wise Saver

Saving is a virtue. Many people earn a lot but go on to spend them all or sometimes even more than what they get.  It teaches you to prioritize by analyzing what you need and set aside the wants that can wait. It involves disciplining yourself about spending within your means and sticking to the rule of frugality you’ve set for yourself.

It’s important to understand that we earn to grow and not just to spend. For us to grow we need to invest and we can finance our investment from our own savings. However, before we think about investing, we need to be clever about how we handle our savings first. We can opt to keep them in the bank first and let it grow before we invest it. There are universal banks and financial institutions like credit cooperatives or small thrift banks where we can deposit our savings. But before we make our choice, let’s be wised up with the Philippine Deposit Insurance Corporation’s campaign for safe and responsible banking with the “Seven Habits of a Wise Saver.”

1. Know your Bank
Know the owners of your bank- the people behind it and the people who manage it. Find out and ask about your bank’s finances and its strengths and weaknesses. PDIC, BSP, SEC and your bank’s websites, newspapers, magazines, television and radio will provide most of the information you need.

2. Know your Bank Products
Understand where you place your cash. Don’t confuse investments with regular deposits. Read and understand the fine print and don’t hesitate to clarify with bank personnel the terms and conditions that are not clear.

3. Know your Bank’s Services and Fees
Choose the right bank for you by knowing your needs and matching these with your bank’s services. Be aware of bank charges and fees.

4. Keep Your Bank Accounts Safe and Updated
Secure your passbook, ATM, certificate of time deposit (CTD), checkbook and other bank records at all times. Have your passbook and CTD’s updated every time you do a transaction. Inform your bank whenever there are changes in your contact details to avoid bank mails with sensitive information getting into the wrong hands.

5. Transact Only Inside the Bank with Authorized Bank Personnel
Do not hesitate to ask personnel to present an ID and always ask for proof of your transactions.

6. Be Informed about PDIC Deposit Insurance
PDIC guarantees deposits up to P500,000 per depositor. Investment products, fraudulent accounts, laundered money and deposit products from unsafe and unsound banking practices are not covered by insurance.

7. Be Cautious
Simply walk away from offers that are too good to be true. Generally, excessively high interest rates carry more risks. Please refer to the Bangko Sentral ng Pilipinas (Central Bank of the Philippines) Circular 640 for more information.

Source:
Be a Wise Saver: A PDIC Campaign for Safe and Responsible Banking

Philippine Deposit Insurance Corporation
4th-10th Floors, SSS Bldg., Ayala Avenue. Cor. V.A. Rufino St., Makati City
Tel: (632) 841-4000
Website: www.pdic.gov.ph

PDIC Depositors Assistance Bureau
4/F, SSS Bldg., Ayala Avenue. Cor. V.A. Rufino St., Makati City
Tel: (632) 841-4630/31


Image above courtesy of:

Ten Commandments for Senior Citizens

Our church’s Outreach Ministry gave a tribute to elders and disabled members recently. They treated us to the Manila Ocean Park, Kulturang Pinoy, and at the SM Mall of Asia. After the activity, they gave the each elder a copy of “Ten Commandments for Senior Citizens”.

I thought of sharing it here on my blog for senior citizens who might be able to drop by this blog and for the children who might be taking care of their aging parents or relatives. It could help them understand aging better.

However, the following are just opinions of its author (whom the copy where I have taken it has not revealed). You might not agree with all of it and I don’t write it as gospel truth but I believe that we can benefit from analyzing and reflecting on its practical ideas.   

Here it is:

1.       Face and accept the reality of getting old, its consequences and the limitations, which growing old brings. Act and behave your age. Quit fooling yourself by trying to look like you were in your youth.
2.       Focus on enjoying people, not on indulging in or accumulating material things.
3.       Plan to spend what you have saved, you deserve to enjoy the few healthy years you have left. Travel if you can afford it. Don’t leave anything for your children or loved ones to quarrel about. By leaving anything, you may even cause more trouble when you are gone.
4.       Live in the here and now, not in the yesterdays and tomorrows. It is only today that you can handle. Yesterday is gone, tomorrow may not even happen.
5.       Enjoy your grandchildren (if you are blessed with any) but don’t be their full time baby-sitter. You have no moral obligation to take care of them. Don’t have any guilt about refusing to baby sit anyone’s kid, including your own grandkids. You parental obligation is to your children. After you have raised them into responsible adults, your duties of child-rearing and babysitting ends. Let your children raise their own offspring.
6.       Accept physical weakness, sickness and other physical pains. It is a part of the aging process. Enjoy whatever your health can allow.
7.       Enjoy what you are and what you have right now. Stop working hard for what you do not have. If you do not have them, it’s probably too late.
8.       Just enjoy your life with your spouse, children, grandchildren, and friends. People who truly love you for who you are and not what you have. Anyone who loves you for what you have will only give you misery.
9.       Forgive and accept forgiveness. Forgive yourself and others. Enjoy peace of mind and soul.
10.    Befriend death. It’s a natural part of the cycle of life. Don’t be afraid of it. Death is the beginning of a new and better life. So, prepare yourself not for death but for a new life.

If I may add one more,

11.    Spend the rest of your days serving the Lord, your God. Delight yourself in God and He will give you the desires of your heart.
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