Easy Questions?

[Griffin NoName]

Possibly I failed to give a vital clue.

The side that I get migraines never gets the cold. The side that gets the cold never gets the migraine.

Chatty wins this round !

[Aggie]

http://en.wikipedia.org/wiki/Nasal_cycle

Even under normal conditions, one nostril tends to be blocked up.  I think one notices it more with a cold since the blockage is complete.

[Griffin NoName]

Fantastic Aggie. Thanks.

[Swatopluk]

Why is it more difficult to swallow pills with warm liquid than cold?

[Griffin NoName]

Because they start breaking down faster in warm liquid?

[Sibling Zono (anon1mat0)]

I noticed that the tongue tends to go back while sipping a hot beverage but I don't know the cause.

Wild, uninformed and baseless speculation: to prevent us from choking with our own blood. I noticed that the reaction is more marked when the stitches from my tonsillectomy came loose.

[Griffin NoName]

Why do they have standard doses for drugs?

Isn't giving a 6' 4" 15 stone man the same dose as a 4' 8" size 0 woman a bit bizarre ?

I am thinking in terms of bad reactions, ie. severe adverse reactions, rather than the killing the bugs aspect. And I am excluding drugs that are given by weight like chemotherapy.

[Sibling Chatty]

Theoretically, a physician is supposed to modify the dose by the size of the patient.

Of course, in THEORY, doctors are all competent and caring...

I wist I could live in Theory. Everything works there.

[Swatopluk]

Experience shows that giving patients not prepackaged doses but e.g. loose powder too often leads to accidents because people are too stupid to get the prescription dose right by themselves (and who has a precision balance at home anyway?). Even "Take one in the morning before breakfast , 2 at noon before lunch and 1.5 before going to sleep not eating anything afterwards" is too complicated for many*. Even the package insert is often far from precise these days. I remember older ones that gave instructions like "15 minutes before the next meal and at least 2 hours after the last. Keep a distance from drug XYZ of at least 1.5 hours or there could be bad mutual influnece". Newer ones drop all the numbers and I am clueless (especially about the ones that should work on the stomach, so a distance to the meal makes eimmediate sense).

*For liquid stuff dosing should be easier, if people were able to count to 20 or being able to tell a tea- from a table-spoon.

[Griffin NoName]

So like cars, amongst other discriminations, woman (and others) have been subjected to one size fits all (men) !

I wonder what my life would have been like with correct doses? And would the list of drugs I cannot take be empty?

And pre-packaged doses for S, M and L would not be too difficult - it might even be a revenue spinner for big Pharma.

My favourite package insert "keep out of the light" - it smacks of evil and secrecy. My chemo had to wear a little jacket during delivery into my veins so no one could see it.

Chatty, can I join you in theory?

[Swatopluk]

The antihypertensives the whole family takes are splittable into 3 parts and other drugs are of the "take x of these according to presription". My mother had once a type she had to take 20(!) each time (large pillbox for that). No problem to fine-tune the intake there .

[beagle]

As Swato says, getting people (especially old people) to take the right drugs in the right doses at the right times is notoriously difficult. For things like lowering blood pressure do you set the dose right for maximum effect, or do you set it so taking two by accident won't kill them?

To get the ideal dose you should probably weigh the same as the rat or beagle they tested it on, but their lives are not to be envied in other respects.

[Sibling Chatty]

I love the dosages that are age and gender balanced, not realizing that a 55 year old X00 pound woman with extensive liver tumors is NOT a typical 55 year old woman.

Forget size. My liver's half non-functioning...

I love my new baby doctor-child (I'm old enough to be his mother, he's a child) who got a computer program that allows you to input all the variables and assess dosages that way. (It's in beta, it's not anywhere near perfect and the five pharmacy professors that wrote it will get an inquiry and call him [real time] for more specifics).

The 'keep from heat and light' ones are the ones I love. If I'm going anywhere and will be gone more than 24 hours, I have to carry an insulated lunch carrier with an ice pack and my spare octreotide. Theoretically, I'm OK for longer, but if I need a massive amount for some reason, this way I have it.

[Aggie]

Sounds like there's a need for custom compounding of pills, combined with time-and-day marked blister-packs (the latter does exist) - i.e. real pharmacies rather than fast-food style pill dispensaries.

Standard practice in Eastern traditional medicine BTW (everything is tailored specific to the patient's overall health, not the symptoms), although the bulk of the materials used do tend to result in a dose being a packet of what appears to be miniature rabbit dung, by the dozen. 

[Griffin NoName]

...........take the right drugs in the right doses at the right times is notoriously difficult.....

I think that's a separate argument.    along the lines of two wrongs don't make a right, although I've never really believed this can ALWAYS be true

.....time-and-day marked blister-packs (the latter does exist)

An EU moan (to cheer Beagle up): increasingly my pills come with the days of the week in more and more obscure languages ! Gone are the days when I can just pop a pill. I need a pile of dictionaries and a diary nowadays, and I still end up confused.