Archive for the ‘Different Medications’ Category

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”


October is Breast Cancer Awareness Month. Although breast cancer is only one of many cancers, I am pleased of the exposure that the many “pink” ribbon brings. It gives me hope that other cancers can have a similar banner of awareness…in the near future. Despite our many progress and technological advances in medicine, cancer remains the second leading cause of death in the United States. For example, Breast Cancer has over 220,000 new diagnosis annually, and over 400,000 deaths each year. Many are surviving a longer time thank in the past.

  • Overall, cancer has taken on a more “chronic” long term debilitating effect, for those who survive initial treatment and are then diagnosed with recurrence/metastatic disease.
  • One the most feared symptom in this category of patients is pain. Overall, 50% to 70% of people with cancer experience some degree of pain, which usually intensifies as the disease progresses.
  • Less than 50% of these patients receive adequate relief of their pain, either because they are afraid to ask because they fear “addiction”, or physicians are unlikely to prescribe adequate medication to attain relief that will allow the patient continued good quality of life.
  • Suboptimal pain control can be debilitating and caregivers are often times unsure how to address this issue.

pm_general_cp_pain_approachThe World Health Organization program for cancer pain control recognizes that 1 in 5 patients with cancer has uncontrolled pain and has a ‘three-step ladder’ for the rational use of analgesics including morphine (recommended adaption to 4-step-ladder – see HERE).

Analgesic pain 4Morphine has long been the ‘gold standard’ for the treatment of severe cancer pain. However, its side-effects, particularly sedation/drowsiness, and cognitive impairment have led to ‘opioid rotation’ to alternatives such as methadone and hydromorphone. The one I like to use most in uncontrolled pain situation is the 72-h transdermal patch for Fentanyl, which offers advantages of reduced side-effects and increased convenience over oral morphine. Another novel pain medication is Intravenous (IV) strontium-89 and bisphosphonate therapy which are effective for both short- and long-term control of metastatic bone pain.

Pain Management Physician Review

Patient Discusses Pain


Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…


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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”


Have a headache? Grab some Motrin (Ibuprofen).

Knee pain? Use some Tylenol (Acetaminophen)

Headache persists? Take more Tylenol? Hip now hurting too. Can you take more Motrin?

Having pain medications available over-the-counter (OTC) is a good thing. But too often, many are not aware of some of the necessary, basic, associated precautions.  Recently, while visiting my Dad, he jokingly noted the ever growing, long list of “side-effects” spewed about medications in commercials.  Like most he wondered, “why take the medication, if the side effects seem to cause more harm?” But, that is for another blog *smile* Let’s tackle the pain medications that millions DO use daily! Let’s define NSAIDs and then we will start with Acetaminophen (Tylenol).


tylenol1Non-Steroidal Anti-inflammatory drugs (NSAIDs) are a group of OTC medications use to decrease mild-moderate pain, reduce fever, and decrease inflammation without the worrisome effect of steroids.  Ibuprofen (Advil, Motrin, Caldolor, Midol, etc.,), Naproxen (Aleve, Naprosyn, Anaprox, etc.,), Aspirin (Zorprin, Bayer aspirin, St. Joseph aspirin, etc.,), among others. Acetaminophen is NOT a NSAID.

  • The primary difference between NSAIDs and acetaminophen (Actamin, Pandadol, Tylenol) lies in the way each relieves pain. Acetaminophen works primarily in the brain to block pain messages and seems to influence the parts of the brain that help reduce fever. That means it can help relieve headaches and minor pains. But it’s not as effective against pain associated with inflammation.
  • Inflammation is a common feature of many chronic conditions and injuries. NSAIDs reduce the level of chemicals that are involved in inflammation. Treatment with NSAIDs can lead to less swelling and less pain.
  • Some pain pills, such as Excedrin Migraine, combine an NSAID — in this case aspirin – with acetaminophen


Acetaminophen (Tylenol) overdose is one of the most common poisoning worldwide! Why? Because taking too much pain reliever can cause liver failure or even death! YES…sudden liver failure (see videos below).

The FDA has set the recommended maximum for adults at 4,000 milligram (mg) per day. It is quite easy to hit this max though!  One gel tablet of extra strength Tylenol, for example, contains 500mg. Do you ever take just ONE Tylenol though? My colleague just indicated that he never takes less than 3 extra-strength pills at a time! That’s 1500 mg at one time…do this 3 times in one day and will be above the max!

tylenolOverdoses from acetaminophen send 55,000 to 80,000 people in the U.S. to the emergency room each year and kill at least 500, according to the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).

Acetaminophen can be found in more than 600 over-the-counter and prescription products used by nearly one in four American adults every week, including household brands like Nyquil cold formula, Excedrin pain tablets, Theraflu and Sudafed sinus pills.

So how do these accidental acetaminophen deaths occur?

Imagine you’ve had major dental surgery, and your dentist prescribes a five-day supply of Percocet.

  • You take the recommended 2 pills every six hours for 2,600 mg of acetaminophen, well below the 4,000-mg-a-day safety threshold.
  • But you’re still experiencing pain, so you decide to add Extra Strength Tylenol, six caplets a day for another 3,000 milligrams.
  • Now you’re feeling better but you still have trouble sleeping, so you take Nyquil, for another 650 milligrams (unaware of the acetaminophen content of the other medications).

After a few days on this 6,250 milligram regimen, experts say acute liver damage is a real risk. Add a couple beers or wine to this…and, well, you get the picture! (Alcohol affects the liver also…)


  • Normal/Regular dose of Tylenol ~325mg
  • Extra-Strength 500mg to 650mg
  • MAX daily recommended dose 4,000mg

PLEASE continue to use Acetaminophen and Acetaminophen products, as needed. Just be aware of the dose limits and use wisely!

Now you know…




Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physicians Desk … Weekly Blog!


Medication mistakes is one of the leading causes of death in the United States…causing over 200,000 deaths, but could be higher as many go unreported. One-third of Americans take 5 or more medications and with the aging Baby Boomers population, some are taking 10 or more medications increasing the possibility for errors!

I cannot emphasize this enough…please pay attention to your prescription medications. Ask your doctor:

  1. What is the name of the medication? (spell it out and write it down!)
  2. What is the dose that you are giving me?
  3. How many time per day should I take it?


After initial pick up at the pharmacy, note the name spelling, color, shape and size. Always check your refills carefully and compare to previous prescriptions.

Take note and be careful…your life could depend on it!

Click video below to watch.

 FDA: Drug Info Rounds 


Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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