Tension Headache, Fioricet and Butalbital
Copyright 2005 David Altfeder
At our online pharmacy and many others, the most frequently prescribed medication is butalbital, the generic form of Fioricet. Patients are prescribed this medication for relief of tension headache. This article summarizes tension headache as well as butalbital to help patients make informed choices about their treatment.
Tension headache, also called "muscle contraction headache" or "stress headache" is a condition involving pain in the head, neck or scalp. It is typically a dull, achy feeling on both sides of the head, often associated with tightness of the muscles in the affected area. Tension headaches usually start in the middle of the day, typically building slowly and gradually. They can become quite severe, even more painful than a migraine headache. The pain may be worsened by noise or glare.
Tension headache is often the result of stress, anxiety or depression. It can also result from holding the head in a constant or awkward position for long times, for example when using a computer, typing or performing fine work using the hands. Other contributing factors may include excessive alcohol consumption, eyestrain, fatigue, excess caffeine, sinus infection and the flu.
Tension headache can be extremely uncomfortable and annoying, but is not dangerous. It is important to differentiate between tension headache and other conditions which result in head pain, however. If the pain is associated with vision changes, dizziness, nausea, vomiting, drowsiness, seizures or it does not respond to treatment, a physician should be consulted immediately.
While the mechanism behind tension headaches is not completely understood, there are a variety of treatments available with varying efficacy for patients. These include relaxation exercises, meditation, hot showers, biofeedback, a hot or cold pack placed on the point of pain, exercise and over the counter medication. Given the escalating nature of the headache, it is advisable to treat the pain as early as possible and prevent the pain from increasing in severity. For many patients, there is simply no substitute for Fioricet or butalbital. This medication is a combination of three ingredients (50 mg butalbital, 325 mg acetaminophen and 40 mg caffeine). For some reason, this combination of ingredients in this ratio of quantities is particularly effective in treating tension headache.
Butalbital is a barbiturate. It is responsible for relaxing the skeletal muscles in the head, neck and scalp. Acetaminophen is an analgesic (pain reliever) and antipyretic (fever reducer). Tylenol is acetaminophen. Caffeine is a central nervous stimulant found naturally in coffee. All the ingredients in Butalbital (Fioricet) are absorbed quickly. They are eliminated from the body in a variety of ways involving the liver and kidneys. It is interesting to note that while the caffeine and acetaminophen are eliminated from the body rather quickly (half of the drug is eliminated from the body in 3 hours), the butalbital component remains in the body much longer (half of the drug is eliminated in 35 hours).
While Fioricet and butalbital are safe medications, it is helpful to understand the precautions advised by the drug manufacturers when taking this medication. If you have a hypersensitivity to any of the components in butalbital, obviously you should consult a physician before taking the medication. Since the medication is cleared from the body by the kidneys and liver, any patient with impared liver or kidney function should consult a physician. The package insert for Fioricet also mentions that patients with porphyria should exercise the same caution, as should patients taking monoamine oxidase (MAO) inhibitors.
Fioricet and butalbital have other warnings as well. The medication can give patients a feeling of intoxication and euphoria, and may be habit forming.
Butalbital is a central nervous system depressant. This attribute accounts for the relaxation of skeletal muscle associated with tension headache, but it also carries the same risk as other CNS depressants. You should avoid driving or operating machinery when using this medication, as it can impair your mental and/or physical abilities. Alcohol can greatly strengthen the CNS depressant capability of the medication- avoid combining alcohol and butalbital.
Adverse reactions to butalbital and Fioricet include: drowsiness, dizziness, lightheadedness, sedation, shortness of breath, nausea, vomiting and abdominal pain. As with any medication, there have been a wide range of other rare adverse reactions reported.
In conclusion, Fioricet and butalbital are safe medications which are effective treatment for tension headaches. An educated patient is a safe patient, so it is important to understand the information in this article. If you do not understand the information in this article, or if you fall into any of the advisory categories, it is best to consult a physician before beginning treatment.
------
David Altfeder is the owner of http://www.deepdiscountpharmacy.net and http://www.buybutalbital.net . He is the author of a series of articles on health, pharmacology and medicine.
New Gene Tool May Unlock Root Causes of Disease
Copyright 2005 Daily News Central
Genetic researchers have made substantial advances in understanding the root causes of common diseases and the history of human evolution, according to a series of reports published in scientific journals this week.
Chief among these accomplishments is the work of an international consortium of more than 200 scientists from Canada, China, Japan, Nigeria, the United Kingdom and the United States published in the October 27 issue of the journal Nature.
The team studied DNA samples from four different parts of the world and concluded that genetic variants located physically close to each other are inherited collectively as groups, called haplotypes. The comprehensive catalog of all of these blocks is known as the "HapMap."
"Built upon the foundation laid by the human genome sequence, the HapMap is a powerful new tool for exploring the root causes of common diseases," says David Altshuler, MD, PhD, director of the program in Medical and Population Genetics at the Broad Institute of Harvard and MIT.
"Such understanding is required for researchers to develop new and much-needed approaches to understand the still-elusive root causes of common diseases, such as diabetes, bipolar disorder, cancer and many others," he adds.
Altshuler and Peter Donnelly, PhD, of the University of Oxford in England are the corresponding authors of the Nature paper.
Greatest Information in Most Efficient Manner
It has been known for a long time that diseases run in families, with perhaps half the risk of any given common disease explained by genetic differences inherited from one's parents. Inheritance also can play a role in different responses to a drug or to an environmental factor.
Because the underlying causes of these common diseases and therapeutic responses remain largely unknown -- and because knowing this information is necessary for successful development of new approaches to prevention, diagnosis and treatment -- identifying the genetic contributors to human health is a fundamental goal of biomedicine.
A new genomics-based approach to human genetics was proposed nearly a decade ago to catalog common human DNA sequence variations comprehensively and to test them systematically for their association to disease in human populations.
Although it is theoretically possible to capture all of this information by sequencing every individual human genome, this is neither technically nor financially feasible.
"The data from the HapMap project allows scientists to select the particular DNA variants that provide the greatest information in the most efficient manner, lowering the costs and increasing the power of genetic research to identify the origin of disease," says Mark Daly, an associate member of the Broad Institute of Harvard and MIT. Daly led the Boston team's statistical and analytical work, and was a member of the writing group for the Nature paper.
Millions of SNPs a Day
Moreover, the HapMap project helped spur a remarkable advance in the technology for testing genetic variations in DNA, making it possible to undertake comprehensive studies in large patient samples.
A single nucleotide polymorphism, or SNP (pronounced "snip"), is a small genetic change, or variation, that can occur within a person's DNA sequence.
"When we started doing this work a number of years ago, determining the genotype of a SNP in a patient cost nearly a dollar, and we could do hundreds a day," notes Stacey Gabriel, director of the Broad Institute's Genetic Analysis platform and an author of the Nature paper.
"Today the prices have dropped in many cases to a fraction of a penny per genotype, and we can do millions a day," Gabriel notes. "This is the difference between not being able to do the studies, and getting them done rapidly and well."
Tag SNPs
The HapMap provides excellent power to capture most human variation and link it to disease or other traits, according to a related paper published in the November issue of Nature Genetics.
Paul de Bakker, Roman Yalensky and their colleagues demonstrated this finding by developing and evaluating methods to select "tag SNPs" that capture the genetic variation in each neighborhood with a minimum amount of work.
Using these tags, scientists can compare the SNP patterns of people affected by a disease with those unaffected far more efficiently than previously has been possible.
"Compared to directly genotyping all common SNPs in the genome in all individuals of a disease study, we observe that selected tag SNPs based on HapMap can save genotyping costs by almost an order of magnitude without losing much power to detect a true association," says de Bakker, a postdoctoral fellow in Altshuler and Daly's group at the Broad Institute.
The widely used tool for tag SNP selection was developed by de Bakker and colleagues.
Previous Computer Models Too Simplistic
Another important observation revealed by the availability of the HapMap data is that previous computer models of human genetics are too simplistic and can lead to false conclusions about the role of genes or genetic loci in different diseases.
Stephen Schaffner, Altshuler and their colleagues at the Broad Institute describe the limitations of these prior models in a paper published in the November issue of Genome Research. They also provide the entire scientific community with updated models that more closely approximate reality, based on the empirical data generated by the HapMap Consortium.
"Better computer models can be valuable tools in understanding the nature of human DNA variation, past changes in human populations size, and evolutionary selection," says Schaffner, a computational biologist in Broad's program in Medical and Population Genetics.
Candidates for Natural Selection
The public availability of HapMap's genome-wide variation data set also makes it possible for scientists to make systematic examinations of potential natural selection sites in the human genome, as well as to re-evaluate previous claims for such selection.
Pardis Sabeti, Eric Lander and their colleagues at the Broad Institute, together with Stephen O'Brien and his colleagues at the National Cancer Institute, used the HapMap data to examine a prominent reported case of natural selection related to HIV infection.
A genetic variation in a T-cell receptor called CCR5-?32, which confers strong resistance to infection by HIV and has been implicated in resistance to the bubonic plague, did not arise recently in the human population, they report in the November issue of PLoS Biology.
"With the benefit of greater genotyping and empirical comparisons from the HapMap, we were able to show that the pattern of genetic variation seen at CCR5-?32 does not stand out as exceptional relative to other loci across the genome and is consistent with neutral evolution," says Sabeti, a postdoctoral fellow at the Broad Institute.
"In fact, the CCR5-?32 allele is likely to have arisen more than 5,000 years ago, rather than during the last 1,000 years as was previously thought," Sabeti adds.
In addition to allowing the re-examination of previous claims of selection, the HapMap data give scientists a new way to identify novel candidates for natural selection.
Attainment of Goal
The successful completion of the HapMap has its roots not only in the completion of the human genome sequence in 2001, but also in the massive effort to characterize and catalog the millions of SNPs across the genome.
Based on these initial data, the haplotype structure of the human genome was recognized as early as 2001, leading directly to the formation of the International HapMap Consortium. Finally, methods for identifying the influence of natural selection on the human genome were described in 2003.
Altshuler, Lander, Gabriel, Daly and many other Broad Institute scientists led or contributed significantly to all of these efforts, in addition to their role in the completion of the HapMap and demonstrations of its utility, as outlined above.
In October 2002, the International HapMap Consortium set the ambitious goal of creating the HapMap within three years. The Nature paper marks the attainment of that goal with its detailed description of the Phase I HapMap, consisting of more than 1 million SNPs.
The consortium also is nearing completion of the Phase II HapMap, which will contain nearly three times more SNPs than the initial version and will enable researchers to focus their gene searches even more precisely on specific regions of the genome.
In line with the Broad Institute's commitment to building critical resources for the scientific community, HapMap data are freely available in several public databases, including the HapMap Data Coordination Center (http://www.hapmap.org) the NIH-funded National Center for Biotechnology Information's dbSNP (http://www.ncbi.nlm.nih.gov/SNP/index.html) and the JSNP Database (http://snp.ims.u-tokyo.ac.jp) in Japan.
------
Rita Jenkins is a health journalist for Daily News Central, an online publication that delivers breaking news and reliable health information to consumers, healthcare providers and industry professionals: http://www.dailynewscentral.com
How to Master the Top 5 Challenges to Breathing in Freestyle
The most common question I hear in the triathlete world about the mysteries of swimming efficiently usually involves something with breathing. In freestyle, it is the first step to get your body position right. Then, for many, you throw in breathing and everything goes haywire! This has to do with lack of balance, using your head instead of your core to breath, and a few other factors.
Here are the top 5 challenges in learning how to breathe in freestyle, along with the remedies on how to get over these:
1. Not Getting Enough Air. There are a couple of reasons this typically happens in freestyle. First, make sure you breathe out all of your air before you rotate to take a breath. When learning, some people try to exhale and inhale while they are rolling to the side for air. There simply is not enough time for this! Your exhalations should only be in the water in the form of bubbles. At first the timing may seem difficult, but eventually you will get used to it. Second, you may be sinking as you breathe. Make sure you are rolling to the side to breathe, and not rotating your head and looking straight up. Practicing the side kicking and shark fin drills, as discussed in The Complete Guide and in the introductory 4-session online clinic you get by signing up for the Tri Swim Coach newsletter will also help you with this challenge.
2. Extended Arm Sinks While Taking a Breath. This is mainly a balance issue. While you breathe to one side, your other arm should be extending. For many swimmers, this extended arm pushes down into the water (elbow drops) and they are sinking while trying to inhale. The side kicking and shark fin drills will also help to improve this. Another drill also discussed in the materials that will help with this challenge is the fist drill, which forces you to not use your hands, therefore improves your balance in the water.
3. Speed is Sacrificed because of a "Pause" While Breathing. A typical scenario is that you feel like you're cruising along just fine and then you take a breath and it feels like you've just lost all your momentum. To remedy this, when you breathe, concentrate first on breathing to the side (as in #1), then on having your mouth parallel to the water, instead of over the water. The latter will take a while to master, but once you do, it will take care of the pause, and improve your speed overall.
4. Difficulty breathing while navigating in a race. You need to look up to see where you are going, and at the same time grab a breath. How can you do both? Start with bilateral breathing (breathing on both sides every 3 strokes). This will help you to see about where you are without lifting your head up as much. When you need to lift your head up to sight, try not to look straight ahead- this will make your hips sink and throw you off balance. Instead, take a quick peek at your target, roll to the side to breath, and bring your head right back down into position.
5. Sucking In Water While Taking a Breath. In practice, this will sometimes occur because of #1 and #2 above. In a race, the waves may cause the inhalation of water instead of air (bilateral breathing will help here as well). The drills to practice to improve balance and avoid this unpleasant occurrence are the side kicking and shark fin drills, as well as the one-arm drill. To perform the one-arm drill, swim a full stroke with one arm while your other arm rests at your side. Breathe on the opposite side of the stroking arm. This is a difficult drill and takes some practice, but it will pay off! For more and to view this and other drills, see the Full Package from Tri Swim Coach.
About The Author:
