In the beginning, 21 years ago, it was Codene Cocktails. That's some pretty WoW stuff!!
Ibuprofin does the trick most of the time but Celebrex does it when Ibu doesn't.
The heating pad does well because it loosens the muscles that have contracted during the night. I can actually turn a warmed electric blanket cold because of not much circulation. I can often turn the pain in my feet off or low by sitting with a heating pad on my lap for awhile. When either cold dampnedd from outside or a dojo floor get to me, I'm done for several days at the time with no relief.
Asprin can be a good tool for healing. Yes it thins the blood, the effect the surgeon who reattached a severed finger on my left hand strived for. To him it was more important than important to live on asprin for something like six weeks.
Anti-inflammatory substances
Moderator: Available
Brett: a knee locking is classically the sign of a meniscal (little separate pad of cartilage between the bones of the joint which themselves are ccovered in cartilage) tear. The flap gets caught and the sensation triggers the knee to freeze, and if it's annoying enough, those doctors you should see might offer to scope the knee and trim it. However if this is something that happens at night and not related to a certain activity I wonder if you mean it just really hurts or swells or something. Then we're talking something else.
I wonder if the new cox2 inhibitors are prescription because of the cardiac warnings for some (not all) or because it makes more money for drug companies. I'm sure at least some of it is the former but I'm ever the cynic. Ever wonder why those nonsedating antihistamines are prescription? The drug companies have to walk a fine line being touting their safety and coming up with reasons they have to remain in the more profitable prescription class.
I wonder if the new cox2 inhibitors are prescription because of the cardiac warnings for some (not all) or because it makes more money for drug companies. I'm sure at least some of it is the former but I'm ever the cynic. Ever wonder why those nonsedating antihistamines are prescription? The drug companies have to walk a fine line being touting their safety and coming up with reasons they have to remain in the more profitable prescription class.
--Ian
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Ian
Like most NSAIDS (ibuprofen, naproxen), Celebrex and Vioxx start as prescription and go OTC with years of experience. Ibuprofen used to be the magic, prescription medication Motrin, for women with menstrual pain and athletes with injuries. Now it's 0ver The Counter (OTC), cheap due to competition (Advil, Nuprin, etc.), and yesterday's medicine from the view of the pharmaceutical company. Need to come up with something new to begin as prescription because: 1) the profits are there, 2) patients want prescription meds that their insurance companies will pay for, and 3) doctors can start people on free samples from all those tall, good looking, (fe)male drug reps that flash their booties in and out of the office and leave lunch.
As it turns out, folks didn't know about the cardiac complications until well into the use of the drug after FDA approval. The jury is still out on all the other possible side effects and complications. So...it IS good that meds start out as prescription; that's for the benefit of the patient. But...there is the $$$ factor there too.
Know what the company that makes Claritin did when the patent ran out? They created Clarinex - the metabolic byproduct of Claritin in the body. It's the SAME DAMNED MEDICINE, only it's prescription again... You can get Claritin OTC now, but patients want the Clarinex because insurance pays for it.
So...you may remain the cynic, Ian. Keep it up! The drug companies need to get away from these activities that make money but don't benefit medicine or mankind. The world isn't really a better place (in the net) with Celebrex and Clarinex.
Time for some new ideas and new cures. Patients need value for their healthcare dollars.
Off of soapbox.
- Bill
Like most NSAIDS (ibuprofen, naproxen), Celebrex and Vioxx start as prescription and go OTC with years of experience. Ibuprofen used to be the magic, prescription medication Motrin, for women with menstrual pain and athletes with injuries. Now it's 0ver The Counter (OTC), cheap due to competition (Advil, Nuprin, etc.), and yesterday's medicine from the view of the pharmaceutical company. Need to come up with something new to begin as prescription because: 1) the profits are there, 2) patients want prescription meds that their insurance companies will pay for, and 3) doctors can start people on free samples from all those tall, good looking, (fe)male drug reps that flash their booties in and out of the office and leave lunch.
As it turns out, folks didn't know about the cardiac complications until well into the use of the drug after FDA approval. The jury is still out on all the other possible side effects and complications. So...it IS good that meds start out as prescription; that's for the benefit of the patient. But...there is the $$$ factor there too.
Know what the company that makes Claritin did when the patent ran out? They created Clarinex - the metabolic byproduct of Claritin in the body. It's the SAME DAMNED MEDICINE, only it's prescription again... You can get Claritin OTC now, but patients want the Clarinex because insurance pays for it.
So...you may remain the cynic, Ian. Keep it up! The drug companies need to get away from these activities that make money but don't benefit medicine or mankind. The world isn't really a better place (in the net) with Celebrex and Clarinex.
Time for some new ideas and new cures. Patients need value for their healthcare dollars.
Off of soapbox.
- Bill
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RACastanet
- Posts: 3744
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA
First... What are the cardiac concerns of Celebrex????
#2... The cost of research is so high and the profitable life so (reletively) short the drug companies need cash to keep on creating the truly new wonder drug breakthroughs. So, high prices keep the wheels turning. When I was a young lad (1950s), our family doctor carried most of the period's wonder drugs in his small bag. Not even a Motrin in there.
This, of course, is the viewpoint of a predatory capitalist!
Regards, Rich
#2... The cost of research is so high and the profitable life so (reletively) short the drug companies need cash to keep on creating the truly new wonder drug breakthroughs. So, high prices keep the wheels turning. When I was a young lad (1950s), our family doctor carried most of the period's wonder drugs in his small bag. Not even a Motrin in there.
This, of course, is the viewpoint of a predatory capitalist!
Regards, Rich
Member of the world's premier gun club, the USMC!
Risk of cardiovascular events associated with selective COX-2 inhibitors.
JAMA. 2001 Aug 22-29;286(8):954-9. Review.
Mukherjee D, Nissen SE, Topol EJ.
Atherosclerosis is a process with inflammatory features and selective cyclooxygenase 2 (COX-2) inhibitors may potentially have antiatherogenic effects by virtue of inhibiting inflammation. However, by decreasing vasodilatory and antiaggregatory prostacyclin production, COX-2 antagonists may lead to increased prothrombotic activity. To define the cardiovascular effects of COX-2 inhibitors when used for arthritis and musculoskeletal pain in patients without coronary artery disease, we performed a MEDLINE search to identify all English-language articles on use of COX-2 inhibitors published between 1998 and February 2001. We also reviewed relevant submissions to the US Food and Drug Administration by pharmaceutical companies. Our search yielded 2 major randomized trials, the Vioxx Gastrointestinal Outcomes Research Study (VIGOR; 8076 patients) and the Celecoxib Long-term Arthritis Safety Study (CLASS; 8059 patients), as well as 2 smaller trials with approximately 1000 patients each. The results from VIGOR showed that the relative risk of developing a confirmed adjudicated thrombotic cardiovascular event (myocardial infarction, unstable angina, cardiac thrombus, resuscitated cardiac arrest, sudden or unexplained death, ischemic stroke, and transient ischemic attacks) with rofecoxib treatment compared with naproxen was 2.38 (95% confidence interval, 1.39-4.00; P =.002). There was no significant difference in cardiovascular event (myocardial infarction, stroke, and death) rates between celecoxib and nonsteroidal anti-inflammatory agents in CLASS. The annualized myocardial infarction rates for COX-2 inhibitors in both VIGOR and CLASS were significantly higher than that in the placebo group of a recent meta-analysis of 23 407 patients in primary prevention trials (0.52%): 0.74% with rofecoxib (P =.04 compared with the placebo group of the meta-analysis) and 0.80% with celecoxib (P =.02 compared with the placebo group of the meta-analysis). The available data raise a cautionary flag about the risk of cardiovascular events with COX-2 inhibitors. Further prospective trial evaluation may characterize and determine the magnitude of the risk.
------
Re: dishonest practices in the pharmaceutical world, seldane (old nonsedating antihistamine) caused cardiac side effects, like serious arrhythmia. The makers knew this, then milked it for everything it was worth before they got their new med Allegra on the market. It's what your body turns seldane into when you swallow it, without the side effect. Why did they wait so long? They're more interested in your money than your health. I don't doubt capitalism is the cause. That's why people are still getting paid to kill other people, I mean make cigarettes. Could you imagine having causing heart attacks and lung cancers your job? I can't, but for the right price a lot of people will do anything. Don't make it good. And there's another way to handle it. Maybe use some of our food reserves to feed the starving pharmaceutical company CEO's?
JAMA. 2001 Aug 22-29;286(8):954-9. Review.
Mukherjee D, Nissen SE, Topol EJ.
Atherosclerosis is a process with inflammatory features and selective cyclooxygenase 2 (COX-2) inhibitors may potentially have antiatherogenic effects by virtue of inhibiting inflammation. However, by decreasing vasodilatory and antiaggregatory prostacyclin production, COX-2 antagonists may lead to increased prothrombotic activity. To define the cardiovascular effects of COX-2 inhibitors when used for arthritis and musculoskeletal pain in patients without coronary artery disease, we performed a MEDLINE search to identify all English-language articles on use of COX-2 inhibitors published between 1998 and February 2001. We also reviewed relevant submissions to the US Food and Drug Administration by pharmaceutical companies. Our search yielded 2 major randomized trials, the Vioxx Gastrointestinal Outcomes Research Study (VIGOR; 8076 patients) and the Celecoxib Long-term Arthritis Safety Study (CLASS; 8059 patients), as well as 2 smaller trials with approximately 1000 patients each. The results from VIGOR showed that the relative risk of developing a confirmed adjudicated thrombotic cardiovascular event (myocardial infarction, unstable angina, cardiac thrombus, resuscitated cardiac arrest, sudden or unexplained death, ischemic stroke, and transient ischemic attacks) with rofecoxib treatment compared with naproxen was 2.38 (95% confidence interval, 1.39-4.00; P =.002). There was no significant difference in cardiovascular event (myocardial infarction, stroke, and death) rates between celecoxib and nonsteroidal anti-inflammatory agents in CLASS. The annualized myocardial infarction rates for COX-2 inhibitors in both VIGOR and CLASS were significantly higher than that in the placebo group of a recent meta-analysis of 23 407 patients in primary prevention trials (0.52%): 0.74% with rofecoxib (P =.04 compared with the placebo group of the meta-analysis) and 0.80% with celecoxib (P =.02 compared with the placebo group of the meta-analysis). The available data raise a cautionary flag about the risk of cardiovascular events with COX-2 inhibitors. Further prospective trial evaluation may characterize and determine the magnitude of the risk.
------
Re: dishonest practices in the pharmaceutical world, seldane (old nonsedating antihistamine) caused cardiac side effects, like serious arrhythmia. The makers knew this, then milked it for everything it was worth before they got their new med Allegra on the market. It's what your body turns seldane into when you swallow it, without the side effect. Why did they wait so long? They're more interested in your money than your health. I don't doubt capitalism is the cause. That's why people are still getting paid to kill other people, I mean make cigarettes. Could you imagine having causing heart attacks and lung cancers your job? I can't, but for the right price a lot of people will do anything. Don't make it good. And there's another way to handle it. Maybe use some of our food reserves to feed the starving pharmaceutical company CEO's?
--Ian
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Rich
We need new cures, not new spins of old ideas. Not legal maneuvers to continue high profit margins on old drugs by attempting to keep generic drug makers tied up in court for several years while your lawyers find ways to circumvent patent law.
Capitalism is supposed to benefit the consumer. Capitalism isn't supposed to mean finding ways to "cook the books" so your senior management can make off with $$ while the rest of the worker bees whose cash is locked up in company stock take it in the rear.
Capitalism is good, coupled with a good dose of common ethics.
'Nuff said.
- Bill
We need new cures, not new spins of old ideas. Not legal maneuvers to continue high profit margins on old drugs by attempting to keep generic drug makers tied up in court for several years while your lawyers find ways to circumvent patent law.
Capitalism is supposed to benefit the consumer. Capitalism isn't supposed to mean finding ways to "cook the books" so your senior management can make off with $$ while the rest of the worker bees whose cash is locked up in company stock take it in the rear.
Capitalism is good, coupled with a good dose of common ethics.
'Nuff said.
- Bill
-
RACastanet
- Posts: 3744
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA
-
RACastanet
- Posts: 3744
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA
IJ: The ethics discusson aside, what should I be on the lookout for regarding side effects of Celebrex. One that I have is that I hold water a while after I take it. From the data above it appears that Vioxx is a bit more risky. Is that correct?
Rich
Rich
Member of the world's premier gun club, the USMC!
They make two points in the abstract; first, total cardiovascular events occured somwhere between 1.39 and 4 times as often, most likely 2.38 times as often with vioxx than with ibuprofen, and this effect had only a .2% chance of being a random chance thing. Second, in both trials, more people were having events while taking both of these drugs than expected. Pooling >23,000 patients from other trials yielded an expected rate of half a percent a year, but the patients on vioxx were having a rate of .74% and those on celebrex, .8% instead of the .52%. Both of these results had a less than 5% chance of being random error or "noise;" in fact the odds that these weren't "real" were 4 and 2% according to their math.
What's interesting here is that while celebrex users were having the highes rate of events compared to the vioxx users and the pooled placebo group, they were NOT having statistically significantly more events than the placebo group in their trial. This makes you wonder if the group that was selected to be randomized to celebrex or nothing had an intrinsically high risk of events to begin with.
The second point doesn't mean anything to me at all at this point. Comparing the celebrex people to people from others in other trials is apples and oranges. Comparing the celebrex users to the celebrex placebo group is comparing apples on celebrex to apples on placebo, and that's the right place to start.
This all needs to be verified with more work--it isn't just the NKTO crowd
FYI there was some stuff last year about ibuprofen undoing the good effects of aspirin on the heart, just to be fair to the tried and true.
What's interesting here is that while celebrex users were having the highes rate of events compared to the vioxx users and the pooled placebo group, they were NOT having statistically significantly more events than the placebo group in their trial. This makes you wonder if the group that was selected to be randomized to celebrex or nothing had an intrinsically high risk of events to begin with.
The second point doesn't mean anything to me at all at this point. Comparing the celebrex people to people from others in other trials is apples and oranges. Comparing the celebrex users to the celebrex placebo group is comparing apples on celebrex to apples on placebo, and that's the right place to start.
This all needs to be verified with more work--it isn't just the NKTO crowd
FYI there was some stuff last year about ibuprofen undoing the good effects of aspirin on the heart, just to be fair to the tried and true.--Ian
