Friday, September 27, 2013

Staying alive

My doctor confided in me recently that his main function as a GP is to keep people alive with drugs, maintaining their lives with selective medications. For example, I now take five different drugs each morning and a further three each night. How can it be that I need all these drugs to retain a natural balance in my physiological condition. And how is it that each of these drugs performs a specific function that does not interfere with any other.

Let's start with a condition I have, hypo-pituitarism, a lowering of the level of hormones from the pituitary gland, the so-called "master gland" of the body, because it controls many of the other hormone-producing glands. How did I get this way? Well, I had a small non-malignant growth removed in 1990 from above my optic nerve just adjacent to the pituitary gland, and because it was so close and the pituitary is so delicate, this gland was damaged and was then unable to deliver its essential hormones into my body. So now I must take a steroid, in my case Hydrocortisone, on a daily basis to replace the natural steroid from the adrenal gland that would normally be produced, namely adrenaline. I also take the drug Eltroxin that replaces the natural thyroid hormone.

For some time I have had high blood pressure and a low heart pulse rate (ca. 40). The problem was that when I took any of the normal bp lowering drugs it also lowered my pulse rate even further, which was not good. So I managed without any heart medication, that is until my blood pressure went even higher (170/90). Then I went to a cardiologist, who gave me an alpha-blocker Losartan instead of the usual beta-blocker. The alpha and beta refer to different types of drug receptors in the heart muscle, beta being the more common one. Most bp medications are beta-blockers, but now that I take an alpha blocker, it lowers my bp without lowering my pulse rate, so I am much better off.

Like many older men I need to get up during the night to take a pee. When this became regularly 3-4 times, I complained to my doc, and he gave me a drug called Cadex, that contains an active ingredient that regulates the need to pee. Even though these tablets contain only 1 mg of the active substance, they work over a period of time to gradually reduce the need to get up during the night, and this makes for a better sleep experience and affects the whole of my life.

I had been suffering from a chronic cough that I experienced especially in the evening and morning when lying in bed. I assumed this was due to the build up of phlegm in my throat, but after some tests the doctor concluded that I had acid reflux that caused the coughing when I was lying down, so he prescribed an antacid tablet, Ompradex, that reduces the production of acid in the oesophagus. Net result, no coughing.

In addition to the above, I take a low dose of aspirin as Tevapirin, an anti-coagulant against blood clotting and strokes, an anti-cholesterol statin called Pravalip, and Vitamin D. All these eight drugs act independently on their own protein receptor or active sites in the body and cause a specific effect. Added together they greatly improve the quality of my life and keep me alive and healthy. Everybody has some things that go wrong that need drugs. Hooray for pharmacology! (note: I must confess a personal interest here, I was a Professor of pharmacology).


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