Natural Products - can induce vioilent catharsis Castor oil ricin, ricinoleic acid ; Anthroquinones senna, cascara ; Stool Softeners surfactants COLACE ; mineral oil II. Drugs that Affect Gastric Acidity Gastic hyperacidity or hypersecretion ; is an etiological factor in GERD and Peptic Ulcer Disease PUD ; . It results in tissue destruction ulcers ; both directly and by activation of digestive enzymes. Control of stomach acidity uses several approaches: neutralization of existing acid, inhibition of acid secretion, enhancement of natural protective processes, and treatment of H. Pylorii infection A ; Antacids weak inorganic bases that neutralize stomach acid and raise pH. Many OTC antacids available Bicarbonate Baking Soda, ALKA SELTZER ; Ca Carbonate TUMS ; mg or Al hydroxide Milk of Magnesia, MAALOX, MYLANTA ; good for episodic treatment of indigestion but not effective vs chronic disease B ; Inhibitors of acid secretion Gastric acid is secreted by a proton pump located in the parietal cell. The activity of this pump is regulated by 1 ; neural stimulation via the vagus nerve; 2 ; endocrine stimulation via gastrin relaesed from G cells; and 3 ; local relaese of histamine from enterochromaffin-like ECL ; cells.
Happy Birthday: Trust and believe in yourself if you want things to happen this year. You are the one in control. You do have wonderful ideas and what it takes to finish what you start. ARIES March 21-April 19 ; : Don't expect things to run according to plan in your personal life. You may take things the wrong way or overreact emotionally. Problems with contractors or equipment in your home will surface. TAURUS April 20-May 20 ; : Use your charm and you'll be able to talk someone into telling you a secret. Social activities can open up doors to potential new partnerships. Short trips will enhance love. GEMINI May 21-June 20 ; : It's time you spoke up and let everyone know what you are thinking. In so doing, you rid yourself of the people who have been taking advantage of you. Clear up old feuds and move forward. CANCER June 21-July 22 ; : Don't let the little things bother you. A chance to do something you enjoy and make a little money at the same time should be your goal. Discuss your options with someone you admire. LEO July 23-Aug. 22 ; : Keep your secrets to yourself today. The less said and the more done, the further ahead you will become. A chance meeting with someone will open your eyes to an opportunity you can't pass up. VIRGO Aug. 23-Sept. 22 ; : Be careful not to give too much of your time or money today. If you are too accommodating, someone will take advantage of you. An important partnership will develop if you discuss your future plans. LIBRA Sept. 23-Oct. 22 ; : Someone will be out to get you one way or another. Don't set yourself up for disappoint.
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What should I expect after surgery? Your recovery depends on your type of procedure, why you had surgery and your previous activity level and health status. Most people need about 4-8 weeks or more after surgery before feeling back to normal. It is not unusual to experience a decrease in your appetite, tiredness, poor sleep, and a depressed mood during this timeframe. If your symptoms persist or worsen contact the surgery clinic or your doctor. How will I manage my pain at home? You will best achieve pain control if you take your pain medication at regularly prescribed intervals usually every 4-6 hours ; to prevent pain build up and taper down as you recover. Strong pain medication or narcotics like Vicodin, Oxycodone, Darvocet ; may be prescribed. DO NOT DRIVE OR DRINK ALCOHOL while taking narcotics. Narcotic medication causes constipation. Stool Softeners Cokace or Ducusate ; and fiber fruits, brans, vegetables, Metamucil ; and extra fluid intake helps. An over-the-counter stimulant laxative Milk of Magnesia, Senekot ; may be needed as well. NSAIDS like ibuprofen Motrin, Advil ; , naproxen Naprosyn, Aleve ; or acetaminophen Tylenol ; taken every 6 hours as needed for pain may be effective in managing it in addition to the narcotics. To prevent Tylenol overdose, do not take a Tylenol doses at the same time as a combination narcotic dose that contains Tylenol, like Vicodin and Darvocet. However, You may take them 4-6 hours apart. How will I care for my incision? Your incision or wound may be sensitive, so wearing loose clothing may feel more comfortable. You can gently wash your incision with soap and water using a clean towel after a shower then pat dry daily. You may shower but NO BATHS OR SOAKING INCISION UNDERWATER like hot tubs or swimming pool ; . DO NOT APPLY ointments or powders on your incision or wound unless directed by your doctor. Do not Smoke. Smoking is bad for wound healing. If you have paper tape called "steri strips" ; on your incision, leave them in place until they begin to fall off naturally. If they become discolored or messy, you may remove those 10-14 days after application. If you have staples on your incision, leave them in place. They will be removed by your home care nurse or in the clinic on a follow up visit. They are usually removed 7-14 days after surgery. How do I care for an open wound if you have one ; ? If you have an open wound, you and your family will be taught to gently pack the wound with moistened gauze using either Normal Saline or Chloropactin solution 2-3 times a day. A home care nurse may visit you to assist with your wound care instructions and bring your dressing supplies this varies depending on your health care insurance ; . You will be given a prescription for the solution to be obtained at the pharmacy and possibly for the dressing supplies. How do I care for my drain if you have one ; ? If you have a drain, the nursing staff will instruct you and your family on care for the drain site, emptying the bulb or flushing as directed by your doctor. You will be asked to bring in your record of the amount of drainage to your next follow-up visit.
Canadians are also, not so proudly, among the biggest users and wasters of energy in the world. But just as our founders made sure Canadians had their own alpine club, we can help ensure the preservation of our alpine wilderness. Like climbing, we need only take one small step at a time. Switching to more efficient light bulbs. Car-pooling to trailheads. Washing and reusing sturdy zip-lock bags. Saying `no' to disposable coffee cups and using ACC mugs every day. At Club gatherings, including trademark Canadian midwinter barbecues, encouraging guests to BYO plate and fork instead of using disposables and rediscovering the camaraderie of group dish washing readily shared in our backcountry huts. As our Club approaches its Centennial, instead of just celebrating the past century, let's make a bigger effort to give our members something to celebrate in another hundred years.
Llmommy october 2nd, 2006, i also took a stool softener after giving birth i believe it was colace but not sure ; , and it caused no problems with bfing and depakote.
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Results excerpted from reference Oberle, S. et al. 1998 ; Circ. Res. 82, 1016 reference 1 ; with permission. Correspondence should be addressed to Henning Schrder, Department of Pharmacology and Toxicology, School of Pharmacy, Martin Luther University, 06099 Halle Saale ; , Germany; email: schroeder pharmazie -halle.
2 Claudia Wilson is grateful for GIC because it provided for her treatment of breast cancer. Rose Turco and her family have lived and paid taxes and have supported the municipal services. She has contributed her services and time to the Town. She is not eligible for social security and medicare. GIC was promised to her. Steve Shangraw stressed that the GIC plan is a commitment. It would be morally wrong to change it. Jim Johnston asked the town not to renege on its moral responsibilities because this was a contract struck in 1972. Roseann Walsh Gosch urged the town to keep its promises. Pauline Turco Meideros told the story of children trying to change the rules in the middle of the game. The town must not do this. Tom Geysen retired on the trust that the town would keep its promises. Priscilla McNally said that after teachers gave their best to this town they shouldn't bear this burden. Mary Cass, the President of Franklin Education Association reminded the councillors that this proposal of changing the insurance is a negotiable issue. Richard Warren explained that as a former superintendent of schools the GIC plan was an attractive benefit for prospective employees. Timothy Hoar asked that different programs be looked at before money is taken from retirees. David Doherty said he came to teach in Franklin because of the GIC. Ken & Ellen Wood said there are many things in life that aren't fair. But this issue can be controlled. Edward Colafe spoke of his love for the town and he counted on this security in his retirement. He said it is wrong to take the GIC away. David Mulcahey accused the council of trying to balance the budget on the backs of the elderly. Kenneth Rose said his pension is in 1980 dollars. Changing the insurance would be a hardship. Pauline Turco Medeiros asked for recognition of Mrs. Carbury who is 96 years old. Mary Cass spoke again. She said that these teachers educated the people who keep voting no on the override. And now the council wants to punish the teachers. Kathleen Parnell said it is criminal to change the insurance on these dedicated teachers. Joe Ferrari recognized the difficulty the councillors have in trying to balance the budget, but changing the GIC is wrong. Rose Turco spoke again. She said the saving is less than .03 and imuran.
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Metabolic Defense helps maintain key metabolic functions. The minerals, nutrients, and herbs in this formula are combined to synergistically: Help maintain healthy cells in the presence of blood glucose. * Balance cellular processes fueled by glucose metabolites. * Help decrease sugar cravings. * Decrease fat and sugar absorption. * Assist in reversing insulin resistance. * Formula Intention TM Metabolic Defense is formulated drawing on the properties of traditional Chinese and Ayurvedic medicine, as well as modern science, to provide a supplement that addresses the concerns of those susceptible to Metabolic Syndrome. * Metabolic Syndrome is a condition characterized by increased waist circumference, hypertension, elevated fasting glucose and insulin resistance. The syndrome is linked to increased risks of low HDL cholesterol and high LDL cholesterol, and blood sugar and cardiovascular diseases. Did you know? Metabolic Syndrome in the United States is 1 estimated to affect 32 % of the population. People with impaired insulin function are at a greater risk of developing life-threatening chronic diseases, including heart disease, which is the number one cause of death in the United States. It is not the reduction of blood glucose levels alone but, also triglycerides, LDL cholesterol, and total cholesterol that effect Metabolic Syndrome symptoms. Insulin resistance, diabetes, and obesity are recognized as inflammatory disorders. What is Metabolic Syndrome? Metabolic Syndrome is associated with increased morbidity and mortality for cardiovascular disease. This condition is represented not only by metabolic alteration such as hyperglycemia, and excess lipids in the blood, but also by a chronic proinflammatory state. Endothelial dysfunction is said to be.
Adverse Effect Constipation Sedation Nausea Vomiting Pruritus Hallucinations Confusion Delirium Myoclonic Jerking Respiratory Depression Management Considerations Begin bowel regimen when opioid therapy is initiated. Include a mild stimulant laxative e.g., Senna, Cascara ; + stool softener e.g., Dolace ; at hs, or in divided doses as routine prophylaxis Tolerance typically develops. Hold sedatives anxiolytics, dose reduction; consider CNS stimulants e.g., increase caffeine intake, methylphenidate or dextroamphetamine ; Dose reduction, opioid rotation; consider metoclopramide, prochlorperazine, scopolamine patch Dose reduction, opioid rotation; consider an antihistamine such as diphenhydramine Dose reduction, opioid rotation, consider neuroleptics haloperidol or risperidone ; Dose reduction, opioid rotation, neuroleptic therapy haloperidol, risperidone ; Dose reduction, opioid rotation; consider clonazepam, baclofen Sedation precedes respiratory depression. Hold opioid. Give low dose naloxone - dilute 0.4 mg 1ml of a 0.4 mg ml amp of naloxone ; in 9 ml normal saline for final concentration of 0.04 mg ml and cytoxan!
Mechanical and chemical activity localized activity many are otc over-the-counter ; adsorbents -kaolin, pectin, activated charcoal laxatives bulk psyllium colloid ; must have a lot of added fluid as part of the therapy saline-magnesium citrate or purgative lemonade this product, like revenge, is best when served: cold stimulant-cascara from the cascara sagrada plant ; or senna from the senna plant ; a favorite addition to diet herb teas emoillent-docusate colace ; literally, you are adding soap to the system taste the liquid version sometime, eeuh ; antacids-chemical neutralization -antacids are weak bases magnesium hydroxide, aluminum hydroxide ; to act as chemical neutralizers, or act as weak buffers, such as calcium carbonate antacids by ingredients: magnesium products: milk of magnesia magnesium hydroxide ; aluminum products: alternagel aluminum hydroxide ; combined magnesium aluminum products: maalox, mylanta calcium carbonate products: tums, rolaids note: these antacids differ both in chemical composition and mechanism of action from the class of antacids known as the h-2 antagonists or proton pump inhibitors.
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This REQUIREMENT is not met as evidenced by: Based on observation and interview it was determined that the facility did not ensure that it is free of medication error rates of five percent or greater. This was evident 3 of 40 opportunities for error. The medication error rate was 7.5%. This resulted in no actual harm with potential for more than minimal harm. The findings are: During medication observation on 4 10 30a.m. the following was observed: 1 ; The Licensed Practical Nurse LPN ; was observed administering Coreg 6.25 milligrams at 9: 00a.m. to resident #33. The physician's order dated 3 28 07 documented Coreg 6.25mg milligrams ; by mouth twice daily with food. It was documented on the medex to be administered at 7: 30a.m. When interviewed on 4 12 00a.m., the LPN stated that she did administer the medication without food. 2 ; The LPN administered Glipizide 5 mg and Clace 2 capsules at 9: 20a.m. to resident #34. The physician's order dated 2 8 07 documented.
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Investigate low urine output, consider Lasix No fluid boluses without clearing with CP fellow or attending OOB to chair Sequential Stockings while in bed Start Sub Q heparin unless contraindicated Resp treatments and physical therapy should be ordered. Day 1-3 OOB ambulating Follow chest tube guidelines for lobectomy After chest tubes are removed, switch to PO pain pills Increase diet when bowel function returns Avoid constipation. Make sure patient is on Colace Use MOM, ducolax as needed. Continue to follow chest tube guidelines Keep foley in male patients until epidural is discontinued Heplock IV when taking PO Begin to plan for discharge Address home care needs with social worker case manager Discharge when appropriate and make sure patient gets a copy of thoracic surgery discharge instructions.
Include Metamucil, Citrucel, Konsyl, and Serutan. Stimulants cause rhythmic muscle contractions in the intestines. Brand names include Correctol, Dulcolax, Purge, and Senokot. Studies suggest that phenolphthalein, an ingredient in some stimulant laxatives, might increase a person's risk for cancer. The Food and Drug Administration has proposed a ban on all over-the-counter products containing phenolphthalein. Most laxative makers have replaced or plan to replace phenolphthalein with a safer ingredient. Stool softeners provide moisture to the stool and prevent dehydration. These laxatives are often recommended after childbirth or surgery. Products include Colace and Surfak. Lubricants grease the stool, enabling it to move through the intestine more easily. Mineral oil is the most common example. Saline laxatives act like a sponge to draw water into the colon for easier passage of stool. Laxatives in this group include Milk of Magnesia and Haley's M-O and requip.
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Same as lumbar puncture. A technique to remove a small amount of the fluid that surrounds the brain and spinal cord. An organ that filters blood, makes antibodies and lies next to the stomach. Often it is enlarged in people diagnosed with leukemia and lymphoma. The building block or seeds of bone marrow and blood formation. Sores in the mouth. Special blood testing to find a donor match for a stem cell transplant. Side effects caused by treatments. One way to meet a child's nutritional needs with solutions containing vitamins, minerals, sugar, electrolytes, lipids and proteins. It is usually given through a central venous catheter. Giving blood or blood products through an IV. An abnormal growth of cells that may be benign or malignant. The virus that causes chicken pox and shingles and sustiva.
By Robin J. Harman, PhD, MRPharmS The legislative controls that govern placing a medicinal product on the market, and liability issues that can affect marketed products, are discussed in this article.
Aminoflavone AF, NSC 686288 ; , a candidate chemotherapeutic agent, possesses a unique antiproliferative profile against tumor cells. Metabolic bioactivation of AF by drug metabolizing enzymes, especially CYP1A monooxygenases, has been implicated as an underlying mechanism for its selective cytotoxicity in several cell culture-based studies. However, in vivo metabolism of AF has not been investigated in detail. In this study, the structural identities of thirteen AF metabolites twelve of which are novel ; in mouse urine or from microsomal incubations, including three monohydroxy-AFs, two dihydroxy-AFs and their sulfate and glucuronide conjugates, as well as one N-glucuronide, were determined by accurate mass measurements and LC-MS MS fragmentation patterns, and a comprehensive map of the AF metabolic pathways was constructed. Significant differences between wild-type and Cyp1a2-null mice, with in the relative composition of urinary metabolites of AF, demonstrated that CYP1A2-mediated regioselective oxidation was a major contributor to the metabolism of AF. Comparisons between wild-type and CYP1A2-humanized mice further revealed interspecies differences in CYP1A2mediated catalytic activity. Incubation of AF with liver microsomes from all three mouse lines and with pooled human liver microsomes, confirmed the observations from urinary metabolite profiling. Results from enzyme kinetic analysis further indicated that in addition to CYP1A P450s, CYP2C P450s may also play some role in the metabolism of AF and sinemet.
Some pain medications can cause constipation if this happens, you may take a stool softener such as colace ; , or a gentle laxative such as milk of magnesia!
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Specifications. Disturbance terms across observations in the same school are clustered, while errors across schools are assumed to be independent. Regression 1 indicates that the average school participation gain for treatment schools relative to comparison schools across both years of the project is 5.6 percentage points, and this is significantly different than zero at 99 percent confidence. Regression 2 presents the "nave" treatment effect estimate of six percentage points for the first year of treatment and four percentage points for the second year, with significance levels of 99 percent and 90 percent respectively. Confidence intervals are wide enough that we cannot reject the hypothesis that the effect is the same in both years. The coefficient estimates on other explanatory variables have the predicted signs: the school average exam score in 1996 is positively related to participation rates, and the proportion of moderate-to-heavy infections in the pupil's standard and geographic zone is negatively though insignificantly ; associated with participation result not shown ; . The magnitude of the effects remains nearly unchanged when pupils initially recorded as dropouts in early 1998 are excluded from the sample results not shown ; . Regression 3 includes the numbers of treatment school pupils and total pupils attending primary school within three kilometers of the school as explanatory variables in order to explore the possibility of school participation externalities. The coefficient estimate on the number of local treatment pupils is positive and significantly different than zero at 90 percent confidence. The coefficient estimate implies that each additional one thousand pupils attending treatment schools within three kilometers leads to an increase of 3.4 percentage points in average school participation. Since there are 449 Group 1 pupils and 570 Group 2 pupils within three kilometers of the average primary school, this implies that school participation was approximately 1.5 percentage points higher on average throughout this area in 1998 due to deworming externalities, and 3.4 percentage points higher on average in 1999. Adding these figures to the "nave" treatment effect estimates suggests that the effect of deworming on school participation in treatment schools was at least 7 percentage points in both 1998 and 1999, although even this is a lower bound, since it is possible that some benefits spilled over beyond three kilometers from treatment schools and albendazole.
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Mexicali Missions Trip The Missions Department is looking for PEOPLE to go on short, one day mission's trip to the Mexicali Iglesia de Dios Church to host a Vacation Bible School for the children that attend this church. We have gone down and helped them with various construction projects for the past several years but this will only be a Bible School Program. We are planning to meet at the church on Saturday, April 14, 2007 at 8: 00 a.m. and should be back by 3: 00 p.m. We need volunteers to help us as we share a story time with the kids Chaplain Richey does this as he speaks Spanish! ; , we will make a craft, play a few games, sing and make sack lunches for all the kids. We would also like to put on an Easter Egg Hunt for the kids. It is a very rewarding time as these children, who have sooooo little physical comforts in their life, are just precious and so loving. You will go home more blessed than them - I can assure you. The Pastor and his wife are lovely people who work so hard in this poor community and are so grateful for the help we give. We will need donations of stuffed plastic eggs so that we can do the Easter Egg Hunt. Please do not use any candy that is chocolate as it melts too easy. The eggs can be stuffed with candy, small prizes, etc. Please take to the church no later than April 12. We need LOTS as there are probably about 30 kids. Please sign up or call Barbara Colace if you are interested in going - we need you! 344-4626 May you prayerfully consider this short, one day missions project don't miss out on a tremendous blessing! Barbara Colace Missions Chairman "And I praying that you will really put your generosity to work, for in so doing you will come to an understanding of all the good things we can do for Christ." Philemon 6.
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January 28, 2005 Lorenzen Center, Legacy Emanuel Hospital, Portland, OR Members Present: Mary Barnum, RN; Will Bean, RN; Brian Graunke, EMT-P; Daniel Hamre, MD; Christine Heyen; John Hopkins, Jon Jui, MD; Kerry Keeler, MD; Nathan Kemalyan, MD; Paul LeSage, EMT-P; William Long, MD Chair Robert Read, MD Vice Chair Kevin Van Syoc, EMT-P; Merlin Curry, EMTP for Craig Warden, MD; Rhonda Wood RN. DHS Staff Present: Susan Werner, Raelene Jarvis recorder ; , Debbie Danna. Absent: . Susan Leathers, RN; Martin Schreiber, MD; Carla Smith, MD; Richard Urbanski, MD; Kent Yundt. In attendance: Cheryl Battazzo, RN; Maureen Harrahill, RN; Bobbie O'Connell, RN, Tate Williams. Dr. Long, Chair, called the meeting to order at 11: 05 am. Review of Minutes Dr. Long It was motioned, seconded, and carried that the STAB meeting minutes of October 29, 2004 be approved with the correction to spelling of two names, and that Dr. Hamre was not yet a member of STAB and was therefore not absent. He is attending for his first meeting today. Health Services Report Susan Werner, RN 1. The new Prehospital Systems Manager is Tim Hennigan, supervising the EMS part of the EMS & Trauma Section. 2. The updated Application for Oregon Trauma Center Accreditation is now available. Please send any feedback to Susie Werner or Raelene Jarvis. 3. The Trauma Registry RFP is in the final stages of DOJ review and writing. It is expected to be out for vendor bid submission between 2 15 and 3 1 05, and have a completed contract by 3 31 05, providing a short timeframe one month ; to evaluate the top 3 vendors. Evaluations will be scheduled with 4 hours per vendor, resulting in 1 days of evaluations. 4. Strategic Planning: the EMS & Trauma Systems Section is working on a "Top to Bottom" review of the office functions. In this process, a facilitator will be contracted to work with the office, and with the advisory boards, such as STAB and buy depakote.
Q. Have you reviewed the report on mercury suggesting that it may mute the effect of polyunsaturated fatty acids? Gochfeld ; A. To my knowledge, there have been five studies on this subject and the results have been mixed. Overall, a conclusive effect cannot be determined, which may be due to the design of the studies. The two studies that indicate a modest harm from mercury indicated that fish with mercury had less of a benefit than fish without mercury. Q. Some people choose fish oil in an attempt to decrease mercury consumption; however, there is a substantial part of the elderly population that is also on blood thinners. Could this cause spontaneous bleeds? Mahaffey ; A. Fish oil from fish is the important portion of the fish for cardiovascular health. In general, thrombosis is not anticipated to occur with fish oil consumption levels below 5 grams per day. Q. Did any studies look at the fatty acid composition? Fitzgerald ; A. Analyses were performed using EPA only or DHA only. Overall, both fatty acids have similar effects, but individual risk factors differed.
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The Ginkgo tree has waited a long time to become popular. Originally imported from China, and now adorning parks and landscaped lawns in North America and Europe, Ginkgo is the sole survivor of the oldest known tree family in the world, dating back 200 million years. Petrified Ginkgo leaves are found abundantly in fossil beds. Now extracts of its leaves are the leading prescription medicines in both France and Germany, accounting for about 1.3percent of the entire drug market in those countries. With constituents chemically similar to the bioflavonoids in citrus, Ginkgo is a circulatory tonic, prescribed for various ailments of the elderly brought on by an aging circulatory system. Hundreds of scientific papers published in Europe and Asia over the last fifty years have verified the usefulness of Ginkgo in treating certain kinds of brain function impairment, hearing loss, dizziness, and poor circulation in the limbs. In September of 1986, La Presse Medicale, a conventional French medical publication, devoted an entire issue to the chemistry, pharmacology and clinical applications of Ginkgo biloba. Ginkgo extracts are available in the U.S. without prescription in health food stores and from alternative medical practitioners. A few case studies from the National College of Naturopathic Medicine in Portland, Oregon, demonstrate the use of this medicine. An 81-year-old woman was brought to the clinic. Her problem: she would get dizzy with any kind of movement or walking, and would often lose her balance. She could walk only with a cane. She had visited numerous medical specialists for her problem, but none of their medications worked for her: her problems were attributed to old age. At the clinic she received some nutritional supplements including niacin ; and a preparation of the herb Ginkgo biloba. At her second visit six weeks later, her dizziness was completely gone, and she reported a 50 percen improvement in her balance. Her elevated blood pressure had significantly decreased as well. A 60-year-old man came to the clinic with mental confusion and poor memory, accompanying his arteriosclerosis. He had intermittent pain in one leg and could only walk with a Iimp. He was given some dietary changes, nutritional supplements and a Ginkgo biloba prescription to take. In one month he reported more clarity of thought and improved memory. After the second month he reported more improvement and said that if he skipped a few doses of the Ginkgo, his symptoms would return. The pain in his leg was gone, and he could walk without a cane.
C.P. a 59 year old man with metastatic prostate cancer, to the spine, living alone. There is a long history of depression, antedating his cancer and this was the reason for his SSI eligibility. CP is independent in ADL's but withdrawn and reclusive. The pain associated with mobility limits medical contacts. An aggressive chemotherapy regime is proposed but there are real concerns about the practicality of implementing this. Medication List: Fentanyl 50 mcq q 72 hr Percocet q 4 hrs prn Reglan 10 mg tid hs Celexa 40 mg qd Nexuim 20 mg qd Dexamethasone 1.5 m bid Taxol 80% 130 mg IV 3 weeks on, 2 weeks off HCTZ 50 mg qd Colace 100 m qd Dulcolax Supp prn.
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