Venlafaxine

Indication

A new class of antidepressant medications, unrelated to the tricyclic antidepressants, used in the treatment of depression.

Side effects

Anxiety, somnolence, dizziness, dry mouth, nausea, abnormal ejaculation (male), impotence, headache, tremor, blurred vision, asthenia, sweating, nervousness, hypertension, and insomnia have been the most commonly reported. Changes in weight, appetite and allergic reactions have also been reported more infrequently. Other less common effects include infection, chills, chest pain, tachycardia, rash, constipation, abnormal dreams, paraesthesias, depression, urinary retention, twitching, change in taste, and tinnitus.

Interactions and precautions
1. Use with caution and at a reduced dosage in those with, liver impairment.
2. Consider overall risk-benefit in those with hypertension.
3. Do not use with alcohol.
4. Do not use with Mao inhibitors--fatal interaction can result.
5. Potential for interaction with over-the-counter cold remedies, consult you physician before use.
6. Use with cimetidine could potentiate the effects of venlafaxine. A dosage reduction (venlafaxine) may be necessary in some individuals.

Usual dose

Adults: oral, 75 mg per day in two to three dicided doses, taken with food.

Myelogram

Myelogram is a diagnostic test that helps in detecting abnormalities of the spine, spinal cord and spinal fluid. A contrast dye is injected into the the neck area (cisternal myelogram) or in the lower back area (lumbar myelogram). Any abnormality or indentation on the spinal cord can be identified with a myelogram test. A bulging disc, tumor or herniated disk can lead to indentations on the spinal cord. A myelogram is conducted for patients who suffer spinal stenosis, herniated disc or inflammation of the arachnoid membrane. Myelogram aids in diagnosing problems of blood supply to the spine and tumors.

A myelogram is ideal for patients who have had metal implants in their spine, preventing them from undergoing an MRI scan or CT scan. A spinal tap is performed to inject the dye into the spinal sac. When combined with a CT scan, a myelogram helps in understanding the condition of the spinal bones and muscles. A patient scheduled for a myelogram must not eat for few hours prior to the test. Pregnant women and those with a history of asthma or epilepsy must keep the doctor informed. Fluid intake must be maintained so as to remain well hydrated. Medications such as blood thinners, antidepressants and diabetes medicines may need to be temporarily stopped. A person is asked to lie down with head in elevated position for few hours after the myelogram test. The risks associated with a myelogram include meningitis, spinal headache and allergic reactions.

Cardiac Arrhythmia

Cardiac arrhythmia refers to a disturbance of the heart rhythm. When the regular heart rhythm is disturbed, it can lead to symptoms that can range from mild to life-threatening. The heart may have slower beats or there may be a blockage of the electrical pathway of the heart. One of the most common form of cardiac arrhythmia is atrial fibrillation. This occurs in older persons when the upper atrial chambers of the heart do not pump correctly. This can lead to blood clots. Heart failure or electrolyte imbalance can bring on cardiac arrhythmia.

Tachycardia is a condition where there is rapid heartbeat due to inefficiency in the blood circulation. Tachycardia is a condition where the heart rhythm is more than 100 beats/minute. This can happen due to stress, hyperthyroidism or alcohol. On the other hand, Bradycardia is a condition where the heart rhythm is less than 60 beats/min. A ventricular arrhythmia can be life-threatening. This happens when there is ventricular fibrillation. It is essential to treat this condition and restore the rhythm within minutes to prevent heart damage and death. Allergic reactions can trigger arrhythmias.

Some persons suffering from cardiac arrhythmia notice symptoms such as dizziness, fainting and lightheadedness. There may be a fluttering or pounding sensation in the chest. Antiarrhythmic agents such as amiodarone and sotalol are prescribed to maintain the normal rhythm of the heart. In cases of atrial fibrillation, warfarin is used to prevent blood clots. Medication for cardiac arrhythmia includes beta blockers such as metoprolol and atenolol to reduce the heart rhythm. An electronic cardiac pacemaker may be implanted to regulate the heart beat.