Hemorrhage

Hemorrhage, excessive discharge of blood from blood vessels, caused by pathological condition of the vessels or by traumatic rupture of one or more vessels. Hemorrhage is a complication of many diseases. Peptic ulcer, for example, may cause hemorrhage by eroding a blood vessel. Stroke is sometimes due to hemorrhage in the brain. Hemophilia, a hereditary blood disease, is characterized by failure of the blood to coagulate. Sudden loss of more than about 1 liter (1 qt) of blood may lead to shock; unless the blood is replaced by transfusion, this shock can be fatal.

Bleeding normally stops through the process of coagulation, or clotting of the blood, and methods used to stop hemorrhage depend on stanching the flow of blood sufficiently for a clot to form. The hemorrhage is most effectively stopped by the application of pressure directly over the wound. Bleeding is also lessened by placing the body so that the wound is uppermost. A tourniquet should never be applied if there is another way to stop the bleeding, as application of a tourniquet increases the likelihood that amputation will be required.

Fibrin film and fibrin foam, plastics made from the blood protein fibrinogen, are extensively used in surgery. Fibrin foam is used in the form of a surgical sponge that rapidly stops bleeding by forming clots. Fibrin film is used to wrap nerves or tendons or as a membrane to cover the brain or other organs. Fibrin may be left without harm in the body, where it slowly dissolves.

Heartburn

Heartburn, condition characterized by a burning feeling in the chest and a sour or bitter taste in the mouth. Heartburn typically develops when the acidic contents of the stomach flow back, or regurgitate, into the esophagus, the muscular tube that carries food from the throat to the stomach.

Heartburn is generally diagnosed with a complete description of the symptoms. In severe cases, a physician may order a barium X ray of the stomach and esophagus to rule out other problems. Alternatively, a physician may examine the esophagus with an endoscope, an instrument that can view the interior of the digestive tract, and take tissue and fluid samples.

Treatments for heartburn in mild cases, over-the-counter medications such as antacids can relieve occasional bouts. Chronic heartburn can be treated with medications that prevent the production of acid in the stomach.

Lifestyle changes, such as quitting smoking or losing weight, also can alleviate or prevent heartburn. Sleeping with the head of the bed elevated 15 cm (6 in) helps prevent the stomach's contents from flowing back into the esophagus. Going to bed on an empty stomach, and cutting back on consumption of alcohol, fat, chocolate, and peppermint also can prevent heartburn.

Pravastatin

Pravastatin, drug used to lower cholesterol levels in the bloodstream in cases when dietary changes, weight loss, and exercise are ineffective in lowering cholesterol. Pravastatin works by blocking the liver enzyme that controls the manufacture of cholesterol. It is primarily effective against low-density lipoproteins (LDL), the form of cholesterol associated with increased risk of heart disease.

Available only by prescription, tablets of pravastatin are taken with or without food, usually at bedtime. The typical dosage ranges between 10 and 40 mg per day. Typically, cholesterol levels begin falling four to six weeks after the medication is started. Pravastatin is often prescribed in combination with a cholesterol-lowering diet.

Pregnant or nursing women, or children under the age of 18, should not take pravastatin. Patients with liver or kidney disease, muscular disorders, cataracts, or a history of alcohol abuse should use this drug with caution. Pravastatin can cause damage to the liver or muscle tissue, although problems can usually be detected early using well-established laboratory tests.

Possible side effects of this drug include dizziness, headache, skin rash, itchiness, stomach pain, nausea, diarrhea, constipation, gas, muscle cramps, or flulike symptoms. Pravastatin may be contraindicated for patients who are also taking the following drugs: cholestyramine, cimetidine, colestipol, cyclosporine, erythromycin, gemfibrozil, ketoconazole, niacin, warfarin, and immunosuppressive drugs.

Brand Name: Pravachol

Simvastatin

Simvastatin, drug used to lower cholesterol levels. It is typically prescribed by a physician when dietary changes, weight loss, and exercise are not effective in reducing cholesterol. Simvastatin works by blocking the liver enzyme that controls the production of cholesterol. It is primarily effective against low-density lipoproteins (LDL), the form of cholesterol associated with increased risk of coronary heart disease.

Tablets are taken with or without food, usually at bedtime. The typical dosage ranges between 5 and 40 mg per day. Effectiveness is usually apparent after four to six weeks of treatment. Simvastatin is usually prescribed in combination with a cholesterol-lowering diet.

This drug should not be taken by patients with liver disease, by pregnant or nursing women, or by young people under the age of 20. Patients with impaired liver function, muscular disorders, cataracts, or a history of alcohol abuse should use this drug with caution.

Possible side effects of this drug include headache, stomach pain, nausea, diarrhea, constipation, gas, muscle weakness, or lowered blood pressure. Other side effects sometimes observed are muscle pain, skin rash, impaired vision, or hepatitis. Simvastatin may interact adversely with the drugs cholestyramine, cimetidine, clofibrate, cyclosporine, erythromycin, gemfibrozil, digoxin, ketoconazole, nicotinic acid, warfarin, and spironolactone.

Brand Name:Zocor

Lovastatin

Lovastatin, drug used to reduce high blood cholesterol levels and slow the progression of coronary atherosclerosis, or hardening of the heart’s arteries. Lovastatin interferes with an enzyme in the liver responsible for making cholesterol, a fatlike substance that can both harden and clog the arteries. This drug reduces low-density lipoproteins (LDL), the type of cholesterol that increases the risk of coronary heart disease, and increases high-density lipoproteins (HDL), the type of cholesterol thought to reduce the risk of heart disease.

Available by prescription only, this drug is dispensed in 10-mg, 20-mg, and 40-mg tablets, which are taken orally. The initial adult dosage is 20 mg taken once a day, after which the dosage may be increased up to 40 mg twice a day. The maximum dosage should not exceed 80 mg daily. Effectiveness should be apparent within two weeks.

This drug should be taken with food, preferably with evening meals. It should not be used by persons who have had an allergic reaction to lovastatin; persons with active liver disease or active peptic ulcers; or pregnant or breast-feeding women. It should be used with caution by persons with reduced liver function and habitual users of alcohol. The safety and effectiveness of lovastatin for people under the age of 20 have not been established. Driving and other risk-related activities should be restricted if dizziness and blurred vision occur while taking this drug.

Common side effects of lovastatin include constipation, diarrhea, dizziness, gas, headache, heartburn, nausea, skin rash, and stomach pain. Less common side effects are blurred vision, fever, muscle aches or cramps, severe stomach pain, and unusual tiredness or weakness. Long-term use of this drug may result in abnormal liver function tests.

Lovastatin may interact adversely with certain drugs including clofibrate, cyclosporine, erythromycin and other macrolide antibiotics such as asithromycin and clarithromycin, gemfibrozil, niacin, and warfarin.

Brand Name:Mevacor