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Originally Posted By Mr_Psmith:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
But why use a FQ instead of Macrobid (2x daily dosing v. 4 with straight nitrofurantoin) or TMP/SMX? Don't get me wrong, I've had a couple UTIs and I got cipro and it knocked them out fast and I didn't have any appreciable side effects, but I thought that FQs were supposed to be limited in use. Is resistance to Macrobid and TMP/SMX that common? Just curious, obviously you have the MD and I don't. There isn't a thing wrong with Sulfa. I used a metric sh*t-ton of it (again... it's cheap, and I'm all about cheap). However, there is more resistance to Sulfa than the quinolones. Macrobid is likewise a fine choice... and there's almost no resistance to it in my area. The argument against Nitrofurantoin is that it's theoretically a bit more bacteriostatic than bacteriocidal, and may be inadequate for more severe infections. For simple/minor/uncomplicated UTIs, it's a top contender. FYI my area's latest antibiogram just came out, and the top three urinary tract organisms are < 40 % sensitive to FQs. Things are changing pretty quickly. We lost quinolones for sexually transmitted infections last year or year before. Yep. We used to use Oflox and Levo for GC. Not any more. 
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"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
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Originally Posted By ipsilateral_7:
thats If you believe that the flu shot works as advertised, which i don't buy th hype except in the subpopulations of the very old, very young and with chronic diseases, especially lung diseases. there is too much self selection bias in the original studies to trust the results, and several have shown that the mortality benefit clearly extends to populations outside of the flu season which further highlights the bias inherent to the study. If you don't mind, what's your background / qualifications? |
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Originally Posted By Mr_Psmith: Originally Posted By TheGrayMan: Originally Posted By BushBoar: But why use a FQ instead of Macrobid (2x daily dosing v. 4 with straight nitrofurantoin) or TMP/SMX? Don't get me wrong, I've had a couple UTIs and I got cipro and it knocked them out fast and I didn't have any appreciable side effects, but I thought that FQs were supposed to be limited in use. Is resistance to Macrobid and TMP/SMX that common? Just curious, obviously you have the MD and I don't. There isn't a thing wrong with Sulfa. I used a metric sh*t-ton of it (again... it's cheap, and I'm all about cheap). However, there is more resistance to Sulfa than the quinolones. Macrobid is likewise a fine choice... and there's almost no resistance to it in my area. The argument against Nitrofurantoin is that it's theoretically a bit more bacteriostatic than bacteriocidal, and may be inadequate for more severe infections. For simple/minor/uncomplicated UTIs, it's a top contender. FYI my area's latest antibiogram just came out, and the top three urinary tract organisms are < 40 % sensitive to FQs. Things are changing pretty quickly. We lost quinolones for sexually transmitted infections last year or year before. Does FQ resistance evolve more quickly or something? For example, the Hopkins ABX guide says that due to high rates of resistance, FQs are not recommended for gonorrhea; the current treatment recommendations include macrolides, cephalosporins, and doxycycline, all of which have been around longer than FQs. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By BushBoar:
Does FQ resistance evolve more quickly or something? For example, the Hopkins ABX guide says that due to high rates of resistance, FQs are not recommended for gonorrhea; the current treatment recommendations include macrolides, cephalosporins, and doxycycline, all of which have been around longer than FQs. In some bacteria, yes. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Originally Posted By TheGrayMan: Originally Posted By BushBoar: Does FQ resistance evolve more quickly or something? For example, the Hopkins ABX guide says that due to high rates of resistance, FQs are not recommended for gonorrhea; the current treatment recommendations include macrolides, cephalosporins, and doxycycline, all of which have been around longer than FQs. In some bacteria, yes. I'm willing to bet that the 2001 anthrax scare accelerated the overuse of FQ leading to resistance - the media made extensive mention of cipro, which likely led to patients asking for it for all manner of infections. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By gasdoc09:
Originally Posted By ipsilateral_7:
thats If you believe that the flu shot works as advertised, which i don't buy th hype except in the subpopulations of the very old, very young and with chronic diseases, especially lung diseases. there is too much self selection bias in the original studies to trust the results, and several have shown that the mortality benefit clearly extends to populations outside of the flu season which further highlights the bias inherent to the study. If you don't mind, what's your background / qualifications? Pulm-cc/internist/Underwear model..... a quick pubmed or google search will bring up the many editorials questioning the results that have been published, or at least the degree of protection they really offer. but needless to say the short version is they work, but nowhere near the levels as advertised. there were severe levels of volunteer bias in the original studies which concluded there was an 84% efficacy rate for the influenza vaccine, and the mortality benefits are likely well overstated as well. Originally Posted By TheGrayMan:
Originally Posted By ipsilateral_7:
Originally Posted By TheGrayMan:
Just get a flu shot... much cheaper to prevent than to treat. If you want to keep some for SHTF, that's OK too. thats If you believe that the flu shot works as advertised, which i don't buy th hype except in the subpopulations of the very old, very young and with chronic diseases, especially lung diseases. there is too much self selection bias in the original studies to trust the results, and several have shown that the mortality benefit clearly extends to populations outside of the flu season which further highlights the bias inherent to the study. *shrug* I always get a flu shot. Feel free to disagree. i get it as well, and recommend it to the properly aged pt or those with medical comorbididies that hace shown benefit from the vaccine, namely my population of chronic lung dz pts. but i doubt the efficacy for random young people without medical conditions. |
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Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
Does FQ resistance evolve more quickly or something? For example, the Hopkins ABX guide says that due to high rates of resistance, FQs are not recommended for gonorrhea; the current treatment recommendations include macrolides, cephalosporins, and doxycycline, all of which have been around longer than FQs. In some bacteria, yes. I'm willing to bet that the 2001 anthrax scare accelerated the overuse of FQ leading to resistance - the media made extensive mention of cipro, which likely led to patients asking for it for all manner of infections. eh, FQ have been way overused, especially in cattle/animal farming, and cipro is very popular for uncomplicated UTIs. |
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TGM (or anyone else), 3rd and 4th generation cephalosporins are pretty expensive - cefdinir is even more expensive than moxifloxacin (though not by much). If I have macrolides, doxycycline, FQs, and, a penicillin like amoxicillin, do I need a cephalosporin? If it's essential to have it, I'll stock some, but given the price if I can cover it with something cheaper and as effective I'd rather do that. For reference, I can get 300mg cefdinir for $2.47/tab, 400mg moxifloxacin for $2.41/tab, and 500mg levofloxacin for $0.20/tab. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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I have found out twice that Cipro does absolutely nothing for acute prostatitis, while Bactrim knocks it right the fuck out. |
TANSTAAFL
National pride is to countries what self-respect is to individuals: a necessary condition for self-improvement. - Richard Rorty
Build your opponent a golden bridge to retreat across. - Scipio Africanus
National pride is to countries what self-respect is to individuals: a necessary condition for self-improvement. - Richard Rorty
Build your opponent a golden bridge to retreat across. - Scipio Africanus
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Originally Posted By wingnutx:
Will using an O2 absorber increase shelf-life? That's a difficult question... However it might not hurt. Controlling temperature and humidity are likely the two most important factors of extending shelflife. Temperature can be moderated in warm envionments by placing carefully protected materials in a well or underground in a shady area, preferably 6 or more feet below the surface, depending on many variables. |
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Originally Posted By EXPY37:
Originally Posted By wingnutx:
Will using an O2 absorber increase shelf-life? That's a difficult question... However it might not hurt. Controlling temperature and humidity are likely the two most important factors of extending shelflife. Temperature can be moderated in warm envionments by placing carefully protected materials in a well or underground in a shady area, preferably 6 or more feet below the surface, depending on many variables. For the rest of us not living in a log cabin your freezer works wonders on extending shelf life. 
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223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Originally Posted By wingnutx: I have found out twice that Cipro does absolutely nothing for acute prostatitis, while Bactrim knocks it right the fuck out. It does generally work, but some of the bacteria that can cause ABP are resistant to FQs in some areas. Funny that the bacteria that caused it was immune to cipro but not to a much older ABX (TMP/SMX). |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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I appreciate the excellent discussion and info many have added to this thread.
Question: My son from a very early age, occasionally develops a skin infection near his eye. It's some type of Herpes disease. When it happens it's critical we get him on Acyclovir 800mg 1daily for 5 days before it reaches the eye. In a SHTF situation, would any of the "fish type" antibiotics work in a pinch. It's the one med I really need to find a way to have more than just one back up. Thanks in advance for the help. |
The 2nd amendment is not just a right, it's a responsibility. So train like it...
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Originally Posted By Fongman:
I appreciate the excellent discussion and info many have added to this thread. Question: My son from a very early age, occasionally develops a skin infection near his eye. It's some type of Herpes disease. When it happens it's critical we get him on Acyclovir 800mg 1daily for 5 days before it reaches the eye. In a SHTF situation, would any of the "fish type" antibiotics work in a pinch. It's the one med I really need to find a way to have more than just one back up. Thanks in advance for the help. None of the antibiotics mentioned will do you any good... Herpes is a virus, and requires specific anti-viral medications. Antibiotics don't do anything against viruses. You've already mentioned the cheapest one: Acyclovir. You could do Famvir, or Valtrex... but those are much more expensive. ETA: and it sounds like your son either has shingles, or recurrent HSV1/2... these episodes tend to be self-limited, and will resolve on their own without treatment (they're painful/itchy... and they do suck... but they're not life-threatening, except in newborns). If the herpes is actually IN the eye, it can damage the cornea, so that specific scenario is a must-treat situation. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Originally Posted By Fongman:
Thank you for the response - I really appreciate it. I guess I need to befriend a doctor somewhere... YW. See my edit... a bit more info for you. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
I believe you are correct. He developed the symptoms when he was about 2. Unfortunately it's always on the side of his nose south of the tear duct. And always works it's way towards the tear duct. His Doctor has always been concerned about it getting into the eye, which is why he always gives us an extra prescription - so that we can start the meds as soon as the rash beings to develop. My son is 18 now and still has to deal with it a couple of times a year. And it always seems to be during high stress times.
Unfortunately, I'm guessing a true SHTF situation would be a time of elevated stress.
I think I just need to get the doc to send us a refill more often and start setting a few doses back... Thank you once again. |
The 2nd amendment is not just a right, it's a responsibility. So train like it...
|
Originally Posted By Fongman:
I believe you are correct. He developed the symptoms when he was about 2. Unfortunately it's always on the side of his nose south of the tear duct. And always works it's way towards the tear duct. His Doctor has always been concerned about it getting into the eye, which is why he always gives us an extra prescription - so that we can start the meds as soon as the rash beings to develop. My son is 18 now and still has to deal with it a couple of times a year. And it always seems to be during high stress times. Unfortunately, I'm guessing a true SHTF situation would be a time of elevated stress.
I think I just need to get the doc to send us a refill more often and start setting a few doses back... Thank you once again. As an aside, I don't know how much I'd worry about this one for SHTF. He probably has a recurrent herpetic infection in the maxillary branch of his trigeminal nerve. Those tend not to spread to the eye, unless you physically wipe some blister juice into the conjunctiva. We sometimes worry a bit more if the blisters actually spread to the top or tip of the nose, since the tip in innervated by the infratrochlear nerve, a branch of the Ophthalmic branch of the Trigeminal nerve.... like so: 
Maxillary herpetic infections tend not to spread to the cornea... so your doc is just being extra careful. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Wow, your awesome...
His infection usually breaks out right on that line. It used to be right up against the tear duct, but as he has grown it has moved down the nose a bit. When he was about 5 it did get into the eye once. That involved a whole bunch of drugs and check ups with a pediatric disease specialist and another eye specialist. That was the only time it actually got into the eye. Thanks for all the extra info. |
The 2nd amendment is not just a right, it's a responsibility. So train like it...
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Originally Posted By Fongman:
Thank you for the response - I really appreciate it. I guess I need to befriend a doctor somewhere... Here ya go...
http://www.alldaychemist.com/312_Famvir-500-mg Virovir 500 mg Generic Name: Famciclovir US. Brand : Famvir 500 mg Manufacturer: FDC Strength: 500 Package: 6 Pills Price: $16.85 Add to cart Add to my wishlist |
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TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By EXPY37:
Originally Posted By Fongman:
Thank you for the response - I really appreciate it. I guess I need to befriend a doctor somewhere... Here ya go...
http://www.alldaychemist.com/312_Famvir-500-mg Virovir 500 mg Generic Name: Famciclovir US. Brand : Famvir 500 mg Manufacturer: FDC Strength: 500 Package: 6 Pills Price: $16.85 Add to cart Add to my wishlist BushBoar led me to the same site. Thank you all very much! |
The 2nd amendment is not just a right, it's a responsibility. So train like it...
|
Originally Posted By BushBoar:
TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Originally Posted By TheGrayMan: Originally Posted By BushBoar: TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). I understand that - I haven't bought PenG tabs because I know the oral bioavailability is poor. What I meant to ask is - is there a significant difference between IM and IV for those drugs that are given parenterally? |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). I understand that - I haven't bought PenG tabs because I know the oral bioavailability is poor. What I meant to ask is - is there a significant difference between IM and IV for those drugs that are given parenterally? Yes... the absorption from intramuscular injections is slower, more erratic, and more difficult to control than an IV infusion. Some antibiotics don't even have an intramuscular preparation... it's IV or nothing. Some antibiotics are so hypertonic and/or irritating to the tissues in a concentrated form (suitable for IM injection) that you literally cannot give them that way, lest you create a necrotic area in the muscle. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
This has been a remarkable thread capable of reaching its full potential thanks to the involvement of ARFCOM's medical and pharmaceutical professionals. I thank all of you for your involvement in this thread. Living in a very lawsuit happy society, I know it is not always easy for you folks to share your opinions openly with others. I appreciate you taking the time to present us with the pertinent info that will better allow us to decide for ourselves if this approach to survival medicine holds promise.
Personally, I've always been the type to never cut corners when it comes to medical issues. I've never tried to save a buck by electing to go with veterinary medicines. I don't take any meds not prescribed to me by a doctor, even if I am reasonably sure of my condition and even if I have access to the necessary drug to treat the ailment (i.e. a sinus infection I could treat with a family member's leftover Amoxicillin). No. I just always go to my clinic, get a diagnosis, then treat it with what the pros prescribe. But that isn't what we are talking about in this thread. Obviously, there are some situations where things might get so bad as to make availability of medicines tough if not impossible. It would stand to reason that for those of us who consider having a minimum one year supply of food on hand should also consider having some antibiotics on hand. If the situation is so bad that food may be unobtainable at the local level, basic medicines will probably likewise be hard to find. In these type of situations, treating yourself may be the only option available. While not an ideal situation to find oneself in, I'd rather have the option of being able to treat myself than to perhaps risk a simple infection becoming a very serious issue, or even fatal. Again, I'm not interested in these Amazon.com "fish antibiotics" as a means to bypass professional medical care or to save a buck on my prescription. I'm interested in them as an option of last resort when all better options have been exhausted or simply become unavailable. Again, this thread has been a valuable read, one of the best I've seen here in the SF in fact. I am going to go back and start again at the beginning and carefully read all the way through again, taking notes and writing down the links that have been shared as well as the recommended basic antibiotics that should be kept on hand. BTW, one quick question. I've noticed lots of people talking about expiration dates, which leads me to believe that under less than ideal storage conditions these drugs have a relatively short shelf life of only one or two years. If that is the case, what would be the recommended minimums to keep on hand at any one time? Obviously one doesn't want to waste a bunch of money on a supply of drugs they are pretty unlikely to need, only to have to dispose of them a few years down the road. So would it make more sense from a $$$ standpoint to only keep enough of each on hand for a couple of courses of treatment or thereabouts? While I'd love to have a 5 gallon bucket full of every common antibiotic available, it really wouldn't be economically feasible for most of us to do so. I'm simply not going to spend hundreds of dollars on stuff that I'll need to toss in a few years. But I can tolerate the idea of buying a few $20 bottles of this stuff and having the peace of mind that I won't have to die of a simple freaking toothache like a Montagnard tribesman in Vietnam's Central Highlands might due to lack of medicine, if the balloon ever goes up. Know what I mean? I could tolerate such a minimal expenditure every few years. |
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Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). I don't mean to get too picky, but ciprofloxacin doesn't have equal bioavailability, i.e ciprofloxacin 500 mg PO = 400 mg IV and 250 mg PO=200 mg IV, just an oversight I am sure, but just thought I would let everybody know. Linezolid, azithromycin, metronidazole are equally bioavailable PO/IV. Also to add to the IM post, there are different diluents (lidocaine, SW, or NS) used to prepare different antibiotics that complicates matters. |
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Originally Posted By Ryerle51:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). I don't mean to get too picky, but ciprofloxacin doesn't have equal bioavailability, i.e ciprofloxacin 500 mg PO = 400 mg IV and 250 mg PO=200 mg IV, just an oversight I am sure, but just thought I would let everybody know. Linezolid, azithromycin, metronidazole are equally bioavailable PO/IV. Also to add to the IM post, there are different diluents (lidocaine, SW, or NS) used to prepare different antibiotics that complicates matters. I'm not sure that's true with Zithromax... got a link? The efficacy may be comparable, but I was under the impression that the oral bioavailability of Azithromycin was significantly lower, though it's still usually effective. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
I stand corrected the bioavailability of PO azith is 40%. The long half life and intracellular concentrations mean that in the real world 500 mg IV is converted to 500 mg PO, so they are pharmacodynamic equals, but not pharmacokinetic equals. azith is a time dependent killer and not concentration dependent in the end gray is right about the bioavailability, but it turns out the bacteria get killed even though I was wrong.
ETA: Grey Man, You have had cases were somebody failed PO azith and you put them on IV azith and they were cured, just curious |
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Originally Posted By Charging_Handle:
Personally, I've always been the type to never cut corners when it comes to medical issues. I've never tried to save a buck by electing to go with veterinary medicines. I don't take any meds not prescribed to me by a doctor, even if I am reasonably sure of my condition and even if I have access to the necessary drug to treat the ailment (i.e. a sinus infection I could treat with a family member's leftover Amoxicillin). No. I just always go to my clinic, get a diagnosis, then treat it with what the pros prescribe. Why not give some 'alternative medicine' a try and see if you can develop some medical independence, self-confidence, knowledge and experience, while you have plenty of back-up and there's time to do it?
Just dip your toe in, a little at a time. [Of course, don't do anything potentially 'harmful'. Like a kidney transplant or sumpin...] 
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Originally Posted By TheGrayMan: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By BushBoar: TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). I understand that - I haven't bought PenG tabs because I know the oral bioavailability is poor. What I meant to ask is - is there a significant difference between IM and IV for those drugs that are given parenterally? Yes... the absorption from intramuscular injections is slower, more erratic, and more difficult to control than an IV infusion. Some antibiotics don't even have an intramuscular preparation... it's IV or nothing. Some antibiotics are so hypertonic and/or irritating to the tissues in a concentrated form (suitable for IM injection) that you literally cannot give them that way, lest you create a necrotic area in the muscle. I've heard that's the case with vancomycin. Is PenG ok for IM use? |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). I understand that - I haven't bought PenG tabs because I know the oral bioavailability is poor. What I meant to ask is - is there a significant difference between IM and IV for those drugs that are given parenterally? Yes... the absorption from intramuscular injections is slower, more erratic, and more difficult to control than an IV infusion. Some antibiotics don't even have an intramuscular preparation... it's IV or nothing. Some antibiotics are so hypertonic and/or irritating to the tissues in a concentrated form (suitable for IM injection) that you literally cannot give them that way, lest you create a necrotic area in the muscle. I've heard that's the case with vancomycin. Is PenG ok for IM use? Penicillin G benzathine/procaine is given IM |
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Originally Posted By Charging_Handle: This has been a remarkable thread capable of reaching its full potential thanks to the involvement of ARFCOM's medical and pharmaceutical professionals. I thank all of you for your involvement in this thread. Living in a very lawsuit happy society, I know it is not always easy for you folks to share your opinions openly with others. I appreciate you taking the time to present us with the pertinent info that will better allow us to decide for ourselves if this approach to survival medicine holds promise. Personally, I've always been the type to never cut corners when it comes to medical issues. I've never tried to save a buck by electing to go with veterinary medicines. I don't take any meds not prescribed to me by a doctor, even if I am reasonably sure of my condition and even if I have access to the necessary drug to treat the ailment (i.e. a sinus infection I could treat with a family member's leftover Amoxicillin). No. I just always go to my clinic, get a diagnosis, then treat it with what the pros prescribe. But that isn't what we are talking about in this thread. Obviously, there are some situations where things might get so bad as to make availability of medicines tough if not impossible. It would stand to reason that for those of us who consider having a minimum one year supply of food on hand should also consider having some antibiotics on hand. If the situation is so bad that food may be unobtainable at the local level, basic medicines will probably likewise be hard to find. In these type of situations, treating yourself may be the only option available. While not an ideal situation to find oneself in, I'd rather have the option of being able to treat myself than to perhaps risk a simple infection becoming a very serious issue, or even fatal. Again, I'm not interested in these Amazon.com "fish antibiotics" as a means to bypass professional medical care or to save a buck on my prescription. I'm interested in them as an option of last resort when all better options have been exhausted or simply become unavailable. Again, this thread has been a valuable read, one of the best I've seen here in the SF in fact. I am going to go back and start again at the beginning and carefully read all the way through again, taking notes and writing down the links that have been shared as well as the recommended basic antibiotics that should be kept on hand. BTW, one quick question. I've noticed lots of people talking about expiration dates, which leads me to believe that under less than ideal storage conditions these drugs have a relatively short shelf life of only one or two years. If that is the case, what would be the recommended minimums to keep on hand at any one time? Obviously one doesn't want to waste a bunch of money on a supply of drugs they are pretty unlikely to need, only to have to dispose of them a few years down the road. So would it make more sense from a $$$ standpoint to only keep enough of each on hand for a couple of courses of treatment or thereabouts? While I'd love to have a 5 gallon bucket full of every common antibiotic available, it really wouldn't be economically feasible for most of us to do so. I'm simply not going to spend hundreds of dollars on stuff that I'll need to toss in a few years. But I can tolerate the idea of buying a few $20 bottles of this stuff and having the peace of mind that I won't have to die of a simple freaking toothache like a Montagnard tribesman in Vietnam's Central Highlands might due to lack of medicine, if the balloon ever goes up. Know what I mean? I could tolerate such a minimal expenditure every few years. As for your last paragraph, most of the medications we've been discussing are inexpensive enough that having a couple hundred tablets on hand is not a major expense; many of them can be had for between 5 and 20 cents per tablet - including levofloxacin and doxycycline, two of the most useful. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By Ryerle51: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By BushBoar: TGM, For those drugs which can be given either IM or IV (PenG, oxytetracycline, etc), is there a substantive difference between the two routes of administration, other than quicker onset of action? I ask because I'd feel comfortable giving myself or someone else an injection via IM, but not via IV. I understand about the sterility procedures necessary. There is frequently a difference in bioavailability... most antibiotics achieve better tissue levels and better MICs when given parenterally (IV or IM)... some MUST be given that way (eg. there is no oral preparation). The only class of antibiotics I know that achieves equal bioavailability orally as it does IV is the quinolones (cipro, levaquin, etc). I understand that - I haven't bought PenG tabs because I know the oral bioavailability is poor. What I meant to ask is - is there a significant difference between IM and IV for those drugs that are given parenterally? Yes... the absorption from intramuscular injections is slower, more erratic, and more difficult to control than an IV infusion. Some antibiotics don't even have an intramuscular preparation... it's IV or nothing. Some antibiotics are so hypertonic and/or irritating to the tissues in a concentrated form (suitable for IM injection) that you literally cannot give them that way, lest you create a necrotic area in the muscle. I've heard that's the case with vancomycin. Is PenG ok for IM use? Penicillin G benzathine/procaine is given IM On the Hopkins ABX guide, I've noticed that PenG benzathine/procaine is not interchangeable with PenG benzathine. What is the reason for that? Why is one more suited to certain indications than the other? |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By Ryerle51:
I stand corrected the bioavailability of PO azith is 40%. The long half life and intracellular concentrations mean that in the real world 500 mg IV is converted to 500 mg PO, so they are pharmacodynamic equals, but not pharmacokinetic equals. azith is a time dependent killer and not concentration dependent in the end gray is right about the bioavailability, but it turns out the bacteria get killed even though I was wrong. ETA: Grey Man, You have had cases were somebody failed PO azith and you put them on IV azith and they were cured, just curious No worries, brother... I feel your pain. I can't keep all the pharmacokinetic stuff straight half the time. 
And if I have a treatment failure with po Zithromax (almost always somebody being treated for pneumonia or sinuses), I tend to switch classes entirely... usually to a quinolone or beta-lactam (and sometimes you add a beta lactam to the zithromax). To some degree, it depends on what you're treating, and the patient population. My pulmonary colleagues are very fond of the Macrolide + 3rd Gen Ceph combo for pneumonia. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
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Originally Posted By TheGrayMan:
Originally Posted By Ryerle51:
I stand corrected the bioavailability of PO azith is 40%. The long half life and intracellular concentrations mean that in the real world 500 mg IV is converted to 500 mg PO, so they are pharmacodynamic equals, but not pharmacokinetic equals. azith is a time dependent killer and not concentration dependent in the end gray is right about the bioavailability, but it turns out the bacteria get killed even though I was wrong. ETA: Grey Man, You have had cases were somebody failed PO azith and you put them on IV azith and they were cured, just curious No worries, brother... I feel your pain. I can't keep all the pharmacokinetic stuff straight half the time.
And if I have a treatment failure with po Zithromax (almost always somebody being treated for pneumonia or sinuses), I tend to switch classes entirely... usually to a quinolone or beta-lactam (and sometimes you add a beta lactam to the zithromax). To some degree, it depends on what you're treating, and the patient population. My pulmonary colleagues are very fond of the Macrolide + 3rd Gen Ceph combo for pneumonia. Ok just making sure, I had you pegged for a prescriber smarter than to just change formulations after a treatment failure ;) |
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Originally Posted By Ryerle51:
Originally Posted By TheGrayMan:
Originally Posted By Ryerle51:
I stand corrected the bioavailability of PO azith is 40%. The long half life and intracellular concentrations mean that in the real world 500 mg IV is converted to 500 mg PO, so they are pharmacodynamic equals, but not pharmacokinetic equals. azith is a time dependent killer and not concentration dependent in the end gray is right about the bioavailability, but it turns out the bacteria get killed even though I was wrong. ETA: Grey Man, You have had cases were somebody failed PO azith and you put them on IV azith and they were cured, just curious No worries, brother... I feel your pain. I can't keep all the pharmacokinetic stuff straight half the time.
And if I have a treatment failure with po Zithromax (almost always somebody being treated for pneumonia or sinuses), I tend to switch classes entirely... usually to a quinolone or beta-lactam (and sometimes you add a beta lactam to the zithromax). To some degree, it depends on what you're treating, and the patient population. My pulmonary colleagues are very fond of the Macrolide + 3rd Gen Ceph combo for pneumonia. Ok just making sure, I had you pegged for a prescriber smarter than to just change formulations after a treatment failure ;)
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"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Originally Posted By BushBoar:
As for your last paragraph, most of the medications we've been discussing are inexpensive enough that having a couple hundred tablets on hand is not a major expense; many of them can be had for between 5 and 20 cents per tablet - including levofloxacin and doxycycline, two of the most useful. Where are you finding levofloxacin for 20 cents per tablet? Quick search from my usual places, with a wide range in price: brand name Levaquin 500 mg tablets - 50 for $1080.91 ($21.62 each, US wholesaler, med license needed to order) levofloxacin generic 500 mg tablets - 100 for $235.00 ($2.35 each, Canadian retailer, rx needed to order) $23.50 for a 10 day treatment course isn't bad, but $.20/tablet is far below anything I've seen for levofloxacin. |
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Just ordered some zithromax from adc.
Why is it SO much cheaper than the script I recently filled for the same thing? |
كافر
Originally Posted By Zakk_Wylde_470:
"Fucking Awesome. I love this song, and i'm a trekkie, so its like donuts with bacon and cheese, all nicely wrapped up in some quality sex and deep fried in beer. For christmas.&#
Originally Posted By Zakk_Wylde_470:
"Fucking Awesome. I love this song, and i'm a trekkie, so its like donuts with bacon and cheese, all nicely wrapped up in some quality sex and deep fried in beer. For christmas.&#
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Originally Posted By gasdoc09: Originally Posted By BushBoar: As for your last paragraph, most of the medications we've been discussing are inexpensive enough that having a couple hundred tablets on hand is not a major expense; many of them can be had for between 5 and 20 cents per tablet - including levofloxacin and doxycycline, two of the most useful. Where are you finding levofloxacin for 20 cents per tablet? Quick search from my usual places, with a wide range in price: brand name Levaquin 500 mg tablets - 50 for $1080.91 ($21.62 each, US wholesaler, med license needed to order) levofloxacin generic 500 mg tablets - 100 for $235.00 ($2.35 each, Canadian retailer, rx needed to order) $23.50 for a 10 day treatment course isn't bad, but $.20/tablet is far below anything I've seen for levofloxacin. From ADC. Levofloxacin generic 500 mg tablets - 10 for $2.04 (20.4 cents each, Indian retailer, no Rx needed to order). |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By BushBoar:
Originally Posted By gasdoc09:
Originally Posted By BushBoar:
As for your last paragraph, most of the medications we've been discussing are inexpensive enough that having a couple hundred tablets on hand is not a major expense; many of them can be had for between 5 and 20 cents per tablet - including levofloxacin and doxycycline, two of the most useful. Where are you finding levofloxacin for 20 cents per tablet? Quick search from my usual places, with a wide range in price: brand name Levaquin 500 mg tablets - 50 for $1080.91 ($21.62 each, US wholesaler, med license needed to order) levofloxacin generic 500 mg tablets - 100 for $235.00 ($2.35 each, Canadian retailer, rx needed to order) $23.50 for a 10 day treatment course isn't bad, but $.20/tablet is far below anything I've seen for levofloxacin. From ADC. Levofloxacin generic 500 mg tablets - 10 for $2.04 (20.4 cents each, Indian retailer, no Rx needed to order). I've looked at ADC's site and in their FAQ it says you need a prescription to buy prescription drugs from them. What is the deal here? Is their idea of "prescription drugs" narcotics, whereas antibiotics are good to go? They sure as hell have super cheap prices, even better than the fish stuff on Amazon. |
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Originally Posted By Charging_Handle: Originally Posted By BushBoar: Originally Posted By gasdoc09: Originally Posted By BushBoar: As for your last paragraph, most of the medications we've been discussing are inexpensive enough that having a couple hundred tablets on hand is not a major expense; many of them can be had for between 5 and 20 cents per tablet - including levofloxacin and doxycycline, two of the most useful. Where are you finding levofloxacin for 20 cents per tablet? Quick search from my usual places, with a wide range in price: brand name Levaquin 500 mg tablets - 50 for $1080.91 ($21.62 each, US wholesaler, med license needed to order) levofloxacin generic 500 mg tablets - 100 for $235.00 ($2.35 each, Canadian retailer, rx needed to order) $23.50 for a 10 day treatment course isn't bad, but $.20/tablet is far below anything I've seen for levofloxacin. From ADC. Levofloxacin generic 500 mg tablets - 10 for $2.04 (20.4 cents each, Indian retailer, no Rx needed to order). I've looked at ADC's site and in their FAQ it says you need a prescription to buy prescription drugs from them. What is the deal here? Is their idea of "prescription drugs" narcotics, whereas antibiotics are good to go? They sure as hell have super cheap prices, even better than the fish stuff on Amazon. I know their FAQ says that, but I've ordered from them several times and I've never been asked for a prescription. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By Charging_Handle:
This has been a remarkable thread capable of reaching its full potential thanks to the involvement of ARFCOM's medical and pharmaceutical professionals. I thank all of you for your involvement in this thread. Living in a very lawsuit happy society, I know it is not always easy for you folks to share your opinions openly with others. I appreciate you taking the time to present us with the pertinent info that will better allow us to decide for ourselves if this approach to survival medicine holds promise. Personally, I've always been the type to never cut corners when it comes to medical issues. I've never tried to save a buck by electing to go with veterinary medicines. I don't take any meds not prescribed to me by a doctor, even if I am reasonably sure of my condition and even if I have access to the necessary drug to treat the ailment (i.e. a sinus infection I could treat with a family member's leftover Amoxicillin). No. I just always go to my clinic, get a diagnosis, then treat it with what the pros prescribe. But that isn't what we are talking about in this thread. Obviously, there are some situations where things might get so bad as to make availability of medicines tough if not impossible. It would stand to reason that for those of us who consider having a minimum one year supply of food on hand should also consider having some antibiotics on hand. If the situation is so bad that food may be unobtainable at the local level, basic medicines will probably likewise be hard to find. In these type of situations, treating yourself may be the only option available. While not an ideal situation to find oneself in, I'd rather have the option of being able to treat myself than to perhaps risk a simple infection becoming a very serious issue, or even fatal. Again, I'm not interested in these Amazon.com "fish antibiotics" as a means to bypass professional medical care or to save a buck on my prescription. I'm interested in them as an option of last resort when all better options have been exhausted or simply become unavailable. Again, this thread has been a valuable read, one of the best I've seen here in the SF in fact. I am going to go back and start again at the beginning and carefully read all the way through again, taking notes and writing down the links that have been shared as well as the recommended basic antibiotics that should be kept on hand. BTW, one quick question. I've noticed lots of people talking about expiration dates, which leads me to believe that under less than ideal storage conditions these drugs have a relatively short shelf life of only one or two years. If that is the case, what would be the recommended minimums to keep on hand at any one time? Obviously one doesn't want to waste a bunch of money on a supply of drugs they are pretty unlikely to need, only to have to dispose of them a few years down the road. So would it make more sense from a $$$ standpoint to only keep enough of each on hand for a couple of courses of treatment or thereabouts? While I'd love to have a 5 gallon bucket full of every common antibiotic available, it really wouldn't be economically feasible for most of us to do so. I'm simply not going to spend hundreds of dollars on stuff that I'll need to toss in a few years. But I can tolerate the idea of buying a few $20 bottles of this stuff and having the peace of mind that I won't have to die of a simple freaking toothache like a Montagnard tribesman in Vietnam's Central Highlands might due to lack of medicine, if the balloon ever goes up. Know what I mean? I could tolerate such a minimal expenditure every few years. +1000 When I started this thread, I never dreamed it would be so productive and full of useful information. Thanks very, very much to you medical professionals for your advice! 
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" Never confuse movement with action." Ernest Hemingway
Protect our 2nd Amendment Rights -- Join the NRA
Protect our 2nd Amendment Rights -- Join the NRA
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As others have mentioned, thanks again to the contributors to this thread - it's been invaluable.
If anyone is interested, I ordered from a few overseas places about a year ago and have been (unfortunately) using a good bit of my supplies. First and foremost, I never self-prescribe. I do research, figure out what I think I'll need and then go to a doctor to get checked out (and see if I was right). He'll write a script and then I'll take my mail order stuff. I didn't use ADC (I used a combo of a canadian and an indian website - AWC and the-drug-store), and have been pleased with the results. I've had a few sinus/ear infections knocked down by the mail-order zithromax or augmentin (hope to have surgery in 2011). Kids have used some for various other things (again, as prescribed by a doctor), and they've worked fine. I do notice a little more odor than I might with the US brands, but their packaging (blister packs) and effectiveness have been perfect. The only thing I'll add here is that I've gone to WebMD and printed out the description, dosage (often by patient weight), side effects and other details for everything I've stocked. I figure in a situation where I may need these, a hard-copy of this information may also be invaluable (i.e. it's very likely the internet may not be available). Just an idea..... |
A democracy exists until the voters discover that they can vote themselves money from the public treasure. From that moment on the majority always votes for the candidates promising the most money.
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Originally Posted By BushBoar:
From ADC. Levofloxacin generic 500 mg tablets - 10 for $2.04 (20.4 cents each, Indian retailer, no Rx needed to order). Maybe I'm being unnecessarily cautious, but ordering Indian meds online from a place that apparently doesn't actually ask for a prescription seems a high risk premium for such a steep cash discount. 750 mg tabs from Cipla (Mumbai, India). 500 mg tabs from Alkem (Mumbai, India). |
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Originally Posted By gasdoc09:
Originally Posted By BushBoar:
From ADC. Levofloxacin generic 500 mg tablets - 10 for $2.04 (20.4 cents each, Indian retailer, no Rx needed to order). Maybe I'm being unnecessarily cautious, but ordering Indian meds online from a place that apparently doesn't actually ask for a prescription seems a high risk premium for such a steep cash discount. 750 mg tabs from Cipla (Mumbai, India). 500 mg tabs from Alkem (Mumbai, India). A great % of the world's meds are mfg'd in India. If they were faulty, we'd likely hear about it. Soon to be China I'd guess. ADC has a great rep. |