#Medications

[maculategiraffe]

so I have always been a bit boggled by the idea of "self esteem." like I have always liked myself and wanted the best for myself and thought I was awesome and yet therapists have constantly been accusing me of having "low self esteem"

and it's only very recently that I have worked out that by Self Esteem they mean more like-- trusting myself. to be able to do what I want done. and my whole life I have been real shaky on that not because I don't think I'm awesome but because I have become increasingly and miserably aware that I have a fucking neurological condition. or two. that make it extremely difficult to do certain things no matter how much I want them done

and now that I've gotten myself diagnosed and medicated I am more getting what they mean. like. now I know I probably CAN do the thing if I am properly medicated and have gotten a good night's sleep and deploy the right playlist. and everything is way less scary because of that

but it's not because. like. I just needed to esteem myself more?? it's like if I fought and fought and finally got a wheelchair and was like "okay NOW I know I can make it through an entire trip to the grocery store" and people were like "see! you just needed to believe in yourself!" no I needed Y'ALL to fucking believe me

[elizabethmerck]

It’s been a while since I posted Bridgerton funny memes. Here’s another product series (medications this time). Hope you have a giggle! 🤭

[macgyvermedical]

Reference Guide to Writing Drug Withdrawal

So your character has a substance use disorder (or physical dependence to a substance for another reason). This post will tell you how to write a scene (or story) in which they go through withdrawal.

NOTE: THIS POST DOES NOT INTEND TO COVER ANYTHING EXCEPT WITHDRAWAL, WHICH IS A VERY SMALL PART OF SUBSTANCE USE DISORDER AND PHYSICAL DEPENDENCE.

Substance Use Disorders and Physical Dependence:

Substance use disorders are chronic illnesses in which a person continues to use a substance (commonly nicotine, alcohol, cocaine, opioids like heroin or fentanyl, benzodiazepines, etc...) even when acquiring or using the substance can be dangerous or cause significant problems in their life (such as problems with money, safety, law enforcement, job security, child services involvement, or physical problems like wounds, infections, side effects, hangovers, and withdrawal). Substance use disorders are a common cause of physical dependence.

Physical dependence is also it's own problem and can occur for other reasons too. For example, many people take prescription medications that they would go through withdrawal from if stopped abruptly (say, because the pharmacy couldn't fill it in time and they ran out). Assuming that the medication is being taken as prescribed, physical dependence in itself does not mean someone has a substance use disorder.

So what is withdrawal? Withdrawal (sometimes called "detox") is the process by which a body stops being physically dependent on a substance. Generally speaking, it is unpleasant. This is because when a body is exposed to a substance repeatedly, it changes how it functions to accommodate that substance. When the substance is removed, there is a period of time where the body has to re-adjust to not having the substance.

For example, alcohol is very similar to the neurotransmitter (brain chemical) GABA. If you drink a lot of alcohol (more than about 4 drinks per day) for longer than about a month, the body decreases the amount of GABA it makes naturally to accommodate the "fake" GABA from the alcohol. If the alcohol is suddenly removed, the body doesn't have enough GABA, and the effects of not having enough GABA result in withdrawal symptoms.

The difference being, someone taking a medication they no longer want to take can slowly reduce the dose to minimize withdrawal symptoms. Someone with a substance use disorder usually finds cutting back nearly impossible. Because of this, managing physical dependence in someone with substance use disorder generally means giving them a similar substance which they get from a pharmacy and take continuously (methadone, buprenorphine), or a similar substance they can then taper off of in a controlled way (benzodiazepines, gabapentin).

Specific Withdrawal Syndromes:

Alcohol/Benzodiazepines:

These are the only two substances that result in a potentially life-threatening withdrawal syndrome, and it's essentially the same syndrome. As stated above, when taken for either 2 weeks for benzodiazepines or 4 weeks for alcohol, the body decreases the amount of GABA it produces naturally. GABA is the "brake pedal" in the brain, slowing things down and decreasing the amount of activity. If you don't have enough GABA, you get too much activity, which can result in severe anxiety, insomnia, seizures, hallucinations, high blood pressure, temperature, and pulse rate, heart arrhythmias, and confusion.

6-12 hours after a person's last drink, they will experience insomnia, anxiety, tremors, and headache.

12-24 hours after a person's last drink, if untreated with benzodiazepines or gabapentin, they may start to experience hallucinations (they typically know they are hallucinating at this point).

24-48 hours after a person's last drink, if untreated, they may start to experience seizures.

48-72 hours after a person's last drink, if untreated, they may start to experience a severe symptom known as delerium tremens. This is a state where they are hallucinating severely and they don't know they are hallucinating anymore. This is also a state where the person has heart rhythm problems that could result in death. This is the most dangerous period during withdrawal.

If a person makes it through 72 hours, they are usually in the clear as far as life threatening symptoms go, though they may experience mild symptoms like headaches and insomnia for long periods afterwards.

Note that medication for alcohol or benzodiazepine withdrawal like other benzodiazepines, phenobarbital, and gabapentin are given only for the first 5 days of withdrawal, tapering to lower doses each day. This gets the person through the dangerous part hopefully with no life threatening symptoms. It does not mean all symptoms are controlled, but they are hopefully kept on the milder end while the brain learns to make it's own GABA again.

Opioids:

Opioids include a range of drugs including prescription medications like oxycodone, hydromorphone, and morphine, as well as street drugs like heroin. Today, the street drug supply in many places is heavily adulterated. Many samples of heroin (and even "pressed pills" made to look like prescription opioids) contain the much stronger opioid fentanyl (which increases risk of overdose) and the sedative xylazine (which causes wounds) in addition to the expected heroin or oxycodone.

Opioids work by pretending to be endorphins- another neurotransmitter usually used by the body to reduce pain and stress. Similarly to GABA in alcohol use, the body reacts to having sustained high amounts of fake endorphins by decreasing the amount of endorphins it makes itself. This means, when the opioids are no longer present, the body can't make itself feel good or recover from pain.

There are many parts of the body that endorphins work in, including the brain, gut, nerves, and spine. When they are removed, symptoms include:

Nausea and vomiting.

Diarrhea.

Insomnia.

Anxiety.

Increased body temperature.

Racing heart.

Muscle and bone pain.

Sweating.

Chills.

High blood pressure.

There is not really a universal timeline for these symptoms like there is with alcohol. For someone who primarily uses short-acting opioids, withdrawal begins 8-24 hours after the last use (though anxiety and cravings can start much sooner). For people who primarily use long-acting opioids, withdrawal can take up to 36 hours to begin following the last use. Generally, symptoms peak within 1-3 days after they start, and acute symptoms last 10-14 days.

Unfortunately, someone who has an opioid use disorder will frequently experience cravings for very long periods of time (potentially the rest of their life) after they stop use. For this reason, people do significantly better at reducing or stopping use over the long haul if they are taking an opioid replacement drug like methadone or buprenorphine.

Methadone and buprenorphine are prescription medications that a person goes somewhere each day to get (methadone) or picks up each day from the pharmacy (buprenorphine). The drugs essentially make it so the person won't go into withdrawal and will have significantly fewer cravings for as long as they take the drug.

The management of opioid withdrawal is usually done by switching the person from a street drug to one of these opioid replacement drugs. However, it is important to note that methadone doesn't work immediately (usually it takes about 2-5 days of titrating it up to get it to a high enough dose to work, longer if the person has a very high tolerance). Buprenorphine requires a certain amount of time in withdrawal (usually a day or two) before it can be given, or it can make withdrawal worse instead of better (something called precipitated withdrawal).

Once someone is on one of these medications, they can choose to stay on them (recommended) or taper off (nice to be off meds in theory, but high rates of return-to-use).

Cocaine/Amphetamines:

Instead of pretending to be a neurotransmitter, stimulants like cocaine and amphetamines prevent the body from re-absorbing the neurotransmitter dopamine, leading to a whole bunch of it hanging out in the brain. This increases concentration and energy and boosts mood. However, taken over long periods of time, the brain kind of burns out and fails to respond to the high levels of dopamine.

You may have heard that amphetamines and cocaine don't have withdrawal states. That would be a myth. People who use stimulants repeatedly for long periods frequently have a withdrawal that is essentially the opposite of the effects of stimulants- they feel very tired, have trouble focusing, and feel depressed because their brains can't use dopamine the same way they did before the drug use. This may last for weeks after cessation of stimulants.

Unfortunately, unlike with alcohol and opioids, there's not a ton that can be done for this withdrawal. There have been several studies, including testing medications like the antidepressant mertazapine, the migraine medicine topiramate, as well as naltrexone and buproprion (also an antidepressant).

In Conclusion:

There is so much more to drug use, substance use disorder, and physical dependence than I am covering in this post. I am just covering a small part of physical dependence, however the cause, by discussing the effects and common treatments for withdrawal.

Thank you all for reading this far! I hope you learned something and will use it in your writing!

[schizopositivity]

I know too many mentally ill and disabled people to think that taking medication every day is strange. At this point it's more baffling to think that some people don't take any medication. Like people are really out here rawdogging life? People exist who don't have to constantly worry about refilling their meds? Now THAT is strange to me.

[like-this-post-if-you]

Like this post if you take daily meds

[sapphic-sprite]

It’s been record breaking high temperatures all over the world for the last couple months so I’d like to implore y’all to please check the warnings on your medications. I know personally one of my medications makes me sensitive to natural/artificial sunlight and the other makes me more susceptible to being dehydrated. SSRIs, commonly, can make you heat intolerant. Make sure you are checking the reactions that your medications can have so you don’t end up in the hospital as summer is not over and we will continue to have increasingly high temperatures.

[localdorkincombatboots]

Please Help My Family

Between handling my mils affairs after her death, rent going up another $200, my mother losing her job, and my bf's medical problems continuing to get worse and his job taking days away from him, we desperately need help.

Where our rent has gotten so high + my mother losing her job which also provided her housing, we're hoping to be able to use her vacation payout to buy the cheapest possible mobile home we've been able to find. It's in such bad shape that it'll probably take a month to fix everything but this appears to be the only way for us to set things up in a way that we won't have to worry as bad about money later on, esp considering lot rent there is 1/4 of the price of our current rent.

We're still behind on all of our current bills due to everthing that has been happening plus more recent events including my bf having another heart attack and his tumors growing to the point of a couple of them metastizing.

Please we desperately need help to catch back up on our current bills and to afford the materials needed to fix the floor in the trailer so that we can move there and not have nearly as many bills to worry about.

PayPal: crackerjaxx7@gmail.com

Venmo: jayep7

Cashapp: jayep7

If you can't send anything, please rebog this so hopefully someone who can help might see this.

[cleolinda]

Medications I am taking for my current ordeal

Prednisone: Steroid. Reduces the inflammation of my herniated disc. Knocked out 99% of the pain. MVP. Mood elevation for a couple of weeks (wanted to deep clean the whole house), then it started to make me kind of mentally scattered and easily agitated. Spinal doctor discontinued it so I can have a Big Steroid in two weeks.

Tylenol: A good time. Helps pain a lot. Does more for me than actual opioids. Watch your liver.

Flexeril: Muscle relaxer. Will make you (me) groggy for days afterwards without actually doing much. Mostly made me not care that things hurt. Did keep me from deep-cleaning the house. It was that or a tranquilizer dart.

Meloxicam: Non-steroidal anti-inflammatory. Leg is a little fussy but 90% of the pain is at bay. Makes me loopy and kind of groggy but it’s only for two weeks. Acceptable.

Tizanidine: Muscle relaxer. No perceptible benefit, feels like being drunk, makes me post about politics. Discontinuing immediately.

[cranquis]

https://www.dea.gov/everyday-takeback-day

A list of free drop-box locations across the United States where you can dispose of unwanted/expired medications.

[maculategiraffe]

ooh ooh I thought of another metaphor for adhd medication

it's like if you were a bird, and you kept flying into windows, because you couldn't see the glass, and you thought it was just air, so you tried to fly through it but instead you got bonked and crashed by an invisible forcefield that you can't see even AFTER you bonk it

so you got REAL wary of invisible bonking forcefields. you never flew fast just in case. you brought a stick along in your beak so you could poke the air to see if it was really air. you developed alternate routes specifically to avoid head bonking. you still got head bonked. constantly.

but the medication takes the sheets of glass away so you can just fly like normal. you just keep flying along to where you want to go and sometimes you're like "I swear I got bonked RIGHT HERE before" because there was definitely a glass wall in that place before but now it's gone. but a lot of the ones that used to be there, you don't even notice. you just fly along. only occasionally stopping to marvel at how long it's been since you flew headfirst into an invisible barrier and gave yourself a concussion.

and all the other birds who never got bonked in the first place are like "see? it's easy! you just fly along! all that about the air crystallizing on you was just your imagination and your laziness and your lack of consideration for others. I'm glad you decided to get your shit together finally"

[dsudis]

Hey the ADHD meds + vitamin C post is misinformation, that’s not true across the board and some adhd meds are fine even mixed into orange juice or yogurt

Ther Drug Monit. 2016 Dec; 38(6): 769–776. Published online 2016 Nov 16. doi: 10.1097/FTD.0000000000000343

PMCID: PMC5158093PMID: 27661399

Whoops! Good to know!

[macgyvermedical]

Building Your Home Pharmacy

So you're in the OTC med section of the pharmacy. You've got 100 bucks burning a hole in your pocket (or maybe like $15 cause you're just starting). You're a new adult who wants to build yourself a tidy home pharmacy.

Well first you've got to know some stuff about over the counter (OTC) meds. This is the post to help you do it.

What are OTC meds? They are medications you can buy from a pharmacy or grocery store without needing a prescription. They have been deemed relatively safe and relatively easy to dose without a doctor's intervention. This does not mean they can't be dangerous, just that the general public can generally be trusted not to accidentally kill themselves with them on the regular. Keep that in your mind for later.

Note that all the medications discussed below are given in their generic names. In order to find these names, look below the brand name on a medication bottle:

Pain Medications:

Acetaminophen/Paracetamol: This is a non-NSAID pain reliever and fever reducer, so it's great for people who can't take NSAIDs due to stomach or kidney issues. Works best for headaches and fevers, but works on other types of pain as well. Technically works best as a suppository, but still works some orally. No increased risk of bleeding. Don't take more than directed. Seriously. This one can kill you or seriously damage your liver.

Ibuprofen: NSAID. Works against pain, inflammation, and fever. Take on a full stomach or you could get ulcers. Don't take if you have kidney problems. You can take this with acetaminophen.

Naproxen: NSAID. Probably the most effective for pain, but works against inflammation and fever as well. Lasts 12 hours. Don't take high doses continuously or you will get kidney problems. You can take this with acetaminophen.

Aspirin: NSAID. This was the first NSAID and it's definitely here to give you stomach ulcers if you don't take it on a full stomach. Technically it works for pain, inflammation, and fever. Most people today take it as a blood thinner. You can take this with acetaminophen.

Allergy/Cold/Congestion Medications:

Diphenhydramine/Doxalamine: First Generation Antihistamines. These are great for nighttime allergies, coughs, insomnia, nausea, and itching. Most people get drowsy from these, but some people get really hyper, especially kids.

Cetirazine/Loratadine/Fexofenadine: Second Generation Antihistamines. These work for allergies and itching and don't cause as much drowsiness.

Phenylephrine/Pseudoephedrine: Decongestants. These work by mimicking epinephrine, making the blood vessels in the nose and sinuses smaller. This makes the nose and sinuses less stuffy, but it raises blood pressure (so don't take if that's a problem for you). Pseudoephedrine is also restricted- you must be an adult to purchase and you can only buy so much. You have to talk to a pharmacist to get it because it can be used to make methamphetamine.

Triamcinolone/budesonide/fluticasone Nasal Spray: These are steroid sprays. They work similarly to the decongestants but only in the nose, and generally don't travel to the rest of the body.

Guifenesin: This is an expectorant, not a decongestant. It works by thinning the mucous in the lungs and airway. This makes it easier for you to cough it up. You have to drink a lot of water with this for it to work, though.

Dextromethorphan: This is a cough suppressant. It works by blocking signals in the brain that tell you to cough. Pretty much everything interacts with this one so if you take any medications talk to your doctor first. Depending on where you live you may have to talk to a pharmacist to get this one due to the potential for abuse.

Digestive Medications

Loperamide: This is an antidiarrheal. It works by decreasing the amount of squishing around your intestines are doing, which helps you hold your diarrhea and lets you continue to function. It is an opioid, but is not absorbed from your digestive tract so it doesn't make you high.

Bismuth Subsalicylate: This works for diarrhea as well, but also nausea, heartburn, and the prevention of traveler's diarrhea. Don't take if you're allergic to salicylates or aspirin. Taking this for an extended period of time can also cause bismuth toxicity.

Calcium Carbonate: This is an antacid. It is very basic pH wise, so can help change the pH of stomach contents pretty quickly. This is usually used for heartburn. If you take any other medications, this can prevent you from absorbing them if you take them within two hours. Using for long periods can cause rebound heartburn when you stop taking it.

Cemetidine/Famotidine/Ranitadine: These are gastric acid reducers, and they work by blocking the type of histamine that is necessary for the production of stomach acid. They are usually used for heartburn and ulcers.

Omeprezole/Esomeprezole: These are also gastric acid reducers, but they work by blocking a different part of the very complicated way our stomachs make acid. After years and years of taking these you might get some bone density problems.

Bisocodyl/Senna: These are laxatives. They work by increasing the movement of the intestines. It's important not to take these consistently unless you can't poop at all without them, or you seriously will not be able to poop without them.

Docusate/Propylene Glycol: These are stool softeners. They work by increasing the amount of water in the intestines. These are pretty safe to take all the time if you need to.

Simethicone: This is a surfactant. It works by accumulating all the gas bubbles in the intestines so they can be expelled. It's usually used for painful gas.

Topical Medications:

Clotrimezole/Miconazole: These are antifungal preparations. They treat yeast infections, athletes foot, jock itch, and ringworm.

Triple Antibiotic Ointment: This is a cream that contains antibiotics. Ostensibly you're supposed to put this on small cuts to decrease risk of infection. IRL just clean it with soap and water and then put some vasaline on it. Studies have shown it works just as well.

Hydrocortisone: This is a steroid cream. You put it on itchy things (bug bites, poison ivy, etc...) and it makes them not itch as much. This one actually works and is generally better than diphenhydramine creams that can't be used on poison ivy.

Permethrin: This is an insecticide. It will help get rid of head and body lice.

Zinc Oxide: This is a skin protectant. It helps prevent diaper rash and chafing. It also makes things feel better once you've already chafed. Technically it is also a sunblock, but it will make you look like a ghost while you're wearing it.

Family Planning:

Levonorgestrel: This is known as the morning after pill. It works by blocking ovulation, so that a sperm and egg cannot meet, preventing pregnancy. It can be taken up to 5 days after unprotected sex, though it works better the sooner it is taken.

Devices:

Blood Sugar Meter/Strips/Lancets: These help measure the amount of sugar in your blood. They are usually used by people with diabetes.

Blood Pressure Cuff: This measures blood pressure automatically with a cuff around the upper arm or wrist. It is usually used by people with high blood pressure.

Ketogenic Test Strips: This measures the amount of ketones in the urine. Ketones are a byproduct of fat breakdown, usually found when the body cannot breakdown carbohydrates for energy and begins to break down fat instead. Usually people who are on a ketogenic diet or people with diabetes use these.

Peak Flow Meter: This measures the amount of air that can be used by the lungs. They are usually used by people with asthma or COPD.

Great, Which Ones Do I Need?

I'd recommend look over the list and see which ones would be most useful for you, and start with those. Over time, collect ones that would be most embarrassing to not have, and then the ones that you're pretty sure you'll never use.

Note that in a dry, unopened package (including inside blister packs), drugs last well beyond their expiration dates. So if you don't use a certain med all that often, get a smaller package of it.

Great, Which Ones Can I Take at the Same Time?

Good question. I'm going to say that if you take any prescription medications, you always want to check with your doctor before taking anything OTC. However, I recommend you use an interaction checker like this one if you want to take more than one OTC med at the same time. One can be found here.

Note:

Loperamide CANNOT be taken with cimetidine/ranitidine/famotidine. This causes bad heart rhythms.

Don't take two meds from the same category together (like cimetadine with ranitidine, or ibuprofen with naproxen, or diphenhydramine and fexofenadine unless a doctor tells you to).

Most antacids (calcium carbonate, sodium bicarbonate) will prevent the absorption of other medications, so take them two hours apart from anything else you take.

Don't drink alcohol with loperamide, detromethophan, acetaminophen, or any antihistamines.

[crazycatsiren]

Every time I'm at the pharmacy I'm reminded from all around me the utter nightmare that's the United States healthcare system.

[earhartsease]

someone close to us who shall remain nameless ordered some grey market testosterone because their GP was dicking them about (resolved now)

it recently arrived and you know how when you buy stuff off etsy it often comes with whimsical extras like sticky stars or gummies?

well this came with free estrogen suppressants and viagra and cialis - and we're speculating that it's maybe a starter pack for people doing steroids or something because wtf

and we were like if they were doing this specifically for transmascs they'd include finasteride or minoxidil instead of viagra

[batwynn]

Ok. Five days without antihistamines before my immunology appointment (FINALLY). I can do it. I won’t even look at a potato. 😤