Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What side effects and drug
interactions are there with OTC asthma medicines?
Ephedrine poses a greater chance of causing adverse drug effects or drug
interactions than epinephrine because it must be absorbed into the body to be
effective. Nervousness, sleeplessness, anxiety, nausea, reduced appetite, rapid
heart beat, tremors (the "shakes"), and urinary retention are the
most common adverse effects. Immediate medical attention may be necessary for
these side effects.
Monoamine oxidase inhibitors (phenelzine, isocarboxazid), clonidine,
selegiline, guanethidine, and ergotamines (ergotamine tartrate,
dihydroergotamine mesylate) may increase blood pressure when used at the same
time as ephedrine. Methyldopa or reserpine may reduce ephedrine levels in the
blood and thereby lessen the effectiveness of ephedrine. Tricyclic
antidepressants (desipramine, amitriptyline, doxepin, and imipramine) may
block the effect of ephedrine. The carbonic anydrase inhibitors acetazolamide
and dichlorphenamide may raise ephedrine blood levels and increase the risk of
side effects from ephedrine. Patients taking any medications should consult
with their physician or pharmacist before starting OTC ephedrine.
Since epinephrine is inhaled directly into the lungs and little is absorbed
into other organs of the body, there is less risk for side effects. Epinephrine
rarely causes rapid heartbeat, irregular heart rhythms, high blood pressure,
tremor, or anxiety.
Since there are specific risks with epinephrine or ephedrine in certain
medical conditions, physician advice and supervision should be sought before
taking epinephrine or ephedrine if there is heart disease (coronary artery
disease, congestive heart failure, irregular heart rhythms), high blood
pressure, thyroid disease, diabetes, or difficulty urinating due to enlargement
of the prostate. In addition, patients should seek medical advice before taking
ephedrine if they already are taking antidepressants.
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing, complaints of chest "hurting," wheezing while breathing, shortness of breath, and feelings of tiredness. Treatment will involve a doctor creating an asthma action plan which will describe the use of asthma medications and when to seek emergency care for the child.
There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC drugs like Primatene Mist and Bronkaid.
Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
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