standards and procedures for evaluating internet drug reactions sites and info

[Ellen Madono]

Hi,

On http://shahrdarcases.wikispaces.com/Case+2+Discussion, a free Internet course about Dr. Ardavan Shahrdar's ground breaking work on Miasms, we have a case with a drug reaction. I am looking for standards for evaluating Internet information on drug reactions.

The reason for this question is the drug, Citalopram (Citalex), has a reaction that I would never have known if I had not already known Dr. Shahrdar's analysis. The patient has epistaxis along with some other reactions that can easily be found on the Internet. I found bleeding of the stomach on the Mayo Clinic site. Then, finally I found generalized hemorrhages (Drugs.com). I am afraid that if had just done a cursory Internet search and did not already know the "answer", I would not have found this drug reaction.
Physiologically, Citalopram works on the nerves. So, what causes the bleeding? Is it rare? I finally found it by putting in the keyword "Epistaxis" as well as "Citalopram." (http://www.drugcite.com/indi/?q=Citalopram&i=EPISTAXIS) Should this be my policy? If after a search of drug name, side-effects or drug reaction does not bring up my suspected symptom, then enter in the specific symptom and the drug name? Are there better sites for physiological explanations?
Best,
Ellen Madono

[Leilanae]

--- In minutus@yahoogroups.com, Ellen Madono wrote:

-----------------------------------------------
Hi Ellen,

Maybe try http://www.fda.gov/default.htm I hope the link copies complete.

Leilanae

[Rochelle]

Hi Ellen ,
It won’t let me in to see the discussion using that link. I was going to contact you as although I managed to pick up the case from your wiki email I couldn’t find the discussion!!
Rochelle
From: minutus@yahoogroups.com [mailto:minutus@yahoogroups.com] On Behalf Of Ellen Madono
Hi,
On http://shahrdarcases.wikispaces.com/Case+2+Discussion, a free Internet course about Dr. Ardavan Shahrdar's ground breaking work on Miasms, we have a case with a drug reaction. I am looking for standards for evaluating Internet information on drug reactions.
The reason for this question is the drug, Citalopram (Citalex), has a reaction that I would never have known if I had not already known Dr. Shahrdar's analysis. The patient has epistaxis along with some other reactions that can easily be found on the Internet. I found bleeding of the stomach on the Mayo Clinic site. Then, finally I found generalized hemorrhages (Drugs.com). I am afraid that if had just done a cursory Internet search and did not already know the "answer", I would not have found this drug reaction.
Physiologically, Citalopram works on the nerves. So, what causes the bleeding? Is it rare? I finally found it by putting in the keyword "Epistaxis" as well as "Citalopram." (http://www.drugcite.com/indi/?q=Citalopram&i=EPISTAXIS) Should this be my policy? If after a search of drug name, side-effects or drug reaction does not bring up my suspected symptom, then enter in the specific symptom and the drug name? Are there better sites for physiological explanations?
Best,

Ellen Madono

[Ellen Madono]

The link to the Case 2 ShahrdarCases is http://secondtimeshahrdarcases.wikispac ... 61244436ll

Still not getting any feedback for standards and procedures for researching drug reaction information.

Best,
Ellen
English: tokyohomeopathy.com
Japanese: tokyohomeopathy.jp

[Irene de Villiers]

How to check out a drug:
Google the drug name to get the original drug name as opposed to generic equivalents.
In this case that is Citalopram.

First option:
Then Google Drugname Medline
(eg Citalopram Medline)

Click on the Medline documentation for the drug. This is the National Library of Medicine updated official version.
In this case that will be:
http://www.nlm.nih.gov/medlineplus/drug ... 99001.html
Scroll down for the 40 side effects listed.
It includes unusual bleeding

Second option:
AFter that google Citalopram side effects
Look for sites with credibility, like drugs.com.
(Always look for an author or organization with credibility)
For example the first site looks specific - but is written by one doctor. I'd skip it:

Drugs.com has a good reputation, and divides the data into lay and professional - look at the professional area;

eg They include Gastrointestinal hemorrhage, and under the hematologic subtopic they include:
"Hematologic side effects including purpura, anemia, epistaxis, leukocytosis, leukopenia, and lymphadenopathy have been reported infrequently. Pulmonary embolism, granulocytopenia, lymphocytosis, lymphopenia, hypochromic anemia, coagulation disorder, and gingival bleeding have rarely been reported. Decreased prothrombin, hemolytic anemia, and thrombosis have been reported" and that NSAIDs like aspirin increase the bleeding risk to potentially life threatening.

The other one (less good than Drugs.com) is WebMD (no specific author system)


Some drugs like this one are notoriously horrible and you will find a lot.

Some drugs are less easy to look up, eg new drugs, or those too well protected by their inventors- and then go to third option:
Google drugname MSDS
(MSDS = material safety data sheet)
This leads to the refs provided by the drug manufacturer/s and the studies on mice or whatever that were done to show how great it is while claimed safe (and is in no way as useful as actual experience in humans but for some things it is all there is!) In this case:

Then click on the measly 5 studies there, and their abstracts. You usually will get more scientificese here, for example:
"Conclusion: SSRIs may exhibit an anti-inflammatory activity on endothelial cells and reduce circulating VCAM-1 and ICAM-1 in vivo, a mechanism which may partly mediate their cardioprotective effects."
You'd need to know what consequences to expect in the system from this chemical principle.
Also they will tend to include what they call benefits in the abstracts and you have to purchase the full paper to see the adverse/side effects.
However with new drugs, it may be all you can find.

With well-known drugs, I'd start with both Medline and Drugs.com
If that's not so good, look for the equivalent in Australia and New Zealand. Drugs are often approved in Australia, five years or more ahead of USA approval and the drug side effect history is longer.
New Zealand data looks to me usually more comprehensive (honest?) than most countries.

Namaste,
Irene

REPLY TO: only
--
Irene de Villiers, B.Sc AASCA MCSSA D.I.Hom/D.Vet.Hom.
P.O. Box 4703 Spokane WA 99220.
www.angelfire.com/fl/furryboots/clickhere.html (Veterinary Homeopath.)
"Man who say it cannot be done should not interrupt one doing it."

[Ellen Madono]

Hi Irene,

You are fantastic. If you don't mind I am going to put this up on the home page of our site. Your name will be cited. This kind of guidance is so important.

Thanks so much,
Ellen Madono
English: tokyohomeopathy.com
Japanese: tokyohomeopathy.jp

[Ellen Madono]

Hi Irene,

I went looking for the equivalent of drugs.com I was not able to find professional information. Used drug name (Citalopram) + new zealand+ side effects. Get only consumer sites.
http://agencysearch.australia.gov.au/se ... rofile=tga Individual reports

I should be able to do better. Maybe my key words were not good.

Ellen Madono

[Dale Moss]

Hi, Ellen
In the USA, we have the PDR (Physician's Desk Reference), which lists drug side effects. For internet searches, I've found www.drugs.com to be a decent site, with relatively full and up-to-date information.
I wonder, however, whether we all have access equally to the same data. I just finished an article on akasthisia created by prescribed anti-depressants. Actually, "akathisia," which is uncontrollable physical restlessness, is not entirely descriptive here: this was a look at pharmaceutically-induced psychotic breaks that resulted in murder or suicide. The research was Australian, and one of the complaints there is that the warnings, including "black box" warnings required on certain meds in the USA, are not always given fully on drugs sold there.
Would this also be true of websites in other countries?
Peace,
Dale

[Ellen Madono]

Dear Dale,

Do you still have the website that you used for the research on akathisia? When I used Drugs.com searching for akathisia, I got a long list of papers, probably because it is not a drug name.
When do you find it more useful to use the Physician's reference than the net? I suppose well known drugs.
Best,
Ellen
English: tokyohomeopathy.com
Japanese: tokyohomeopathy.jp

[Dr. Joe Rozencwajg, NMD]

For the NZ information, go to www.medsafe.govt.nz click on "Data Sheets" type the generic name in the search box AND ask the search engine to look for the generic name, voila; it is generally extremely complete by law, and I have been surprised many times by facts I did not know about very old and well-known (I thought) drugs.....
Dr. J. Rozencwajg, NMD. "The greatest enemy of any science is a closed mind". www.naturamedica.webs.com