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Article
Wed, 14th May 2014
 

You visit the doctor for a repeat prescription, and inadvertently mention how expensive everything is these days. The doctor grunts, and the computer chatters out a bit of paper, which you gleefully clutch and vanish out the door. Next stop is the pharmacy next door, where the bit of paper is handed over. Come back in ten minutes, the lady in white says. Next day you attack the new box of pills, naturally expecting the usual blister pack of round white tablets.

Shock Horror

But no! There is a bottle half filled with loose pink oval ones, no blister pack. Um, you think. Has the doctor got it wrong. Of course not, you think, as the tablet is downed with a gulp of water. But the niggling thing in your mind says "Something is not right here". The difference of course is that the doctor heeded your call for economy, and now wrote a prescription for a "generic substitute". This is a tablet which in theory is identical to the original brand, but is a cheaper version.

Bioavailability

The effect, called "bioavailability" on the body is said to be the same. There may be differences in colour, shape, packaging, bottle or box. There may be a difference in content. The active ingredient is the same, but additional inactive stuff called excipients such as fillers and binders may be different. A new drug has a legal life of ten years. After this, competitors can market it under a different name provided it is shown to have the same beneficial effect.

Generic

Thus "brand" and "generic" names are now available for most commonly used medication. Occasionally a patient may react adversely to the different colour, filler or binder, but this is rare. A rash may occur with sensitivity to a colouring agent, for example. Most doctors discuss the matter with the patient before prescribing, and the patient can opt for the cheaper version. It is largely an individual choice. Personally as a GP I prefer to stick to the brand I have used and trusted for years.

 
FOR ARTHRITIS

Q: 

My doctor merely says to take paracetamol for my arthritis, but in this day and age this seems too simple.

A: 

Arthritis affects vast numbers and produces pain from mild to severe. Paracetamol 2 x 500 mg after each meal is currently the simplest and safest treatment. Maximum dose is 4 g a day. A vast number of other products have been available since the mid 1950s but most have fallen into disfavour. Side effects, essentially bleeding from the gut and adverse heart issues head the list. Each person is assesssed and an individual management plan worked out. There certainly are other medications. Also, physical methods such as as phyhsiotherapy, massage, musculo skeletal interventions and exercises, acupuncture, hydrotherapy, and often finally surgery.

 
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AGGRESSIVE DAD

Q: 

My 64 year old dad, retired 4 years, has become very aggressive. He is overly abrasive, abusive, aggressive, specially if one disagrees or criticizes. This is uncharacteristic.

A: 

Medical intervention is essential. He is probably heading for early dementia. There could be a medical reason which may be diagnosed and treated. Sudden uncharacteristic mental behaviour must be taken seriously. Brain cells wearing out, tumours (not necessarily cancer), various forms of dementia. Alzheimers can set in at a relatively early age.

 
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MOPPING FACE

Q: 

I am 65 and eternally mopping my sweating face, even in cool weather. I have tried acupuncture. I am not overweight. It is embarrassing. My husband says my internal thermostat is not working.

A: 

There are vast numbers of sweat glands in the face and scalp They are under nervous control with reduced hormonal production, this starts to go crazy. Talk to your GP. It is quite likely that a short course of HT - hormonal therapy - may reduce symptoms. Today this is considered safe for periods up to five years in women. Some doctors have blood hormonal levels assessed and prescribe according to these results.

 
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NECK PAIN

Q: 

I suffer from pains in the neck, and my job of sitting all day and working at a keyboard probably does not help.

A: 

The less the muscle fibres are used, the more rigid they become. This leads to spasm, causing pain. Movement of the neck muscles, in as many directions as possible, helps keep them supple and spasm free. Even when sitting, it is possible to spend sixty seconds regularly with various simple stretching exercises. Drink lots of water also to keep fibre well hydrated. Keep a filled glass at your desk to remind you. Avoid fizzy chemical drinks.

 
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UP THE SKIRTS

Q: 

I am a teenager and am constantly amazed by TV stories and the fact guys are constantly trying to get their beady eyes up our skirts. What's up with them?

A: 

This is all part of the jungle and the wild uncontrollable hormone system in young guys, and the mating game. All nature cares about is "perpetuating the species", and without this, humanity would die out! Don't knock it, for women have their equivalent which is to continue to tantalize. When women have reproduced (and the more times the better according to nature), the mad zeal wears off for both, but the next heap of kids keeps it going. Nothing changes. Survival and sex are the two biggest issues on the planet.

 
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This health advice is general in nature. You are advised to seek medical attention from your doctor or health care provider for your own specific symptoms and circumstances.

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