David B. Katague is an online memoirist and cultural essayist whose writing has appeared on HubPages

Monday, October 21, 2019

Drugs for the Treatment of Malaria

From slideshare.net
One of the highlights in my employment with FDA was my promotion to GS-14 Expert Status in 1993. I started in 1990 as a Chemistry Reviewer (GS-13).

Press Release of My GS-14 Promotion, 1993
One of the areas of my FDA (GS-14) expertise was Anti-malarial drug products. Therefore, my interest with drugs for the treatment of malaria has never stopped even 17 years after my retirement.  This article summarizes the current FDA approved drugs for the treatment of malaria for your reading pleasure and information.

Antimalarial medications, also known as antimalarials, are designed to prevent or cure malaria. Such drugs may be used for some or all of the following:
  • Treatment of malaria in individuals with suspected or confirmed infection
  • Prevention of infection in individuals visiting a malaria-endemic region who have no immunity (malaria prophylaxis)
  • Routine intermittent treatment of certain groups in endemic regions (intermittent preventive therapy)
Some antimalarial agents, particularly chloroquine and hydroxychloroquine, are also used in the treatment of rheumatoid arthritis and lupus-associated arthritis.

Current practice in treating cases of malaria is based on the concept of combination therapy (e.g., Coartem), since this offers several advantages, including reduced risk of treatment failure, reduced risk of developing resistance, enhanced convenience, and reduced side-effects. Prompt and accurate parasitological confirmation by microscopy, or alternatively by rapid diagnostic tests, is recommended in all patients suspected of malaria before treatment is started.

Here's a short video made by WHO about malaria.

https://youtu.be/gwYIyjwYluc

The following list of medications are in some way related to, or used in the treatment of this condition. The Chemistry, Manufacturing and Control (CMC) of some of these drugs were reviewed and approved by me as the Chemistry Reviewer and Team Leader if the Division of Anti-Infective Drug Products from 1990 to 2002.


Drug name Rx / OTC Preg CSA Reviews Rating
artemether / lumefantrine C N 4
9.0
Coartem C N 4
9.6
Malarone C N 3
7.0
mefloquine B N 6
2.8
doxycycline D N 5
8.0
Plaquenil N N Add
0.0
chloroquine N N 1
10
hydroxychloroquine N N Add
0.0
atovaquone / proguanil C N 3
7.0
clindamycin B N Add
0.0
Doxy 100 D N 1
10
primaquine N N Add
0.0
atovaquone C N 1
10
Lariam B N 5
3.3
Doryx D N Add
0.0
Cleocin B N Add
0.0
Monodox D N Add
0.0
Vibramycin D N Add
0.0
Morgidox D N Add
0.0
Oraxyl D N Add
0.0
Vibra-Tabs D N Add
0.0
Doryx MPC D N Add
0.0
Ocudox D N Add
0.0
Cleocin HCl B N Add
0.0








 




Saturday, October 19, 2019

Book Review: The Box of Noli's Bones by Felix Llamido, M.D.


I received a complimentary and autographed copy of Dr. Llamido's book(photo above) last week. It is a story of the Japanese-American War in the Philippines that happened during his childhood. The book is historical fiction or creative nonfiction which contained historical facts and his memories of the war as well as of his relatives and friends. It is well written and an engaging story. I finished reading it in three hours non-stopped with only one bathroom break. It was time well spent and better than watching television.
  
I enjoyed the book very much as it reminded me of my own and Macrine's( my spouse of 62 years) childhood experiences during the Japanese-American War in the Philippines. There are similarities and differences in the events described beautifully in detail by the author in his book and my own and Macrine's childhood experiences.

My experiences and recollections of the war as a child growing up during the Japanese-American War in the Philippines was discussed in detail in my autobiography ( http://davidbkatague.blogspot.com) as well as in my Hubpages.com writing account published on December 8, 2011.

 https://hubpages.com/literature/my-childhood-memories-of-world-war-2

The first major difference is my experience was in Panay Island whereas Dr. Llamido's book venue is in Luzon. Other events in the book that is similar to my own and Macrine are: water boarding ( artisan well vs the ocean high tides involving Macrine's grand father), monitor lizard vs a python encounters and the airplane dogfights hillside and meadows watching.


Dr Llamido and I during our college years in UP ( mid 1950's). Dr Llamido is squatting on the first row holding a newspaper. I am standing at the back row, 3rd from the Left.

For My first review of this book click on:
https://davidbkatague.blogspot.com/search?q=felix+llamido

Two other events in Dr Llamido's book that are very similar to my own are the Palawan Massacre and the Guerilla's methods of messaging. The Palawan massacre  reminds me of the massacre of my Mothers relatives (Balleza clan) in  Barotac Viejo, Iloilo that I discussed in my blog :

https://davidbkatague.blogspot.com/search?q=balleza+massacre

I am rating this book 5 star out of 5 and highly recommend it not only to history enthusiasts but also to all who love to read good books and history.

At the end of the book under Liberation, page 255 , the author was telling us of his encounter with a GI repeating a coded radio message which he did not understand. He was more interested in the Dentyne gum, the GI was distributing to the children.

" It was my first taste of gum--ever.  On the way home Dida asked, What did you do with your gum?  I swallowed it. 

I could see the disbelief in her face.  You are supposed to only chew it.  Now your intestines will stick together.  I did not sleep well that night as I waited to die.  

But I didn't and I am glad. If I had died, who would be around to write this story." 

This gum incident reminded me of my own chewing gum story.  I was enjoying my gum when a neighbor (younger) kid started following me and started begging for my gum. It was the only gum I have left, so with reluctance I spew it out and gave it to him so he would stop begging. Without hesitation, he put it in his mouth and chewed it with gusto.   I am not sure what he did with the gum after he finished chewing ( may be he also swallowed it) as I was just too happy to get away from him. 

For details on this book click on:

https://www.amazon.com/Box-NOLIs-Bones-story-Philippines-ebook/product-reviews/B07VCN67WP/ref=cm_cr_dp_d_show_all_btm?ie=UTF8&reviewerType=all_reviews

Personal Note: Dr Llamido and I were dormates at the University of the Philippines Mens South Dorm ( Narra Hall) when he was a pre-med student and I was a Chemistry student/ Instructor in the early and Mid-1950's. He visited me and Macrine with his son from Los Angeles in November, 2018 here in Northern California. We get reacquainted-thus getting a complimentary copy of his well-written and engaging book. Again, thank you for my complimentary copy of your book. May your book be one of Amazon's best sellers for 2019-2020.

Friday, October 18, 2019

Selective Serotonin Reuptake Inhibitors as Anti-Depressants



Lisa Lings recent documentary in CNN on the dangers and harmful side effects of benzodiazepines, a drug prescribed to treat anxiety prompted me to do some search on antidepressants because I have two closed relatives taking anti-depressant medications. 

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants. They can ease symptoms of moderate to severe depression, are relatively safe and typically cause fewer side effects than other types of antidepressants do.

SSRIs treat depression by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain nerve cells (neurons). SSRIs block the reabsorption (reuptake) of serotonin into neurons. This makes more serotonin available to improve transmission of messages between neurons. SSRIs are called selective because they mainly affect serotonin, not other neurotransmitters. SSRIs may also be used to treat conditions other than depression, such as anxiety disorders.

SSRIs (selective serotonin reuptake inhibitors) such as Prozac, Paxil and Zoloft revolutionized the treatment of depression and related disorders when they arrived on the market in the 1980s. But research has found that SSRIs can cause serious side effects ranging from withdrawal complications to birth defects to suicidal thoughts and behavior in younger patients.



Eleven percent of Americans aged 12 years and over take an antidepressant medication, according to the Centers for Disease Control and Prevention.
The use of antidepressants increased nearly 400 percent between 1988 and 2008. SSRIs are the most common class of antidepressants in the U.S. and are believed to be safer and generally cause fewer side effects than other antidepressants.

The Food and Drug Administration (FDA) has approved these SSRIs to treat depression:
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil, Pexeva)
  • Sertraline (Zoloft)

All SSRIs are thought to work in a similar way and generally can cause similar side effects, though some people may not experience any. Many side effects may go away after the first few weeks of treatment, while others may lead you and your doctor to try a different drug.

Possible side effects of SSRIs may include, among others:
  • Nausea, vomiting or diarrhea
  • Headache
  • Drowsiness
  • Dry mouth
  • Insomnia
  • Nervousness, agitation or restlessness
  • Dizziness
  • Sexual problems, such as reduced sexual desire, difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction)
  • Impact on appetite, leading to weight loss or weight gain
Which antidepressant is best for you depends on a number of issues, such as your symptoms and any other health conditions you may have. For details click on:

https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825

SSRI's should not be withdrawn without consultation with your physician. Sudden withdrawal will usually cause patients to suffer SSRI discontinuation syndrome.

Wednesday, October 16, 2019

Dangers of Long Term Use of Benzodiazepines


Photo from: treehouserehab.org

My heart and mind was filled with worry after watching Lisa Ling's CNN report on the dangers of long term use of benzodiazepines. Why was I worried? I have a very closed relative suffering from anxiety. I hope she is not taking a benzo drug. I did some Internet search and here's a summary of what I found.

Benzodiazepines are a class of drugs primarily used for treating anxiety, but they also are effective in treating several other conditions. The exact mechanism of action of benzodiazepines is not known, but they appear to work by affecting neurotransmitters in the brain, chemicals that nerves release in order to communicate with other nearby nerves. One of these neurotransmitters is gamma-aminobutyric acid (GABA), a neurotransmitter that suppresses the activity of nerves. Scientists believe that excessive activity of nerves may be the cause of anxiety and other psychological disorders, and benzodiazepines reduce the activity of nerves in the brain and spinal cord by enhancing the effects of GABA.

 Adult men and women use benzodiazepines to treat:

Other uses for benzodiazepines

These medications also are used for:
Benzodiazepine drugs (also called benzos) are habit forming and can lead to addiction. Long-term use also can lead to tolerance, which means that lower doses will become ineffective and patients will need higher doses. These drugs are abused to get 'high' due to their effects on the brain.

What are the side effects of benzodiazepines?

Common side effects include:
Serious side effects include:

Here is a list of examples of brand and generic names of benzodiazepines available in the US.
Xanax, Klonopin and Valium are the most popular brands and widely prescribed.

For details read:

(https://www.medicinenet.com/benzodiazepines_sleep-inducing-oral/article.htm)

Monday, October 14, 2019

My Most Productive Week of Personal Blogging


First Week of Autumn- Photo from almanac.com
Last week was my most productive week of personal blogging. I wrote  six articles from October 6 to 13. The subjects varied from Dodies' first novel, Cloyne Court ( https://marinduqueawaitsyou.blogspot.com/2019/10/cloyne-court-by-dodie-katague-update.html )to Ditas resemblance to her Grandmother  (https://whyretireinthephilippines.blogspot.com/2019/10/ditas-and-grand-mother-paz-balleza.html).  I usually just write only 2 to 3 articles per week.

I wrote on a variety of subjects:Personal Relationships, Food, Mental Health, Retirement, Books and Family.

1.  A Thoughtful Relative and Neighbor

https://davidbkatague.blogspot.com/2019/10/a-thoughtful-relative-and-neighbor.html
 
2. Macrine's Favorite Lunch

https://myfavoritepinoydishes.blogspot.com/2019/10/macrines-favorite-lunch-and-other-pinoy.html
Lengua Tacos (Beef Tongue)-One of Macrine's Favorite lunches

3. Seventeen Years after My Retirement from the FDA

https://chateaudumer.blogspot.com/2019/10/seventeen-years-after-my-retirement.html

4. Coping with Grief- Ditas and Carenna

https://theintellectualmigrant.blogspot.com/2019/10/coping-with-grief-and-loss-of-loved-one.html

I am reposting the articles above in case you missed reading them. A  happy autumn day greetings to all my FB friends and relatives all over the world!

Here's Nat King Cole rendition of Autumn Leaves for your listening pleasure:

https://youtu.be/L1JiYe543x0

Topics in my blogs in the next two weeks: antimalarials, Benzo's, SSRI, diabetic and mirtazapine drugs

Sunday, October 13, 2019

Ditas and Grand Mother Paz Balleza Katague

Is there a resemblance between my youngest daughter ( Ditas Katague) and my mother (Paz Barrido Balleza Katague)?. A few of my relatives think there is. I think Ditas has more resemblance to my younger sister-Agnes or her first cousins Jemma and Krisheil. Judge for your self in the following photos.


Latest two pictures of Ditas

Mama Pacing and My Siblings, 1976

Amor (Knitz) Wedding- Agnes is in front row to the Right, 1976

My Three Sisters-Agnes is in the Middle

Ditas and Carenna, 2016

Mama Pacing and Me, Mid-1980's
Mama Pacing, Baby Agnes and Flocy visit with Igsoon Ceding and Family, San Jose, CA, 1979

Ditas First Cousin, Jemma Katague daughter of Erico( RIP) my younger brother

Ditas First Cousin, Krisheil Katague- daughter of Ruben-my youngest brother

CarennaKT September, 2019

Carenna latest photo, Age 16, Junior in high school- Ditas only daughter

Friday, October 11, 2019

Dealing with the Grieving Process


My heart melts with sadness and compassion, as I read the following paragraph from my daughter's FB page last month.

"With great humbleness in the span of 14 days, CarennaKT and I have had wonderful accomplishments. But to be truthful, it has been bittersweet. To have made the Top 100 list was a huge surprise - and yet the one person I wanted to celebrate with - Nick Thompson - my biggest supporter and cheerleader - wasn't here to celebrate. And thus the emptiness in my heart grows bigger.

And a week later - a huge milestone for our daughter, Carenna - passing her drivers license test (the first try) and no one believed 6 months ago that I would be able to teach her how to drive. And her Dad wasn't there to give her a high five and hug and tell her how proud of her he was.

And then finally this week - my interview on the "Getting Curious with Jonathan Van Ness" @curiouswithjvn podcast went live. I love the title "Why is the Census So Majorly F**king Important? with Ditas Katague aired and the promo videos - I was told had over 200K views/plays. All of this should fill my heart, but it is empty - because the joy that I should feel is always shadowed with the grief I have been hiding from - and it comes after me like a stealth golden owl hunts it prey in the darkness.

So I walk with my grief, and I realize I cannot bury myself in work or travel or sheer exhaustion. I realize I must sit and feel something I avoid - because if you avoid joy, you can avoid grief? Only if you are numb...being numb, would be easy to lack compassion, to not care, to walk around as the empty shell that I am.

Many may say - gosh it's been 7 years "aren't you over it yet'? I was asked this by a close relative. Actually, it was directed at Carenna just 10 months after her Dad died - I was asked, "aww, isn't she over her Dad dying yet?" Unbelievable. I know we are blessed to have many friends and family who do support us and I don't want to appear ungrateful, but some days after working another 80 hour week, the lack appreciation is real. Enough feeling sorry for myself - back to being numb".

My wife and I felt helpless to alleviate our daughter and grand daughter sadness and grief. However, we want them to know, we are here and if there is anything we can do, just let us know. Here's some wisdom and information I found on how to deal with the grieving process.


How to deal with the grieving process

While grieving a loss is an inevitable part of life, there are ways to help cope with the pain, come to terms with your grief, and eventually, find a way to pick up the pieces and move on with your life.

1.Acknowledge your pain.
2.Accept that grief can trigger many different and unexpected emotions.
3.Understand that your grieving process will be unique to you.
4.Seek out face-to-face support from people who care about you.
5.Support yourself emotionally by taking care of yourself physically.
6.Recognize the difference between grief and depression.

Source:https://www.helpguide.org/articles/grief/coping-with-grief-and-loss.htm


Here are some comments from DITAS Facebook friends:

1.Ditas we met just moments after Nick passed. I would never have guessed that you and Carenna had been through that by simply watching you. It was apparent that you both just had your stuff together. You have been honest about these troubles and as I have learned you better my respect for you deepens, both of you. There is no cure for grief. It doesn't end. You don't get the over the loss of such a person. Grief changes shape and color. I have found it helpful to remember the joy of my relationship with the person I've lost. Because grief wouldn't be there without a solid foundation of love and joy. When you mention Nick I hear that. I hear you mention your love and your joy. Thanks for continuing to feel and to express these thoughts.

2. Congratulations on your recent accomplishments Ditas! I fully empathize with your sentiments. It has been six years for me. One learns to live and celebrate again, but the void remains.

3. Lifting you in prayer and Hugs 🙏🏾

4. There will be many many more accomplishments. After all, we're talking about Ditas and Carenna! ✨⭐🌟 Nick is there for all of them. He's always there. Reminding ourselves of this helped us get through losing our dad on earth when we were young kids.

5. Feel what you need to feel! I love you both.

6. First off, congratulations to both of you for all of your accomplishments over the past two weeks, very cool. Thank you for sharing!!! I have been reminded time after time that pain and joy coexist. Your word, "bittersweet" sums it up. I read all of the posts before from your friends and family and they give support and wise advise. Trust that love remains forever, you are strong (and friggin awesome) it's okay to cry, it's okay to laugh, as Amy said, feel what you need to feel. All this to say, it sucks, it's hard and I'm sorry. We will carry it with us until we are reunited on the other side.

7. Thank you for sharing this. He was lucky to be so loved. Sending you a hug. Such important milestones and all so well deserved.

8. Ditas, I follow Martha Jo Atkins. She deals with death and dying and all that goes with it. I’ve found her posts and those who follow her to be insightful and comforting.

9. I love you, Ditas. You bring so much joy and inspiration to everyone who knows you.

10. Hugs and love to you and Carenna! You can always count on me, my dearest cousin! Love you!!! Yu’ve been so incredibly strong and composed... just let go. Don’t be numb. Cry, laugh, cry again. We’re here for you both!

11. Ditas-Thank you for letting us in and sharing your truth. My identical twin sister died 23 years ago and that loss and grief took much of me with it. I understand much of your pain my friend. While the path of grief is yours that you must take you’re surrounded by so many of us who love you and are here for you during this journey. Be brave my warrior and you can and must do this. I’m here for you. ❤️

Here's a short Ted Video about coping with Grief

: http://t.ted.com/SLw0qFU
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