Talking Cures
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Diuretic Drugs Necessity Explored Explained Understood?

Medical Science allows us to understand the Human Body is 98% Water - to which they have the scientific proof do they not - thus we are obliged to accept these findings.

We all know water is a seriously precious commodity that life cannot exist without; so why waste it.

One may term this - as hiding from the truth as we all appear to do, when mysterious illness strikes.

This Paper is as much of what is reasonable to consider - as it is a matter of fact...

It is also combined information from Wikipedia and a number of professional sources.

 Please accept this document is not in pursuit of a literary or grammatical prize it is an expression and opinion of the understandings made by Medical Science and why at the close of the year 2016 no illness has a cure - with words highlighted in different ways to accentuate the obvious and not so obvious.

Therefore it may contain a number of repeats - giving rise to different opinions and or conflicting information; perhaps therefore, this particular medical and often complementary medical activity, demands such scrutiny.

Moreover, for a Medically qualified Person considered as. Anecdotal - a posh word for storytelling.

If in reading this paper - my writing appears to be like a foreign language or even rambling.

Consider reading this paper - not as a book; take some time to comprehend the contents.

Where I would like to think and feel sure, it will make sense?

So often, we read or hear in detail. "What" (description or symptoms) of an illness - but rarely if ever does anyone take the time to truly explain...

"...WHY," or how it is really caused...

...this paper is designed to answer many of the questions - we are so often left with.

Where many times we have the questions and no answers - or the answers and not the questions.

If I have unwittingly left anything out or not satisfactorily answered, please email (address at the end of this page) and I will include it in this Paper at the earliest opportunity.

Please include item number or a copy and paste if possible - of the item that is not clear.

Did we not all struggle as a Child to learn many things we now through the experience of life - are now extremely competent with.

No apology if offered if discussions are repeated within this paper.

The understanding for this, nothing is more repeating than illness that is there every day of one's life and - despite treatments, does not get better or as is often the case or have a satisfactory explanation/understanding...

In addition - Often becomes worse, because as it appears; Medical Science continues to write Scientifically Proven Papers about illness; in a confusing, repeating, strange to many, language/words or descriptions and in a manner that confuses everyone - and ultimately even themselves!

The first thing in the process of answering this is, for any one suffering, it is clear...

"...New understandings are required about illness..."

Far too many times I have heard from People...

"If Doctors cannot Cure me how can a Person not medically qualified."‏

...making it appear the existing quality medical education is the same worldwide?..

...Non-existent.

If on reading this or any of Talking Cures understanding of illness one gets the impression...

....I am angry...

...then please believe it; because in 2016. People are not only not recovering from any illness - so often the treatments make them worse and no one knows why or it appears. Cares.

One could also be forgiven for thinking I am against:

1. Doctors.

2. The Medical Profession.

3. Medical Scientists.

4. Medical Researchers.

5. Alternative Medicine.

6. Complimentary medicine.

7. Religion.

The reality is I am a staunch supporter of any Person or Institution that helps People through tough Emotional and Physical concerns.

I confess to being most seriously against Bad Medical Science that has never once in real terms demonstrated the cause is truly known of any illness and as a result created a cure...

= ...no more illness and no more medications.

More importantly I find it difficult to comprehend the Medicines created to treat any illness often has so many side-effects and in some cases even causes symptoms the medicine was indeed prescribed to treat.

Indicating Doctors desire or ability of - only being in the "moment" to relieve the symptoms is important, with no real consideration given to the long-term negative effects and often worsening of symptoms and most certainly no link between passed seemingly treated symptoms and the present presentations of symptoms - is ever made.

From Talking Cures point of view and therapeutic practice - names of illness especially Medically Diagnosed recognised and Scientifically proven, are of no real value in the understanding and treatment of any illness - the only Name we should use or symptom we may label is...

"A Person is unable to achieve a Healthy and satisfactory lifestyle...”

...Or never allowed to become the Person they should have been...

Thus requires. “Specialised assistance,” in order to make sense of the presenting symptoms, the cause and reason for them - enabling automatic resolution via the Persons own immune systems and Body replication process - referred to as, the Entire Body Chemistry. 

...Surely if a Person cannot be in control of self-repair - when can they be in control!

To a trained Medical Mind these questions and answer updates may well appear or feel patronising - it is hoped not, as their structure is at the very "Heart," of the success of Talking Cures as a therapeutic application and may well be a serious asset and improvement in Medical, Alternative and Complimentary Treatment outcome success.

In order to fully appreciate this, it is helpful to consider and accept;

All of the information as to why a Person became ill in the first place and as a consequence - all of the information required for them to automatically create immune response repair is - not only contained within the confines of their Mind - it is the only information required to bring about the required Automatic Cure; using their own immune systems and Body replication processes. As designed by the Mind and Body.

By creating very cleverly constructed questions - Knowing the Person is able to answer them with their own knowledge of themselves of which they are a Master and if they are unable to with my interpretations, accepted as re-education of their own information, that continues/completes on an ongoing bases; the process either returning to well-health or well-health for the very first time in their lives.

Based on the secure knowledge...

"...The only Person with the Integrity and Wisdom to fully Understand their illness and its cause - is the Person themselves."

There are most serious considerations as to why this process of Talking Cures as with all illness treatment interventions - appears not to succeed...

...when a Protection created in response to early Childhood Emotional and or Physical Traumas is so great the Person is unable to see the Protection and therefore unable to lower the Protection - allowing a Person to observe in a safe therapeutic environment the cause and consequences of such Protection, is the only safe way to resolve illness.

And. As a result, to gently - if one dare use such words, lower the Protection, which will allow an immune response and an automatic alteration in ones thinking process, leading to a natural life - with comfort of Mind and Body, thereby...

...Always maintaining control of ones own Standard and Priorities and Code of Conduct.

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These explanations are from a collection of Scientifically Proven papers in the public domain and discussion forums and are in a Question and Answer forum style.

It is important to accept I am both the Questioner, on behalf of interested Person's - as well as the Person supplying the Answers, or Responding thus in many ways, my own best critic.

Leaving one to choose the Questions and Answers that are important for a better or individual understanding of seemingly mysterious illnesses.

Furthermore it is imperative one recognises; I have no medical qualifications to make such assertions as contained within my answers.

This should leave one in no doubt - it is only written because the entire medical profession since its creation, have never once produced a cure for any illness.

A life-time of medication - is not to be considered a cure, only management of an ever changing and most times ever-growing list of symptoms and medications.

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Question. 1. Big statement to make; by what Standards and Priorities do you make such assertions and what Checks and Balances do you apply to demonstrate validity and you are not being Psychotic and therefore Delusional.

Answer. 1. Nice question and of course very valid. 

A. Although only recently creating a written list of Checks and Balances - it is; a Standards and Priority protocol I have adopted in many ways for all of my Thirty Four years as a therapist - although perhaps Guilty for not as I do today adhering to most if not all of them:

B. When I make such statements as this. "Never once has anyone demonstrated better knowledge or ability than myself."  I apply these checks and Balances; to ensure I am not being Psychotic and Delusional.

C. To count as equal or superior to Talking Cures - a therapeutic application or Institutional Body has to fit into this well tried and trusted - yet simple criteria.

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Check List.  

1. If the Person still has any form of Mind or Body symptoms stopping them enjoying life for themselves. The only measure of successful treatment one may use is "failure" and that is 100%. 

2. One must recognise there is only one illness. "A Person requires Specialised assistance" and symptom naming is of no value.

3. One must not use Hypnosis Direct Suggestion for symptom removal.  

4. One must not symptom manage - we as a Patient - demonstrate the symptoms we experience and thus present to practitioners, are able to alter on a minute by minute bases and as there can be so many identifiable symptoms - the smartest computer the world has to offer; would not be able to keep track of which ones, one is in reality applying treatment too.

5. One must not utilise: Pills, Potions or Lotions. This being symptom management.

6. One must understand the Emotional Phenotype and the rationale behind same. "What we show to the world based on our entire Emotional and Physical history from at least Conception."

7. One must understand the value of Symptom Substitution - or changing Symptom Presentation and be in front of, or at least in line with it happening and know what to do with the new or returning symptoms.

8. One must understand the entire Body Chemistry; or more importantly how the Body Chemistry is influenced by the Mind, its memory store of thoughts; known, remembered or not and its complete Positive or negative Emotional and Physical history.

9. One must not or only use in perpetuum, on, for, or with a Person - more than one treatment regime.

10.  One must not work as part of a team.

11.  One must work in perpetual continuity - never change treatment protocols or methods.

12. One must not Ego Boost. Shows a weakness in the treatment regime - which should ONLY allow a Person's Self Estimation/worth to rise or be restored in keeping with the resolution of aged negative thoughts.

13. One must not have weaknesses in the treatment regime - yet if one recognises same; by demonstrating so rather than hiding, this is acceptable.

14. One must accept the Patient - always in real-terms knows themselves better than the therapist ever could.

15. One must be able to teach the Person to use their Mind for themselves and thus are clone of no one. Especially the Therapist.

16. With a willing party there is no part of a Persons Subconscious Mind - we; working as a team cannot get in to.

A. It is just a question of time as the Mind will only release what it desires to release at a pace that is comfortable.

1. Working on the bases - the Body will go into Toxic Shock if this is ignored.

17. Perhaps not to be missed and should perhaps be number one on this list - No Patient should ever be given false promises of cures, as it was similar activity that created the illness in the first place.

A.  Therefore at the very first appointment I take a very comprehensive list of presenting symptoms.

B. From this list I am able to make an informed decision of what is possible for the Person to resolve - if indeed their Mind will allow, using their own Immune Systems and Body replication processes.

C. Any symptom of Mind or Body that does not fall within this scope has a definitive requirement of a Caveat - a set aside.

D. With; "We do not know what is possible to do with that symptom - however that is not going to stop us continually working towards resolution, or if we are only able to resolve the cause to satisfaction - thereby allowing a more comfortable living with the symptom; to be a fundamental right not a gift.     

Sadly I have never found anyone or treatment process able to pass this Simple Criteria for one to recognise as an equal or superior. 

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Question. 2: Given the understanding you have no medical qualifications - are you able to explain how you can present this information regarding perhaps an illness you have no real prior knowledge of; in the way that you seem very able and comfortable with?

Answer. 2: Good question and thank you.

A. First may we understand it is the ability to work - using only the Persons Mind, of which it appears there is no known precedent, with as many and constantly changing set of symptoms a Person is able to present; is the very foundation from which I work.

1. Furthermore one has to consider. If one does not know the cause of the illness - yet professes a specialism of perhaps decades - which still has no cures...

A. Is there really a true benefit in being highly Medically Qualified and using Scientifically Proven Treatments.

B. My understanding and acceptance - everyone in the Medical Profession and indeed all other modalities of treatment are doing the very best they are able with Management techniques, yet fail to truly comprehend the enormity of the constantly repeated statement.

C. "Of the 100,000 illness recognised and diagnosed," still in 2016 there is not one definitive cure for any illness.

D. Thus I start from a piece of information where a Person - say on Facebook or LinkedIn posts a question about an illness and collect from the available sources, as much information as I am able, regarding the latest information known about the illness.

1. In this instance - my own Professional and as a Patient up-to-date personal experience is the very reason I am writing this paper.

2. Surely writing Patients History without knowing the absolute and thus true thoughts and feelings of a Patient is for - the therapist - profit or kudos only. 

E. I then create a new web page and copy and paste the information into the page.

F. From here I start the edit process of this information - yet do not attempt to understand it, in much the same way a Person with the illness may in pursuit of answers and questions.

G. Part of the edit process is to convert words, that appear are used only to confuse - by researching many medical publications or dictionaries, into a readable format, thus in many cases providing the meaning of the word.

This sometimes proves to be quite a time consuming task.

H. Then I go through every word of the document and edit out the grammatical parts that I feel could read better. IE. Don't - do not. Doesn't - does not or isn't - is not, and first Person, "You" and at the same time apply reference numbers to each sentence as well as colour highlights of information I feel deserves such treatment.

I. Finely - once the page is in a presentable format. I then start to comprehend the enormity of the message and make responses as required, ending with why Talking Cures feels or has proven if only to my own satisfaction, how the illness is caused.

J. Once the creation process is complete I use a number of ways to spell check the entire document - often confused by different ways of spelling the word from country to country.

K. Some forty to sixty hours later, or more depending on the amount of information - having read the document more times than I am able to count.

L. Finely I check for the best level of continuity.  

1. From this point I take the decision it is ready to publish free of any sign up - no collection of saleable contact information or fees; for all to use at their desire, or educational requirements.

2. After all of this there are still times when an error jumps out at me.

3. Usually at this time with a final read/edit - I am reminded; I have no Medical Qualifications and often breath a sigh of relief.

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Diuretic Necessity Explored Explained Understood?

Courtesy of Wikipedia, the free encyclopedia:

This article is about making 2016 sense of this Individually Symptom Medication requirement .

Regarding Person's having disorders with many interrelated symptoms - all with unknown cause and no known cure..,

...requiring removal of residual Water from the Body with Diuretic Medications.

Question. 3. Re Question 2. Answer. 2. D. 1: Please explain how you are implicated in this paper?

Answer. 3: Later as we advance on this paper I will explain how it will be written in simple terms to enable understanding in the same simple manner and how I am implicated.

A. May we start now with some of my personal history. In 1992 I had a Heart Attack which damaged the Heart Muscle causing scarring and at the same time a restriction of the Hearts ability to Pump Blood around the Body and through the Lungs. 

B. Please take the time to first read the paper at this link; Blood

C. It was not until 2013 then 2015 following a scan of my Heart this information was put into a Scientifically proven set of numbers - namely 25% Ejection Fraction.

D. From as early as 1983/4 feeling I was heading for a Heart attack - I worked on my own negative history as well as with many others - often as a Patient led therapeutic technique Demonstration in a study group to stop or ensure the Heart attack never arrived.

E. In 2013 My Heart went into an Arrhythmia - irregular Heart Beat.

F. Since 1992 and to date I have worked somewhat tirelessly to resolve the true Mind cause of the attack at the same time seeking to permanently self-repair the damaged Heart Muscle and Arrhythmia - utilising only the Entire Body Chemistry and Body Replication Processes. Neither to the best knowledge have previously been achieved or even considered possible by Medical Science.

G. My response was to increase my personal workload of treatments to resolve the true-cause - sending as a sign of success me into hospital from June 2013 on numerous occasions.

1. In the absence of my own treatments as described there is a strong possibility I would be on multiple medications or dead, the former creating or increasing the possibility of my early demise.

H. Not least amongst them was 17th August 2016 during a visit to the hospital to monitor the ICD in my chest - they found I was in an VT Arrhythmia which they could not pace me out of and later anaesthetized shocks whilst the Hearts VT Rhythm was restored. The VT Rhythm soon reinstated itself.

1. An Implantable Cardioverter-Defibrillator (ICD) or automated implantable Cardioverter Defibrillator (AICD) is a device implantable inside the Body.

2. The ICD is Able to perform Cardioversion, Defibrillation and as it is a modern version, pacing of the Heart.

3. The device is therefore capable of correcting most life-threatening Cardiac Arrhythmias.

I. A transfer to our local Cardiac Specialist Hospital unit and further treatment appeared to bring me out of the Arrhythmia.

J. Later information received through my thought processes was to explain - the entire episode was as a result of a successful treatment I had given myself.

K. One - that even I; Especially living on my own, required skilled monitoring and complying  medical supervision intervention and medications.

L. On Wednesday 23rd August 2016 I was discharged having been in normal rhythm for five days.

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Echo Scan.

Section. 1.

1. One of the tests the hospital put me through in August 2016, was an Echo Scan which demonstrated my Heart was now pumping at 35% efficiency instead of the October 21st 2015 value of 25% - leaving me to consider my treatment indeed had the ability of repairing the damaged Heart pumping values.

2. Both values confirmed in writing by the Cardiac Teams.

A. scan of documents  = 25 percent. 35 percent.

3. Because there is no way or desire to prove who should take the credit; this must been seen as work in progress and in collaboration with the cardiac teams - who gave me one of a few management medications - a Diuretic Medication; explaining it was to improve the pumping ability of the Heart by removing the Water surrounding it.

4. There was no mention at this time of improving the output of Blood from the Heart to lungs  - known as the Ejection Fraction.

5. No more than I am able to ascertain through internet searching - the possibility of improving permanently, or the Ejection Fraction is being seriously researched, albeit there are studies, these only indicate the use of Management by Medication. 

6.  Leaving one to question - if the medication is stopped, does the Ejection Fraction return to prior measurements.

A. This was later to be confirmed as correct; by my own General Practitioner. 

7. Medical Science suggests the Ejection Fraction of a normal Heart is 55%. See link Heart

8. During one of the nights spent in hospital and of being awake - as my sleeping pattern had been altered. I worked out the protocols of giving a Person with an Arrhythmia - or indeed any Person with one or a number of illnesses; a small but regular - short or long-term dose of Diuretic Medication...

Question. 4: That sounds a complex process - how will you start?

Answer. 4: First we must explore the requirements underpinning the necessity: of the medications used, the medication side-effects, the organs of the Body implicated and the diverted biological/emotional process - following the requirement for prescribing and consumption of such medications.

9. Conclusion: Thus - with the information contained within the scanned (Section 1. 2. A) papers my long-term working on my Mind and its instructions through the Brain to the Biological Body, thereby  causing the damaged Heart, the possibility started to become a serious possibility of self-Repair; using only the Mind via the Brain and all Body Chemicals, Immune systems and Body replication processes.

A. As the Body has a Seven year replication process - in my Mind; I set this as a guideline for the time it might take for my Heart Muscle to fully restore itself; in the same manner although taking only weeks - the Liver is known too.

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Diuretic.

Section. 2.

From Wikipedia, the free encyclopedia...

Diuretic Drug - Class identifiers:

Use: Forced Dieresis. Hypertension ATC code C03.

External links. MeSH D004232.

1. A Diuretic is any substance that promotes the production of Urine.

2. This includes forced Dieresis.

3. Diuresis (/ˌdaɪəˈriːsᵻs/ or /ˌdaɪjəˈriːsᵻs/) is increased urination and the physiologic process that produces such an increase.

4. Involves extra urine production in the kidneys as part of the Body's homeostatic maintenance of fluid balance.

5. There are several categories of Diuretics.

6. All Diuretics increase the excretion of water from Bodies, although each class does so in a distinct way.

7. Alternatively, an anti diuretic such as Vasopressin, or Antidiuretic Hormone, being an agent or drug which reduces the excretion of Water in Urine.

8.  Conclusion. One is unable to argue with the Medical Necessity of a Diuretic Medication.

A.  However in the absence of better knowledge and treatments one would request. "What is the Long-Term effect of excreting water from the Body" - on not only the Skin, but every cell in the Body.

B. Although accepting the Body is 98% water - can the extremities as well as all other organs actually afford this continual loss of water.    

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Medical uses In Medical Treatments.

Section 3.

1. Diuretics are used to treat Heart Failure, Liver Cirrhosis, Hypertension, Influenza, Water Poisoning and certain Kidney Diseases.

2. Some Diuretics, such as Acetazolamide, help to make the Urine more Alkaline and are helpful in increasing excretion of substances - such as Aspirin in cases of overdose or poisoning.

3. Diuretics are often abused by those with eating disorders, especially bulimics, in attempts to lose weight.

4. The Antihypertensive actions of some Diuretics - Thiazides and loop Diuretics in particular are independent of their Diuretic effect.

5. That is, the reduction in Blood Pressure is not due to decreased Blood volume resulting from increased Urine production, but occurs through other mechanisms and at lower doses than that required to produce Diuresis.

6. Diuresis is increased urination and the physiologic process that produces such an increase.

7. It involves extra urine production in the Kidneys as part of the Body's homeostatic maintenance of fluid balance.

8. In healthy People, the drinking of extra water produces mild diuresis to maintain the Body water balance.

9. Many People with health problems such as Heart failure and Kidney failure need diuretic medications to help their Kidneys deal with the fluid overload of edema - a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the Body.

10. These drugs help the Body rid itself of extra water via the extra urine.

11. The concentrations of electrolytes in the Blood are closely linked to fluid balance.

12. Indapamide was specifically designed with this in mind and has a larger therapeutic window for hypertension - without pronounced Diuresis than most other Diuretics.

13. Types High ceiling/loop Diuretic High ceiling Diuretics may cause a substantial Diuresis – up to 20% of the filtered load of NaCl (salt) and water.

14. This is large in comparison to normal renal sodium reabsorption which leaves only about 0.4% of filtered sodium in the Urine.

15. Loop Diuretics have this ability and are therefore often synonymous with high ceiling Diuretics.

16. Loop Diuretics, such as furosemide, inhibit the Body's ability to reabsorb sodium at the ascending loop in the nephron, which leads to an excretion of Water in the Urine, whereas water normally follows sodium back into the extracellular fluid.

17.  Other examples of high ceiling loop Diuretics include Ethacrynic Acid and Torsemide.

18. Thiazides. Thiazide-type Diuretics such as Hydrochlorothiazide act on the distal convoluted tubule and inhibit the sodium-chloride symporter leading to a retention of water in the Urine, as water normally follows penetrating solutes.

19. A Symporter is an integral membrane protein that is involved in the transport of many differing types of molecules across the cell membrane.

20. The Symporter works in the plasma membrane and molecules are transported across the cell membrane at the same time.

21. Frequent Urination is due to the increased loss of water that has not been retained from the Body as a result of a concomitant relationship with sodium loss from the convoluted tubule.

22. Concomitant definition, existing or occurring with something else, often in a lesser way; accompanying; concurrent: an event and its concomitant circumstances.

23. The long-term Anti-hypertensive action is based on the fact that Thiazides decrease preload, decreasing Blood Pressure.

24. On the other hand, the short-term effect is due to an unknown vasodilator effect that decreases Blood Pressure by decreasing resistance.

25. Carbonic Anhydrase inhibitors inhibit the Enzyme Carbonic Anhydrase which is found in the proximal convoluted tubule.

26. This results in several effects including bicarbonate accumulation in the Urine and decreased sodium absorption.

27. Drugs in this class include Acetazolamide and Methazolamide.

28. Conclusion. Is it not fair to say words as this (item 24) "due to an unknown vasodilator effect" Invalidates every aspect of such studies.

A. Leaves one to question: Is there a distinct possibility the excretion of water from the Body in such a manner as the medication describes has a long-term-effect of making the entire Body chemistry more (link) Toxic and Caustic - thus creating more mysterious symptoms than the "unknown vasodilator effect," are able to explain.

B. Moreover - Item 8 demonstrates the Body will always seek to maintain a balance.

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Potassium-sparing Diuretics.

Section 4.

1. These are Diuretics which do not promote the secretion of Potassium into the Urine; thus, potassium is retained and not lost as much as with other Diuretics.

2. The term. "Potassium-Sparing," refers to an effect rather than a mechanism or location.

3. Nonetheless, the term almost always refers to two specific classes that have their effect at similar locations: Aldosterone Antagonists: Spironolactone, which is a competitive Antagonist of Aldosterone.

4. Aldosterone normally adds sodium channels in the principal cells of the collecting duct and late distal tubule of the nephron.

5. Spironolactone - prevents Aldosterone from entering the principal cells, preventing sodium reabsorption.

6. Similar agents are Eplerenone and Potassium Canreonate and Epithelial sodium channel blockers: Amiloride and Triamterene.

7. Conclusion. Words as this surely demonstrate all treatments around Diuretic's are no more than guesswork. As demonstrated by - The term "Potassium-Sparing" refers to an effect rather than a mechanism or location.

A. Is this not a clear demonstration the Medical Profession whilst not accepting Humans have a Mind - only a Brain; is as a result locked into combat like in a Castle surrounded by a moat - only able to work with or defend the Organs within the ramparts.

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Calcium-sparing diuretics.

Section 5.

1. The term; "Calcium-Sparing Diuretic," is sometimes used to identify agents that result in a relatively low-rate of excretion of calcium.

2. The reduced concentration of Calcium in the Urine can lead to an increased rate of Calcium in serum. 

3. Derangements of this mechanism lead to Hypercalcemia or Hypocalcemia, both of which can have important negative consequences for health.

A. Hypercalcemia is a condition in which the calcium level in the Blood is above normal.

1. Too much calcium in the Blood can weaken  bones, create kidney stones and interfere with the way the Heart and Brain works.

2.  Hypercalcemia most commonly results from overactive parathyroid gland.

B. Hypocalcemia occurs as the result of Hyperparathyroidism or another underlying condition, the underlying condition may need treatment.

C.  If this is the case, a Doctor may not be able to cure Hypocalcemia.

4.  In Humans, when the Blood plasma ionized calcium level rises above its set point, the thyroid gland releases calcitonin, causing the plasma ionized calcium level to return to normal.

5.  When it falls below that set point, the parathyroid glands release parathyroid hormone (PTH), causing the plasma calcium level to rise.

A. Parathyroid glands are small glands of the endocrine system which are located in the neck behind the thyroid.

B. Parathyroid glands control the calcium in the Body and how much calcium is in the bones and in the Blood.

C.  Calcium is the most important element in the Body,  it is used to control many systems.

D.  Calcium is regulated very carefully by the Body. 

6. The sparing effect on Calcium can be beneficial in Hypocalcaemia, or unwanted in Hypercalcemia.

7. The Thiazides and Potassium-Sparing Diuretics are considered to be Calcium-Sparing Diuretics.

8. The Thiazides cause a net decrease in Calcium lost in Urine.

9. The Potassium-Sparing Diuretics cause a net increase in Calcium lost in Urine, but the increase is much smaller than the increase associated with other Diuretic classes.

10. By contrast, loop Diuretics promote a significant increase in Calcium Excretion.

11. This can increase risk of reduced bone density.

12. Conclusion. Should one not ask "By what process does Calcium become reduced in the. Blood yet in response increased in the Blood Serum?"

A. My guess this is researched and conclusions are made - where no one highly medically qualified is able to mediate this process to a cure or rebalancing back to what is considered normal.

B. Giving rise to the serious possibility this is no more than an Hypotheses or educated guesswork.

C.  Demonstrated by the inability to recognise if the Thyroid and Parathyroid Glands are not working normally or as expected - this is no more than symptoms of a disorder as yet unrecognised.

D.  Leaving one to consider - if the driving force behind the activity of the Thyroid and the Four Parathyroid Glands is not understood - then one in reality understands very little in the way the Body works. 

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Osmotic Diuretics.

Section 6.

1. Osmotic Diuretics. E.G. mannitol are substances that increase Osmolality but have limited tubular epithelial cell permeability.

2. They work primarily by expanding extracellular fluid and plasma volume, therefore increasing Blood Flow to the Kidney, particularly the peritubular - tiny Blood vessels in the capillaries.

3. This reduces medullary osmolality and thus impairs the concentration of Urine in the loop of Henle - which usually uses the high osmotic and solute gradient to transport solutes and water.

4. Furthermore, the limited tubular epithelial cell permeability increases osmolality and thus water retention in the filtrate.

5. It was previously believed that the primary mechanism of Osmotic Diuretics such as mannitol - is that they are filtered in the glomerulus, but cannot be re-absorbed.

6. Thus their presence leads to an increase in the Osmolarity of the filtrate and to maintain Osmotic balance, water is retained in the Urine.

7. Definition of Plasma Osmolarity. The Osmolarity of Blood Plasma, is an estimation of the osmolar concentration of plasma and is proportional to the number of particles per litre of solution; it is expressed as mmol/L.

8.  This is what is used when a calculated value is derived.

9.  It is derived from the measured Na+, K+, Urea and Glucose concentrations...

10.  ...Is a measure of the hydration status...

A. ...Whereby - The plasma Osmolarity is sensitive to changes in Hydration status.

11.  Glucose, like Mannitol, is a sugar that can behave as an Osmotic Diuretic.

12.  Unlike Mannitol, glucose is commonly found in the Blood.

13.  Mannitol, also known as mannite or manna sugar, is a white, crystalline solid that looks and taste sweet like sucrose. 

14.  Medically it is used to treat increased intracranial pressure... 

15.  ...It also has several industrial uses.

16.  In plants its purpose is to alleviate Osmotic Stress. 

17.  Serious side-effects may include worsening Heart Failure Electrolyte Abnormalities and Low Blood Volume.

18.  It is unclear if it is safe in Pregnancy.

19.  Mannitol is classified as Sugar Alcohol; that is, it is derived from a sugar (mannose) by reduction.

20.  Other sugar alcohols include Xylitol and Sorbitol.

21. Mannitol and sorbitol are isomer, the only difference being the orientation of the hydroxyl group on carbon 2.

22. However, in certain conditions, such as Diabetes Mellitus, the concentration of Glucose in the Blood - Hyperglycemia, exceeds the maximum reabsorption capacity of the Kidney.

23. When this happens, glucose remains in the filtrate, leading to the Osmotic retention of Water in the Urine.

24.  Glucosuria causes a loss of Hypotonic Water and Na+, leading to a Hypertonic state with signs of volume depletion, such as dry mucosa, hypotension, tachycardia and decreased turgor of the skin.

A. Dry Mucosa is Sjögren’s or Dry mouth, usually called ‘xerostomia’ (zeer-oh-stomia), is a common symptom most often caused by a decrease in the amount or quality of saliva.

B. Many Patient's experience some degree of Dry mouth, which has implications in many chronic diseases: Diabetes, Depression and has many causes, including: prolonged use of many prescription drugs, medical treatments such as radiation therapy to the head and neck or bone marrow transplantation.

25. Turgor is the degree of elasticity of skin and with poor Turgor takes time to return to its normal position.

26. Lack of skin turgor is a sign of Dehydration  which occurs with moderate to severe fluid loss.

27.  Mild dehydration is when fluid loss of 5% of the Body weight.

28. Moderate dehydration is 10% loss and severe dehydration is 15% or more loss of Body weight.

29.  Glycosuria or Glucosuria is the excretion of glucose into the urine.

30.  Ordinarily, urine contains no glucose because the kidneys are able to reabsorb all of the filtered glucose from the tubular fluid back into the Bloodstream.

31.  Glycosuria is nearly always caused by elevated Blood glucose levels, most commonly due to untreated Diabetes Mellitus.

32. Rarely, glycosuria is due to an intrinsic problem with glucose reabsorption within the kidneys - such as Fanconi syndrome, producing a condition termed Renal Glycosuria.

A. Fanconi syndrome is a rare disorder of kidney tubule function that results in excess amounts of glucose, bicarbonate, phosphates (phosphorus salts), uric acid, potassium and certain amino acids being excreted in the urine.

33. Glycosuria leads to excessive water loss into the urine with resultant dehydration, a process called Osmotic Diuresis.

34. Use of some drugs, especially stimulants, may also increase Blood Glucose and thus increase Urination.

35. Conclusion. Is this not a clear and unambiguous demonstration - as all items mentioned in this section are no  more than symptoms; thus no one truly understands the implication of all other Body Chemicals in one integral and integrated unit - Blood.

A.  Item 25 Turgor offers clues to the use of Diuretics.

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Low ceiling Diuretics.

Section. 7.

1. The term "low ceiling Diuretic" is used to indicate a Diuretic has a rapidly flattening dose effect curve - in contrast to "high ceiling," where the relationship is close to linear.

2. It refers to a pharmacological profile, not a chemical structure.

3. However, certain classes of Diuretic usually fall into this category, such as the Thiazides.

4.  Mechanism of action Diuretics are tools of considerable therapeutic importance.

5.  First, they effectively reduce Blood Pressure.

6.  Loop and thiazide Diuretics are secreted from the proximal tubule via the organic anion transporter-1 and exert their Diuretic action by binding to the Na(+)-K(+)-2Cl(-) co-conspirator type 2 in the thick ascending limb and the Na(+)-Cl(-) co-conspirator in the distal convoluted tubule, respectively.

7. Conclusion. When one following a consultation with a Doctor or Medical Specialist is given a medication with the stern warning you must take these to be well or you must not stop taking these to stay well - one never questions the Doctor knows best syndrome.

A.  Even when often years later a new illness emerges and yet another pill is prescribed.

B. That is until the likes of myself comes along and is able to recognise the early warning signs of so called Side-effects from medications.

C.  May we recall my earlier comment. "I do not subscribe to side-effects of medications."

D.  I do however subscribe to the taking of Poisons recognised in this paper - with more than 800 negative effects, such a poison is able to have on the entire Body Chemistry and the Mind, forcing it to create - even more mysterious symptoms than the original illness.

E. Thus with the explanation "pharmacological profile (Section 7 Item 2,)" has no long-term value in the use of Diuretic requirement.

F. Based on the consideration - if the medication is stopped the Blood Pressure will rise back to the pre reduced level. 

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Classification of common Diuretics and their mechanisms of action.

Section 8.

Examples Mechanism Location - numbered in distance along Nephron - Ethanol, Water Inhibits Vasopressin secretion. Acidifying Salts CaCl2, NH4Cl

1. Arginine Vasopressin receptor.

2. Antagonists Amphotericin.

3.  Lithium Citrate Inhibits Vasopressin's action.

4.  Collecting duct Selective Vasopressin V2 Antagonist.

A. Sometimes called Aquaretics; Tolvaptan Conivaptan, Bind aquaporin channels in the apical membrane of the renal collecting ducts in Kidneys causing an increase in renal free water excretion or aquaresis, an increase in Urine serum sodium concentrations, a decrease in Urine Osmolality and an increase in Urine output.

5.  Collecting duct Na-H exchanger Antagonists Dopamine Promotes Na+ excretion.

6. Proximal tubule Carbonic Anhydrase inhibitors Acetazolamide, Dorzolamide Inhibits H+ secretion, resultant promotion of Na+ and K+ excretion.

7. Proximal tubule Loop Diuretics Bumetanide, Ethacrynic Acid, Furosemide and Torsemide Inhibit the Na-K-2Cl symporter.

8.  Medullary thick ascending limb Osmotic Diuretics glucose - especially in uncontrolled Diabetes, mannitol Promotes Osmotic Diuresis.

9. Proximal tubule, descending limb Potassium-sparing Diuretics Amiloride, Spironolactone, Eplerenone, Triamterene, Potassium Canrenoate. Inhibition of Na+/K+ exchanger: Spironolactone inhibits Aldosterone action, Amiloride inhibits epithelial sodium channels.

10.  Cortical collecting ducts. Thiazides Bendroflumethiazide, Hydrochlorothiazide Inhibits reabsorption by Na+/Cl− symporter.

11. Distal convoluted tubules Xanthines Caffeine, Theophylline, Theobromine Inhibits reabsorption of Na+, increase glomerular filtration rate.

12. Tubules Chemically, Diuretics are a diverse group of compounds that either stimulate or inhibit various hormones that naturally occur in the Body to regulate Urine production by the Kidneys.

13. As a Diuretic is any substance that promotes the production of Urine, Aquaretics that cause the excretion of free water are a sub-class.

14. This is includes all the Hypotonic Aqueous preparations, including pure water, black and green teas and teas prepared from Herbal medications.

15. Any given herbal medication will include a vast range of plant-derived compounds, some of which will be active drugs that may also have independent Diuretic action.

16.  Conclusion. Whilst we must recognise the requirement in this form of understanding - is it sufficient when the outcome is only of worsening symptoms in the medium to long-term; called medication side effects.

A. Where the use of the term Sub Class; is no more than an attempt to hide how little is really known.

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Diuretic Medications.

Section 9.

Spironolactone

Pronunciation Generic Name: spironolactone - spir ON oh LAK tone.

Brand Names: Aldactone.

Side Effects Dosage Interactions Patient Professional information.

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What is Spironolactone?

Section 10.

1. Spironolactone is a Potassium-sparing Diuretic - water pill that prevents the Body from absorbing too much salt and keeps potassium levels from getting too low.

2. Spironolactone is used to diagnose or treat a condition in which there is too much Aldosterone in the Body.

3. Aldosterone is a hormone produced by the adrenal glands to help regulate the salt and water balance in the Body.

4. Spironolactone also treats fluid retention - Edema in People with congestive Heart failure, Cirrhosis of the Liver, or a Kidney disorder called; Nephrotic Syndrome.

5. Edema is a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the Body.

6. This medication is also used to treat or prevent Hypokalemia - low potassium levels in the Blood.

7. Spironolactone may also be used for purposes not listed in this guide.

8. Conclusion. Whilst one must not take my own personal experience of this medication as Scientific Proof - if one does not know the true cause of Edema and address this - instead of only medicating the symptoms; is not one demonstrating - one knows very little.

A. Thus my views are as worthy as the Scientific Proof.   

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Important information.

Section 11.

1. Spironolactone should not be used if the Patient has kidney disease, high levels of potassium in the Blood, Addison's disease - an Adrenal Gland Disorder, or if they are unable to urinate, or are also taking Eplerenone.

2. Chronic Pain Management: From a Healthcare Professional's Guide In animal studies, it appears Spironolactone caused certain types of Cancers and Tumours.

3.  It is not known whether these effects would occur in People using this medicine.

4.  Ask a Doctor about the risks.

5. Conclusion. Is it not fair to suggest as this medication has over 100 (see Section 17) known side effects - would a Dedicated Doctor really be able to advise of the risks of taking this medication.

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Before taking this medicine.

Section 12.

1.  Spironolactone should not be prescribed if the Patient is allergic to it, or has: Kidney Disease, or unable to urinate; Addison's disease - an adrenal gland disorder; high levels of potassium in the Blood - Hyperkalemia; or are also taking Eplerenone.

2. To make sure Spironolactone is safe, seek advise from a Doctor regarding pre existing: Liver Disease; Heart Disease; an electrolyte imbalance - such as low levels of magnesium in the Blood; or if an NSAID has been prescribed - Nonsteroidal anti-inflammatory drug, Cholestyramine, Heparin, Lithium, Heart or Blood pressure medication, Potassium supplements, Steroid Medicine, or another Diuretic.

3.  In animal studies, Spironolactone caused certain types of tumours, some of which were cancerous.

4.  However, very high doses are used in animal studies.

5.  It is not known whether these effects would occur in People using regular doses.

6.  A Doctor should inform or advise of risks.

7.  It is not known whether Spironolactone will harm an unborn Baby.

8.  A Woman should advise the Doctor if pregnant or plans to become pregnant while using this medication.

9.  Spironolactone can pass into breast milk and may harm a nursing Baby.

10. It is advised not to breast-feed while using this medicine.

11. Conclusion. Is it not the wise thing to say with the known side-effects often causing the very symptoms prescribed to assist - this medication should be on the Poisons List.

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How should Spironolactone be taken?

Section 13.

1.  Spironolactone should be taken exactly as prescribed by a Doctor.

2.  Follow all directions on the prescription label.

3.  Do not take this medicine in larger or smaller amounts or for longer than recommended.

4.  While using Spironolactone, frequent Blood tests are recommended.

5.  This medication can cause unusual results with certain medical tests.

6.  Tell any attending prescribing Doctor of the use of Spironolactone.

7. If surgery is planned, tell the surgeon ahead of time - of Spironolactone having been prescribed.

8.  Surgery may require suspending using the medicine for a short time.

9.  If being treated for High Blood Pressure, keep using this medication even when feeling well.

10.  High Blood pressure often has no symptoms.

11.  It may be a necessity to use Blood Pressure medication for life.

12.  Store at room temperature away from heat, light and moisture.

13. Conclusion. Once again with the use of words like this "frequent Blood tests are recommended."

A. Is there not be sufficient information available to prescribing Doctors  - to not prescribe this medication in the first instance.

B. In my own case although one cannot Scientifically Prove this - after taking the medication for just five days; near two months later - 31st October 2016; The Kidney Pains and other symptoms - trembling all over; appear to have only just recently subsided.  

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Dosage Information.

Section 14.

1.  Dosage Information - in more detail.

2.  What happens if a dose is missed.

3.  Take the missed dose as soon as the missing dose is remembered.

4.   Skip the missed dose if it is almost time for the next scheduled dose.

5.   Do not take extra medicine to make up the missed dose.

6.   Conclusion. Perhaps enough said in the words. "Do not Take."

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What happens if a Person overdoses?

Section 15.

1. Seek emergency medical attention or call a Poison Help line.

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Dietary substances to be avoided.

Section 16.

1.  Drinking alcohol can increase certain side-effects of Spironolactone.

2.  Do not use salt substitutes or low-sodium milk products that contain potassium.

3. These products could cause the potassium levels to get too high while taking Spironolactone.

4.  Avoid a high-salt diet.

5.  Too much salt will cause the Body to retain water, which may reduce the effectiveness of this medicine.

6.  Spironolactone may impair thinking or mental reactions.

7.  Requiring care whilst driving or doing anything that requires being alert.

8.  Avoid becoming overheated or dehydrated during exercise and in hot weather.

9.  Follow Doctor's instructions about the type and amount of liquids required.

10.  In some cases, drinking too much liquid can be as unsafe as not drinking enough.

11.  Conclusion. As most People have to look after their self in the Main, following Medical advise is there not a clue here ;  "impair thinking or mental reactions."

A.  Not to take the medication in the first place - no matter how it is deemed necessary; for how, if this became a reality without the benefit of PhD in Medical Knowledge and Training - would one know if Diet is making symptoms worse. 

B.  Surely if the Doctors do not know - who does.

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Spironolactone Side Effects.

Section 17.

A. Get emergency medical help if there are any signs of an allergic reaction to Spironolactone: hives; difficulty Breathing; Swelling of the Face, Lips, Tongue, or Throat.

B.  Stop using Spironolactone and call a Doctor at once, with signs of:

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Spironolactone Side Effects.

1.  Stomach bleeding.

2.  Bloody or Tarry stools.

3.  Coughing up blood or vomit that looks like coffee grounds.

4.  High potassium.

5.  Slow heart rate.

6.  Weak pulse.

7.  Muscle weakness or limp feeling.

8.  Tingly feeling.

9.   Low sodium.

10.  Slurred speech.

11.  Hallucinations.

12.  Severe weakness.

13.  Loss of coordination.

14.  Feeling unsteady.

15.  Seizure.

16.  Convulsions.

17.  Fainting.

18.  Shallow breathing - Breathing may stop.

19.  Symptoms of any electrolyte imbalance - dry mouth, increased thirst.

20.  Drowsiness.

21.  Lack of energy.

22.  Restless feeling.

23.  Confusion.

24.  Nausea.

25.  Vomiting.

26.  Increased Urination.

27.  Muscle cramps or weakness.

28.  Fast Heart Rate.

29.  Little or no Urinating.

30.  Feeling of imminent passing out.

Common Spironolactone side effects may include:

31.  Mild Nausea or Vomiting.

32.  Diarrhoea.

33.  Breast swelling or tenderness.

34.  Dizziness.

35.  Headache.

36.  Mild drowsiness.

37.  Leg cramps.

38.  Impotence.

39.  Difficulty having an erection.

Severity: Major.

If any of the following side effects occur while taking Spironolactone, check with a Doctor immediately:

40.  Incidence not known.

41.  Abdominal or stomach cramping.

42.  Burning or tenderness.

43.  Bleeding gums.

44.  Bloody or black, Tarry stools.

45.  Bloody Urine.

46.  Breast Pain.

47.  Chest Pain.

48.  Chills.

49.  Clay-colored stools.

50.  Clear or bloody discharge from the nipple.

51.  Cloudy Urine.

52.  Coma.

53.  Confusion.

54.  Constipation.

55.  Convulsions.

56.  Cough or hoarseness.

57.  Dark Urine.

58.  Decrease in Urine output.

59.  Decrease in Urine-concentrating ability.

60.  Diarrhoea difficulty with swallowing.

61.  Dimpling of the breast skin.

62.  Dizziness.

63.  Drowsiness.

64.  Fast or irregular Heartbeat.

65.  Fever with or without chills.

66.  General feeling of tiredness or weakness.

67.  Headache.

68.  Heartburn.

69.  Hives.

70.  Itching.

71.  Skin rash.

72.  Increased thirst.

73.  Indigestion.

74.  Inverted nipple.

75.  Loss of appetite.

76.  Lower back or side Pain.

77.  Lump in the breast or under the arm.

78.  Muscle Pain.

79.  Cramps.

80.  Muscle spasms or twitching.

81.  Nausea and vomiting.

82.  Painful or difficult Urination.

83.  Persistent crusting or scaling of the nipple pinpoint.

84.  Red spots on the skin puffiness.

85.  Swelling of the eyelids or around the eyes. face, lips, or tongue.

86.  Redness or swelling of the breast.

87.  Severe stomach Pain.

88.  Shakiness and unsteady walk.

89.  Sore on the skin of the breast that does not heal.

90.  Sore throat.

91.  Sores.

92.  Ulcers, or white spots on the lips or in the mouth.

93.  Swelling of the face. Fingers, feet, ankles, or lower legs swollen.

94.  Painful, or tender lymph glands in the neck, armpit, or groin.

95.  Tightness in the chest.

96.  Trembling.

97.  Troubled Breathing.

98.  Unpleasant Breath Odour.

99.   Unsteadiness.

100.  Trembling, or other problems with muscle control or coordination.

101.  Unusual bleeding or bruising.

102.  Unusual tiredness or weakness.

103.  Vomiting of Blood or material that looks like coffee grounds.

104.  Weight gain.

105.  Yellow eyes or skin.

106.  Conclusion. Is Medical Science so blinded by the requirement for profit not to recognise there is not a Doctor in the world that would be able to keep track of these symptoms - oops Side effects; especially if they were constantly changing on a  minute by minute or daily bases.

A.  The side effects in red in this section are those within myself I believe were caused or aggravated by this medication - that have subsided since ceasing consumption. 

Severity.

B.  Minor Some Spironolactone side effects may not need any medical attention.

C.  As your Body gets used to the medicine these side effects may disappear.

D.  Your health care professional may be able to help prevent or reduce these side effects, but do check with them if any of the following side effects continue, or are concerned about them:

107.  Incidence not known:

108.  Burning feeling in the chest or stomach.

109.  Hair loss or thinning of the hair.

110.  leg cramps sores.

111.  Welting, or Blisters.

112.  Stomach upset.

113.  Swelling of the breasts or breast soreness in both females and males.

114.  Unusual dullness or feeling of sluggishness.

115.  Conclusion. It always concerns me when the words "May" is used in a Scientific Paper as it implies guesswork.

A.  Although I am unable to quantify - it appears there is a possibility my breast tissue has increased in the past month or so September/Oct 2016, most certainly I have put on weight. 

B.  Not all side effects for Spironolactone  may be reported.

C. Consulting a Doctor or Healthcare Professional for medical advice is always recommended.

D.  With all these 114 side-effects how could any Doctor or Patient keep track of these - surely it would take a computer of greater capability than current available - then would any one know what to do with the results

E.  With Known or reported side-effects or a legal (we are not responsible as we published) marker or Disclaimer for damage limitation of the negative side-effects of Spironolactone...

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Symptoms of overdose.

Section 18.

1. If any of the following symptoms of overdose occur while taking Spironolactone, get emergency help immediately:

2. Symptoms of overdose: Irregular Heartbeat nervousness numbness or tingling in the hands, feet, or lips rash with flat lesions or small raised lesions on the skin reddened skin weakness or heaviness of the legs.

3.  Conclusion. Based on the well and scientifically proven fact there are some Seven Billion People in the world and the Blood Chemistry is Unique to every one thus different - how would one really know if one was overdosing.

A. In addition;  Irregular Heartbeat is just another word for Arrhythmia; thus the medication is quite capable of giving me the very symptoms I went into hospital for.

B.  For most of my Thirty Four years as a therapist I have adhered to the principle - there are no such thing as Side Effects from Medications, what the use of medications does to the Body via the Mind is quite another matter. 

C.  Whatever the substance consumed - if it is not in keeping with the dietary substances set by the Mind following Emotional and or Physical traumas, the understanding of the traumas will cause the Mind to create a new way of achieving the understanding required.

D.  New symptoms often referred to as Side-effects of Medications.

E. This does not indicate anything other than the Mind and Body will see medications as Poisons - no matter how clever the medications are at curing the disorder.

F. Thus in my own case to say I am suffering Kidney Pain nearly two month after ceasing the medication is true - however although I have never had such symptoms in my life; one must recognise this is due to my Minds response to the Poisons consumed; even though it was following only Five Days of use.     

For Healthcare Professionals.

Section 19.

1.  Applies to Spironolactone: compounding powder, oral tablet Metabolic

2.  One of the most sensitive and quickest tests for Hyperkalemia is the electrocardiogram (ECG), which usually demonstrates pronounced, "tented", or "peaked" T-waves, if not QRS widening.

3.  Hyperkalemia is the medical term that describes a potassium level in the Blood that is higher than normal.

4.  Potassium is a nutrient that is critical to the function of nerve and muscle cells, including those in the Heart.

5.  The first line of treatment for Hyperkalemia with ECG - Electrocardiogram changes - is intravenous calcium.

6.  A second line therapy is prompt treatment with intravenous glucose 20% to 50% and regular insulin 0.25 to 0.50 units for every gram of glucose given.

7.  Moderate Hyperkalemia can sometimes be successfully treated with sodium polystyrene sulfonate exchange resin.

8.  Sulfonate's are polymers derived from polystyrene but containing sulfonate functional groups.

9. They are widely used to remove ions such as potassium, calcium and sodium from solutions in technical or medical applications.

10.   Results of a case-controlled study revealed that Heart failure Patients who develop Hyperkalemia while receiving Spironolactone tend to be older, likely to have Diabetes, have higher baseline potassium levels and are receiving a beta-blocker.

11.  In one study, Hyperkalemia requiring discontinuation of therapy occurred in 3.6% of Patients and the rate of Serious Hyperkalemia. i.e., greater than 6.0 mEq/L) was 1.6%.

12.  In contrast, another study reported that 24% of Heart failure Patients developed Hyperkalemia and 12% developed serious Hyperkalemia while receiving Spironolactone.

13.  Also, 31% of Patients developed Hyponatremia.

14. Hyponatremia is a condition that occurs when the level of sodium in the Blood is abnormally low.

15.  Sodium is an electrolyte and it helps regulate the amount of water that is in and around Body cells.

16. Hyperchloremic metabolic acidosis is associated with Spironolactone therapy in Patients with liver disease and/or severe Renal Dysfunction.

17.  Hyperchloremic acidosis is a form of metabolic acidosis associated with a normal anion gap, a decrease in plasma bicarbonate concentration and an increase in plasma chloride concentration.

18. Urine Anion Gap.

19.  The Urine anion gap is calculated using measured ions found in the urine.

20.  It is used to aid in the differential diagnosis of metabolic acidosis.

21. The term "anion gap," without qualification usually implies serum anion gap.

22. The "Urine Anion gap" is a different measure, principally used to determine whether the kidneys are capable of appropriately Acidifying Urine.

23. Although plasma anion gap is normal, this condition is often associated with an increased Urine anion gap, due to the kidney's inability to secrete ammonia.

24.  Metabolic side-effects have been the most common side effects of Spironolactone.

25.  Hyperkalemia has been reported in approximately 10% of Patients, which has caused intermittent muscle paralysis and Death in rare cases.

26.  Hyperkalemia is particularly likely in Patients with Renal Dysfunction.

27. Hyponatremia has been reported in 12% of Patients and may be more likely in Patients with liver disease due to the non osmotic release of antidiuretic hormone (ADH).

28.  Electrolyte disturbances have been reported post marketing.

29. Hyponatremia is a condition that occurs when the level of sodium in the Blood is abnormally low.

30.  Sodium is an electrolyte and it helps regulate the amount of water that is in and around the Body cells.

31.  Endocrine. Endocrinologic side effects have been due to the Antiandrogenic properties of Spironolactone.

32.  Antiandrogenic...

33.  Antiandrogens, or Androgen blockers, first discovered in the 1960s, prevent androgens like testosterone and dihydrotestosterone (DHT) from expressing their biological effects in responsive tissues.

34.  Antiandrogens alter the androgen pathway by blocking the appropriate receptors or affecting androgen production. 

35.  Five percent to 30% of male Patients complained of Gynecomastia, impotence or diminished libido.

36.  Gynaecomastia. Enlargement of a Man's Breasts, usually due to hormone imbalance or hormone therapy.

37.  Female Patients reported hirsutism, oligomenorrhea, amenorrhea, menorrhagia and breast tenderness.

38.  These side effects appeared to be dose-related and were more likely during long-term therapy

39.  It is different than Hypertrichosis, which is excessive hair growth anywhere on the Body.

40.  Hirutism is the term used when a woman grows too much Body or facial hair in a pattern seen normally occurring only in Men.

41.  Oligomenorrhea is a condition in which a Woman has infrequent menstrual periods.

42.  It occurs in Women of Childbearing age.

43.  Some variation in menstruation is normal, but a Woman who regularly goes more than 35 days without menstruating may be diagnosed with Oligomenorrhea.

44.   Periods usually occur every 21 to 35 days.

45.  Amenorrhea (uh-men-o-REE-uh) is the absence of menstruation - one or more missed menstrual periods.

46.  Women who have missed at least three menstrual periods in a row have Amenorrhea, as do girls who have not begun menstruation by age 15.

47.  The most common cause of amenorrhea is pregnancy.

48.  Menorrhagia is a menstrual period with abnormally heavy flow and falls under the larger category of abnormal uterine bleeding (AUB).

49. Abnormal uterine bleeding can be caused by structural abnormalities in the reproductive tract, anovulation, bleeding disorders, or cancer of the reproductive tract.

50.  Initial evaluation aims at figuring out pregnancy status, menopausal status and the source of bleeding.

51.  Gynecomastia may be more likely in some Male Patients with liver disease due to the increased conversion of androgens to oestrogens in severe liver disease.

52.  Gynecomastia is a common disorder of the endocrine system in which there is a non-cancerous increase in the size of Male breast tissue.

53.  Most adolescent Boys, up to 70%, have some breast development during puberty.

54.  Newborn and adolescent Males often experience temporary gynecomastia due to the influence of maternal hormones and hormonal changes during puberty, respectively.

55.  The development of gynecomastia is usually associated with benign pubertal changes; in adolescent Boys, the condition is often a source of psychological distress.

56.  However, 75% of pubertal gynecomastia cases resolve within two years of onset without treatment.

57.  In rare cases, gynecomastia has been known to occur in association with certain disease states.

58. Gynecomastia may be seen in individuals with Klinefelter Syndrome or certain cancers, with disorders involving the endocrine system or metabolic dysfunction, with the use of certain medications, or in older males due to a natural decline in testosterone production.

59.  Klinefelter Syndrome (KS) also known as 47 XXY or XXY, is the set of symptoms that result from two or more X chromosomes in Males.

60.  The primary feature is sterility.

61.   Often symptoms may be subtle and many People do not realize they are affected.

62.  Sometimes symptoms are more prominent and may include weaker muscles, greater height, poor coordination, less body hair, smaller genitals, breast growth and less interest in sex.

63.   Often it is only at puberty that these symptoms are noticed.

64.  Intelligence is usually normal; however, reading difficulties and problems with speech are more common.

65.   Symptoms are typically more severe if three or more X chromosomes are present.

66.  Spironolactone interferes with 17-hydroxylase activity, which causes a decrease in testosterone synthesis.

67.  It also inhibits the intracellular binding of Dihydrotestosterone to its receptor.

68.  Dihydrotestosterone - commonly abbreviated to DHT, or 5α-dihydrotestosterone - 5α-DHT, is also known as 5α-androstan-17β-ol-3-one, and is a sex steroid and androgen hormone.

69.  The enzyme 5α-reductase synthesizes DHT from testosterone in the prostate, testes, hair follicles and adrenal glands.

70.  This enzyme reduces the 4,5 double-bond of the testosterone.

71. Relative to testosterone, DHT is much more potent as an agonist of the androgen receptor.

72. Rare cases of young Women with liver disease who developed Menarche only after Spironolactone was discontinued are reported.

73. Since estradiol synthesis is partially dependent on testosterone synthesis, Spironolactone may cause primary or secondary Amenorrhea in adolescents.

74. Renal Results of a case-controlled study indicate that Heart failure Patients who developed renal insufficiency while receiving Spironolactone tended to have a lower baseline Body weight, a higher baseline serum creatinine, required higher doses of loop Diuretics and were also likely to be receiving a Thiazide Diuretic.

75.  In this study, the incidence of Renal Insufficiency requiring discontinuation of therapy was 3.7%.

76.  In contrast, another study reported that 25% of their Heart failure Patients developed Renal Insufficiency while receiving Spironolactone.

77.  Renal side effects have included Renal Insufficiency, manifested by increased BUN and serum creatinine.

78.  Conclusion. Surely when one considers this information came from Scientific Sources there is enough here for professionals to consider this medication is a Poison and of no therapeutic value.

A.  Is it possible with the increased amount of diagnosed Diabetes certainly in those over say Fifty - the new illness was in fact caused by the very medication prescribed to treat other conditions and "May" not in many cases and reality be - Diabetes at all.

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Cardiovascular.

Section 20.

1. Cardiovascular side-effects have included mainly Hypovolemia, although the understanding the risks of Hyperkalemia associated Spironolactone has been important, especially in some Patients with Heart Disease.

2.  Hypovolemia - also hypovolaemia or oligemia is a state of decreased Blood volume; more specifically, decrease in volume of Blood plasma.

3.  It is thus the intravascular component of volume contraction or loss of Blood volume due to things such as bleeding or dehydration, but, as it also is the most essential one, hypovolaemia and volume contraction are sometimes used synonymously.

4. Hypovolemia is characterized by sodium - salt, depletion and thus differs from dehydration, which is defined as excessive loss of Body water.

5.  Cases of Hyperkalemia associated with fatal and refractory ventricular fibrillation are reported during Spironolactone Therapy.

6.  Hypovolemic shock, also known as haemorrhagic shock, is a life-threatening condition that results when the Body Loses a significant - more than 20 percent or one-fifth of the Body’s Blood or fluid supply.

7.  Hyperkalemia is the medical term that describes a potassium level in the Blood that is higher than normal.

8.  Potassium is a nutrient that is critical to the function of nerve and muscle cells, including those in the Heart.

9.  Conclusion. Whenever I am in Hospital and discuss with the medical team members they all suggest. "That is what is mentioned in the Evidence Base."

A.  No one it appears is prepared to consider - let alone accept the Negative side of taking a medication with so many Life Threatening side effects which they must surely be aware of; as demonstrated in Item 5.

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Dermatologic.

Section 21.

1. In one case, histology of an associated Lupoid Eruption was consistent with Lupus Erythematosus, including immune deposits at the dermal-epidermal junction.

2. There was a striking absence of serologic signs of Lupus, however the rash resolved after Spironolactone was discontinued.

3. Dermatologic side-effects have occurred in less than 5% of Patients and included rare cases of lichen planus and a Lupus-like syndrome.

4. Lupus Eruption:

A. Pertaining to Lupus Vulgaris.

B. Also known as Tuberculosis Luposa are Painful cutaneous tuberculosis skin lesions with nodular appearance, most often on the face around the nose, eyelids, lips, cheeks, ears and neck.

C. It is the most common - tuberculosis skin infection.

D. The lesions may ultimately develop into disfiguring skin ulcers - if left untreated.

E. The term; "Lupus," to describe an ulcerative skin disease dates to the late thirteenth century, though it was not until the mid-nineteenth that two specific skin diseases were classified as Lupus Erythematosus and Lupus Vulgaris.

F. The term; "Lupus," may derive from the rapacity and virulence of the disease; a 1590 work described it as - "a malignant ulcer quickly consuming the nether parts.

G.  Is a variant of Sarcoidosis marked by small papular lesions.

5.  Sarcoidosis is an inflammatory disease in which granulomas, or clumps of inflammatory cells, form in various organs.

A.  This causes organ inflammation.

B. Sarcoidosis may be triggered by the Body's immune system responding to foreign substances, such as viruses, bacteria, or chemicals.

C.  Appears to have a cause steeped in Animals - Dogs in particular.

D.  Although first described in the late 1800’s Some still believe it may be due to an immune reaction to a trigger such as an infection or chemicals in those who are genetically predisposed;  

E.  However the cause of Sarcoidosis is still unknown.

6.  Lupoid Eruption: This was not so easy to research - one such understanding is; Drug eruptions are among the most common inflammatory diseases of the skin and also among those biopsied most often.

A.  Yet, the value of histopathologic examination of drug eruptions has often been disputed.

B.  One reason is that the spectrum of histopathologic changes in drug eruptions is broad.

C. Nevertheless, each histopathologic pattern assumed by drug eruptions has a limited number of differential diagnoses where numerous criteria and clues are available to distinguish drug eruptions from other diseases associated with similar patterns.

D. By recognition of common patterns, consideration of differential diagnoses and attention to distinct clues, a histopathologic diagnosis of drug eruption can usually be made with confidence.

7.  lupus Erythematosus: is a name given to a collection of autoimmune diseases in which the Human immune system becomes hyperactive and attacks normal, healthy tissues.

A.  Symptoms of these diseases can affect many different Body systems, including joints, Skin, Kidneys, Blood cells, Heart and Lungs.

8. Dermatologic side-effects have included Stevens-Johnson Syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS), alopecia and pruritus.

9.  Stevens-Johnson Syndrome is usually caused by an unpredictable adverse reaction to certain medications.

10.  It can also sometimes be caused by an infection.

11. The syndrome often begins with flu-like symptoms, followed by a red or purple rash that spreads and forms blisters.

12. The affected skin eventually dies and peels off.

13. Toxic Epidermal Necrolysis (TEN), also known as Lyell's syndrome, is a rare, life-threatening skin condition that is usually caused by a reaction to drugs.

14. The disease causes the top layer of skin - the epidermis to detach from the lower layers of the skin - the dermis, all over the Body, leaving the Body susceptible to severe infection.

15. The case fatality ratio ranges from 25 to 30% and death usually occurs as a result of Sepsis and subsequent multi organ system failure.

16. Treatment primarily involves discontinuing the use of causative agent(s) and supportive care in either the intensive care unit or burns unit of a hospital.

17. Conclusion. If Medical Science has not since the term; "Lupus," was created, to describe an ulcerative skin disease in the late thirteenth century and since the late 1800's when Sarcoidosis was described - answered; why both are still of unknown cause and with no known cure; it is abundantly clear Medical Science has no intentions of answering these questions. 

A. Leaving one to question the validity of item 7. "The Human immune system becomes hyperactive and attacks normal, healthy tissues."

B. With items 9 and 10 as contradictory as they come. 

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Hypersensitivity.

Section.

1. 44-year-old woman developed acute pulmonary edema, disseminated intravascular coagulation and a generalized rash within 30 minutes of ingesting a single Spironolactone-Hydrochlorothiazide tablet.

2.  An inadvertent re challenge resulted in the same sequelae.

A. A sequela - usually used in the plural, sequelae is a pathological condition resulting from a disease, injury, therapy or other trauma.

B. Typically, a sequela is a chronic condition that is a complication which follows a more acute condition.

C.  It is different from, but is a consequence of, the first condition.

D. Time wise, a sequela contrasts with a late effect, where there is a period, sometimes as long as several decades, between the resolution of the initial condition and the appearance of the late effect.

3. Hypersensitivity side-effects have included rashes which occurred in about 1% of Patients.

4.  Rare cases of Eosinophilia, contact Dermatitis and Anaphylaxis have been reported.

5.  Conclusion. If one is unable to find the cause of an illness, create a cure or worse are causing it with short-term symptom management, then blinding by science or a change of Name - Will confuse the long suffering Patient.

6. Then as Item. 2.A. - describes; "if the right one does not get you the left one will."

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Gastrointestinal.

Section 23.

1.  Gastrointestinal side effects have been minor.

2.  General abdominal discomfort, Diarrhoea and vomiting were reported in less than 5% of Patients.

3.  However, a case-controlled study has revealed that Patients receiving Spironolactone are at an increased risk - dose-related of developing upper gastrointestinal adverse events such as gastric bleeding and gastric or duodenal ulcers.

4.  Conclusion. Surely when the Evidenced Based Medical Science clearly demonstrates the toxic nature of a mediation - it is a sign and a signal to stop prescribing and selling it.

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Hematologic.

Section 24. 

1.  Heamatologic; is the study of Blood in Health and Disease.

2. It includes problems with the Red Blood Cells, White Blood cells, platelets, Blood vessels, bone marrow, Lymph nodes, Spleen and the Proteins involved in Bleeding and clotting - hemostasis and thrombosis.

3. Hematologic side effects have been rare and included case reports of reversible Leukopenia and Agranulocytosis.

4.  Some cases of Agranulocytosis are associated with a normal bone marrow, suggesting peripheral destruction of White Blood cells, while some cases of Agranulocytosis have been associated with bone-marrow Hypocellularity of the Myelocytic cell lines.

5. Leukopenia; Leukocytopenia, Leucopenia - White Blood cells are the soldiers that constitute the immune system of the Human Body.

6.  Agranulocytosis is an uncommon condition in which bone marrow does not make enough neutrophils.  

7.  Neutrophils are white Blood cells the Body needs to fight infections. 

8.  They make up the largest portion of White Blood cells in the Body.

9.  In Leukopenia there is a diminished White Blood cell count.

10.  Leukopenia may be caused by diseases, medications and genetic deficiencies.

11. Conclusion. Is it possible no more is required to be said by the guesswork in the last sentence.

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Hepatic.

Section 25.

1.  Is a name give to activity of and relating to the Liver.

2.  Hepatic side effects have been rare.

3.  Two cases of Hepatitis have been strongly associated with Spironolactone.

4.  A 53-year-old woman with Aldosteronism secondary to an adrenal Adenoma developed reversible Hepatitis during Spironolactone Therapy.

5. The syndrome resolved upon drug discontinuation and was reproducible on re challenge.

6.  The authors did not find signs or symptoms of hypersensitivity to the drug.

7.  A 74-year-old man with edema, minimal alcohol consumption - less than 30 g/day and no history of liver or biliary disease became icteric (icterus) 7 weeks after beginning Spironolactone Therapy.

8.  Icterus also known as Jaundice, is a yellowish or greenish pigmentation of the skin and whites of the eyes due to high bilirubin levels.

9.  It is commonly associated with itchiness.

10.  The faeces may be pale and the Urine dark.

11.  Jaundice in Babies occurs in over half in the first week following birth and in most is not a problem.

12.  Liver biopsy revealed cholestatic lesions with many biliary thrombi and overloaded centrilobular cells, damaged hepatocytes and focal necrosis.

13.  Infectious hepatitis was serologically excluded.

14. All liver function abnormalities normalized three months after discontinuing Spironolactone.

15. It has been reported there is  a structural similarity between Spironolactone and steroids - drugs which are associated with cholestatic liver injury.

16. Conclusion. The more I write and respond to this paper on Diuretics and the medication Spironolactone - the more I feel for the many People whose lives may well be being destroyed perhaps worse than the illness and how fortunate I am to have not only recognised the possible side-effects after such a short time; but had the courage to stop the medication and report it to my own General Practitioner - before any possibility of losing my otherwise well and Healthy life. 

A. However there are many known or reported side-effects - or; a legal notices of, "we are not responsible as we published" a there is marker or Disclaimer for damage limitation of the negative side-effects of Spironolactone...

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Section. 26.

A. Having explored the side effects of Spironolactone... is in not fitting we include the Medications Ingredients whether they are active or not.

 

1. Calcium Sulfate (or calcium sulphate) is the inorganic compound with the formula CaSO4 and related hydrates.

A.  In the form of γ-anhydrite (the anhydrous form), it is used as a desiccant.

B. A desiccant is a hygroscopic substance that induces or sustains a state of dryness - desiccation, in its vicinity.

C.  Commonly encountered pre-packaged desiccants are solids that absorb water.

D. Desiccants for Specialised purposes may be in forms other than solid and may work through other principles, such as chemical bonding of water molecules.

E.  They are commonly encountered in foods to retain crispness.

F.  Industrially, desiccants are widely used to control the level of water in gas streams.

G.  One particular hydrate is better known as plaster of Paris and another occurs naturally as the mineral gypsum.

H.  It has many uses in industry.

I.  All forms are white solids that are poorly soluble in water.

J.  Calcium sulfate causes permanent hardness in water.

2. Hypromellose. Or Hydroxypropyl methylcellulose; hydroxypropyl methyl cellulose; HPMC; E464

A. Hypromellose (INN), short for hydroxypropyl methylcellulose (HPMC), is a semisynthetic, inert, viscoelastic polymer used as eye drops, as well as an excipient and controlled-delivery component in oral medicaments, found in a variety of commercial products.

B.  As a food additive, hypromellose is an emulsifier, thickening and suspending agent and an alternative to animal gelatin. Its Codex Alimentarius code (E number) is E464.

C.  Hypromellose is a solid and is a slightly off-white to beige powder in appearance and may be formed into granules.

D.  The compound forms colloids when dissolved in water.

E.  This non-toxic ingredient is combustible and can react vigorously with oxidising agents.

F.  Microcrystalline cellulose is a term for refined wood pulp and is used as a texturizer, an anti-caking agent, a fat substitute, an emulsifier, an extender and a bulking agent in food production.

G.  The most common form is used in vitamin supplements or tablets.

3.  Polyethylene Glycol.

A.  For medical use of polyethylene glycol, it is Macrogol.

B. Macrogol is the international nonproprietary name for polyethylene glycol (PEG). Macrogols are commonly used as laxatives, i.e. to treat constipation, in both Children and Adults.

C.  Lower molecular weight Macrogol's are used as excipients in pharmaceutical products as solvents in oral liquids and soft capsules.

D. Polyethylene glycol (PEG) is a polyether compound with many applications from industrial manufacturing to medicine.

E. Available forms and Nomenclature - also called Binominal Nomenclature or Binary Nomenclature is a formal system of naming species of living things by giving each a name composed of two parts, both of which use Latin  grammatical forms.

F.  PEG, PEO, or POE refers to an oligomer or polymer of ethylene oxide.

G.  The three names are chemically synonymous, but historically PEG is preferred in the biomedical field, whereas PEO is more prevalent in the field of polymer chemistry.

H.  While PEG and PEO with different molecular weights find use in different applications, and have different physical properties (e.g. viscosity) due to chain length effects, their chemical properties are nearly identical.

I. Different forms of PEG are also available, depending on the initiator used for the polymerization process – the most common initiator is a monofunctional methyl ether PEG, or methoxypoly(ethylene glycol), abbreviated mPEG.

J. Lower-molecular-weight PEGs are also available as purer oligomers, referred to as monodisperse, uniform, or discrete.

K. Very high purity PEG has recently been shown to be crystalline, allowing determination of a crystal structure by x-ray diffraction.  

L. PEGylation is the act of covalently coupling a PEG structure to another larger molecule, for example, a therapeutic protein, which is then referred to as a PEGylated protein. PEGylated interferon alfa-2a or −2b are commonly used injectable treatments for hepatitis C infection.

M.  PEG is soluble in water, methanol, ethanol, acetonitrile, benzene, and dichloromethane, and is insoluble in diethyl ether and hexane.

N.  It is coupled to hydrophobic molecules to produce non-ionic surfactants.

O.  PEGs contain potential toxic impurities, such as ethylene oxide and 1,4-dioxane.

P.  Polyethylene Glycol (PEG) and related polymers (PEG phospholipid constructs) are often sonicated when used in biomedical applications.

Q.  However, as reported by Murali et al., PEG is very sensitive to sonolytic degradation and PEG degradation products can be toxic to mammalian cells.

R. It is, thus, imperative to assess potential PEG degradation to ensure that the final material does not contain undocumented contaminants that can introduce artifacts into experimental results.

S. PEGs and methoxypolyethylene glycols are manufactured by Dow Chemical under the trade name Carbowax for industrial use, and Carbowax Sentry for food and pharmaceutical use.

T. They vary in consistency from liquid to solid, depending on the molecular weight, as indicated by a number following the name.

U. They are used commercially in numerous applications, including as surfactants, in foods, in cosmetics, in pharmaceutics, in biomedicine, as dispersing agents, as solvents, in ointments, in suppository bases, as tablet excipients and as laxatives.

V.  Some specific groups are lauromacrogols, nonoxynols, octoxynols, and poloxamers.

W. Macrogol, used as a laxative, is a form of polyethylene glycol. The name may be followed by a number which represents the average molecular weight (e.g. macrogol 3350, macrogol 4000 or macrogol 6000).

4.  Ethylene Glycol and its ethers are nephrotoxic if applied to damaged skin.

A.  Nephrotoxicity is toxicity in the kidneys.

B.  It is a poisonous effect of some substances, both toxic chemicals and medications on renal function.

C. There are various forms and some drugs may affect renal function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.

5.  Titanium dioxide Or -Titania - Rutile - Anatase - Brookite...

A.  Insoluble in water.

B. Titanic acid.

C. Titanium dioxide, also known as titanium(IV) oxide or titania, is the naturally occurring oxide of titanium, chemical formula TiO.

D. When used as a pigment, it is called titanium white, Pigment White 6 (PW6), or CI 77891.

E. Generally it is sourced from ilmenite, rutile and anatase.

F. It has a wide range of applications, from paint to sunscreen to food colouring.

G. When used as a food colouring, it has E number E171.

H. It is mainly sourced from ilmenite ore.

I. This is the most widespread form of titanium dioxide-bearing ore around the world.

J. Rutile is the next most abundant and contains around 98% titanium dioxide in the ore.

K. The metastable anatase and brookite phases convert irreversibly to the equilibrium rutile phase upon heating above temperatures in the range 600–800 °C (1,112–1,472 °F).

L. Titanium dioxide has eight modifications – in addition to rutile, anatase and brookite, three metastable phases can be produced synthetically as monoclinic, tetragonal and orthorombic and five high-pressure forms - α-PbO2-like, baddeleyite-like, cotunnite-like, orthorhombic OI and cubic phases also exist.

6.  It will be helpful to note - there are although difficult to accept. Seven - so called Inactive Ingredients as well!

Section 26 Conclusion 2.

A.  Spironolactone belongs to the group of medicines referred to as Diuretics.

B.  It is a medicine which works on the Heart and Blood vessels and is used to treat high Blood pressure and Heart failure. 

C. Lowering high Blood pressure helps prevent strokes, Heart attacks and kidney problems.

D.  It is also used to treat swelling - edema caused by certain conditions such as Heart failure and liver disease by removing excess fluid and improving symptoms such as breathing problems.

E. With continued or long term use apart for the side-effects listed above - where does the water continue to come from and to what effect.

F.  Leaving one to question. "With some 114 known reported or possible side effects," for how long is the medication able to maintain the desired effect and what happens if the medication is stopped. 

G.  Can one really understand the implications in this medications with what appears to be Acidic properties when some of the ingredients or chemicals are used in so many other products from Pain to Sunscreen - not allied to Health let alone good Health.  

Known or possible side effects = 114.

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Oncologic.

Section 27.

1.  Oncologic definition, the branch of Medical Science dealing with Tumours, including the origin, development, diagnosis, treatment of Malignant Neoplasms and prevention.

2. Neoplasm Tumour, namely an invasive colorectal cancer - the crater-like, reddish, irregularly shaped tumor.

3.  Neoplasm is an abnormal growth of tissue and when it also forms a mass is commonly referred to as a tumor.

4.  This abnormal growth - neoplasia usually but not always forms a mass.

5. The World Health Organization (WHO) classifies neoplasms into four main groups: benign neoplasms, in situ neoplasms, malignant neoplasms and neoplasms of uncertain or unknown behavior.

6.   Malignant neoplasms are also simply known as cancers.

7.  Prior to the abnormal growth of tissue, as neoplasia, cells often undergo an abnormal pattern of growth, such as metaplasia or dysplasia.

8.  However, metaplasia or dysplasia does not always progress to neoplasia - the word from Ancient Greek "new" and plasma "formation, creation."

9. Oncologic side-effects have included isolated case reports of Tumorigenesis - the production or formation of a tumour or tumours. but this has not been substantiated in large studies.

10. Animal studies have suggested an association between Spironolactone with benign adenomas of the thyroid and testes, malignant breast tumours, proliferative changes in the liver, including hepatocellular carcinoma and leukaemia.

11.  Dosages used in these studies were 25 to 250 times the maximum recommended Human dosage - on a per kg basis.

12.  Musculoskeletal reports: Leg cramps Nervous system, Lethargy, dizziness.

13.  It is possible that some side-effects of Spironolactone may not have been reported.

14.  These can be reported to the FDA.

15.  Always consult a healthcare professional for medical advice.

16.  Conclusion.  Clearly because there is still it appears much to learn - the full list of possible life threatening side-effects of this medication will surely be beyond the reach and understanding of the highest trained medical practitioner.

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Question 5.  In understanding the above information is there a suggestion there in not much available in order to truly explain the use of Diuretics and how the Body and Mind are affected?

Answer 5.  There is much information - however as usual it is very cross referencing thus appears to contradict itself, in addition is of Biological understandings only.

Question 6.  How simply is Talking Cures able to express the way it affects the Mind and Body?

Answer 6.  With the amount of information available to express - if only in my own case of limited information it should not be to difficult; so let us see what we can do.

A. In order to do so; we must remember the Bodies Blood system is very complex - however I trust the Mind to such a degree we can surely lay it out  simply and make a good pro and con case regarding the often deemed necessary...

...Diuretic Therapeutic intervention.

B.  If we take my own case of the Water around my Heart; I did wonder if the Doctor was rather guessing, using information of many other Patients or the published data as expected; rather than having true knowledge of my scan information in making the decision to prescribe the drug.

C.  Having read the side-effects relating to the drug - I am not so sure he really was working in my best interest, so let us get on with the job at hand and not concern ourselves with such trivialities.

D.  Whilst there are many forms and makes of Diuretics for this instant we are just going to concentrate on one - I have recent and personal knowledge of...

Spironolactone a Diuretic...

E.  Is marketed under the brand name Aldactone among others, is a medication primarily used to treat fluid build-up due to Heart failure, Heart and liver scarring, or kidney disease.

F.  Other uses include high Blood pressure, low Blood potassium that does not improve with supplementation, early puberty, excessive hair growth in Women and as a component of hormone replacement therapy for trans-gender women. It is taken by mouth.

G.  Conclusion.  When there is reported to be so many known side-effects from the use of this medication is it not reasonable to consider a name change is in reality no more than hiding the truth.

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A simplistic Understanding of the Main Organs of the Body.

Section 28.

1. From this point on we will only concern ourselves with a rather simplistic understanding, using only the main organs and how such medications has perhaps in the Short to  long-term the opposite effect to that desired by the dedicated Doctors and Consultants.

2.  In very simple terms the Body is a Circuit - explained like a figure Eight with the center point - passing close rather than crossing, with the Heart at the Centre.

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The Kidneys.

Section 29.

1.  However in order to continue with the simplicity - we are going to start at the Kidneys and just imagine the arteries pass through the kidneys and exit as Veins on their way back to the Heart.

2. The Kidneys are bean-shaped organs that serve several essential regulatory roles in vertebrates.

3. Their main function is to regulate the balance of electrolytes in the Blood, along with maintaining pH Homeostasis - Blood System Body Balance.

4. They also remove excess organic molecules from the Blood and it is by this action, that their best-known function is performed: the removal of waste products of metabolism.

5.  Kidneys are essential to the Urinary System and also serve homeostatic functions such as the regulation of electrolytes - including salts, maintenance of acid-base balance, maintenance of fluid balance and regulation of Blood pressure - via the salt and water balance.

6. They serve the Body as a natural filter of the Blood and remove water-soluble wastes which are diverted to the bladder.

7. In producing Urine, the kidneys excrete nitrogenous wastes such as Urea and Ammonium.

8.  They are also responsible for the reabsorption of Water, Glucose and Amino acids.

9.  The Kidneys also produce hormones including calcitriol and erythropoietin.

10. An important enzyme, renin, is also produced in the Kidneys; acting as a negative feedback.

11. Located at the rear of the abdominal cavity in the retroperitoneal space, the Kidneys receive Blood from the paired Renal Arteries and drain into the paired Renal Veins.

12.  Each Kidney excretes Urine into a Ureter which empties into the Bladder.

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The Liver.

Section 30.

1. The Liver's highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions.

2.  Estimates regarding the organ's total number of functions vary, but textbooks generally cite it - being around 500.

3.  The arteries pass through the Liver and pass Blood through the Liver and exit as Veins on their way back to the Heart.

4.  The Liver is like all organs - a vital organ of the Human Body, it is located in the upper right quadrant of the abdomen, below the diaphragm.

5.  The Liver has a wide range of functions, including detoxification of various metabolites, protein synthesis and the production of biochemicals necessary for digestion.

6. The Liver is a gland and plays a major role in metabolism with numerous functions in the Human Body, including regulation of glycogen storage, decomposition of Red Blood Cells, plasma protein synthesis, hormone production and detoxification.

7.  It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids.

8. The Liver has a somewhat unique and as yet in other organs un-explored ability of regenerating itself - thus is an extremely clever organ.

9. Surgically remove a large section and in around six weeks or so it will automatically regrow.

10.  Liver. We will remember this "regrow" information it will come in handy later.

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Section 31.

The Bladder.

1. The Bladder is a Hollow Muscular Organ situated at the base of the Pelvis. 

2. Urine collects in the Bladder from the two Ureters, which open into the Bladder at its back and connect to the Kidneys.

3. Urine leaves the Bladder via the Urethra, a single muscular tube which ends in the Urethral Orifice.

4. Anatomically, the Bladder is divided into a fundus at the top, two Ureteric Orifices and an opening for the Urethra which surrounds the Trigone of the Bladder.

5. In Men, the Prostate Gland lies outside the opening for the Urethra.

6. The Bladder is situated below the peritoneal cavity near the pelvic floor.

7. In Men, it lies in front of the rectum, separated by a space. Its opening is at the end of Mans Penis.

8. In Women, it lies in front of the uterus with its opening within the genitalia between the Labia Major and Labia Minor towards the front of the Female Body.

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Section 32.

The Gallbladder.

A. Is a small pouch that sits just under the Liver, stores bile produced by the Liver.

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The Stomach.

Section 33.

1. The Stomach is a muscular, hollow, dilated part of the gastrointestinal tract that functions as an important organ in the digestive system.

2. The Stomach is present in many animals including vertebrates, echinoderms, insects - mid-gut and molluscs.

3. In Humans and many other vertebrates it is involved in the second phase of Digestion, following Mastication - Chewing.

4. In most vertebrates, the Stomach is located between the Oesophagus and the small Intestine.

5. It secretes digestive enzymes and gastric acid to aid in food digestion.

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The Pyloric Sphincter.

Section 34.

1. The pyloric sphincter controls the passage of partially digested food - chyme, from the stomach into the Duodenum where peristalsis takes over - to move this through the rest of the intestines.

2. Peristalsis is a series of wave-like muscle contractions that moves food to different processing stations in the digestive tract.

3. The process of peristalsis begins in the esophagus when a bolus of food is swallowed.

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The Intestines.

Section 35.

1. The intestines are vital organs in the gastrointestinal tract of our digestive system.

2. Their functions are to digest food and to enable the nutrients released from that food to enter into the Bloodstream.

3.  Human intestines consist of two major subdivisions: the small intestine and the large intestine.

4.  The small intestine is much smaller in diameter, but is much longer and more massive than the large intestine.

5.  Together the intestines take up most of the space within the abdominal Body cavity and are folded many times over to pack their enormous length into such a small area.

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The Bowel.

Section 36.

1. The Bowel is the last portion of the digestive tract and is sometimes called the large Intestine or Colon.

2. The digestive tract as a whole is a hollow tube that extends from the Mouth to the Anus.

3. The function of the digestive system is to take food into the Body and to remove and excrete waste.

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How the Bowels and Anus work.

Section 37.

1. To understand it helps to know how the lower part of the gut works.

2. The colon - large bowel is the lower part of the gut.

3. It is more than 1 metre long.

4. As food moves through the Colon it absorbs water and forms waste products - Faeces.

5. This ensures that Faeces are fairly solid and the Body does not waste water.

6. The Colon may absorb 1 litre of fluid a day.

7. The Colon contains lots of helpful bacteria that break down food residues - turning some of them into wind and manufacturing some vitamins.

8. The muscles of the Colon gently contract and relax all the time, rolling the waste matter about like clothes in a washing machine and pushing the Faeces towards the Rectum, which is the last section of the Bowel before the Anus - back passage.

9. Several times a day, usually after meals, the Colon makes some big muscular contractions to excrete the Faecal material in the rectum beyond it.

10. By the time the Faeces reach the rectum they are almost solid because most of the water has been re-absorbed.

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The Rectum and Anal Canal.

Section 38.

1. The large Bowel - Colon leads into the last part of the gut, which is called the rectum.

2. It is about 12–15 cm long.

3. The final 3 cm of the gut is called the Anal Canal.

4. When Faeces arrive in the Rectum, it sends a message to the nerve centres in the spinal cord and these send a message to the Sphincter Muscles of the Anal Canal, making them relax to open the Anus.

5. If it is inconvenient for us to have our Bowels open, the Brain sends a message to the spinal cord to prevent the - ‘Open Anus,’ message being sent.

6. We are not aware of this until the rectum becomes very full, when we have to make a conscious effort to keep the Anus closed.

7. When we allow the Anus to open, the muscles in the wall of the large bowel and rectum contract to push the Faeces out.

8. The wall of the Anal Canal is very Muscular.

9. The Muscles keep the Anus closed, except when Faeces are passed.

10. The innermost ring of muscle of the Anal Canal is called the ‘Internal Sphincter.’

11. This muscle, which is not under our conscious control, maintains a resting pressure in our Anal Canal.

12. The outermost ring of muscle of the Anus is called the ‘External Sphincter.’

13. It also eventually forms the pelvic floor.

14. This muscle is more like the sort of muscle that we have in our arms and legs and we are able to control it - until the urge to pass Faeces becomes overwhelming.

15. It is obvious that in Babies the system of nerve messages that keep the Anus shut is not in place - Babies pass Faeces as soon as the rectum fills.

16. After about 18 months of age, the system develops, but in some Children this can take a long-time.

17. A network of small veins lies under the lining of the anal canal.

18. These veins form a soft, spongy pad that acts as an extra seal to keep the canal closed until the messages to evacuate the Bowels are received.

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Mucus Secretion.

Section 39.

1. The lining of the intestinal systems is or should be very slimy - so that Food then Faeces can easily pass along.

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The Heart.

Section 40.

1. The Heart is a muscular organ in Humans and other animals, which pumps Blood through the Blood vessels of the circulatory system.

2.  Blood provides the Body with Oxygen and Nutrients, as well as assists in the removal of Metabolic Waste.

3. The Heart is located in the middle compartment of the Chest.

4. In Humans, other mammals and birds, the Heart is divided into four chambers: upper left and right atria and lower left and right ventricles.

5. Commonly the right atrium and ventricle are referred together as the right Heart and their left counterparts as the left Heart.

6. In a healthy Heart Blood flows one way through the Heart due to Heart valves, which prevent back flow.

7. The Heart is enclosed in a protective sac, the Pericardium, which also contains a small amount of fluid.

8. The wall of the Heart is made up of three layers: Epicardium, Myocardium and Endocardium.

9. The Heart is a muscular organ that pumps Blood throughout the Body, with a rhythm determined by a group of Pacemaking cells in the Sinoatrial Node.

10. These generate a current that causes contraction of the Heart, traveling through the atrioventricular node and along the conduction system of the Heart.

11. The Heart receives Blood Low in Oxygen from the systemic circulation, which enters the right atrium from the superior and inferior venae cavae and passes to the right ventricle.

12. From here it is pumped into the pulmonary circulation, through the Lungs where it receives Oxygen and gives off Carbon Dioxide.

13. Oxygenated Blood then returns to the left atrium, passes through the left ventricle and is pumped out through the aorta to the systemic circulation - where the Oxygen is used and metabolized to Carbon Dioxide.

14. The Heart beats at a resting rate close to 72 beats per minute and provides a system pressure stated as normal - 120 Systolic. 80 Diastolic - and many variations according to individual circumstances.

15. Exercise temporarily increases the rate, but lowers resting Heart rate in the long-term and is good for Heart Health.

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The Lungs. 

Section 41.

1. The Lungs are the primary organs of respiration in Humans and many other animals including a few fish and some snails.

2. In mammals and most other vertebrates, two lungs are located near the backbone on either side of the Heart.

3. Their function in the respiratory system is to extract Oxygen from the atmosphere and transfer it into the Bloodstream and to release Carbon Dioxide from the Bloodstream into the atmosphere, in a process of gas exchange.

4.  Respiration is driven by different muscular systems in Humans, the primary muscle that drives breathing is the diaphragm.

5. The Lungs also provide airflow that makes vocal sounds including Human Speech possible.

6.  Humans have two lungs, a right lung and a left lung.

7.  They are situated within the thoracic cavity of the chest.

8.  The right lung is bigger than the left, which shares space in the chest with the Heart.

9.  The Lungs together weigh approximately 1.3 kilograms - 2.9 lb and the right is heavier.

10. The Lungs are part of the lower respiratory tract that begins at the trachea and branches into the bronchi and bronchioles and which receive air breathed in via the conducting zone.

11. These divide until air reaches microscopic alveoli, where the process of gas exchange takes place.

12. Together, the lungs contain approximately 2,400 kilometers - 1,500 miles of airways and 300 to 500 million alveoli.

13. The lungs are enclosed within a sac called the pleural sac which allows the inner and outer walls to slide over each other whilst breathing takes place, thereby minimising friction.

14.  This sac encloses each Lung and also divides each Lung into sections called Lobes.

15.  The right Lung has three lobes and the left has two.

16.  The lobes are further divided into bronchopulmonary segments and lobules.

17. The Lungs - the bronchial circulation, have a Unique Oxygenated Blood supply and receive deoxygenated Blood sent from the Heart for the purposes of being re-oxygenated via the pulmonary circulation.

End of Section.

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Introduction.

Section 42.

1. We mentioned earlier about making this process simple - we must of course in doing so remember the entire Mind and Body is at all times is; whether a Person is ill or well, working in complete harmony. - if this were not the case in just a couple of weeks or so a Person would no longer be able to live.

2. For the first part we are going to consider the working of only these listed organs as we are talking about the requirement for Diuretics as a treatment requirement - this first part is for a well Person.

3. As we also discussed the circulatory system is for this instance considered as a figure of eight - where the centre does not cross it passes by, moreover we are, going to start at the Kidneys:

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Introduction to Organ Participation.

The Kidneys.

Section 43.

1. Receives Blood from the Heart and filters the Blood for impurities - sends waste to the Bladder for excretion.

2. Following Blood passing around the system for life giving energy and well being, it passes through the Kidneys for cleansing  - then back to the Heart.

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The Liver. 

Section 44.

1. Filters Poisons out of the Blood as a detoxification process.

2.  As Blood passes around the system for life giving energy and well being - then back to the Heart, the Liver in line or in turn; carries out it many functions.

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The Bladder.

Section 45.

1. Excretes waste as Urine via the Urethra. of the Male and Female organs.

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The Stomach. 

Section 46.

1. Following chewing receives food from the mouth on its way through the entire intestinal system and is part of the process required to extract all of the Nutrients for the Mind and Body to live a natural and comfortable life - relative to the life-style created by the entire thought content within the Mind.

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The Intestines.

Section 47.

A. Is part of the process required to extract all of the Nutrients for the Mind and Body to live a natural and comfortable life - relative to the life style created by the entire thought content within the Mind.

B. And processes the consumed foodstuff into waste for excretion.

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The Sphincter's.

Section 48.

1. Through the entire intestinal system there are more sphincters than I am aware of or required to know, every one of them is required to function in harmony for efficient extraction of nutrients and waste disposal for a healthy and comfortable Mind and Body life.

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The Bowel.

Section 49.

1. The Bowel system items is perhaps the most important of them all for a happy and healthy life style.

2.  If this does not work Nothing works as designed.

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The Rectum and Anal Canal. 

Section 50.

1. Last part of the digestive intestine system - responsible for final control of waste disposal.

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Mucus secretion.

Section 51.

1. There are numerous Mucus secreting sites in the Body and all are required to work in harmony for a happy and healthy life style.

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The Heart.

Section 52.

1. The Pumping organ of the Body required to push at the correct pressure the Blood around the system and back to the Lungs for re oxygenating.

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The Lungs. 

Section 53.

1. Receives deoxygenated Blood from the entire system via the Heart for re-oxygenating from the freely available source in the atmosphere and delivers it back to the Heart for re circulating around the system.

End of Section.

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Section 54.

1. A whistle stop tour one may consider that only repeated the earlier in less detail.

2. And of course one would be correct, however it was where I started - is the clue in the requirement of Diuretics as a requirement of a treatment option.

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Section 55.

May we explore...

1.  We mentioned earlier for the Mind and Body to work naturally every-single-cell in the Body - no exception, is required to work in harmony and if it does not - illness will prevail.

2. Following Emotional And or Physical Traumas: Pre or At Conception. During Confinement at and post birth until the age of (see link) Twenty One; or the Person leaves the Parental home - which ever comes first...

3. ...Although - Working on instructions from the Mind - the Body Chemistry will be perfectly balanced at all times; no matter how ill a Person becomes or is close to Death.

4. Let us explore...

End of Section

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Explanation.

Section 56.

1. May we revisit the same processes with different information and start this explanation at:

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The Kidneys.

Section 57.

1.  For this explanation is at the beginning of the figure eight.

2. Working on instructions from an Emotionally damaged Mind in simple-terms sends Blood to the Liver in a more Toxic and Caustic form.

3.  At the same time becomes Toxic and Caustic itself - thus as a self and Body Protection recycles the waste back around the Body as Urea to return to the Kidneys for re-cleansing.

4.  There is no part of the Body that does not become a recipient of the Urea - however just one cycle is never a problem - this only becomes so, through continuous cycles of ever more Toxic and Caustic Blood.

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The Liver.

Section 58.

1. The Liver meanwhile has to cope with the Blood that is both Toxic and Caustic and work harder at filtering what now feels like an indigestible poison.

2. At the same time has to contend with other forms of chemicals: Alcohol, Social Drugs and Medications.

3.  Often or only at the same time. Putting the Liver under stress.

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The Bladder. 

Section 59.

1. Has to now deal with the extra waste that is both Toxic and Caustic - by having to vacate more often; during and compromising, sleep time, making sleep less restorative, during this process the Urethra and Bladder sphincter becomes somewhat inflamed and raw and other organs implicated - the Prostate.

2.  Often making passing of Urine difficult to impossible.

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The Stomach.

Section 60.

1. Meanwhile recognises this activity and seeks to respond - either by vacating, with a loss of precious water the Bowels or Retaining the waste - both are the same.

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The Intestines.

Section 61.

1.  Now on the receiving end of more waste that is Toxic and Caustic backs up and the waste becomes compacted.

2.  Excretes less full filling nutrients into the Blood Stream and the Body becomes more acidic toxic and caustic - causing inflammation anywhere the toxins are able to reach.

3.  Detoxing is not a possibility - although one may be kidded into believing this happening it will only last a short-time and then become more toxic.

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The Sphincter's.

Section 62.

1. Become inflamed and no longer respond to the natural signals required to move food/fuel through the system and vacate the Bowels.

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The Bowel.

Section 63.

1. Involved in the final chemical exchange for Body regeneration and secretion of the waste becomes dry - insufficient mucus and instead of the Rectum and Anal Canal when full being part of the evacuation signalling process  - they no longer work automatically.

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The Rectum and Anal Canal.

Section 64.

1. All involved in the secretion of the waste becomes dry - insufficient mucus and instead of the Rectum and Anal Canal when full being signal creators - no longer work automatically.

2.  Causing so often straining to pass motions.

3. Giving rise to the belief the final waste secretors-sphincters are in spasm, thus  require medical stretching.

4. Straining and Stretching are just about the worst thing a Person could do to their intestine and entire Body systems.

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Mucus Secretion.

Section 65.

1. Is now at a premium in all secreting areas - either Dry or over Moist. Both are the same, neither allow natural and full vacation of the Bowels.

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The Heart.

Section 66.

1. Receives the now depleted of Oxygen and Toxic and Caustic Blood back from the system to pump to the Lungs to be re-oxygenated.

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The Lungs.

Section 67.

1. The Lungs now have to deal with and excrete - not only the Carbon Dioxide created via respiration but the extra poisoned Blood the Kidneys and Liver have not been able to secrete and then exchange that with fresh Oxygenated Air from the atmosphere.

2.  All of this activity causes - Excessive Friction which creates HEAT.

3. This process also compromises the Unique Oxygenated Blood supply the Lungs require for their own consumption and activity.

End of Section

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Explanation.

Section 68.

1. May we revisit the same processes with different information and start this explanation at:

Section 69.

1. May we now explore the real processes that are going on when Diuretic - or water retention becomes a requirement for treatment.

2.  Following Emotional and or physical traumas in Childhood - sometimes many decades before the Person becomes ill enough to require a Diuretic Treatment; in order for the Heart to function better. 

3.  Often or not, limbs or other areas of the Body become swollen with so called Water that are Painful in the lower legs; making walking and thus exercising. Difficult to impossible.

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The Kidneys.

Section 70.

1.  Now working under duress are failing in their duty to keep the Blood free of impurities as it cannot recognise most of them are of the Kidneys own making - by unwittingly Poisoning the entire Body.

2.  Urea being just one of these Body poisons.

3.  If this were not the case in just a couple of weeks a Person would no longer be able to live.

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The Liver.  

Section 71.

1.  Plays much the same part as the Kidneys contributing to ill health.

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The Heart. 

Section 72.

1. Is where this process becomes interesting and often at the centre of Diuretic requirement.

2.  Once the kidneys and Liver start to recirculate the Urea for re-cleansing - the Heart is put under duress and although it should have an Ejection Fraction of say 55% is only able to achieve this often through the Mind raising the Blood Pressure.

3. Interestingly. The Heart is the only Body Organ -  removed from the Body and connected to a supply of the correct liquid and jump started; Will happily beat on its own.

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The Bladder. 

Section 73.

1. Meanwhile has more Urine to process or the Urine is an irritant to the system - making frequent urination a necessity and as the Mind never sleeps causing the requirement to raise during the night sometimes multiple times in order to vacate the Bladder.

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The Intestines.  

Section 74.

1. Being the waste disposal unit for the entire Body is now caused to back up and become compacted - sometimes taking weeks to vacate and then not completely - the Body is not dormant during this time it is constantly recirculating the waste to make room for more food-fuel.

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The Sphincter's.

Section 75.

1.  All sphincters now are inflamed - even if on investigation this does not show.

2.  Causing the intestines to become more and more inactive.

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The Bowel. 

Section 76.

1.  It must surely be said - If the Bowel does not function correctly - nothing in the Body will be able to function as designed.

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The Rectum and Anal Canal.

Section 77.

1. Thus the Lower and perhaps all of the intestines and Bowel system no longer have a function of value - apart from becoming a central Radiator to emanate Heat to the intestines and stomach area for survival. Requiring water as a coolant.

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Mucus Secretion. 

Section 78.

1. The requirement of Heat in the system is in direct response to the Mind having been placed in Fear many decades earlier - which lowers the Body Core Temperature, therefore without the relief of understanding of the traumas the mucus required for the intestines to have a fluidity of movement; is compromised - dried or excessively increased.

2.  Both Dried and Excessively increased must be seen as the same process.  

3. Passage of mucus or slime from the Bowel can be a normal phenomenon, the amount varies between individuals.

4. There is an extra seal at the Anus which stops the slime - mucus from leaking out.

5. Although this may appear not to be so as the Bowel often can leak mucus giving rise to belief there is Mucus in the system.

6. The most common medical reason for increased mucus are SYMPTOMS diagnosed as cause: Irritable Bowel Syndrome, however it can also be increased in - Inflammatory Bowel Disease, Ulcerative Colitis and Crohn’s Disease as well as some Bowel Tumours.

7. All at the closing of 2016 with all of these and many more symptoms with cause unknown and no known cure - and management being extremely difficult.

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The Heart. 

Section 79.

1.  Now this is where this whole process become really interesting.

2. The Heart is no longer able to Pump to the Lungs a sufficient quantity of Deoxygenated Blood for its new requirements - thus once the Lungs have done their work and disposed of the waste of metabolism and re-oxygenate the Blood - there is insufficient freshly Oxygenated Blood for the Body's requirements.

3. This and the Heat in reaction to Fear lowered core temperature - causing cooling water to collect around the Heart - thereby compromising the Heart pumping ability even further.

4. Thus as a result of a hydraulic style action the Heart has to pump harder for the same output and it must be seen the Heart - will become somewhat tired in this process.

5. Making it appear there is a requirement of a Diuretic Medication to remove the Water and improve the Heart's pumping ability.

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The Lungs.

Section 80.

1. Now the Lungs no longer receiving their own uncompromised supply of Oxygenated Blood become the only important organ of the Body - as all the waste in the Blood is now funneled through the Lungs as a last ditched attempt to cleanse the Body and in so doing has insufficient time to re-oxygenate the Blood for the Heart to Pump to the system - causing Blood Oxygen Fatigue that permeates to every cell in the Body and has no exit strategy.

2. Moreover the Lungs are themselves compromised by the compacted waste in the intestines across the chest under the rib-cage putting undue pressure on the size and working ability of the Lungs.

3. In turn adding to the Hearts inability to pump the correct Ejection Fraction of Blood.

4. Adding more heat that has to be dissipated or cooled by collecting water in and around the Heart.

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The Mind and Brain. 

Section 81.

1. We return to the Mind - so often if not always dismissed as a mere inconvenience as it holds the truth we all desire but forever fear to possess.

2. We are therefore obliged to consider and indeed accept - the Blood activity we have mentioned has no option but to pass through the Brain, all of which the Mind has instructed the Body to react to via the entire Body Chemistry; which now acts as an agitator in and too the Mind and in turn the entire Body - no exceptions.

3.  A never ending circle and self defeating prophesy one might consider.

4. And in so doing creates so many illness mysteries: Brain Fog, ME CFS Ever changing Fatigue and Pains - that defy all treatment options.

5. Fibromyalgia Pain and or sensitivity in every cell in the Body, often referred to as Endocrine disorders.

6.  There is no illness that is not implicated in this process.

7.  There we are back to the beginning of the circle of what we may call respiration.

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Section 82.

We started this paper with;

1.  Medical Science allows us to understand the Human Body is 98% Water - to which they

have the scientific proof do they not - thus we are obliged to accept these findings.

2. We all know water is a seriously precious commodity that life cannot exist without; so why waste it.

3. Thus any Diuretic Activity that expels Water from the Body is not only of no value in the treatment of the illness it was first prescribed for, but in the short medium and long-term - even if the medication is stopped after only a short period is most destructive for the Mind/Body.

4. That not only cannot survive in the absence of Water - by reducing the content it only makes the Body in the Short-Medium to Long-Term; even more Toxic and Caustic causing organ failure and slow; yet painful end of life.

5. Is it not worthy of consideration - it is a Fundamental Right; not an Emotional Gift to which one has to be eternally grateful, to question and even chastise medical research or institutions that are continually digging the preverbal hole in pursuit of improving the health care outcomes for us a Patients; Yet still in 2016 they never seem to achieve the outcome desired.

6. Moreover it is a right removed - if as we so often able to listen with our Mind, hear,  an ill Person say, "do not take my illness away from me. I will not know what to do with the time without it,"  if one joins them in the hole and not only continues digging - but attempts to fill in the hole at the same time.

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Section 83.

Question 7. Have you forgotten the items you marked in the Liver section. "We will remember this information it will come in handy later - automatically regrow, moreover how does it relate to the Heart and Ejection Fraction and yourself.

Answer 7.  There are a number of pieces of recently acquired information relating to myself we should include - before I return to the subject you have kindly mentioned.

1. My General Practitioner confirmed my kidney function depleted since August having now ceased taking the Spironolactone has now improved 10th October 2016 thus appearing to confirm; Spironolactone  and Amiodarone  have ability to deplete Kidney Function.

A. Which is why on leaving the Hospital on August 24th I was instructed. "I must have a Blood test within Five days of leaving hospital."

2.  Let us look at the Liver - the medical profession has long since known and indeed capitalised on the fact the Liver will regenerate itself in around six weeks by taking a portion of health liver from a donor and connecting it to a Person with some form of liver disease - often I am told with great success.

Question 8. How may I ask does this relate to you and the; or your Heart?

Answer 8. In essence it does not - apart from the ability to regenerate - better to say repair itself.

1.  It is clear this has been well researched and written about with published peer reviewed papers - albeit I have not in this instance checked as the information to hand is sufficient.

2.  Now the Heart is a different matter - long has Medical science stated; with as far as I know a degree of confidence. "The Heart is the only muscle in the Body that will not self repair.

3.  Even this last part of the information one would seek to challenge - demonstrated by the amount of People in Pain worldwide, much of it is Muscle Pain and is amongst the biggest lack of success of Medical Science to even manage Pain; for more than a short-time.

Question 9.  So how does this relate to the Heart?

Answer 9.

1. As we discussed earlier - according to the Medical Profession the Body does not or cannot repair damaged Heart muscle - even though it will happily beat on its own outside of the Body.

2. Yet it appears No One within the confines of Medical Science is researching this strange phenomenon! I have long since wondered why.

3. Until 2013, yet in reality it started in 1983/4/5 with my working on myself and with others to stop what I knew intuitively was going to happen - me having a Heart attack.

4. In June 2013 whilst doing a very dusty DIY job at home my Heart went into an Arrhythmia, causing me to be hospitalised.

5. Although the cardiac Specialist said it was going to happen at some time as a result of the Heart Attack. 

6. I have to say reluctantly I accepted this and was able to consider later the possibility of my Heart having been in and out of Arrhythmia over the years without my knowledge - although I had no obvious symptoms of this - as I was extremely fit and active.

7. My first spell in hospital saw - with the skill of the cardiac team, very quickly my Heart return to a normal rhythm.

8. During this time I underwent a battery of the most sophisticated of electronic and chemical investigations one could possibly imagine - not at any time was there a suggestion there was any Artery Blockage in and around my Heart.

9. One month later - following what I thought - was an office chair with wheels slipping out from under me as I sat down, causing me to crash my head on the desk, knocking myself out. How long for I am unsure of - when I came to I had a strange view of the underside of a chair.

10. Picking myself up I got on a bus and went to the hospital for a scheduled check up - needless to say I was back in a Bed in the cardiac ward with my Heart in an Arrhythmia.

11. This time I had to be shocked - out a few days later I had an ICD implanted into my chest to shock me back if it happened again - a insurance they suggested.

12.  During my stay in hospital one of the tests they carried out was a scan of my Heart - it was not until much later I became aware of the importance of this.

13. The hospital confirmed this in writing my Heart had an Ejection factor of 25%.

14.  Had I not the knowledge I have - this would surely have frightened the life out of me as 25% of 100% leaves the Heart in a very sorry state.

15. Of course it did not take long for me to work out as the Heart in most People only pumps around  55%, this then had to be 100% thus the 25% was not so bad - I feel sure even though I discussed this with the cardiac team  the way I looked at the numbers was not fully accepted. 

16.  However  as the entire arm of Medical profession only works on mathematical models I took strength from their somewhat limited discussion. Bearing in mind, time is in short supply in a hospital.

17. From 2013 I now had another job to consider - I am not so clever at working on myself as I am with others - to stop me having another  Heart attack and my Heart going into perhaps; uncontrollable Arrhythmias.

18.  Sixteen Months went by and no Arrhythmias and No shock from the ICD - during this time I was very busy working on myself and for a change very successful. Demonstrated after such a long time lapse; by the ICD shocking me because my Heart beat increased to 150 plus beats a minute.

19. Another spell in hospital - this time I emerged with the desire to repair the Heart Muscle - working on my secure understanding of how the Mind interacts with the Body if one resolves my pre birth and life traumas to my daily satisfaction, the possibility exists the Heart will self-repair and the Arrhythmias stop. 

20. Of course one must as I have accept I cannot do this on my own only the special equipment of the medical profession could confirm this  - my June 2016 stay  in hospital confirmed this for me as a scan revealed my Ejection Fraction was now at a more healthy 35%.

21. Although one must not get too excited about this as it is still work in progress - since being released from hospital on 26th June 2016 my general demeanor and energy has improved despite being affected by side-effects from the Diuretic Medication I had the wisdom to cease after just five days.

22. Leaving me to consider the long-term effects of taking a Diuretic was to give me the very symptoms they were prescribed in the first instance for - to ease the pressure of my Heart where in reality is was as likely the pressure over many years in my compacted intestines denying the Lungs the ability to supply sufficient oxygenated Blood and making the Heart have to work harder thereby; denying it the ability to self repair.

23. In addition one surely has to ask is there really a benefit for a Patient in being prescribed a Diuretic or is it no more than a good little earner that only creates more mysterious symptoms.

24. From my own short-term experience in the first twenty four hours of taking the Spironolactone I somewhat calculated I had consumed some two liters of liquid and passed as urine some four litres - this continued even after being off the medication for some Three Weeks, waking me each night once or twice.

25.  Each time I say to myself If the Body is 99% Water how long can my Body keep this up and more important what is it doing to my sacrificial organ - my Skin and what is happening to my Body Chemistry with the shortage of water moreover is this demonstrated by the Pain I have in my Kidneys. Now at the 27th October 2016 easing but still there. 

26.  Recently I discussed with my Doctor relating to Spironolactone used and my decision to stop taking it.  At the same time I spoke to the Doctor about the Heart Ejection Fraction who suggested "There are medications to do this" I asked And "if the medications are stopped," "The Ejection Factor  returns as before" - was, without hesitation, the reply.

27. This led me with the Pains in my Kidneys and compromised sleep and weight gain to look into Amiodarone one of the other medications I am on for Heart Arrhythmia my GP had already confirmed this medication has the ability with side-effects to damage kidneys.

 Important Information.

28.  Amiodarone is for use in treating life-threatening Heart Rhythm disorders.

29.  One should not take this medicine if allergic to Amiodarone or iodine, or have a serious Heart condition such as "AV block" (unless a pacemaker is in situ), a history of slow heart beats, or if the Heart cannot pump Blood properly.

30. Grapefruit and Medicines - A Possible Deadly Mix? This medicine can cause dangerous side-effects on the liver or lungs.

31. On reading this section on Amiodarone one should consider; If the company in their literature or publications are saying - this list of side effects, whilst not complete; has to have validity.

32. Surely if the manufactures are saying so - if they do not know with their scientifically proven research, who does know.

33. Leading one to believe this medicine like so many instead of being part of the solution is in the Short to long-term - the problem.

34. Here in the United Kingdom we have a government agency called the Advertising Standards Agency - within the rules it says; all adverts are to be Honest Fair and True.

35.  Now I am minded even the written word is an advert even if it does not have a price tag and the word Cure must not be used in any form unless it is backed up with the necessary Scientific Proof.

36. Having myself and Talking Cures passed the scrutiny of the ASA there are no such words on my website no more than a suggestion - one should come for treatment. 

37. The reason for this apart from the ASA rules a Person has to decide for themself what style of treatment suits them - as any treatment should be for their Health of Mind and Body improvement. And not for Profit ONLY.

38. Why am I saying this one might ask; We started this discussion regarding Diuretic treatment Necessity Explored Explained Understood? 

39. The evidence suggest there are many side-effects from this as many forms of medication often appear to be creating the very illness they were prescribed for - now it would be most dishonest, first to myself, the entire medical profession and anyone reading this for Patient or Professional reasons.  if I was not as far as one can be - completely honest.

40. The rational behind this has surely as the Scientific Evidence for the use of medications is only from the professional point of view - where as this is both, thus, has to be considered somewhat unique and openness and honesty can only improve the outcome desired by not only our dedicated medical professionals; but the Patient and Family as well.    

41. Since 2013 I have been on a number of drugs in order to control the Arrhythmia  and apart from the month of June July 2013 where I did not take them - I have since, despite the numerous changes of which one or two of them based on the available evidence I have in consultation with my GP stopped taking.

42. One may wish to argue if one looks at my hospital stays - the medications  have not been very effective - this is where I must take my share of the responsibility - because I live on my own every stay has been a sign of the success of my own treatment aided by the dedicated Doctors and Cardiac teams, for without their help I may well have not survived - now we must not have this must we.

43. Following my transfer from Southend to Basildon Hospital (18th August 2016) I was given an intravenous medication - Amiodarone for Seventy Two hours and since that time and from discharge been on 200mg a day plus Bisoprolol oral 10 mg and Ramipril 10mg a day.

44. In addition have as well as the aforementioned negative effects of  the Diuretic Spironolactone. I have now a number of symptoms I have never had in my life or are now much worse. 

45. Namely a Pain in the Kidneys and symptoms that I have had before and resolved them many years ago Nervousness and return of the recently resolved Constipation, yet at 31st October 2016 somewhat improving back to before 17th August 2016.

46. Although I am not able to truly determine as I would with a Person I am treating - as yet, whether these are as a result of a successful treatment waiting to complete its task or side-effects from medications.

47. I am  mindful of the information the cardiac teams and my own GP gave me of the damage these drugs can have on the Kidneys and the knock on side-effects on my Heart and its recently improved pumping ability - caused by once again my intestines being compacted, enough for me to investigate the Side-effects of: Amiodarone, Bisoprolol and Ramipril. 

48. Leaving me no option; but to include the information in this paper although on the face of it they are not connected to Diuretic requirements.

----------------------------------------

Section. 84.

This information is in the public domain and supplied by a group that specialises in the knowledge of medication side-effects.  

Amiodarone Side Effects  from Minor to Major.

Commonly reported adverse and side effects of Amiodarone include:

1. Hypersensitivity.

A. Hypersensitivity also called hypersensitivity reaction or intolerance, although still not well understood, is a set of undesirable reactions produced by the normal immune system, including allergies and autoimmunity.

2. Pneumonitis.

Inflammation of the walls of the alveoli - air sacs in the lungs.

3. Pulmonary Toxicity.

Inflammation of the walls of the alveoli - air sacs in the lungs.

4. Interstitial Pneumonitis.

Also known as acute interstitial pneumonia or Hamman–Rich syndrome although not clearly understood is a rare, severe lung disease, that usually affects otherwise healthy individuals.

5. Blurred Vision.

6. Visual Halos around lights.

7. Peripheral Neuropathy.

Develops when nerves in the Body's extremities – such as the hands, feet and arms are damaged. Symptoms depend on which nerves are affected.

8. Phototoxicity.

A. A type of Photosensitivity is also called Photoirritation, is a chemically induced skin irritation, requiring light, that does not involve the immune system.

B.  The skin response resembles an exaggerated sunburn.

C. The involved chemical may enter into the skin by topical administration or it may reach the skin via systemic circulation following ingestion or Parental administration.

For the Consumer.

9.  Applies to Amiodarone - Oral tablet:

A. Other dosage forms: intravenous solution In addition to its needed effects, some unwanted effects may be caused by Amiodarone.

B.  In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects.

Checking with a Doctor immediately is recommended if any of these side effects occur when taking Amiodarone.

More common.

10. Cough dizziness.

11. lightheadedness.

12. Fainting.

13. Fever.

14. Slight numbness or tingling in the fingers or toes.

15. Painful breathing.

16. Sensitivity of the skin to sunlight.

17. Shortness of breath.

18. Trembling or shaking of the hands.

19. Trouble with walking unusual and uncontrolled movements of the Body with weakness of the arms or legs.

Less Common.

20. Blue-Gray coloring of the skin on the face, neck and arms.

21. Blurred vision or blue-green halos seen around objects.

22. Coldness.

23. Dry eyes.

24. Dry, puffy skin.

25. Fast or irregular Heartbeat.

26. Nervousness.

27. Pain and swelling in the scrotum.

28. Sensitivity of the eyes to light.

29. Sensitivity to heat.

30. Slow Heartbeat.

31. Sweating.

32. Swelling of the feet or lower legs.

33. Trouble with sleeping.

34. Unusual tiredness.

35. Weight gain or loss.  

36. Rare Skin rash.

37. Yellow eyes or skin.

Incidence of unknown recorded numbers.

38. Abdominal or stomach Pain.

39. Agitation.

40. Back, leg, or stomach Pains.

41. Bleeding gums.

42. Blistering, peeling, or loosening of the skin.

43. Bloating.

44. Blood in the urine.

45. Bloody, black, or tarry stools. 

46. Blue lips, fingernails, or skin.

47. Blurred or double vision.

48. Chest Pain.

49. Chills.

50. Clay-colored stools.

51. Coma.

52. Confusion; confusion as to time, place.

53. Person coughing or spitting up Blood.

54. Cracks in the skin.

55. Dark Urine.

56. Decreased Urine output.

57. Depression.

58. Diarrhea.

59. Difficult or labored breathing.

60. Difficult Urination.

61. Dry cough.

62. Eye Pain.

63. Fast Heartbeat.

64. Fatigue.

65. General Body swelling.

66. High fever.

67. Holding false beliefs that cannot be change by fact.

68. Hostility.  

69. Inability to have or keep an erection.

70. Indigestion.

71. Irregular, fast, slow, or shallow breathing.

72. Irritability.

73. Itching joint or muscle Pain.

74. Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs.

75. Lethargy.

76. Loss in sexual ability, desire, drive or performance.

77. Loss of heat from the Body.

78. Lower back or side Pain.

79. Mood or mental change.

80. Muscle cramps or spasms.

81. Muscle pain or stiffness.

82. Muscle twitching.

83. No breathing.

84. Noisy breathing.

85. Nosebleeds.

86. Pain in the abdomen, groin, or scrotum.

87. Pain or burning with urination.

88. Pains in the stomach, side or abdomen, with the possibly of radiating to the back.

89. Pale skin.

90. Pinpoint red spots on the skin.

91. Rapid weight gain.

92. Rash.

93. Red skin lesions, often with a purple center.

94. Red, irritated eyes.

95. Red, swollen skin.

96. Scaly skin.

97. Seeing, hearing, or feeling things that are not there.

98. Seizures.

99. Severe headache.

100. Sneezing.

101. Sore throat.

102. Sores.

103. Ulcers, or white spots on the lips or in mouth.

104. Stupor.

A. From Latin stupere, "be stunned or amazed," is the lack of critical mental function and a level of consciousness wherein a sufferer is almost entirely unresponsive and only responds to base stimuli such as Pain.

B. It usually appears in infectious diseases, complicated toxic states, severe hypothermia, mental illnesses, severe clinical depression, epilepsy, vascular illnesses and shock.

C. Those in a Stuporous state are rigid, mute and only appear to be conscious, as the eyes are open and follow surrounding objects.

105. Swelling.

A. Of the face, ankles, or hands swelling of the scrotum swollen or Painful glands tightness in the chest troubled breathing unpleasant breath odor unusual bleeding or bruising unusual excitement, nervousness, or restlessness unusual tiredness or weakness vomiting of Blood, wheezing

Other Side Effects.

106. Some of the side-effects that can occur with Amiodarone may not need medical attention.

A.  As the Body adjusts to the medicine during treatment these side effects may go away.

B.  A health care professional may be able to explain ways to reduce or prevent some of these side-effects.

C.  If any of the following side-effects continue, are bothersome or creates unanswered questions about them, check with a health care professional:

More common.

107. Constipation.

108. Headache.

109. Loss of appetite.

110. Nausea and vomiting.

Less common.

111. Bitter or metallic taste.

112. Decrease in sexual interest.

113. Decreased sexual ability in males.

114. Dizziness.

115. Flushing of the face.

For Healthcare Professionals.

116. Applies to Amiodarone: compounding powder, intravenous solution, oral tablet.

General.

The most common adverse reactions were:

117. Corneal Microdeposits.

A. Appear in the majority of adults treated with Amiodarone.

B. They are usually discernible only by slit-lamp examination, but give rise to symptoms such as visual halos or blurred vision in as many as 10% of Patients.

118. Hypotension.

119. Photosensitivity.

Very Common. 

120. Cardiovascular effects 10% or more.

121. Hypotension - up to 20.2%.

Common.  

122. Bradycardia 1% to 10%: -

A. Means that the Heart beats very slowly.

B. For most People, a Heart rate of 60 to 100 beats a minute while at rest is considered normal.

C. If the Heart beats less than 60 times a minute, it is slower than normal.

D. A slow Heart rate can be normal and healthy.

123. Blood pressure decreased.

124. Congestive Heart failure.

125. Heart arrest.

126. Ventricular Tachycardia.

A. Is a pulse of more than 100 beats per minute with at least three Irregular Heartbeats in a row.

B. It is caused by a malfunction in the Heart's electrical system.

C. The Heart rate is controlled by electrical impulses that trigger each contraction and determine the rhythm of the Heart.

127. Cardiac Arrhythmia.

Also known as cardiac dysrhythmia or irregular heartbeat, is a group of conditions in which the heartbeat is irregular, too fast, or too slow.

128. Sinoatrial Node Dysfunction. 

A. Refers to a number of conditions causing physiologically inappropriate atrial rates.

B. Symptoms may be minimal or include weakness, effort intolerance, palpitations, and syncope. Diagnosis is by ECG. Symptomatic patients require a pacemaker.

129. Flushing Uncommon. 130.

 - 0.1% to 1%.  

Conduction Disturbances.

Very Rare.

131. Less than 0.01%: Marked Bradycardia.

132. Sinus arrest or sinus pause - is a medical condition wherein the Sinoatrial node of the Heart transiently ceases to generate the electrical impulses that normally stimulate the myocardial tissues to contract and thus the Heart to beat.

133. Vasculitis.

A. Vasculitis; literally means, 'inflammation of the Blood vessels.'

B. Damaged cells release chemicals that cause Blood vessels to leak fluid into the tissues, causing tissue swelling.

134. Hot flushes.

Frequency not reported.   

135. Torsade de pointes.

A. Torsades de pointes or torsade de pointes. TdP or simply Torsades, translated as; "twisting of the points."

B. Is a specific type of abnormal Heart Rhythm that can lead to sudden cardiac death.

C. It is a polymorphic ventricular tachycardia that exhibits distinct characteristics on the electrocardiogram (ECG).

D. It was described by Dessertenne in 1966.

E. Prolongation of the QT interval can increase a Person's risk of developing this abnormal Heart Rhythm.

136. Collapse.

137. Atrial fibrillation.

138. Nodal Arrhythmia,

139. QT interval prolonged,

140. Sinus Bradycardia.

141. Ventricular Fibrillation.

A. Is a Heart rhythm problem that occurs when the Heart beats with rapid, erratic electrical impulses.

B. This causes pumping chambers in the Heart - the ventricles, to quiver uselessly, instead of pumping Blood.

142. Shock.

143. Asystole.

A. Also known as flatline, is a state of no electrical activity from the Heart and therefore no Blood flow.

B. It results in cardiac arrest.

144. Pulseless electrical activity.

145. Cardiogenic shock.

A. Is a life-threatening medical condition resulting from an inadequate circulation of Blood due to primary failure of the ventricles of the Heart to function effectively.

B. As this is a type of circulatory shock, there is insufficient perfusion of tissue to meet the demands for oxygen and nutrients.

146. Atrioventricular block.

A. AV Block - is a type of Heart Block in which the conduction between the atria and ventricles of the Heart is impaired.

B. Under normal conditions, the sinoatrial node - SA node in the atria sets the pace for the Heart and these impulses travel down to the ventricles.

147. Severe Hypotension.

A. Is low Blood pressure, especially in the arteries of the systemic circulation.

B. Severely low Blood pressure can deprive the Brain and other vital organs of Oxygen and Nutrients, leading to a life-threatening condition called shock.

Postmarketing reports.

148. Sinoatrial Block.

A. The initial impulse in a Heart is usually formed in the Sinoatrial - SA node and carried through the atria, down the internodal atrial pathways and to the Atrioventricular - AV node.

B. In normal conduction, the impulse would travel across the “bundle of His” - AV bundle, down the bundle branches and into the Purkinje fibers.

C. This would depolarize the ventricles and cause them to contract.

D. In an SA block, the electrical impulse is delayed or blocked on the way to the Atria, thus delaying the Atrial beat.

E. This is different from an AV Block, which occurs in the AV node and delays ventricular depolarization.

F. SA blocks are categorized into three classes based on the length of the delay.

149. Intraventricular conduction disorders.

A. Conduction is the progression of electrical impulses through the Heart.

B. Which cause - The Heart’s rhythm its pace or beat.  

C. One can have a conduction disorder without having an arrhythmia, but some arrhythmias arise from conduction disorders.

150. Bundle branch block.

A. Normally, the electrical impulse travels down both the right and left branches at the same speed. Thus, both ventricles contract at the same time.

B. Occasionally there's a block in one of the branches, so impulses must travel to the affected side by a detour that slows them down.

B. That means one ventricle contracts a fraction of a second slower than the other.

C. But a bundle branch block shows up as an abnormality when the electrical impulses through the Heart are recorded with an electrocardiogram (ECG).

151. Infra-His = Infra Hisian Block.

A. Heart block is a disease or inherited condition that causes a fault within the Heart's natural pacemaker, due to some kind of obstruction or "block" in the Electrical Conduction System of the Heart.

B. Despite the severe-sounding name, Heart block may often cause no symptoms at all in some cases, or occasional missed Heartbeats in other cases - which can cause lightheadedness, Syncope - fainting and Palpitations, which may require an artificial pacemaker to be implanted, depending upon exactly where in the Heart conduction is being impaired and how significantly it is affected.

152. Ventricular Extrasystole.

A. Extrasystoles are essentially extra beats, or contractions, which interrupt the normal regular rhythm of the Heart.

B. They occur when there is electrical discharge from somewhere in the Heart other than the Sino-atrial node.

C. They are classified as atrial or ventricular extrasystoles according to their site of origin.

153. Antegrade conduction via an accessory pathway.

A. Antegrade Conduction is usually down the normal pathway with retrograde conduction via an accessory pathway that is located along the mitral valve annulus.

154. Hepatic.   

Common (1% to 10%):

155. Acute liver disorders with high serum transaminases and/or jaundice including hepatic failure.

156.  Liver function tests abnormal.

157.  Nonspecific hepatic disorder.

Very rare (less than 0.01%):

158.  Pseudo alcoholic hepatitis.

159.  Cirrhosis.

160.  Serum transaminases increased

Frequency not reported:

161.  ALT increased.

A.  Significantly elevated levels of ALT (SGPT) often suggest the existence of other medical problems such as viral hepatitis, Diabetes Congestive Heart failure, Liver damage, Bile duct  problems, Infectious mononucleosis or  myopathy, so ALT is commonly used as a way of screening for liver problems.

B.  Elevated ALT may also be caused by dietary choline deficiency.

C.  However, elevated levels of ALT do not automatically mean that medical problems exist.

D. Fluctuation of ALT levels is normal over the course of the day and they can also increase in response to strenuous physical exercise.

162. AST increased.

A. Aspartate transaminase (AST) or aspartate aminotransferase, also known as AspAT/ASAT/AAT or serum glutamic oxaloacetic transaminase (SGOT), is a pyridoxal phosphate (PLP)-dependent transaminase enzyme - first described by in 1954.

B. AST catalyzes the reversible transfer of an α-amino group between aspartate and glutamate and, as such, is an important enzyme in amino acid metabolism.

C. AST is found in the liver, heart, skeletal muscle, kidneys, brain and red blood cells.

D. Serum AST level, serum ALT - alanine transaminase level and their ratio (AST/ALT ratio) are commonly measured clinically as biomarkers for liver health.

Postmarketing reports:

163.  Cholestatic hepatitis.

164.  Holestasis.

165.  Jaundice.

166. Alkaline phosphatase increased.

167.  Blood lactate dehydrogenase increased.

168. Respiratory.

Common (1% to 10%):

169.  Pulmonary toxicity.

A.  Pulmonary toxicity is the medical name for side effects on the lungs.

B. Although most cases of pulmonary toxicity in medicine are due to side-effects of medicinal drugs, many cases can be due to side effects of radiation (radiotherapy).

C. Other - non-medical causes of pulmonary toxicity can be chemical compounds and airborne particulate matter.

170.  Pulmonary inflammation or Fibrosis.

A. Pulmonary fibrosis - literally "scarring of the lungs" is a respiratory disease in which scars are formed in the lung tissues, leading to serious breathing problems.

B.  Scar formation, the accumulation of excess fibrous connective tissue - the process called fibrosis, leads to thickening of the walls and causes reduced Oxygen supply in the Blood.

C.  As a consequence Patients suffer from perpetual shortness of breath.

D. In some Patients the specific cause of the disease can be diagnosed, but in others the probable cause cannot be determined, a condition called idiopathic pulmonary fibrosis.

E. There is no known cure for the scars and damage in the lung due to pulmonary fibrosis.

171. Adult respiratory distress syndrome.

A. Acute Respiratory Distress Syndrome - ARDS, is a medical condition occurring in critically ill Patients characterized by widespread inflammation in the lungs.

B. ARDS is not a particular disease, rather it is a clinical phenotype which may be triggered by various pathologies such as trauma, pneumonia and sepsis.

Very rare (less than 0.01%):

172. Bronchospasm.

A.  Bronchospasm is a chief characteristic of Asthma and Bronchitis.

B.  Description. Bronchospasm is a temporary narrowing of the bronchi - airways into the lungs caused by contraction of the muscles in the lung walls, by inflammation of the lung lining, or by a combination of both.

173.  Interstitial Pneumonitis.

A. Usual interstitial pneumonia (UIP) is a form of lung disease characterized by progressive scarring of both lungs.

B. The scarring - fibrosis, involves the supporting framework - The interstitium is a lace-like network of tissue that extends throughout both lungs and includes many different lung conditions.

C. The most common symptoms of interstitial lung disease are a dry cough and shortness of breath.

D. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.

E. Acute interstitial pneumonitis - also known as acute interstitial pneumonia or Hamman–Rich syndrome is a rare, severe lung disease that usually affects otherwise healthy individuals.

F. There is no known cause or cure.

174. Severe respiratory complications.

175.  Apnea.

A.  Apnea or Apnoea is suspension of breathing.

B.  During apnea, there is no movement of the muscles of inhalation and the volume of the lungs initially remains unchanged.

C.  Depending on how blocked the airways are - patency, there may or may not be a flow of gas between the lungs and the environment.

D. Gas exchange within the lungs and cellular respiration is not affected.

Frequency not reported:

176.  Pulmonary Hemorrhage.

A. Pulmonary hemorrhage - or pulmonary haemorrhage, is an acute bleeding from the lung, from the upper respiratory tract, the trachea and the alveoli.

B.  When evident clinically, the condition is usually massive.

C. The onset of pulmonary haemorrhage is characterized by cough productive of Blood -hemoptysis and worsening of oxygenation leading to cyanosis.

1. Cyanosis is the appearance of a blue or purple coloration of the skin or mucous membranes due to the tissues near the skin surface having low oxygen saturation.

D. Although the pathogenesis is uncertain, it is probable that the symptoms are a consequence of hemorrhagic pulmonary edema.

E.  Pathogenesis. the development of morbid conditions or of disease; more specifically the cellular events and reactions and other pathological mechanisms occurring in the development of disease.

F. Includes the study of the relationship between the cause and the lesions and that between the lesion and the clinical signs.

177. Lung Edema.

A.  Is a condition in which the lungs fill with fluid.

B.  When this occurs, the Body struggles to get enough oxygen.

178.  Respiratory Disorder.

A. Respiratory disease is a medical term that encompasses pathological conditions - affecting the organs and tissues that make gas exchange possible in higher organisms and includes conditions of the upper respiratory tract, trachea, bronchi, bronchioles, alveoli, pleura, pleural cavity and the nerves and muscles of breathing.

B.  Respiratory diseases range from mild and self-limiting, such as the common cold, to life-threatening entities like bacterial pneumonia, pulmonary embolism, acute asthma and lung cancer.

179.  Alveolar Pneumonitis.

A. Inflammation of the walls of the alveoli - air sacs in the lungs. the air-containing cells of the lungs.

Postmarketing reports:

180.  Possibly fatal respiratory disorder.

181.  Bronchiolitis.

A.  Bronchiolitis is inflammation of the bronchioles, the smallest air passages of the lungs.

B.  It usually occurs in Children less than two years of age with the majority being aged between three and six months

C. It presents with coughing, wheezing and shortness of breath which can cause some Children difficulty in feeding.

D.  This inflammation is usually caused by respiratory syncytial virus - 70% of cases and is much more common in the winter months.

182.  Obliterans Organizing Pneumonia.

A. Bronchiolitis obliterans organizing pneumonia (BOOP), also known as cryptogenic organizing pneumonia, is a form of non-infectious pneumonia; more specifically, BOOP is an inflammation of the bronchioles - bronchiolitis and surrounding tissue in the lungs.

B. It is often a complication of an existing chronic inflammatory disease such as rheumatoid arthritis, dermatomyositis, or it can be a side-effect of certain medications such as Amiodarone.

C.  Some authors have recommended the use of an alternate name, cryptogenic organizing pneumonia (COP), to reduce confusion with bronchiolitis Obliterans, a distinct and unrelated disease.

D.  The clinical features and radiological imaging resemble infectious pneumonia.

E. However, diagnosis is suspected after there is no response to multiple antibiotics and Blood and sputum cultures are negative for organisms.

183. Dyspnea.

A.  Dyspnea is unpleasant or uncomfortable breathing.

B.  It is experienced and described differently by Patients depending on the cause.

184.  Cough.

185.  Hemoptysis.

A. Hemoptysis or Haemoptysis is the act of coughing up Blood or Blood-stained mucus from the bronchi, larynx, trachea, or lungs.

B.  This can occur with lung Cancer.

186.  Wheezing.

187.  Hypoxia.

A. Is and Cerebral Hypoxia are - a reduced supply of Oxygen affecting every cell of the Body, specifically when involving the Brain; where the Brain is completely deprived of Oxygen, it is called Cerebral Anoxia.

B. There are four categories of Cerebral Hypoxia; they are, in order of severity: diffuse Cerebral Hypoxia (DCH), focal cerebral ischemia, cerebral infarction and global cerebral ischemia.

C. Prolonged hypoxia induces neuronal cell death via apoptosis, resulting in a hypoxic brain injury.

188.  Pulmonary infiltrates.

A.  A pulmonary infiltrate is a substance denser than air, such as pus, blood, or protein, which lingers within the parenchyma of the lungs.

B.  Pulmonary infiltrates are associated with pneumonia, tuberculosis, and nocardiosis.

C.  Pulmonary infiltrates can be observed on a chest radiograph.

189.  Pulmonary Mass.

A.  A pulmonary mass is any area of pulmonary opacification that measures more than 30 mm.

A. The commonest cause for a pulmonary mass is lung cancer.

190. Pleuritis.

A.  Pleuritis - also known as Pleurisy is an inflammation of the pleurae, the membranes of the pleural cavity surrounding the lungs.

B. There are many possible causes of pleurisy but viral infections spreading from the lungs to the pleural cavity are the most common.

C. The inflamed pleural layers rub against each other every time the lungs expand to breathe in air.

D. This can cause sharp pain when breathing, also called Pleuritic Chest Pain.

E. The condition may either be primary or secondary and is often associated with a pleural effusion.

F. A Pleural Effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs.

G. This excess can impair breathing by limiting the expansion of the lungs.

H. Various kinds of pleural effusion, depending on the nature of the fluid and what caused its entry into the pleural space, are hydrothorax - serous fluid, hemothorax - blood, urinothorax - urine, chylothorax  - chyle, or pyothorax - pus.

I. A pneumothorax is the accumulation of air in the pleural space and is commonly called a "collapsed lung."

191. Pulmonary Phospholipidosis.

A. Phospholipidosis is a lysosomal storage disorder characterized by the excess accumulation of phospholipids in tissues.

B. Many cationic amphiphilic drugs, including anti-depressants, antianginal, antimalarial, and cholesterol-lowering agents, are reported to cause drug-induced phospholipidosis (DIPL) in animals and humans.

C. The mechanisms of DIPL involve trapping or selective uptake of DIPL drugs within the lysosomes and acidic vesicles of affected cells.

D. Drug trapping is followed by a gradual accumulation of drug-phospholipid complexes within the internal lysosomal membranes.

E. The increase in undigested materials results in the abnormal accumulation of multi-lammellar bodies (myeloid bodies) in tissues.

F. It is not possible to predict  which tissues will be affected by DIPL in animals and humans.

192. Eosinophilic Pneumonia.

A. Eosinophilic pneumonia (EP) is a disease in which an eosinophil, a type of white blood cell, accumulates in the lung.

B. These cells cause disruption of the normal air spaces - alveoli, where oxygen is extracted from the atmosphere.

193. Acute respiratory distress syndrome.

A. Acute respiratory distress syndrome (ARDS) is a life-threatening medical condition where the lungs cannot provide enough oxygen for the rest of the Body.

194. Ocular.

195.  Of, or relating to the eye, or the sense of sight. 

A.  Resembling the eye; Seen by, or seeing with, the eye; 

Very common - 10% or more:

196. Corneal Microdeposits.

 - up to 90% or more.

Common - 1% to 10%:

197. Visual Disturbance.

Very Rare:

Less than 0.01%:

198.  Optic Neuropathy/Neuritis

Frequency not reported:

199.  Permanent blindness.

200.  Papilledema.

A.  Papilledema is a condition in which increased pressure in or around the Brain causes the part of the optic nerve inside the eye to swell.

B.  Symptoms may be fleeting disturbances in vision, headache, vomiting or a combination.

201.  Corneal degeneration.

202.  Eye discomfort.

203.  Scotoma.

A.  A Scotoma (Greek σκότος/skótos, darkness; plural: scotomas or scotomata) is an area of partial alteration in the field of vision consisting of a partially diminished or entirely degenerated visual acuity that is surrounded by a field of normal – or relatively well-preserved vision.

204.  Lens opacities.

A.  The Patient word result for Lens opacities.

B.  Cataracts can be classified by using the lens opacities classification system LOCS III.

C.  In this system, Cataracts are classified based on type as nuclear, cortical, or posterior.

D. The Cataracts are further classified based on severity on a scale from 1 to 5.

205. Macular Degeneration.

A. Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred or no vision in the center of the visual field.

B.  Early on there are often no symptoms.

C.  Over time, however, some People experience a gradual worsening of vision that may affect one or both eyes.

D.  While it does not result in complete blindness, loss of central vision can make it hard to recognize faces, drive, read, or perform other activities of daily life.

E.  Visual hallucinations may also occur but these do not represent a mental illness.

F. There is as yet no outright cure for age-related macular degeneration, but some treatments may delay its progression or even improve vision.

G. Treatments for macular degeneration depend on whether the disease is in its early-stage, dry form or in the more advanced, wet form that can lead to serious vision loss.

206. Keratopathy.

A. Band keratopathy is a corneal disease derived from the appearance of calcium on the central cornea.

B. This is an example of metastatic calcification, which by definition, occurs in the presence of hypercalcemia.

207.  Gritty eyes.

208.  Itching.

209.  Burning.

Postmarketing reports:

210.  Visual field defects.

211.  Blurred vision.

212 Dermatolgic.

Very common - 10% or more:

213. Photosensitivity - up to 10%.

Common (1% to 10%):

214. Slate-gray or bluish pigmentations of light-exposed skin.

Very rare (less than 0.01%):

215. Erythema.

A. Erythema multiforme is a type of hypersensitivity reaction.

B.  It occurs in response to medicines, infections, or illness.

216.  Rash.

217.  Exfoliative Dermatitis.

A. Exfoliative dermatitis is widespread erythema and scaling of the skin caused by preexisting skin disorders, drugs, cancer, or unknown causes.

B.  Symptoms and signs are pruritus, diffuse erythema and epidermal sloughing.

C.  Diagnosis is clinical.

D. Treatment involves corticosteroids and correction of the cause.

218. Alopecia.

A. Hair loss, also known as alopecia or baldness, refers to a loss of hair from part of the head or body.

B. Hair loss in some People causes psychological distress.

C. Common types include: Male-pattern hair loss, Female-pattern hair loss, alopecia areata and a thinning of hair is known as telogen effluvium.

D. The cause of Male-pattern hair loss is a combination of genetics and male hormones.

E. The cause of Female pattern hair loss is unclear.

F. The cause of alopecia areata is autoimmune and the cause of telogen effluvium is typically a physically or psychologically stressful event.

G. Less common causes of hair loss include, certain medications including chemotherapy, HIV/AIDS, hypothyroidism, malnutrition including iron deficiency, lupus and radiation therapy.

219.  Sweating.

Frequency not reported:

220.  Granuloma.

A.  Granuloma is an inflammation found in many diseases.

B.  It is a collection of immune cells known as histiocytes - macrophages.

C.  Granulomas form when the immune system attempts to wall off substances it perceives as foreign - but is unable to eliminate.

221.  Angioedema.

A. Angioedema can have several different causes, but in many cases the exact cause is unknown.

B.  Some of the main causes of Angioedema are outlined below.

C.  Angioedema is often the result of an allergic reaction.

D. This is where the Body mistakes a harmless or even a harmful substance such as a well meaning medication or a certain food, for something dangerous.

E. It releases chemicals into the Body to attack the substance, which cause the skin to swell.

F.  Certain types of food - some types of medication; including some antibiotics, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen are able to have this effect.

222.  Medication.

A.  Some medicines can cause angioedema – even if  not allergic to the medication.

B. The swelling may occur soon after start to take a new medication, or possibly months or even years later.

C.  Medications that can cause Angioedema include:

D. Angiotensin-converting enzyme (ACE) inhibitors, such as enalapril, lisinopril, perindopril and ramipril, which are used to treat high Blood pressure

E. Angioedema caused by medication is known as; "drug-induced angioedema.

F. Angioedema, also known as Angiooedema, Quincke's Edema and Angioneurotic Edema, is the local and or rapid swelling (edema) of the dermis - deeper layers of the skin, the subcutaneous tissue, mucosa and submucosal tissues.  

G. Angioedema can be classified as acquired.

H. It can also occur as a side-effect to certain medications, particularly ACE inhibitors.

I. Edema of the gastrointestinal mucosa typically leads to severe abdominal Pain; in the upper respiratory tract, it can be life-threatening.

J. Urticaria (hives) may develop simultaneously. 

K. In severe cases, stridor of the airway occurs, with gasping or wheezy inspiratory breath sounds and decreasing oxygen levels.

L. Sometimes, the cause is recent exposure to an allergen (e.g. peanuts), but more often it is either idiopathic (unknown) or only weakly correlated to allergen exposure.

M. In hereditary Angioedema, often no direct cause is identifiable, although mild trauma, including dental work and other stimuli, can cause attacks.

N. These stomach attacks can last one to five days on average and can require hospitalization for aggressive Pain management and hydration.

O. As the symptoms and diagnostic tests are almost indistinguishable from an acute abdomen e.g. perforated appendicitis.

P.  It is possible for undiagnosed HAE patients to undergo laparotomy - operations on the abdomen or laparoscopy - keyhole surgery; that turns out to have been unnecessary.

Q.  Predicting where and when the next episode of Edema will occur is impossible.

R. Most Patients have an average of one episode per month, but there are also Patients who have weekly episodes or only one or two episodes per year.

S. The triggers can vary and include infections, minor injuries, mechanical irritation, operations or stress.

T.  In most cases, Edema develops over a period of 12–36 hours and then subsides within 2–5 days.

U. Besides a family history of the disease, only a laboratory analysis can provide final confirmation.

V. The former is used during the reaction cascade in the complement system of immune defense, which is permanently overactive due to the lack of regulation by C1-INH.

223. Drug induction...

A. ACE inhibitors can induce Angioedema.

B. ACE inhibitors block the enzyme ACE so it can no longer degrade bradykinin; thus, bradykinin accumulates and causes Angioedema.

C. Bradykinin is an inflammatory mediator.

D. It is a peptide that causes Blood vessels to dilate - enlarge and therefore causes Blood pressure to fall.

224. History...

A. Heinrich Quincke first described the clinical picture of Angioedema in 1882, although there had been some earlier descriptions of the condition.

B. William Osler remarked in 1888 that some cases may have a hereditary basis; he coined the term, "hereditary angioneurotic edema."

C. Drug-induced angioedema...

225.  Stevens-Johnson syndrome.

A.  Is usually caused by an unpredictable adverse reaction to certain medications.

B.  It can also sometimes be caused by an infection.

C. The syndrome often begins with flu-like symptoms, followed by a red or purple rash that spreads and forms blisters.

D. The affected skin eventually dies and peels off.

226.  Spontaneous Ecchymosis.

A. An ecchymosis is a subcutaneous spot of bleeding from extravasation of Blood with diameter larger than 1-centimetre - 0.39 in.

B. It is similar to and sometimes indistinguishable from a hematoma, commonly called a bruise, though the terms are not interchangeable in careful usage it is recognised as. Bleeding into the skin.

227. Pustular Psoriasis enhanced.

A. Pustular Psoriasis looks different to Plaque Psoriasis, although plaque and Pustular psoriasis can coexist or one may follow the other.

B. The main distinguishing feature of Pustular Psoriasis is the appearance of white pus spots surrounded by or on top of areas of red skin.

C. This does not mean there is infection present.

D. The spots simply show that the skin has been invaded by white blood cells.

E. The Person is not infected and neither are they contagious in any way.

F. Pustular Psoriasis flare-ups can be triggered by some medicines, irritating substances on the skin, ultraviolet light overdoses, pregnancy, systemic steroids - especially sudden withdrawal of tablet or high potency topical steroids, infections or emotional stress.

Postmarketing reports:

228. Toxic Epidermal Necrolysis.

A. Toxic Epidermal Necrolysis - TEN, also known as Lyell's syndrome, is a rare, life-threatening skin condition that is usually caused by a reaction to drugs.  

229. Erythema Multiforme.

A. Is a skin reaction that can be triggered by an infection or medication.

B. It is usually mild and goes away in a few weeks.

230.  Skin Cancer. 

231.  Bullous Dermatitis.

A. The term bullous drug eruptions refers to adverse drug reactions that result in fluid-filled blisters or bullae.

B. Blistering can be due to various medications, prescribed or over-the-counter, natural or synthetic.

232. Drug rash with eosinophilia and systemic symptoms - DRESS.

233. Eczema.

A. Dermatitis, also known as Eczema, is a group of diseases that result in inflammation of the skin.

B. They are characterized by itchiness and red skin.

C. In cases of short duration there may be small blisters while in long term cases the skin may become thickened.

D. The area of skin involved can vary from small to the entire Body.

E. Allergic contact dermatitis; however, can occur following brief exposures to specific substances to which a Person is sensitive.

F. The exact cause of dermatitis is often unclear.

234. Nervous system.

Common 1% to 10%:

235. Extrapyramidal symptoms.

A. Extrapyramidal symptoms (EPSs), such as akathisia, dystonia, psuedoparkinsonism may be mistaken for true parkinsonism and dyskinesia, as found in Parkinson's disease and after short-term exposure to certain medications - are serious drug-induced side effects that can be problematic for Persons who receive antipsychotic medications (APMs) or other dopamine-blocking agents.

236. Extrapyramidal Tremor.

A. Extrapyramidal symptoms (EPS), also known as extrapyramidal side effects (EPSE), are drug-induced movement disorders that include acute and irregular, jerky movements.

B. These symptoms include dystonia - continuous spasms and muscle contractions, akathisia - motor restlessness, parkinsonism - characteristic symptoms such as rigidity, bradykinesia - slowness of movement and tremor.

C. Antipsychotics are often discontinued due to inefficacy and intolerable side effects such as extrapyramidal symptoms.

237. Tremor/abnormal involuntary movement.

238. Lack of coordination.

239. Gait.

240. Abnormal/ataxia.

A. Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that includes gait abnormality.

B. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement.

241. Dizziness.

242. Paraesthesia.

A. Paraesthesia is a sensation of tingling, tickling, pricking, or burning of a Person's skin with no apparent physical cause.

B. The manifestation of a Paraesthesia may be transient or chronic.

C. The most familiar kind of Paraesthesia is the sensation known as; "pins and needles" or of a limb; "falling asleep."

D. A less well-known and uncommon but important Paraesthesia is formication, the sensation of bugs crawling.

243. Headache.

244. Abnormal taste and smell.

- 0.1% to 1%:

245. Peripheral sensorimotor neuropathy.

A.  Neuropathy means a disease of, or damage to nerves.

B. There are many causes of peripheral neuropathy, including many drugs, diabetes, shingles, kidney failure and vitamin deficiency.

C.  Many causes of peripheral neuropathy can be successfully treated or prevented.

D.  The treatment for peripheral neuropathy depends on its cause.

Very Rare.

 - less than 0.01%:

246. Cerebellar Ataxia.

A. The Cerebellum is the area of the Brain responsible for controlling gait and muscle coordination.

B. Acute cerebellar ataxia (ACA), also known as cerebellitis, is a disorder that occurs when the cerebellum becomes inflamed or damaged.

247. Benign intracranial hypertension.

A. Idiopathic intracranial hypertension (IIH), sometimes called by the older names benign intracranial hypertension (BIH) or pseudo tumor cerebri (PTC), is a neurological disorder that is characterized by increased intracranial pressure - pressure around the Brain in the absence of a tumor or other diseases.

B. The main symptoms are stroke-like headache, nausea and vomiting, as well as pulsatile tinnitus - sounds perceived in the ears, with the sound occurring in the same rhythm as the pulse, double vision and other visual symptoms.

C. If untreated, it may lead to swelling of the optic disc in the eye, which can progress to vision loss.

D. However, is often referred to as idiopathic intracranial hypertension – idiopathic means there is no known cause; thus there is no clear reason for the condition.

248. Vertigo.

A. Vertigo is when a Person feels as if they or the objects around them are moving when they are not.

B. Often it feels like a spinning or swaying movement.

C. This may be associated with nausea, vomiting, sweating, or difficulties walking.

D. It is typically worsened when the head is moved.

E. Vertigo is the most common type of dizziness.

F. The most common diseases that result in vertigo are benign paroxysmal positional vertigo.

G. Ménière's disease and labyrinthitis.

H. Less common causes include stroke, brain tumors, brain injury, multiple sclerosis and migraines.

I. Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed.

J. Other causes may include toxin exposures such as to carbon monoxide, alcohol, or aspirin.

K. Vertigo is a problem in a part of the vestibular system.

L. Other causes of dizziness include presyncope, disequilibrium and non-specific dizziness.

Frequency not reported.

249. Peripheral Neuropathy.

A. The Peripheral Nervous system connects the nerves from the Brain and spinal cord, or central nervous system, to the rest of the Body.

B. The job of these nerves is to deliver signals about physical sensations back to the Brain.

C. Peripheral neuropathy is a disorder that occurs when these nerves malfunction because they are damaged or destroyed.

250. Demyelinating.

A. A Demyelinating disease is any condition that results in damage to the protective covering - myelin sheath that surrounds nerve fibers in the Brain and Spinal cord.

B. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

251. Polyneuropathy.

A. Is the simultaneous malfunction of many peripheral nerves throughout the Body.

B. Infections, toxins, drugs, cancers, nutritional deficiencies and other disorders can cause many peripheral nerves to malfunction.

252. Nerve Conduction.

A. Nerve conduction is the system of how the electrical impulses information travels around the Body.

B. Nerve conduction studies (NCS) and have been created in order to make sense of Nerve Conduction - when it is not functioning correctly or damaged and are often required for a complete diagnostic study.

C. The studies may be diagnostically helpful in Patients suspected of having almost any PNS disorders...

D. Including those of nerve roots, peripheral nerves, muscle and neuromuscular junction. Cranial nerves and spinal cord function.

E. The process of choosing the appropriate tests is the responsibility of the clinical neurophysiologist (CN) and not the referring Doctor and is planned as a dynamic series of steps designed to answer specific questions about nervous system function raised by the clinical picture.

253. Neurolipidosis.

A. Neurolipidosis ‎- plural neurolipidoses describes the pathology of a group of lysosomal storage diseases in which lipids accumulate in the central nervous system.

B. Lysosomal - a Body membrane, storage diseases, are a group of approximately 50 rare inherited metabolic disorders/diseases that result from defects in lysosomal function in which lipids accumulate in the central nervous system.

254. Neuromyopathy.

A. A simultaneous disease of nerves and associated muscle tissue.

255. Parosmia.

A. Parosmia is a smell disorder.

B.  In this disorder the part of Brain that recognizes sense of smell is not able to perceive the odor of substances.

C. In fact the odor of a substance is perceived as something offensive by the olfactory lobe of the Brain which in reality is not present.

D. Thus, in Parosmic Patients even the natural pleasant odor of a substance is perceived to be offensive and foul.

E. Many patients recognize the natural odor similar to fecal odor, chemical, burning, or rotten.

F. People suffering from Parosmia are distressed in their day to day life as they are not able to distinguish between aromas of different food products.

G. Upper respiratory tract infection, traumatic head injury, Parkinson's disease, sinusitis are some of the causes of Parosmia.

H. There is no specific treatment of Parosmia, but after few days or weeks the problem may decrease on its own. 

Postmarketing reports:

256.  Confusional State.

257.  Disorientation.

258.  Delirium.

259.  Intracranial pressure increased.

260.  Hypoesthesia.

A.  Hypoesthesia - or hypesthesia refer to a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli.

B.  In everyday speech this is sometimes referred to as, "numbness."

C.  Hypoesthesia is one of the negative sensory symptoms associated with cutaneous sensory disorder - CSD.

D.  In this condition, Patients have abnormal disagreeable skin sensations that can be increased - stinging, itching or burning or decreased - numbness or hypoesthesia.

E.  There are no other apparent medical diagnoses to explain these symptoms.

261.  Parkinsonian symptoms.

A.  Parkinson's signs and symptoms may include Tremor. A tremor, or shaking, usually begins in a limb, often hand or fingers.

262. Psychiatric.

Common - 1% to 10%:

263.  Nightmare.

264.  Sleep disorders.

265.  Libido decreased.

A.  Also known as sex drive, is a Person's overall sexual drive or desire for sexual activity.

B.  Sex drive is influenced by biological, psychological and social factors.

266.  Insomnia.

267.    Sleep Disturbance.

Frequency not reported:

268.  Vivid Dreams.

269.  Chronic Anxiety.

Postmarketing reports:

270.  Hallucination.

271.  Gastrointestinal. 

Common - 1% to 10%:

272. Nausea.

273. Constipation.

274. Abdominal Pain.

275. Salivation.

276. Abnormal Effects.

Frequency not reported:

277. Vomiting.

278. Dysgeusia.

A. Is a condition in which a foul, salty, rancid, or metallic taste sensation will persist in the mouth.

279. Ageusia is the inability to detect any tastes, which is rare.

A. Often, People who feel they have a problem with their sense of taste are experiencing a loss of smell instead of a loss of taste.

280. Diarrhea.

Postmarketing reports:

281.  Pancreatitis.

A.  Pancreatitis is inflammation of the pancreas.

B.  The Pancreas is a large organ behind the stomach that produces digestive enzymes.

B.  There are two main types, acute pancreatitis and chronic pancreatitis.

C.  Signs and symptoms of pancreatitis include Pain in the upper abdomen, nausea and vomiting.

282. Dry Mouth.

283. Other Effects.

Common (1% to 10%):

284.  Fever.

285.  Malaise.

A. A general feeling of discomfort, illness, or unease whose exact cause is difficult to identify.

286.  Fatigue.

A. Also called exhaustion, tiredness, languidness, languor, lassitude and listlessness, is a subjective feeling of tiredness which is distinct from weakness and has a gradual onset.

B. Unlike weakness, fatigue can be alleviated by periods of rest.

C. Fatigue can have physical or mental causes.

287. Endocrine.  

Common - 1% to 10%:

288.  Hypothyroidism.

A.  Is the name given to the condition resulting from an under-active thyroid gland.

B. This means that it is not producing enough thyroid hormone for the Body's requirements.

289.  Hyperthyroidism.

A. An overactive thyroid found at the front of the neck, is where the thyroid gland produces too much of the thyroid hormones.

B.  Very rare - less than 0.01%:

290. Syndrome of inappropriate antidiuretic hormone secretion.

A.  The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition that causes the Body to make too much antidiuretic hormone - ADH.

B.  ADH is a chemical that helps keep the right balance of fluids in the Body.

Frequency not reported:

291. Thyroid function tests abnormal.

Postmarketing reports:

292. Thyroid nodules/cancer.

293. Metabolic.

Common (1% to 10%):

294.  Anorexia.

295. Edema.

Frequency not reported:

296.  Weight Gain.

297.  Symptomatic Hypercalcemia.

298.  Appetite decreased.

299. Hematologic.

Common (1% to 10%):

300. Coagulation Abnormalities.

Very rare (less than 0.01%):

301. Hemolytic Anemia.

302. Aplastic Anemia.

303. Thrombocytopenia.

Frequency not reported:

304.  Bone Marrow Granuloma.

305.  Bone Marrow Depression.

Postmarketing reports:

306. Pancytopenia.

307. Neutropenia.

308. Agranulocytosis.

309. Granulocytosis.

310. Musculoskeletal.  

Common (1% to 10%):

311. Muscle weakness.

Frequency not reported:

312. Back pain.

Postmarketing reports:

313. Myopathy.

314. Rhabdomyolysis 

A. Rhabdomyolysis is a condition in which damaged or destruction of skeletal muscle (especially in horses) breaks down rapidly.

B. Symptoms may include muscle pains, weakness, vomiting, and confusion.

C. There may be tea coloured urine or an irregular Heartbeat.

D. Some of breakdown products, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure.

315. Muscle Spasm.

Local Common (1% to 10%):

316. Injection Site reactions.

317. Genitourinary.    

Very rare (less than 0.01%):

318.  Epididymo-orchitis.

A. Epididymo-orchitis is an inflammation of the epididymis and/or testis.

B. It is usually due to infection, most commonly from a urine infection or a sexually transmitted infection.

319.  Impotence.

Postmarketing reports:

320.  Epididymit.

321. Immunologic. 

Very rare (less than 0.01%):

322. Anaphylactic shock.

Frequency not reported:

323. Hypersensitivity reaction.

324. Positive antinuclear antibodies.

325. Immunoglobulin level increased.

Postmarketing reports:

326. Anaphylactic/anaphylactoid reaction.

A. Anaphylactoid reactions are defined as those reactions that produce the same clinical picture with anaphylaxis but are not IgE mediated, occur through a direct nonimmune-mediated release of mediators from mast cells and/or basophils or result from direct complement activation.

327. Renal.

Very rare (less than 0.01%):

328.  Blood Creatinine Increased. 

Frequency not reported:

329.  Kidney function abnormal.

330.  Chronic Renal Failure worsened.

Postmarketing reports:

331.  Renal Impairment.

332.  Renal Insufficiency.

333. Acute renal failure.

334.  References; Not all side effects for Amiodarone may be reported.

A.  Always consult a Doctor or healthcare professional for medical advice.

335.  Conclusion...

A.  As we have previously discussed. I am not given to Medication Side-effects, preferring to accept they are the Mind - when consuming a Poison, will first do everything in its power to excrete the Poison.

B.  In addition if the makers of Medications do not know the known or possible side effects of their product - then one has to ask in reality who does know.

C.  However - like we can survive underwater for a minute or so, certain death is predicted if we stay under or are forced to remain - as is the case with medication with known effects on the entire Body; whatever the illness they are prescribed for or taken on a regular bases; before the system is able to cleanse itself of the negative effect - the Mind will then create a new symptom called side-effects of medication - try to tell me there is a difference.   

D.  With all of these in the region of or considered 334 side effects, how could any Doctor or Patient keep track of these - surely it would take a computer of greater capability than current available; then would anyone know with Scientifically proven Medicine what to do with the results

E.  Known or reported side-effects or a legal notice of "we are not responsible as we published" a marker or Disclaimer for damage limitation of the negative side-effects of Amiodarone...

336. Having explored the side effects of Amiodarone is in not fitting we include the Medications Ingredients whether they are active or not.

 

1. A salt, especially of an alkaloid, formed by the direct union of hydrochloric acid with an organic base that makes the organic constituent more soluble.

2. It will be helpful to note - there are although difficult to accept. Six - so called Inactive Ingredients as well! 

336. Conclusion. There is much to be said regarding this medication yet only one item amongst all of the known, published or possible side-effects - draws my serious attention as described in Item 1. Above. "hydrochloric acid." And the damage it occasions on internal organs in the medium to long-term.

Known or Possible side effects...Total = 334.

----------------------------------------

Section 85.

Bisoprolol Side Effects

In Summary.

A. More frequently reported side effects include: fatigue. See below for a comprehensive list of adverse effects.

For the Consumer.

B.  Applies to Bisoprolol: oral table.

C.  In addition to its needed effects, some unwanted effects may be caused by Bisoprolol.

D.  In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects.

It is essential to advise a Doctor immediately if there are any Major side effects or any of these as per this list occur when taking Bisoprolol:

Less common.

E.

1. Body Aches or Pains.

2. Chest Pain.

3. Chills.

4. Cough.

5. Difficult or laboured Breathing.

6. Ear Congestion.

7. Fever.

8. Headache.

9. Loss of voice.

10. Nasal Congestion.

11. Pain or Tenderness around eyes and cheekbones.

12. Shortness of Breath or troubled breathing.

13. Sneezing.

14. Sore Throat.

15. Stuffy or Runny Nose.

16. Tightness in Chest.

17. Unusual Tiredness or Weakness.

18. Wheezing.

Rare.

19. Chest discomfort.

20. Lightheadedness, Dizziness, or Fainting.

21. Slow or irregular Heartbeat.

If any of the following symptoms of overdose occur while taking Bisoprolol, get emergency help immediately:

Symptoms of overdose:

22. Anxiety.

23. Blurred Vision.

24. Cold Sweats.

25. Coma.

26. Confusion.

27. Cool, Pale Skin.

28. Decreased Urine Output.

29. Depression.

30. Dilated Neck Veins.

31. Dizziness,.

32. Fainting. 

33. Lightheadedness - when suddenly getting up from a lying or sitting position.

34. Extreme Fatigue.

35. Fast Heartbeat.

36. Increased Hunger.

37. Irregular Breathing.

38. Nausea.

39. Nervousness.

40. Nightmares.

41. Noisy Breathing.

42. Seizures.

43. Shakiness.

44. Slurred Speech.

45. Sweating.

46. Swelling of Face, Fingers, Feet, or Lower Legs.

47. Weight Gain.

48. Minor Side Effects.

1. Some of the side effects that can occur with Bisoprolol may not need medical attention.

2. As the Body adjusts to the medicine during treatment, these side effects may go away.

3. A qualified health care professional may also be able to tell you about ways to reduce or prevent some of these side effects.

4. If any of the following side effects continue, are bothersome or if produce questions about them, check with a health care professional:

Less common.

49. Abnormal or decreased touch sensation.

50. Diarrhea.

51. Difficulty in moving.

52. Lack or Loss of Strength.

53. Muscle Pain or Stiffness.

54. Pain in joints.

55. Sleeplessness.

56. Trouble Sleeping.

57. Unable to Sleep.

58. Vomiting.

For Healthcare Professionals.

Applies to Bisoprolol: oral tablet.

General.

The more commonly reported side effects observed with this drug are:

59. Bradycardia.

60. Dizziness.

61. Hypotension.

Cardiovascular.

62. A. Bradycardia occurred as a dose-related event.

63. B. Cardiac failure occurred in 18.4% of Patients - n=1328 compared with 22.8% of placebo -treated Patients - n=1321.

Very common.

64. A. 10% or more:

65. B. Bradycardia - up to 15.2%.

Common.

1% to 10%:

66. Chest Pain.

67. Heart Failure aggravation.

68. Hypotension.

69. Cold Extremities.

70. Peripheral Edema.

71. Ischemia.

A.  An inadequate Blood supply to an organ or part of the Body, especially the Heart Muscles.

72. Conduction disorder.

73. Left Cardiac failure.

74. Palpitation.

75. Vein disorders.

Uncommon.

0.1% to 1%:

76. Atrioventricular (AV) disturbances.

77. Orthostatic Hypotension.

A. Orthostatic hypotension, also known as postural hypotension or shortened to - orthostasis and colloquially called head rush, occurs when a Person's Blood pressure falls when suddenly standing up from a lying or sitting position.

Frequency not reported:

78. Other rhythm disturbances.

79. Claudication.

A. Claudication is Pain and/or cramping in the lower leg due to inadequate Blood flow to the muscles.

B. The Pain usually causes the person to limp, typically is felt while walking and subsides with rest..

C. The word "claudication" comes from the Latin "claudicare" meaning to limp.

Nervous System.

Very common.

10% or more:

80. Dizziness.

Up to 13.3%.

Common.

 1% to 10%:

81. Headache.

82. Extremity Numbness.

83. Cerebrovascular Disorder.

84. Syncope.

85. Hypoesthesia.

Frequency not reported:

86. Vertigo.

87. Paraesthesia.

A.  Is a sensation of tingling, tickling, pricking, or burning of a Person's skin with no apparent physical cause.

88. Hypoesthesia.

89. Hyperesthesia.

90. Somnolence.

A. Somnolence (alternatively "sleepiness" or "drowsiness") is a state of strong desire for sleep, or sleeping for unusually long periods - compare hypersomnia.

B. It has distinct meanings and causes.

C. It can refer to the usual state preceding falling asleep, the condition of being in a drowsy state due to circadian rhythm disorders, or a symptom of other health problems.

D. It can be accompanied by lethargy, weakness and lack of mental agility.

91. Decreased Concentration/Memory.

92. Tremor.

93. Taste abnormalities.

Postmarketing reports:

94. Unsteadiness

Respiratory.

Very common.

10% or more:

95. Dyspnea.

up to 13.8%.

Common.

1% to 10%:

96. Pneumonia.

97. Bronchitis.

98. Coughing.

99. Exertional Dyspnea.

A. Related to Exertional Dyspnea: paroxysmal nocturnal dyspnea, palpitation, orthopnea.

B. Breathlessness or shortness of breath; labored or difficult breathing.

C. It is a sign of a variety of disorders and is primarily an indication of inadequate ventilation or of insufficient amounts of oxygen in the circulating Blood.

100. Upper respiratory tract infection.

101. Respiratory distress.

102. Stridor.

103. Respiratory Tract Edema.

104. Respiratory Tract Hemorrhage.

105. Sinusitis.

Uncommon.

0.1% to 1%:

106. Bronchospasm.

B. Bronchospasm is a chief characteristic of asthma and bronchitis.

A. Description. Bronchospasm is a temporary narrowing of the bronchi - airways into the lungs caused by contraction of the muscles in the lung walls, by inflammation of the lung lining, or by a combination of both.

Rare.

0.01% to 0.1%:

107. Allergic Rhinitis.

A. Sinusitis occurred as a dose-related event.

Immunologic.

Very common:

108. Antinuclear antibody (ANA) conversions. 

UP to 15%.

Common.

1% to 10%:

109. Viral infection.

Dermatologic.

Common.

1% to 10%:

110. Pruritus.

A. Is a Skin Itching that can be caused by allergic reactions, skin conditions, insect bites, infections, or conditions that affect the Body as a whole.

B. Generalised Pruritus without a rash - especially in People over the age of 65 is usually caused by dry skin.

C.  Sometimes it is not possible to determine the exact cause of the Itching..

Uncommon.

0.1% to 1%:

111.  Sweating.

Rare.

0.01% to 0.1%:

112.  Itching.

113.  Flushing.

114.  Rash.

Very rare.

less than 0.01%:

115.  Alopecia.

116.  Psoriasis-like rash.

117. Psoriasis exacerbation.

Frequency not reported:

118.  Acne.

119.  Eczema. 115. Skin irritation.

120.  Cutaneous Vasculitis.

A. Vasculitis is a term referring to inflammation of Blood vessels - when it affects small or medium sized Blood vessels in the skin, it is known as Cutaneous Vasculitis.   

B. These vessels may be arteries, veins or both and vasculitis can affect any part of the Body.

C. Occasionally  cutaneous  vasculitis  can  be  a  sign  of inflammation  occurring  in  other  organs; referred to as systemic vasculitis and further investigation may be required for a full diagnosis.

Postmarketing reports:

121. Dermatitis.

122. Exfoliative Dermatitis.

Gastrointestinal.

123. Diarrhea occurred as a dose-related event.

Common.

1% to 10%:

124. Nausea.

125. Vomiting.

126. Diarrhea.

127. Constipation.

128. Dyspepsia.

129. Epigastric pain - not food related.

A. Epigastric Pain is localized to the region of the upper abdomen immediately below the ribs.

B. Often, those who experience this type of pain feel it during or right after eating or if they lie down too soon after eating.

C. It is a common symptom of gastroesophageal reflux disease (GERD) or heartburn.

130. Abdominal Pain.

131.  Gastritis.

132.  Dry Mouth.

Frequency not reported:

133.  Gastric Pain.

134.  Peptic Ulcer

Metabolic.

Common.

1% to 10%:

135.  Purine metabolism disorder.

136.  Carbohydrate metabolism disturbed.

137.  Weight changes.

138.  Cholesterol changes.

139.  Potassium levels altered.

140.  Blood lipid changes.

Rare.

0.01% to 0.1%:

141.  Increased triglycerides

Frequency not reported:

142.  Gout.

Postmarketing reports:

143. Increased Uric Acid

144.  Increased Glucose.

145.  Uric Acid. Serum Potassium. Glucose and phosphorus increases associated with use of this drug were not of clinical importance and rarely resulted in discontinuation.

Musculoskeletal.

Common.

1% to 10%:

146.  Limb Pain.

147.  Myalgia.

148.  Arthropathy.

A.  An Arthropathy is a disease of a joint.

B.  Although the terms "Arthropathy" and arthritis have very similar meanings, the former is traditionally used to describe the following conditions: Reactive Arthropathy and is caused by an infection, but not a direct infection of the synovial space.

149.  Arthralgia.

A.  The term Arthralgia literally means joint Pain. 

B.  Osteoarthritis is a degenerative joint disease that is the commonest form of arthritis.

C.  Autoimmune conditions that are responsible for inflammatory Arthralgia's include: rheumatoid arthritis, scleroderma and systemic lupus erythematosus.

Uncommon.

0.1% to 1%:

150.  Muscular Weakness.

151.  Cramps.

Frequency not reported:

152.  Back Pain.

153.  Neck Pain.

154.  Twitching.

Other.

Common.

1% to 10%:

155.  Asthenia.  

A.  Asthenia. Denotes a medical term referring to a condition or symptoms but also disease in which the Body lacks or has lost strength, either as a whole or in any of its parts.  

156.  Fatigue.

157.  Body Pain.

158.  Fever Malaise.

Rare.

0.01% to 0.1%:

159.  Hearing Disorders.

Frequency not reported:

160.  Earache.

161.  Tinnitus. 

162. Fatigue and asthenia occurred as dose-related events.

Psychiatric.

Common.

1% to 10%:

163.  Insomnia.

164.  Anxiety.

Uncommon.

0.1% to 1%:

165.   Sleep disorders.

166.  Depression.

Rare.

0.01% to 0.1%):

167.  Nightmares.

168.  Hallucinations.

Frequency not reported:

169.  Restlessness.

170. Genitourinary.

A.  The genitourinary system or urogenital system is the organ system of the reproductive organs and the urinary system.

B.  These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathways, like the male urethra.

C.  Also, because of their proximity, the systems are sometimes imaged together.

Common.

1% to 10%:

171. Urinary tract infection.

Rare.

0.01% to 0.1%:

172. Potency disorders

Frequency not reported:

173.  Decreased Libido.

174.  Peyronie's Disease.

A. Peyronie's disease or Peyronie disease, also known as induratio (Bent) Penis Plastica (IPP) or chronic inflammation of the Tunica Albuginea (CITA), is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the Penis - affecting an estimated 5% of men.

B. Specifically, scar tissue forms in the Tunica Albuginea, the thick sheath of tissue surrounding the corpora cavernosa causing Pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening.

C.  A variety of treatments have been used, but none have been especially effective.

175.  Polyuria.

176. Hepatic.

Common.

1% to 10%:

177.  Hepatomegaly.

Rare.

0.01% to 0.1%:

178.  Increased liver enzymes - ALT, AST.

179.  Hepatitis.

A. Transaminase elevations of 1 to 2 times the upper limit of normal were reported in 6.2% of Patients, with a multiple occurrence rate of 1.9%.

B. Generally, this increase was the result of underlying disorders or resolved with continued use of this drug.

180. Hypersensitivity.

Rare.  

0.01% to 0.1%:

Postmarketing reports:

181.  Angioedema.

A. Of the 15% of Patients who developed positive ANA status, one-third of Patients converted back to a negative titer with continued use.

182. Ocular.

Rare.  

0.01% to 0.1%:

183.  Reduced tear flow.

Very rare.

less than 0.01%:

184.  Conjunctivitis.

Frequency not reported:

185.  Visual disturbances.

186.  Ocular Pain.

187.  Ocular pressure.

188. Renal.

A. Creatinine and BUN were associated with slightly increased levels, but these effects were generally not of clinical importance and rarely resulted in discontinuation.

Frequency not reported:

189.  Cystitis.

190.  Renal Colic.

Postmarketing reports:

191.  Increased Creatinine and BUN.  (mg/dL) and Serum Creatinine (Cr) (mg/dL).Blood Urea Nitrogen - BUN.

192. Hematologic.   

A. During treatment with this drug, decreased levels of WBCs and platelets were not of clinical importance and rarely resulted in discontinuation.

Postmarketing reports:

193.  Purpura.

A.  A rash any of a number of diseases characterized by such a rash of purple spots on the skin caused by internal bleeding from small Blood vessels.

194.  Decreases in WBC and platelets.

195.  Not all side effects for Bisoprolol may be reported.

A. Consulting a Doctor or Healthcare Professional for medical advice is always recommended.

B. With all these 191 side-effects how could any Doctor or Patient keep track of these - surely it would take a computer of greater capability than current available - then would any one know what to do with the results.

C. Known or reported side-effects or a legal notice of "we are not responsible as we published" a marker or Disclaimer for damage limitation of the negative side-effects of Bisoprolol...

----------------------------------------

Bisoprolol.

196. Having explored the side effects of Bisoprolol... is in not fitting we include the Medications Ingredients whether they are active or not.

 

1. Dicalcium phosphate is the calcium phosphate with the formula CaHPO4.

A. The "di" prefix in the common name arises because the formation of the HPO42– anion involves the removal of two protons from phosphoric acid, H3PO4.

B. It is also known as dibasic calcium phosphate or calcium monohydrogen phosphate.

C. There are three crystalline forms: a dihydrate, CaHPO4•2H2O ('DPCD'), the mineral brushite; a hemihydrate, CaHPO4•0.5H2O; and anhydrous CaHPO4, ('DCPA'), the mineral monetite.

D. Below pH 4.8 the dihydrate and anhydrous forms of dicalcium phosphate are the most stable (insoluble) of the calcium phosphates.

2. Dicalcium phosphate is used as a food additive, it is found in some toothpastes as a polishing agent and is a biomaterial.

A. In the dihydrate (brushite) form it is found in some kidney stones and in dental calculium.

B. Microcrystalline cellulose is a term for refined wood pulp and is used as a texturizer, an anti-caking agent, a fat substitute, an emulsifier, an extender, and a bulking agent in food production.

C. The most common form is used in vitamin supplements or tablets.

3. Titanium dioxide, also known as titanium(IV) oxide or titania, is the naturally occurring oxide of titanium, chemical formula TiO.

A. When used as a pigment, it is called titanium white, Pigment White 6 (PW6), or CI 77891. Generally it is sourced from ilmenite, rutile and anatase.

B. It has a wide range of applications, from paint to sunscreen to food colouring.

C. When used as a food colouring, it has E number E171.

D. Silicon dioxide, also known as silica (from the Latin silex), is a chemical compound that is an oxide of silicon with the chemical formula SiO2.

E. It has been known since ancient times.

F. Silica is most commonly found in nature as quartz, as well as in various living organisms.

G. In many parts of the world, silica is the major constituent of sand.

H. Silica is one of the most complex and most abundant families of materials, existing both as several minerals and being produced synthetically.

I. Notable examples include fused quartz, crystal, fumed silica, silica gel and aerogels.

J. Applications range from structural materials to microelectronics to components used in the food industry.

4. It will be helpful to note there are Eight other ingredients for the Body Organs to cope with.  

197. Conclusion.

A. Bisoprolol belongs to the group of medicines referred to as beta-blockers.

B. It is a medicine which works on the Heart and Blood vessels.

C. It does this by blocking tiny areas - called beta-adrenergic receptors where messages sent by some nerves are received by the Heart and Blood vessels.

D. As a result, the heart beats more slowly and with less force.

E. The pressure of Blood within the Blood vessels is reduced and it is easier for the Heart to pump Blood around the Body.

F. These actions are of benefit with high Blood pressure - hypertension, or heart failure which is a condition where the Heart is not working as well as it should.

G. Because the Heart is using less energy, it also helps to reduce Chest Pain of Angina.

H. Leaving one to question. "With some 191 known reported or possible side effects," for how long is the medication able to maintain items: B.C.D.E.F and G. 

 Known or Possible side effects...Total = 195.

----------------------------------------

Section 86.

Ramipril Side Effects.

In Summary.

1. Commonly reported side effects of Ramipril include:

A. Hypotension.

B. Increased Cough.

See below for a comprehensive list of adverse effects.

For the Consumer.

2.

A. Applies to Ramipril: oral capsule, oral tablet.

B. As well as its needed effects, Ramipril may cause unwanted side effects that require medical attention.

Major Side Effects.

3. If any of the following side effects occur while taking Ramipril, check with a qualified Doctor immediately:

More common.

4.  Blurred Vision.

5.  Confusion.

6.  Dizziness.

7.  Faintness, or lightheadedness when getting up suddenly from a lying or sitting position.

8.  Sweating.

9.  Unusual tiredness or weakness.

Less common.

10. Arm, Back, or Jaw Pain.

11. Chest Pain or discomfort.

12. Chest tightness or heaviness.

13. Chills.

14. Cloudy Urine.

15. Cold Sweats.

16. Decrease in Urine output.

17. Decrease in urine-concentrating ability.

18. Fainting.

19. Fast or irregular Heartbeat.

20. Nausea.

21. Shortness of Breath.

Minor Side Effects.

A. Some Ramipril side effects may not need any medical attention.

B. As the Body gets used to the medicine these side effects may disappear.

C. A qualified health care professional may be able to help prevent or reduce these side effects.

D. It is advisable to check with them if any of the following side-effects continue, or if there is  a concern about them:

More common.

22. Cough.

Less common.

23. Diarrhea.

24. Feeling of constant movement of self or surroundings.

25. Sensation of spinning.

26. Vomiting.

For Healthcare Professionals.

A. Applies to Ramipril: oral capsule, oral tablet:

General. 27.The Most common adverse side-effect is Hypertention.

Cardiovascular.

Very common.

10% or more:

28. Hypotension - 11%.

Common.

1% to 10%:

29. Angina Pectoris.

30. Postural Hypotension.

31. Orthostatic Blood pressure decreased.

Uncommon.

0.1% to 1%:

32. Symptomatic Hypotension.

33. Myocardial Ischemia.

34. Myocardial infarction.

35. Tachycardia.

36. Arrhythmia.

37. Palpitation.

38. Flushing.

Rare.

less than 0.1%:

39. Vascular stenosis.

40. Hypoperfusion.

A. Shock or a sudden disturbance of mental equilibrium.

B. A condition of acute peripheral circulatory failure due to derangement of circulatory control or loss of circulating fluid.

C. It is marked by hypotension and coldness of the skin and often by tachycardia and anxiety.

D. Untreated shock can be fatal.

E.  Called also Circulatory collapse.  

41. Vasculitis.

A. Vasculitis is the designation given to a group of uncommon diseases which result in inflammation of the blood vessels with both arteries and veins being affected, for some unknown reason the immune system attacks healthy Blood vessels, causing them to become swollen and narrow.

B. There are many different types of diseases with vasculitis the symptoms vary, but it can cause fever, fatigue, weight loss.

C. Churg-Strauss syndrome and Giant cell Arteritis; are examples.

Frequency not reported:

42. Disturbed orthostatic regulation.

43. Raynaud's Phenomenon.

Gastrointestinal.

Common.

1% to 10%:

44. Nausea.

45. Vomiting.

46. Diarrhea.

47. Gastrointestinal Inflammation.

48. Digestive disturbances.

49. Abdominal discomfort.

50. Dyspepsia.

Uncommon.

0.1% to 1%:

51. Pancreatitis.

52. Pancreatic enzymes increased.

53. Abdominal Pain.

54. Small bowel angioedema.

55. Gastritis.

56. Constipation.

57. Dry mouth.

Rare.

less than 0.1%:

58.  Glossitis - inflammation of the tongue.

Frequency not reported:

59. Dysphagia.

60. Gastroenteritis.

61. Increased Salivation.

62. Gastric Pain.

63. Aphthous Stomatitis.

A. Is a common condition characterized by the repeated formation of benign and non-contagious mouth ulcers (aphthae) in otherwise healthy individuals.

B. The informal term canker sores is also used, mainly in North America, although this may also refer to any mouth ulcer.

Other.

Common.

1% to 10%:

64. Fatigue.

65. Asthenia.

66. Vertigo.

67. Bronchitis.

68. Sinusitis.

69. Chest Pain.

Uncommon.

0.1% to 1%:

70. Peripheral Edema.

71. Pyrexia.

72. Libido decreased.

Rare.

less than 0.1%:

73.  Conjunctivitis.

74.  Hearing impaired.

75.  Tinnitus.

Frequency not reported:

76.  Hearing loss.

77.  Edema.

78.  Malaise.

79.  Gynecomastia.

Respiratory.

Common.

1% to 10%:

80. Cough.

81. Nonproductive Tickling Cough.

82. Cough increased.

83. Dyspnea

Uncommon.

0.1% to 1%:

84.  Bronchospasm.

85.  Asthma aggravated.

Frequency not reported:

86.  Eosinophilic Pneumonitis.

87.  Epistaxis.

88.  Nasal Congestion.

Psychiatric.

Uncommon.

0.1% to 1%:

89. Depressed Mood.

90. Anxiety.

91. Nervousness.

92. Restlessness.

93.  Sleep disorder.

Rare.

less than 0.1%:

94. Confusional state

Frequency not reported:

95. Depression.

96. Insomnia.

97. Disturbance in attention.

Nervous system.

Common.

1% to 10%:

98. Headache.

99. Dizziness.

100. Syncope.

Uncommon.

0.1% to 1%:

101. Paraesthesia.

102. Dysgeusia.

103. Ageusia.

104. Somnolence

Rare.

less than 0.1%:

105.  Tremor.

106.  Balance disorder.

Frequency not reported:

107.  Smell disturbance.

108.  Amnesia.

109.  Convulsions.

110.  Neuralgia.

111.  Neuropathy.

112.  Cerebral Ischemia.

113.  Ischemic Stroke.

114.  Transient Ischemic attack.

115.  Psychomotor skills impaired.

116.  Burning sensation. 

117.  Parosmia.

Musculoskeletal.

Common.

1% to 10%:

118.  Muscle Spasm.

119.  Myalgia.

Uncommon.

0.1% to 1%:

120.  Arthralgia.

A.  The term Arthralgia - literally means joint Pain.

Frequency not reported:

121.  Arthritis.

Dermatologic.

Common.

1% to 10%:

122. Maculopapular rash.

A. The Patient with an acute Maculopapular rash presents a diagnostic challenge to the clinician.

B. The term Maculopapular is somewhat non-specific, as many eruptions have a primary morphology of macules or papules and the term may be misused to indicate any rash.

C. The term rash is itself also non-specific and is sometimes incorrectly applied to any skin finding; eruption may be preferred for a cutaneous reaction of acute onset.

Uncommon.

0.1% to 1%:

123.  Pruritus.

A. Severe itching of the skin, as a symptom of various ailments.

124.  Hyperhidrosis.

A. Hyperhidrosis is a condition characterized by abnormally increased sweating in excess of that required for regulation of Body temperature and is associated with a quality of life burden.

B. From a psychological, emotional and social perspective, sweating or excessive perspiration may be due to a disorder of the thyroid or pituitary glands: diabetes mellitus, tumours, gout, menopause, certain drugs, or mercury poisoning.

C. Other factors can play a role, including certain foods, drinks, nicotine, caffeine and smells.

D. The cause of primary hyperhidrosis is unknown, although it is usually the result of some other underlying condition.

E. A common complaint of Patients is they get nervous because they sweat, then sweat more because they are nervous.

F. Some physicians claim it is caused by over activity of the: Sympathetic nervous system because; Anxiety or excitement has exacerbated the condition for many sufferers.

Rare.

less than 0.1%:

125. Exfoliative Dermatitis.

126. Urticaria.

127. Onycholysis; is the separation of a fingernail or toenail from its pink nail bed.

Frequency not reported:

128. Purpura.

129. Pemphigus.

130. Pemphigoid. is a rare autoimmune disorder that can develop at any age, including in kids, but that most often affects the elderly. Pemphigoid is caused by a malfunction of the immune system and results in skin rashes and blistering on the legs, arms, and abdomen.

131. Erythema Multiforme.

132. Toxic Epidermal Necrolysis.

133.  Stevens Johnson syndrome.

134.  Sweating increased.

135.  Alopecia.

136.  Psoriasis aggravated.

137. Dermatitis Psoriasiform. Is somewhat rare condition of unknown casue involving raised thin ridges on the skin surface lying beside long papillae, that according to the National Center for Biotechnology Information. It causes itchiness and comprises a large group of related conditions

138.  Lichenoid exanthema. When it has been induced by a medication it can be called more specifically a Lichenoid drug eruption. The rash of a Lichenoid drug eruption can sometimes be difficult to distinguish from idiopathic lichen planus because of similarities in the clinical appearance and the pathology .

139. Enanthema. eruption on a mucous membrane (as the inside of the mouth) occurring as a symptom of a disease.

Renal.

Common.

1% to 10%:

140. Abnormal kidney function.

Uncommon.

0.1% to 1%:

141. Renal impairment.

142. Acute Renal failure.

Metabolic.

Common.

1% to 10%:

143. Creatinine increased.

Creatinine.

A. Creatinine is a breakdown product of creatine phosphate in muscle and is usually produced at a fairly constant rate by the Body - depending on muscle mass.

B. Serum creatinine - a blood measurement is an important indicator of renal health because it is an easily measured by product of muscle metabolism that is excreted unchanged by the kidneys.

C. It is then transported through Blood to the other organs, muscle and brain, where, through phosphorylation, it becomes the high-energy compound phosphocreatine.

D.  Creatinine is removed from the Blood chiefly by the kidneys,

E.  If the filtration in the kidney is deficient, creatinine Blood levels rise.

F. Therefore, creatinine levels in Blood and urine may be used to calculate the creatinine clearance (CrCl), which correlates with the glomerular filtration rate (GFR).

144.  Blood Potassium increased.

Uncommon.

0.1% to 1%:

145.  Anorexia.

146.  Decreased Appetite.

147.  BUN increased.

A. The Blood Urea Nitrogen or BUN test - is primarily used, along with the creatinine test, to evaluate kidney function in a wide range of circumstances, to help diagnose kidney disease and to monitor People with acute or chronic kidney dysfunction or failure.

Frequency not reported:

148. Weight gain.

149. Hyponatremia.

150. Loss of appetite.

151. Uric Acid elevated.

152. Blood Glucose elevated.

153. Blood Sodium decreased.

Postmarketing reports:

154. Hypoglycemia.

Genitourinary.

Uncommon.

0.1% to 1%:

155. Worsening of preexisting Proteinuria.

156. Urine output increased.

157. Transient Erectile impotence.

Frequency not reported:

158. Proteinuria.

159. Impotence.

Ocular.

Uncommon.

0.1% to 1%:

160.  Visual disturbance.

161.  Blurred Vision.

Hematologic

Uncommon.

0.1% to 1%:

162. Eosinophilia.

163. Hemoglobin.

A red protein responsible for transporting Oxygen in the Blood.

164. Hematocrit decreased.

The ratio of the volume of Red Blood cells to the total volume of Blood.

Rare.

less than 0.1%:

165.  Neutropenia.

166.  Agranulocytosis.

167.  White Blood cell count decreased.

168.  Red Blood cell count decreased. 

169.  Platelet count decreased.

Frequency not reported:

170.  Pancytopenia.

171.  Hemolytic Anemia.

172.  Thrombocytopenia.

173.  Leucopenia.

174.  Bone Marrow failure.

Hepatic.

Uncommon.

0.1% to 1%:

175.  Hepatic Enzymes increased.

176.  Conjugated Bilirubin increased.

Rare.

less than 0.1%:

177.  Cholestatic Jaundice.

178.  Hepatocellular Damage.

Frequency not reported:

179.  Hepatic failure.

180.  Hepatitis.

181.  Jaundice.

182.  Acute Liver failure.

183.  Hepatocellular Damage .

184.  Cholestatic Hepatitis.

185. Cytolytic Hepatitis. is a liver disease causing cell destruction. This condition can be dramatic and cause massive and rapid damage to liver cells. It may also be gradual as is typically the case of alcoholic or viral cirrhosis.

186.  Serum Bilirubin elevated.

Immunologic.

Uncommon.

0.1% to 1%:

187.  Angioneurotic Edema.

188.  Angioedema.

Very rare.

less than 0.01%:

189. Photosensitivity

Frequency not reported:

190. Anaphylactic reaction.

191. Anaphylactoid reaction.

192. Apparent Hypersensitivity reaction.

193. Antinuclear Antibody increased.

Endocrine.

Frequency not reported:

194.  Syndrome of inappropriate antidiuretic hormone secretion.

195.  It is possible that some side effects of Ramipril may not have been reported.

----------------------------------------

The following must be taken as INFORMATION provided by Peter Smith Talking Cures.

However the Medical Drug Related information provided by Professionals who have knowledge and legal ability to prescribe medications...

...And is Freely available in the public domain.

Section 87.

1. Always consult a healthcare professional for medical advice.

2.  However this is important information in the understanding of the many Side-effects of the Medications mentioned in this web page.   

3.  Applies to the following strength(s): 1.25 mg ; 2.5 mg ; 5 mg ; 10 mg. 

4. Therefore this information as below must not be considered as a substitute for legal medical advice.

5.  Always consult a Medically Qualified Doctor or Pharmacist.

Usual Adult Dose for.

6.  Hypertension.

7.  Congestive Heart Failure.

8.  Cardiovascular Risk Reduction.

Additional dosage information. 

9.  Renal Dose Adjustments.

10.  Liver Dose Adjustments.

11.  Dose Adjustments.

12.  Precautions.

13.  Dialysis.

Other Comments.

14. Usual Adult Dose for Hypertension.

15. Initial dose: 2.5 mg orally once a day for Patients not taking a Diuretic.

16. Maintenance dose: 2.5 to 20 mg/day in one or two equally divided doses.

Comments.

17.  Adjust dose according to Blood Pressure response.

18. The antihypertensive effect may diminish toward the end of a once daily dosing interval; consider increasing dose or twice daily administration.

19.  If Blood pressure is not controlled with this drug alone, a Diuretic may be added.

Use.

20.  Treatment of Hypertension, to Lower Blood pressure, alone or in combination with a Thiazide Diuretic.

Usual Adult Dose for Congestive Heart Failure...

21.  Initial dose: 2.5 mg orally twice a day.

22.  Maintenance dose: 5 mg orally twice a day.

Comments.

23.  If possible, decrease concomitant Diuretic dose to reduce likelihood of hypotension.

24. After first initial dose, observe at least two hours and until Blood pressure has stabilized at least an additional hour.

25.  If Patient becomes hypotensive on initial dose, reduce to 1.25 mg twice a day.

26. After one week on initial dose, increase toward maintenance dose as tolerated; may increase about every 3 weeks.

27. Initial hypotension does not preclude subsequent titration with this drug, following effective hypotension management.

Use.

28. Treatment of stable Patients who have demonstrated clinical signs of congestive heart failure within the first few days after sustaining acute Myocardial Infarction.

Usual Adult Dose for Cardiovascular Risk Reduction.

29.  Initial dose: 2.5 mg orally once a day for one week; 5 mg orally once a day for next three weeks, then increase as tolerated.

30.  Maintenance dose: 10 mg orally once a day

Comments.

31. If Patient is hypertensive or recently post myocardial infarction, may administer in divided doses.

Use.

32. To - Reduce the risk of myocardial infarction, stroke, or death from cardiovascular causes in Patients 55 years or older at high risk of developing a major cardiovascular event because of a history of coronary artery disease, stroke, peripheral vascular disease, or diabetes that is accompanied by at least one other cardiovascular risk factor (hypertension, elevated total cholesterol levels, low high-density lipoprotein (HDL) levels, cigarette smoking, or documented microalbuminuria; can be used in addition to other needed treatment such as antihypertensive, antiplatelet, or lipid lowering therapy.

Renal Dose Adjustments.

33.  CrCl 40 mL/min or less: Reduce usual dose by 25%.

34.  CrCl less than 90 mL/min and hypertension: Initial dose: 1.25 mg orally once a day; may titrate up until Blood pressure controlled or to maximum dose of 5 mg/day.

35.  CrCl less than 90 mL/min and Heart failure: Initial dose: 1.25 mg orally once a day; may increase to 1.25 mg twice daily and to maximum dose of 2.5 mg twice daily.

36.  Renal artery stenosis: Initial dose: 1.25 mg orally once a day.

Liver Dose Adjustments.

37.  Data not available.

Dose Adjustments.

38.  Volume depletion, e.g., past and current diuretic use:

39.  Initial dose: 1.25 mg orally once a day.

Precautions.

BOXED WARNING:

40. FETAL TOXICITY: When pregnancy is detected, discontinue this drug as soon as possible.

41. Drugs that act directly on the renin angiotensin system (RAS) can cause injury and death to the developing fetus.

42.  Safety and efficacy have not been established in Patients younger than 18 years.

43.  Consult WARNINGS section for additional precautions.

Dialysis.

44.  Data not available.

Other Comments.

Administration advice.

45.  Capsules may be opened and sprinkled in 4 ounces of applesauce, apple juice, or water; mixture may be stored 24 hours at room temperature or 48 hours refrigerated.

Monitoring.

46.  Monitor serum potassium periodically.

47. In hypertensive Patients with unilateral or bilateral renal artery stenosis, monitor renal function during the first few weeks of therapy.

48. Consider monitoring white blood cells in Patients with collagen vascular disease, especially if associated with renal impairment.

Drug interactions between Spironolactone - Aldactone and Ramipril.

49.  Results for the following 2 drugs:

50.  Aldactone - Spironolactone.

51.  Ramipril.

Consumer.

Professional.

52.  Interactions between your selected drugs.

53.  Major.

54.  Spironolactone ↔ Ramipril

55. Applies to: Aldactone - Spironolactone and Ramipril. 

56. Using Ramipril together with Spironolactone may increase the levels of potassium in the Blood - hyperkalemia, especially if dehydrated or have kidney disease, diabetes, heart failure, or if an older adult.

57.  Hyperkalemia can cause symptoms such as weakness, confusion, numbness or tingling and uneven Heartbeats.

58. If a medically qualified  Doctor prescribes these medications together, a dose adjustment or special tests to confirm safely of taking both medications - may be required.

59.  It is important to tell a Doctor about all other medications in use, including vitamins and herbs.

60.  Do not stop using any medications without first talking to an attending  Doctor. 

61.  Switch to professional interaction data.

62.  Not all side effects for Ramipril  may be reported.

63. Consulting a Doctor or Healthcare Professional for medical advice is always recommended.

64. With all these 194 side-effects how could any Doctor or Patient keep track of these - surely it would take a computer of greater capability than current available - then would anyone know what to do with the results.

A. Known or reported side-effects or a legal notice of "we are not responsible as we published" a marker or Disclaimer for damage limitation of the negative side-effects of Ramipril...

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Ramipril.

Section. 88.

1. Having explored the side effects of Ramipril... is in not fitting we include the Medications Ingredients whether they are active or not.

 

2. Ferrosoferric Oxide 0r: Ferric ferrous oxide; triiron tetraoxide; black iron oxide; magnetic iron oxide; Ethiops iron.

A. Melting point: mp 1538°.

B. Practically insoluble in water.

C. Soluble in acids.

1. As red-black lumps magnetic iron oxide Fe3O4 is found in nature as magnetite and also obtained synthetically from iron by heating in steam.

D.  Or from a ferrous salt and an alkali by precipitation and oxidation and used chiefly as a pigment in paints, linoleum, ceramic glazes; in colouring glass; as a polishing compound; in the textile industry; in cathodes; as catalyst and polishing material - called also iron(II,III) oxide.

3. Potassium Hydroxide is an inorganic compound with the formula KOH, and is commonly called caustic potash.

A.  Along with Sodium Hydroxide, this colorless solid is a prototypical or Strong Base..

B.  It has many industrial and niche applications, most of which exploit its corrosive nature and its reactivity toward Acids.

C. KOH is noteworthy as the precursor to most soft and liquid soaps as well as numerous potassium-containing chemicals.

4. It will be helpful to note there are Six other ingredients for the Body Organs to cope with.  

5.  Conclusion. Before taking this medicine:

A.  Ramipril is used to treat high Blood pressure - hypertension or congestive Heart failure and to improve survival after a Heart Attack.

B. Use of this medicine is not recommended if allergic to ramipril or to any other ACE inhibitor, such as benazepril, captopril, fosinopril, enalapril, lisinopril, moexipril, perindopril, quinapril, or trandolapril.

C.  Recommendations for Diabetes, do not use Ramipril together with any medication that contains - aliskiren - Amturnide, Tekturna, Tekamlo, Valturna.

D.  There may also need to avoid taking ramipril with Aliskiren if there is a presence of kidney disease.

E. To make sure ramipril is safe, tell a Doctor if  there is a presence of these illness:

F.  Kidney disease - or if on dialysis.

G.  Liver Disease.

H. Diabetes.

I. Also with the diagnoses of Diabetes, do not use Ramipril together with any medication that contains aliskiren - Amturnide, Tekturna, Tekamlo, Valturna or a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis.

J. Leaving one to question. "With some 194 known reported or possible side effects," for how long is the medication able to maintain the symptom suppression desired.

1. Moreover with it appears so many Doctors desperate to fulfill Government Guidelines by Diagnosing everyone with Diabetes - including myself.

2. If we just seek to include items B. C. and D and ignore the known side effects how would anyone be able to compute the negative effects of these mediations or chemicals on a Mind and Body.

3. In addition; As Items F and G are implicated to be caused as side-effects from one or all of the medications involved in this paper by what protocol is this able to be Scientifically Proven and of Clinical not a Hypothetical-Hypotheses value.

Known or possible side effects = 194.

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Section 89.

 ...Total Known or Possible Side-Effects for all four medications.

1. Spironolactone = 114. 

2. Amiodarone = 334.

3. Bisoprolol = 195.

4. Ramipril =194.

5. Approximate Total = 837.  

6. Conclusion: Whilst is must be recognised - our many Dedicated Doctors and Specialists in the world of Scientific Medicine and indeed all of the Complementary and Alternative treatment approaches available for the many diverse and ever changing symptoms of Mind and Body a Person is able to present, are without doubt doing the very best possible with the knowledge base currently known.

A. As to finding the cause of illness of Mind and Body and how to apply an effective treatment to cure instead of manage - is quite a different matter.

B. It will also be noted on these four medications and is clear to see - there are approximately Eight Hundred and Thirty Seven  - known or possible side-effects a Person on these medications is able to develop within the entire Body Chemistry. 

C. Not even the most highly trained practitioner using the latest chemical analysing machines would be able to keep track of the symptoms by using any form of medication, lotion or potion symptom management - before the Mind created as a result of the applied treatments and quicker than the speed of light; new and even more mysterious symptoms.

C.  It will also have been noted there are so many side-effects or symptoms shown with each Medication it would surely be next to  making it near to  impossible to determine which medication caused which effect.

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Section 90.

Question 10. Are you able to explain why side-effects happen, if the medications are not to be considered solely responsible?

Answer. 10. Nice question and thank you.

A. There surely can be no doubt with the many medications and the requirement of profit from the research to develop the mediations and the worldwide market to sell these medications having to be somewhat coersed  into buying them - no different to many other products whilst the customers may well be there, first they have to be willing to buy, more important an Person or Patient must not be created to buy or require medications.

B.  We are all Children of Parents or in the main Parents of Children.

C. As Children ourselves like our own Children we are subject to traumas that interfere with our entire Body Chemistry.

D.  In the process of maturing we have cause to plan our future and our Children is part of this process.

E. In our loving ways and in order to protect our Children from traumas in the same manner as ourselves - we overly control our Children and in so doing make their life; ours and in this process cause Anxiety - often with no known cause.

F. This Anxiety in turn and time - instead of being able to relieve it we turn it on ourselves and thus it becomes a weapon - mostly of self-destruction and of those whose lives we touch.

G. Time passes and the now painful Anxiety is insidiously altered to what will be known and treated as Biological Symptoms that have to have a biological treatment.

H. This process includes the Brain - thus confirming all illness is of a biological; albeit unknown and often mysterious cause.

I. These symptoms in order to relieve the Anxiety have to be understood and in turn presented to - first a Parent; who in order to protect themselves and complicity in the process of illness creation, insist a Doctors visit must be made.

J. The Doctor with all the wisdom and scientific data to hand makes a diagnoses and issues a prescription.

K. Seemingly as time passes either the symptoms disappear or become worse or more diverse. Requiring another medication.

1. These are now known as Side-Effects from Medications.

2. Had the medication not been applied the natural side-effects would take a course not created by the consumption of Poisons to the Body and Mind, thus the Immune Systems would very likely be able to resolve them.

3. If they do not no amount of medications will ever alleviate the symptoms.   

Conclusion 10. It makes not much difference which of these processes take top spot - no one notice's as the treatment was never for the Person with the Anxiety or the presenting symptoms - it was to relieve the Anxiety of the Parents and or the Doctors.

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Section 91.

Question. 11. Have you or have you not made the case for the use or not of Diuretic Medication as a treatment option?

Answer. 11.  Interesting question of which there are surely two answers. Yes and No.

A. Based on the serious amount of information from the medical profession and the current understanding of illness along with the complicity of perhaps every Person on the planet - whether ill or not or for Profit only; until we all accept. "All" illness is a Process of the Mind following Childhood Emotional and or Physical Traumas that effects the entire Body Chemistry...

B. ...It is the very best we can expect and thus nothing in real-terms anything to do with the Body - although the biological destruction of the Body may appear to contradict this.

C. Thus there is a requirement for Diuretic Medications only because previous symptom presentations have only been made worse by multiple medications and their side-effects.

Conclusion. 11.  Much debate is made of the complex nature of illness within the Brain and Body from a Biological point of view - yet strangely not much if anything at all on the Mind and its incumbent thoughts be they positive, negative, or indifferent and the effects this process has on the entire Body/Blood Chemistry; especially in the process of creating illness symptoms that brings about the requirement of Diuretic medication.

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Section 92.

1. In reading and or accepting the comments contained in this entire document one has to also consider they are a collection of the medical profession and perhaps a number of pharmaceutical companies or a collection by others of the publicly published information.

2. Along with my Professional and Personal experience - thus unless specifically or personally applied, should not be taken as an indication of medically or Talking Cures approved advise.

3. Please use the information as a tool for a better understanding of scientifically proven medical issues - as illness may be considered a weapon of self destruction; with, as yet of unknown medical cause. 

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Section 93.

1. May we now explore the pathway the Mind and Body takes leading up to including and post the symptoms that require the application of a Diuretic medical intervention...

A. Diuretic medication has the sole or intended purpose of removing water build up in areas of the Body and in amounts not conducive to allowing the Body to function in a balanced and natural and comfortable manner.   

B. Whilst there must be a consideration water will build up in every area of the Body for this exercise we are going to concentrate on three areas - two we cannot see with the naked eye and the lower legs.

C. The two we are unable to  see are the Heart and Lungs and the legs encapsulated within the largest organ of the Body - the skin, being a visible signal or clue - either there is something wrong in the Body or in the presence of a Diuretic medication something not quite right - everywhere.

D.  For any organ of the Body not to work as designed - like all machinery even a computer, there has to be instructions and these instructions only ever arise within the Mind where we must be aware for the Person and for the Mind, illness as an outcome, is not something wrong; it is a demonstration something is terribly wrong in the Mind and has created an Anxiety that cannot automatically be relieved.

1. Where the Person as a result of a Mind interfering trauma makes biological reactions - via Fear.

E. Below is a numbered list that will relatively speaking apply to everyone irrespective of the diagnosed symptoms that identifies from the very start of the process - to the eventual requirement  of a Diuretic medication and the not so readily considered consequences of such an application that has the sole intention of improving the quality of a Person's life... 

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Section 94.

1. Fear lowers the Body temperature - sends the Person right to the very core, cold inside and out. No tests will ever prove or disprove this as the Mind/Body has already compensated for the apparent imbalance by re-establishing through Osmotics; a new entire Body chemistry balance.

2. As the Fear now is set and cannot be automatically resolved - the resulting anxiety, although with biological presentations is an emotion only for short-term use, set to activate with no apparent direct warning or demonstrable reason; in order to maintain the core temperature. 

3. Inadequacy - unable to cope with life's demands.  The biological reaction to this sets the foundation for ALL illnesses that occur in the entire life of a Person. NO Exception.

4.  Body Chemistry becomes both Toxic and Caustic and lacks sufficient Oxygen - acting as an exciter to the Mind.

5. The Mind in order to improve the Body temperature instructs - via emotional response, generally speaking but not exclusively; Anger in Men and Aggression in Women,  organs of the Body to work harder to ensure the core temperature is maintained.

6. Namely The Heart - which has to pump harder for the same effect and the Lungs that struggle to work as the Blood for Lungs to work is less Oxygenated, thus Toxic and Caustic (one may wish to consider both of these terms can indicate - Acidic) which creates Heat the Body is now unable to cool; as it is on instructions from the Mind, the heat is created.

7. The Body/Mind sense the Heat as being unnatural and seeks to mitigate this by collecting water as a cooling agent in and around the Heart and Lungs rather like condensation on a cold surface. 

8. Making the pumping and oxygenating of the Blood more difficult causing the Body to -  as the retaining of the water in no longer in its natural control, store the excess water in areas of the Body now unable to cope in a satisfactory manner. In this instance - at the far end of the Hearts pumping ability, the legs. 

A.  Once this process is started the Body is unable to restore the natural osmotic balance.

9. The third organ of the Body - the legs we spoke of earlier - now acts as a window to the world in order for the Mind to obtain the "understanding required," of the originating Fear cause.

10. We cannot altogether blame the medical profession - for our failing to or accepting of, recognising the skin drying and shriveling is a sign to be recognised something is wrong. thus we dismiss this as getting old or old before our time.

11.  There are many ways the skin will demonstrate there is a something more than skin deep going on - with eruptions and disorders like Psoriasis and Lupus - names of no value in understanding the process so eloquently hidden from view. Demonstrating the Skin has been sacrificed in order to protect the internal organs.

12. With such skin damage comes the call. "Go to the Doctor" and get something for that skin problem - the dry and withered skin now completely ignored or accepted.

13. The Doctor willingly obliges based on the. "Data or Evidence Base" ignores the overall value of the Skin and makes a diagnoses or even prescribes a medication of some description or other.

A.  Having first if only to themself - applied a diagnoses or posh  recognisable name; to the skin symptom presentation.     

14. This is described in Section 6 Item 25 and 26. Turgor, now offers clues to the eventual destructive use of Diuretics.

A. Turgor: The degree of elasticity of skin, sometimes referred to as skin turgor.

1. The assessment of skin turgor is used clinically to determine the extent of Dehydration, or fluid loss, in the Body.

2. The measurement is done by pinching up a portion of skin - often on the back of the hand between two fingers, so that it is raised for a few seconds.

3. The skin is then released to observe how fast it returns to its normal - flat position.

4. If no dehydration is present, the skin returns quickly to the normal position.

5. With moderate to severe dehydration, decreased skin turgor causes the pinched-up skin to remain elevated and only slowly return to its flat position.

15. As we have discussed the skin is only a signalling agent - something is wrong, thus is a sacrificial organ for no matter how bad the skin is damaged in general it will not take a life.

16. As the signals from the skin are ignored - the Mind/Body has to gather the required understanding in a different manner and there are many - however we are for this instance only interested in the process that leads to the use and effects of Diuretic Medications.

17. Had the skin situation been recognised as Dehydration - thus a signal something is wrong with the internal operation of the Body: a dry mouth and unquenchable thirst was a serious clue; this sadly may not have  been - dismissed by the diagnoses of Diabetes.

18. The pathway to the end product; a set of symptoms recognised as now fitting the Scientific Data - can be long and arduous, often taking many decades of emotional unrest symptom presentation and numerous medications.

A. leading up to: A Heart attack, Arrhythmias and the often associated Breathing problems. Of course all attributed to High Blood Pressure, high Cholesterol and of course the swollen legs - Clearly demonstrating the Body is retaining Water and thus must be medicated to remove what is considered the excess. 

19. Following the clinical guidelines a Cardiologist or Doctor would prescribe Spironolactone - one of a number of Diuretics available in 25, 50, or 100MG doses depending on the degree of water retention observed or diagnosed and the desired effect.

A. It appears there is a recommended maxim limit of 400mg daily although there is a possibility depending on a Doctors advise and requirement this may be increased. 

20. My Spironolactone prescription was 25mg which I took for five days. Having considered the side-effects of just this one medication - two months later; I have also questioned, are the other three medications or their combined effort, having a Diuretic effect as well.

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Section 94.

21. So what are the long-term effects on my Mind and Body.

22. We started this with. "Medical Science allows us to understand the Human Body is 98% Water - to which they have the scientific proof do they not - thus we are obliged to accept these findings.

A. We all know water is a seriously precious commodity that life cannot exist without; so why waste it."

23. With my Heart already compromised having had a Heart attack near Twenty Five years ago still demonstrating the muscle is scarred and if we as a result accept - entering into Arrhythmias on a regular bases; can extracting water at perhaps +/- twice the amount consumed lead to an improvement in Heart and general health or create more symptoms as side-effects.

24.  If the information in 23 above is to be accepted - how may we observe this in my or any other Persons Body.

A.  Firstly we have to accept I only took the Spironolactone for Five Days and in this time I was passing infinitely more than the amount of water consumed and in so doing there was a new pain in both my kidneys.

1. Two months later although the kidney pain resolved, I have to consider - one or all three of the medications I have been prescribed and still taking are having a Diuretic effect.

25.  Leaving us to explore the long-term effects of this on my Mind and Body.

A.  As a therapist I never attempt to predict the future outcome of Talking Cures treatment on a Patient or myself - however with medications effects on my Mind and Body, perhaps we can make an exception in this case.

B. At the moment at the age of near 73, the ability of my skin to return to normal following a pinch is very good, more over when I am out - I am often complimented with; I look younger than my years.

C. Whilst I must confess my Lips are a little dry - not requiring a moisturizing agent and my mouth moist - not requiring consuming lots of Water and more importantly apart from my stomach being a little more padded than I would desire, the rest of my Body, is not swollen, thus I consider at this time I am quite normal.

D. However I am very mindful had I continued the Spironolactone  it may not have been very long before my entire Body demonstrated by the skin now all wrinkled drawn and grey would have been seriously Dehydrated as indeed would every cell in my Body and my Mind would respond by insidiously adjusting the entire Body Chemistry;  making it more Toxic, Caustic and Acidic - and in the process causing a  further lacking in well Oxygenated Blood.

E. Although my own treatment on myself appears to be improving my Heart function with the Ejection Fraction improved,  It is reasonable to consider continuation of the Spironolactone would create the very symptoms it was prescribed for: My heart not pumping properly My Lungs not functioning well - leading to my Blood not being properly Oxygenated and  all the Organs of my Body slowly insidiously over perhaps many years, closing down thus bringing an untimely and perhaps a very Painful of Mind and Body, exit from this world. 

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F. May we remind ourselves of Section. 3. 9.

1. Many People with health problems such as Heart failure and Kidney failure may as far as their medical teams believe - need Diuretic Medications to help their Body and Kidneys deal with the fluid overload of edema - a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the Body.

G. Sadly it appears no one, has, or perhaps would make the connection - only on Post Mortem, with surprise and bewilderment would the mortician find the Lungs and Heart were like Sponges and would scratch their head asking, "why are they full of water," then throw the useless organs away and not blink or even look back to see or ask - why this in reality happened.

F. And most certainly not make the connection of the Minds activity in constantly adjusting the entire Body Chemistry in accordance with instructions required - resulting from emotional and or physical traumas. Now made more complex by the addition of the poisonous effect on the Body; emanating from the many possible side-effects of the medications intended to assist or create improvement in the Persons health - instead of the destructive effects of illness.

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Section 95.

Question. 12. Would it be a fair observation to suggest you have missed in your answer to conclusion -  Section 93. 1. B. with these words "three areas." a very important factor?

Answer. 12.  It is fair. It was not so much I missed something, although most serious in the understanding of the - damage Diuretic Medications create in a Body; it did not altogether fit in the Main three items: Heart, Lungs and Legs - we used as an entry and example.

Question 13.   Correct me if I am wrong it is Muscles and Water loss; you refer too?

Answer.  13. Correct - let us explore this.

A. As a lateral (sideways) look at Skin in illness as well as Diuretic Medication use, we can include Muscles - for without these having natural Tonus, which dehydration would create.

1. The entire Body is no longer able to stand erect and thus function in a manner allowing ALL of the organs to function in a comfortable manner.

B. These type of symptoms can often be observed - where a Person is no longer able to keep their Head erect; thus the chin ends up permanently on the Chest, making breathing difficult to impossible.

C. The harder it is for the Person to Breath the more Toxic and Caustic the entire Body chemistry and effectively Oxygenated the Blood becomes - causing confusion to set in as the entire Body begins the slow but deliberate and insidious process of shutting down, as it is unable to comply with the activity of the Mind as a result of significant others thinking their Child's Mind was theirs to control.

Question 13. Conclusion.

Muscle wastage.

A. We discussed in item 142…

1. …Creatinine is the process of the continuous breakdown of Muscles.

2.  Creatinine is then transported around the Body and becomes high energy.

3.  Ultimately it is removed from the Blood chiefly by the Kidneys.

4.  If the filtration in the Kidney is deficient, Creatinine Blood levels rise.

B. Surely this information alone is sufficient to consider the effects of any medication that promotes water excretion from the Body is only at the expense of all other organs and in the short-medium to long-term - not therapeutic at all.

C. The effects of the use of Diuretics can be observed with an every day experience.

1. If we leave an Apple in the fridge or in a bowl on the kitchen worktop - it will last fresh and eatable for quite a long-time.

2. Pierce the skin and soon the apple will go brown and be uneatable as it Dehydrates.

3. Would this not be the same with a Body - if a drug forced the Body to excrete water in ways, it is not designed too. 

4. In addition any Dehydration or excretion of  water from the muscles and skin causing all any other organs to suffer the same poisonous attack.

A. Moreover - Water can no longer be  consumed even to excess to provide hydration of the skin, muscles and organs. 

B. Moreover item - Question 13 Conclusion A 2 possibly holds clues - as to the biological cause of that next to Blood - greatest mystery of all. Fatigue; that no amount of rest, dietary considerations or medications changes will alleviate.

B. Like the Parents and significant loved ones who created the illness in the first instance - the Medial Profession; is still today as we close 2016... Blindly doing what they have always done as this is what they always got - illness that only pretends to improve. 

Section. 96.

Question. 1. Accepting on the face of it you are harsh when it comes to the activities of the Medical Profession, would I be correct you are not harsh towards our many Doctors and Front line clinicians.

Answer. 1.  My feeling are as previously and many times stated - I most seriously recognise the dedication of all front-line practitioners.

A. Sadly I never see any evidence - although this is beginning to change, that demonstrates and is being questioned -  "why they are not being really successful" or. "Why is Medical Science not as successful as the Scientific Evidence appears to demonstrate."

B. May I satisfy your question with information that fits nicely within this paper.

C. Whilst I can make comment as to how many chemicals there are in Blood - I do recognise it is only a guess as still today Medical Science who I rely on for such information; still has not made a definitive count.

D. The same must be said for medications - although the list must be incredibly long. 

E. As we have discussed in this document there are with just four medications over 800 known and reported side effects.

F. Therefore it is to be considered a Super Human feat of knowledge and endurance for our dedicated front line medical staff to  take a list of the symptoms  presentation from a Patient.

G. Diagnose the many symptoms into a named illness and then from all of the many hundreds and thousands of medications - pick the ones suited to the presented symptoms for best management and then after all of this compute what is a real symptom from known side effects - that are often the same as the presenting symptoms.

H. All of this deserves support for their dedication even if the outcome is as so often reported - not the success desired.    

… or is the entire Medical Profession clearly confused and badly in error.

Kindest regards and best wishes

Peter Smith Talking Cures    

We all have a lot to teach and a lot to learn and learn we must.

This is my truth now tell me yours - change someone's Mind.

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...In illness - The Mind/Brain/Body is not in the slightest doing something wrong, it is desperately trying to right a serious and terrible wrong?

"No apologies are made if this paper is seen as repeating or simplistic, for too long Scientific Medical Papers have been written in a manner no one truly understands, if this were not so, cures would have long since been found making this paper and Talking Cures unnecessary or redundant.

Whilst it must be recognised, the framework - part of the content, for this paper is in the public domain and credit given to the authors;

Peter Smith Talking Cures asserts the right to be recognised as author and Intellectual ©Copyright holder of his contribution to this document."

Diuretic. Explored Understood Explained." Author Peter Smith Talking Cures Copyright 21st November 2016.

Thus, in keeping with the generosity of many contributors - this document is free to use as an Education or Patient led assistance - in its entirety.

Talking Cures is a Twenty First Century Medicine...

...able to treat multiple symptoms of Mind and Body in a Person.

Via Telephone 01702 603030 or Skype. Talking.Cures

Criticisms and comments however harsh are welcomed and warmly responded too and seen as an accolade far greater than a United Kingdom Knighthood or Noble Prize.

Please feel invited to mail with questions or comments about this web site

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