(3) take “the pill”
(3) Proguanil (Paludrine®):
There are several dangerous myths regarding Chloroquine (Nivaquine® or Daramal® or • Prophylaxis does not make the diagnosis • Dosage: Two tablets every day starting one • It does protect against the development of week prior to exposure until four weeks after. • Contra-indications: Known allergy to • Prophylaxis is not 100% effective - hence the Proguanil. Interactions with Warfarin (An anti-coagulant/blood thinning agent that is • Not all anti-malaria medication is safe with • Side effects: Heartburn (Tip: take after a • Malaria is often fatal – making prophylaxis meal, with a glass of water and do not lie down shortly after taking Proguanil); mouth Anti-malaria drugs, like all drugs, have potential ulcers (Tip: take folic acid tablets, 5 mg per side effects. The majority of side effects day, if this occurs); loose stools (self limiting decrease with time. Serious side effects are rare and can be avoided by careful selection • Use in pregnancy: Safe, but must be taken of a tablet or combination of tablets to suit your with a folic acid supplement: 5 mg per day. requirements (country, region and season). (Note: scuba diving is not considered safe The following drugs are available for the The combination of Chloroquine and Proguanil (1) Doxycycline (Vibramycin® or
is about 65% effective for resistant falciparum Cyclidox® or Doryx®, etc.):
malaria. Although not a first choice, its relative Doxycycline
• Used extensively in the prevention of safety and limited side effects may justify its use chloroquine resistant malaria. About 99% effective. Not officially recommended for (4) Atovaquone/Proguanil (Malarone ®;
use in excess of eight weeks for malaria Malanil ®):
prevention, but it has been used for as long • Registered in South Africa as a causal prophylaxis in February 2004. Safety in diving have used it with no adverse effects. Use • Dosage: 100 mg daily after a meal starting with caution. Additional sensitivity to motion one - two days before exposure until four weeks after exposure. Doxycycline should Preliminary data suggests it is safe for pilots. be taken with plenty of non-alcoholic liquid. • Effective against malaria isolates that are breasfeeding, children < eight years. • Controlled studies have shown a 98% overall • Side effects: Nausea, vomiting, diarrhoea, prevention of P. falciparum malaria.
vaginal thrush and may reduce the efficacy • Dosage: One tablet daily for adults, starting 24 - 48 hours prior to arrival in endemic • Use in pregnancy: Unsafe (as is scuba area, during exposure in endemic area and for seven days after leaving the endemic Doxycycline is DAN-SA’s agent of choice time each day with food or a milky drink. (2) Chloroquine (Nivaquine® or Daramal®
impairment (i.e. significant renal disease or Plasmaquine®):
is likely to be incompatible with diving). • Contains only chloroquine. Must be taken in Safety in children < 11 kg has not been combination with Proguanil (Paludrine®). • Dosage: Two tablets weekly starting one • Side effects: Heartburn (Tip: take after week before exposure until four weeks after lie down shortly after taking Atovaquone/ • Contra-indications: Known allergy, epilepsy.
photosensitivity (sunburn; prevention – apply • Use in pregnancy: Safety in pregnancy and • Use in pregnancy: Safe. (Note: scuba diving lactating women has not been established. is not considered safe during pregnancy.) (Note: scuba diving is not considered safe during pregnancy.) Autumn 2009 ALERTDiver 37

Source: http://www.dansa.org/downloads/autumm2009/print/page39.pdf

Microsoft word - nutrsg10.doc

Chapter 10:Study Guide Concept Questions: 1. Which tissues comprise total body fat and which comprise fat- free mass? 2. Discuss conditions in which fat cells can increase in size and number. 3. Why is it necessary to have some body fat? 4. List three roles for subcutaneous fat. 5. What is visceral fat? 6. What is cellulite? 7. Describe at least two differences between brown fat tissues an


The new england journal of medicineAlan Kadish, M.D., Alan Dyer, Ph.D., James P. Daubert, M.D., Rebecca Quigg, M.D., N.A. Mark Estes, M.D., Kelley P. Anderson, M.D., Hugh Calkins, M.D., David Hoch, M.D., Jeffrey Goldberger, M.D., Alaa Shalaby, M.D., William E. Sanders, M.D., Andi Schaechter, B.S.N., R.N., and Joseph H. Levine, M.D., for the Defibrillators in Non-Ischemic Cardiomyopathy T

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