Traditional Medicine vs Modern Medicine

Diphenhydramine is an antihistamine used for treating allergic reactions. Histamine is released by the body during several types of allergic reactions and--to a lesser extent--during some viral infections, such as the common cold. When histamine binds to its receptors on cells, it stimulates changes within the cells that lead to sneezing, itching, and increased mucus production. Antihistamines compete with histamine for cell receptors; however, when they bind to the receptors they do not stimulate the cells. In addition, they prevent histamine from binding and stimulating the cells. Diphenhydramine also blocks the action of acetylcholine (anticholinergic effect) and is used as a sedative because it causes drowsiness. The FDA originally approved diphenhydramine in 1946. Diphenhydramine is used for the relief of nasal and non-nasal symptoms of various allergic conditions such as seasonal allergic rhinitis. It is also used to alleviate cold symptoms and chronic urticaria (hives). Although antihistamines are the preferred class of drugs in allergic rhinitis, they only reduce symptoms by 40%-60%. Diphenhydramine also is used for allergic reactions involving the eyes (allergic conjunctivitis), to prevent or treat active motion sickness, and for mild cases of Parkinsonism, including drug-induced Parkinsonism. The last two uses (motion sickness and Parkinsonism) are based on the anticholinergic effects of diphenhydramine, and not its antihistamine effects. Diphenhydramine is also used for treating insomnia. DOSING: Diphenhydramine has its maximal effect about one hour after it is taken. When used to combat insomnia, it is prescribed at bedtime. Patients over the age of 60 years are especially sensitive to the sedating and anticholinergic effects of diphenhydramine, and the dose should be reduced. Doses vary depending on formulation. A common regimen for treating adult allergic reaction is 25-50 mg every 4-6 hours not to exceed 300 mg daily. DRUG INTERACTIONS: Diphenhydramine adds to (exaggerates) the sedating effects of alcohol and other drugs than can cause sedation such as the benzodiazepine class of anti-anxiety drugs [for example, diazepam (Valium), lorazepam (Ativan), clonazepam (Klonopin), alprazolam (Xanax)], the narcotic class of pain medications and its derivatives [for example, oxycodone and acetaminophen (Percocet), and hydrocodone and acetaminophen (Vicodin), guaifenesin with hydromorphone (Dilaudid), Codeine, propoxyphene (Darvon)], the tricyclic class of antidepressants [for example, amitriptyline (Elavil), imipramine (Tofranil), desipramine (Norpramin)], and certain antihypertensive medications [for example, clonidine (Catapres), propranolol (Inderal)]. Diphenhydramine can also intensify the drying effects of other medications with anticholinergic properties [for example, dicyclomine (Bentyl), bethanechol (Urecholine), Probanthine].

Alprazolam is an anti-anxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others. Alprazolam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders. The FDA approved alprazolam in October 1981. PREPARATIONS: Tablets: 0.25, 0.5, 1 and 2 mg. Tablets ER (extended release): 0.5, 1, 2 and 3 mg. Tablets (Orally disintegrating): 0.25, 0.5, 1 and 2 mg. Solution: 1 mg/ml STORAGE: Alprazolam should be stored at room temperature, 15 C to 30 C (59 F to 86 F). PRESCRIBED FOR: Alprazolam is used for the treatment of anxiety disorders and panic attacks. Anxiety disorders are characterized by unrealistic worry and apprehension, causing symptoms of restlessness, aches, trembling, shortness of breath, smothering sensation, palpitations, sweating, cold clammy hands, lightheadedness, flushing, exaggerated startle responses, problems concentrating, and insomnia. Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of alprazolam. DOSING: Alprazolam may be taken with or without food. The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily. The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily. The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily. DRUG INTERACTIONS: Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam. Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation. Carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol) and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver. PREGNANCY: Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy. NURSING MOTHERS: Alprazolam is excreted in breast milk and can affect nursing infants. Therefore, it should not be used by women who are nursing. SIDE EFFECTS: The most frequent side effects of alprazolam taken at lower doses are drowsiness or lightheadedness, which probably reflect the normal actions of the drug. Side effects of higher dosages (those used for panic attacks) include fatigue, memory problems, speech problems, constipation, and changes in appetite with resultant changes in weight. Alprazolam can lead to addiction (dependency), especially at high doses over prolonged periods of time. Abrupt discontinuation of alprazolam after prolonged use can lead to symptoms of withdrawal such as insomnia, headaches, nausea, vomiting, lightheadedness, sweating, anxiety, and fatigue. Seizures can occur in more severe cases of withdrawal. Consequently, patients on alprazolam for extended periods of time should slowly taper the medication under a doctor's supervision rather than abruptly stopping the medication.

XANAX Tablets contain alprazolam which is a triazolo analog of the 1,4 benzodiazepine class of central nervous system-active compounds. The chemical name of alprazolam is 8-Chloro-1-methyl-6-phenyl-4H-s-triazolo [4,3-α] [1,4] benzodiazepine. Alprazolam is a white crystalline powder, which is soluble in methanol or ethanol but which has no appreciable solubility in water at physiological pH. Each XANAX Tablet, for oral administration, contains 0.25, 0.5, 1 or 2 mg of alprazolam. XANAX Tablets, 2 mg, are multi-scored and may be divided as shown below: Inactive ingredients: Cellulose, corn starch, docusate sodium, lactose, magnesium stearate, silicon dioxide and sodium benzoate. In addition, the 0.5 mg tablet contains FD&C Yellow No. 6 and the 1 mg tablet contains FD&C Blue No. 2. What are the precautions when taking alprazolam (Xanax)? Before taking alprazolam, tell your doctor or pharmacist if you are allergic to it; or to other benzodiazepines (such as diazepam, lorazepam); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: severe lung/breathing problems (such as COPD, sleep apnea), liver disease, kidney disease, drug or alcohol abuse, glaucoma. This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages. XANAX Tablets Labels