c******n
发帖数: 516 | 1 我妈高血压及血液粘稠很多年，一直吃降压药和拜尔阿司匹林，由于出国前带来的拜尔
阿司匹林吃完了，我老公在这里买了一小瓶试着让我妈吃看管不管用，我们根据他以前
吃的剂量是0.1g的肠溶阿司匹林，所以在这里就买了一瓶类似的，剂量是81mg的，叫
bayer low dose safety coated "baby"aspirin. 因为想多买一些带回去，所以不知道
买的对不对，望知道的朋友给讲一下，非常感谢。我查到的说是低剂量的阿司匹林口服
抗血栓，可以经常服用，可是这面买到的上面写着pain reliever，所以我就比较疑惑
，感觉高剂量才是解热止疼。另外，问一下大家在美国有没有什么药或者保健品对血液
粘稠比较管用？万分感谢。 |
m****8
发帖数: 419 | 2 i bought this one for my parents too |
r*****2
发帖数: 309 | 3 not quite familiar with aspirin used in China. Here we usually use baby
aspirin (81 mg) to decrease blood viscosity. I think the answer is yes, it
should be ok to treat your mom's condition. |
u*****0
发帖数: 156 | 4 Aspirin irritates the stomachs and might cause ulcers with prolonged use.
You might want to consider using Prevacid along with it.
Plavix is better than aspirin and is gentler to the stomachs than aspirin.
It is going generic soon. You can keep an eye on this med.
However, 20% of Chinese do not respond to Plavix. You need to run a genetic
test to determine whether your mom is a responder or not.
【在 c******n 的大作中提到】
: 我妈高血压及血液粘稠很多年，一直吃降压药和拜尔阿司匹林，由于出国前带来的拜尔
: 阿司匹林吃完了，我老公在这里买了一小瓶试着让我妈吃看管不管用，我们根据他以前
: 吃的剂量是0.1g的肠溶阿司匹林，所以在这里就买了一瓶类似的，剂量是81mg的，叫
: bayer low dose safety coated "baby"aspirin. 因为想多买一些带回去，所以不知道
: 买的对不对，望知道的朋友给讲一下，非常感谢。我查到的说是低剂量的阿司匹林口服
: 抗血栓，可以经常服用，可是这面买到的上面写着pain reliever，所以我就比较疑惑
: ，感觉高剂量才是解热止疼。另外，问一下大家在美国有没有什么药或者保健品对血液
: 粘稠比较管用？万分感谢。
|
u***e
发帖数: 611 | 5 plavix还不是OTC吧，也比较贵，一般tolerate不了aspirin的才换成plavix
楼主买的aspirin是对的。 |
u*****0
发帖数: 156 | 6 Generics = Off patents
OTC = No prescription needed.
Generics != OTC
OTC Tylenol is still brand name. Acetaminophen is the generic name for
Tylenol.
We will never see the day when Plavix goes OTC. But its generic med will be 80%-90% cheaper once the drug is off patent.
【在 u***e 的大作中提到】
: plavix还不是OTC吧，也比较贵，一般tolerate不了aspirin的才换成plavix
: 楼主买的aspirin是对的。
|
Y*Z
发帖数: 51 | 7 Hi, usmle10, I have a question: it was said that aspirin is 肠溶 aspirin,
do you think it still results in ulcer of the stomach? I am just wondering...
genetic
【在 u*****0 的大作中提到】
: Aspirin irritates the stomachs and might cause ulcers with prolonged use.
: You might want to consider using Prevacid along with it.
: Plavix is better than aspirin and is gentler to the stomachs than aspirin.
: It is going generic soon. You can keep an eye on this med.
: However, 20% of Chinese do not respond to Plavix. You need to run a genetic
: test to determine whether your mom is a responder or not.
|
Y*Z
发帖数: 51 | 8 Hi, usmle10, I have a question: it was said that aspirin is 肠溶 aspirin,
do you think it still results in ulcer of the stomach? I am just wondering...
genetic
【在 u*****0 的大作中提到】
: Aspirin irritates the stomachs and might cause ulcers with prolonged use.
: You might want to consider using Prevacid along with it.
: Plavix is better than aspirin and is gentler to the stomachs than aspirin.
: It is going generic soon. You can keep an eye on this med.
: However, 20% of Chinese do not respond to Plavix. You need to run a genetic
: test to determine whether your mom is a responder or not.
|
u*****0
发帖数: 156 | 9 Come and visit us often. Hope you were not offended or anything. I want to be as sensitive as I could.
【在 u***e 的大作中提到】
: plavix还不是OTC吧，也比较贵，一般tolerate不了aspirin的才换成plavix
: 楼主买的aspirin是对的。
|
u*****0
发帖数: 156 | 10 google: aspirin and ulcer.
...
【在 Y*Z 的大作中提到】
: Hi, usmle10, I have a question: it was said that aspirin is 肠溶 aspirin,
: do you think it still results in ulcer of the stomach? I am just wondering...
:
:
: genetic
|
|
|
d**o
发帖数: 618 | 11 额滴神啊，楼上又是那谁的马甲啊。我不是有意去识别的，实在是这个语言风格太独特
了啊。而且，为了吃aspirin而加吃proton inhibitor，或者为了吃波立维而做基因测
试，这个思路真是相当的奇特啊。我不得不说，相当的杀鸡用牛刀、、、
回复楼主，我虽然还没开始学医，不过正好对此略知一二，因为我爸吃aspirin眼角会
出血，所以一直吃波立维(Plavix)。但对大多数老人，长期吃baby aspirin是标准做法
，我亲见过这里的医生对年纪大的病人几乎一概建议吃baby aspirin。如果你妈以前一
直吃都正常，应该就不用担心usmle10说的溃疡的问题，因为副作用不会只限于胃，眼
角牙齿等很多地方都可能会有出血现象。 |
c******n
发帖数: 516 | |
u*****0
发帖数: 156 | 13 Thanks very much for not laughing out loud this time.
Prevacid might be an overkill for certain patients. But it is good for the
high-risk group. As a precaution, it can be justified if cost is not part of
the equation. I simply pointed out an option. It is up to the patient and
his doctor to make the decision.
Personalized medicine is the cutting-edge stuff. Not very many doctors know of the
genetic test. But the effectiveness has been scientifically proven. You
dont want to take a drug with all the side effects if it does not convey the intended benefits. Right?
Google: Plavix and Genetic Test. Your mom might not be a responder either.
Spend $500 for the test and thank me later.
=================================================================
My original post:
Aspirin irritates the stomachs and might cause ulcers with prolonged use.
You might want to consider using Prevacid along with it.
Plavix is better than aspirin and is gentler to the stomachs than aspirin.
It is going generic soon. You can keep an eye on this med.
However, 20% of Chinese do not respond to Plavix. You need to run a genetic
test to determine whether your mom is a responder or not.
=======
DOJO's comment:
【在 d**o 的大作中提到】
: 额滴神啊，楼上又是那谁的马甲啊。我不是有意去识别的，实在是这个语言风格太独特
: 了啊。而且，为了吃aspirin而加吃proton inhibitor，或者为了吃波立维而做基因测
: 试，这个思路真是相当的奇特啊。我不得不说，相当的杀鸡用牛刀、、、
: 回复楼主，我虽然还没开始学医，不过正好对此略知一二，因为我爸吃aspirin眼角会
: 出血，所以一直吃波立维(Plavix)。但对大多数老人，长期吃baby aspirin是标准做法
: ，我亲见过这里的医生对年纪大的病人几乎一概建议吃baby aspirin。如果你妈以前一
: 直吃都正常，应该就不用担心usmle10说的溃疡的问题，因为副作用不会只限于胃，眼
: 角牙齿等很多地方都可能会有出血现象。
|
c******k
发帖数: 237 | 14 呵呵，这已经超出 LZ 请问的本意了。
Usmle10, thank you for your post about plavix and genetic test. As far as I
know, current clinic guideline has yet recommended genetic test per primary
care setting at the present time. Further studies are needed to determine if
such test is meaningful and cost-effective. Please update me if you have
more information on this, especially the data collected from non-Caucasian
population. I'll keep my ears opened too. I am surprised that you mentioned
personalized medicine, which is indeed cutting-edge and requires not only
everyday clinical practice, but genetic and information technology. We
should have no doubt that medicine would be more personalized on the top of
standardization by the next decade.
the
of
and
know of the
the intended benefits. Right?
.
【在 u*****0 的大作中提到】
: Thanks very much for not laughing out loud this time.
: Prevacid might be an overkill for certain patients. But it is good for the
: high-risk group. As a precaution, it can be justified if cost is not part of
: the equation. I simply pointed out an option. It is up to the patient and
: his doctor to make the decision.
: Personalized medicine is the cutting-edge stuff. Not very many doctors know of the
: genetic test. But the effectiveness has been scientifically proven. You
: dont want to take a drug with all the side effects if it does not convey the intended benefits. Right?
: Google: Plavix and Genetic Test. Your mom might not be a responder either.
: Spend $500 for the test and thank me later.
|
u*****0
发帖数: 156 | 15 Yes, the genetic test is not in the guideline. Partly, it is because the
government and insurance companies do not want to pay for it.
Trust me, if your mom is on Plavix, have her tested out of your own pocket. |
d**o
发帖数: 618 | 16 Why should we trust you?!
以我作为病人家属立场而言，对你这个基因测试的建议不屑一顾，原因很简单，吃波立
维就是因为已经对aspirin不耐了，波立维是目前唯一的替代选项，即使基因测试出它
没有效果又如何，又不是说测出它有副作用，我不会因此改变我爸的treatment plan。
何况基因测试只是测无穷多个CYP基因里的一种，万一有别的现在还不知道的基因可以
消化clopidogrel呢？如果是做药代测出没有消化还比较有说服力。基因测试太新，不
成熟！
.
【在 u*****0 的大作中提到】
: Yes, the genetic test is not in the guideline. Partly, it is because the
: government and insurance companies do not want to pay for it.
: Trust me, if your mom is on Plavix, have her tested out of your own pocket.
|
u*****0
发帖数: 156 | 17 I love your attitude and your manner. Keep at it.
You can keep churning out "I dont understand why he treated you differently" and laughing out loud as I amuse you.
【在 d**o 的大作中提到】
: Why should we trust you?!
: 以我作为病人家属立场而言，对你这个基因测试的建议不屑一顾，原因很简单，吃波立
: 维就是因为已经对aspirin不耐了，波立维是目前唯一的替代选项，即使基因测试出它
: 没有效果又如何，又不是说测出它有副作用，我不会因此改变我爸的treatment plan。
: 何况基因测试只是测无穷多个CYP基因里的一种，万一有别的现在还不知道的基因可以
: 消化clopidogrel呢？如果是做药代测出没有消化还比较有说服力。基因测试太新，不
: 成熟！
:
: .
|
t*********m
发帖数: 360 | 18 very interesting.
USMLE 10, show your data. |
d**o
发帖数: 618 | 19 旧话重提，今天查到NEJM的这篇最新文章，报告是否缺乏CYP2C19基因并不影响clopidogrel的临床表现，可见的确没有必要做该基因测试。文章引言提到了那个FDA的警告，而结论间接cast doubt on this warning:
"In conclusion, our study shows that CYP2C19 loss-of-function variants do not modify the efficacy and safety of clopidogrel. Therefore, loss-of-function allele carrier status should not preclude the use of clopidogrel at currently recommended doses in patients with acute coronary syndromes whose condition is being managed conservatively. Although similar results were observed in patients with atrial fibrillation, larger studies will be needed to definitively rule out a genetic effect of the loss-of-function alleles in this patient population."
"Effects of CYP2C19 Genotype on Outcomes of Clopidogrel Treatment"
http://www.nejm.org/doi/pdf/10.1056/NEJMoa1008410
the
pocket
【在 d**o 的大作中提到】
: Why should we trust you?!
: 以我作为病人家属立场而言，对你这个基因测试的建议不屑一顾，原因很简单，吃波立
: 维就是因为已经对aspirin不耐了，波立维是目前唯一的替代选项，即使基因测试出它
: 没有效果又如何，又不是说测出它有副作用，我不会因此改变我爸的treatment plan。
: 何况基因测试只是测无穷多个CYP基因里的一种，万一有别的现在还不知道的基因可以
: 消化clopidogrel呢？如果是做药代测出没有消化还比较有说服力。基因测试太新，不
: 成熟！
:
: .
|
u*****0
发帖数: 156 | 20 Let me read the article first and get back to you later. But first of all,
I want to thank you very very much for not laughing at me this time. I
guess some people could change for the better.
clopidogrel的临床表现，可见的确没有必要做该基因测试。文章引言提到了那个FDA的
警告，而结论间接cast doubt on this warning。
【在 d**o 的大作中提到】
: 旧话重提，今天查到NEJM的这篇最新文章，报告是否缺乏CYP2C19基因并不影响clopidogrel的临床表现，可见的确没有必要做该基因测试。文章引言提到了那个FDA的警告，而结论间接cast doubt on this warning:
: "In conclusion, our study shows that CYP2C19 loss-of-function variants do not modify the efficacy and safety of clopidogrel. Therefore, loss-of-function allele carrier status should not preclude the use of clopidogrel at currently recommended doses in patients with acute coronary syndromes whose condition is being managed conservatively. Although similar results were observed in patients with atrial fibrillation, larger studies will be needed to definitively rule out a genetic effect of the loss-of-function alleles in this patient population."
: "Effects of CYP2C19 Genotype on Outcomes of Clopidogrel Treatment"
: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1008410
:
: the
: pocket
|
d****y
发帖数: 2180 | 21 看了一下文章的abstract, 结果看来基本上都是clopidogrel比placebo要好。
看到这一段，‘P=0.02 for interaction‘。 看来clopidogrel加上gain-of-function
allele疗效就是1+1〉2了。
" In contrast, gain-of-function carriers derived more benefit from
clopidogrel treatment as compared with placebo than did noncarriers
(rate of primary outcome among carriers, 7.7% vs. 13.0%; hazard ratio,
0.55; 95% CI, 0.42 to 0.73; rate among noncarriers, 10.0% vs. 12.2%;
hazard ratio, 0.85; 95% CI, 0.68 to 1.05; P=0.02 for interaction). "
clopidogrel
的临床表现，可见的确没有必要做该基因测试。文章引言提到了那个FDA的警告，而结
论间接cast
doubt on this warning:
do not modify the efficacy and safety of clopidogrel. Therefore, loss-
of-function allele carrier status should not preclude the use of
clopidogrel at currently recommended doses in patients with acute
coronary syndromes whose condition is being managed conservatively.
Although similar results were observed in patients with atrial
fibrillation, larger studies will be needed to definitively rule out a
genetic effect of the los: s-of-function alleles in this patient
population."
【在 d**o 的大作中提到】
: 旧话重提，今天查到NEJM的这篇最新文章，报告是否缺乏CYP2C19基因并不影响clopidogrel的临床表现，可见的确没有必要做该基因测试。文章引言提到了那个FDA的警告，而结论间接cast doubt on this warning:
: "In conclusion, our study shows that CYP2C19 loss-of-function variants do not modify the efficacy and safety of clopidogrel. Therefore, loss-of-function allele carrier status should not preclude the use of clopidogrel at currently recommended doses in patients with acute coronary syndromes whose condition is being managed conservatively. Although similar results were observed in patients with atrial fibrillation, larger studies will be needed to definitively rule out a genetic effect of the loss-of-function alleles in this patient population."
: "Effects of CYP2C19 Genotype on Outcomes of Clopidogrel Treatment"
: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1008410
:
: the
: pocket
|
