Many viewers have left comments regarding the side effects of statin medications. These oral medications are used to lower cholesterol levels. The surgeons discuss risk factors and some specific side effects of statin medications. They also discuss the nocebo effect which is almost like the opposite of the placebo effect.

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General information is not medical advice
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Master Antipsychotic Side Effects: Extrapyramidal Symptoms

Extrapyramidal side effects (EPS) represent one of the most tested topics on psychiatry board exams. These motor disturbances occur due to antipsychotic blockade of dopamine receptors in the nigrostriatal pathway.

Remember the "DAAPT" mnemonic to identify the five major EPS presentations:

Dystonia

Acute sustained muscle contractions causing abnormal postures; often affecting neck, jaw, and eyes. Typically occurs within days of starting treatment.

Akathisia

Subjective feeling of inner restlessness with objective motor restlessness. Patients often pace, shift weight, or fidget constantly.

Akinesia/Bradykinesia

Decreased spontaneous movement and slowed movement, respectively. Often misdiagnosed as depression or medication non-response.

Parkinsonism

Triad of rigidity, bradykinesia, and tremor. Classical pill-rolling tremor at rest. Usually develops within weeks to months.

Tardive Dyskinesia

Late-onset, potentially irreversible choreiform movements. Typically affects orofacial muscles with lip smacking and tongue protrusion.

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Over a third of post-menopausal breast cancer patients who take aromatase inhibitors abandon their treatment, because the drug's side effects are so unbearable, according to researchers from Northwestern University. Aromatase inhibitors are typically given to patients following chemotherapy, radiation therapy, and breast cancer surgery, usually for about 5 years.

(USMLE topics) Hypercalcemia: calcium metabolism, hormonal control, etiology, diagnosis, symptoms, treatment, prognosis.

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The amount of calcium in circulation is MAINLY regulated by 2 hormones: parathyroid hormone (PTH) and calcitriol. PTH is produced in the parathyroid gland while calcitriol is made in the kidney. When serum calcium level is low, PTH is UP-regulated. PTH acts to PROMOTE calcium release from bones and REDUCE calcium loss from urine. At the same time, it stimulates production of calcitriol, which promotes absorption of calcium in the small intestine while also INcreases RE-absorption in the kidney. Together, they bring UP calcium levels back to normal. The REVERSE happens when calcium level is high. This feedback loop keeps serum calcium concentrations within the normal range.
HYPERcalcemia is generally defined as serum calcium level GREATER than 2.6 mmol/L. Because the total serum calcium includes albumin-bound and free-ionized calcium, of which only the LATTER is physiologically active, calcium levels must be corrected to account for albumin changes. For example, INcreased albumin levels produce HIGHER serum calcium values but the amount of FREE calcium may STILL be normal. On the other hand, in conditions with low blood pH, albumin binds LESS calcium; releasing MORE FREE calcium while the total serum calcium may appear normal.
Most symptoms of hypercalcemia can be attributed to the effect it has on action potential generation in neurons. High levels of extracellular calcium INHIBIT sodium channels, which are essential for DEpolarization. Hypercalcemia therefore REDUCES neuronal excitability, causing confusion, lethargy, muscle weakness and constipation. In most cases, excess calcium in the blood is a direct result of calcium release from bones as they break down, becoming weak and painful. As the kidneys try to get rid of the extra calcium, MORE water is also removed, resulting in dehydration, excessive thirst and kidney stones. Extremely high extracellular calcium may also affect cardiac action potentials, causing arrhythmias. Typical ECG findings include short QT interval, and in severe cases, presence of Osborn waves.
While hypercalcemia may result from a variety of diseases and factors, HYPERparathyroidism and cancers are responsible for about 90% of cases, with the former being by far the most common cause. In HYPERparathyroidism, PTH is OVERproduced due to benign or malignant growths within the parathyroid gland.
An existing cancer elsewhere in the body can cause hypercalcemia in 2 major ways. First, some cancer cells produce a protein similar to PTH, called PTHrP, which acts like PTH to increase serum calcium. Unlike PTH, however, PTHrP is NOT subject to negative feedback; consequently, calcium levels may keep rising unchecked. Second, cancers may spread to bone tissues, causing bone resorption or osteolysis, and subsequent calcium release into the blood.
Hypercalcemia treatment consists of lowering blood calcium levels with a variety of drugs, and addressing the underlying cause. While treatment outcome for hyperparathyroidism is generally excellent, prognosis for malignancy-related hypercalcemia is poor, possibly because it usually occurs in later stages of cancer.

Lorazepam is a medication that belongs to a class of drugs known as benzodiazepines. Benzodiazepines are a group of psychoactive drugs that have a depressant effect on the central nervous system, leading to sedation, muscle relaxation, and anxiety reduction. Lorazepam is commonly prescribed for the short-term treatment of anxiety disorders, as well as for managing symptoms of alcohol withdrawal, insomnia, and certain types of seizures.

Key points about lorazepam include:

1. Anxiolytic Effects: Lorazepam is primarily used as an anxiolytic (anxiety-reducing) medication. It works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. GABA inhibits the activity of nerve cells, leading to a calming and sedative effect.

2. Dosage Forms: Lorazepam is available in various forms, including tablets, oral solutions, and injectable solutions. The injectable form is often used in hospital settings to manage acute anxiety or agitation.

3. Short-Term Use: Due to the risk of tolerance, dependence, and withdrawal symptoms, lorazepam is usually prescribed for short-term use, typically not exceeding a few weeks. Prolonged or excessive use can lead to physical and psychological dependence.

4. Withdrawal: Abruptly stopping lorazepam after regular use can lead to withdrawal symptoms, including anxiety, restlessness, insomnia, muscle tension, and in severe cases, seizures. Tapering off the medication under medical supervision is usually recommended to avoid withdrawal complications.

5. Side Effects: Common side effects of lorazepam include drowsiness, dizziness, muscle weakness, and impaired coordination. Less common side effects may include memory problems, confusion, and changes in mood.

6. Precautions: Lorazepam should be used with caution in individuals with a history of substance abuse, as well as those with a history of depression or other mental health disorders. It's important to inform your healthcare provider about any medications you are taking, as lorazepam can interact with other drugs and substances, including alcohol.

7. Elderly and Special Populations: The effects of lorazepam can be more pronounced in the elderly population, leading to increased sedation and risk of falls. Dosage adjustments may be necessary for older adults. Pregnant and breastfeeding women should consult their healthcare providers before taking lorazepam, as it can potentially affect the developing fetus or infant.

8. Medical Supervision: Lorazepam should be taken under the supervision of a medical professional who can monitor its effects, adjust the dosage, and guide the discontinuation process when necessary.

It's important to note that lorazepam and other benzodiazepines are not recommended for long-term use due to the potential for dependence and other adverse effects. If you have concerns about anxiety or any other medical condition, it's advisable to consult a healthcare provider who can recommend appropriate treatment options based on your individual needs.