Tri-State Neighbor: South Dakota Farm Newspaper

Q:I have had a violent cough for several months and have been treated with four different medications, a chest X-ray and a blood test, all to no avail. I started taking lisinopril about the time this all began and noted that a cough was one of the side effects. When I asked my doctor, though, I was told that the drug was not the cause.

I have not been able to get restful sleep because of the constant coughing. Have you ever heard of such a reaction to this medication?

A:ACE inhibitors (benazepril, captopril, enalapril, fosinopril, lisinopril, quinapril and ramipril) are prescribed to lower blood pressure. They're very effective and usually well tolerated.

A persistent cough that doesn't respond to cough medicine is a common complication, however. One study from South Korea found that a daily iron supplement, ferrous sulfate, may help ease this symptom (Hypertension, August 2001). If not, your doctor might consider a different blood pressure drug.

Q:Years ago, you wrote about an enzyme in pineapple juice that helps with arthritis pain. At that time, I was in my early 40s and already having pain in my hands and feet from arthritis.

I started drinking one glass of pineapple juice a day, and my symptoms cleared up. I may eventually develop arthritis, but hopefully it will not be as severe as it would have been.

A:Pineapple juice contains bromelain, which appears to have anti-inflammatory activity. One study found that a product containing bromelain (Phlogenzym) was effective in easing discomfort from hip arthritis (Clinical and Experimental Rheumatology, January-February 2006).

Q:I've had success with Listerine for smelly feet. If it kills germs that cause bad breath, it might knock out germs that cause stinky feet.

I applied Listerine to clean feet and wiped out the insides of my shoes as well. At the end of the day, both feet and shoes are odor-free.

A:The herbal extracts and alcohol in Listerine are versatile for battling fungi and bacteria that can cause odor or itch.

Q:How much ibuprofen can a person take and for how long before needing to talk to a doctor? I have read that stomach upset might indicate problems. I can't really take any NSAID or aspirin unless I eat a “mini-meal” at the same time. Otherwise, my stomach hurts.

I was taking 1,600 to 2,400 milligrams per day of ibuprofen for weeks before surgery, and I expect to need some medicine to help with pain relief throughout my physical therapy.

As long as I eat with each does, my stomach feels OK, but I'm trying to lose weight. I am also concerned about what the medicine could be doing to my insides. Any information you can provide on other approaches to pain relief would be greatly appreciated.

A:Ibuprofen, like all NSAIDs, can be irritating to the digestive tract. Stomach ulcers are always a risk. Other complications include high blood pressure, kidney damage, fluid retention, heart failure and toxic skin rash. The high doses you are using require medical supervision.

Topical NSAIDs might be a safer alternative. Canadian pharmacies sell Pennsaid (diclofenac and DMSO) if you have a prescription. You may also find fish oil or herbs like boswellia, ginger or turmeric beneficial.

Q:I'm surprised you haven't mentioned an important issue facing asthmatics. The Food and Drug Administration has decided that generic albuterol inhalers should be taken off the market. The result is that these stalwarts of asthma relief will no longer be available.

Instead, the generic inhalers are being replaced by the exact same medicine with a different delivery system. That means it will cost substantially more. How could a generic magically turn into a more expensive brand-name drug?

A:The FDA has determined that asthma inhalers may no longer contain CFCs (chlorofluorocarbons). These propellant gases damage ozone, and the United States agreed years ago to eliminate them from spray cans, air-conditioning units and refrigerators.

This means that lower-cost generic albuterol inhalers will disappear. People with asthma might have trouble finding such products even before the 2008 deadline.

They are being replaced by alternatives that use HFA (hydrofluoroalkane). Brand names like ProAir HFA, Proventil HFA and Ventolin HFA all contain albuterol, but they do cost more than the old, generic CFC-powered inhalers.