Question: Are sleeping pills harmful?
Most sleeping pills are very safe, provided they are taken in the recommended manner, but if used constantly for many weeks or months, patients may find it very difficult to stop them as they become dependent upon them. The greatest problem with the use of sleeping pills is that they are taken unnecessarily, particularly by elderly people who do not need large amounts of sleep. These pills are better taken intermittently when really needed, and they will work far more effectively.

Question: As a 77 year old, my doctor has suggested that I take 100 mg of aspirin every day to reduce my risk of having a stroke or heart attack, but I have had a stomach ulcer in the past and take Zantac every day. I was told that I should never take aspirin again because of my ulcer. What should I do?
Aspirin is a marvelous medication, and one of the oldest in current medical use, having being first marketed by a German chemist (Bayer) in 1899. It may be used to relieve pain, reduce inflammation (eg. in arthritic joints), decrease the risk of bowel cancer and reduce the ability of blood to clot.
This last use makes it suitable to reduce the risk of blood clots in the brain (stroke) or coronary arteries (heart attack), and as a result it is widely recommended by doctors to be taken regularly by all patients over 50. When used to relieve pain, aspirin is taken in doses of 600 mg (two tablets), four times a day, but when used to reduce blood clotting, only a very small dose of 75 to 100 mg a day is necessary, and strangely, higher doses may be less effective in reducing the risk of clots.
Aspirin also has side effects, most commonly resulting in stomach pain, and sometimes bleeding from the stomach, but this effect is dose dependent, and the higher the dose, the greater the risk of side effects. Low-dose aspirin is available in special formulations that reduce, but do not entirely eliminate, the risk of stomach side effects. These are marketed as Astrix, Cartia and Cardiprin, and are subsidised by the government for pensioners under the pharmaceutical benefits scheme.
It is possible that you will suffer stomach side effects from taking low dose aspirin long term, and if this occurs there is a substitute medication (Plavix), that is much more expensive than aspirin, but it does not have some of the added benefits of aspirin (eg. against bowel cancer). It is only subsidized by the government under very stringent conditions.

Question: What is the Inderal my doctor has prescribed for me used for? I always like to know about my medication, and several friends have told me they are on this drug, but for different reasons. Your advice would be appreciated.
Inderal (also known as propranolol) is one of the most interesting drugs in the pharmacopoeia as it can be used for an amazingly wide range of conditions. It has been available for more than 25 years so a great deal is known and understood about the drug.
Its uses include treatment of high blood pressure, control of irregular heartbeats, control of an overactive thyroid gland, control of fine tremors, prevention of migraines, prevention of heart attacks, control of anxiety in actors and examination candidates, prevention of angina and use in several other rare diseases and conditions. It is quite incredible that one drug can do so much. There are some people who should not use it though. They include asthmatics and diabetics, and in some forms of heart failure it must be used with caution.
Inderal is generally a very safe drug, and can be taken in very high doses if necessary. Side effects are uncommon but may include allergies, dizziness, nightmares, tiredness and impotence.

Question: Can people who have had stomach ulcers take aspirin? Can enteric-coated aspirin be used in these people?
Unfortunately it does not matter how you take aspirin, be it by tablet, in solution, coated with a substance that delays absorption (enteric-coated) or even as a rectal suppository. Once it is in the body, it may affect the balance between the acid in the stomach and the thick mucus that lines the stomach. The mucus protects the stomach from the concentrated hydrochloric acid that it contains, but if the production of mucus is reduced, or the mucus is less thick, the acid will penetrate through to the stomach wall and cause inflammation, pain and eventually an ulcer.
Many of the medications used to treat arthritis, including Indocid, Voltaren, Naprosyn, Brufen, Dolobid, Orudis, Feldene etc. act the same way as aspirin, and can affect the mucus lining of the stomach. Newer anti-arthritis medications such as Vioxx and Celebrex can sometimes be taken by some people with stomach ulcers.
The vast majority of people taking aspirin and anti-arthritis drugs suffer no side effects from them, but if you have a past history of stomach ulcers, it is wise to avoid these medications if at all possible. Paracetamol can be used as a substitute for aspirin, as it has no adverse effects on the stomach.