Trilipix or fenofibric acid is a lipid lowering medication. Fenofibric acid is the metabolite of fenofibrate. Fenofibrate is a white to yellowish powder, which is freely soluble in water. Trilipix oral preparations are contained is delayed release capsules.

Trilipix Side-effects

Trilipix side-effects result from the lowering of cholesterol synthesis. Cholesterol is essential for body processes especially the maintenance of cell membranes. Side-effects of Trilipix include:

1. Rhabdomyolysis

The reduction in cholesterol synthesis causes changes in the cell membrane wall of skeletal muscle cells. As a result, the muscle fibers are destroyed. Rhabdomyolysis is a fatal disease that can be life-threatening. Patients taking Trilipix should monitor for signs of muscles pains and dark urine because these may indicate rhabdomyolysis as Trilipix side-effect.

2. Myalgia and Muscle spasms

As a result of muscle fiber destruction, the patient may experience myalgia or muscle pain. This Trilipix side-effect can be managed by analgesics and anti-inflammatory medications.

3. Increased CPK

CPK or creatine phosphokinase are chemicals released in the blood because of death of tissues. Specifically, there is an increase in CPK-MM as a Trilipix side-effect, because of destruction of skeletal muscles. Increased CPK is usually diagnosed through blood tests and management of this Trilipix side-effect relies on the actual cause of the condition.

4. Acute Renal Failure

The death of muscle cells produces myoglobin as Trilipix side-effects. The build-up of myoglobin in the kidneys results in kidney failure. Kidney failure is managed through dialysis, limitation of salt intake and water to prevent build-up and edema.

5. Increased ALT

ALT or alanine aminotransferase is an enzyme that increases when problems in the liver occur. Trilipix is metabolized in the liver which means that any over dose or overuse of the drug may result in liver disease as Trilipix side-effect. ALT is detected through liver function test.

6. Increased AST

AST or aspartate aminotransferase is also a liver enzyme elevated during Trilipix therapy. It is important to detect the levels of liver enzymes to determine any ongoing liver problem as Trilipix side-effect.

7. Hepatitis

Liver toxicity as Trilipix side-effect may result as a result of high levels of Trilipix in the liver. Hepatitis is managed through administration of immunoglobulin and albumin or high protein diet.

8. Cirrhosis

The result of liver damage is cirrhosis, which is the permanent scarring of the liver. Prolonged use of Fenofibrate severely damages the liver because the organ is responsible for metabolizing it. Cirrhosis is usually managed by supportive administration of corticosteroids, B vitamins, fat soluble vitamins and high protein diet. This Trilipix side-effect is permanent because cirrhotic cells do not regenerate.

9. Abdominal Pain

Inflammation of the liver caused by hepatotoxicity may present as abdominal pain on the right upper quadrant. Pain may be treated using anticholinergics to reduce muscle spasms.

10. Other minor Trilipix side-effects

• Dyspepsia
• Diarrhea
• Constipation
• Nausea
• Sinusitis
• Headache
• Dizziness
• Fatigue

These Trilipix side-effects are a result of altering the cell membranes because of reduction in total cholesterol.

Despite the side-effects, Trilipix is essential for lowering the lipid levels in the body to prevent more life-threatening diseases such as atherosclerosis and coronary artery disease that may lead to myocardial infarction and stoke. Proper prescription and compliance to therapy is essential to manage hyperlipidemia.

What is Glandular Fever?

Glandular fever or medically known as infectious mononucleosis is a viral infection involving the Epstein-Barr virus (EBV). It is also known as kissing’s disease because of its oral transmission. It is also known as Filatov’s disease or Pfeiffer’s disease. It is an acute febrile disease that commonly affects children up to young adults. The infection usually affects the oral cavity with symptoms of sore throat, fever, fatigue and enlargement of lymph nodes.

The specific populations that glandular fever affects are those aged 10 to 25 years old. EBV is a type of a herpes virus belonging to the family of Herpesviridae. Once the virus reaches the body, it replicates in the cells in the pharynx and affects the B lymphocytes resulting in enlarged lymphocytes.

Glandular Fever Symptoms and Signs

Children usually do not manifest any symptoms or may only experience flu-like symptoms. Other ages may also not experience any problems, but adolescence and young adults develop glandular fever symptoms. These include:

• Sore throat. The Epstein-Barr virus usually stays and replicates on the pharynx, which leads to pharyngitis or sore throat. The throat may be coated with a whitish material. The tonsils are also usually affected.
• Severe fatigue. As with any infection, people suffering from glandular fever may experience severe fatigue as a symptom. This is due to the increased metabolic rate and the loss of energy brought by the virus.
• Fever. Fever is a classical sign of infection. Glandular fever is characterized as having continuous high grade fever.
• Muscle pains. The patient may also experience muscle pains as a result of the virus. This mimics the flu-like symptom of body malaise and myalgia.
• Puffiness around the eyes. The virus may affect the eye area and may cause swelling. This symptom usually resolves rapidly.
• Diaphoresis. Diaphoresis or increased sweating is also experienced by people with glandular fever.
• Enlargement of the lymph nodes. The virus may further spread on the lymph nodes causing it to swell and enlarge. Lymph nodes on the groin, armpit and neck usually enlarge.
• Spleenomegaly. This condition involves the swelling of the spleen because of increased destruction of the B lymphocytes as well as the rapid hemolysis of the red blood cells. The destroyed cells go to the spleen and may cause mild pain on the left upper quadrant below the ribs.
• Enlargement of the liver. The liver may also experience swelling because of circulation of the virus to the area. The affectation of the liver also results in jaundice or the yellowish discoloration of the skin.
• Glandular fever rash. A non-itchy skin rash may also develop in all parts of the body, which eventually disappears.
• Loss of appetite. Patients may also experience loss of appetite as a result of inflammation of the throat.
• Difficulty of breathing. Patients may also experience dyspnea because of obstruction of the upper airways as a result of severe pharyngitis.

Severe symptoms of the disease include rupture of the spleen, low platelet count, low white blood cell and red blood cell count and the presence of erythema multiforme or a severe development of skin rash.

Diagnosis of glandular fever is very important because it mimics other diseases such as streptococcal infections, influenza, diphtheria, leukemia and common colds. Classical symptoms of glandular fever are confirmed by blood tests that identifies problems on the lymphocytes. Heterophile antibodies are also identified.

How do you get Glandular Fever?

Glandular fever is spread through direct contact with the person’s saliva as well as through droplets. It is termed as kissing’s disease because the most common transmission is through kissing an infected person or a contact with the infected oral secretions. Symptoms of glandular fever usually occur 30 to 50 days after the exposure to the virus.

Can you get Glandular Fever twice?

Glandular fever stimulates the formation of active natural immunity once the patient suffered the infection. The body produces antibodies that detect the presence of the virus next time the person gets exposed. Because of this, it is uncommon that a person can have glandular fever twice because of the life-long immunity it develops. However, some patients may experience period of inactivity wherein the person develops a dormant infection. Once the virus becomes active again, the person becomes infectious again, but may not experience symptoms anymore.

Glandular Fever Treatment

Glandular fever is a viral infection, which means that the disease is self-limiting or resolves on its own. There is no specific treatment for the disease and it only requires palliative treatment or symptomatic relief. Managements often involve:

Rest

Rest is an essential management during the acute phase of the disease to relieve weakness and fatigue. Activities are normally resumed after the acute phase. Contact sports and also other high impact activities should be avoided to prevent rupture of the spleen

Medications

Medications are also given to relieve symptoms. Medications include:

• Non-steroidal anti-inflammatory medications. Medications such as ibuprofen help relieve pain and lower the fever. Aspirin is almost not used especially in children because of potential side-effect of Reye’s syndrome.
• Corticosteroids. Corticosteroids are also used to reduce inflammation in the pharynx and tonsils. The most commonly prescribed steroid is Prednisone.
• Anti-viral medications. Anti-viral drugs such as acyclovir and valacyclovir help reduce viral shedding and it also proven to lessen the Epstein-Barr virus, thereby reducing the severity of the disease. Anti-viral medications are usually given to severe EBV infections and may not be given to mild cases.
• Antibiotic therapy when streptococcal infections arise. In EBV infection with streptococcal infections, antibiotics such as penicillin may be given to treat the bacterial infection. Ampicillin and amoxicillin are contraindicated because of occurrence of non-allergic rash in EBV patients. However, EBV only infections are not prescribed with antibiotics because they are deemed ineffective in eradicating the virus.
• Fluid intake. Increased fluid intake is also beneficial for those suffering fever to prevent dehydration.
• Throat care. Gargling with antiseptic solutions helps in reducing sore throat and pharyngeal infections.

Patients also need to increase the immune system by consuming fruits and vegetables as well as vitamin C supplements to prevent secondary infections and help in faster recovery.

Is Glandular Fever contagious?

Glandular fever is highly contagious during the first six weeks from the time the signs and symptoms appeared. However, some studies have revealed that glandular fever can be transmitted as long as several months with the longest time of up to 18 months even when the signs and symptoms already disappeared.

The virus easily spreads through kissing, inhaling droplets when the patient coughs or sneezes and using eating utensils infected with saliva.