# Prescription medications



## IrishMike (Jan 29, 2012)

Can these be bought over the counter in MX?
Not the creepy ones.
Asking, because when was travelling there many, many years ago I remember buying antibiotics there (I have a deg. in Pharmacology)
Or is the same as USA/Canada, where a doctors visit is required?


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## TundraGreen (Jul 15, 2010)

IrishMike said:


> Can these be bought over the counter in MX?
> Not the creepy ones.
> Asking, because when was travelling there many, many years ago I remember buying antibiotics there (I have a deg. in Pharmacology)
> Or is the same as USA/Canada, where a doctors visit is required?


Many drugs that require a prescription in the US can be purchased without one in Mexico.


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## joaquinx (Jul 3, 2010)

Antibiotics need a prescription. All other medications do not.


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## conklinwh (Dec 19, 2009)

So far, we or people visiting have yet to find a prescription that we couldn't get filled over the counter. Now many times we needed to know the generic name as the brand names sold here different although by well known drug companies. Also, the dosages we wanted were sometimes hard to find or non-existent so we had to improvise.
The drugs do tend to be much cheaper and often less than the Part D copay but not always, especially if a brand name. 
Now, I know that there is some pressure to tighten up what can be sold over the counter so you really need have a specific drug list with dosages to understand your situation.


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## maesonna (Jun 10, 2008)

Antibiotics used to be freely available, but the regulations requiring prescriptions for this class of drugs were tightened up within the last year or so. 

Some psychiatric medications are also strictly controlled.


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## Longford (May 25, 2012)

TundraGreen said:


> Many drugs that require a prescription in the US can be purchased without one in Mexico.


The situation has changed markedly in the past couple or several years. Many, maybe most, pharmaceuticals which were once available over the counter without a prescription now require one. The law and/or regulations are sometimes skirted but the federal government had cracked-down. Typically, what requires a prescription in the USA is supposed to require one in Mexico. The World Health Organization has been putting pressure on developing nations to get them to better enforce the laws, mostly in response to the improper use of antibiotics.


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## joaquinx (Jul 3, 2010)

Longford said:


> Many, maybe most, pharmaceuticals which were once available over the counter without a prescription now require one.


Longford, this statement is too vague. As a person who buys a number of medications monthly, the only time I needed a prescription was when the doctor prescribed an antibiotic. I had to hand over the prescription which was then stamped by the pharmacy clerk and not returned to me. For my other medications, I simply hand the clerk the end-flaps that state the medications name and dosage. Narcotic medications are very difficult to get prescribed and filled. Only certain doctors have the ability to write prescriptions and most pharmacies do not carry them.


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## mickisue1 (Mar 10, 2012)

Longford said:


> The situation has changed markedly in the past couple or several years. Many, maybe most, pharmaceuticals which were once available over the counter without a prescription now require one. The law and/or regulations are sometimes skirted but the federal government had cracked-down. Typically, what requires a prescription in the USA is supposed to require one in Mexico. The World Health Organization has been putting pressure on developing nations to get them to better enforce the laws, mostly in response to the improper use of antibiotics.


I find that ironic, since two of the biggest offenders in creating super bugs are the animal husbandry industry, which mixes antibiotics in feed, and the cleaning supplies industry, which has convinced millions of Americans that they must NOT have a microbe within 100 ft of their homes.

As we all know, neither of those industries is in a hurry to stop or modify their practices.

Interestingly enough, it's been noted for at least two decades that people who live in "very clean" homes tend to develop more allergies, and more asthma.


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## Longford (May 25, 2012)

mickisue1 said:


> I find that ironic, since two of the biggest offenders in creating super bugs are the animal husbandry industry, which mixes antibiotics in feed, and the cleaning supplies industry, which has convinced millions of Americans that they must NOT have a microbe within 100 ft of their homes.
> 
> As we all know, neither of those industries is in a hurry to stop or modify their practices.
> 
> Interestingly enough, it's been noted for at least two decades that people who live in "very clean" homes tend to develop more allergies, and more asthma.


:focus:

It's not an "American" issue. It's a worldwide crackdown on people who self-diagnose, self-treat ... incorrectly. Mexican lifestock and poultry producers don't act much differently when it comes to what's given the animals. In fact, the oversight is likely to be much less in Mexico and abuses greater. Production facilities are, for the most part, huge agribusiness operations. 

The Mexican crack-down on sale/purchase of presciption medications relates to regulations which were pre-existing ... but largely ignored by both the government and pharmacies. The government, pressured by the WHO (as other countries were pressured) launched tighter oversight. I don't recall the list of pharmaceuticals covered. Obviously, some pharmacists skirt the law. It's Mexico. 

Regarding something, a medication, not being available someplace (asked in another posting above) ... any legitimate pharmacy, especially the Class 1 pharmacies, can get you what you need on a two or three advance notice. That's been both my experience and observation.


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## TundraGreen (Jul 15, 2010)

mickisue1 said:


> ...
> Interestingly enough, it's been noted for at least two decades that people who live in "very clean" homes tend to develop more allergies, and more asthma.


I hadn't heard about this theory. Apparently, it is called the "Hygiene Hypothesis". The evidence for and against it seems mixed. It's not that easy to test and the studies that have been done seem to show mixed results from what I was able to find about it.


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## stilltraveling (May 7, 2012)

IrishMike said:


> Can these be bought over the counter in MX?
> Not the creepy ones.
> Asking, because when was travelling there many, many years ago I remember buying antibiotics there (I have a deg. in Pharmacology)
> Or is the same as USA/Canada, where a doctors visit is required?


As of last year, you need a prescription for antibiotics. Most pharmacies have a GP in-house, so you pay a small fee for the consult and they'll prescribe just about anything you want.


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## stilltraveling (May 7, 2012)

joaquinx said:


> Longford, this statement is too vague. As a person who buys a number of medications monthly, the only time I needed a prescription was when the doctor prescribed an antibiotic.


This policy went into effect last year and it was very intentional. By law, pharmacies can be fined or even shut down if they don't have a prescription for every antibiotic dispensed. This does not apply to anti-fungal medications, but antibiotics and antiviral meds now all require a prescription. The same also applies to animals (as that is one of the biggest offenders). 

I wrote my dissertation on the emergence of antibiotic resistance back in the mid-90s and everything in there is coming to fruition. There is a worldwide push to reduce antibiotic use because we are slowly moving into the "post-antibiotic era" of medicine. There are strains of TB circulating out there that are resistant to all but maybe one antibiotic in the arsenal. Most of those "flesh eating bacteria" you hear about in the news are simply staphylococcus that have become resistant to everything in the arsenal. Antibiotics have been woefully overused in the past 50 years, either by people self-diagnosing and treating, improper use (not completing the treatment regimen because they felt better after a few days) and by physicians who were treating empirically without performing cultures and sensitivity testing. 

A common scenario was if one of your children had a throat infection and then another child got a similar infection months later, people were quick to skip the cost of an office visit and just buy the same medication used the last time. Another big contributor was pharmacists (or simply the clerks working there) would dispense antibiotics based on limited knowledge or, even worse, what they had in stock. 

I remember a pediatrics professor back in the day telling us that you have to prescribe an antibiotic, otherwise the mother would think you haven't done anything and she would take her child to another doctor. The fact that the overwhelming majority of childhood infections are viral be damned. I'm afraid this still goes on to an alarming extent in private practice.


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## stilltraveling (May 7, 2012)

TundraGreen said:


> I hadn't heard about this theory. Apparently, it is called the "Hygiene Hypothesis". The evidence for and against it seems mixed. It's not that easy to test and the studies that have been done seem to show mixed results from what I was able to find about it.


There is a lot of evidence on the periphery to support this hypothesis. Like you said, it is very difficult to perform a controlled study. However, there is overwhelming evidence to support the hypothesis that exposure to dirt, cow manure and similar "dirty" things early in life greatly reduces the incidence of asthma. 

I make it a point to get my children into playing in the mud from an early age and never scold them for coming home dirty. That's what childhood is all about!


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## mickisue1 (Mar 10, 2012)

TundraGreen said:


> I hadn't heard about this theory. Apparently, it is called the "Hygiene Hypothesis". The evidence for and against it seems mixed. It's not that easy to test and the studies that have been done seem to show mixed results from what I was able to find about it.


I agree, it's difficult to test.

But the fact that exposing one's immune system to challenges helps it to distinguish between actual and perceived dangers to the system is, as stilltraveling noted, well established.

It's helpful to have a (biochemist?) backing me up!


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## stilltraveling (May 7, 2012)

mickisue1 said:


> It's helpful to have a (biochemist?) backing me up!


Physician. Biochemistry makes my head hurt.


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## mickisue1 (Mar 10, 2012)

stilltraveling said:


> Physician. Biochemistry makes my head hurt.


Heh. I kind of like it, myself. But then, it slides into the puzzle of nutrition that is my particular passion.

It makes my head hurt, too, but if I read slowly and multiple times, I get that EUREKA moment.

I've read, in the nuns study on aging brains, that keeping your brain engaged in complex processes helps to slow the progress of degeneration. Biochemistry is as good a "complex process" as any.

Plus, I have a biochemistry professor living next door. Helpful.


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## stilltraveling (May 7, 2012)

I'll stick with Sudoku.


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## maesonna (Jun 10, 2008)

A particular interesting instance of the hygiene hypothesis is the link between hookworm (absence of) and Crohn’s disease. Interested readers can find plenty of references to learn more. In a subset of people, apparently, in the absence of parasites, the immune system attacks the person’s own body causing this debilitating condition, and the disease can be controlled without too much harm with a careful, controlled exposure to parasites.


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## stilltraveling (May 7, 2012)

maesonna said:


> A particular interesting instance of the hygiene hypothesis is the link between hookworm (absence of) and Crohn’s disease. Interested readers can find plenty of references to learn more. In a subset of people, apparently, in the absence of parasites, the immune system attacks the person’s own body causing this debilitating condition, and the disease can be controlled without too much harm with a careful, controlled exposure to parasites.


The data on that last part is still quite mixed. When we figure out Crohn's disease and IBD (they might be the same disease, still hard to tell), we'll learn more about gut immunity than we have learned in the last 50 years. 

The effects of our environment, even things we assume are good effects like hygiene and clean water, are interacting with our physiology in ways we never imagined. I'm afraid we're still in the infancy of this science. People 100 years from now will think our medicine was as primitive as I feel about medicine 100 years ago. 

Can I just download myself to a hard drive already and get this over with? Biology is so yesterday.


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## mickisue1 (Mar 10, 2012)

Am I the only one, when I think of "modern" medicine, who thinks about a Star Trek episode where the crew somehow transports themselves to this era, in order to do something or another that needs doing?

Dr McCoy, having drunk something he shouldn't, gets weepy, and comments about how they cut into people with scalpels to do surgery, and how barbaric it all is.


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## TundraGreen (Jul 15, 2010)

mickisue1 said:


> Am I the only one, when I think of "modern" medicine, who thinks about a Star Trek episode where the crew somehow transports themselves to this era, in order to do something or another that needs doing?
> 
> Dr McCoy, having drunk something he shouldn't, gets weepy, and comments about how they cut into people with scalpels to do surgery, and how barbaric it all is.


You are not the only one. Whenever I see a Star Trek episode I think that most current medical practices will look unbelievably barbaric in 100 years.


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## cuylers5746 (Mar 19, 2012)

IrishMike said:


> Can these be bought over the counter in MX?
> Not the creepy ones.
> Asking, because when was travelling there many, many years ago I remember buying antibiotics there (I have a deg. in Pharmacology)
> Or is the same as USA/Canada, where a doctors visit is required?


Here's my take on the Legal Drug Industry in Mexico;
First off you need to know Mexico is still a country where you the consumer are responsible for what you ingest in your body. If you want to kill yourself, well there's one less mouth to feed. It's not like in the USA, where the Insurance Cos. have heavily lobbied Congress getting laws passed against almost any possible activity that might cause you harm - and them paying out a claim to you! I'll take the Mexican way any day. Same way for walking down the sidewalk. Don't look where you're going and fall in a crack or hole and break a leg or arm? Can't sue the City, they'd laugh you out of Court. Mexico in a lot of ways is what Pres. Ronald Reagan was trying to bring back to the USA - responsibility for yourself!

I know a little about it, as my Brother-in-Law used to have a Pharmacy, and my wife's Aunt had one for over 60 years, back when they mixed compounds.

1.) Very high quality Pharma Drugs can be obtained in Mexico - mostly without Prescription.
In the 1930's Lilly, Bayer, Scquibb, etc. from Europe and USA established big, top quality
production facilities in Mexico City. Very tight qualtiy controls. Same companies as in 
Europe and USA and same owners. Same Drugs as in USA, same quality made by same
companies.

You will hear typically from your Doctors in the USA, that they're low quality, conterfeit, etc.
HOGWASH! Yes, maybe right at the border you can get some conterfeit what would be
Prescription Drugs sold, that they got from China or elsewhere, but that's pretty much the
limit of it. Even at the border a top name Pharmacy will have legitimate drugs. That's the crap 
the Big Pharma sellsmen blow in their ear.

2.) Up until about 10 years ago you could buy most drugs at 1/4th the cost as in the USA. That
changed through a major, concerted long lobbying effort the Big Pharma from the USA in 
Mexico City. Since then Drugs are expensive now for Mexicans as they doubled in price,
to now about 50% of what they are in the USA. The lobbying was a concerted effort to try
and reduce the likely hood of Americans going to Mexico to get their Drugs, while Big Pharma
continued to jack up prices in the USA to astronomical levels.

For instance; I can remember back in the 1930's we had to pay $30 USD/ pill of a Fertility 
Drug for my wife. We drove down to Ensenada, Baja and bought the same pills in quantity
from the same Manufacturer, but in Mexico for like $1.30 USD equivalent. Oh, and the 
Pharmacist profusely apologized for having to charge so much for it.

3.) There is a list of some 53 controlled Drugs in Mexico. You can ask any good Pharmacy to
look at the list. Most of them are addictive, dangerous drugs, and some antibiotics. This list
was only recently imposed in last 10 years or so.

4.) Three or four years ago the World Health Organization threw a scare into every consumer on
the planet. They said countries needed to crack down on supurfulous antibiotic use as super
strains of germs were developing amune to the current antibiotics. They really got people
scared that super strains of bugs out of India were already here and ready to mutate across
the planet. Well that's when Mexico acted and put antibiotics on that listed of restricted drugs.

Was it justified, or was it just another lobby effort by Big Pharma USA? You be the judge. Me
I still haven't made up my mind yet.

So, now a huge advantage of prescribing yourself and eliminating the Medical Doctor is "partially" taken away in Mexico. I say that, as you can still go into a Generic Pharmacy store, some owed by the big discount chains like Fenix and for $25 - 30 pesos see a recent Medical Graduate and have him/her prescribe you your antibiotic - but it will be in a generic form. 

Big deal, now you wait 15-30 mintues and it only cost you about $2.00 USD. Maybe it's worth the Government having done that to cut down on the misuse of antibiotics? Personally, I feel the Mexican way is so superior to the USA way. When you get over 40 years of age, you will have re-occuring illnesses that you've seen through out your life and can much quicker diagnose and prescribe yourself than a Medical Doctor. Hell, why not just go buy the drug over the counter? Most Pharmacists (the top licensed one in the Pharmacy) can help you with the Prescription for $0.00 consultation.

If you live in a Mexican City and get to know your little Generic Pharmacy Physician well? Well, we get our little Doctora to write us name brand Prescriptions, even though they're not supposed to - only sell their Generic Brand. Quicker as their office is attached to the Pharmacy and no appointments needed, first come first served basis.

Hope this helps.


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## stilltraveling (May 7, 2012)

1. Counterfeit drugs are far more prevalent than just at the border. The Secretary of Health confiscates tons of counterfeit drugs every year throughout the country (especially in Mexico City) and those are just the ones they find. 

2. Anyone who thinks antibiotic resistance is something only happening in India knows nothing about infectious disease. There are bugs that we treated 20 years ago with common antibiotics that are now resistant to every drug that existed in that era. 

Antibiotic resistance is a serious crisis. Remember what we did with people with leprosy and tuberculosis 75 years ago? We sent them to live somewhere where they couldn't infect anyone else. That's what a post-antibiotic world will look like if we don't start controlling the use of these very powerful and very useful drugs. It's one thing to refill your prescription for captopril because you've been taking it for years and your blood pressure is stable. It's another thing entirely to take the same antibiotic you took 3 years ago because the infection you have now feels similar. Do you know it's the same infection? Do you know what strains are circulating currently in the community? Do you know what the current resistance patters are? You can't unless you consult an expert. Even the new graduate working in the pharmacy is aware of these factors (BTW, that "new" graduate already has two years of experience before he's allowed to work). 

The very first patient treated with penicillin was a police officer who scratched his face on a rose thorn while tending his garden. That scratch became infected and he ultimately was in a coma with a systemic infection. In those days, sepsis was an end-stage disease that very few people recovered from. Penicillin was the wonder drug that brought him back from the brink. Now it's useless against almost every bacteria out there. 

Imagine a world where a scratch from a rose is enough to kill you. That's where we're going so long as people think taking an antibiotic willy-nilly is a question of personal freedom.


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## cuylers5746 (Mar 19, 2012)

*Ans on Antibiotics*



stilltraveling said:


> 1. Counterfeit drugs are far more prevalent than just at the border. The Secretary of Health confiscates tons of counterfeit drugs every year throughout the country (especially in Mexico City) and those are just the ones they find.
> 
> 2. Anyone who thinks antibiotic resistance is something only happening in India knows nothing about infectious disease. There are bugs that we treated 20 years ago with common antibiotics that are now resistant to every drug that existed in that era.
> 
> ...



Hey, did I say anthing about prescribing yourself antiobiotics? NO,


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## mickisue1 (Mar 10, 2012)

Wow.

I fell off a toboggan when I was in the second grade, and scratched my face on some ice. The erysipelas infection that resulted was dealt with by being given a shot of penicillin. I was, however, susceptible to it; had three more bouts before my system developed a better ability to deal, near the end of the fourth grade.

In a way, I was lucky that my face ballooned up from the infection; it led my parents to get me help, STAT.

Years later, while working on a med-surg floor, I cared for a woman who'd been on an antibiotic drip for a week for the same bacterial infection in her leg. To say I was shaken up by that would be an understatement.

I think it's one reason why I'm so adamant against using "antibacterial" home care products, and believe strongly in a good scrubbing and covering for scratches and cuts, rather than slathering antibiotic cream on them. 

As you noted, it's not just in India that there are antibiotic resistant bacteria. For every parent who thinks that they need to wash their countertops with Clorox wipes, there is a kid who'll have an overactive immune system, and another whose strep throat refuses to get better.


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## edgeee (Jun 21, 2012)

TundraGreen said:


> You are not the only one. Whenever I see a Star Trek episode I think that most current medical practices will look unbelievably barbaric in 100 years.


which means, you might live long enough to see it, if they hurry.

changing public opinions and perceptions is about as easy as teaching a clam to whistle.
once antibiotics became 'miracle drugs' everyone loved them and they still do.
they don't WANT to believe the romance is over.

these are, by and large, the same people who think soap kills germs, but don't know what a germ is. (for that they should be forgiven - there is no universally accepted definition. the words is hardly used anymore.) 

in the same vein, people DO want to believe that if it kills bacteria, it should kill a virus, so they do, even if they don't know the difference.
(fun fact i found: a single average bacterium is about 100 times larger than a single average virus.)
and if you dare read on it gets worse.
from the Wikipedia>Virus:
*"Opinions differ on whether viruses are a form of life, or organic structures that interact with living organisms."*

hard to kill something that may not be alive to begin with. _did i just open the wrong door?_

anyway, enough common knowledge exists to drive consumer demand for antibacterial products, mainly hand cleanser.
some experts are concerned the same scenario, but much worse, is now at hand.
(i couldn't resist.)
if the bacteria have been evolving to keep up, they will probably keep doing it.
and if the very popular cleaners give them the chance to start sooner, they probably will,
and they will do so in a much larger environment, ever widening.

a world where bad bacteria can't be killed would not be pretty.

i was not aware of this, but now it scares me a little.
i'll be long gone by then, but i have not ruled out the existence of reincarnation.

ST, have you any insight about this trend? how likely is it that the pattern will repeat itself, - i'm guessing it's high - and how fast might it happen?


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## Detailman (Aug 27, 2011)

cuylers5746 said:


> Here's my take on the Legal Drug Industry in Mexico;
> First off you need to know Mexico is still a country where you the consumer are responsible for what you ingest in your body. If you want to kill yourself, well there's one less mouth to feed. It's not like in the USA, where the Insurance Cos. have heavily lobbied Congress getting laws passed against almost any possible activity that might cause you harm - and them paying out a claim to you! I'll take the Mexican way any day. Same way for walking down the sidewalk. Don't look where you're going and fall in a crack or hole and break a leg or arm? Can't sue the City, they'd laugh you out of Court. Mexico in a lot of ways is what Pres. Ronald Reagan was trying to bring back to the USA - responsibility for yourself!
> 
> I know a little about it, as my Brother-in-Law used to have a Pharmacy, and my wife's Aunt had one for over 60 years, back when they mixed compounds.
> ...


"Hey, did I say anthing about prescribing yourself antiobiotics? NO,"

________________________________________________________________

You were talking about both prescription drugs and antibiotics and "yes", you not only said it but in fact put it into writing. That was the clear insinuation.


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## stilltraveling (May 7, 2012)

edgeee said:


> ST, have you any insight about this trend? how likely is it that the pattern will repeat itself, - i'm guessing it's high - and how fast might it happen?


It's not so much a pattern repeating itself as it is a constant process. Evolution is always occurring. It's basically a question of two main factors: natural selection driven primarily by changes in the environment and the number generations that transpire. 

For us, and mammals in general, it's an agonizing slow process. We reproduce too slowly to see much evolution, if any. Bacteria, on the other hand, produce thousands of generations per hour. When you throw a substance into their environment that selectively kills certain individuals with certain traits, only those with traits to survive that change go on to reproduce . . . thousands of generations per hour. Before you know it, the entire population is resistant and is passed on to a new host. The first-line drug no longer works, so you have to move on to the next one. 

Another neat (scary) thing about bacteria is that they pass their survival trait on to other individuals who do not yet have that trait through things called plasmids. They literally pass a copy of the DNA sequence that gave them resistance to the guy next to them. It's as if a human evolved a new gene at midlife, evolving during their own lifetime. Michael Phelps passes you a swim gene, suddenly you're in the Olympics at 40. 

So it's a race. We find new mechanisms to stop them (or, more commonly, slow them down so that our body can finish them off) and they find new ways to survive. Fever is a defense mechanism. It doesn't kill most of the bugs that infect us these days, but it did a very long time back in our evolution which is why every mammal does it in response to an infection. The antibiotic was our own plasmid. We figured out a substance that would kill a lot of the bacteria that cause disease in humans and we passed that information on to the next guy. We leaped ahead of our microscopic competitors in a single decade, turning the vast majority of deadly conditions into something we only think happens to very old people. The effect on post-partum infections alone was a huge leap in human survival. 

What was originally a secret weapon in WW2 became so common every village in India could have access to it. In the wake of that discovery, we developed a lot of other drugs that kill or slow the bacteria with new methods. But somewhere around the 1970s, we ran out of low-hanging fruit. All of the easy mechanisms to stop the bacteria had been found and the drugs had retired to generic status, making them widely available in even the most remote corners of humanity. 

Meanwhile, the bugs weren't gone. They had been evolving all that time and killing people just like they always had, only at a much lower rate. Because the drugs were all available generically, the only way to make money was to develop new brand-name drugs. However, because there were so many generic antibiotics out there, there wasn't much of a demand for expensive new antibiotics. So the entire field went dormant. Once a bug develops resistance to one drug in a class, it's generally resistant to all drugs in that class (there are a few exceptions). Only two new classes of antibiotics have been developed in the last 3 decades. That whole time, the bugs have continued to evolve. 

Multi-drug-resistant tuberculosis grew out of improper treatment with the first-line drugs, usually by patients not completing their treatment regimen. They felt better so why continue to take this drug for another 6 months? So they passed their resistant strain on to the next guy for whom the first line of treatment is now useless. After a few rounds of that, all cases in a given community are resistant. After a small percentage of those cases also fail to properly complete treatment, the community is full of extensively-drug-resistant tuberculosis. Now we're seeing cases of totally-drug-resistant tuberculosis. They are few in number, but they're growing every year. We haven't evolved many new drugs for tuberculosis in a very long time. The bug is catching up. 

And so is every other bug. The treatments I learned in medical school for empirical therapy of common illnesses are now mostly worthless. Bactrim is mostly useless for urinary tract infections. It cured over 80% of them when I was in school 20 years ago. The same goes for most infections. The effectiveness of a given drug varies from city to city, country to country, because their bug populations have evolved under different pressures. Empirical therapy is being used less and less these days. A culture and sensitivity test is becoming necessary for even common infections, lest you find out 3 days into treatment that it's not working and now your patient is septic and you don't even know why. There are intestinal bugs that are resistant to vancomycin, bugs that can kill you dead. Common infections that we used to treat with a round of oral antibiotics turn into horrific lesions that require hospitalization and, in the worst cases, amputation to cut of its march towards the heart and brain. We're back to amputating for infections, something that had been relegated to Civil War movies. 

There's always an equilibrium at play. Our body's innate and learned defenses maintain that balance hopefully long enough to reproduce and rear our young. That's really all nature cares about. We tipped the balance in our favor through hygiene and nutrition, but the bugs were still there and still popping up at opportune moments to kill us. Antibiotics tipped the balance of that battle in our favor and continue to do so. However, unless we start developing new antibiotic classes the way we were in the middle of the last century, the bugs will ultimately catch up. We can slow down their progress through judicious use of the antibiotics we have currently, but that's only buying time. How long depends on our universities and pharmaceutical industry. Two classes in 30 years isn't going to cut it. Again, it won't kill us off. It's an equilibrium. If the balance tips in the favor of the bugs, it just means we'll die younger and more often, but we'll still be here. 

In the end, it's the bugs that will win. Our bodies are merely sentient transport devices for all the bugs we carry around. There are more bacteria in you and on you than there are cells that make up you. Once you are dead, they will consume you and return to the soil until they find someone else to feed them. 

Enjoy the ride!


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## RVGRINGO (May 16, 2007)

Very well put.
Our advances may, in many ways, end up being the seeds of our own extinction. The 'bugs' may play a role, but so do environmental changes of other sorts which are equally ignored by the majority. I'm reminded of the 'extinction' of smallpox; fact or fiction? rumore has it that there are 'strategic stockpiles' which could be weaponized. If that is done, we old timers have been vaccinated, but few younger than baby boomers will be immune. They will die off & we're helpless to replace them. In any case, modern civilization's collapse could easily leave us starving to death by any number of means. It won't be pleasant, whatever the ultimate cause. That 'ride' may be very bumpy.


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## stilltraveling (May 7, 2012)

Smallpox is not extinct. It no longer circulates in the wild, but very sick people have decided that keeping it around may be useful in future conflicts. It sits in a few government labs frozen in time, ready to pounce on the naive immune systems of it's favorite food. It sits in the palm of the **** sapien hand. It would be so easy to crush this bug once and for all, but we make tools out of everything. 

So instead of the human race destroying this bug that has killed so many billions of our own kind, we've decided to co-opt it into our arsenal. Like a closer in baseball. Just in case. It may be the end of us for the reasons you've stated. Another generation of unvaccinated humans and it will certainly have the potential to wipe out 90% of us. I hold out the hope that we will soon be past this hunter-gatherer habit of murdering our competitors and stealing their women and move on to what's next. Then we'll finally decide to incinerate it once and for all. 

Or not.


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## edgeee (Jun 21, 2012)

stilltraveling said:


> ... Like a closer in baseball. Just in case. . .


i'm afraid you just lost some of your audience.


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## RVGRINGO (May 16, 2007)

Wasn't the plague the real cause of the renaissance? The Spanish Flu may even have given a boost to the Industrial Revolution of the early 20th century.
I'm old enough to remember when there were 1/3 as many people. Life was certainly different then.


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## stilltraveling (May 7, 2012)

RVGRINGO said:


> Wasn't the plague the real cause of the renaissance? The Spanish Flu may even have given a boost to the Industrial Revolution of the early 20th century.
> I'm old enough to remember when there were 1/3 as many people. Life was certainly different then.


I haven't heard of such a connection to the Spanish Flu. The plague, however, had a massive impact on world history. 

There is a lot of evidence to support the theory that the massive die off resulted in a shortage of labor, giving tremendous negotiating power to workers. Also, entire estates had been abandoned and the survivors, regardless of their class, simply moved in. The inability of the church to do anything to stem the tide, as well as the thousands of young laypersons they ordained in order to give last rites to the plague victims (the older priests had mostly died from the same plague), most certainly gave impetus to the rise of protestantism. 

In fact, the overgrowth of abandoned fields was so large there actually was a drop in atmospheric Co2 levels and a mini ice-age. 

I'm kind of a medical history nerd.


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## FHBOY (Jun 15, 2010)

*Refills In Mexico*

While I am down in Ajijic this month, a couple of my prescriptions will run out. The logical option is to have them refilled before I leave BUT...

If I was to bring the vial with me, would I be able to walk into a pharmacy and get the same drug OTC? Would I need a US doctors prescription? These are drugs like Lipitor, a beta blocker, etc. Before RV went in for surgery he offered to have Lady RV look into this if I sent him a list. He had too much on his plate, so I am just looking for info.

Thanks.


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## Longford (May 25, 2012)

FHBOY said:


> While I am down in Ajijic this month, a couple of my prescriptions will run out. The logical option is to have them refilled before I leave BUT...
> 
> If I was to bring the vial with me, would I be able to walk into a pharmacy and get the same drug OTC? Would I need a US doctors prescription? These are drugs like Lipitor, a beta blocker, etc. Before RV went in for surgery he offered to have Lady RV look into this if I sent him a list. He had too much on his plate, so I am just looking for info.
> 
> Thanks.


What I would do, if I was in your position would be ... ask the pharmacist for advice. Technically, I believe you're supposed to present a prescription for all medications purchased at a pharmacy. I'm speaking of the prescription pharmaceuticals, not over-the-counter stuff. However, I hear reports, infrequent as they have been, that some pharmacies are filling prescriptions as they did for many years before the rules tightened ... on request of the customer. If your pharmacist tells you a prescription is necessary and he/she cannot just accept the empty, or near-empty bottle you have with you, it will be easy enough, and inexpensive enough, to take that pill bottle to a local physician, explain the situation, have a conversation and I'm confident you will be able to walk from his/her office with a prescription in-hand which you can present to the pharmacist and receive what you need. If you haven't left for Mexico yet it should be easy enough to get a refill on your prescriptions before departing on the trip.


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## joaquinx (Jul 3, 2010)

The only time prescriptions are needed are for medications that contain narcotics or for antibiotics. A US doctor's prescription will not get you either one of these. All other medications are sold over the counter. They will need the Spanish name if the name is different and the dosage. Narcotics are difficult to get as most doctors don't have the permission to prescribe them and most pharmacies do not carry them. As a precaution, only buy any medications at national drugstores or supermarkets. There are counterfeits.


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## stilltraveling (May 7, 2012)

FHBOY said:


> Would I need a US doctors prescription? These are drugs like Lipitor, a beta blocker, etc.


All of those drugs can be bought OTC. Send a complete list and I'll let you know if anything on it doesn't fall into that category.


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## FHBOY (Jun 15, 2010)

joaquinx said:


> The only time prescriptions are needed are for medications that contain narcotics or for antibiotics. A US doctor's prescription will not get you either one of these. All other medications are sold over the counter. They will need the Spanish name if the name is different and the dosage. Narcotics are difficult to get as most doctors don't have the permission to prescribe them and most pharmacies do not carry them. As a precaution, only buy any medications at national drugstores or supermarkets. There are counterfeits.


Where can I find the Spanish names of the drugs, none are narcotics. Doesn't the generic name translate directly into the Spanish? Like atorvastatin for Lipitor, or Metoprolol Tartrate for Lopresser?

I will refill here before I leave, but would really like to learn the system and the prices.


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## Longford (May 25, 2012)

FHBOY said:


> Where can I find the Spanish names of the drugs, none are narcotics. Doesn't the generic name translate directly into the Spanish? Like atorvastatin for Lipitor, or Metoprolol Tartrate for Lopresser?
> 
> I will refill here before I leave, but would really like to learn the system and the prices.


I take the same medications you're referring to.

Many pharmacies, particularly "farmacias de primera classe" have a PDR ... Physicians Desk Reference ... in which they can check on the names of medications. You're visiting an area infested with foreigners and you'll not be the first such person to walk in and ask for these things. Someone Lakeside posting here can probably refer you a particular pharmacy in Ajijic or Chapala or the LSC can do that if you visit there. Chances are both will be more expensive in Mexico than currently priced in the USA, or about the same.

Thinking on my earlier comments further, I think joaquinx accurately states that not all pharmaceuticals require a prescription. The purchase of narcotics and antibiotics are two classes of drugs scrutinized most. Presenting your bottles to the pharmacist will help that person accurately fill the prescription .. particularly when it comes to the strength which can vary widely. Strengths sometimes are different in Mexico than in the USA and you may have to cut your pills to adjust.


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## stilltraveling (May 7, 2012)

FHBOY said:


> Where can I find the Spanish names of the drugs, none are narcotics. Doesn't the generic name translate directly into the Spanish? Like atorvastatin for Lipitor, or Metoprolol Tartrate for Lopresser?
> 
> I will refill here before I leave, but would really like to learn the system and the prices.


Send me the whole list. I'll translate it for you. 

Many of the brand name drugs are the same as in the States, but many are different. You may want to stick with the brand names or go with the generics. I always prescribe generic names because frankly I don't see much of a difference. There are some important exceptions to that rule, but probably not anything you're taking.


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## joaquinx (Jul 3, 2010)

atorvastatina and tartrato de metoprolol. Although I can't say for sure right now, Lipitor and Lopresser and available here. I have to go to the supermarket this afternoon, so give me your dosages and I'll check on the prices.

Also, if your over 55 (I think that is the age) you can get an INAPAM card that will give you discounts of many items, including bus fares and medications. I get a 7% discount at Chedraui supermarkets.


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## stilltraveling (May 7, 2012)

joaquinx said:


> atorvastatina and tartrato de metoprolol. Although I can't say for sure right now, Lipitor and Lopresser and available here. I have to go to the supermarket this afternoon, so give me your dosages and I'll check on the prices.
> 
> Also, if your over 55 (I think that is the age) you can get an INAPAM card that will give you discounts of many items, including bus fares and medications. I get a 7% discount at Chedraui supermarkets.


Metoprolol (Lopressor) sells under various brand names here. It's spelled the same in English and in Spanish. 

Atorvastatina (Lipitor) is available here as a generic or as Lipitor from Pfizer. 

Both of these drugs I prescribe as generics. There are a few drugs that I only prescribe as brand names, but those are mostly intravenous drugs for use in the hospital. Any of their generics in the national pharmacies (Similares, Farmacia del Ahorro, Farmacia Roma, etc.) are just as good as the brand names but cost about 1/4 what Pfizer will charge you.


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## Longford (May 25, 2012)

FHBOY said:


> I will refill here before I leave, but would really like to learn the system and the prices.


Being inquisitive is a good thing. Especially so if you're going to be living in Mexico one day.

I don't know for how long some of the name brand medications may have been available in their generic form in Mexico, but within the past year two of mine have gone generic in the USA ... Plavix and Lipitor. Now that they're available in generic form I save $1,200 a year as compared to what I paid before (because of the high co-pays which are requirements of my Blue Cross/Blue Shield healthcare insurance).


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## Isla Verde (Oct 19, 2011)

joaquinx said:


> Also, if your over 55 (I think that is the age) you can get an INAPAM card that will give you discounts of many items, including bus fares and medications. I get a 7% discount at Chedraui supermarkets.


You can get an INAPAM card when you reach 60. At the Superama pharmacy I get a 5% discount and a whopping 50% off on inter-city bus fares plus free or discounted admission to many museums and a nice discount on movie theater admissions.


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## FHBOY (Jun 15, 2010)

Isla Verde said:


> You can get an INAPAM card when you reach 60. At the Superama pharmacy I get a 5% discount and a whopping 50% off on inter-city bus fares plus free or discounted admission to many museums and a nice discount on movie theater admissions.


A bit off topic but...what do you need to get the card? Documentation wise.

:focus:


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## Isla Verde (Oct 19, 2011)

FHBOY said:


> A bit off topic but...what do you need to get the card? Documentation wise.
> 
> :focus:


I got mine a few years ago in Mexico City, so the details are hazy. I'll look through my files and see what I can find. Of course, what is required in Mexico City may not be what is required in other parts of the country.


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## joaquinx (Jul 3, 2010)

I showed them my Passport, my FM3, birth certificate, and electric bill.


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## Longford (May 25, 2012)

FHBOY said:


> A bit off topic but...what do you need to get the card? Documentation wise.
> 
> :focus:




Discount Card


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## Isla Verde (Oct 19, 2011)

It looks like I had to show my birth certificate, my CURP, an official ID with photo, two recent photographs _tamaño infantil_, and the name of someone to be notified in case of emergency.


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## RVGRINGO (May 16, 2007)

Isla Verde said:


> It looks like I had to show my birth certificate, my CURP, an official ID with photo, two recent photographs _tamaño infantil_, and the name of someone to be notified in case of emergency.


You must also know your blood type and have proof of address and the necessary information for emergency notification of a family member, friend, etc.


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## Isla Verde (Oct 19, 2011)

RVGRINGO said:


> You must also know your blood type and have proof of address and the necessary information for emergency notification of a family member, friend, etc.


I don't know my blood type and no one asked for it when I applied for the card.


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## RVGRINGO (May 16, 2007)

Here, it is required. You can have it typed at any local lab.


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## TundraGreen (Jul 15, 2010)

Isla Verde said:


> I don't know my blood type and no one asked for it when I applied for the card.


My first credencial came from a DIF (Desarrollo Integral Familia) office. They put my blood type on the DIF card but not the INAPAM credencial. Later I got an INAPAM credencial from a dedicated INAPAM office. They didn't ask about blood type.


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