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Ask Dr. Lang: answers to questions about alcohol & antibiotics, cardiac devices, and ingrown toenails.

Q Is it safe to drink alcohol if I'm taking antibiotics?

Alt depends on the antibiotic you're taking. For instance, combining alcohol with erythromycin may cause alcohol to enter your bloodstream more rapidly. Drinking alcohol also can worsen upset stomach, drowsiness, and dizziness associated with certain antibiotics. And, if you take antibiotics such as metronidazole (Flagyl[R]), tinidazole (Tindamax[R]), or sulfamethoxazole (Bactrim[R], Septra[R]), avoid consuming any alcohol, as the combination may cause more severe side effects, such as rapid heart rate, headache, flushing, and nausea.

The best, and safest, approach, is to review your medications with your doctor and pharmacist to find out whether or not it's safe for you to imbibe while taking antibiotics.

Q If I have pacemaker, can I undergo imaging studies, such as MRI?

A With age, more and more people require implantable cardiac devices, such as pacemakers and implantable cardioverter defibrillators (ICD). And, at some point, many of these same people will require an imaging study, such as computed tomography (CT) scans or magnetic resonance imaging (MRI), for a non-cardiac-related condition.

Generally, people with implantable cardiac devices can undergo CT scans safely, although the U.S. Food and Drug Administration recommends minimizing X-ray exposure to the implanted device. Dental X-rays and diagnostic ultrasound imaging are considered safe for people with cardiac devices.

In the past, people with pacemakers or ICDs were generally warned against undergoing MRI, due to concerns that the powerful magnetic waves from the imaging machine could damage the implantable devices or alter their function.

More recently, manufacturers have developed cardiac devices that are MRI-safe or allow patients to undergo MRI under certain conditions. Some studies have found that MRI imaging may be done safely in areas away from the chest, even in patients with standard pacemakers or ICDs. (Note that MRI is not safe for patients with cardiac device leads [wires] left in the body after a new device or leads have been implanted.)

If you need a cardiac device, ask about the pros and cons of MRI-safe and MRI-conditional models. And, if you're recommended for an MRI, inform your doctor about your pacemaker or ICD, whether it's MRI-safe or MRI-conditional, and whether you have any leads left over from an older device. In any case, you should be monitored by the radiologist and a cardiologist during the scan.

Q How can I treat ingrown toenails?

A An ingrown toenail develops when the corner or side of one of your toenails grows into the surrounding skin of the toe, causing pain, swelling and, in some cases, infection. To prevent ingrown toenails, cut your toenails straight across and keep them even with the tips of your toes. Wear comfortable shoes that don't pinch your toes.

Usually you can treat ingrown toenails at home by soaking your feet in warm water for 15 to 20 minutes several times a day and sliding a piece of dental floss soaked with antiseptic or water under the affected nail to help it grow above the skin edge (change the floss daily). Use a topical antibiotic and bandage to cover the sore area. Wear open-toed shoes or sandals until the problem resolves. If the condition worsens or you notice pus or redness that appears to be expanding, see your doctor.

Ingrown toenails can be especially problematic if you have diabetes, so check your feet and toenails regularly, and see your physician if you notice any problems.

Editor-in-Chief Richard S. Lang, M.D., M.EH., EA.C.P

Vice Chairman, Cleveland Clinic Wellness Institute
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Author:Lang, Richard S.
Publication:Men's Health Advisor
Article Type:Interview
Date:Aug 1, 2015
Words:588
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