The Salina Journal from Salina, Kansas on May 4, 1997 · Page 68
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The Salina Journal from Salina, Kansas · Page 68

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Salina, Kansas
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Sunday, May 4, 1997
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Page 68
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Q&A Fitness By FLORENCE GRIFFITH JOYNER i GEORGE FOREMAN Q: Once and for all: Is it more important to stretch before or after exercise? I'm 62. Five days a week I do aerobics, strength training, then stretching. Should stretching exercises be done before aerobics? Some instructors have told me to do it one way; some the other. Which is the right order? Estelle M. Moreland, Santa Maria, Calif. Flo-Jo: To me, there really isn't a right or wrong way. But many experts insist that, to prevent injuries, you should warm up the muscles before using them. This includes a warm-up before any intense stretching. "Cold" stretching can lead to injuries. By saving your stretching until after aerobics, you ensure the muscles will be warm enough and get the maximum benefit. I like to warm up before stretching because my body has been trained that way and I have not experienced a workout injury in 30 years doing it that way. In your case, if you're comfortable ending your workout with stretching, by all means continue. I'm proud of you. Keep on keeping on! Q: I live in western Texas, which is Incredibly flat. I enjoy hiking and need advice on how best to prepare for the terrain in the Colorado mountains. Could you recommend a program? J. Grain, Midland, Texas George: First, find a really good treadmill machine that allows you to change the angle of the incline. Start off easy, then slowly work your way up, over several weeks or months, until the incline is at the maximum setting. I used to think treadmills couldn't possibly help. Then, while training in the West Indies for my 1991 bout with Evander Holyfield, I got in the best shape of my life. I noticed my work on the treadmill had made me stronger. And, people: Don't be ashamed to hold onto the handrails of your machine for safety. At first I thought: If I'm going to walk up mountains and I'm holding onto these handrails, I'm not going to be as balanced. But it's better to be safe and not injure yourself before you even step out into the great outdoors. Holding onto the handrails is not going to take away anything, because it's the legs you want to work on. Don't be ashamed to hold on! Q: In a recent column, a reader mentioned she was in a "running club." I have been a runner most of my life. To me, it has always seemed a solitary sport because I don't want to compete, yet most teams are competitive. Do you have information on running clubs nationwide? Johanna Granville, Pittsburgh Flo-Jo: Running clubs are the perfect way for athletes to commune without being competitive. To find one near Big mill: A documentary about Foreman's 1974 "Rumble in the Jungle" title fight against Muhammed Ali won an Oscar this year. you, check with gyms, the "Y" or the local parks and recreation department. Also, the USA Track & Field Association (1-317-261-0500) has a national listing of teams. Or scan clubs' home pages on the Web. You're bound to find at least one club with like-minded runners. If somehow you find only dead ends, consider starting your own club. You'll be surprised how many runners out there feel just as you do. ca 'No room for excuses' Many readers ask how they can stay motivated in their workouts. "The most inspirational thing I ever heard in my L _ life," George Foreman says, "was when Muhammed Ali was champion of the world in the '60s and there was a chance he might have to be incarcerated because he refused to join the Army. The word was that All would stay in shape even if he had to work out in a telephone booth! "That idea leaves no room for excuses. So I always tell people they need to look in the mirror and say to themselves, 'Look, you are all I have, of body. I'm going to get in shape. I owe it to myself, even if I have to work out in a telephone booth.'" Gtorft Foreman and Florwct Griffith Joyner answer questions on getting and staying in shape in this exclusive twice-monthly column. It next runs in the May 16-18 issue. Write: "Q&A: Fitness," 1000 Wilson Blvd., Arlington, Va. 22229-0012 (fax: 703-276-5518; e-mail: fitness@usaweekend.com). Please include your name, address and daytime telephone number, with the area code. CAUTION: FEDOM. LAW PHOHWTt DWUBUti WITHOUT PHI SCHIITIIM. (buspirone HCI.USP) Brief Summary of Prescribing Information, 12/94. For complete prescribing information, please consult official package circular. CONTRAINDICATIONS Hypersensitivity to buspirone hydrochlorlde. WARNINGS Tta italiWiiliiw ol I«S|W to I |)|U(M bUo| i iBowwilM when BuSpar was administered concomilanlly with an MAOI. such concomitant use Is not recommended. BuSpar should not be employed In lieu of appropriate antipsychoSc treatment PRECAUTIONS Qininl - Interference with cognitive and motor performance: Although buspirone Is less sedating than other anxiolytics and does not produce significant functional impairment, its CNS effects In a given patient may not be predictable: therefore, patients should be cautioned about operating an automobile or using complex machinery until they are reasonably certain that buspirone does not affect them adversely. Although buspirone has not been shown to increase alcohol-Induced Impairment in motor and mental performance, It Is prudent to avoid concomitant use with alcohol. Potential lor withdrawal reactions in sedative/hypnotic/anxiorytic drug-dependent patients: Because buspirone will not bloc)' the withdrawal syndrome often seen with cessation ol therapy with benzodiazepines and other common sedative/hypnotic drugs, before starting buspirone withdraw patients gradually Irom their prior treatment, especially those who used a CNS depressant chronically. Rebound or withdrawal symptoms may occur over varying lime periods, depending In part on the type of drug and its elimination half-life. The withdrawal syndrome can appear as any combination ol irritability, anxiety, agitation, insomnia, tremor, abdominal cramps, muscle cramps, vomiting, sweating, llu-llke symptoms without fever, and occasionally, even as seizures. Possible concerns related to buspirone's binding to dopamine receptors: Because buspirone can bind to central dopamine receptors, a question has been raised about its potential to cause acute and chronic changes In dopamine mediated neurological function (e.g., dystonia, pseudoparklnsonism, akathisia, and tardive dyskinesia). Clinical experience in controlled trials has (ailed to Identity any significant neuroleptic-llke activity; however, a syndrome of restlessness, appearing shortly after initiation ol treatment, has been reported: the syndrome may be due to Increased central noradrenerglc activity or may be attributable to dopamlnergic effects (I.e., represent akathisia). Inlmatllof iu PitlmU - Patients should be Instructed to Inform their physician about any medications, prescription or nonprescnption, alcohol, or drugs they are now taking or plan to take during treatment with buspirone; to inform their physician if they are pregnant, are planning to become pregnant, or become pregnant while taking buspirone; to Inform their physician if they are breast feeding: and not to drive a car or operate potentially dangerous machinery until they experience how medication allects them. Dm latwieUtut - Concomitant use with other CNS active drugs should be approached with caution (see WARNINGS). Concomitant use with trazodone may have caused 3- to 6-fold elevations on SGPT (ALT) In a lew patients. Concomitant administration of BuSpar and haloperidol resulted In increased serum haloperidol concentrations in normal volunteers. The clinical significance Is not clear. Buspirone does not displace tightly bound drugs like phenytoln, propranolol, and warfarin from serum proteins, but may displace less firmly bound drugs like digoxin. However, (here was one report of prolonged prothrombin lime when buspirone was given lo a patient also treated with warfarin, phenytoin. phenobarbital, digoxin. and Synthrold. Circlicrjtntttt. Kudjfiff'r. loptlimtal o/Arttfty-No evidence ol carcinogenic potential was observed in rats or mice: buspirone did not Induce point mutations'nor was DNA damage observed; chromosomal aberrations or abnormalities did not occur. AMOMCK Tialoftnle UvM - Pregnancy Category B: Should be used during pregnancy only if clearly needed. Hatlae wlttn -Administration to nursing women should be avoided if clinically possible. Prtltliic Uu - The salely and effectiveness have not been determined in Individuals below ID years of age. UttlnllM fltlt'ty-"" unusual, adverse, age-related phenomena have been Identified in elderly patients receiving a toy, modal daily dose of 15 mg. Uu la Pitlmtr HHtt la^iini Htfttlc it Rttll FvteUea - Since buspiione is metabolized by the liver and excreted by the kidneys, it Is not recommended In severe hepatic or renal Impairment. ADVERSE REACTIONS (*•• ilw PRECAUTIONS) Coumtulf OOlirwrf Tim more commonly observed untoward events, not seen at an equivalent incidence in placebo-treated patients include dizziness nausea headache, nervousness, llghtheadedness, and excitement AnmliM WM BtironllmHUtt 1 ol Jmlauel - The more common events causing discontinuation included: central nervous system disturbances (34%) primarily dizziness, Insomnia, nervousness, drowsiness, lightheaded feeling: gastrointestinal disturbances (1.2%), primarily nausea: miscellaneous disturbances (1.1%), primarily headache and fatigue. In addition, 3.4% of patients had multiple complaints, none of which could be characterized as primary. tocMWK* la CatltttlM ClUeil IMifr - Adverse events reported by 1% or more of 477 patients who received buspirone in lour-week, controlled trials: Cardiovascular: Tachycardla'palpltalions 1%. CNS: Dizziness 12%, drowsiness 10%, nervousness 5%, insomnia 3%, lightheadedness 3%, decreased concentration 2%, excitement 2%, anger/hostility 2%, confusion 2%, depression 2%. F.ENT: Blurred vision 2%. Gastrointestinal: Nausea 8%, dry mouth 3%, abdominal/gastric distress 2%, diarrhea 2%, constipabon 1%. vomiting 1%. Mysculoskeletal: Musculoskeletal aches/pains 1%. Neurological: Numbness 2%, paresthesla 1%, ^coordination 1%. tremor 1%. Sk/n:Skin rash 1%. Miscellaneous: Headache 6%, fatigue 4%, weakness 2%, sweating/clamminess 1%. OMwfMote QttmttOwi»l Mf latin PniuriuUia FnJujtfM -The relative fiequency ot all other undesirable events reasonably associated with the use ol buspirone In approximately 3000 subjects who took multiple doses under well-controlled, open, and uncontrolled conditions Is defined as follows: Frequent are those occurring in at least 1/100 patients; Infrequent are those occurring In 1/100 to 1/1000 patients; and rare are those occurring In less than 1/1000 patients. Cardiovascular - frequent: nonspecific chest pain: Infrequent: syncope, hypotension, and hypertension; rare: cerebrovascular accident, congestive heart failure, myocardlal infarction, cardiomyopathy, bradycardla. Central Nervous System - frequent: dream disturbances; infrequent: depersonalizatlon, dysphoria, noise intolerance, euphoria, akathlsla. tearfulness, loss of Interest, dissociative reaction, hallucinations, suicidal Ideation, seizures; rare: feelings ol claustrophobia, cold Intolerance, stupor, slurred speech, psychosis. EENT- frequent: tinnitus, sore throat, nasal congestion; infrequent redness and itching of the eyes, altered taste, altered smell, conjunctivitis; rare: Inner ear abnormality, eye pain, photophobia, pressure on eyes. Indocnne - rare: galactorrhea. thyroid abnormality. Gastrointestinal - infrequent: flatulence, anorexia, Increased appetite, salivation, irritable colon, rectal bleeding; rare: burning ol the tongue. Genitourinary - infrequent: urinary frequency, urinary hesitancy, menstrual Irregularity and spotting, dysuria; rare: arnenorrhea, pelvic Inflammatory disease, enuresls, nocturla. Musculoskeletal - Infrequent: muscle cramps, muscle spasms, rigid/stiff muscles, arthralgias. fVeurotoj«a/-Infrequent: Involuntary movements, slowed reaction time; rare: muscle weakness. Respiratory Infrequent: hyperventilation, shortness ol breath/and chest congestion; rare: eplslaxis. Sexual Function - Infrequent: decreased or Increased libido; rare: delayed ejaculation, Impotence. Sinn - Infrequent: edema, pruritus, flushing, easy bruising, hair loss, dry skin, lacy edema, blisters; rare: acne, thinning of nails. Clinical Laboratory - Infrequent: Increases in hepatic aminotranslerases (SGOT, SGPT); rare: eosinophllia, kjukopenla, thrombocytopenia. Mlsullamous -infrequent: weight gain, fever, roaring sensation in the head, weigh! loss, malaise; rare: alcohol abuse, bleeding disturbance, loss of voice, and hiccoughs. POtnNTMODUCTWN CUNKAL EXKMENCfc Rare occurrences of allergic reactions (Including urticaria), cogwheel rigidity, dystonk reactions, ataxlas, extrapyramldal symptoms, dyskinesias (acute and tardive), ecchymosls, emotional lability, tunnel vision, and urinary retention have been reported. Because of the uncontrolled nature of these spontaneous reports, a causal relationship to BuSpar has not been determined. DRUG ANISE AND DtPENOCNCE CnlnHut lnUmi Clut - Nol a controlled substance. Mjiiu/Mtf AjtitofelJu' Otnotitu - Buspirone lias shown no potential tor abuse or diversion and there Is no evidence that it causes tolerance, or either physical or psychological dependence. However, since it is difficult to piedicl from experiments the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed, physicians should carefully evaluate patients lor a history ol drug abuse and follow such patients closely, observing them lor signs ol buspirone misuse or abuse (e.g., development ol tolerance, incrementation ol dose, drug-seeking behavior). OVERDOIAtf Situ U4 Snofton* - At doses approaching 375 mg/day the following symptoms were observed: nausea, vomiting, dizziness, drowsiness, mlosis, and gastric distress. A few cases of overdosage have been reported with complete recovery as the usual outcome. No deaths have been reported following overdosage with BuSpar alone. Rare cases ol Intentional overdosage with a fatal outcome were Invariably associated with Ingeslion of multiple drugs/or alcohol, and causal relationship to buspirone could not be determined. KKoantiit OwflfeM Ttulntul - General symptomatic and supportive measures should be used along with Immediate gastric lavage. No specific antidote is known and dialyzability of buspirone has not been determined. U.S.A. Patent Nos. 3,717,634 and 4,182.763 $& BridotMyen Squibb Company Priri«ton.N| 08543 USA, Based on 81843-DIM-05-S Revised December 1994

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