Carafate (Sucralfate)
| Online Pharmacy: | Minimal Price: | Best Buy: | Shipping: | Payment | Delivery to: |
|---|---|---|---|---|---|
| medixresources "Carafate" | 1000 mg | 14/free |      | most countries | |
| 30 pills $108.52 | 90 pills $242.41 | ||||
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| tl-pharmacy "Generic Carafate" | 1g | 10-21 days/free |    | every country | |
| 30 pills €47.54 | 360 pills €345.09 | ||||
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| medrx-one | Not available for sale | 10 days/free | | most countries | |
| leadmedic "Carafate" | 1000 mg | 14-21days/$10
5-7 days/$25 | | every country | |
| 30 pills $140.96 | 90 pills $314.82 | ||||
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| Medph | Not available for sale | FedEx next day/$24 |  | USA only | |
| med-pen "Carafate" | 1gm | 14-20 days/$10
7-14 days/$20 |   | most countries | |
| 30 Tabs $29.7 | 240 Tabs $165.6 | ||||
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| ourpharmacyrx "Carafate" | 1 gm | 14-21 days/$15
5-12 days/$30 | | most countries | |
| 30 pills $33 | 180 pills $124.2 | ||||
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| RxPharms | Not available for sale | 14-24 days/free | | worldwide | |
| RxMedShop | Not available for sale | 8-16 days/$20
5-9 days/$30 3-6 days/$40 | | most countries | |
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CHRONIC CONFUSION: ALCOHOL
As many people have learnt to their cost, the effects of acute alcohol consumption can be both seen and felt. The elderly are no different in this, though their tolerance to alcohol may be diminished. Initial feelings of well-being give way to increasing loss of social inhibitions, unsteadiness, slurred speech, difficulty concentrating, then to aggressive tendencies, nausea and vomiting, and finally to falls and unconsciousness. All of the above can occur even faster if alcohol is mixed with medication. Thus alcohol abuse should be considered in all cases of acute confusional states as well as chronic ones.
Some elderly people have carried their alcohol abuse along with them for years. These are probably in a minority, for the effects of severe alcohol abuse are not compatible with a long life. However these chronic abusers may show the effects of the alcohol on every body organ. The liver may be cirrhotic (severely scarred and fibrotic) and after heavy drinking bouts they may become yellow (due to a form of hepatitis – inflammation of the liver). General nutrition is often poor and the person looks malnourished, being thin, with a poor complexion, bad teeth and skin, a tendency to bruise easily and prone to chest infections, etc. This poor nutrition can be general or more specific if vitamins are missing. Alcoholics can be deficient in the vitamin thiamine and then present fairly acutely with falls, due to an inability to walk properly (ataxia – not the acute effects of alcohol), eye problems and an acute confusional state (Korsakoff’s psychosis), the whole brain condition being called Wernicke’s encephalopathy. The response to being given thiamine is usually dramatic.
If the supply of alcohol is suddenly withdrawn from a chronic abuser (admission to hospital or old people’s home) then it can produce the DT’s (delirium tremens). This is a very dangerous condition, with a craving for alcohol and then confusion, accompanied by hallucinations. It can be fatal, especially in the more frail elderly alcohol abuser. The long-term effects of alcohol on the brain are equally as bad. Alcohol is a well recognized cause of chronic confusion or dementia. The memory loss is accompanied by a deterioration of the personality. The emotional trauma to carers is very great indeed – having to cope with a dementing person made regularly worse by bouts of heavy drinking.
Some people only turn to alcohol in late life. It may be possible to find a precipitating cause such as bereavement, depression or a chronic painful medical condition. These people usually present with frequent falls or frequent bouts of confusion that disappear after 24 hours in hospital. They have not been drinking long enough for the physical signs to show and their bodies are not dependent on the alcohol so that they rarely get the DTs. Alcohol may be smelt on the breath or found in the blood in someone who is unconscious. More commonly, empty bottles are found in the bedside cabinet during an assessment visit to an old lady who is falling over a lot, and someone has requested her admission to an institution.
Long-term dependence on alcohol is as hard to treat in elderly people as it is in the younger age groups. A commitment to stop and keep off alcohol under difficult circumstances has to be present. There are many organizations that can help but few centers for rehabilitation of alcohol abusers will consider elderly people. The late onset drinker has a better prognosis, for it may be possible to identify the cause of the drinking and treat it. There are a few people who appear to develop a drinking habit detrimental to their health after they have started to become confused with a dementing illness such as Alzheimer’s disease, and these few can be particularly hard to help.
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