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March 12th, 2010
05:12 PM ET

FDA issues new warning for Plavix

By Saundra Young
CNN Medical Senior Producer

A new boxed warning has been added to the anti-blood clotting drug Plavix by the Food and Drug Administration, who says the medication doesn't work well in people who have difficulty metabolizing the drug.

Plavix is used by patients with heart disease to help decrease risk of heart attack, stroke and death. It works on platelets–special blood cells that help blood clot to stop bleeding–by preventing blood clots from forming.

Plavix needs to be activated by the liver enzyme, CYP2C19. Patients that have reduced liver enzyme function can't activate the drug making it less effective for them. They're called "poor metabolizers" and this puts them at greater risk of heart attack, stroke and death.

"We want to highlight this warning to make sure health care professionals use the best information possible to treat their patients," said Mary Ross Southworth, a clinical analyst in the Division of Cardiovascular and Renal Products in the FDA's Center for Drug Evaluation and Research.

The Agency says there are tests available to evaluate CYP2C19 and determine if you are a "poor metabolizer." They say patients should talk to their doctors to determine if they should stop taking the drug.

Last November the FDA issued a warning about using Plavix in conjunction with over the counter stomach acid reducer Prilosec and Prilosec OTC when new data found that taking the two together reducedPlavix's anti-clotting effect by about half. .

Plavix is available only by prescription. It's made by Bristol-Myer Squibb and Sanofi Aventis, who issued the following statement "The revisions to the prescribing information for Plavix reflect the companies' ongoing research in collaboration with the FDA, which better defines the patient population that may be affected by a genetic variation in CYP2C19 and alternate treatment strategies."

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


March 12th, 2010
04:48 PM ET

Swim tips and drills for triathletes

By Laura Cozik
Athletic Director, CNN Fit Nation Triathlon Challenge
CEO, Team Lipstick Triathlon

In a triathlon, the swim is the shortest part of the race, but mentally the swim can be the most difficult part of the competition. In my opinion, it is just that type of adversity that makes triathlon so rewarding. Bring it on!! You must learn to embrace the open water, make friends with it, find peace in it, and enjoy the camaraderie of those around you. And in order to do that, you must prepare.

The following drills focus on improving your upper-body technique as well as your breathing. Since you’ll be using your legs to bike and run, a strong upper-body swim is the way to go in triathlon. And improving your lung capacity will help you to calm down and breathe easy when swimming. I am listing a few of my favorite swim drills, plus a few tips for the swim portion of the triathlon, focusing on your race-day experience. You can type the drills below into YouTube to see video demonstrations.

*Catch-up drill: A very popular drill, for a reason. The catch-up drill teaches swimmers to delay their catch, keeping the body more streamlined, focusing on a long stroke and a long body position. One arm goes through a full cycle of the freestyle swim stroke, while the other arm remains extended forward. When the stroking arm “catches up” to the arm that is extended forward, the waiting arm then takes a turn.

*Tennis ball drill: This is a great drill for teaching swimmers how to use their entire forearm when pulling under the water. Swim regular freestyle, but with a tennis ball in each hand. In this closed-fist position, swimmers have to use their entire forearm to pull themselves through the water. After practicing for a while, get rid of the tennis balls and try to perform the same good technique, but now with the added power of your hand!

*Fingertip drag: This drill encourages a high elbow during the recovery phase of the swim stroke, when the arm is out of the water. As the arm exits the water, fingertips drag along the surface of the water before re-entering. This should be done very relaxed.

*Group swimming: The triathlon swim is a contact sport, so practice swimming in small, close proximity groups. You can swim 3-4 athletes side by side in one lane of the pool, or maybe a small cluster of 6-7 athletes. Get used to feeling other arms and legs while swimming. It’s nice to know you’re not alone!

*Sighting: There are many ways to practice sighting- the skills that allow you to swim in a straight line toward your intended location, while in open water. One of my favorites is to swim directly toward someone in your lane. Just before you bump heads, swim around each other (to the right or left, but that should be decided ahead of time), then swim back where you came from. You’ll have to sight a LOT.

*Hypoxic sets: Improving your lung capacity when swimming is key! When you bike or run, you can breathe as often as you like, but when you swim, you have to follow a timed pattern. Doing hypoxic drill sets will help to improve your lung capacity. One way is to try swimming a 25 meter lane, from one end to the other, without breathing at all! Take a break when you get to the other side until you feel completely recovered, then repeat. Do about 4 of these during every swim workout and watch them improve!

Here are some other tips that will be helpful during your triathlon swim:

*You must, must, must practice swimming in open water prior to race day. If the race allows you a practice swim the day prior, or minutes prior to start time, DO IT! Get rid of the fear of the unknown before the gun goes off.

*Wear a wetsuit, for warmth and buoyancy. Practice swimming in it, and especially removing it, prior to race day.

*Find the objects you plan on sighting during your swim, just prior to race start. Buoys are good, but sometimes it’s also beneficial to find a building, a particular object, or something that is not actually IN the water to sight.

*Choose your goggles according to the clearness of the day. Orange is my favorite tint as it brightens up a cloudy day, and also cuts the glare of a sunny day.

If you are nervous, think “just keep swimming, just keep swimming”, or whatever mantra helps you. You can also picture the cocktails and friends that will be waiting at the celebration that night.

Keep up the good work with your training, and please send any questions you may have about triathlon training.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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