Meds

Neurotransmitters and the side effects of antidepressants

Meds
July 22, 2011

We  certainly wish that antidepressants in particular, and all psychiatric medications in particular were free of side-effects. It would be a boon to our patients, and their families. Sadly, there is no such thing as a medication without any risk of side-effects. Even over-the-counter medications such as Tylenol, Benadryl an aspirin can have pretty serious side-effects.

Some side-effects of medications are related to dose — the higher the dose, the …

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Pharmacies selling prescription information to data mining companies

Meds
June 30, 2011

Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.

The data privacy and security concerns surrounding the transfer of de-identified data are significant.  To “de-identify” what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal …

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What to do with a prescription bottle with the wrong pills inside

Meds
March 22, 2011

Have you ever opened a prescription bottle to find the wrong pills inside? If so, you may have found it to be an expensive mistake.

Whatever the reason for the error (and there are numerous possible causes), here is how to best handle the situation.

Of course, it is always smart to confirm the medications, quantities and dosages at the pharmacy checkout.  A mistake recognized at the time of purchase can be easily …

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Alternatives to NSAIDs, pros and cons

Meds
February 3, 2011

by Marianna Rakovitsky, RPh

Recently, I have talked about the concerns with the use of NSAIDs and their effects on the heart.  All medications carry a risk of adverse effects. NSAIDs are usually very effective in controlling pain especially muscle and bone pain, but they also carry a potential risk of side effects such as stomach and kidney problems, increased risk of bleeding and adverse effects …

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FDA regulation and non-approved use of drugs

Meds
January 26, 2011

The other day, I happened to be talking to Mark, a sales representative from one of the pharmaceutical companies.  He’s the type of rep that many doctors don’t mind seeing – someone who is careful of your time, is happy to hunt down the answers to questions that come up on the medications his company makes, and brings by useful information about new drugs that seem to be practice-appropriate.  He …

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Create a disease to market a new drug

Meds
January 24, 2011

An excerpt from White Coat, Black Hat.

by Carl Elliott

Many of us have a relatively simple, commonsense view of the way that drug development and marketing work.

People get diseases; scientists develop drugs to treat those diseases; and marketers sell the drugs by showing that the drugs work better than their competitors. Sometimes, however, this pattern works in reverse. Drug company scientists develop a drug …

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How cocaine can be used in sinus surgery

Meds
January 16, 2011

Many people are already aware that marijuana is now legal in some states in the US with a medical prescription.

What many people may not realize is that cocaine is also used in medical care, especially in the ENT world.

Cocaine is one of the most potent anesthetic and vasoconstrictor. These two characteristics make it an ideal medication for use during sinus surgery as well as any nasal procedure where bleeding and …

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Why doctors should profit from dispensing medications

Meds
January 15, 2011

Hold onto your hats. I am about to enter dangerous territory. I am about to suggest maybe doctors should profit from dispensing medications from their office to offset declining reimbursements and rising expenses by using prescriptions as a source of ancillary revenues.

Why dangerous?  For a number of reasons.

One, physicians still grapple with the perception that it is improper for a physician to make money from …

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Adding tiotropium (Spiriva) to an inhaled steroid a mistake?

Meds
December 30, 2010

There is a lot of press about a study recently published in the New England Journal of Medicine that shows that adding tiotropium (Spiriva) to an inhaled steroid might have benefit in asthmatic patients. This study is creating a lot of buzz due to recent concerns of ICS/LABA safety and might prompt doctors and patients to start switching (some already have before this study came out). However, this …

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Antibiotics need to become controlled substances and regulated

Meds
November 29, 2010

Antibiotics for viral infections are a big pet peeve of mine. No. Make that a huge pet peeve.

Some doctors prescribe antibiotics for coughs and stuffy noses because the patients want them. If you’re one of those patients who think that antibiotics make your coughs go away, or clear up your stuffy noses, or somehow make your sinus headaches vanish, or if you’re a doctor who prescribes antibiotics for these symptoms, …

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Help patients synchronize their prescription drugs

Meds
November 12, 2010

Here’s the scenario: on the 2nd of the month, a patient with diabetes on metformin and high blood pressure on benazepril sees her family physician for a routine follow up.

The patient’s blood pressure is elevated and the decision is made to add carvedilol to help get the blood pressure to goal. The patient’s metformin and benazepril “drop” (are renewed) at the pharmacy on the 18th of every month, a date …

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Arimidex price markup at major pharmacy chains

Meds
October 22, 2010

The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply. I found some very surprising results:

Costco: $27

Walgreens (with Saver Card): $325 (without Card): $380

CVS: $361

Walmart: $347

Target: $340

These are not typos. Costco is selling a one-month supply of generic Arimidex for $27, …

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Finasteride, fruit, and the matter of prostate health

Meds
October 14, 2010

by Arnon Krongrad, MD

The noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I consumed pomegranate juice, I could cheat death.

Last week, the Federal Trade Commission charged POM Wonderful, LLC, makers of pomegranate products, with deceptive advertising. …

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DTC advertising, and its history with the FDA

Meds
September 18, 2010

Advertising is everywhere.

That should come as no surprise to anyone who has lived in modern America. It is impossible to turn on the television, ride the subway, or even sort through the daily mail without coming across an ad for a new car, a soft drink, or the latest digital toy. These advertisements have only one goal: to entice you to buy their products. This is harmless enough when these …

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How drug companies sell psychiatrists on their drugs

Meds
August 26, 2010

An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc.

In 1993, the FDA approved Neurontin for the treatment of epilepsy. This should have been a cause for celebration at Warner-Lambert, the drug company that introduced it, but the celebration was muted. The FDA had …

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Creatine causing muscle cramps and how supplements may be dangerous

Meds
August 18, 2010

About a month ago, a 44-year-old insurance executive came to see me with complaints of headaches and muscle cramps. His pain was caused by the typical cluster headache located behind one eye, accompanied by one-sided tearing and nasal congestion, and often triggered by occasional wine or chocolate. The muscle cramps mainly affected the legs and seemed to worsen after exercise.

When I got the results of his lab work, I was …

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Pharmaceutical sponsored dinners have educational value

Meds
August 5, 2010

It is insulting to think that doctors who are ostensibly smart enough to save one’s life are in fact so stupid, or merely gullible enough, to be swept away by what is in actuality only a very weak potion of sales-presentation intermixed with and embedded within generally informative and pharmaceutical-balanced subject-focused medical lectures.

Such lectures occur usually at a private function room at a restaurant or, in conjunction with a served …

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