Drugs and prescribing

1,242 articles · Since 2007

Articles, page 18

The art of off-label prescribing

July 10, 2019Jul 10, 2019

Some drugs are used for indications beyond their original FDA approved ones that make complete sense. I mean, if old seizure medications help nerve pain, it might be reasonable to try new ones for the same purpose if everything else…

Sometimes the broader use of a medication leads to additional FDA approved indications. One good example is bupropion, Wellbutrin, for smoking cessation. It even got a new name for that indication, Zyban, …

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The art of off-label prescribing

The basics of the MMR vaccine from a pediatrician

Roy Benaroch, MD

July 8, 2019Jul 8, 2019

As the U.S. endures its largest measles outbreak in 25 years -- one that’s almost certainly going to get worse before it gets better -- we’re getting a lot of calls and questions at my office. What’s measles, what’s the…

As the U.S. endures its largest measles outbreak in 25 years — one that’s almost certainly going to get worse before it gets better — we’re getting a lot of calls and questions at my office. What’s measles, what’s the best way to prevent it, when should the vaccine be given to adults and children?

The measles vaccine is given as “MMR,” which teaches the immune system to fight off measles, …

The allure of complementary and alternative medicine

Steven Reidbord, MD

June 28, 2019Jun 28, 2019

“Complementary and alternative medicine” (CAM) is a category that includes all the methods of physical or mental healing that do not fall under the umbrella of western medicine. Examples include comprehensive healing traditions from other cultures, such as Chinese or Ayurvedic (Indian) medicine; herbal remedies; and a wide variety of mind-body treatments, such as meditation and yoga. CAM treatments are popular everywhere, including here in the U.S. …

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If we don’t pay now to vaccinate our children, they will pay later

Peter Ubel, MD

June 27, 2019Jun 27, 2019

The HPV vaccine saves lives. It does so by reducing a person’s chance of being infected by the human papilloma virus, a virus that causes a whole range of cancers including, most importantly, cervical cancer. Vaccinate your teenage daughter against…

Yet currently, the majority of American teenagers, boys and girls, are reaching adulthood without the full …

How hospitals can help with the opioid epidemic

Christopher Moriates, MD & Richard Bottner, PA-C

June 21, 2019Jun 21, 2019

Nearly half a million individuals with opioid use disorders are hospitalized each year in the United States. While they are in the hospital, medical providers often treat complications of this disorder, such as bloodstream infections, but rarely directly address their…

The ethics behind the world’s most expensive medication

Robert Pearl, MD

June 14, 2019Jun 14, 20192

With the recent FDA approval, Zolgensma became the world’s most expensive medication. Priced at $2.125 million per patient, the one-dose gene therapy is a potential life-saver for children with spinal muscular atrophy (SMA). Now, the treatment is at the center…

Industry watchdogs are outraged. They say Zolgensma is merely the …

Why you shouldn’t be happy with $137 insulin

Elisabeth Rosenthal, MD

June 13, 2019Jun 13, 2019

Eli Lilly and Co. recently announced with some fanfare that it was manufacturing a generic version of its own best-selling insulin brand, Humalog, which it would sell for half off — $137.35 versus about $275. David Ricks, the chief executive…

David Ricks, the chief executive of Lilly, said the company was making this seemingly beneficent gesture because “many patients are struggling to afford their insulin.”

But they’re struggling, in large part,

…

MKSAP: 35-year-old woman with constipation

mksap

June 8, 2019Jun 8, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old woman is evaluated for constipation. She reports passage of hard stool every 3 to 4 days and associated bloating. Her symptoms have…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 35-year-old woman is evaluated for constipation. She reports passage of hard stool every 3 to 4 days and associated bloating. Her symptoms have been present for more than 10 years and have progressed gradually. Trials of over-the-counter fiber supplementation and polyethylene glycol worsened the bloating, prompting discontinuation. Senna …

How anti-vaxxers are just like the rest of us

Jennifer Reich, PhD

June 5, 2019Jun 5, 2019

Whenever I talk about my research on how parents come to decide to reject vaccines for their children, my explanations are met with a range of reactions, but I almost always hear the same questions. What is wrong with those…

Whenever I talk about my research on how parents come to decide to reject vaccines for their children, my explanations are met with a range of reactions, but I almost always hear the same questions.

What is wrong with those parents?
Are they anti-science?
Are they anti-expert?
Are they simply ignorant or selfish?
Are they crazy?

The year is not half over, and the number of measles cases has now exceeded highs not …

People who take opioids are the AIDS patients of today

Heather Finlay-Morreale, MD

June 4, 2019Jun 4, 20194

Stigma towards health conditions interferes with access to compassionate care. Both social stigmas from friends and family and medical stigma from professionals are issues. Perhaps the worst recent example of medical stigma is how people with HIV/AIDS were treated in the 1980s. They were isolated physically and spiritually. While in medical school a professor related that on the HIV floor the food trays were left outside the door like

…

The breakthroughs and failures of medicine

Shannon Casey, PA-C

June 2, 2019Jun 2, 2019

There is a pervasive tendency to turn to medicine looking for magic. Patients and health care professionals alike generally expect medicine to be able to cure diseases, alleviate symptoms, and relieve suffering. Historically, medicine has met and exceeded these expectations…

However, in some cases, these expectations can cause a blurring of the lines between hope and reality, resulting in false “promises” and preventable disappointment.

You may be …

You can save your baby for $2 million. Can we afford to do this?

Edward Hoffer, MD

May 31, 2019May 31, 20193

You can save your baby for $2 million. Can you afford to do this? If you cannot, should we all pay? Spinal muscular atrophy (SMA) is a rare genetic disease affecting the part of the nervous system that controls voluntary…

You can save your baby for $2 million. Can you afford to do this? If you cannot, should we all pay?

Spinal muscular atrophy (SMA) is a rare genetic disease affecting the part of the nervous system that controls voluntary muscle movement. All types of SMA result from a single known cause, a deficiency of a protein called SMN, for “survival of motor neuron.” When SMA symptoms are present at birth …

Unapproved CBD products may not be as safe as they seem

Kenneth Finn, MD

May 26, 2019May 26, 20196

In recent years, a flood of cannabis and cannabis-derived products like CBD have entered the market – often claiming to cure or treat an array of health issues and ailments. These products are everywhere, but there is little scientific evidence…

In recent years, a flood of cannabis and cannabis-derived products like CBD have entered the market – often claiming to cure or treat an array of health issues and ailments.

These products are everywhere, but there is little scientific evidence to support the hype that surrounds them.

As a doctor, I’m deeply concerned at where this industry is heading – and the potential risks to patients and consumers.

I urge my peers to …

MKSAP: 60-year-old woman with persistent constipation

mksap

May 25, 2019May 25, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old woman is evaluated for persistent constipation symptoms of 2 years' duration. She has reflex sympathetic dystrophy syndrome involving the right arm and…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 60-year-old woman is evaluated for persistent constipation symptoms of 2 years’ duration. She has reflex sympathetic dystrophy syndrome involving the right arm and neck that began 3 years earlier and requires chronic opioid analgesic therapy. She reports passing two hard bowel movements per week. Trials of several fiber …

Should adults receive another dose of MMR?

Roy Benaroch, MD

May 20, 2019May 20, 2019

While the vast majority of measles cases in the U.S. and worldwide are occurring in unvaccinated children, a fair percentage is also occurring in adults. With more-widespread transmission of measles, it’s becoming more important for all of us – yes,…

Measles is probably the single most contagious infection that humans face. The key to preventing the return of widespread measles is in …

No, the HPV vaccine isn’t optional

Chad Hayes, MD

May 19, 2019May 19, 2019

A lot of parents ask me about the HPV vaccine, "Isn't that the optional one?" Well, let me walk you through why my answer to that question is a hard "no." Human papillomavirus (HPV) is a virus that causes warts…

A lot of parents ask me about the HPV vaccine, “Isn’t that the optional one?” Well, let me walk you through why my answer to that question is a hard “no.”

Human papillomavirus (HPV) is a virus that causes warts and several types of cancer. There are over 200 different strains of HPV, some of which tend to cause warts on the hands, feet, or face. Other strains …

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No, the HPV vaccine isn’t optional

The new aspirin guidelines: The media does a disservice to patients

Olubadewa A. Fatunde, MD, MPH

May 13, 2019May 13, 2019

Much media attention has been paid to the new guidelines from American College of Cardiology/American Heart Association (ACC/AHA) on the primary prevention of cardiovascular disease. Based on new clinical trial data, ACC/AHA no longer recommends that healthy adults without cardiovascular disease — emphasis on without cardiovascular disease — take daily aspirin for the primary prevention of cardiovascular disease.

This change, while significant, is highly nuanced and dependent on …

Why aren’t you treating opioid addiction?

Kathleen A. Hallinan, MD

May 11, 2019May 11, 20195

Our community had one of “those” providers — a midlevel who was the local pain person. If you had pain, go to her. She would write you for anything you could want and more. It’s unclear if she was unscrupulous or just inept. But last year, the DEA finally figured out what she was doing and yanked her license. There was nothing in the news. Nothing on the internet. We …

If your child is ever prescribed an opioid, read this post first

Michael Milobsky, MD

May 10, 2019May 10, 20194

What if I told you that your adolescent child could contract a disease that can never be cured, but only maintained? That it would be a lifelong struggle that could change their personality, compromise their potential and values, destroy their relationships and have a long-term detrimental effect on their overall and mental health? That this disease can even be fatal, when ineffectively maintained? What if I told you that the …

Seeing the effects of the opioid crisis play out live

Praveen Suthrum

April 29, 2019Apr 29, 2019

Recently, I was at a health care facility in a semi-urban region, less than 100 miles from a major metro. It had a whiff of industry from good times that have long drifted by. I tried to locate a Starbucks.…

Recently, I was at a health care facility in a semi-urban region, less than 100 miles from a major metro. It had a whiff of industry from good times that have long drifted by.

I tried to locate a Starbucks. Google Maps spotted one and took me towards the local university campus. As I drove there, I noticed several pain management clinics advertising themselves in unusual ways for “relief.”

Once inside the …