Drugs and prescribing

1,242 articles · Since 2007

Articles, page 20

How opioids can destroy the most beloved of personalities

February 22, 2019Feb 22, 2019

“I feel like a caged animal” — My patient offered me this lens through which to view his life seeped in chronic pain. For him, pain dictated his entire sense of being — it was something that simply could not be distilled down to a single value on a 10-point scale. The cage represented the restriction of life and the boundaries within which he was allowed to experience, let alone …

A shortage of Kayexalate leads to an ER visit

Hans Duvefelt, MD

February 21, 2019Feb 21, 20193

Last week I had a patient with mild kidney disease and a high potassium. I thought that it would be easy to take care of. We called around to all the pharmacies from Bangor to Ellsworth to Belfast, and nobody…

It happened to be on a Tuesday night with my Suboxone group starting at 5 o’clock. The patient had been there since 4; his …

The problem with high-potency marijuana

Libby Stuyt, MD

January 30, 2019Jan 30, 20193

Advocates for the legalization of medical and retail marijuana are quick to point out all the possible benefits that a community might see from such a venture. These include increased jobs, increased tax revenue, possible medical benefits and they advertise it as “safe” and “healthy” and “organic.” Many people who have voted for legalization thought they were talking about the marijuana of the 1960s to 1980s when the THC content …

Read more…

The problem with high-potency marijuana

Real physician voices, twice a week

Free, and one click to unsubscribe.

Generics aren’t going to help the cost of chemotherapy drugs

Peter Ubel, MD

January 29, 2019Jan 29, 2019

Chemotherapy drugs have become ridiculously expensive. Many new drugs come to market costing more than $100,000 per patient for a full course of treatment. Often, patients have to pay a significant portion of these costs. For example, a 20% co-insurance rate, typical for basic Medicare coverage, leaves patients responsible for more than $20,000 of chemotherapy costs, an often crippling burden.

Fortunately, many expensive cancer drugs are going …

Your patients are counting on you

Adam Striker, MD & American Society of Anesthesiologists

January 27, 2019Jan 27, 2019

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. I recently attended a state medical society’s annual meeting where the agenda consisted of an awards program, several speakers and a keynote address. The highlight of the evening,…

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

I recently attended a state medical society’s annual meeting where the agenda consisted of an awards program, several speakers and a keynote address. The highlight of the evening, however, was listening to patients share their stories with the local medical community. We’ve all heard from patients in a formal setting before, so it wasn’t necessarily unique, …

Read more…

Your patients are counting on you

We have a shot at preventing cervical cancer

Lisa N. Abaid, MD, MPH

January 25, 2019Jan 25, 2019

Many people think eradicating cancer is unattainable. But for cervical cancer, we are well on our way to doing just that. Cervical cancer was once the leading cause of death in women in the U.S. But we are on the…

Many people think eradicating cancer is unattainable. But for cervical cancer, we are well on our way to doing just that.

Cervical cancer was once the leading cause of death in women in the U.S. But we are on the cusp of vanquishing this disease thanks to regular pap screening and a vaccine that protects women and men from developing the human papilloma virus (HPV), the cause of nearly all cervical …

The conflict between pharmacists and their corporate superiors

Vamsi Aribindi, MD

January 24, 2019Jan 24, 2019

Pharmacists play an essential role in today’s ever-expanding health care system today. They check for drug interactions, watch for signs of opioid overprescribing and try to determine whether a drug for one condition prescribed by one doctor will negatively impact the patient because of another diagnosis the patient has. In hospital units, their roles have become yet more complex — often serving on various quality committees, managing daily dosages of …

How hospitals are taking advantage of the 340B Drug Pricing Program

Peter Ubel, MD

January 23, 2019Jan 23, 2019

Sometimes it is hard for hospitals to provide expensive care to poor patients. When a low-income patient needs $20,000 of chemotherapy, a hospital loses money if that patient cannot pay for the medicine, or pays through Medicaid, with its relatively stingy reimbursement. Fortunately, the federal government created a program for hospitals that care for a disproportionate share of low-income patients, whereby they can purchase those medicines at a discount. The program …

Marijuana will not fix the opioid epidemic

Kenneth Finn, MD

January 20, 2019Jan 20, 20193

Marijuana has been used for reported medical purposes for thousands of years when the plant had THC content of 0.5 to 3%. The most common reported medical use is for pain. Several states and the District of Columbia have some…

There has been discussion about how cannabis will help curb the opioid epidemic. It’s been reported that medical cannabis …

A call for the end of routine opioid use after wisdom tooth removal

Amy Ma & Susan Sutherland, DDS

January 15, 2019Jan 15, 2019

We are writing as a parent and a dentist to spread a message to parents and dental health care providers across Canada: there are alternatives to prescribing opioids after wisdom tooth removal. Removing wisdom teeth is considered by many as…

We are writing as a parent and a dentist to spread a message to parents and dental health care providers across Canada: there are alternatives to prescribing opioids after wisdom tooth removal.

Removing wisdom teeth is considered by many as a rite of passage for teenagers. It is one of the most common surgical procedures done in young people aged 16 to 24.

Amy’s 16-year-old son, Felix recently had his wisdom teeth …

Using probiotics in children: a pediatrician’s take

Christopher Johnson, MD

January 14, 2019Jan 14, 2019

The over-the-counter sale of probiotics is a huge industry. They are heavily promoted on social media as a cure-all for a wide variety of ills. Probiotics are live cultures of what are often called “good bacteria,” and there are solid physiological reasons for recommending them. But, and this is a huge but, actual clinical data demonstrating their usefulness behind some well-defined disorders is pretty scant. Their potential usefulness in many …

Countering misinformation about flu vaccine: Why it’s so hard

Dominik Stecula, PhD & Kathryn Haglin, PhD & Matthew Motta, PhD

January 13, 2019Jan 13, 20194

Many Americans hold beliefs about the flu vaccine that are at odds with the best available scientific evidence. For example, a recent study found that more than two-fifths, or 43 percent, of Americans believe that the seasonal flu vaccine can give us the flu. Scientific research strongly suggests that this is not true. Because most modern flu shots do not contain a live virus, the shot itself simply cannot get …

Qualifying conditions for medical marijuana

Patricia Frye

January 9, 2019Jan 9, 2019

An excerpt from The Medical Marijuana Guide: Cannabis and Your Health. Despite the fact that the U.S. Department of Health and Human Services applied for a patent on cannabinoids as neuroprotectants and antioxidants in 1999 and was granted that patent…

An excerpt from The Medical Marijuana Guide: Cannabis and Your Health.

Despite the fact that the U.S. Department of Health and Human Services applied for a patent on cannabinoids as neuroprotectants and antioxidants in 1999 and was granted that patent in 2003, cannabis is still Schedule I. This means it is deemed to be of no medical value and has a high potential for abuse. For this reason, medical …

Seasoned medical professionals prescribe new medicines sparingly

Michael Kirsch, MD

December 31, 2018Dec 31, 20183

I prescribe heartburn medicines every day. There’s a gaggle of them now -- Prilosec, Nexium, Prevacid, Protonix -- to name a few. As far as experts know, their primary effect is to reduce the production of stomach acid. This is…

I prescribe heartburn medicines every day. There’s a gaggle of them now — Prilosec, Nexium, Prevacid, Protonix — to name a few. As far as experts know, their primary effect is to reduce the production of stomach acid. This is why they are so effective at putting out your heartburn fire. In simple terms: no acid, no heartburn.

I am quite sure that well-meaning physicians like myself do not understand or …

The insanity of American health care prices played out in this one, real oncology appointment

Peter Ubel, MD

December 3, 2018Dec 3, 20182

The oncologist had prescribed Xgeva hoping it would strengthen her bones while also delaying the progression of Angela Kahn's breast cancer. But Kahn (a pseudonym) couldn't get over the price of the drug. Before the oncologist had a chance to…

The oncologist had prescribed Xgeva hoping it would strengthen her bones while also delaying the progression of Angela Kahn’s breast cancer. But Kahn (a pseudonym) couldn’t get over the price of the drug. Before the oncologist had a chance to ask how she was feeling, she blurted out that the medication cost “$15,000 a shot.” “That’s crazy,” the oncologist replied, continuing by saying the price “fits right in with the …

The recent fish oil and vitamin D studies: Go beyond the headlines

Mary Chris Jaklevic

December 1, 2018Dec 1, 20183

Results of a much-anticipated trial on fish oil and vitamin D generated conflicting headlines recently. Some stories declared good news about the popular supplements. Reuters wrote that fish oil “can dramatically reduce the odds of a heart attack while vitamin…

Results of a much-anticipated trial on fish oil and vitamin D generated conflicting headlines recently.

Some stories declared good news about the popular supplements.

Reuters wrote that fish oil “can dramatically reduce the odds of a heart attack while vitamin D’s benefits seem to come from lowering the risk of death from cancer.”

The Washingto n Post reported fish-oil medications were found “effective” in protecting …

Beware the hazards of over-the-counter (OTC) pain medications

Abeer Arain, MD, MPH

November 29, 2018Nov 29, 20182

A 30-year old male patient was recently admitted to my service via the emergency department. He came in complaining of abdominal pain and dark tarry stools. He mentioned a recent fall resulting in knee pain for which he had been taking 400 mg ibuprofen four times daily. He underwent upper GI endoscopy and was diagnosed with a bleeding gastric ulcer from his self-prescribed misuse/overuse of ibuprofen.

Fortunately, he recovered, but this …

3 ways pharmacists can change your prescribing habits

Alex Barker, PharmD

November 28, 2018Nov 28, 2018

As the health care landscape evolves, health care provider roles continue to shift. Industries recognize the power of collaboration and the strength of communication between different providers; among those, the pharmacist and the physician. Unfortunately, doctors and pharmacists have historically…

As the health care landscape evolves, health care provider roles continue to shift.

Industries recognize the power of collaboration and the strength of communication between different providers; among those, the pharmacist and the physician.

Unfortunately, doctors and pharmacists have historically had strained relationships. In many cases, communication suffers, which can lead to adverse drug events (ADEs), or harm caused to a patient as a result of medication exposure.

It’s worth noting, though, that …

Don’t miss this adverse drug reaction when tapering benzodiazepines

Christy Huff, MD

November 27, 2018Nov 27, 20184

“Alice Woods” is dying of metastatic breast cancer, but she cares little for awareness efforts like pink ribbons and catchy hashtags like #stage4needsmore. You see, Alice has akathisia due to an adverse effect from discontinuing Klonopin — a condition that has caused her far more suffering than her terminal cancer. It has also prevented her from receiving adequate cancer treatment and is, therefore, ending her …

Suboxone for pain makes sense. Why don’t more doctors prescribe it?

Hans Duvefelt, MD

November 19, 2018Nov 19, 20189

Many patients who end up in Suboxone treatment have chronic pain. They were originally prescribed other opiates and ended up addicted to them. Skeptics argue that is just substituting one opiate for another. But that isn’t quite accurate. More on…

Many patients who end up in Suboxone treatment have chronic pain. They were originally prescribed other opiates and ended up addicted to them.

Skeptics argue that is just substituting one opiate for another. But that isn’t quite accurate. More on that in a bit.

In my seven years of prescribing Suboxone for opiate addiction, I have often observed how potent a pain reliever this medication is, even in fairly low doses. More …

Drugs and prescribing

Articles, page 20

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular