Drugs and prescribing

1,242 articles · Since 2007

Articles, page 36

Why we’re not ready to embrace Eastern medicine

July 12, 2014Jul 12, 2014

"The Eastern medicine revolution?" These were the words emblazoned across the screen behind Dr. David L. Katz, founding director of the Yale-Griffin Prevention Research Center, as he discussed the growing popularity of holistic integrative medicine on a recent edition of…

“The Eastern medicine revolution?”

These were the words emblazoned across the screen behind Dr. David L. Katz, founding director of the Yale-Griffin Prevention Research Center, as he discussed the growing popularity of holistic integrative medicine on a recent edition of the Katie Couric Show.

The conversation centered on the opening of Cleveland Clinic’s Chinese herb therapy ward in January of this year, the first of its kind at a major U.S. hospital. Dr. …

MKSAP: 64-year-old man with knee osteoarthritis

mksap

July 12, 2014Jul 12, 20144

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated for a 2-year history of knee osteoarthritis. He has bilateral knee pain that worsens with walking. He has tried…

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

A 64-year-old man is evaluated for a 2-year history of knee osteoarthritis. He has bilateral knee pain that worsens with walking. He has tried topical therapies, physical therapy, and acetaminophen, none of which has provided relief. The patient also has peripheral vascular disease, hyperlipidemia, and hypertension. Medications are hydrochlorothiazide, pravastatin, and a …

Why are doctors still prescribing Zetia?

Janice Boughton, MD

July 10, 2014Jul 10, 201436

A health research company just released a list of the 100 top drugs in America according to sales. 29th on the list, with sales of over $1.8 billion, is the cholesterol lowering drug ezetimibe, brand name Zetia. This drug was…

This drug was released over 10 years ago because it worked really well in combination with statin drugs such as Zocor (simvastatin) to lower LDL cholesterol levels. It was released as a single agent and combined …

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Ailments are big business

Hans Duvefelt, MD

July 8, 2014Jul 8, 20143

Back when Prozac (fluoxetine) and Zoloft (sertraline) were new, I remember the mental acrobatics doctors made to justify giving these drugs to anxious patients. The drugs were approved for treating depression, but we knew they often seemed to help anxiety. The reason, we were told, was that some anxious patients were actually depressed, deep down, and we had just failed to recognize their depression.

Now, with studies to support their use …

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Ailments are big business

Guessing if medications are covered by a patient’s insurance company

Michael Kirsch, MD

July 7, 2014Jul 7, 201419

One of the frustrating aspects of medical practice is trying to decide if the medication I am prescribing is covered by the patient’s insurance company. Even with the advent of electronic medical records, which should be able to determine this,…

Here’s how it works. Individual insurance companies have formularies — lists of approved drugs — that they encourage patients and their physicians to use. …

Navigating the prescription drug abuse epidemic

Chiduzie Madubata, MD

July 2, 2014Jul 2, 2014

Over the past few months, more attention has been paid to the prescription drug epidemic, with increasing rates of accidental deaths noted across the country. Legislatures in different states are currently considering laws to provide first responders access to reversal agents, such as naloxone, to treat people found on the scene who have likely overdosed on these medications. With increasing media coverage, the public is becoming more aware about the …

The case of Makena: Speaking out against unfair drug pricing

Rekha Murthy

June 29, 2014Jun 29, 20148

I’m 34 weeks pregnant and working hard to keep this baby inside me for as long as possible. As with my last pregnancy, there’s a real risk that the baby could come too early. But we’re both holding on so…

The science is my biggest concern right now. I will spare you much of it because, man or …

E-cigarettes are an emerging threat to children

Afshine Ash Emrani, MD

June 29, 2014Jun 29, 20142

There is a new emerging health threat to our children: nicotine poisoning. The number of nicotine exposures in children reported to the National Poison Data System has more than tripled in the last year. Here’s the fact every parent should…

There is a new emerging health threat to our children: nicotine poisoning.

The number of nicotine exposures in children reported to the National Poison Data System has more than tripled in the last year.

Here’s the fact every parent should know: 1 tablespoon of nicotine oil can be lethal to a 60-pound child!

When doctors were campaigning against tobacco companies through public health legislation, we did not foresee a resultant new market for …

A prostate cancer breakthrough: The good and not-so-good news

J. Leonard Lichtenfeld, MD

June 18, 2014Jun 18, 2014

The annual meeting of the American Society of Clinical Oncology is a place where many commercial interests jostle for attention to make their latest promising therapy the star of the show. But a standard widely available generic drug stole the show by producing incredible results in improving survival for men with advanced prostate cancer. And that has some of us …

Dr. Bob Sears deserves blame for declining vaccination rates

Jennifer Gunter, MD

June 9, 2014Jun 9, 201411

Measles is on its way to an all time high. In 2000, measles was eliminated (meaning some travelers from areas with low vaccine penetration might arrive in the U.S. with the disease, but no case came from U.S.), but has…

Measles is on its way to an all time high.

In 2000, measles was eliminated (meaning some travelers from areas with low vaccine penetration might arrive in the U.S. with the disease, but no case came from U.S.), but has been slowly creeping back. Since 2008, this has been more than a trickle.

Let’s put the important goal of measles elimination in perspective. Before …

Applying the anti-vaccine mentality to car seats

Lucy Hornstein, MD

June 9, 2014Jun 9, 201410

What if a big TV station came out with a blockbuster story claiming that infant car seats were implicated in cerebral palsy (CP)? After all, something like 99.7% of babies diagnosed with cerebral palsy had been brought home from the hospital in a car seat. In fact, every single time they went anywhere in a car, they were strapped into them. That’s …

The problem with an anti-medication bias

Albert Fuchs, MD

June 6, 2014Jun 6, 201415

“I don’t like taking medicines.” All physicians hear some form of this opinion very frequently. Even more frequently, patients don’t state this view outright but rely on it to completely subvert their doctor’s plans. When I was new to practice…

“I don’t like taking medicines.”

All physicians hear some form of this opinion very frequently. Even more frequently, patients don’t state this view outright but rely on it to completely subvert their doctor’s plans.

When I was new to practice such an utterance would shock and confuse me.

“I don’t want to take any medicines,” a patient would declare.

“That’s fine,” I would reassure my interlocutor. “It’s a free country. No one is going …

Find yourself a physician who is stingy with prescriptions

Roy Benaroch, MD

June 5, 2014Jun 5, 201436

Antibiotic use is the direct cause of the rise of untreatable superbugs that are killing people. Antibiotic use is also the cause of most cases of C. diff colitis in kids, a potentially life-threatening, difficult-to-treat gut disorder. Antibiotics have also…

Antibiotic use is the direct cause of the rise of untreatable superbugs that are killing people.

Antibiotic use is also the cause of most cases of C. diff colitis in kids, a potentially life-threatening, difficult-to-treat gut disorder. Antibiotics have also been linked with recurrent wheezing in infants and inflammatory bowel disease. They can also trigger allergic reactions that can be …

Medical cannabis: Be informed and challenge the myths

Arielle Gerard, MD, MPH

June 1, 2014Jun 1, 201425

Medical cannabis is a treatment option with a low risk of dependence, minimal side effects, and few detrimental health effects, that has the potential to help hundreds of thousands of people suffering from various debilitating symptoms. Medical cannabis has gotten…

The unintended consequences of marijuana legalization

Brian C. Joondeph, MD

May 31, 2014May 31, 201419

Colorado and Washington are the first states to legalize recreational marijuana. In my state of Colorado, Amendment 64 was passed by 55 percent of voters by ballot referendum last year and took effect on January 1 of this year. State government officials are giddy with the prospects of increased revenue from marijuana sales. Marijuana tourism is booming in Colorado, giving new meaning to “Rocky Mountain High.” Now, four months into this new experiment, it may be worth looking …

A morning in the substance abuse clinic

Hans Duvefelt, MD

May 27, 2014May 27, 20143

It’s another Monday morning at the substance abuse clinic. It is my turn as the doctor in the black swivel chair in the corner office overlooking a half-vacant strip mall. Today’s first inductee is a pregnant 22-year-old with track marks…

It’s another Monday morning at the substance abuse clinic. It is my turn as the doctor in the black swivel chair in the corner office overlooking a half-vacant strip mall.

Today’s first inductee is a pregnant 22-year-old with track marks on her forearms. Her obstetrician and case worker at the Department of Human Services made her come. It is obvious she is less than thrilled.

“How long have you been doing opiates?” …

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A morning in the substance abuse clinic

It’s time for doctors to say no to drugs

James C. Salwitz, MD

May 22, 2014May 22, 201424

The United States of America is addicted to narcotics. I do not mean the millions of individuals who are hooked. I mean the whole nation is jonesing for the stuff. I also do not mean the junk that slips into our nation in coffee cans or across midnight borders. I mean the billions of pills pouring off assembly lines. I could blame pharma or the FDA, but the truth is …

A holistic view on integrative medicine

David L. Katz, MD

May 21, 2014May 21, 20148

I was recently on the Katie Couric Show to discuss integrative medicine. Somewhat ironically, I returned from Manhattan that same day to a waiting email from a colleague, forwarding me a rather excoriating critique of integrative medicine and asking me…

I was recently on the Katie Couric Show to discuss integrative medicine. Somewhat ironically, I returned from Manhattan that same day to a waiting email from a colleague, forwarding me a rather excoriating critique of integrative medicine and asking me for my opinion.

The juxtaposition, it turns out, was something other than happenstance. The Cleveland Clinic has recently introduced the use of herbal medicines as an option for its patients, generating considerable media attention. Some of …

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A holistic view on integrative medicine

Lethal injection perverts the ethics of practicing medicine

Karen S. Sibert, MD

May 20, 2014May 20, 201417

I give what could be lethal injections for a living. That’s right. Nearly every day I give someone an injection of midazolam, vecuronium, and an IV solution containing potassium chloride–the three drugs in the “cocktail” that was supposed to kill…

I give what could be lethal injections for a living.

That’s right. Nearly every day I give someone an injection of midazolam, vecuronium, and an IV solution containing potassium chloride–the three drugs in the “cocktail” that was supposed to kill convicted murderer Clayton Lockett quickly and humanely in Oklahoma.

Here’s the difference between an executioner and me. I use those medications as they are intended to be used, giving anesthesia to my …

A few thought-provoking questions about essential oils

Justin Smith, MD

April 29, 2014Apr 29, 20145

I get asked a lot about essential oils. I answer very little. Why? The answer is simply that we don’t know much about how or if they work. Except from stories about how they have helped certain people in certain…

I get asked a lot about essential oils. I answer very little. Why?

The answer is simply that we don’t know much about how or if they work. Except from stories about how they have helped certain people in certain situations, no one has done a large studies to truly evaluate their effectiveness or safety.

The main explanation for why they are used is that people (parents) are simply looking for something that’s an alternative to …

Drugs and prescribing

Articles, page 36

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