Drugs and prescribing

1,242 articles · Since 2007

Articles, page 41

Protect patients from the effects of biased research

June 23, 2013Jun 23, 2013

Approval from the U.S. Food and Drug Administration to market a new drug is a critical waypoint along the path to profits for pharmaceutical manufacturers. Unfortunately, recent case studies have illustrated that FDA approval does not necessarily provide assurances of…

In last month’s Georgetown University Health Policy seminar, we discussed two examples, anemia drugs and the diabetes drug rosiglitazone (Avandia), which were …

The FDA is regulating the wrong things

Janice Boughton, MD

June 16, 2013Jun 16, 20139

The Food and Drug Administration was created in 1927 in order to carry out the mission of the Food and Drug Act put into effect by Theodore Roosevelt in 1906. In the early 1900's and before, medicines killed and maimed…

The Food and Drug Administration was created in 1927 in order to carry out the mission of the Food and Drug Act put into effect by Theodore Roosevelt in 1906. In the early 1900’s and before, medicines killed and maimed people in gruesome ways and adding chemical substances to foods to mask the fact that they were rotten or substandard was felt to need some sort of legal response. The …

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The FDA is regulating the wrong things

Stop prescribing benzodiazepines for anxiety

Anonymous

June 14, 2013Jun 14, 2013171

As a physician in a rural health clinic, I frequently see patients who complain of anxiety. The majority of these patients are in their 20s to 40s. Some have never been evaluated by a mental health professional, and many of these patients take benzodiazepines on a chronic basis. After current review, I wonder if we as primary care physicians are good at treating anxiety, or are we contributing to drug …

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Prescription labels need to come in languages other than English

David Margolius, MD

June 8, 2013Jun 8, 201373

As the saying goes, "With great power comes great responsibility." That applies to physicians when prescribing medications, but it also should apply to pharmacies when they're dispensing medications. In December, after seven years of exams, lectures and rounds, I received…

As the saying goes, “With great power comes great responsibility.” That applies to physicians when prescribing medications, but it also should apply to pharmacies when they’re dispensing medications.

In December, after seven years of exams, lectures and rounds, I received my medical license. Finally, I had the power to prescribe medications without the co-signature of my supervisor. “Be careful,” she advised, “remember the …

Is self-rationing of medications a good or a bad thing?

Trudy Lieberman

June 6, 2013Jun 6, 20137

In America, the conventional wisdom is that we don't ration health care. But we do, and there's no better example than patients rationing themselves when it comes to the medicines they take. Recently, a young twenty-something I know had a…

In America, the conventional wisdom is that we don’t ration health care. But we do, and there’s no better example than patients rationing themselves when it comes to the medicines they take.

Recently, a young twenty-something I know had a nagging cough—seasonal allergies, her doctor said and prescribed a generic medicine for asthma and allergies. She did not fill the prescription—the $160 price tag was too steep. Although she had health …

Don’t punish all doctors to find a few dangerous physicians

Shirie Leng, MD

June 5, 2013Jun 5, 201334

One of the things that used to make physicians different from other providers is the ability to prescribe drugs. This is not true anymore, but the majority of prescriptions are still written by doctors. Prescribing practices of physicians vary widely across different populations and specialties. If a doctor takes Medicare patients, his prescribing patterns are part of the mountains of data Medicare collects about it’s patients. In 2003 the government …

The only thing a cleanse truly cleans is your wallet

Jennifer Gunter, MD

May 30, 2013May 30, 20134

From time to time I get asked about cleanses. What is typically meant by a “cleanse” is only drinking a juice concoction for several days. Some cleanses add things like cider vinegar, cayenne pepper, or other supposedly “healthy” substances. The…

The most common reasons to “cleanse” that I hear from people who drink these things include:

Lose weight
Feel better
Remove “toxins”

Let’s start with weight loss. Cleanses are very low calorie and don’t contain protein …

When patients rely on financial assistance programs for drugs

Nancy Meredith

May 22, 2013May 22, 201319

I had been laid off a few months when my ulcerative colitis kicked in, and my doctor and I struggled to get it under control. After trying a variety of medicines, my health continued to deteriorate and I agreed to…

Remicade is a potent drug, administered through an IV infusion at the oncology center that comes with a whole host of potential side effects. The dosage requires an initial …

We want teens to know about emergency contraception

Wendy Sue Swanson, MD

May 16, 2013May 16, 201314

The FDA announced recently that it is approving Plan B for all girls age 15 and up without a prescription. This is good news for girls in the US of A. The easier the access to contraception, the less likely…

The FDA announced recently that it is approving Plan B for all girls age 15 and up without a prescription.

This is good news for girls in the US of A. The easier the access to contraception, the less likely girls will have an unintended pregnancy.

As many as 80% of pregnancies in teen girls in the United States are unintended. Most pregnancies are …

Can coffee help you live longer?

Manoj Jain, MD, MPH

May 13, 2013May 13, 20133

If you drink coffee, I have some bad news and some good news. The bad news is that the more cups of coffee you drink, the higher your risk of dying early. The good news is that if you "risk…

If you drink coffee, I have some bad news and some good news. The bad news is that the more cups of coffee you drink, the higher your risk of dying early. The good news is that if you “risk adjust,” then the more cups of coffee you drink, the lower your risk of dying early. Let me explain.

According to a …

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Can coffee help you live longer?

Prescribing antibiotics: It’s time to draw a hard line

Wesley Nickens, MD

May 11, 2013May 11, 20139

This is a call to arms to my fellow providers to protect our patients from themselves and our willingness to comply with their requests. We live and practice in a society filled with fear of medications and their side effects. People will not take blood pressure, cholesterol, or diabetic medication because of the side effects they have heard or read about.

However, these same patients will take antibiotics every day of …

When alternative cancer therapy harms patients

James C. Salwitz, MD

May 6, 2013May 6, 201337

After a terribly painful and debilitating illness, Steve died. He had been treated for Stage 2 Hodgkin’s Disease with a series of intense therapies including German enzymes, American antineoplastins, Mexican naturopathy and Chinese herbs, complemented by focused meditation, innumerable vitamins, extreme diet modification and acupuncture for severe pain. He fought the cancer with every ounce of his being, doing everything to survive, except the one thing that had an 85% …

Azithromycin and long QT syndrome: Facts from a cardiologist

John Mandrola, MD

May 4, 2013May 4, 2013

Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.” If you write a blog on medical decision-making and heart rhythm matters, it seems…

Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”

If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:

[Azithromycin] can cause

…

A high calcium diet and calcium supplementation: Is it bad for you?

Janice Boughton, MD

April 30, 2013Apr 30, 201310

An article from Sweden was recently published showing that in a very large group of women, over 60,000 of them, followed for 19 years as part of an also very interesting study of the effectiveness of mammograms, women who get more calcium, in their diet or as supplements, had a higher risk of dying of anything, but especially of heart attacks. It is …

Planting drug industry-funded papers in medical journals

Martha Rosenberg

April 29, 2013Apr 29, 20135

Where did the medical community get the idea that Vioxx, Trovan and Baycol were safe and the benefits of Prempro, Neurontin and bisphosphonates outweighed their risks? From research published in medical journals written by drug companies or drug-company funded authors.…

Scratch the surface of many blockbuster drugs that went on to be discredited, or even withdrawn as risks emerged, and an elaborate “publication plan” emerges, developed by …

Against the medicalization of marijuana

Steve Adelman, MD

April 29, 2013Apr 29, 201312

As an addiction psychiatrist, I have seen marijuana do far more harm than good. So with the medical use of marijuana in Massachusetts now legal under state law, what should physicians do? Recently, I attended a chilling presentation from Dr.…

As an addiction psychiatrist, I have seen marijuana do far more harm than good. So with the medical use of marijuana in Massachusetts now legal under state law, what should physicians do?

Recently, I attended a chilling presentation from Dr. Kevin Hill, an addiction psychiatrist at McLean Hospital, at a meeting of the Massachusetts chapter of the American Society of Addiction Medicine on the topic “Medical Marijuana: What is the Proper …

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Against the medicalization of marijuana

The ethical shortcomings of selling supplements

Lucy Hornstein, MD

April 28, 2013Apr 28, 201338

A crunchy friend of mine on Facebook re-posted something from an even crunchier friend of hers who was shocked to find that many naturopaths sell supplements. Actually, she feels that selling them is okay; so is prescribing them. But selling…

As I read her screed against the ND who conducted a cursory history and exam before checking off $750 worth …

It’s time to put the vaccine-autism link behind us

Roy Benaroch, MD

April 27, 2013Apr 27, 201314

First, it was the MMR-autism link—that turned out to be a complete fabrication, a fraud invented by a single “researcher” who made up his data. He was taking money from plaintiff’s lawyers, and he was trying to patent his own,…

Then, the mercury connection. A mercury-containing preservative, thimerosal, …

Why are some generic drugs so expensive?

Leslie Ramirez, MD

April 23, 2013Apr 23, 201310

Two of the biggest -selling prescriptions of all time, Plavix, an anti-platelet medication, and Lipitor, a cholesterol lowering medicine, have been available in generic form since May 2012 and November 2011, respectively. However, most retail pharmacies are still charging patients $100-$200 monthly for these medications. Why? And what does this market oddity say about our chances of lowering healthcare costs in the United States?

Patients are used to paying a high …

Curb prescription drug abuse by following Mayor Bloomberg

Kevin Pho, MD

April 20, 2013Apr 20, 20135

Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than…

A version of this column was published in USA Today on April 1, 2013.

Drugs and prescribing

Articles, page 41

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