Drugs and prescribing

1,242 articles · Since 2007

Articles, page 43

MKSAP: 71-year-old man with new dyspnea on exertion

January 27, 2013Jan 27, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 71-year-old man is evaluated in the emergency department for new dyspnea on exertion. He has a 15-year history of type 2 diabetes mellitus…

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

A 71-year-old man is evaluated in the emergency department for new dyspnea on exertion. He has a 15-year history of type 2 diabetes mellitus and has had a number of changes in his medications over the past 12 weeks to improve glycemic control. His dosage of metformin has been increased to 1000 mg/d, glyburide …

Why I’m not sure that psychiatric medications work

Steve Balt, MD

January 25, 2013Jan 25, 201333

I have a confession to make. I don’t think what I do each day makes any sense. Perhaps I should explain myself. Six months ago, I started my own private psychiatry practice. I made this decision after working for several…

I have a confession to make. I don’t think what I do each day makes any sense.

Perhaps I should explain myself. Six months ago, I started my own private psychiatry practice. I made this decision after working for several years in various community clinics, county mental health systems, and three academic institutions. I figured that an independent practice would permit me …

MKSAP: 67-year-old woman is transferred to the ICU

mksap

January 19, 2013Jan 19, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 67-year-old woman is transferred to the cardiothoracic intensive care unit (ICU) after undergoing repair of an abdominal aortic aneurysm. She has a 12-year…

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

A 67-year-old woman is transferred to the cardiothoracic intensive care unit (ICU) after undergoing repair of an abdominal aortic aneurysm. She has a 12-year history of type 2 diabetes mellitus.

Her blood glucose level on arrival at the ICU is 289 mg/dL (16.0 mmol/L). Although no longer on a cardiopulmonary bypass pump, she remains intubated …

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Dramatically influence drug prices by positive action

Jay Ham, MD

January 4, 2013Jan 4, 2013

Doctors at Memorial Sloan-Kettering Cancer Center recently declared they would not use Zaltrap (Sanofi), for advanced colorectal cancer. In a New York Times editorial, they suggested the extraordinary cost for incremental benefit could not justify its use. Sanofi appeared to…

Doctors at Memorial Sloan-Kettering Cancer Center recently declared they would not use Zaltrap (Sanofi), for advanced colorectal cancer. In a New York Times editorial, they suggested the extraordinary cost for incremental benefit could not justify its use. Sanofi appeared to cave to the pressure and announced a 50% discount – which only made things worse.

This August, Zaltrap received FDA approval for the treatment of advanced colorectal cancer. In …

It’s time to rethink the role of antivirals in flu treatment

Kenneth Lin, MD

December 31, 2012Dec 31, 20122

Flu season has begun in the U.S., and in addition to familiarizing themselves with the Advisory Committee on Immunization Practice's vaccination guidelines for the 2012-13 season (offer influenza vaccine to everyone 6 months of age or older), physicians should consider…

Flu season has begun in the U.S., and in addition to familiarizing themselves with the Advisory Committee on Immunization Practice’s vaccination guidelines for the 2012-13 season (offer influenza vaccine to everyone 6 months of age or older), physicians should consider how they plan to diagnose patients with suspected influenza. Despite the availability of multiple antiviral medications for influenza, whom to treat remains a …

How drugs are promoted isn’t a freedom of speech issue

PalMD

December 31, 2012Dec 31, 201220

I learned of a disturbing decision from the Court of Appeals for the Second Circuit. In an insane ruling, two of judges determined that a drug rep promoting “off-label” uses for a drug was exercising his freedom of speech. Let’s…

Of all the ways pharmaceutical companies …

Advair and the long acting beta agonist paradox

Larry Chiaramonte, MD

December 24, 2012Dec 24, 20122

The long-acting beta agonist (LABA) paradox strikes again. A new article in a Milwaukee newspaper sounds an old theme. Advair, the most widely used asthma medicine, contains a long-acting beta agonist—salmeterol. “ ong-acting beta-agonists have been linked to 1,900 asthma…

“[L]ong-acting beta-agonists have been linked to 1,900 asthma deaths from 2004 through 2011, according to an estimate provided by AdverseEvents Inc., a private firm that analyzes drug side effect data reported to …

Saving the world from unnecessary prescriptions

David Gelber, MD

December 17, 2012Dec 17, 201211

Today I experienced another example of the growing efficiency of the healthcare world: The Steward of Scripts. First, a little background information is necessary. After I perform surgery it is necessary to perform a number of immediate post operative duties.…

Today I experienced another example of the growing efficiency of the healthcare world: The Steward of Scripts.

First, a little background information is necessary. After I perform surgery it is necessary to perform a number of immediate post operative duties. The operative note must be dictated, a brief note is written in the chart, post operative orders are written and, for patients that are going home the same day, prescriptions must …

Know which medicines you take and why you take them

Shirie Leng, MD

December 13, 2012Dec 13, 20123

Doctor: What medicines do you take at home? Patient: Something for the diabetes. Doctor: Do you know the name of it? Patient: "Starts with an M. Or a P. Honey, what's the name of that pill? Wife: Well dear, I…

Doctor: What medicines do you take at home?

Patient: Something for the diabetes.

Doctor: Do you know the name of it?

Patient: “Starts with an M. Or a P. Honey, what’s the name of that pill?

Wife: Well dear, I don’t know but it’s a little blue one. You know doc, the little blue one?

Nothing will drive your health care provider more crazy than conversations …

Why you should avoid the temptation of drug coupons

Kevin Pho, MD

December 10, 2012Dec 10, 20126

October 24th, 2012 in USA Today. As the cost of prescription drugs soar, more patients are turning to online coupons or discount cards from drug companies or promotional offers in magazines. In the past year, it is estimated that 19…

A version of this column was published on October 24th, 2012 in USA Today.

As the cost of prescription drugs soar, more patients are turning to online coupons or discount cards from drug companies or promotional offers in magazines. In the past year, it is estimated that 19 million Americans whom took prescription drugs used such incentives to save money. The healthcare industry …

The conversation that takes place before the flu shot

Suzanne Koven, MD

December 5, 2012Dec 5, 20124

In our practice, doctors have the option to administer influenza vaccines right in the exam room. The truth is, giving the flu shot only takes a couple of seconds. The syringes are pre-filled, so all you have to do is…

It’s the conversation that precedes the flu shot that takes time.

Take yesterday. A very intelligent middle-aged …

10 advances that have changed medicine forever

Deep Ramachandran, MD

December 4, 2012Dec 4, 20123

I’ve been thinking lately about all the great advances in medicine over the years. There have been lots of them. And despite everything you’ve heard about looming cuts in healthcare, I have no doubt that the hits will keep on coming. Since I seem to be on this Top 5 thing lately, I figured I would continue this ride and rank my top 10 medical advances over the years. There …

Balance the risk of stroke versus the risk of bleeding

John Mandrola, MD

December 4, 2012Dec 4, 2012

There was good news recently in the atrial fibrillation world. Though no surprise to heart rhythm doctors, an FDA investigation reveals no evidence that new cases of bleeding are any higher with dabigatran (Pradaxa) than with warfarin. The full statement…

There was good news recently in the atrial fibrillation world.

Though no surprise to heart rhythm doctors, an FDA investigation reveals no evidence that new cases of bleeding are any higher with dabigatran (Pradaxa) than with warfarin.

The full statement from the FDA is here.

The assessment was undertaken because after approval of the novel anticoagulant (blood-thinner) a large number of adverse events were reported to the FDA. Despite conscientious medical …

Selling a cure based on imaginary evidence is immoral

PalMD

November 9, 2012Nov 9, 201212

In the ongoing battle to gain from our society’s scientific illiteracy, Dr. Oz has nocked another arrow. This time, he as the cure for all fatigue. I hope he’s got this right because this is one of the most common…

Fatigue is a tough one. Everyone has experienced fatigue at some point, and as a physician, part of my job is to figure …

Warn patients that generic pills look different

Michael Todd Sapko, MD, PhD

November 4, 2012Nov 4, 20123

Generic formulations of drugs using active pharmaceutical ingredients are an immense cost savings to patients and healthcare systems. On the other hand, questions remain as to whether generics are truly equivalent to brand name pharmaceuticals. Are the pharmacokinetics the same?…

Generic formulations of drugs using active pharmaceutical ingredients are an immense cost savings to patients and healthcare systems.

On the other hand, questions remain as to whether generics are truly equivalent to brand name pharmaceuticals. Are the pharmacokinetics the same? Are they bioequivalent? While this is a difficult topic to research clinically, I would argue that the vast majority of brand name and corresponding generic drugs are indeed equivalent (though there …

Pharma needs to embrace social media

Paul Tunnah

October 28, 2012Oct 28, 20123

Anyone working in the pharma industry will know it has been a tough few years. Dwindling innovation in the drug pipelines, the impact of global economic pressures and an increasing global focus on healthcare cost containment have all combined in…

As the backdrop to all this, social media has rapidly been finding its place as a powerful media in sectors selling …

Read more…

Pharma needs to embrace social media

Why clinical decision making in psychiatry is difficult

Julia Frank, MD

October 17, 2012Oct 17, 2012

“All psychiatrists do is push drugs!” I have heard this repeatedly, from students, wary patients, even family members who don’t pick up on a carefully worded hint that they just might benefit from getting help. For some reason, no one…

“All psychiatrists do is push drugs!”

I have heard this repeatedly, from students, wary patients, even family members who don’t pick up on a carefully worded hint that they just might benefit from getting help. For some reason, no one makes the same complaint about infectious disease specialists, or oncologists, though I wager that the success rates of our drug treatments are roughly equivalent.

As a psychiatrist, I try to treat people …

Does Linzess have a role in IBS with constipation?

Edward Pullen, MD

October 13, 2012Oct 13, 20123

Linzess is a new drug that received FDA approval by Forest Laboratories for use in irritable bowel syndrome (IBS) with constipation and in chronic idiopathic constipation. It got my attention because of its biochemistry. Learning about the mechanism of action…

Learning about the mechanism of action of new drugs like Linzess reminds me how much more is understood about the molecular biological level of physiologic function of the human body than when I was in med school. Linzess …

Population health initiatives by the pharmaceutical industry

David B. Nash, MD, MBA

October 13, 2012Oct 13, 2012

I have been beating the population health drum for more than 20 years, and I think the rest of the band is finally catching on to the rhythm. From healthcare reform efforts at the very top of the heap to…

I have been beating the population health drum for more than 20 years, and I think the rest of the band is finally catching on to the rhythm.

From healthcare reform efforts at the very top of the heap to the healthcare industry to large and small communities, there is a heightened awareness that the physical and mental health of our diverse population is linked to our continued health and success …

Compounding pharmacies need stricter FDA oversight

David Pittman

October 13, 2012Oct 13, 20123

The current fungal meningitis outbreak has put a spotlight on compounding pharmacies, and regulators and stakeholders say Congress needs to clarify exactly who should regulate these entities. The practice of compounding, which has been around for decades, was intended to…

The current fungal meningitis outbreak has put a spotlight on compounding pharmacies, and regulators and stakeholders say Congress needs to clarify exactly who should regulate these entities.

The practice of compounding, which has been around for decades, was intended to give pharmacies the ability to produce a product under a doctor’s orders when a particular drug wasn’t available. …