Drugs and prescribing

1,242 articles · Since 2007

Articles, page 49

The future of vaccines for infectious diseases

June 23, 2011Jun 23, 20116

In concert with sanitation and clean water supplies, vaccination has been the most cost effective means of preventing infectious diseases. Most vaccines have been inexpensive, easy to administer (albeit objected to by the recipient’s arm!), safe and effective. From when…

In concert with sanitation and clean water supplies, vaccination has been the most cost effective means of preventing infectious diseases.

Most vaccines have been inexpensive, easy to administer (albeit objected to by the recipient’s arm!), safe and effective. From when I was a child until today the number of new vaccines has multiplied dramatically. This will only continue at an accelerated pace in the coming years. In the future many …

How switching from brand name drugs to generics is sometimes absurd

Paul Sax, MD

June 16, 2011Jun 16, 201112

I had an interesting exchange with one of our nurses recently about a long-term patient of ours. The e-mails went something like this: Got a fax from —-’s insurance that his Lipitor won’t be covered anymore. They will cover simvastatin,…

I had an interesting exchange with one of our nurses recently about a long-term patient of ours.

The e-mails went something like this:

Got a fax from —-’s insurance that his Lipitor won’t be covered anymore. They will cover simvastatin, lovastatin, and pravastatin. Let me know what you want to do.
Charlie

He’s on darunavir, and all three of those statins are contraindicated because of drug-drug interactions. Rosuvastatin?
Paul

Checked with them — rosuvastatin needs

…

The accidental genius of homeopathy thrives

George Lundberg, MD

June 16, 2011Jun 16, 201137

All thoughtful physicians I know consider the historical theory and philosophy of homeopathy to be rubbish, balderdash, preposterous, BS, or, politely, NOT PLAUSIBLE; thus, not even worth testing for safety and efficacy. Then, why, when one asks Mr. Google by…

Then, why, when one asks Mr. Google by entering … Homeopathy … and clicking, does one receive 9.9 million results?

And, why does the National Health Service of the U.K. continue to fund homeopathic hospitals, clinics, and treatments?

And why are …

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Medication reconciliation brings the ER back to 1960

Chris Rangel, MD

June 14, 2011Jun 14, 201110

What a blessing and a curse it must have been to practice medicine fifty years ago. Most internists had only about twenty or so medications that they used regularly. It was a curse not to have effective medications to treat…

What a blessing and a curse it must have been to practice medicine fifty years ago.

Most internists had only about twenty or so medications that they used regularly. It was a curse not to have effective medications to treat many common ailments but somewhat of a blessing not to have the modern medical nightmare of having patients on 15-20 chronic medications with all the logistical problems of keeping track of …

Why the word “drug” promotes a public bias in chronic pain treatment

Jack Cain

June 14, 2011Jun 14, 20116

by Jack Cain In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain. Part of that debate is fueled…

by Jack Cain

In the United States, there is a heated debate at all levels over the increased use of narcotic pain relievers, especially as part of a long-term treatment regimen for chronic pain. Part of that debate is fueled by the pejorative use of the term “drug” instead of “medication” in conjunction with the legal prescribing, dispensing and consumption of these substances.

Bias is …

The unintended consequences of medical marijuana

Emily Gibson, MD

June 10, 2011Jun 10, 201137

It was 1978 and I was a third year medical student when my friend was slowly dying of metastatic breast cancer. Her deteriorating cervical spine, riddled with tumor, was stabilized by a metal halo drilled into her skull and attached…

It was 1978 and I was a third year medical student when my friend was slowly dying of metastatic breast cancer.

Her deteriorating cervical spine, riddled with tumor, was stabilized by a metal halo drilled into her skull and attached to a scaffolding-like contraption resting on her shoulders. Vomiting while immobilized in a halo became a form of medieval torture. During her third round of chemotherapy, her nausea was so …

Cultural attitudes influence the benefit from stem cell therapy

Stephen C. Schimpff, MD

June 8, 2011Jun 8, 20112

Embryonic stem cells are present after a fertilized egg divides for two or three days. They have the seemingly miraculous ability to turn into any of the tissue types in the body—whether brain neurons, beating heart cells, bone, or pancreatic…

Those used in science are …

Implications of the placebo effect for physicians

Lukas Zinnagl, MD

June 6, 2011Jun 6, 20118

The placebo effect is somewhat of a mystery in modern medicine. Wikipedia calls a placebo "a sham or simulated medical intervention." Commonly, when we refer to a placebo we mean dummy-drugs, but the placebo effect has further applications in medicine,…

The placebo effect is somewhat of a mystery in modern medicine. Wikipedia calls a placebo “a sham or simulated medical intervention.” Commonly, when we refer to a placebo we mean dummy-drugs, but the placebo effect has further applications in medicine, such as sham surgery or false information.

Now, a great video produced by an Australian journalist from the ABC Science Show has compiled …

Niaspan and how comparative effectiveness research was done well

Harlan M. Krumholz, MD

June 3, 2011Jun 3, 201111

Comparative effectiveness research — investigations that determine which treatments are best — has attracted attention in the health care debate. Critics charge that these studies are designed to restrict choice. The Center for Medicine in the Public Interest released a report that suggested that they would stifle innovation. Often they are framed as studies to support efforts to keep useful but expensive …

Unrealistic optimism in early phase new drug studies

Richard Leff, MD

June 3, 2011Jun 3, 20113

In a thoughtful posting in the New York Times, Dr. Pauline Chen, a well respected observer of the doctor-patient relationship, points out an ethical dilemma that faces cancer researchers working in drug development conducting early phase (I) new drug studies.…

In a thoughtful posting in the New York Times, Dr. Pauline Chen, a well respected observer of the doctor-patient relationship, points out an ethical dilemma that faces cancer researchers working in drug development conducting early phase (I) new drug studies. Ethicists have identified that patients in these studies often have unrealistic optimism about their personal outcomes despite …

How stem cells will impact medical care

Stephen C. Schimpff, MD

May 27, 2011May 27, 20116

Stem cells will usher in the era of regenerative medicine, allowing the creation of cells, tissues and organs to treat or cure diseases and injuries. This will be a fundamental alteration in our approach to medical care and a transformational medical megatrend. And it will be very “personalized medicine” to provide the specific individual with custom tailored new cells and tissues for organ repair or …

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How stem cells will impact medical care

Omega 3 fatty acids and the prevention of heart disease

PalMD

May 25, 2011May 25, 2011

Omega-3 fatty acids (more properly called “n-3 fatty acids”) are a group of naturally occurring fat molecules. They are found mainly in fish and other marine-derived oils, but some can also be extracted from plants. Omega-3′s are currently very popular,…

Omega-3 fatty acids (more properly called “n-3 fatty acids”) are a group of naturally occurring fat molecules.

They are found mainly in fish and other marine-derived oils, but some can also be extracted from plants. Omega-3′s are currently very popular, but the evidence for their usefulness isn’t so clear. A recent study failed to show any benefit in preventing dementia. A new study out …

Almost everyone over the age of 60 should receive the zoster vaccine

Stephen C. Schimpff, MD

May 25, 2011May 25, 201116

Herpes zoster (or shingles) is caused by the same virus that causes chicken pox. Zoster increases in incidence with advancing age. It is estimated that over 1 million Americans get shingles annually with the resulting acute discomfort and often chronic…

Herpes zoster (or shingles) is caused by the same virus that causes chicken pox.

Zoster increases in incidence with advancing age. It is estimated that over 1 million Americans get shingles annually with the resulting acute discomfort and often chronic pain thereafter. A vaccine was introduced by Merck in 2006; the initial studies of 38,546 patients indicated …

How a specialty pharmacy denies a physician his medication

Aaron E. Carroll, MD

May 19, 2011May 19, 201149

Holy crap. My medication did not arrive today. How can this possible be happening? Do they not know this medication is not optional? Let me recap. I called over a week ago for a refill. I am only allowed (by…

Holy crap.

My medication did not arrive today.

How can this possible be happening? Do they not know this medication is not optional?

Let me recap. I called over a week ago for a refill. I am only allowed (by my insurance) to use the (non-local) specialty pharmacy that they own for this medication. They told me my medication would arrive yesterday, which was the day after I’d use my last …

Belimumab (Benlysta) to treat systemic lupus erythematosus (SLE)

Stephen C. Schimpff, MD

May 19, 2011May 19, 20112

Genomics promises to fundamentally change much of medical care. But the ultimate value of this new understanding of basic human biology will in many cases come with fits and starts. The saga of belimumab (Benlysta) and Human Genome Sciences (HGS)…

Systemic lupus erythematosus (SLE) occurs in somewhere between 300,000 and 4 million Americans according to the …

Lunch money Pharma spends on physicians

Deep Ramachandran, MD

May 16, 2011May 16, 201182

Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much ... Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).…

Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much …

Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).

It has spurred me to contemplate the ever increasing scrutiny paid to the relationship between the pharmaceutical industry …

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Lunch money Pharma spends on physicians

How business will affect pharmaceutical reps

Steve Woodruff

May 11, 2011May 11, 201110

There’s been a lot of talk in the past year about how we need to re-think the role and profile of the pharmaceutical/biotech sales rep. This dialogue needs to happen, given the trends that are rapidly shrinking the size of…

There’s been a lot of talk in the past year about how we need to re-think the role and profile of the pharmaceutical/biotech sales rep.

This dialogue needs to happen, given the trends that are rapidly shrinking the size of sales forces. Of course, when you poll the doctors, they are going to focus on the need for greater depth of clinical knowledge. …

One in four children in the United States are on chronic medications

Maggie Kozel, MD

May 10, 2011May 10, 201121

The Wall Street Journal reported that a study of prescription patterns in 2009, conducted by IMS Health, showed that 25% of children in the US were on regular medication. IMS Health is a firm that provides "marketing intelligence" to pharmaceutical…

The Wall Street Journal reported that a study of prescription patterns in 2009, conducted by IMS Health, showed that 25% of children in the US were on regular medication.

IMS Health is a firm that provides “marketing intelligence” to pharmaceutical companies. The firm’s job is to keep the $800 billion per year global pharmaceutical industry on a continued pattern of growth. Hopefully these consultants accomplished something quite different this week. Hopefully they …

How genomics can help doctors target drug therapy

Stephen C. Schimpff, MD

May 5, 2011May 5, 20112

Little more than a decade ago, most people had never heard of the word genomics; today it is used frequently. It is indeed a revolutionary science that is and will transform medical research and medical care. To better understand how this new science will markedly change medicine, it is convenient to consider it through a few categories:

Pharmacogenomics
Nutragenomics
Disease classification
Disease

…

The trend from drugs of value to medications of convenience

Doctor Grumpy, MD

May 2, 2011May 2, 201110

Pharmaceuticals are amazing stuff. You can bitch and moan about their costs, side effects, or the number of them you're taking, but what they've done to extend life and improve its quality is truly remarkable. And for all the bad…

Pharmaceuticals are amazing stuff. You can bitch and moan about their costs, side effects, or the number of them you’re taking, but what they’ve done to extend life and improve its quality is truly remarkable.

And for all the bad raps they get, I salute the pharmaceutical industry, and those who work anonymously in labs around the world, to bring us these miracles.

But …

Drugs and prescribing

Articles, page 49

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