Medications

Physicians writing on KevinMD about the drugs they prescribe and the ones they cannot get: prior authorization and step therapy, opioid prescribing and the tapers that followed the CDC guideline, the GLP-1 drugs from Ozempic to oral Wegovy and what happens when patients stop them, shortages, compounded versions, and what a prescription costs the patient. Three maintained records draw on this archive: Opioids: what physicians and pain patients say, in their own words, Prior authorization: what physicians say, in their own words, and GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.

How drug information fine print fails to communicate

Steve Woodruff

Medications

June 6, 2010

As someone deeply immersed in pharma communications, and especially the newer realm of social networking, I’ve been closely following the ongoing process of the industry/FDA dance, trying to figure out how social media/web 2.0 approaches “fit” with pharmaceutical manufacturers and their various audiences.

And I keep wondering if we’re going about the whole thing the wrong way.

Think about the fine print PI (Product Information) you see in a magazine, accompanying a …

Cocaine and drug addiction from work exposures

Jan Gurley, MD

Medications

June 6, 2010

It’s hard to look at the mug-shot of the 60-year-old woman charged with tampering with forensic drug evidence (basically, stealing police-confiscated cocaine) without wondering how things got to this point. I mean, surely they weed out the felons, and the known addicts, and do a background check, and then make you pee in a cup before they even hire you for a job like this. Right?

So just exactly how can …

Doctors can report bad drug ads to the FDA

MedPage Today

Medications

June 4, 2010

by John Gever

A new FDA program seeks to enlist healthcare professionals in flagging improper sales tactics for prescription drugs.

Although the agency calls the program “Bad Ad,” its interest goes beyond broadcast and print advertisements to include misleading in-person presentations.

Housed within the Division of Drug Marketing, Advertising, and Communication (DDMAC), the program is intended to increase the number of eyes and ears available to monitor pharmaceutical companies’ promotional activities — especially …

Proton pump inhibitors associated with fracture and C. difficile

Charles Bankhead

Medications

May 31, 2010

by Charles Bankhead

Proton pump inhibitors (PPIs) significantly increased the risk of both fracture and recurrent infection with Clostridium difficile, investigators in separate studies reported.

PPI use increased the odds of spine, forearm/wrist, and total fractures by 25% to 50% over three years, but had no effect on the risk of hip fracture. Overall, the acid-fighters had a modest effect on bone mineral density (BMD), Seattle researchers reported in the May 10 …

Your asthma or COPD inhaler is not available, and what to do

Matthew Mintz, MD

Medications

May 28, 2010

As reported in MedPage Today, the FDA announced the end for CFC-propelled inhalers. Of the seven inhalers with deadlines for removal, only three are still being made:

Flunisolide (Aerobid Inhaler System) on June 30, 2011
Albuterol and ipratropium combination (Combivent Inhalation Aerosol) on Dec. 31, 2013
Pirbuterol (Maxair Autohaler) on Dec. 31, 2013

The reason for this is because CFC’s are harmful for the environment, and the newer inhalers have to be replaced with …

How primary care should manage chronic pain patients

Juliet K. Mavromatis, MD

Medications

May 28, 2010

In April 2010 the American Society of Anesthesiologists (ASA) published updated guidelines for the management of chronic pain. The guidelines were based on a review of recent scientific evidence as well as a survey of expert opinion. As I read through the guidelines, summarizing the efficacy of various therapies for chronic pain ranging from epidural injection to medication management, some of my most challenging clinical cases involving pain management …

Few receive the shingles vaccine because of cost to doctors

MedPage Today

Medications

May 26, 2010

by Michael Smith

It’s a classic good-news, bad-news story.

The vaccine against shingles, already shown to be effective, is both safe and well-tolerated, researchers found after following more than 38,000 participants in the randomized trial that led to the 2006 approval of the vaccine.

On the other hand, few people are getting the vaccine, and for a variety of reasons — including its cost — researchers noted in a separate study. Both analyses …

Legalizing marijuana, an opinion from a former JAMA editor

George Lundberg, MD

Medications

May 23, 2010

While I was still the editor of JAMA, I was in Boston in January, 1997, to do my regular teaching at Harvard. I dropped in to see my friend Jerry Kassirer, the editor of the New England Journal of Medicine. Little did I know that Jerry was in the midst of a firestorm of protest for his just-published editorial called “Federal Foolishness and Marijuana.” Jerry told me that he received …

Ritalin and Adderall to improve college grades

Edward Pullen, MD

Medications

May 19, 2010

I watched 60 Minutes on CBS recently, and was surprised to hear how many college students are using stimulants like methylphenidate (Ritalin) and amphetamine/dextroamphetamine (Adderall) to get better grades.

These drugs are amphetamines, and Schedule 2 drugs that require a written prescription, cannot be faxed or called into pharmacies, and are considered to have high abuse and addiction potential by the FDA. They have the same type of effect on the …

Crucial public health issues facing legalizing marijuana

Jan Gurley, MD

Medications

May 16, 2010

So what do I know about this issue? As the physician and City public health administrator tasked with the initial implementation of Proposition 215 (legalizing medical marijuana) – I learned a lot.

On the data side, I compiled every bit of published research about marijuana (positive and negative) from the previous thirty years, researching every conceivable symptom and/or adverse event. The results were published and widely cited. I also …

Fight against salt needs consumer help

MedPage Today

Medications

May 14, 2010

by Cole Petrochko

As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I know a thing or two.

Well, it would be hard to not know much about salt after the recent string of attention paid to the “white shaken one” — eat too …

Read more…

Fight against salt needs consumer help

Free prescription drug samples cost patients more money

Leslie Ramirez, MD

Medications

May 1, 2010

Free is good, right? If you have to pay out of pocket for medicines, free prescription drug samples from your doctor’s office might seem like a godsend. But nine times out of ten, these free samples end up costing you more money. Here’s how.

First of all, pharmaceutical reps only get paid to give out brand new medicines that their companies are trying to promote. They are giving out these drugs …

Statins for heart disease prevention, is the luster fading?

MedPage Today

Medications

April 29, 2010

by Peggy Peck

First, my disclosure: I’ve written at least one news article about every major statin trial since 4-S, and I’ve been mightily impressed with almost all of the statin data. So, I was also impressed when the JUPITER results were reported about a year and a half ago — although I became a little less “impressed” as JUPITER continued to …

Alternative medicine isn’t taught to doctors in medical school

Crystal Phend

Medications

April 26, 2010

by Crystal Phend

Physicians don’t know much more about complementary and alternative medicine than their patients do, according to a new survey.

Most healthcare professionals who answered an online survey of Drug and Therapeutic Bulletin subscribers said their profession was just as poorly informed about herbal medicines (75.5%) as the general public (86.3%).

And almost half of respondents rated their own knowledge about herbal medicines as “quite” or “very” poor (36.2% and 10.4%, …

Patient adherence to drugs is low and what doctors can do

Shantanu Nundy, MD

Medications

April 22, 2010

Frequently in preventive health we ask patients to take medications that will reduce the risk of a certain bad medical outcome years down the road: cholesterol-lowering agents that lower the risk of a heart attack, blood pressure-lowering agents that reduce the risk of kidney disease, glucose-lowering medications that reduce the risk of diabetes-related complications.

Sometimes these medications make patients feel better — for example, insulin in patients with symptomatic diabetes or …

Dabigatran is superior to warfarin, but at what cost?

John Mandrola, MD

Medications

April 18, 2010

Dysrhythmias like atrial fibrillation (AF), more often than not, require medical therapy.

The dreaded blood thinner, warfarin (Coumadin) comes to the fore often. In aggregate, I have likely spent months of my life discussing the risks and benefits of this much maligned drug. Common rat poison is made from the same ingredients as warfarin — only rats keep eating it and die days later of bleeding, while humans have the blood …

Diet pills can be dangerous and should be used with caution

Kristina Fiore

Medications

April 17, 2010

by Kristina Fiore

Diet pills that are adulterated with undeclared pharmaceutical ingredients can be addictive, researchers say.

In a case report, a 29-year-old female patient became addicted to Brazilian diet pills that contained unlabeled ingredients, and suffered subsequent psychiatric comorbidities, Benjamin R. Smith, BS, and Pieter A. Cohen, MD, of Harvard Medical School reported in The American Journal on Addictions.

“Given the rising prevalence of adulterated diet pills, increasing awareness among clinicians of …

Neosporin and other OTC drugs to avoid

Edward Pullen, MD

Medications

April 12, 2010

Most people use non-prescription medications without giving much thought to the potential side effects or problems that may be associated with their use.

Here are 5 popular OTC meds you should avoid, and better alternatives. I bet most of you use one or more of these. Neosporin, Topical Vitamin E, Afrin nasal spray (or other short acting nasal decongestant sprays), daily headache medications, and sedating antihistamines.

1. Neosporin: Neosporin in the most …

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Neosporin and other OTC drugs to avoid

Statistical analysis in medical journals should be unbiased

MedPage Today

Medications

April 10, 2010

by Todd Neale

Editors of medical journals should unite in requiring independent statistical analyses of industry-sponsored clinical trials, according to the two top editors of the Journal of the American Medical Association.

Such a measure would help prevent any inappropriate influence from the study sponsors on data analysis and reporting, wrote Catherine DeAngelis, MD, MPH, editor-in-chief of JAMA, and Phil Fontanarosa, MD, MBA, executive deputy editor …

Children who are traumatized need more than medication

Claudia M. Gold, MD

Medications

April 9, 2010

In the Academy Award winning film, Precious, the main character’s transformation comes about largely through her ability to tell the story of her trauma, specifically in the form of writing. In this endeavor she is encouraged by a loving teacher.

In the book History Beyond Trauma, two French psychoanalysts argue that symptoms their patients exhibit represent the horrors of war that are not spoken of, sometimes for generations. The patient is …

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