Medications and Prescribing

Physicians writing on KevinMD about prescribing: the prior authorization that stands between a prescription and a pharmacy, opioids and the tapers that followed the CDC guideline, GLP-1 drugs and what happens when patients stop them, compounded and direct-to-consumer drugs, shortages, and what a prescription costs the patient. Three maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, and GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.

Treating ADHD may not improve kids’ school grades

Kevin

Conditions and Diseases

February 18, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Adhering to guidelines when treating children with attention deficit hyperactivity disorder (ADHD) relieved symptoms but had no effect on kids’ performance in school or in their relationships with others, researchers found.

Although parents and teachers noted significant improvements in symptoms among ADHD kids (P<0.001) in a special treatment program, there …

How alternative and herbal medications can have dangerous side effects

Kevin

Medications

February 13, 2010

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Herbal medicines are not always the harmless nostrums that many patients and even some physicians think, but may actually contribute to cardiovascular morbidity and mortality, researchers warned in a review covering 44 years of research into the subject.

Many such products, including aloe vera, ginkgo biloba, ginseng, and green tea, can …

Neuroscience explains why changing addictive behavior is so difficult

Kevin

Conditions and Diseases

February 12, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

By the end of January, many New Year’s resolutions have been tossed out with the leftover holiday cookies. That’s because change is hard — and neuroscientists are learning why.

Advances in neuroimaging have enabled researchers to peer inside the brains of addicts and patients with addictive behaviors. They can see in …

Similarities between H1N1 flu pandemic conspiracies and the Y2K bug

Kevin

Conditions and Diseases

February 10, 2010

Originally published in MedPage Today

by Mike Himowitz

When I read Michael Smith’s account of European politicians taking WHO to the woodshed for allegedly conspiring with vaccine makers to overinflate the danger from H1N1 pandemic flu, I was reminded of a similar — and equally silly — argument that occurred exactly a decade ago.

In the early days of 2000, you …

An anesthesiologist accused of making up trial data pleads guilty to federal charges

Kevin

Medications

February 8, 2010

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

A Massachusetts anesthesiologist accused of fabricating data in studies of pain drugs will plead guilty to federal criminal charges under an agreement with prosecutors.

Scott Reuben, MD, a well-known pain researcher at Baystate Medical Center in Springfield, Mass., was charged with one count of healthcare fraud.

Early last year, the hospital …

How should pharmacy benefit managers (PBMs) and pharmacies communicate with physicians?

Kevin

Medications

February 2, 2010

by George Van Antwerp

In the pharmacy and pharmacy benefit manager (PBM) business, there are lots of reasons to reach out to a physician:

* Drug-drug interactions
* A chemically equivalent version of the drug prescribed is available
* A therapeutically equivalent version of the drug prescribed is available
* The prescribed drug is not covered
* A prior authorization is required
* The patient is required to try an alternative drug first (step therapy)
* The prescribed …

A comprehensive plan to fight obesity begins at an early age

Kevin

Conditions and Diseases

February 2, 2010

Originally published in HCPLive.com

by Jeffrey Gene Kaplan, MD, MS

In a given year in the U.S., 1/4th of US men and 2/5ths of US women attempt to lose weight, unfortunately, they often fail to keep the weight off.

Sobering statistics that we see all around us, particularly poignant in my office as a pediatrician. Clearly a multifaceted approach is required, but the most …

Why doctors are too quick to prescribe drugs for ADHD

Kevin

Medications

February 1, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Physicians may be too quick to medicate children suspected of having attention deficit hyperactivity disorder (ADHD).

The etiology of the disease is not well understood, and while some cases may have neurological causes, children may respond to psychotherapy instead, Esther Fine, PhD, a psychoanalyst in private practice in Los Angeles, told …

How can doctors stop drugs prescribed by other physicians that are no longer effective?

John Mandrola, MD

Medications

January 30, 2010

Here are two vignettes illustrating the failure of doctors to master the obvious and maybe a window onto the future struggles to control medical costs.

A 90-year old is referred for care due to “end stage dementia.” End-stage dementia is medical speak and as such does not really convey the appropriate imagery. It means a skeletal man, in a wheelchair or mostly in bed, with diapers, who has does not know …

Will New York’s ban on salt really make patients healthier?

Kevin

Conditions and Diseases

January 29, 2010

Originally posted in MedPage Today

by Mike Himowitz

I have a libertarian streak that compels me to shout “Nanny State!” when local governments put up speed-trap cameras to extort money from otherwise law-abiding citizens who drive a few miles over artificially low limits. Same for legislators who want to make me a criminal for calling my wife on my cell phone to ask her if I should pick up anything at …

Can morphine help prevent post-traumatic stress disorder (PTSD)?

Kevin

Medications

January 25, 2010

Originally posted in MedPage Today

by Todd Neale, MedPage Today Staff Writer

The use of morphine may prevent the development of post-traumatic stress disorder (PTSD) in military personnel injured in combat, an observational study showed.

Those who received the drug during resuscitation or trauma care were about half as likely to later develop PTSD (OR 0.47, P<0.001), according to Troy Lisa Holbrook, PhD, …

When are stroke patients more likely to receive clot busting drugs?

Kevin

Medications

January 23, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Patients suffering an acute ischemic stroke are about 20% more likely to receive clot-busting therapy with tissue plasminogen activator (tPA) if they arrive at the hospital on the weekend, a retrospective study showed.

However, there was no difference in rates of inhospital mortality based on the time of admission, Abby …

How psychiatrists may be giving their patients too many drugs

Kevin

Medications

January 16, 2010

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Psychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said.

About 60% of patients with psychiatrist office visits leading to a drug prescription received at least two medications in 2005-2006, according to government survey data analyzed by Ramin …

Do neuroenhancement pills really improve attention, memory, or cognition?

Kevin

Medications

January 15, 2010

Originally published in HCPLive.com

by Victor G. Dostrow, MD

The Internet is filled with reports of remarkable cognitive enhancement with various nostrums.

Many are not regulated, and the pages are typically associated with glowing testimonials and a link to sign up for uninterrupted (and uninterruptible) delivery of the miracle substance. More to the point of this post, other blogs, reports, and forum comments opine as to notable benefits of taking prescription medications marketed …

Don’t use kitchen spoons to measure drug dosages

Kevin

Medications

January 15, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Individuals using standard spoons from their home kitchen to dispense liquid medications may be pouring too little or too much of the drugs, researchers found.

Among volunteers trying to pour a teaspoonful of cold and cough medicine, using a slightly larger spoon resulted in underdosing and using a much larger …

What will the next big medical advance be?

Kevin

Medications

January 14, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It’s tough to make predictions, especially about the future.

That famous observation from baseball great Yogi Berra applies in spades to medicine.

What technological advance or new insight will shape the next few years? As Yogi noted, it’s tough to predict:

It could be — as Leif Ellisen, MD, PhD, thinks — tumor genotyping.

National Influenza Vaccination Week: Time to take stock of our influenza vaccination efforts

Kevin

Conditions and Diseases

January 11, 2010

The following is part of a series of original guest columns by the American Medical Association.

by Nancy H. Nielsen, MD

Back in September, I wrote in this space about ways physicians can prepare their practices to handle this challenging flu season and mentioned the importance of vaccination for all health care professionals. Today as National Influenza Vaccination Week begins, this is an excellent opportunity to remind ourselves, …

Cardiologists discuss how far myocardial infarction management has come

Kevin

Medications

January 10, 2010

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

“What we did for patients with acute MI was place them in a cool, dark place. Give them morphine for pain and lidocaine to prevent arrhythmias and hope for the best.”

The speaker is Steven Nissen, MD, director of Cardiovascular Medicine at the Cleveland Clinic. He is describing standard care 25 …

Is erectile dysfunction associated with restless leg syndrome?

Kevin

Conditions and Diseases

January 9, 2010

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Men with restless leg syndrome (RLS) had a significantly increased risk of erectile dysfunction compared with men who did not have the neurologic disorder, data from a large cohort study showed.

The likelihood of erectile dysfunction increased with the frequency of restless leg episodes, reaching an adjusted risk apex about …

Despite no cure, progress in the treatment of HIV/AIDS

Kevin

Conditions and Diseases

January 6, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It’s 1984. A 20-year-old homosexual man walks into the clinic complaining of swollen glands.

It could well be a death sentence.

It is only three years since the first handful of cases of what would come to be known as acquired immune deficiency syndrome (AIDS) were described. Little is known about …

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