Drug Updates

Therapeutic Drug Use Stats (CDC)

  • Percent of persons using at least one prescription drug in the past month: 48% (2005-2008)

Source: Health, United States, 2009, table 95

Physician office visits

  • Number of drugs ordered or provided: 2.3 billion
  • Percent of visits involving drug therapy: 73%
  • Most frequently prescribed therapeutic classes:
    • Analgesics
    • Antihyperlipidemic agents
    • Antidepressants

Source: National Ambulatory Medical Care Survey: 2007 Summary, tables 22, 23, 24

Hospital outpatient department visits

  • Number of drugs ordered or provided: 224.9 million
  • Percent of visits involving drug therapy: 73%
  • Most frequently prescribed therapeutic classes
    • Analgesics
    • Antidepressants
    • Antihyperlipidemic agents

Source: National Hospital Ambulatory Medical Care Survey: 2007 Outpatient Department Summary, tables 20, 21

Medication Errors in Critical Care Patients (Medscape)

Abstract

Objective To systematically review clinical evidence gathered by direct observation of medication errors in adult patients in intensive care units.
Methods Articles published between 1985 and 2008 in English-language journals indexed by the Cumulative Index for Nursing and Allied Health Literature and PUBMED were searched for studies on medication errors made by intensive care unit nurses. Studies in which errors were detected via direct observation were included.
Results Six studies met the inclusion criteria, and error incidence varied considerably among them. Wrong dose, wrong administration time and rate, and dose omission were the most common errors. Antibiotics, electrolytes, and cardiovascular drugs were commonly associated with errors, but the evidence about factors contributing to errors was inconclusive. Increased monitoring was the most common consequence of medication errors, whereas life-threatening and fatal adverse events were rare.
Conclusions Identification of patterns and characteristics of medication errors can guide preventive interventions. Factors contributing to errors, as well as drugs and error types associated with severe adverse events, deserve further investigation. (Posted: 02/02/2011; American Journal of Critical Care. 2011;20(1):36-44. © 2011 American Association of Critical-Care Nurses)

Drugs Linked to Violence (PLos)

We identified 1527 cases of violence disproportionally reported for 31 drugs. Primary suspect drugs included varenicline (an aid to smoking cessation), 11 antidepressants, 6 sedative/hypnotics and 3 drugs for attention deficit hyperactivity disorder. The evidence of an association was weaker and mixed for antipsychotic drugs and absent for all but 1 anticonvulsant/mood stabilizer. Two or fewer violence cases were reported for 435/484 (84.7%) of all evaluable drugs suggesting that an association with this adverse event is unlikely for these drugs.

A List of All 31 Drugs Related to Violence (PLOS)

Why Drugs Have Side Effects (webmd)

Side effects fall into several categories. Allergic reactions can happen with any drug and can range from itching and rash all the way up to a life-threatening anaphylactic reaction.

Other side effects simply “come with the territory.” Some drugs can’t help but trigger side effects because of their chemical structure. One example is the common allergy drug diphenhydramine (also known by the brand name Benadryl). Though it eases allergy symptoms,  it also suppresses the activity of the body chemical acetylcholine, and that leads to drowsiness and a host of other side effects, including dry mouth.

Some drugs have barely noticeable side effects when dosed properly. For example, Warfarin, used to prevent blood clots, is usually well tolerated, but serious internal bleeding can occur.

Side effects may only pop up when certain drugs are mixed with certain other things. These might also be considered drug interactions. Drinking alcohol with narcotic painkillers can lead to trouble breathing. Drinking grapefruit juice can affect the blood levels of several drugs, including the heart drug digoxin 

Statins & Stroke Risk (Arch Neurology)

ABSTRACT

Context  Statins are widely prescribed for primary and secondary prevention of ischemic cardiac and cerebrovascular disease. Although serious adverse effects are uncommon, results from a recent clinical trial suggested increased risk of intracerebral hemorrhage (ICH) associated with statin use. For patients with baseline elevated risk of ICH, it is not known whether this potential adverse effect offsets the cardiovascular and cerebrovascular benefits.

Objective  To address the following clinical question: Given a history of prior ICH, should statin therapy be avoided?

Design  A Markov decision model was used to evaluate the risks and benefits of statin therapy in patients with prior ICH.

Main Outcome Measure  Life expectancy, measured as quality-adjusted life-years. We investigated how statin use affects this outcome measure while varying a range of clinical parameters, including hemorrhage location (deep vs lobar), ischemic cardiac and cerebrovascular risks, and magnitude of ICH risk associated with statins.

Results  Avoiding statins was favored over a wide range of values for many clinical parameters, particularly in survivors of lobar ICH who are at highest risk of ICH recurrence. In survivors of lobar ICH without prior cardiovascular events, avoiding statins yielded a life expectancy gain of 2.2 quality-adjusted life-years compared with statin use. This net benefit persisted even at the lower 95% confidence interval of the relative risk of statin-associated ICH. In patients with lobar ICH who had prior cardiovascular events, the annual recurrence risk of myocardial infarction would have to exceed 90% to favor statin therapy. Avoiding statin therapy was also favored, although by a smaller margin, in both primary and secondary prevention settings for survivors of deep ICH.

Conclusions  Avoiding statins should be considered for patients with a history of ICH, particularly those cases with a lobar location.

Death By Medicine Update (Dr. Mercola)

I agree that these are huge contributors to what is killing us as a nation financially and as a people. But I DON’T agree with the context in which they’re presented. If you’ve followed all the information I’ve given you here, and even skimmed the 2003 Death by Medicine article, then I think you’ll see why I think the major contributors have a slightly different paradigm — and that the only way we are get healthier as a nation, and drive medical costs down too, is to change that paradigm.

That’s because the foundational causes of what’s driving health care costs in America are:

  1. The emphasis on sickness and treatment, rather than health, fitness, and prevention which is primarily fostered by ultra-sophisticated marketing strategies employed by the drug cartel.
  2. Fraud — by both consumers and providers, including the drug industry.
  3. Unnecessary procedures, medications, hospitalizations and screenings
  4. Medical mistakes, hospital-acquired infections, and surgical and device errors

If we were only to address these issues, beginning with changing the emphasis of our well-being to health and fitness, and then following the healthy lifestyle that paradigm suggests, I promise that the issue of sickness in America and what it’s costing us — as well as the death-by-medicine events will begin to fade away very quickly.

It’s time to quit bombarding your body with medical interventions and to reward yourself with the fit and healthy body that come from living fit and lean.

Proposed WA Bill to Make Health Care Providers Approve Vaccine Religious/Philosophical Objections (NVIC)

Co-sponsors of the new Washington state vaccine law do not acknowledge in the bill that there is already a federal law in place since 1986, 20, 21 which legally requires doctors, nurses and all vaccine providers to: 

  1. Give parents vaccine benefit and risk information before vaccination takes place;
  2. Record serious health problems, including hospitalizations, injuries and deaths, after vaccination in the child’s permanent medical records;
  3. Report serious health problems after vaccination 22 to the federal Vaccine Adverse Events Reporting System (VAERS); 23 and
  4. Keep a permanent record of all vaccines given, including the manufacturer’s name and lot number.

Unfortunately, today most vaccine providers do not obey these important federal law requirements. So if the goal of the new law is to educate parents about vaccination, it should simply state that all vaccine providers are legally required to give every parent Vaccine Information Statements (VIS) produced by the Centers for Disease Control, 24 which also contain information about reporting vaccine reactions and the federal vaccine injury compensation program.

Which Medications To Avoid with Delirum (Medscape)

Abstract: Background: delirium is a common clinical problem and is associated with adverse health outcomes. Many medications have been associated with the development of delirium, but the strength of the associations is uncertain and it is unclear which medications should be avoided in people at risk of delirium.
Methods: we conducted a systematic review to identify prospective studies that investigated the association between medications and risk of delirium. A sensitivity analysis was performed to construct an evidence hierarchy for the risk of delirium with individual agents.
Results: a total of 18,767 studies were identified by the search strategy. Fourteen studies met the inclusion criteria. Delirium risk appears to be increased with opioids (odds ratio [OR] 2.5, 95% CI 1.2–5.2), benzodiazepines (3.0, 1.3–6.8), dihydropyridines (2.4, 1.0–5.8) and possibly antihistamines (1.8, 0.7–4.5). There appears to be no increased risk with neuroleptics (0.9, 0.6–1.3) or digoxin (0.5, 0.3–0.9). There is uncertainty regarding H2 antagonists, tricyclic antidepressants, antiparkinson medications, steroids, non-steroidal anti-inflammatory drugs and antimuscarinics.
Conclusion: for people at risk of delirium, avoid new prescriptions of benzodiazepines or consider reducing or stopping these medications where possible. Opioids should be prescribed with caution in people at risk of delirium, but this should be tempered by the observation that untreated severe pain can itself trigger delirium. Caution is also required when prescribing dihydropyridines and antihistamine H1 antagonists for people at risk of delirium and considered individual patient assessment is advocated.

From Age and Ageing  Which Medications to Avoid in People at Risk of Delirium.A Systematic ReviewPosted: 02/06/2011; Age and Ageing. 2011;40(1):23-29. © 2011 Oxford University Press

 

Nutrigenomics

Nutrient Mixture with Green Tea and Vitamin C Decreases Influenza A (pubmd)Biofactors. 2007;31(1):1-15. Abstract

Influenza, one of the oldest and most common infections, poses a serious health problem causing significant morbidity and mortality, and imposing substantial economic costs. The efficacy of current drugs is limited and improved therapies are needed. A unique nutrient mixture (NM), containing ascorbic acid, green tea extract, lysine, proline, N-acetyl cysteine, selenium among other micronutrients, has been shown to exert anti-carcinogenic and anti-atherogenic activity both in vitro and in vivo. Many of the constituents of NM have been shown to have an inhibitory effect on replication of influenza virus and HIV. This prompted us to study the effect of NM on influenza A virus multiplication in infected cells and neuraminidase activity (NA) in virus particles. Addition of NM to Vero or MDCK cells post infection resulted in dose-dependent inhibition of viral nucleoprotein (NP) production in infected cells. NM-mediated inhibition of viral NP was selective and not due to cytotoxicity towards host cells. This antiviral effect was enhanced by pretreatment of virus with the nutrient mixture. Individual components of NM, namely ascorbic acid and green tea extract, also blocked viral NP production, conferring enhanced inhibition when tested in combination. Incubation of cell-free virus with NM resulted in dose-dependent inhibition of associated NA enzyme activity. In conclusion, the nutrient mixture exerts an antiviral effect against influenza A virus by lowering viral protein production in infected cells and diminishing viral enzymatic activity in cell-free particles. PMID: 18806304

Zinc’s Positive Effect on Bone (Springerlink)

Zinc has a suppressive effect on the receptor activator of nuclear factor (NF)-?B ligand (RANKL)-induced osteoclastogenesis. Zinc transporter has been shown to express in osteoblastic and osteoclastic cells. Zinc protein is involved in transcription. The intake of dietary zinc causes an increase in bone mass. ?-Alanyl-l-histidinato zinc (AHZ) is a zinc compound, in which zinc is chelated to ?-alanyl-l-histidine. The stimulatory effect of AHZ on bone formation is more intensive than that of zinc sulfate. Zinc acexamate has also been shown to have a potent-anabolic effect on bone. The oral administration of AHZ or zinc acexamate has the restorative effect on bone loss under various pathophysiologic conditions including aging, skeletal unloading, aluminum bone toxicity, calcium- and vitamin D-deficiency, adjuvant arthritis, estrogen deficiency, diabetes, and fracture healing. Zinc compounds may be designed as new supplementation factor in the prevention and therapy of osteoporosis.

Omega 3 Balance Related to Mood and Nervous System Communication (VitalChoice)

The INSERM team fed mice a life-long diet imbalanced in omega-3 and omega-6 fatty acids.
 
They found that the resulting shortage of omega-3s and overload of omega-6 fats disturbed communication between brain cells (neurons).
 
Critically, this was the first research to show the omega-imbalanced diet virtually shut down their brain cells’ CB1R cannabinoid receptors, which play a key role in between-cell communications (i.e., neurotransmission).
 
And the “neuronal dysfunction” induced by an omega-imbalanced diet was accompanied by depressive behaviors among the mice.
 
Among omega-3 deficient mice, the usual effects produced by cannabinoid receptor activation disappeared, along with the critical antioxidant effects exerted by the brain’s cannabinoid compounds.
 
The researchers discovered that the omega-3 deficient diet impaired synaptic plasticity – the ability to form new connections in the brain – in at least two areas (prefrontal cortex and nucleus accumbens) involved in reward, motivation, and emotional regulation.

Health

Lack of Sleep Linked Childhood Obesity (ABC News)

Report Pediatric Journal Study:

Total sleep time for obese children was more variable on weekends than on school days and they tended to get less catch-up sleep compared with normal and overweight youngsters. Those who got the least amount of sleep overall had a 4.2 times higher risk of tipping the scales in the obese range than other children. When the researchers drew blood samples from a third of the children at random, the heaviest children also had the unhealthiest blood profiles.

America’s Eating Addiction (Mark Hyman, MD) 

Food made of sugar, fat, and salt can be addictive. Especially when combined in secret ways the food industry will not share or make public. We are biologically wired to crave these foods and eat as much of them as possible. We all know about cravings, but what does the science tell us about food and addiction, and what are the legal and policy implications if certain food is, in fact, addictive?

Here are some of the scientific findings confirming that food can, indeed, be addictive(ii):

  1. Sugar stimulates the brain’s reward centers through the neurotransmitter dopamine exactly like other addictive drugs.
  2. Brain imagining (PET scans) shows that high-sugar and high-fat foods work just like heroin, opium, or morphine in the brain.(iii)
  3. Brain imaging (PET scans) shows that obese people and drug addicts have lower numbers of dopamine receptors, making them more likely to crave things that boost dopamine.
  4. Foods high in fat and sweets stimulate the release of the body’s own opioids (chemicals like morphine) in the brain.
  5. Drugs we use to block the brain’s receptors for heroin and morphine (naltrexone) also reduce the consumption and preference for sweet, high-fat foods in both normal weight and obese binge eaters.
  6. People (and rats) develop a tolerance to sugar—they need more and more of the substance to satisfy themselves—just like they do for drugs of abuse like alcohol or heroin.
  7. Obese individuals continue to eat large amounts of unhealthy foods despite severe social and personal negative consequences, just like addicts or alcoholics.
  8. Animals and humans experience “withdrawal” when suddenly cut off from sugar, just like addicts detoxifying from drugs.
  9. Just like drugs, after an initial period of “enjoyment” of the food the user no longer consumes them to get high, but to feel normal.

Science for Sale (Mark Hyman, MD)

RECENT STUDY in the Journal of the American Medical Association found over 40 percent of the best designed, peer-reviewed scientific papers published in the world’s top medical journals misrepresented the actual findings of the research.(i) The “spin doctors” writing the papers found a way to show treatments worked, when, in fact, they didn’t.

Doctors and health care consumers rely on published scientific studies to guide their decisions about which treatments work and which don’t. We expect academic medical researchers to determine what needs to be studied, and to objectively report their data. We rely on government regulators to prevent harmful medications from being approved, or to quickly remove harmful medications or treatments from the market.

What most physicians and consumers don’t recognize is that science is now for sale, published data often misrepresents the truth, academic medical research has become corrupted by pharmaceutical money and special interests, and government regulators more often protect industry than the public. Increasingly, academic medical researchers are for hire, and research, once a pure activity of inquiry, is now a tool for promoting products.

Science has always been considered an objective endeavor that removes bias and is inherently true and reliable. While we may acknowledge that some science is inferior in design or execution, and that there are a few corrupt scientists, we mostly believe what is published in the world’s top medical journals such as the Journal of the American Medical Association and New England Journal of Medicine can be counted on to guide our medical decisions. We still have trust in the scientific method. That trust may be misguided.

Environmental Chemicals in Pregnant Women in the US: NHANES 2003-2004.

Abstract (Environ Health Perspect. 2011 Jan 14. [Epub ahead of print])

Background: We analyzed biomonitoring data from the National Health and Nutritional Examination Survey (NHANES) to characterize both individual and multiple chemical exposures in U.S. pregnant women. Methods: We analyzed data for 163 chemical analytes in 12 chemical classes for subsamples of 268 pregnant women from NHANES 2003-2004, a nationally representative sample of the U.S. population. For each chemical analyte, we calculated descriptive statistics. We calculated the number of chemicals detected within the following chemical classes; polybrominated diphenyl ethers (PBDEs), perfluorinated compounds (PFCs), organochlorine pesticides, and phthalates, and across multiple chemical classes. We compared chemical analyte concentrations for pregnant and non-pregnant women using least square geometric means, adjusting for demographic and physiological covariates. Results: The percent of pregnant women with detectable levels of an individual chemical ranged from 0 to 100 percent. Certain PCBs, organochlorine pesticides, PFCs, phenols, PBDEs, phthalates, polycyclic aromatic hydrocarbons (PAHs) and perchlorate were detected in 99 to 100% of pregnant women. The median number of detected chemicals by chemical class ranged from 4 (out of 12 PFCs) to 9 (out of 13 phthalates). Across chemical classes, median number ranged from 8 (out of 17 chemical analytes) to 50 (out of 71 chemical analytes). We found, generally, levels in pregnant women were similar or lower than levels in non-pregnant women, adjustment for covariates tended to increase levels in pregnant women compared to non-pregnant women. Conclusions: Pregnant women in the U.S. are exposed to multiple chemicals. Further efforts are warranted to understand sources of exposure and implications for policy-making. PMID: 21233055

The Overexpense of American Medicine (Dr. Mercola)

Now, if you’re like most people, when you’re faced with an ailment or disease and your physician “sells” you on a particular surgical procedure or drug treatment, you probably expect it to solve your problem, improve your health, or, at the very least, live up to its advertised ideals.

But in the United States this is, sadly, expecting too much. American medical care is the most expensive in the world, and for this “price” Americans get:

  • Back surgery
  • Heartburn surgery
  • Prostate treatments
  • Implanted defibrillators
  • Coronary stents
  • C-sections
  • Whole body screens
  • High-tech angiography
  • Mammography
  • Virtual colonoscopy

    •  

    So please understand that if you live in the United States, your health is not safe in the hands of the conventional medical system. The current medical paradigm, with its focus on a drug, surgery or other high-tech solution for every symptom, actually creates a mind-boggling amount of needless suffering and premature death.

     Tribute to Jake Lallane (Dr. Mercola)