by James Hubbard, M.D., M.P.H.

You’ve seen plenty of products that advertise they’re “FDA-approved.”  What does that really mean?

The U.S. Food and Drug Administration wants you to know that all advertising is not as it seems.  Many products that say “FDA-approved” aren’t. Some are not even in the jurisdiction of the FDA to approve.  They couldn’t approve them if they wanted to.  Others can be “approved” before the FDA really knows much about them.  What about food and drugs?  The words are in the title of the agency so the FDA must approve them.

Well, not really.

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by James Hubbard, M.D., M.P.H.

A while back there was news on a couple of pharmaceutical companies working on a new drug type that decreased appetite by blocking the same receptors in the brain that stimulate hunger after smoking marijuana.  Early trials showed promise, but later studies proved that, to take an dose of taranabant strong enough to decrease appetite effectively, the side-effects increased also.  The risk of increased anxiety, depression and suicidal thoughts was too much so Merck has cancelled further testing and pulled the drug from FDA consideration.

I am disappointed in the failure, but commend Merck for doing the right thing.  It is an example of the time, expense and risk involved in trying to bring a new drug to market.  It is also a good example of a medical news story, highly touted and broadcast initially, with little follow-up.  Get the headlines from big media. Get the real scoop from JHMFD.

Can you think of other examples?

by James Hubbard, M.D., M.P.H.

A few months back, the American Academy of Pediatrics (AAP) recommended drugs for some children to lower cholesterol.  Outrage, controversy and indignation followed.  Apparently this reaction took the AAP by surprise.  I am not sure why.

Authors of an opinion piece called “Storm Over Statins: The Controversy Surrounding the Pharmagologic Treatment of Children” take a look at this dilemma in the Sept. 25, 2008, issue of the NEJM.

They write:

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by James Hubbard, M.D., M.P.H.

Reader’s Digest website has “13 Things Your Pharmacist Won’t Tell You.” There are some good tips, such as asking about the $4.00 generics.  Some chains offer this on certain generic drugs, so it doesn’t hurt to ask.  Better yet, get a list to show to your health-care provider so he or she can prescribe one if it’s appropriate.  Just don’t insist since the drug for your condition may not be on the list.

My addition to tip number three (basically, “Pharmacists make mistakes, too”): Always check you prescriptions before you leave, if possible.  Make sure you have all your medicines, in the right quantity, and that they are what you were prescribed (having asked your doctor what he or she is prescribing before you leave the office).

As a consumer, I was surprised with Secret # 2.

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by James Hubbard, M.D., M.P.H.

Patients need to be informed. That’s what my blog and magazine are all about. But sometimes, how you think about that information can physically affect you.

The placebo effect, or placebo response, has been known for years. A placebo is a treatment that has no active ingredients–no logical reason to have any effect, a sugar pill. The placebo effect is when this inactive treatment provides active results. For instance, placebo has helped alleviate pain, lower blood pressure; the list could go on. That’s why the best medical studies compare the active treatment to placebo (placebo-controlled).

It can happen to anyone, and I see it frequently. If someone thinks a treatment will cause an effect, it can. There are loads of studies, some showing actually physiological changes in the body–the power of positive thinking, mind over matter.

But what happens when the opposite effect occurs?

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by James Hubbard, M.D., M.P.H.

Heath Ledger is only one of many to die from an accidental overdose. The July 28, 2008 Archives of Internal Medicine found a 360 percent increase in “Fatal Medical Errors” (FME) between 1983 and 2004. The increased percentage was primarily in those that combine prescription medication with street drugs or alcohol. In 1984 there were 92 deaths reported of this nature. By 2004 the number was 3792.

With more emphasis on outpatient, non-hospital care in the past few years, there is less supervision and more powerful medications given than ever before. So what to do?

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by James Hubbard, M.D., M.P.H.

My unscientific, personal observation is that every woman eventually has a bladder infection that starts Friday afternoon after their regular doctor has closed.

Well, that may be an exaggeration, but the women who do have the burning, frequent and urgent urination, certainly don’t want to wait until Monday for relief so they come to the minor emergency clinic, where I occasionally work on weekends.

But is there anything you can you do at home? Does cranberry juice help? What if you’re a man with these symptoms?

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by James Hubbard, M.D., M.P.H.

I quit playing competitive basketball in my late 30s because I had seen several weekend warriors near my age who had torn their Achilles. It would just happen out of the blue. To me, it did not seem to be worth the risk. Tendon tears are very painful and sometimes require surgery, and you might have to wear a splint or cast for six weeks to three months.

The FDA has issued a strong warning about an increased risk of tendinitis (inflammation) or tendon rupture (tear) with flouroquinolone antibiotics (such as Avalox, Cipro, Factive, Floxin, Levaquin, Noroxin and Proquin XR).

The warning will be in a “black box” in the package insert. Doctors widely prescribe flouroquinolones for wound, ear, urinary tract, prostate and other infections. They’re usually well tolerated.

So, what is a person to do?

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by James Hubbard, M.D., M.P.H.

With the FDA debating on diabetes drugs and heart disease, what can you do in the meantime to make sure you’re safe? Well, there just happens to be a proven, all-natural, drug-free method–without the extra-risk worries. What is it? You may have guessed.

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by James Hubbard, M.D., M.P.H.

So you’re diabetic. Your cholesterol is high, and you’re overweight; you’re at increased risk for cardiovascular disease. You start on medicine that lowers your sugar … but increases your risk for cardiovascular disease even more. Not good.

This is the dilemma in which patients, physicians and drug companies find themselves. Some studies have suggested that certain diabetes drugs may be worsening heart-disease risk. What to do?

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