Archive for the ‘Medications’ Category

Acupuncture treatment for headaches: It works, says Cochrane

Tuesday, March 3rd, 2009

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

Acupuncture got an official seal of approval from a respected medical organization this year. It effectively treats tension-type headaches and helps keep away migraines—even better than other preventive treatments—they said.

The Cochrane Collaboration is in independent, well-respected, nonprofit organization that analyzes evidence-based medicine (available studies) to to come up with recommendations of whether interventions work.  They are strict, conservative and not easy to please, and it’s hard to get their approval.  So if they think some treatment works, the evidence bears them out.

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Accidental overdose of narcotics and acetaminophen: Beware the ingredients

Thursday, February 26th, 2009

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

The FDA has become concerned about an increase in deaths from “accidental” narcotics overdoses.  Apparently, the powers that be have come to recognize what we docs have known all along: Not all who ask for prescription narcotics use them in the manner prescribed, and some will do anything for their “fix.” (more…)

Drug Ads: How can they be made better?

Monday, February 23rd, 2009

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

I recently wrote about why drug ads are the way they are. Lo and behold, a study comes out that suggests perhaps a change is in order.

The FDA recognizes we need better quality drug direct-to-consumer ads.  Several groups, including the Institute of Medicine, have called for better information conveying benefits versus adverse effects in these ads.

From a sponsor’s standpoint, ads are for one reason: to sell products.  Regulators are there to make sure these ads aren’t misleading, but don’t want to place undue restrictions that cause ads (and their money) to disappear.  So where is the middle ground?

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Why do drug ads list all those side effects? And should they?

Thursday, February 12th, 2009

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

Have you ever been watching one of those ads for prescription drugs touting how wonderful the drug is … then they go into detail about side effects like may it may cause blurred vision, anal leakage, heart palpitations, blindness, maybe death?  Why do they do that?  You don’t see it on all drug ads, just some.  Are these drug companies just more open and truthful than others?

Stay tuned for “the rest of the story.”
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Asthma inhaler change: Switch to albuterol HFA increases price; government mandates the cause

Tuesday, February 3rd, 2009

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

Unless you have asthma, you probably don’t know the cost of inhalers doubled starting the first of the year. This wasn’t due to market factors or greedy pharmaceuticals, nor did it improve quality of or access to health care.  It was due to a government regulation, just like the regulations on the mortgage, auto and airline industries that have contributed to their bankruptcy.

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Dangers of lidocaine gel, other skin numbing agents: Is lidocaine really safe for mammograms?

Thursday, January 22nd, 2009

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

A while back, I blogged about a study that suggested over-the-counter lidocaine gel decreases the discomfort of a mammogram. (The gel numbs the skin after you rub it on.)

Recently, the FDA issued an alert reminding us that, although there were no serious side effects in the study, this same lidocaine gel and similar numbing agents can cause life-threatening side effects if you absorb too much through the skin.  Rarely, it has caused heart irregularities, seizures, breathing problems, coma and death.

A lot to risk for the minimal benefit found in the study, don’t you think?  In small amounts it appears to be safe, but the FDA recommends:

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Lyrica and fibromyalgia: Why does a medicine for nerve pain help a muscle disease?

Friday, January 16th, 2009

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

I’m starting to wonder if we’re on the right path with fibromyalgia. Is it truly the type of disorder we think it is? Here are some clues I’ve come up with. What do you think, Sherlocks?

I recently wrote about a JAMA study that showed how well the antidepressant amitriptyline worked for fibromyalgia symptoms, though we don’t know why. That got me to thinking. We also don’t know why another drug, Lyrica, helps.

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Prescribing narcotics and other habit forming drugs. A doctor’s view on why it can be complicated

Friday, January 9th, 2009

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

Like a lot of doctors, I have mixed feelings about narcotics.  They are great for severe, short-term pain and a must for some terminal cancer pain.   Some people abuse them for nothing more than the high they get.  And then there are all of the in-betweens.  We doctors are kind of caught in the middle, also.  We can lose our license if we prescribe too much or inappropriately.  We are told, by some groups, we prescribe too little to the patients that really need it.  But how do we know who really needs them?  If we are too gullible, we will be prescribing to a bunch of abusers, too strict and we are doing a disservice to those in need.

It is the long-term, chronic use that concerns us the most.  Narcotics are habit forming. They alter your mental state. If you take them long enough, you will have a physical withdrawal trying to get off of them.  Most people will become tolerant needing more and more to get the same effect.

So what to do?

 

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How to boost your immunity during the cold and flu season

Friday, January 2nd, 2009

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

photo by James Gathany

Looking for a cure for the common cold or flu?  Sorry to disappoint.  You won’t find one that is proven to work.  Trying to boost your immunity to fight off those pesky viruses?  You’ve come to the right place.  As a reminder, colds and influenza are caused by viruses that affect your upper respiratory system.  Antibiotics kill bacteria, not viruses.  They don’t work on colds or the flu.  If you do get one of these nasty viruses, it has to run its course as your body’s immune system fights it to the finish.  Here are some ways you can boost and strengthen your immune system to help in the battle.

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JAMA study shows brand name and generic cardiovascular drugs are equivalent, but hedges in conclusion

Thursday, December 4th, 2008

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

Some drugs have a narrow therapeutic index.  You need just the right amount in your system.  Too little and it doesn’t work; too much and you can have toxic effects.  Doctors worry about these and many hedge on the side of caution by using the more expensive but trustworthy brand-name medicine.  But are they really more reliable than the cheaper generic alternative?

The latest JAMA takes on this question by trying to make sense of all past studies that have looked at cardiovascular brand and generic therapeutic levels in patients.

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