prescription drugs

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In the National World War II museum, it is easy and even triumphant and pride-generating to look back and see some of the scientific advances made during World War II.  There’s no doubt that science is advancing.  But I wonder if our ethics can keep pace.

I am fairly proud of Teflon.  And synthetic cortisone is widely used and may have saved plenty of lives. It’s a steroid that knocks down the action of the immune system.  When a medical substance becomes cheaper and easier to use and known to the public, then it runs a real danger of getting overused.  Most concern about overuse is focused on illegal steroids taken by athletes.  Nevertheless, everything that can be helpful and fast may make things worse. One example would be the over-prescribing of steroids to kids with allergies.

Penicillin had been invented before WWII, but its use did not become widespread until WWII.  Of course, it took people awhile to find out about the ability of bacteria to develop resistances to antibiotics.  This has led to newer and stronger antibiotics, which would not be the worst thing in the world. Unfortunately, the excessive use of antibiotics has led to untreatable infections, such as methicilline-resistant strep and an untreatable strain of tuberculosis. Read more on Science and War (and Ethics)…

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Ever heard of capitation?  In healthcare, it can mean that a clinic makes more money by following more patients.  Payments are per person, rather than per service.  I guess I shouldn’t be surprised, then, that they refused to dismiss this guy from their care.

He was a 32 year old young man who was diagnosed with an anxiety disorder.  He had been working independently as a pool cleaner but he couldn’t stand it anymore.  He was always nervous.  As a matter of fact, this man was nervous about everything he did.  Perhaps it was a generalized anxiety disorder, but surely something a great deal more.  He wasn’t having panic attacks, and he exhibited far more than the usual one or two things found in generalized anxiety disorder.

I tried to start him on some medications — as much as I didn’t like the medications he had been started upon.  He had been given regular Xanax in slowly increasing doses.  As nervous as he was, he wasn’t stupid.  He said, “It’s really funny.  The medication makes me sleep, but it sure doesn’t stop me from being nervous.” Read more on The Nervous Pool Cleaner…

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I have spent as little time as possible on the staff of hospitals.  The interface between doctors and administrators has always seemed to be dominated by petty politics.  People are interested in money, and secondary to that, some vague sort of reputation or power.

A large and prestigious Midwestern hospital used to have a certain kind of meeting every few months.  This hospital had only the vaguest of University associations — just enough to make it look academic and research oriented.  I knew perfectly well it was neither.

It was a luncheon meeting of the medical staff and a few administrative types — uncommonly well-catered. There were about 25 folks, but only two other women who looked as uncomfortable as I was.

The meeting was to discuss certain hospital statistics, including some case details.  As the meeting agenda was passed around, the head of the hospital reminded us of the meeting “rules.”  We were gently reminded that no recordings were permitted and neither were extraneous notes.  We each received an agenda, which were carefully counted out as they were distributed.  We were told that at the end of the meeting they would be collected — and counted — before any of us could leave. Read more on Hospital Accountability Is An Ideal (Not Always Reality)…

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As it turns out, this whole bit about the use of antibiotics in livestock and poultry is a complex issue.  It’s well beyond anything that anyone would guess at first blush.  The best online summary is the position paper put out by Food Marketing Institute.  Curiously enough, it doesn’t have a year on it.  Based on the references, I’d guess it was probably around 2005.

The Food and Drug Administration has approved the use of therapeutically low doses of antibiotics in feed.  However, very few studies were conducted.  They decided that giving little bits of antibiotics to animals would help avoid illness.  What this means in practical life is that they will grow faster and produce more meat prior to being slaughtered and eaten.

Everybody agrees that using too many antibiotics in humans can cause humans to become resistant to those antibiotics.  This has been blamed on everything from patients who want a prescription for an illness that isn’t caused by bacteria to doctors feeling they need to give a prescription to justify their fee.  This kind of talk has been around for a long time. Read more on Antibiotics in Livestock Feed Endanger The Entire World…

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Whitney Houston’s death might be “old news” already, but I still think her death may not have been in vain.

Because Whitney was a star, we were treated to hearsay before facts.  She drank in the morning, in a public place, and according to some observers may have been behaving a bit strangely.

There is an old screener for alcoholism called the “CAGE” questionnaire.  It’s named after the four questions that presumably even a primary care physician — who has little room left in an overtaxed memory — could remember. Read more on Whitney Houston’s Death May Not Have Been in Vain…

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To paraphrase some recent political campaigns, the FDA was against Qnexa before they were for it.

I’ve written about this diet drug compound before —  HERE And HERE.

Last time I wrote about this “drug,” I thought it was down for the count. Aauugghh!!!!

Like a scene from “Night Of The Living Diet Drugs” – it is back from the grave.

You bet your life! (Literally if you take this) – our protective government watchdogs at the FDA originally said this was too dangerous to unleash on the public.  Then – as the politicians say – they did a “Flip Flop.” This No-Vowel remedy QNEXA (ok, it has a couple of vowels, but not enough) is not actually a drug — it is a combination of two drugs.

This is of course, the cheapest way to get a new product on the market and eliminate R&D costs as well as testing for safety and efficacy. The company takes two separate FDA-approved agents and combines – kind of like making Frankenstein out of left-over body parts.

(This is turning into a Halloween column, isn’t it?  Sorry.) Read more on They’re Ba-a-a-a-ck!!! Zombie Diet Drugs!!!…

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Many people are proud of the state from which they came. But I value the state they (we, all of us) can go to.

It’s called a “Resource State.”

Don’t bother looking on a map – unless it is a map of the cerebral cortex.  Yet, it isn’t clearly defined as a location in the brain either.

I know it sounds mysterious, but it is easy to access and the benefits once you get there are astronomical.  I think I need to give you some illustrations to make my point.

Once when I was in prison (that always gets attention – but actually I was employed as a prison psychiatrist and not serving time for criminal activities) I treated a young man of 28 who was doing time for armed robbery.  His problem was depression with occasional suicidal ideation. Read more on The Resource State — Your Magic Ticket To Happiness…

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I was trying to remember when prescription drugs were allowed to advertise on television (called “Direct To Consumer Advertising, or DTCA”).  Fortunately, I didn’t have to bust my memory cells – I just had to “Google it.”

1995. The year all HHHHell broke loose.  At least if you were a doctor.

Suddenly, patients could make their own diagnoses and prescriptions and just phone the order in to their doctor.  At least, that’s how most patients thought it should work.  And – hoo boy! – were they upset when it wasn’t quite that easy.

Comedian Dennis Miller has a hilarious line: “I divide medical practitioners into two camps. Those who will give me a scrip for Vicodin over the phone, and those who won’t.”

Hilarious if you aren’t a doctor, that is. Read more on RX Package Insert — Just Read It!…

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If there is one time to get scared, it is when  a drug company, a government agency, a popular magazine article or – heaven forbid – your doctor says a metabolite is “better” than the drug it came from.

A metabolite is the substance that is left after the body breaks down (metabolizes) a medication.
  
Everyone in this picture know that oxycontin — read “morphine” — has lots of addiction-type problems.  Synthesized by the Germans in 1914, it has been around for quite a while, although not terribly commercially exploited until the folks at Endo Pharmaceutical started pushing it. Read more on Pain Killers Can Be A Prescription For Disaster…

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Number 5 in the USA Today catalog of medical changes in the past 25 years is (imagine a drum roll playing – and CYMBAL CRASH!) — antidepressants are the most popular drugs. Read more on Antidepressants Are Popular — And Dangerous…

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