Nine months ago I saw a new patient, a delightful 86-year old male. His past medical history included lymphoma many years ago, a stroke five years ago, dyslipidemia and hypertension. Medications included aspirin, a generic statin, and a non-generic ARB-HCT combination, which he had been on for years. He lived alone with a lot of support from his loving and attentive family. The patient looked great. I refilled his meds ...

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The ability to critically assess the validity of a clinical trial is one of many important skills that a physician strives to develop. This skill helps guide clinical decision-making, and there are a number of things that we are trained to look for to help determine the validity of any given study. Right at the top of the list of factors that go into this appraisal is that of study ...

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It was during my residency that the first indication of heart toxicity of antibiotics affected me personally.  The threat was related to the use of the first of the non-drowsy antihistamines – Seldane – in combination with macrolide antibiotics, such as Erythromycin causing a potentially fatal heart arrhythmia.  I remember the expressions fear from other residents, as we had used this combination of medications often.  Were we killing people when we treated their ...

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I grew up in the American Deep South, in Lower Alabama, with Jim Crow and Old Crow, where fire-breathing preachers, Harper Lee, Truman Capote, and I all knew that one may never kill a mockingbird. And in that day and place, the "War on Drugs" was actively waged county by county. The drug was alcohol and the method of war was called "local option." Every several years, the Baptists and the ...

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It’s crazy out there in blood thinner land. The novel blood thinning drug for patients with atrial fibrillation, dabigatran (Pradaxa) cannot get a break. It’s all over the TV: Pradaxa = Bad drug. Look at this image: On the prestigious heart news site, theheart.org, an insignificant 113-patient study presented as a poster at a small symposium -- by a researcher with ties to anti-coagulation clinics ...

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Behind the headlines “FDA Panel Unanimously Rejects…” and “Arthritis Pill From Pfizer Wins Support…” was, for me, over 600 pages of reading and two days at the FDA as the Consumer Representative to the Arthritis Advisory Committee (AAC). These were my first meetings following an almost yearlong process that started with a nomination by Diane Aronson, the Consumer Representative whose term was ending, and culminated with my four year ...

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The FDA is deciding whether to allow patients to purchase prescription medications over the counter for many common ailments. This idea is controversial. On one hand, deregulation would remove one of the largest barriers to receiving treatment for some conditions – the doctor’s visit. If no doctor’s visit is necessary to receive necessary blood pressure medications or diabetes medications, then patients don’t have to wait for an appointment and the patient/government ...

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An excerpt from The Truth About Statins. Like all physicians, I’ve had interactions with pharmaceutical companies. Shortly after I went into private practice in Rhode Island in 1977, I received a telephone call from a drug company representative. He offered me an all-expense-paid weeklong trip to Germany to attend a medical conference. I was taken aback, knowing that the cost of such a trip would run to thousands of dollars. I ...

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In our world of 24/7 media, where we seem to hear about the next big cure, important dietary change or very dangerous drug virtually every day, it is hard to believe that the news people, tweeters and bloggers could miss anything that is going on in health care today.  However, it appears most everyone missed a big one. This might be one of the most important stories in health care today, that no one ...

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An excerpt from Born With a Junk Food Deficiency, (Prometheus Books, 2012).  Can anyone remember life before Direct-to-Consumer (DTC) advertising with its notorious “Ask Your Doctor” ads? The only thing laypeople knew about prescription drugs came from the ads they peeked at in the Journal of the American Medical Association (JAMA) in the doctor’s waiting room. The ads were full of vaguely ominous terms—nulligravida? hemodialysis?—as well as side effects ...

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