Meds

The Massachusetts gift ban benefits health insurance companies

by Edison Wong, MD

With the recent proposal to repeal the so-called Massachusetts “gift ban” (more appropriately referred to as the “interaction ban”), I asked myself who stands to gain the most from such bans?

Is it the consumers or patients? Is it the physicians or their practices? Is it the federal or state governments? Nope. Sadly, it is the insurers who gain the most, at the expense of patients.

The …

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Beware of fake Tamiflu sold online

by Cole Petrochko

The FDA warned consumers to be alert for websites selling a fake “generic” version of the flu drug oseltamivir (Tamiflu), which may be dangerous to patients allergic to penicillin.

The Tamiflu fake does not contain the active ingredient of the drug it imitates but does contain cloxacillin, which can cause anaphylaxis in patients allergic to antibiotics in the same class as penicillin.

The FDA uncovered the mimic through purchasing the …

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ER visits rise because of prescription drug abuse

by Michael Smith

The number of emergency room visits for nonmedical use of prescription painkillers more than doubled between 2004 and 2008, according to a CDC estimate.

The increase was part of a trend that saw emergency room visits for nonmedical use of all prescription and over-the-counter medications reach the same level as those for abuse of illicit drugs, the agency said in the June 18 issue of Morbidity and Mortality Weekly …

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Rosiglitazone (Avandia) stays on the market, with stronger warnings

by Emily P. Walker

An advisory panel voted 20-12 to recommend that the FDA allow rosiglitazone (Avandia) to stay on the market, but most panelists want to see the controversial diabetes drug carry tougher warnings on its label.

Wednesday’s vote marks the second time an FDA advisory panel has essentially endorsed rosiglitazone. In 2007, a panel voted that while the drug appears to …

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Ecstasy overdose is becoming more frequent at rave parties

by Crystal Phend

Overdoses of the “club drug” ecstasy at all-night rave dance parties may be a rising but under-reported public health problem, the CDC said.

What may be the first public health investigation into the epidemiology of ecstasy overdose revealed that 18 patients landed in hospital emergency departments for illness related to the hallucinogenic stimulant within 12 hours after a Los Angeles New Year’s Eve rave.

This cluster of events was accompanied …

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Will Avandia survive the FDA advisory panel?

by Crystal Phend and Emily Walker

Despite hints that the FDA may be leaning toward pulling rosiglitazone (Avandia) from the market, it’s going to be a tough decision for the advisory committee slated to begin meeting on Tuesday, and things could still go either way, leading endocrinologists predict.

“I think the FDA advisory committee is going to struggle with this because none of the data is conclusive,” …

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Linezolid resistant Staphylococcus aureus (LRSA) emerging

by Kristina Fiore

The first known outbreak of linezolid and methicillin-resistant Staphylococcus aureus (LRSA) occurred during a 13-week period in 2008 in a hospital in Madrid, researchers say.

The LRSA outbreak, involving 12 patients in the hospital’s intensive care unit (ICU), was also the first with cfr gene-mediated linezolid resistance and was associated with nosocomial transmission and prior administration of linezolid, Miguel Sanchez Garcia, MD, PhD, of Hospital Clinico San Carlos in …

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Abuse of prescription drugs starts in high school

by Todd Neale

One high school student in five has taken a prescription drug without a doctor’s order, according to a nationwide survey.

Abuse of a prescription drug was most common among white students (23%), followed by Hispanics (17.2%) and blacks (11.8%), according to Danice Eaton, PhD, of the CDC’s Division of Adolescent and School Health in Atlanta, and colleagues.

Improper use increased steadily from ninth grade (15.1%) to 12th grade (25.8%). Girls …

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American cigarettes contain more carcinogens

by Todd Neale

Levels of tobacco-related nitrosamines — known carcinogens produced when curing tobacco — are higher in popular brands of American cigarettes compared with those from other countries, potentially leading to more cases of lung cancer, researchers found.

The study of 126 smokers in four countries found that exposure to one carcinogen — 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) — was highest among those from the U.S. compared with smokers from England, Canada, and Australia, …

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Injectable heroin or methadone for addiction treatment

by Charles Bankhead

Heroin addicts had almost a threefold increase in negative urine specimens when treated with supervised heroin injection rather than with oral methadone, data from a British study showed.

Overall, 72% of patients had negative specimens at least 50% of the time compared with 27% of patients assigned to oral methadone, according to the report published in the May 29 issue of The Lancet.

Treatment with injectable heroin almost doubled the …

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Citalopram and other SSRI drugs can reduce hot flashes

by Charles Bankhead

Hot-flash frequency and severity declined by 50% in postmenopausal women treated for six weeks with the antidepressant citalopram, according to data from a placebo-controlled, randomized clinical trial.

The trial, conducted among 254 women with frequent hot flashes (at least 14 hot flashes a week for a month or longer), found that the lowest of three citalopram doses was as effective as the highest for dousing hot flashes, but the …

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Multiple vaccines in infants are harmful, a theory disproved

by John Gever

Worries that cramming multiple vaccinations into the first months of life slows brain development have no basis in fact, researchers said.

There was no evidence of neurodevelopmental delays or deficits associated with on-time vaccination in an intensively studied cohort of more than 1,000 children, according to Michael J. Smith, MD, and Charles R. Woods, MD, of the University of Louisville, in the June issue of Pediatrics.

“These data may reassure …

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Pain requires doctors to accept false positives on drug seeking behavior

Patients requiring controlled substances to manage their pain have always been controversial to treat.

Every time the subject is broached on this blog, the comments inevitably becomes a contentious discussion of “drug seeking behavior” versus treating legitimate pain.

It’s a problem that doctors nationwide grapple with every day, and is addressed in a recent essay from the New York Times.

Michael Kahn is a Boston psychiatrist, who recently asked residents how they …

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