Meds

Is the newest, long-lasting insulin necessarily the best?

Originally published in HCPLive.com

by Anita Ramsetty, MD

We are very fortunate to have a number of newer insulins available for our patients.

For years we had animal insulins only. NPH and Regular, then we had Ultralente. The development of analog insulins marked the upswing in technology that we would sustain for a period of time. The most recent big blip in the …

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Does the seasonal flu vaccine offer protection against H1N1 influenza?

Originally published in Insidermedicine

Receiving a seasonal flu vaccine may offer some protection against the H1N1 flu, although it by no means should replace an H1N1 vaccine, according to research published in the latest issue of the British Medical Journal.

Here is some information about the H1N1 vaccine and seasonal flu vaccine:

• They are two separate vaccines. A seasonal flu …

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Has the ban on doctors accepting drug company gifts gone too far?

Select states have taken a hard line against doctors accepting any type of gifts from drug companies.

And that includes food of any kind, which makes for some awkward moments at national physician conventions.

So, during this week’s ACEP Scientific Assembly in Boston, WhiteCoat snapped a picture of this notice, which borders on farcical:

drug company gifts

I’ve heard similar stories from other …

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Does Chantix increase suicide risk?

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Contrary to information that led the FDA and other regulatory agencies to release warnings about varenicline (Chantix), a new study has found “no clear evidence” of a relationship between the risk of suicide and the smoking-cessation drug.

medpage-todayBoth varenicline and bupropion (Zyban), another drug used in smoking cessation programs, were …

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Migraines and the stigma of chronic pain medication use

by Diana Lee

A recent episode of the A&E show Intervention about a woman with occasional migraines and other serious health problems who takes up to 50 Percocet pills a day made me uncomfortable. Maybe Danielle, the woman featured in the episode, really does have migraine attacks. But she is also an addict. One condition really has nothing to do with the other. Many people with acute or chronic pain use …

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Is the doctor or patient responsible for celebrity drug overdoses?

When it came to Michael Jackson, I argued recently that the singer himself had to share some of the blame.

An op-ed in the Houston Chronicle places more blame, however, on a celebrity’s enablers, be it a personal physician or part of their entourage with access to a doctor.

By enabling a celebrity’s dependence to drugs, the piece, citing the case of Anna Nicole Smith, says, “facilitation of Smith’s prescription drug …

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Are generic drugs truly equivalent to brand name medications?

In an effort to cut prescription drug costs, there is constant pressure to switch from brand name medications to their generic equivalents.

But in this special report from MedPage Today, there may be some variability between generic medications that can lead to clinical symptoms. However, most of the data is anecdotal, and at best, based on retrospective data.

For instance, when it comes to anti-seizure medications, some neurologists are cautioning about …

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Do drug companies and the pharma industry deserve to be villains?

by Michael Kirsch, MD

Demonizing the pharmaceutical industry has become a parlor game for many who enjoy the challenge of shooting at an oversized target. Scapegoating Big Pharma? Now, that takes guts.

Never mind the gazillions they spend on research and development to create tomorrow’s treatments for cancer, arthritis, depression, infectious diseases, heart attacks and strokes. I know that drug industry executives are not all eagle scouts whose mission …

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Should consumer prescription drug ads be reined in?

I’ve previously written that direct to consumer drug advertising should be banned, similar to the rest of the world, except for New Zealand.

The main reason reason is that many of the advertised products are for expensive, brand name drugs that have little advantage over their generic counterparts.

In a New York Times’ Room for Debate post on the issue, various viewpoints are presented. I find myself agreeing with internist …

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Should Singulair be sold over the counter?

The WSJ Health Blog wrote that Merck is considering selling their asthma medication Singulair over the counter.

It’s Merck’s best-selling drug, with revenues in excess of $1.3 billion. But internist Matthew Mintz has some reservations about the proposal.

His issue is that Singulair merely treats the symptoms, rather than the problem that can exacerbate asthma:

Singulair works in the same way that antihistamines work: by treating the symptoms. Inhaled corticosteroids …

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Did Michael Jackson’s doctor give propofol, a possible cause of death for the King of Pop?

Things are looking increasingly bleak for Dr. Conrad Murray, Michael Jackson’s personal physician.

Reports are circulating that the powerful anesthetic propofol, also known by its trade name Diprivan, was found in the singer’s body. According to ABCNews, “the autopsy of Michael Jackson found the powerful anesthetic propofol, as well as several prescription drugs, in his system, and law enforcement sources say …

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Are doctors pressured to prescribe opiate drugs?

When it comes to opiate drugs, like morphine, there is a bitter debate between patients who are in chronic pain, and the doctors who are vilified for under or over-prescribing these medications.

But there are some other subtle influences that push doctors to prescribe these drugs, in some cases inappropriately. An ER physician talks about the issue, saying, “when dealing with a patient who is in pain, or appears to …

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Did the Avandia scare harm patients, and is Steven Nissen to blame?

The recent RECORD trial did not associate the diabetes drug Avandia with cardiovascular events.

Internist Matthew Mintz, a staunch defender of the drug, argues that because of the scare, “over 100,000 type 2 diabetic patients [needed] insulin, which could have been avoided.”

Who’s to blame? Dr. Mintz blames cardiologist Steven Nissen, whose questionable meta-analysis started the debacle, and The New England Journal of Medicine for fanning the flames. He …

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The games drug seekers play

Patients who are addicted to narcotic painkillers reveal methods to try and receive more drugs from an emergency room.

In the interview, the patient admits calling 911 and feigning chest pain. Why?

What the caller, and only the caller, knows is that his chest is not throbbing in pain. Actually, his chest is fine. What he has done is just reserve his personal medical limousine for transport to the head of …

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How zinc-containing Zicam can harm patients and damage their sense of smell

Zicam is becoming an example of the dangers of mass-marketing unproven homeopathic remedies.

As MedPage Today reports, the FDA has warned patients to stop using Zicam, as the product can lead to anosmia, or loss of the sense of smell.

This isn’t a new claim, since, “In 2006, the company paid $12 million to settle 340 lawsuits brought by consumers who claimed the zinc nasal gel adversely affected their sense of smell.”

Amy …

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Is Chantix safe, and why Zyban, or bupropion, also received a black box warning

Popular smoking cessation drugs Chantix and Zyban received black box warnings from the FDA, the strongest of its kind.

Chantix, in particular, is quite effective in helping patients to quit smoking, but has been dogged by instances of increased suicidality, especially in those already having a psychiatric diagnosis.

As this report in MedPage Today states, “Reports of behavioral changes, depressed mood, agitation, …

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Did propofol, or Diprivan, kill Michael Jackson?

As predicted, the details surrounding the singer’s death continue to get more bizarre.

Recent reports have stated that the powerful anesthetic Diprivan, generically known as propofol, was found in the singer’s house. Apparently, according to a nurse, Jackson “was begging for the powerful sedative to help him get over insomnia.”

There are zero circumstances where propofol should ever be used for insomnia. …

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Vicodin and Percocet banned and taken off the market, or is a black box warning more likely?

The FDA has declared war on acetaminophen, with Vicodin and Percocet being collateral damage.  You can bet Dr. Gregory House is sweatin’ pretty hard over this news.

In the last few days, acetaminophen, otherwise known as the brand name Tylenol, has been squarely in the FDA advisory panel’s crosshairs. In general, it’s a very safe medication, but there is …

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