Medications

How psychiatrists may be giving their patients too many drugs

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Psychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said.

About 60% of patients with psychiatrist office visits leading to a drug prescription received at least two medications in 2005-2006, according to government survey data analyzed by Ramin …

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Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Recent reports have said that Michael Jackson died from a propofol overdose. Is that really the case?

Here’s what happened, according to the published timeline.

— At about 1:30 a.m., [Dr. Conrad] Murray gave Jackson 10 mg of Valium.
— At about 2 a.m., he injected Jackson with 2 mg of the anti-anxiety drug Ativan.
— At about 3 a.m., Murray then administered 2 mg of the sedative Versed.
— At about 5 …

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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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Did Demerol cause Michael Jackson’s cardiac arrest and death?

Michael Jackson’s death continues to consume the news cycle.

There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol …

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Is House M.D. bad for medicine?

A few days ago, we talked about how Scrubs was a relatively accurate portrayal of medical life.

Let’s talk about the other end of the spectrum, namely, Fox’s House M.D.

As an emergency physician notes, the doctors in the House-universe seem super-human. Indeed, “the docs on that show are not only walking encyclopedias of rare diseases, but they are …

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Her hands and feet amputated, a Brazilian model dies from Pseudomonas aeruginosa sepsis. What happened?

Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.

How can this happen?

Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film, or CT scan likely would have been done to confirm the diagnosis. I assume that a urinalysis was also performed, and if …

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How Hurricane Ike destroyed a medical center

Last month’s hurricane hit the University of Texas Medical Branch at Galveston particularly hard, with the institution suffering $700 million in damage:

It cannot begin to take on patients, open up wings and generate revenue until it repairs critical operations like its blood bank, pharmacy, kitchens and radiology department, but it lacks the millions needed for the repairs, and so far the federal and state governments have not come through …

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Eliminating copays

Reverse cost-shifting. Some companies are eliminating copays on drugs:

Desperate for ways to curb soaring health-care costs, a groundswell of employers and health insurers are turning to a radically different approach: motivate patients to take not just the cheapest medicines, but the ones they need the most.

Over the past decade, health plans have sought to save money by shifting costs onto workers and encouraging them to …

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Anesthesia awareness lawsuit

A patient committed suicide after being awake during his surgery:

The Baptist minister from Raleigh County, W.Va., killed himself in February 2006 ““- two weeks after he allegedly suffered the trauma of having surgery without anesthesia. The phenomenon of anesthesia awareness is associated with psychological conditions such as post-traumatic stress disorder.

In a suit filed last month, Sizemore’s family say anestheliogist Dr. Bruce Cannon and nurse assistant Larry Rupe …

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Michael Moore’s Sicko

One stunt is detailed in the NY Post. Get ready for some single-payer love in his upcoming film:

Filmmaker Michael Moore’s production company took ailing Ground Zero responders to Cuba in a stunt aimed at showing that the U.S. health-care system is inferior to Fidel Castro’s socialized medicine, according to several sources with knowledge of the trip . . .

. . . But the sick sojourn, …

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Minute Clinic in the airport

Targeting the busy traveler:

Conveniently located in Terminal C at Newark Liberty International Airport, Harmony Pharmacy will redefine America’s retail drugstore shopping experience. From dispensing prescriptions to offering access to an on-site nurse practitioner to providing an exceptional shopping experience, Harmony Pharmacy is bringing together the best aspects of a traditional European pharmacy coupled with a service focused staff to reach today’s busy traveler.

(via The Health Care Blog)

Epidural overdose: An anesthesiologist responds

Tragic event, but as usual, news reports raises more questions than answers:

The drugs used in labor epidurals are usually a dilute local anesthetic and a small amount of narcotic. Using both types of drugs in combination allows lower concentrations of each individual drug to be used, hence improving the margin of safety for each. In labor epidurals, our goal is relieve pain without causing significant weakness. That is why …

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A cruise doctor is sued over a methadone overdose

The physician was faulted for not having the antidote on hand during the emergency:

According to the suit, at about 1:45 p.m. the next day, Ginsburg ran into the hallway screaming for help.

A nearby volunteer firefighter heard and started CPR on Ashley. Ginsburg called 911.

A nurse arrived at the cabin at approximately 2:10 p.m. Ginsburg told her that five of his Vicodin pills were missing.

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How pain patients are treated like criminals

A responsible narcotic-using pain patient writes:

I no longer go to emergency rooms for help with any pain. They might fix my broken bone but then ask, “How many hospitals do you go to to try to get extra drugs?” One ER doctor told me to “go home and play your little drug games.”

Problem is, for every responsible narcotic user, you have another hundred who play the drug …

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The hypertension conspiracy

Dr. Crippen thinks Big Pharma is to blame:

Dr Crippen’Â’s old fashioned” treatment for blood pressure costs a few pence a month, and the drugs he uses (such as beta-blockers and diuretics) have been around for years. They have a proven safety record. They are not going to produce any surprises. The only problem is that they do not offer any profit to the big drug companies.

Will Vioxx make a comeback in the wake of the Texas verdict?

“After August’s $253 million verdict against Merck & Co. in the nation’s first Vioxx-related civil trial, Lisa Stringer is worried that the loss will stop the company from bringing the only painkiller that gives her relief back to the market.

Stringer, 38, of Chicago, suffers from a spinal condition that causes nerve pain, particularly in her hands. …

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Overmedicating the Elderly

A new study from the Journal of the American Geriatrics Society states that almost one in three seniors are receiving medications “deemed potentially inappropriate for older people”.

Medicines on the list included antispasmodic drugs and propoxyphene. Several solutions to the problem are mentioned, all centered around good communication between doctor and patient, and knowledge of drug side effects in the elderly.

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