Medicine and Pharmaceuticals

Medication mistakes outside of a health care facility are on the rise and resulting in serious outcomes—with home locations leading the pack. According to a new study that tracked unintentional therapeutic pharmaceutical errors and focused on those causing profound impairment, disability and death, there was a 100% rate increase from 2000 to 2012.

All age groups reflected such an increase, except those under six years of age—this trajectory most likely is attributed to the FDA’s 2007 restriction of cold and cough suppressant sales to children under six due to their lack of proven efficacy and their ability to do harm. Shortly, I will address the respective, unique challenges to...

Warning: chemistry lesson inside. Chemophobes, naturopaths, and the art history majors at NRDC may leave now. OK. Now, let's get started.

Versed may very well be the second coolest drug out there. It might have even had a shot at being #1, but we chemists (like wine connoisseurs) can be pretty snooty too. According to my highly refined (and snooty) palate, the prize for the coolest drug goes to propofol - hands down (See: Your Next Colonoscopy May Be More Fun Than Golf). 

But one should not dismiss the awesomeness of Versed (generic name midazolam) simple because propofol eats its lunch. It's still pretty great stuff. Once that bad boy hits your blood - life is good and you...

Depression is something of a black box. Its underlying causes aren't completely understood, nor why particular medications work for some people but not others. Even worse, treatments are not fully successful in up to 60% of patients. Learning more about the molecular details of mental illness will go a long way toward designing better drugs.

With these ends in mind, a team of Portuguese researchers examined the effects of two antipsychotic medications (which can also be used to treat major depression) on the behavior and physiology of rats. Their results are published in Translational Psychiatry.

Rats can be made to exhibit depressive-like symptoms through chronic mild stress. In this study, the rats were subjected to various types of unpleasantness, such as...

Direct to consumer (DTC) advertising of prescription drugs have been around in both print and television since the mid-80's. It is a considerable business expense — in 2015 roughly $5.5 billion was spent on brand drug advertising along with a paltry half-billion on generics. Within a very short time after the airing of the first pharmaceutical ad, the FDA required communication of side effects and other information. Over the ensuing 30 years compromises by both manufacturers and the FDA result in the ads we see today. Here is the ...

The CDC just issued its latest weekly MMWR report, (1) and this one needs to be taken seriously. The report, which is entitled "Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease — United States" once again shines light upon "chronic Lyme disease."  Not only is there no such disease (2), but this doesn't stop unscrupulous health care providers from extracting large amounts of money from people who don't feel well and do not have a diagnosis to explain their ailments. Typically, such doctors take advantage of vague, non-specific symptoms that can be associated with any number of conditions to exploit patients by...

Otto Warmbier, the college student arrested and detained in North Korea, returned to the United States in a "coma" that has endured since March 2016. Early accounts of the North Korean government's version of events alleged an unfortunate combination of botulism and sleeping pills caused it. His father disputes the credibility of this claim. 

This morning, the spokesperson from the hospital caring for him indicated he was stable and sustained "severe neurological injury." More insight will be forthcoming as a hospital press...

Prescription drugs represent 10% of our healthcare costs, $325 billion in 2015. The alarming cost of drugs is the least transparent of our healthcare costs, but impact patients the most. 50% of us take prescription medications and with few exceptions out of pocket payments for pharmaceutical are greater than other out of pocket costs like surgery or hospitalization. It is a cost that patients constantly encounter and underlies the incessant concerns about pharmaceutical prices. The response by the system creating cost-sharing patches - rebates, discounts, co-payments, and deductibles - have completely removed the meaning of list price. [1] The real cost of drugs is impossible to know. The Brookings Institute with the Schaeffer Center for Health Policy and Economics presented an online...

Flight operations for the F-35 fighter jet were suspended until further notice due to multiple episodes of apparent oxygen deprivation of pilots. Fortunately, back-up oxygen systems of the F-35A Lightning II fighters were employed successfully in all instances and the pilots navigated their planes to safety.

The U.S. Air Force takes this very seriously, as it must given the catastrophic potential of pilot hypoxia— which I will shortly describe in detail. A multidisciplinary team of experts including, but not limited to the following will be reviewing air craft technology to pilot clinical status to gear deficiencies, for instance: aerospace engineers, physiologists, aeromedical specialists, maintainers, Lockheed Martin, Naval Air Systems Command, Air Force Life Cycle Management...

One of the many responses to the opioid crisis has been the development of Prescription Drug Monitoring Programs (PDMP) - databases containing the drug utilization of patients based upon physician prescriptions. As a result, we have a lot of information on who is prescribing and who is taking opiates. In a paper from the National Bureau of Economic Research [1], a recent working paper by Thomas Buchmueller and Colleen Carey looked at The Effect of Prescription Drug Monitoring Programs (PDMP) on Opioid Utilization in Medicine.

 

PDMPs, permit physicians to view a patient’s prescribing history.  PDMP use are part of the controversial CDC guidelines,

 

Clinicians should review the patient’s history of...

The newest wrinkle in the assault of opioid drugs on Americans is just about the last thing we need: Killer pills.

Opioid pills, such as Vicodin and Percocet have (wrongfully) been blamed for the soaring death toll in the US (See: No, Vicodin Is Not The Real Killer In The Opioid Crisis). But, in a perverse twist, pills are, in fact now making a greater contribution to the number of overdoses. But it is not the real pills that are doing the damage. Rather, it is counterfeit versions of those real pills, which can be indistinguishable from the real thing. And extremely dangerous. 

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