Archive for November, 2009
November 25th, 2009 by Nina Thompson, ARNP
Researchers found an increased risk of cardiovascular events including stroke, myocardial infarction and cardiac death among people taking the prescription diet drug, sibutramine (Meridia).
Sibutramine (Meridia) is a prescription diet drug approved by the FDA in 1997 for the management of obesity in conjunction with a reduced calorie diet. It is only indicated for individuals with an initial body mass index of at least 30 kg/m2, or at least 27 kg/m2 with other risk factors such as diabetes, high cholesterol, or controlled high blood pressure.
The labeling of Meridia currently recommends avoiding the use of it in patients with a history of coronary artery disease (heart disease), congestive heart failure (CHF), arrhythmias, or stroke.
Learn more about the benefits of exercise and How to Start an Exercise Program
Source: “Early Data Link Diet Drug to MI, Stroke, and Cardiac Death” from MedPage Today, November 2009
November 21st, 2009 by Nina Thompson, ARNP
Brand named drugs are becoming more and more expensive these days and many people just can’t afford them. Often insurance companies won’t pay for a brand name if a generic equivalent is available, so more than ever people are faced with the question–are the generics equally effective and safe?
Both the FDA and generic drugmakers say that the generics are clinically identical to the brand named medications, but is this always the case?
Generic drugs have to meet the requirements of the FDA which requires ”90% confidence intervals for maximal concentration and the area under the concentration-time curve must be no less than 80% and no more than 125% of the means for the branded drug”, according to MedPage Today. In other words, yes there can be some variation.
This variation may or may not be a problem. It can be serious if the disease requires very specific blood levels of the drug, however, such as in a seizure disorder.
Carbamazepine (Tegretol) is a drug used to treat seizure disorders. The levels of the drug need to be predictable, reliable and effective, otherwise a seizure may occur. In a recent study at John Hopkins University, generic versions varied markedly in FDA-sanctioned bioequivalence studies. So in the case of carbamazepine, this variability could have significant clinical consequences for patients who switch from the branded product or from one generic version to another.
Another drug of concern is generic thyroid. Fortunately a blood test (TSH) can determine if you’re getting the right amount of thyroid medication, but it should only be done two months after taking the medication on a daily basis. Also, the problem might arise if the pharmacy switches generic brands, which they have been known to do. So if you have a choice, choose the brand name when it comes to thyroid medicine. If you’re forced to take the generic option, let your doctor know and pay attention to the color and appearance of the pill. If it ever changes, ask the pharmacist. If the pharmacy does switch generics, let your doctor know so a blood test can be scheduled.
As a health care practitioner, I’m concerned about generic alendronate (Fosamax). While the generic version may contain the correct amount of the drug, you may not be getting the absorption needed for it to be effective. This is particularly important for medications that have poor GI absorption to begin with. The absorption of the generic may be even worse than the brand name with the end result being little or no benefit when it comes to improving bone density.
Venlafaxine (Effexor), a popular drug for depression was recently studied by Franck Chenu, PharmD, PhD, of the University of Ottawa. The researchers found that the side effects of the generic version was three times more common than with the branded version, Effexor. Their findings were reported in the July 2009 issue of the Journal of Clinical Psychiatry.
When it comes to generics it’s always a good idea to talk it over with your doctor before you make the decision of generic versus brand name. And if you can only afford generic, let your doctor know.
Source: “AAN: Wide Variability in Generic Versions of Epilepsy Drug”, MedPage Today, May 1, 2009
Source: “Generics versus Brands: Are They Really Equivalent?”, MedPage Today, August 25, 2009
November 17th, 2009 by Nina Thompson, ARNP
According to data recently released by the American Institute for Cancer Research (AICR), more than 100,000 cancers in the US each year are linked to excess body fat. It is well known that being overweight puts people at an increased risk of some types of cancer, but this research highlights the extent of the problem.
Excess body fat appears to be linked to 49% of endometrial cancers, 35% of esophageal cancers, 28% of pancreatic cancers, 24% of kidney cancers, 21% of gallbladder cancers, 17% of breast cancers, and 9% of colorectal cancers.
According to one of the researchers, “The evidence is clear: If people sustain a normal body weight and remain physically active throughout life, it will have a major impact on cancer incidence.”
Learn more about the benefits of exercise and How to Start an Exercise Program
Source: American Cancer Society, November 2009
November 17th, 2009 by Nina Thompson, ARNP
Huge changes in breast cancer screening have recently been announced by a government appointed task force, the U.S. Preventive Services Task Force (USPSTF). But the American Cancer society is highly critical of the new guidelines.
The USPSTF now says average-risk women between the ages of 40 and 50 don’t need a mammogram, and those between the ages of 50 and 74 should only have a mammogram every two years instead of every year. Routine screening is not recommended for women older than 74, whereas previously it was recommended every one to two years.
According the to USPSTF, the changes have been made because the benefits of earlier testing are minimal compared to the risk of false alarms and unneeded biopsies.
But this appears to be nothing more than a cost-cutting measure by the federal government. According to the Chief Medical Officer of the American Cancer Society, this recommendation is based on the conclusion “that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not”. This ”is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them.”
Source: AP, November 2009
November 13th, 2009 by Nina Thompson, ARNP
A flu vaccine finder service is being provided by Google at google.com/flushot, which is designed to locate facilities that offer H1N1 and seasonal flu shots.
The flu-shot finder service will soon be available at flu.gov, as well as the website of the American Lung Association.
November 11th, 2009 by Nina Thompson, ARNP
Weight loss alone has been well known to improve mood and sense of well being, but whether one particular diet is better than another has not been well established.
In a recent study, people who followed a low-fat diet had lasting improvements in hostility, confusion, depression, and overall bad mood scores during one year of dieting compared with those on a low-carb diet.
Both groups of dieters also showed an initial improvement in working memory that didn’t disappear over time.
Read more:
Source: Archives of Internal Medicine, Nov. 9, 2009
November 10th, 2009 by Nina Thompson, ARNP
Rinsing sinuses with a saline solution tends to have soothing short-term benefits, removes the bad mucus, and helps treat sinus infections. But a recent study found that chronic rinsing with saline can actually make a person more likely to get infections in the long run by stripping the nose of good mucus needed for immune protection.
The researcher’s advice is to avoid using nasal saline irrigation on a long-term basis, limiting its use only to when an infection is present. This study is to be presented Sunday in Miami Beach at the annual meeting of the American College of Allergy, Asthma & Immunology.
Source: “Sinus Rinses May Do More Harm Than Good” Health Day, Yahoo News, November 9, 2009
November 5th, 2009 by Nina Thompson, ARNP
Two or more servings per day of artificially sweetened soda was associated with a two-fold increased risk of faster kidney function decline in a recent study from Brigham and Women’s Hospital in Boston. There was no connection in the study, however, between sugar-sweetened beverages and kidney function decline.
A second study found a link between higher dietary sodium intake and kidney function decline. This is consistent with previous studies on experimental animal data that showed high sodium intake appeared to promote progressive kidney disease.
Both studies are to be presented this week at the annual meeting of the American Society of Nephrology, in San Diego.
One in nine American adults have kidney disease and millions more are at increased risk of getting it, but most don’t know it. Kidney disease can be detected and treated early to prevent prevent the progression of kidney disease to kidney failure. High risk groups include those with diabetes, hypertension and family history of kidney disease. Also African Americans, Hispanics, Pacific Islanders, Native Americans and Seniors are at increased risk.
Source: “Diet Soda, Sodium Tied to Kidney Trouble: Studies” Health Day News, November 2, 2009
Source: National Kidney Foundation
