Category: Pharmaceuticals
Science, Evidence and Guidelines
Disclaimer: I am a paid Medscape blogger and writer, and since they are in part supported by advertisements from the Pharmaceutical companies, indirectly I am in the thrall of Big Pharma. I found Harriet’s post on the Medscape Connect topic of How do you feel about Evidence-Based Medicine? interesting. I wondered about the breakdown of the comments by both specialty and opinions...
How do we avoid harming the elderly with prescription drugs?
Is the best medicine no medicine at all? Sometimes. My past posts have emphasized that the appropriateness of any drug depends on an evaluation of benefits and risks. There are no completely safe interventions, and no drug is free of any side effects. Our choice is ideally informed by high-quality data like randomized controlled trials, with lots of real-world experience so we...
Choosing Wisely: Five things Pharmacists and Patients Should Question
Is the health care spending tide turning? Unnecessary medical investigations and overtreatment seems to have entered the public consciousness to an extent I can’t recall in the past. More and more, the merits of medical investigations such as mammograms and just this week, PSA tests are being being widely questioned. It’s about time. Previous attempts to critically appraise overall benefits and consequences...
Cannibalism?
For all the goofiness that is SCAM, I never thought I would have a post with Cannibalism in the title. The ability for humans to find imaginary healing properties in everything from duck liver and heart diluted 1:100 200 times, rhinoceros horns, and waving hands over people to adjust energy fields that do not exist is remarkable. Somehow I never thought Jeffrey...
The drug expiry date: A necessary safety measure, or yet another Big Pharma conspiracy?
Consider this scenario: You’re in good health and take no prescription drugs. You use the following remedies occasionally: Excedrin for the rare migraine Arnica 30CH for bumps and bruises Echinacea capsules, when you feel a cold coming on Today you look in your cupboard, and notice all three products expired last year. Would you still consider taking any of them? Why or...
Gold mine or dumpster dive? A closer look at adverse event reports
All informed health decisions are based on an evaluation of expected risks and known benefits. Nothing is without risk. Drugs can provide an enormous benefit, but they all have the potential to harm. Whether it’s to guide therapy choices or to ensure patients are aware of the risks of their prescription drugs, I spend a lot of time discussing the potential negative consequences of...
Feet of Clay
It has been tough in Portland this year. The Trailblazers, our NBA, and only professional team, started out on a tear, then went right down the toilet. It is painful to see such promise dribbled away. Sigh. Why is elation always followed by disappointment? Everyone and everything has feet of clay. Except Cassius Marcellus. At the beginning of March the NEJM had...
The New England Journal of Medicine Sinks a Bit Lower
I suppose it was bound to happen, but it still rankles. Here is the back cover of last week’s issue of the decreasingly prestigious New England Journal of Medicine: Here’s the front cover: It’s the 200th Anniversary issue, no less. Some might protest that ‘probiotics’—live bacteria of ‘good’ varieties, as far as the gut is concerned—aren’t all that implausible, and that...
Generic Drugs: Are they Equivalent?
With healthcare costs continuing to rise, generic drugs are looking more attractive than ever. The prospect of getting the same drug at a lower cost is tempting to anyone with a large drug bill — patient or insurer alike. The savings are massive: Lipitor lost patent protection last month — it was a $10 billion drug, and the generic versions are priced...
Reducing the Risk of Adverse Drug Events
Critics of mainstream medicine often point to the dangers of drugs. I previously wrote about “Death by Medicine,” where I explained the fallacy of fixating on harmful effects of drugs without putting them into perspective with all the good drugs do. Yes, patients have died from severe allergic reactions to penicillin, but penicillin has also saved countless lives. A recent article in The...