FOR MORE LINKS, SEE this FM diary AND THIS ON diabetes/obesity/kidney disease & related topics, ETC. FIND SPECIFIC KEYWORDS IN DIARIES BY HOLDING DOWN THE CONTROL KEY AND TAPPING THE F KEY.
Adverse drug effects are a common phenomenon in 'western','traditional', over-the-counter, herbal, 'home-remedy' &etc practice alike, through any instance or combination of individual genetics, human error, carelessness, ignorance, malice, belief that adverse effects are part of the "price" patients must "pay" for having illness or injury (especially older patients - capacity to metabolize drug substances changes with advancing years); concealment of complete drug trial results and skewing of drug trial results by drug development companies or researchers in order to avoid loss of major investment and/or make a profit no matter the cost no matter to whom; manufacture and distribution of counterfeited drugs for malice or profit; contamination during manufacture or packaging (accidentally or for malice or for profit, e.g., industrial espionage); invisible or neglected personal health issues affecting drug metabolism ... and so on.
Certain factors particularly figure in healthcare approaches where profit and/or expertise expected to be taken on faith (with or without formal credentials) may act upon patient eagerness or desperation, especially in the absence of effective regulation standards and enforcement, full disclosure, fully informed reasonably-educated consent... and especially in this era of international health-substance commerce.
The mostly-plain-English professional articles linked in this compilation discuss some of these factors and imply more, some mentioning particular drugs and substances, the variety and impact of adverse effects, currently-known and in-development methodology for decreasing adverse drug events, and so on. In emphasizing recency, this is not an exhaustive list but an intense sampling of free-access materials illustrating the scope of the problem and how professionals, patients, and caregivers try to minimize adverse drug effect risks in their workplaces, communities, and families.
Valuable concepts can be multiple, complex, and obscure upon first read, but with thought become clearer. Example: Antidepressant-Induced Suicidality: How Translational Epidemiology Incorporating Pharmacogenetics Into Controlled Trials Can Improve Clinical Care (11 pp.):
Randomized controlled trials (RCTs) have been a staple of the drug development process for several decades. Here, we review the origins of RCTs and their adoption within drug development, highlighting shortcomings that tend to be ignored and possible solutions offered from personalized medicine:[if prescribed without discrimination for individual genetic capacity to metabolize a drug well, its] adverse effects may outweigh the benefits. As an example, we focus on the development of antidepressants and [the severe adverse drug response potential involved, and] we conclude with a discussion of how pharmacogenetics may address some of the deficiencies of RCTs, bringing the focus of drug response back to the individual patient[as exemplified by] the discovery of genetic markers associated with antidepressant-induced suicidal ideation. [emphasis added. --ed.]
Other items are crystal clear immediately:
"New freedom-of-information policies have made thousands of pages of previously confidential clinical trial documents and clinical study reports (CSRs) publicly available. In an article published online June 13 in the BMJ, a group of experts has proposed that the information be used to report previously unpublished, "abandoned", or "invisible" trials and to correct previously misreported trials."
Skimming the links provides a good grasp of the current state of the problem. For reading at the links, below the orange-peel is an introduction to free use of MEDSCAPE; other cited items are free as-is. Links/citations open parallel browser tabs rather than navigating away, and are numbered for convenience and easy reference in discussion here or elsewhere — the order implies no other significance. Presence or absence of blockquotes is subjective choice on the part of the somewhat jaded editor of this list, it does not mean exerpted citations are more valuable than the rest, and exerpts are not necessary summaries or complete abstracts. Inclusion of an article does not necessarily reflect agreement with its premise (objectionable articles often are revelatory and informative).
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Therapeutic Advances in Drug Safety JOURNAL ARTICLES AVAILABLE AT MEDSCAPE
International Journal for Quality in Health Care ARTICLES AVAILABLE AT MEDSCAPE
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1. Abuse of U.S. Generic-Drug Rules Costs Consumers Billions, Report Says
2. Adverse Drug Events Reporting News
3. Adverse Drug Event Nonrecognition in Emergency Departments An Exploratory Study on Factors Related to Patients and Drugs
4. Amoxicillin Adverse Effects Underreported, Underrecognized
Malcom Gillies, PhD, from NPS Medicine Wise, Sydney, New South Wales, Australia, and colleagues published their systemic review and meta-analysis of randomized trials online November 17 in the Canadian Medical Association Journal. The review was intended to evaluate clinical studies and inform clinicians about harms from amoxicillin, thereby enabling physicians to make more informed decisions when prescribing this common antibiotic.
The team focused on 45 clinical trials (27 studying amoxicillin, 17 studying amoxicillin-clavulanic acid, and 1 studying both). Only 25 trials provided data that allowed the authors to evaluate harms. The authors conclude from this that adverse events were underreported in the medical publications.
5. Anaesthesia-Related Anaphylaxis:Adverse drug reactions are a common cause of anaesthetic-related morbidity and mortality in healthy patients. They include drug intolerance or immune-mediated reactions, including anaphylaxis.
6. Antibiotic [clarithromycin] and Calcium-Channel Blockers [associated with increases in hospitalization for acute kidney injury, hypotension, and death, according to new research.]
7. Antibiotic Resistance
The problem of antibiotic resistance has been festering for decades and has finally reached the crisis point, according to the Infectious Diseases Society of America (IDSA), the Centers for Disease Control and Prevention (CDC), WHO, the European Union, and President Obama. The CDC has identified a broad menu of worrisome pathogens that are becoming resistant, and many pathogens that may soon be untreatable.
The highest-ranking pathogens (considered "urgent") are carbapenemase-producing Enterobacteriaceae, Neisseria gonorrhoeae, and Clostridium difficile.[3] The latter is possibly confusing, because the consensus is that the drug of choice is oral vancomycin and, to my knowledge, no vancomycin-resistant strain has been reported among more than 10,000 isolates. A possible explanation is resistance of C difficile to fluoroquinolones, which appeared to drive the epidemic of the NAP1 strain in much of Europe and North America in the mid-1990s...
This antibiotic crisis reflects the combined impact of overuse of antibiotics ("use it and lose it") and the failed market response. Major pharmaceutical suppliers have largely abandoned the antibiotic development field owing to very poor economic return ("We
are not in the business to go out of business"). [emphasis added. --ed.]
The major development for a coordinated multifaceted response is the President's Council of Advisors on Science and Technology (PCAST) proposal proposal to President Obama that was previously summarized for Medscape. In essence, this combines efforts for a massive US/global surveillance system combined with gene sequencing, incentives for pharmaceutical development, and emphasis on antibiotic stewardship as a condition of payment by the Centers for Medicare & Medicaid Services (CMS)...
For providers, the immediate message is to conserve antibiotics using established methods. These include:
• Short antibiotic courses;
• Procalcitonin levels to guide decisions about starting and stopping antibiotics;
• Waiting-room announcements that antibiotics are given only according to guidelines;
• Use of molecular diagnostics to improve rapid pathogen detection;
• Automatic stop orders;
• Gene sequencing to inform infection control...
• Efforts to prevent nosocomial infections with the four infections that account for the largest numbers in cost, by dollars and deaths: central line bacteremia, ventilator-associated pneumonia, Clostridium difficile infection, and surgical-site infection (primarily colon resection and vaginal hysterectomy)... The 2014 Hit Parade: Infectious Disease Stories of the Year: John Bartlett's Annual Review - J.G. Bartlett, MD - December 09, 2014
8. Antibiotic Resistance 'Catastrophic': UK Official
9. Antibiotic Use Falls in Hospitals With Antimicrobial Plans
9a. Antibiotics and Neuropathy: What's the Latest?
10. Antibiotics Prescribed for Kids at Twice Expected Rate
11. Antibiotics, Resistance, and Learning From Ebola An Interview With CDC Director Tom Frieden
12. "Antidepressant-Induced Liver Injury Underestimated [in the literature]"
13. Antimicrobial Resistance: Risk Associated With Antibiotic Overuse and Initiatives to Reduce the Problem
13a. Antimicrobial Stewardship: Another Focus for Patient Safety?
14. Antipsychotic [ziprasidone (Geodon, Pfizer Inc) and its generic counterparts] Linked to Potentially Fatal Skin Reaction
15. Antipsychotics Linked to Acute Kidney Injury
16. Anxiolytic, Hypnotic Medications May Triple Mortality Risk
...A retrospective cohort study of more than 100,000 age- and sex-matched patients showed that those who used anxiolytics and/or hypnotics were 3 times more likely to die prematurely during the 7 -year follow-up period than those who did not use these drugs. In addition, significant dose-response associations were shown for benzodiazepines and the "Z drugs" – zaleplon (Sonata, Pfizer Inc), zolpidem, and zopiclone...
17. As Quality Control Violations Rise, FDA Chief Heads to India February 06, 2014
18. Benzodiazepines for anxiety, depression, or insomnia, increases Alzheimer's risk Full text as well as abstract available at the link as of Sept 2014.
19. Big Pharma Brandishes a Big Whip
20. Brief [symptom-]Scale Linked to Antidepressant Overprescribing
21. Cancer Drug Trials That Should, But Won't, Be Done
22. Cannabis-Related ED Visits Rise in States With Legalized Use
23. Cardiovascular Impact of Drugs Used in the Treatment of Diabetes
24. CDC Expert Commentary: Antimicrobial Resistance: The Big Picture (includes link to CDC document)
25. Chemical Intolerance Common in Primary Care Patients
26. Chemo Safety: Can Biomarkers Help?
27. China Hands Drugmaker GSK Record USD 489 mln Fine for Paying Bribes
28. Clarithromycin Tied to Risk of Cardiac Death in Cohort Study
29. Cognitive Risks of Anticholinergics in the Elderly
30. Common Antibiotic Cotrimoxazole Plus ACE Inhibitor or ARB Could Raise Risk of Sudden Death
31. Complementary and Alternative Medicine in the Real World - You May Practice Evidence-Based Medicine, but Your Patients Don't
This article focuses on the uses of Complementary and Alternative Medicine (CAM) by patients and suggests strategies for understanding and addressing this use without referring back to the evidence base. The rationale for this discussion pivots on the observation that patients are already using these approaches, and for many there are anecdotal and historical bases for use which patients find persuasive in the absence of scientific evidence. [emphasis added. --ed.]
32. [Copper surfaces for prevention of infection in healthcare environments]
33. Corruption Tars Drug Industry Drive to Improve Access for Poor
34. Cow Antibiotic Often Misused by Farmers
35. Dapagliflozin: Clinical Practice Compared With Pre-registration Trial Data
...The rate of discontinuation of dapagliflozin due to side effects (22%) was higher than reported in trials (3–4%), but 52% of people tolerating dapagliflozin were able to stop or reduce one or more other diabetes medications.
Conclusions Dapagliflozin is effective at improving glycaemic control. It also reduces blood pressure, results in weight loss, and reduces the need for concomitant diabetes medications. However, it is not as well tolerated in real-world patients as in participants of clinical trials. [emphasis added. --ed.]
36. Death, Cancer Increased With Hypnotics (sleep drugs)
37. Doctors Need to Learn About Nutrition
38. Dopamine receptor-blockers-cause of tardive dystonia
39. Drug-Induced Neurologic Conditions- Headings include: Cerebrovascular Effects, Cognitive Impairment and Delirium, Neuroleptic Malignant Syndrome, Movement Disorders, Seizure Disorders, Serotonin Syndrome, Insomnia.
40. Drug-Induced Urinary Incontinence (oral estrogens, alpha-blockers, sedative-hypnotics, antidepressants, antipsychotics, ACE inhibitors, loop diuretics, nonsteroidal anti-inflammatory drugs, and calcium channel blockers)
41. Drugmaker GSK to Invest USD 200 Million in African Factories, R&D (see also. e.g.,
42. China Hands Drugmaker GSK Record USD $489 Million Fine for Paying Bribes AND 43. GSK to Stop Paying Doctors in Major Marketing Overhaul AND 44. GSK Says Investigating Claims of Bribery in Jordan, Lebanon AND 45. GSK Agrees to Pay $3 Billion in Healthcare Fraud Case etc.
46. Drugmakers May Need Indemnity for Fast-Tracked Ebola Vaccines
47. Drug-Related Falls in Older Patients: Implicated Drugs, Consequences, and Possible Prevention Strategies
48. Drug-Resistant Malaria: The World's Next Big Health Crisis?
49. Drug-Resistant Superbug Found in 1915 Soldier Killed by Dysentery
50. Drug-Test Physicians? Docs Say 'No Way'
51. [Drugs with vertigo, dizziness, drowsiness, psychomotor impairment, muscular weakness, and cognitive impairment side-effects are a major contributor to patient falls, injuries, accidents, and other adverse consequences]
52. 8 Ways to Deal With Antibiotic Resistance
53. ER Trips for Kids' Pain and Coughs Often End With Codeine...
...Depending on their ethnicity, up to a third of people are known to metabolize codeine much faster than usual, which could lead to an overdose. Over a dozen reports of children dying from normal doses of codeine have been reported among those so-called ultra-rapid metabolizers, Kaiser and her colleagues wrote in a paper released online April 21 in Pediatrics.
Dr. Alan Woolf of Boston Children's Hospital, who co-wrote a commentary on the new study, added that some people's bodies may not break the drug down enough for it to be effective. It can also be abused.
A number of organizations, including the American Academy of Pediatrics (AAP) and American College of Chest Physicians (ACCP), recommend against codeine use for coughs or upper respiratory infections in children.
The Canadian Ministry of Health and the European Medicines Agency prohibit its use in anyone younger than 12 years old. [emphasis added. --ed.]
54. Engaging Underrepresented Populations in Medical Research (e.g., women, ethnic 'minorities' depending on locale, children, the elderly.)
55. Error Modelling in Anaesthesia
56. Evidence Underlying Most Guidelines May Be Questionable - January 21, 2014
57. Fake Medicines Worth USD $31 Million Seized in Global Crackdown
58. FDA Bans Imports From Canadian Drugmaker Apotex's India Plant
59. FDA Drug Approvals: Quality of Evidence Varies Widely
60. FDA Panel Gives Combo Opioid Thumbs Down
...Moxduo (QRxPharma Inc), an immediate-release combination capsule of morphine sulfate and oxycodone hydrochloride, should not be approved for the treatment of moderate to severe acute pain, according to the unanimous decision of the US Food and Drug Administration's (FDA's) Anesthetic and Analgesic Drug Products Advisory Committee.
The committee also agreed that the presented data don't provide sufficient evidence that Moxduo is safer than morphine and/or oxycodone alone.
In commenting on the safety issue, committee chair Randall Flick, MD, associate professor of anesthesiology, Mayo Clinic Children's Center, Rochester, Minnesota, said the "primary failing" was in the study design and the inability of the committee to rely "with confidence" on multiple post hoc analyses performed by the company.
61. FDA Warns of Fraudulent Ebola Drug Claims
62. FDA Warns of Small Cardio, Cerebrovascular Risk With Xolair
63. First Discuss Risk, Then (Maybe) Write a Statin Prescription
64. Gene Variants Linked to LDL Response With Statins
65. Global Effort Launched to Fight Infectious Disease Threats (including antimicrobial resistance)
66. Health Environments Research & Design Journal The design of a health care facility can impact how safely and efficiently health care is provided.
67. Healthcare-Acquired Infections Reduced by Copper Surfaces
68. High Price of Cancer Drugs Is Harming Patients
68a. Hospira Recalls 10 Lots of [ the antineoplastic agent] Mitoxantrone " a worldwide voluntary recall ... because of confirmed subpotency and elevated impurity levels..."
and 69. Hospira Recalls Flexible IV Solutions Due to Leakage [potential which may increase the contamination] Risk - "11 different products (54 lots in total) distributed ... from September 2013 through October 2014, with expiration dates between August 1, 2015, and January 1, 2016."
70. How Common Are Drug and Gene Interactions? Prevalence in a Sample of 1143 Patients [With CYP2C9, CYP2C19 and CYP2D6 Genotyping]
Executive Summary
Background:
Adverse drug reactions (ADRs) are a major preventable public health problem.
Better identification of ADRs can save money and lives.
Drug–drug interactions (DDIs) are recognized as a major cause of ADRs. However, in
addition to DDIs, CYP genotyping now allows drug–gene interactions (DGIs)
and drug–drug–gene interactions (DDGIs) to be identified as a potential
source of ADRs as well.
Results:
1053 major or substantial interactions in 501 individuals.
DGIs represented 14.7%, DDGIs 19.2% and DDIs 66.1% of major or substantial
interactions.
DGIs represented 13.9%, DDGIs 21.5% and DDIs 64.6% of major interactions.
Conclusion:
Identification of DGIs and DDGIs increased the number of potential clinically
significant interactions by approximately 50% as compared with DDIs alone.
This increased the number of individuals identified with potential clinically
significant ADRs. [emphasis added. --ed.]
71. How Selenium, Vitamin E Increase Prostate Cancer Risk
and see also 71. Bayer Sued by the Center for Science in the Public Interest, for Prostate Cancer Claims About Selenium in Multivitamin - 2009
72. How to Fix a Broken Market in Antibiotics VERY INTERESTING, REVELATORY ARTICLE. READING IN FULL RECOMMENDED.
73. Human Error Seen in Measles Vaccination Deaths in Syria
September 22, 2014 GENEVA (Reuters) - A muscle relaxant appears to have been mixed mistakenly with measles vaccine, killing 15 children in northern Syria this week, the World Health Organization (WHO) said on Friday, calling it the biggest such tragedy in memory [and] likely to damage trust in health services in opposition-held areas.
The manufacturer, who has not been identified, shipped the vaccine in powder form with a diluent to a hub in Syria where it was stored and then sent to Deir al-Zor and Idlib provinces, for the campaign to vaccinate tens of thousands of children that began on Monday, WHO spokesman Christian Lindmeier told a news briefing in Geneva. "In the hub apparently, (from) what we know so far, the diluent was kept ... together in the same refrigerator with a muscle relaxant. The relaxant is called atracurium. This got mixed in some cases instead of the diluent with the vaccine powder.
Pointing to human error, he said: "So the ones who packed it obviously put the wrong ampoules with the vaccine powder into the package. Then it gets shipped in the vaccine carriers to the facility, there it gets unpacked, mixed and then it has to be used within 6 hours. So both at the packing and at the unpacking there had to be gross negligence."
The muscle relaxant, usually administered as an anaesthetic for surgery, works according to weight, so all the children who died were under the age of two, he said. Older children survived after vomiting, diarrhea and anaphylactic shock.
Lindmeier said: "It seems very clear that it was not the manufacturer's fault, not that the vaccine is contaminated, but it's a fault on the ground, again not established whether it's human error or deliberate" ...The WHO said it could not completely rule out sabotage, so the measles inoculation campaign remained suspended until the investigation was finished.
74. Human use of Antibiotics Marketed for Pets: An Alarming Trend
75. Improper Use of Prescription Drugs Costs $200 Billion a Year, Report Finds
76. In Race for Bigger Margins, Drug Makers Willing to Lose the India 'Advantage'
India's $15 billion a year pharma industry, the world's largest source of cheap generics, is already reeling from a string of drug recalls and quality control issues which have called into question the regulator's oversight.
77. Inappropriate Prescribing in Older Fallers "Ireland study especially found "A high prevalence of psychotropic medication identified pre-fall: anxiolytics (15.7%), antidepressants (26%), hypnosedatives (30%)."
78. India Acts to Repair Reputation as Drugs Exporter
79. India to Set Up New Drugs Regulator for Traditional Medicines
NEW DELHI (Reuters) - India is seeking to increase sales of its ayurvedic and other traditional therapies in the estimated $100 billion global market for alternative medicine and plans to set up a new quality control regulator, the government said on Thursday.
Ayurveda is an ancient Indian health system that includes medicines, meditation, exercise and dietary guidelines practiced by millions on the Indian subcontinent and increasingly in the West.
But Health Minister Harsh Vardhan said India's share in the global market for such medicines remained "negligible" compared to countries like China, and quality standards failed to meet international specifications.
"The government has decided to address this lacuna," Vardhan said in a statement.
"It is a pity that China has captured such a huge share of the world market whereas India's presence is non-existent."
Ayurvedic and other traditional therapies are popular in Indian rural areas which still have poor access to modern health facilities. Homeopathic medicines also find wide acceptance.
Under the new universal health plan, Prime Minister Narendra Modi's administration aims to offer 30 free traditional medicines to all its citizens, a senior health ministry official told Reuters last week.
On Thursday, the government said it would provide financial support to traditional drugs manufacturers to help them enhance quality and meet global standards.
Other products such as creams and oils containing ayurvedic herbs are manufactured by domestic companies such as Dabur and Emami. The Indian market for such products registered a 13% growth in 2013, according to Euromonitor International.
80. Indian Minister Backs Calls to End Health Sector Corruption
81. Insulin-Related Hypoglycemia: Common, Costly, Preventable
82. Italian Watchdog Says Novartis, Roche Colluded Over Eye Drug
Intra-operative Awareness:
83. PTSD Common in Patients With Intraoperative Awareness
84. 'Waking Up' During Surgery May Have Long-Term Psychological Harm
...Accidental awareness during general anaesthesia [AAGA] happens in roughly one in every 19,000 cases, according to a major new study on this highly feared complication... Its occurrence can have life-long psychological harm, according to the 5th National Audit Project (NAP5) report from the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland...
85. Awareness and Memory Function During Paediatric Anaesthesia (
British Journal of Anaesthesia March 2008)
Previous research indicates a much higher incidence of awareness during anaesthesia in children than in adults... The incidence of awareness during surgery in children is approximately eight times that measured in adults by postoperative recall...
Research using the isolated forearm technique [which involves inflating a cuff around the patient’s forearm just before injection of neuromuscular blockers, leaving the forearm free to move even though the rest of the body is paralysed for surgery] shows that the true incidence of intraoperative awareness is at least four times the incidence suggested by postoperative recall. Awareness is indicated by motor responses to commands to move the isolated hand...
In adults, there is evidence of continued memory function even during deep anaesthesia... Presenting words during surgery activates or ‘primes’ mental representations of those words and thus facilitates a response to, or with, those words on recovery even though patients have no conscious or explicit recollection of the words... This facilitated responding as a consequence of prior exposure is known as implicit memory.
The effects of this preserved implicit memory on patients’ subsequent well-being are not known but it is conceivable that priming of existing anxieties, for example, by negative operating room comments, may contribute to symptoms of trauma on recovery...
Implicit memory develops early in childhood, reaching adult levels from as early as 3 yr of age... so children are hypothetically also at risk of memory priming during surgery.
.
86. (Japan's) Daiichi Sankyo Pledges Bold Action on [Indian drugmaking arm Ranbaxy Laboratories Ltd] Production Problems
87. Johnson & Johnson to Pay $2.2 Billion to End Probes
88. Justice Dept Alleges Omnicare Received Kickbacks From Abbott Labs
89. Landmark CDC Report Details Threat of 'Post-antibiotic Era'
90. Lead Poisoning in Pregnant Women Who Used Ayurvedic Medications From India New York City, 2011-2012
91. Lidocaine Injection Recalled in 28 States (by Hospira, Dec 2013)
92. Major Settlements With Medtronic, NECC for Injured Patients
93. Many Clinical Trials Unable to Supply High-Quality Evidence - 2012
94. Medical Marijuana May Worsen PTSD Symptoms, Increase Violence
95. Medicare Advantage Plans Underreport High-Risk Prescribing - September 30, 2013
96. Medication Leading Cause of Child Poisoning in US
97. Medscape Multispeciality Patient Safety News & Perspectives webpage
98. Menopausal Hormone Treatment in Postmenopausal Women: Risks and Benefits
99. Millions Use Illicit Drugs, Struggle With Mental Illness
100. Mislabeling Prompts Recall of Ibuprofen and Oxcarbazepine Tablets
101. More Drugs Added to FDA Watch List (April 21, 2014)
102. New Drug Information Resources for Pharmacists at the National Library of Medicine
103. New Drug Review 2014
New molecular entities (NMEs), as defined by the FDA, are new drug products containing as their active ingredient a chemical substance marketed for the first time in the United States. The following descriptions of NMEs approved in 2013–2014 (1) detail the basic clinical and pharmacologic profiles of each new drug, as well as key precautions and warnings. Also included is a brief summary of selected pharmacokinetic, adverse-reaction, drug-interaction, and dosing data submitted to the FDA in support of the manufacturer's New Drug Application.
This review is intended to be objective rather than evaluative in content. The information for each NME was obtained primarily from sources published prior to FDA approval. Experience clearly demonstrates that many aspects of a new drug's therapeutic profile are not detected in premarketing studies and emerge after the drug is used in large numbers of patients.
Studies have demonstrated the appearance of "new" adverse reactions for many NMEs within 2 to 3 years after they first become available. Some of these drugs may eventually acquire at least one black box warning for serious adverse drug reactions or are withdrawn from the market for safety reasons not recognized at the time of approval.
Hence, while this review offers a starting point for learning about new drugs, it is essential that practitioners be aware of changes in a drug's therapeutic profile as reported in the pharmaceutical literature and by their own patients. emphasis added. --ed.
104. The New Oral Anticoagulants and Management of Bleeding
105. 9 Things Chronic Pain Specialists Want Hospitalists to Know
106. Nonbenzodiazepines for Sleep Linked to Hip Fractures
107. Novartis Sued Over Alleged Kickbacks for Exjade to Pharmacy Firm AND Novartis Ordered to Face U.S. Lawsuit Over Doctor Kickbacks
108. Opioid-Induced Adverse Effects Hit Social Media Sept 2014
109. Pain Med [tramadol can induce hypoglycemia requiring hospitalization ... potentially fatal ... researchers state.]
110. Pain Patients at Cognitive Risk From Anticholinergic Burden
Young patients with chronic pain who take medications other than opioids to cope with their symptoms may experience cognitive adverse effects from these drugs... Although researchers expected that patients with chronic pain would have a higher anticholinergic cognitive burden than healthy persons, they were surprised to find that the highest burden was among those aged 30 to 39 years...
...Common medications that have anticholinergic effects include those taken for pain (atropine, codeine), for sleep (alprazolam, amitriptyline), for mood (bupropion, haloperidol), for gastrointestinal discomfort (dimenhydrinate, loperamide), and for cardiac issues (atenolol, dipyridamole).
These drugs block cholinergic transmission at muscarinic receptor sites. These receptors mediate the primary cognitive effects attributed to cholinergic pathways, including attention, learning... short-term memory [and executive function]...
[It's known that older people typically] have neuropsychological deficits with the use of anticholinergic medications [— as the body ages] the central nervous system becomes more sensitive to these medications [— but this] study should serve as a reminder that when [any patient needs a medication], physicians might consider an option that doesn't increase the risk for cognitive dysfunction...
Polypharmacy among patients with chronic pain [additionally poses] a growing problem. These patients [are given drugs] not only for their pain but also for depression, anxiety, sleep problems, and adverse drug effects, such as constipation and drowsiness... these patients might reach for OTC medications that also have cholinergic effects... [emphasis added. --ed.]
111. Painkiller Overdose Epidemic Spreading to Teens, CDC Says
112. Patient Expectations Largely Dictate Antidepressant Response
113. Perampanel-Induced Rash Noted in Young Epilepsy Patient
114. Persistent Organic Pollutants [earlier wikipedia discussion] (POPs) are
organic compounds that are resistant to environmental degradation through chemical, biological, and photolytic processes. Because of this, they have been observed to persist in the environment, to be capable of long-range transport, bioaccumulate in human and animal tissue, and biomagnify in food chains, with significant impacts on human health and the environment.
Many POPs are currently or were in the past used as pesticides [against weeds, insects, plant diseases, vermin, etc]. Others are used in industrial processes and in the production of a range of goods such as solvents, polyvinyl chloride, and pharmaceuticals. [Most] are created by humans in industrial processes, either intentionally or as byproducts.
Public concern about contamination by POPs increased recently due to the multitude of evidence showing the negative effects of POPs on human health and the environment. Several compounds have been identified as [neuroendocrine/hormonal] disruptors which can alter normal function...in humans and wildlife. [Once in the system, they persist] for decades, causing problems such as cancer, birth defects, learning disabilities, immunological, behavioral, neurological and reproductive [issues] in human and other animal species.
The effect of POPs on human and environmental health was discussed, with intention to eliminate or severely restrict their production, by the international community at the Stockholm Convention on Persistent Organic Pollutants in 2001.
115. Petition Calls on Roche to Cut Breast Cancer Drug Price
and 115a. Roche Says Vials of Counterfeit MabThera Found in Germany
116. Pharmacists fighting preventable hypoglycemia events (see also end-of-month hypolycemia surgers among very-low-imcome diabetics)
117. Physicians' Role in Drug Marketing Questioned - January 22, 2014
118. Potentially Inappropriate Drug use with Hospitalised Older Adults: Results From the CRIME Study
119. Pressure to Publish Leading to Scientific Misconduct (presentation at the 27th European College of Neuropsychopharmacology (ECNP) Congress, October 18 - 21, 2014; Berlin, Germany)
120. [prevalent Rxs in the U.S.]
121. The President's Report on Antibiotic Resistance: What Does It Mean to Clinicians?
122. Price of New Cancer Drugs as High as Market Can Bear
123. Randomized Clinical Trials: 1 in 3 Not Reported
Industry-funded trials were nearly twice as likely to go unreported as studies that had not received industry funding. Previous studies have shown that published trials contain less than half of the patient-outcomes data contained in company-controlled documents. The lack of availability of results from these trials contributes to publication bias and also constitutes a failure to honor the ethical contract that is the basis for exposing study participants to the risks inherent in trial participation.
124. Reduced Activity Raises Cautions in Older Men Using Statins
125. Replay of Energetic Deal-Making Seen for Drugmakers in 2014
126. Risk of Thiazide-induced Metabolic Adverse Events [common] in Older Adults
127. Roche's Diet Drug [Xenical] Tied to Kidney Damage (2011)
128. Second-Generation Antipsychotic-induced Akathisia (2009)
129. Scientists propose how antioxidants can accelerate cancers and why they don’t protect against them
130. Selective Serotonin ReUptake Inhibitors (SSRIs) & Hypnotics Increase Fracture Risk
131. SSRI Fracture Risk Exceeds That of Corticosteroids and Proton Pump Inhibitors
132. Sterilization Deaths Expose India's Struggle With Faulty Drugs
133. Strong Link Between Frequent Falls and Psychotropic Meds
134. Study Links Antidepressants to Gait Impairment in Older Adults
135. Supplements to Slow Macular Degeneration [might instead accelerate the condition in people with certain genotypes]
136. Ten Drugs Cause Majority of ER Visits in Adults for Adverse Psych Med Effects By Rob Goodier July 16, 2014
137. 10 Drugs That May Cause Memory Loss {aarp}
138. Ten Rivals Join With NIH to Search for New Drugs
139. Top 100 Most Prescribed, Top-Selling Drugs (2014)
140. Top 100 Selling Drugs of 2013
141. Too Many Antibiotics! Patients and Prescribers Speak Up (MEDSCAPE SLIDESHOW)
142. Toxic and Drug-induced Peripheral Neuropathies:Updates on Causes, Mechanisms and Management
143. Turning the Tide Against Inappropriate Antibiotic Prescriptions? What Providers, Policy-Makers, and Patients Need to Know
144. U.S. FDA Bans More Products From Indian Drugmaker Ranbaxy (January 23, 2014)
145. Vancomycin-associated Nephrotoxicity and the use of Higher Trough Concentrations in Infants and Children
146. Warfarin Excess in Atrial Fibrillation Patients on Aspirin Ups Dementia Risk
147. Warn Patients of Herbal Products' Contamination Risks
148. When Men Want Testosterone, Show Them the Evidence (January 24, 2014)
149. Why Are Drug Costs So High in the United States?
150. Why the Product Labeling for Low-Dose Vaginal Estrogen Should Be Changed
151. Worldwide Recall of [approximately 940,000 individual units of] Potassium, Sodium Chloride IV Solutions [by Baxter International]
and 152. Mold Prompts Recall of Baxter Peritoneal Dialysis Solution
and 153. Dextrose and Sodium Chloride IV Solutions Recalled [by Baxter Int'l]
and
A few Medscape commenters on proactive practices to decrease/prevent need for curative practices, including drugs:
Nurse - Critical Care/Intensive Care: I have as my alter ego, a goat farm. We have found that an increase of vitamins and mineral support eliminates the need for antibiotic use in our animals. We found support for this in the Livestock farming efforts of Australia of all places. Pat Coleby has written some excellent books, and oddly, if you consider how stubborn US docs and vets are about vitamins and super nutrition, Mrs. Coleby began her foray into the extensive use of vitamin C, copper, kelp meal, cod liver oil and dolomite based on advice from Australian Veterinarians. She has written on sheep, goats and cattle. It is a very interesting read and we are working toward balancing our soil minerals for better pasture here in the states. ... I personally have seen a cure of an odd late stage mastitis in one of my best milkers, from the giving of dense vitamin concentrates and have seen long term mastitis also cleared up with same. My goal is to provide these nutrients at all times so we can avoid crisis entirely.
We have also seen the elimination of external mites in tiny kittens from a pinch of dense nutrient vitamin powder given orally. we have also seen changes in coat and smelliness and fleas in puppies fed grain based dog food to meat based dog food when they came to the farm- and they improved in all areas.
Yes, I do recall, the original Florence Nightengale used to use comfort and warmth and cleanliness and food to help the soldiers heal. She would be horrified at some of the things we do now
Another Nurse: As a clinical pharmacist and pharmacy director in both acute and outpatient venues for 40 years I do not believe the medical community can regulate itself with significance in this issue.
Another Nurse: If we educate [even just] at a grade 2 level, then all the people will have a chance to help in this crisis, I think we tend to over complicate things when an explanation is required.
Similar comments came from practitioners identifying themselves as being from Nigeria, "Africa", Bangladesh, India, "Latin America", "Europe" and Canada.