Entries in Medication (32)


Prescription Painkillers for Small Surgeries May Lead to Long-Term Use

iStockphoto/Thinkstock(TORONTO) -- Older adults who receive pain medications after surgery may be at higher risk of becoming addicted, according to a new study published in the journal Archives of Internal Medicine.

Physicians often prescribe opioids, including codeine and oxycodone, after outpatient surgeries.

While these drugs are proven to be effective for temporary pain relief, they are also associated with side effects including sedation, constipation and breathing problems, as well as addiction.

Researchers analyzed data from nearly 400,000 Canadian patients ages 66 and older who received an opioid prescription within seven days of undergoing surgery for cataracts, gallbladder removal, prostate tissue removal or varicose vein stripping.

What they found was that more than 10 percent of the patients who received an opioid after a surgery were identified as long-term opioid users one year after surgery. They also found patients were 3.7 times more likely to use non-steroidal anti-inflammatory drugs on a long-term basis if they received a prescription for the drug within seven days after surgery.

"We tried to look at what some of the events are that start people on the road to acute or chronic use of opioids," said Dr. Chaim Bell, associate professor of medicine at University of Toronto and co-author of the study. "It's much easier to prevent the initiation of the medication than wean people off it later. Everyone should get pain relief, but the painkiller and the dose should be tailored to the specific patient."

The findings align with the general experience of Dr. David Maine, director of the Center for Interventional Pain Medicine. He said the decision to start and prescribe an opioid at any time is a serious one. Treatment goals should be clearly defined when a prescription is first written, to ensure safety and effectiveness of the medication -- and to minimize the risk of addiction.

"Generally with older patients, if starting an opioid, we set up a short interval follow-up to ensure tolerability of the medication as well as efficacy," said Maine. "If either of those are an issue then we make a change. Sometimes that change is discontinuing the medication entirely. Ultimately, I think the decision to stop an opioid analgesic is as important as the decision to start."

Dr. Timothy Collins of the Pain and Palliative Care Program at Duke University Medical Center said the results of the study are surprising since patients who undergo such small surgeries should be finished with their pain medications after 10 to 14 days.

"Changes in the way pain medications are prescribed such as linking the pain medication to a specific outcome would help," said Collins. "Patients would have to have better function, or significant improvement on a pain scale, in order to continue on the medication. Frequently patients just say 'I feel better' or 'it helps some' but do not have any other evidence that the medication is actually helping them function better."

One in five American adults received a painkiller prescription in 2006, totaling more than 230 million total prescription painkiller purchases.

And in 2010, the Centers for Disease Control and Prevention reported that the number of fatal opioid poisonings more than tripled from 4,000 in 1999, to 13,800 in 2006.

Lack of communication between surgeons and family physicians may contribute to excessive painkiller prescriptions, along with the potential addiction and abuse of them, Bell said. Communication barriers, such as hearing or cognition deficits in older patients, also may hinder patients' understanding of when it is appropriate to taper a pain medicine or take it only on an as needed basis, said Dr. Doris Cope, director of the Pain Medicine Program at University of Pittsburgh Medical Center.

The study emphasizes the importance of tailoring patient education on a case-by-case basis, as well as the need for careful coordination of medical care among a patient's surgeons, doctors and caregivers, said Cope. Hopefully, she added, "this can be better achieved in the offices of busy primary care physicians."

Copyright 2012 ABC News Radio


Cancer Patients Fume Over Counterfeit Avastin

J.B. Reed/Bloomberg News(OCEANSIDE, Calif.) -- Cancer patients are furious that a counterfeit version of the drug Avastin has landed in U.S. clinics.

Avastin, which is made by the Oceanside, Calif.-based company Genentech, is used in combination with chemotherapy to treat cancers of the colon, brain, kidneys and lungs. But the counterfeit lacks the tumor-starving ingredient some patients need to survive.

"It's an outrage," said Diane Barraza, 48, who takes Avastin for stage IV colon cancer. "For a company to sell this drug, put it in our blood, it's an outrage."

The U.S. Food and Drug Administration announced Tuesday that 19 clinics in California, Texas and Illinois may have purchased the phony Avastin from Quality Specialty Products, an "unapproved" foreign supplier also known as Montana Health Care Solutions. The counterfeit vials are labeled "Avastin" but indicate "Roche" as the manufacturer. Roche is the parent company of Genentech.

"The counterfeit contains no Avastin, no generic Avastin, no active ingredient whatsoever," Genentech spokesman Ed Lang told ABC News. Lang said the contents of the vials are still under investigation.

For patients like Barraza, a fake cancer drug would be the cruelest con.

"To sit in the chemo chair and watch that stuff drop into my veins," said an emotional Barraza, who lives in Fullerton, Calif., with her 6-year-old daughter. "It's all I've got. And it might just be water?"

Avastin is expensive, costing upwards of $650 for a small vial. But Montana Health Care Solutions sold the counterfeit vial for $480, according to one of the clinics -- a cost savings of 25 percent.

"Obviously it makes good business sense to try to get the drug at a reduced cost," said Dr. Jack Jacoub, a medical oncologist at Orange Coast Memorial Medical Center in Fountain Valley, Calif. "But when you start to get drug pricing that's markedly different from that of the standard distributor, it should raise a red flag."

Only four U.S. distributors are authorized to sell Avastin to doctor's offices; another four can sell the drug wholesale to hospitals. Montana Health Care Solutions is not an authorized Avastin distributor. Jacoub, who treats Barraza, said his clinic buys Avastin in bulk from an approved distributor for $593.20.

Montana Health Care Solutions claimed to be based in Belgrade, Mont. But the company's recently disconnected phone number has a New Brunswick, Canada, area code. It's unknown whether Montana Health Care Solutions knew the Avastin was counterfeit. They also sold other cancer drugs, including Neulasta and Faslodex, at a significantly discounted price.

The FDA was alerted to the possible counterfeit in December 2011 by the Medicines and Healthcare Products Regulatory Agency in the UK, according to Genentech's Lang. In a Feb. 10 letter, the agency urged the 19 clinics known to have purchased through unapproved distributors to "retain and secure" any unused drugs. The counterfeit Avastin vials have the lot numbers B86017, B6011, B6010, and the labels are slightly different.

Counterfeit or illegally imported drugs are rare in the U.S. but not unheard of. In 2008, heparin (a blood thinner) imported from China killed 81 Americans.

"Counterfeit drug makers have reached a level of sophistication where the real and fake products look almost identical," said Peter Pitts, president of the Center for Medicine in the Public Interest and former associate commissioner for the FDA. Pitts estimated that counterfeit drugs generated $75 billion in 2010, a figure expected to grow by 20 percent annually. "It's a low-risk, high-reward proposition. It's almost a perfect crime -- people aren't getting the drugs they need and they end up dying."

For Barraza, who will have four more Avastin treatments over the next two months, the thought of criminals profiting from her disease is sickening.

"I wish they could understand what it feels like to be a cancer patient, to take a drug and to suffer," she said. "I'd do anything to stay alive, but I need the right medication."

Copyright 2012 ABC News Radio


Critical Shortage of Children's Leukemia Drug

iStockphoto/Thinkstock(HOUSTON) -- Medication used to treat the most common form of childhood leukemia is in short supply, adding to the largest nationwide shortage of critical lifesaving hospital medications in nearly a decade.

All five pharmaceutical companies that make the injection drug methotrexate, which treats acute lymphoblastic leukemia by slowing the growth of cancer cells, have either slowed or stopped manufacturing of the drug, according to the U.S. Food and Drug Administration. The companies have cited high demand or manufacturing delays as reasons for the shortage.

If the shortage continues, physicians and pharmacists fear thousands of children will be left without lifesaving treatment.

"This, to us in oncology, is a national crisis," said Brooke Bernhardt, clinical pharmacy specialist in the department of hematology and oncology at Texas Children's Hospital in Houston.

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According to Dr. Michael Link, pediatric oncologist and president of the American Society of Clinical Oncology, some hospital pharmacies have reported having only a couple weeks of supply left.

Many oncologists are especially worried about the shortage of the preservative-free form of methotrexate, which is considered less toxic.

Only the preservative-free methotrexate can be injected into the spinal fluid of cancer patients to prevent the spread and recurrence of the disease.

Each year, nearly 3,000 children and adolescents under age 20 are diagnosed with acute lymphoblastic leukemia in the United States, according to the National Cancer Institute. Eighty percent of children are successfully treated.

The agency said it's uncertain when the next batch of methotrexate will be available.

Drugs for heart patients, some antibiotics, and intravenous drugs have been hard for hospitals to find, but cancer drugs have arguably taken the hardest hit.

To compensate, some physicians have had to split vials among patients or use comparable medications. In some cases, physicians may triage the medication, delaying treatment for some who may not need it immediately.

President Obama issued an executive order in October 2011 to reduce the dire shortage. The order instructed the Food and Drug Administration to broaden reporting of potential drug shortages, expedite regulatory reviews that can help prevent shortages, and examine whether potential shortages have led to price gouging.

The drug shortage has compromised or delayed care for some patients and may have led to otherwise preventable deaths.

While the FDA can oversee imports of drugs that are in short supply, it cannot regulate how much a company can make. In fact, manufacturers are not required to report shortages to the FDA.

The amount of a drug made available within a hospital is set by an agreement between the hospital and the manufacturer.

Limited manufacturing, lagging production time and lack of profits from these drugs contribute to the shortages. The production costs for some drugs can outweigh the money that companies can make from them, since many drugs now have cheaper generic alternatives. So manufacturers stop making the drugs.

Since these medications are mainly housed in hospitals, most patients won't know they can't have them until they really need them.

"Many physicians may be willing to mention the shortage to the family because they're just as frustrated," said Bernhardt.

However, Bernhardt said, that supply counts depend on location. Some hospitals may not be experiencing a shortage at all, she said.

"We don't want to stir up fear, but [families] should remain in contact with their physician," said Bernhardt.

Copyright 2012 ABC News Radio


New Review Questions Effectiveness of Tamiflu

Hannah Johnston/Getty Images(OXFORD, England) -- Could Tamiflu (Oseltamivir) be not as effective as originally reported? The efficacy and safety of the drug, known as the most widely used medication against the influenza virus, has been questioned in a report published Tuesday in the British Medical Journal.

Researchers at the Cochrane Collaboration found that evidence supporting the use of Tamiflu is flawed and say that Roche -- the company that manufactures Tamiflu -- is withholding important data from independent reviewers and government agencies.

According to a BMJ release, researchers at Cochrane attempted to test Roche's claims that Tamiflu could prevent complications from influenza and reduce the number of patients needing hospital treatment. Their trials were hindered, however, when Roche refused to release its own complete trial data for analysis.  Reports from European Medicines Agency (EMA) were available to investigators, but presented "inconsistencies," the BMJ release stated.

More than 70 governments have placed orders for Tamiflu, with at least 220 million treatment courses stockpiled since 2003, according to the CDC.  Roche has reportedly pocketed $3.4 billion from sales of the medication.

Amid the questions raised about the Tamiflu maker's willingness to make data public for review, Roche maintains they have given Cochrane all the information needed to conduct a substantial evaluation. But one Cochrane investigator says this is not the case.

"In the BMJ in December 2009, Roche promised full study reports to any legitimate investigators," said Dr. Peter Doshi of the Johns Hopkins School of Medicine. "They have not provided a single full study report to Cochrane, despite our repeated requests."

Copyright 2012 ABC News Radio


Neck Pain: Chiropractors, Exercise Better than Medication, Study Says

iStockphoto/Thinkstock(NEW YORK) -- When it comes to neck pain the best medicine is no medicine at all, according to a new study published in the Annals of Internal Medicine.

The study, funded by the National Institutes of Health, tracked 272 patients with recent-onset neck pain who were treated using three different methods:

  1. Medication
  2. Exercise
  3. A chiropractor

After 12 weeks the patients who used a chiropractor or exercised were more than twice as likely to be pain-free compared to those who relied on medicine.

The patients treated by a chiropractor experienced the highest rate of success, with 32 percent saying they were pain-free, compared to 30 percent of those who exercised. Only 13 percent of patients treated with medication said they no longer experienced pain.

“Doesn’t surprise me a bit,” Dr. Lee Green, professor of family medicine at the University of Michigan, told ABC News. “Neck pain is a mechanical problem, and it makes sense that mechanical treatment works better than a chemical one.”

Dr. John Messmer, who specializes in family medicine at Penn State College of Medicine, agrees.

“I always prescribe exercises and/or physical therapy for neck pain,” he wrote. “I also tell patients that the exercises are the treatment and the drugs are for the symptoms.”

The exercises prescribed to patients in the study were simple and designed to be performed at home with the help of instructional photos.

Click Here to See the Neck Exercises

Copyright 2012 ABC News Radio


ADHD Meds Safe for Adults, Research Finds

Comstock/Thinkstock(OAKLAND, Calif.) -- New research out of Kaiser Permanente Northern California finds that Ritalin and other drugs used to treat attention deficit disorder are safe for use in adults. Ohio State University psychiatry professor Dr. L. Eugene Arnold says there are more than a million adults on the drug in the U.S.

"Not everybody outgrows the problem as they mature, some do but some don't," says Arnold.

The study -- the largest of its kind -- reviewed health records for more than 400-thousand adults aged 25-65 and found that there was no difference in the number of heart attacks, strokes and other heart-related deaths from people not taking the drugs.

Dr. Arnold says taking one of the FDA-approved medications for ADHD "would not be unusually risky" if good reason exists.

But there are still safety concerns, Arnold adds.

"Things that could increase the risk would be older age, previous cardiac problems, high blood pressure, pre-existing medication," Arnold warns.

Whatever a patient chooses -- at any age -- Dr. Arnold advises against simply settling for the medication.

"A combination of treatment has been shown to be most effective whether it's with children or adults …" Dr. Arnold says.

Copyright 2011 ABC News Radio


Boy, 12, Tells Congress of Years on ‘Stupid’ Meds

John Foxx/Stockbyte/Thinkstock(WASHINGTON) -- A 12-year-old boy told Congress Thursday that he was medicated into a near-stupor with mind-altering drugs during the four years he bounced among foster care homes.

“I think putting me on all these stupid meds was the stupidest thing I’ve ever experienced in foster care and was the worst thing anyone could do to foster kids,” the boy, identified only as Ke’onte, told the Senate Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security.

The seventh-grader, who was adopted by a Texas family in 2009 and who ABC News has been following for a year, said he had tantrums as a foster child and was inaccurately diagnosed as bipolar and having ADHD.

“I’ve been in the mental hospital three times during foster care, and every time I had to get on more meds or new meds to add to the ones I was already taking,” he said. Ke’onte said his meds made him feel irritable, gave him stomachaches and affected his appetite.

“I remember having a bowl of spaghetti and had three bites and then I was done,” he said.

He said he would get so tired “it felt like I would collapse wherever I was in the house.”

Ke’onte’s testimony came as a Government Accountability Office report was released that found that the federal government had not done enough to oversee the treatment of foster children with powerful drugs.

The report, whose contents were revealed by ABC News on Wednesday, coincided with a nationwide ABC investigation on the overuse of the most potent mind-altering drugs on many of the country’s nearly 425,000 foster children.

Ke’onte, who was on up to four medications at a time during his years in six foster homes, said that therapy has helped him in a way that meds never did. “In therapy, you talk about the deepest thing and it hurts, but you can deal with it better the next time,” he said.

Now, he said, he is first chair in clarinet in his school band, participates in cross-country and has three small roles in the school play.

“I’m not only more focused in school … I’m not going to the office anymore for bad behavior and I’m happy.”

Copyright 2011 ABC News Radio


Pharmacy Errors: Swallowing the Wrong Pill

Comstock/Jupiterimages/Thinkstock(WASHINGTON) -- Have you ever left the doctor’s office not remembering exactly which medication your doctor prescribed and later, whether the pharmacist got it right?

Names like Darvan and Diovan can sound the same. But one is a pain reliever while another is used to treat high blood pressure. And when a pharmacy gives one of the medications to a patient who really needs the other, it could lead to some serious consequences.

Anecdotal evidence suggests that this problem is more common than believed, especially since there are various ways to fill prescriptions, including in-store and online. But there’s no formal method used to track pharmacy errors, according to Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality.

Besides medications that may sound or look alike, other factors can contribute to the wrong prescription getting filled.

Reading a doctor’s handwriting may be just as difficult for some pharmacists as it is for patients. And because some prescriptions are filled with the cheaper generic alternative of a prescribed brand name drug, it’s difficult for many patients to tell whether they’re receiving the correct substitute.

Most pharmacies don’t report prescription errors because they’re not required to. Neither the federal government nor most states in the U.S. have laws requiring that drugstores report prescription errors, even if the cases lead to serious complications or death.

“Pharmacies consider even one prescription error to be one too many,” said Chrissy Kopple, spokeswoman for the National Association of Chain Drug Stores. “Recognizing that human error is a possibility in any profession, pharmacies constantly pursue opportunities to improve safety.”

Scanning technology is used in some instances to verify that the medication that has been prescribed matches the medication that’s dispensed. Also, the use of electronic prescribing is on the rise, which can potentially reduce the risk of errors from prescribers’ handwriting and from incorrectly entering prescription information.

But until these technologies catch on, both pharmacists and patients should create their own checks and balances to make sure the right medication gets into the right hands, said Kopple.

The Agency for Healthcare Quality and Research offers a few tips that consumers can use to lower the chance of  pharmacy errors:

When your doctor writes a prescription for you, make sure you can read it.

When you pick up your medicine from the pharmacy, ask the  pharmacist if this is the medicine that your doctor prescribed.

Open the bag containing your medication container and make sure the medicine matches your prescription, and your name is on the container.

Make sure you understand how to properly take the medication -- ask your pharmacist about how much medication to take, when, and whether you should expect to experience any side effects.

Copyright 2011 ABC News Radio


Preserving Antibiotics: Best Practices to Ward Off Superbugs

John Foxx/Thinkstock(LOS ANGELES) -- Failure to develop new antibiotics to combat the rising numbers of superbugs is contributing to the rise in infections worldwide, according to a report published Thursday by a European researcher in the journal Lancet.

The paper comes at the heels of a surveillance report released Thursday by the European Center for Disease Prevention and Control that found that rates of one type of drug-resistant bacteria have reached 50 percent in some European countries.

Overuse of antibiotics is to blame for the spread of drug-resistant bacteria, the report said. But the problem is not limited to Europe, where programs and legislation has been developed in some countries to restrict inappropriate use of antibiotics. Every year, millions of Americans take antibiotics when they may not really need it.

“We’ve been shouting in the wind for years and Europe gets it,” said Dr. Brad Spellberg, associate professor of medicine at the Los Angeles Biomedical Institute at Harbor-UCLA Medical Center.   

Overuse and misuse of antibiotics can change germs, allowing them to develop resistance to antibiotics. But some bacteria have never responded to antibiotics to begin with.

"When we use a drug [sic] we kill off the bacteria that are susceptible and leave behind the bacteria that is resistant so they can grow and spread,” he said.

“Antibiotic use does not cause antibiotic resistance,” said Spellberg, adding that antibiotic use only speeds the spread of resistance.

And the so-called “impeding catastrophe” -- as described in the report released in the Lancet -- of no new antibiotics to ward off these bugs suggests that many people may go on to develop potentially untreatable infections.

Antibiotics are only effective for certain bacterial infections. But almost daily, antibiotics are unnecessarily prescribed for respiratory infections like the common cold, sore throat, ear infections, and bronchitis.  

$1.1 billion is spent annually on unnecessary adult upper respiratory infection antibiotic prescriptions, according to the U.S. Centers for Disease Control and Infection.

Besides calling for restricting inappropriate use of antibiotics, experts should also research alternative ways to treat bacterial infections such as immunotherapy, look for vaccines to prevent infections, and develop tests to help physicians diagnose infections that will benefit from antibiotics.

The CDC announced in November it will launch a nationwide tracking system that will let over 4,000 hospitals see the amount of antibiotics it uses, compare its use to other hospitals, and potentially help hospitals better manage when it dispenses antibiotics.

Copyright 2011 ABC News Radio


Getting Big Pharma to Treat Childhood Cancers

Stockbyte/Thinkstock(WASHINGTON) -- At age five, some kids have won pee-wee sports championships or perhaps a class spelling bee, but for Luke Fochtman of Okemos, Mich., his fifth birthday marked his victory over a much larger foe -- cancer.

"Through 72 weeks of treatment, chemotherapy, 105 fevers, he never said 'no' to us," says Luke's mom Monica Fochtman, 36.  "That to me was very inspiring and humbling.  To be in the presence of that kind of grace gave me the courage to keep going," she says.

Though Luke's type of pediatric sarcoma has a high recurrence rate, he is currently cancer-free.

In honor of her little hero, Fochtman shaved her head this week alongside 45 other mothers of children with cancer as part of a larger effort to raise awareness for pediatric cancer.  This "Shave for the Brave" event took place on Wednesday in the nation's capital as part of a series of events leading up to Friday's Second Annual Childhood Cancer Summit and meeting of the Congressional Pediatric Cancer Caucus.

One of the biggest issues on the docket this year is the dire need for better pediatric cancer treatments.  Because there are so many different types of pediatric cancers, the market for any particular drug would be small, making it highly unlikely that pharmaceutical companies will take up the cause.  As a result, the vast majority of drugs used on pediatric cancer patients today were created for adults 30 or even 50 years ago.

Luke's chemotherapy was developed 25 years ago, says Fochtman, and was so harsh that it caused repeated bacterial infections in her son as his immune system was completely knocked out by the chemo rounds.

"We are desperate for new treatments.  We have not had a single meaningful improvement in pediatric cancer medication in decades and the children have paid the price," says Dr. Peter Adamson, chief of the Division of Clinical Pharmacology & Therapeutics at The Children's Hospital of Philadelphia.  "Even though we cure four out of five pediatric cancer patients, even those who survive often go on to have lifelong side effects from the treatment we give them."

Adamson will be presenting to the Caucus Friday, arguing for changes in legislation to make developing pediatric cancer drugs more financially appealing to pharmaceutical companies.

Copyright 2011 ABC News Radio

ABC News Radio